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Jansen J, Brouwer S, Alma MA, Boot CRL. Experiences of workers with long-term disabilities on employer support throughout the RTW process in The Netherlands: a qualitative study. Disabil Rehabil 2024:1-8. [PMID: 38660937 DOI: 10.1080/09638288.2024.2343823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE The aim of this qualitative study was to explore ways that employer support influenced successful return to work (RTW) in workers with disabilities. METHODS We conducted a semi-structured interview study among 27 workers with disabilities in the Netherlands who received a partial disability benefit two years after sick leave and who continued working in paid (part-time) employment after a period of long-term sickness absence (> 2 years). We analyzed data by means of thematic analysis. RESULTS We identified four types of employer support that were experienced as factors of successful RTW: 1. Supervisor accessibility; 2. Supervisor engagement; 3. Supervisor strategies; and 4. Supervisor-initiated work accommodations. More specifically, during the preparations for RTW phase, the supervisor's active role involved having a positive and open attitude toward facilitating RTW; during the initial RTW phase, the supervisor's role involved being creative in finding solutions for work accommodations; and during the sustained RTW phase, the supervisor's role included helping workers who still needed changes in their work situations. CONCLUSION The elements of successful employer support reveals that the pressure on the shoulders of the supervisor is high. Future research should further investigate whether supervisors need more phase-specific training from their organization.
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Affiliation(s)
- Joke Jansen
- Department of Health Sciences, Community and Occupational Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cecile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Societal participation & Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Wedema D, Wardenaar KJ, Alma MA, van Asselt ADI, Korevaar EL, Schoevers RA. A blended module (STAIRS) to promote functional and personal recovery in patients with a major depressive disorder in remission: study protocol of a concurrent mixed methods randomized controlled trial. BMC Psychiatry 2023; 23:727. [PMID: 37805486 PMCID: PMC10560411 DOI: 10.1186/s12888-023-05213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Despite the availability of a wide variety of evidence-based treatments for major depressive disorder (MDD), many patients still experience impairments in their lives after remission. Programs are needed that effectively support patients in coping with these impairments. The program Storytelling and Training to Advance Individual Recovery Skills (STAIRS) was developed to address this need and combines the use of peer contact, expert-by-experience guidance, family support and professional blended care. The aim of the planned study is (1) to assess the efficacy of the STAIRS program in patients with remitted MDD, (2) to investigate patients' subjective experiences with STAIRS, and (3) to evaluate the program's cost-effectiveness. METHODS A concurrent mixed-methods randomized controlled trial design will be used. Patients aged between 18 and 65 years with remitted MDD (N = 140) will be randomized to either a group receiving care as usual (CAU) + the STAIRS-program or a control group receiving CAU + some basic psychoeducation. Quantitative efficacy data on functional and personal recovery and associated aspects will be collected using self-report questionnaires at the start of the intervention, immediately following the intervention, and at the six-month follow-up. Insights into patients' experiences on perceived effects and the way in which different program elements contribute to this effect, as well as the usability and acceptability of the program, will be gained by conducting qualitative interviews with patients from the experimental group, who are selected using maximum variation sampling. Finally, data on healthcare resource use, productivity loss and quality of life will be collected and analysed to assess the cost-effectiveness and cost-utility of the STAIRS-program. DISCUSSION Well-designed recovery-oriented programs for patients suffering from MDD are scarce. If efficacy and cost-effectiveness are demonstrated with this study and patients experience the STAIRS program as usable and acceptable, this program can be a valuable addition to CAU. The qualitative interviews may give insights into what works for whom, which can be used to promote implementation. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov on 1 July 2021, registration number NCT05440812.
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Affiliation(s)
- David Wedema
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - Klaas J Wardenaar
- Department of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Antoinette D I van Asselt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Eliza L Korevaar
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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Kroon SJC, Alma MA, Bak M, van der Krieke L, Bruggeman R. Values and practice of collaboration in a mental health care system in the Netherlands: a qualitative study. Int J Ment Health Syst 2023; 17:15. [PMID: 37291607 DOI: 10.1186/s13033-023-00584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/23/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND To offer optimal care, the mental health system needs new routes for collaboration, involving both interprofessional and interorganizational aspects. The transition from intramural to extramural mental health care has given rise to new dynamics between public and mental health care, introducing a challenge for interprofessional and interorganizational collaboration. This study aims to determine values and expectations of collaboration and to understand how collaboration in mental health care organizations takes shape in daily practice. METHODS We conducted a qualitative study using semi-structured interviews and a focus group, in the setting of the Program for Mentally Vulnerable Persons (PMV). Data were analysed following thematic analysis. RESULTS We found three aspect that were considered important in collaboration: commonality, relationships, and psychological ownership. However, our findings indicate a discrepancy between what is considered essential in collaboration and how this materializes in day-to-day practice: collaboration appears to be less manageable than anticipated by interviewees. Our data suggest psychological ownership should be added as value to the interorganizational collaboration theory. CONCLUSION Our study offers a new definition of collaboration and adding "psychological ownership" to the existing literature on collaboration theory. Furthermore, we gained insight into how collaboration between different organizations works in practice. Our research points to a discrepancy between what all the partners find important in collaboration, and what they actually do in practice. Finally, we expressed ways to improve the collaboration, such as choosing between a chain or a network approach and acting on it and re-highlighting the goal of the Program Mentally Vulnerable persons.
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Affiliation(s)
- Suzanne J C Kroon
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research , University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Meike Bak
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Alma MA, van der Mei SF, Brouwer S, Hilbrands LB, van der Boog PJM, Uiterwijk H, Waanders F, Hengst M, Gansevoort RT, Visser A. Sustained employment, work disability and work functioning in CKD patients: a cross-sectional survey study. J Nephrol 2023; 36:731-743. [PMID: 36315355 PMCID: PMC10090013 DOI: 10.1007/s40620-022-01476-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/01/2022] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Kidney failure negatively affects opportunities for work participation. Little is known about work functioning of employed CKD patients. This study investigates work-related outcomes, and examines associations between patient characteristics and employment status. METHODS We performed a cross-sectional survey study in nine nephrology outpatient clinics in the Netherlands among working age (18-67 years) CKD Stage G3b-G5, dialysis and transplant patients (n = 634; mean age 53.4 years (SD 10); 53% male; 47% Stage G3b-G5, 9% dialysis, 44% transplantation). We assessed employment status, work disability, work-related characteristics (i.e., work situation, working hours, job demands), work functioning (i.e., perceived ability to work, productivity loss, limitations in work), work environment (i.e., work accommodations, psychosocial work environment), as well as health status and fatigue. RESULTS Sixty-five percent were employed reporting moderate work ability. Of those, 21% received supplementary work disability benefits, 37% were severely fatigued, 7% expected to drop out of the workforce, and 49% experienced CKD-related work limitations. Work accommodations included reduced working hours, working at a slower pace, adjustment of work tasks or work schedule, and working from home. Multivariable analysis of sustained employment showed associations with younger age, male gender, higher level of education, better general and physical health and pre-emptive transplantation. Transplant patients had the highest work ability and highest expectation to maintain work. Dialysis patients had the highest productivity loss and perceived the most limitations regarding functioning in work. Stage G3b-G5 patients reported the lowest social support from colleagues and highest conflict in work and private life. CONCLUSIONS Employed CKD patients experience difficulties regarding functioning in work requiring adjustment of work or partial work disability. In addition to dialysis patients, stage G3b-G5 patients are vulnerable concerning sustained employment and work functioning.
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Affiliation(s)
- Manna A Alma
- Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Sijrike F van der Mei
- Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Femke Waanders
- Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands
| | - Maaike Hengst
- Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Ron T Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annemieke Visser
- Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Bouma SE, van Beek JFE, Alma MA, Diercks RL, van der Woude LHV, van den Akker-Scheek I, Stevens M. What affects the implementation of lifestyle interventions in patients with osteoarthritis? A multidisciplinary focus group study among healthcare professionals. Disabil Rehabil 2022; 44:8283-8293. [PMID: 34889696 DOI: 10.1080/09638288.2021.2011438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify factors affecting the implementation of lifestyle interventions (LIs) in patients with hip and/or knee osteoarthritis (OA) from the perspective of primary and secondary healthcare professionals (HCPs) in the Dutch healthcare system. METHODS Multidisciplinary focus groups were composed. Data analysis was performed following thematic analysis. The Tailored Implementation for Chronic Diseases checklist was used to guide data analysis. RESULTS Four focus groups meetings were conducted with 38 participating HCPs (general practitioners (or in-training), orthopedic surgeons (or in-training), physiotherapists, dieticians, a general practice assistant, lifestyle counselors, and nurse practitioners). Influencing factors were grouped into nine themes: (1) intervention factors; (2) individual HCP factors; (3) patient factors; (4) professional interactions; (5) incentives and resources; (6) capacity for organizational change; (7) social, political and legal factors; (8) patient and HCP interactions; and (9) disease factors. CONCLUSIONS A wide variety of factors affecting the implementation of LIs was identified in this study, where the importance of effective interdisciplinary collaboration was emphasized by the multidisciplinary group of participants. This thorough analysis of influencing factors is an important first step toward improved implementation of LIs within OA care. Further research is required to identify the most significant targets for change in daily practice.Implications for RehabilitationThe implementation of lifestyle interventions (LIs) by healthcare professionals (HCPs) in patients with hip and/or knee osteoarthritis (OA) is affected by both individual and environmental factors.The influencing factors identified in this study can support the development of interventions aimed at improving the implementation of LIs in OA care.A multilevel approach is required when developing interventions to improve the implementation of LIs in OA care.Continued efforts of both primary and secondary HCPs and policymakers are needed in order to promote the use of LIs within OA care.
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Affiliation(s)
- Sjoukje E Bouma
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Juliette F E van Beek
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ron L Diercks
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Inge van den Akker-Scheek
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Martin Stevens
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Alma MA, Nijenhuis-Huls R, de Jong Z, Ulgiati AM, de Vries A, Dekker AD. Detecting sleep apnea in adults with Down syndrome using WatchPAT: A feasibility study. Res Dev Disabil 2022; 129:104302. [PMID: 35853354 DOI: 10.1016/j.ridd.2022.104302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/02/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In daily practice, sleep apnea is underdiagnosed in people with Down syndrome. The WatchPAT can detect sleep apnea in a less invasive way. AIM This study aimed to evaluate the feasibility of the WatchPAT to detect sleep apnea in individuals with Down syndrome. METHODS AND PROCEDURES Thirty-one participants with Down syndrome (aged 18+) were included. Sleep apnea was detected with the WatchPAT and compared to results of the STOP-Bang Questionnaire (current practice). Experiences of participants, caregivers and clinicians were studied using a combination of quantitative and qualitative methods. OUTCOMES AND RESULTS Among the 68% of participants who accepted the WatchPAT, sleep apnea was detected in 95% of participants. Younger participants and participants with mild/moderate intellectual disabilities were more likely to accept the device. STOP-Bang did not detect most cases of sleep apnea. For the degree of sleep apnea, interrater reliability was substantial (k = 0.71) to almost perfect (k = 0.91). Considering experiences, caregivers and clinicians were predominantly positive about the WatchPAT. CONCLUSIONS Our study showed that the WatchPAT is a promising device to detect sleep apnea in people with Down syndrome. Compared to polysomnography, detection with this device is less invasive and less burdensome for people with Down syndrome. Furthermore, the WatchPAT is a relatively accessible solution to implement in care institutions.
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Affiliation(s)
- Manna A Alma
- Department of Practice-oriented Scientific Research (PWO), Alliade, Heerenveen, The Netherlands; Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rixt Nijenhuis-Huls
- Department of Practice-oriented Scientific Research (PWO), Alliade, Heerenveen, The Netherlands
| | - Zarah de Jong
- Department of Practice-oriented Scientific Research (PWO), Alliade, Heerenveen, The Netherlands
| | - Aurora M Ulgiati
- Department of Practice-oriented Scientific Research (PWO), Alliade, Heerenveen, The Netherlands
| | - Anja de Vries
- Department of Practice-oriented Scientific Research (PWO), Alliade, Heerenveen, The Netherlands
| | - Alain D Dekker
- Department of Practice-oriented Scientific Research (PWO), Alliade, Heerenveen, The Netherlands; Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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Visser A, Alma MA, Bakker SJL, Bemelman FJ, Berger SP, van der Boog PJM, Brouwer S, Hilbrands LB, Standaar DSM, Stewart RE, Gansevoort RT. Employment and ability to work after kidney transplantation in the Netherlands: The impact of preemptive versus non-preemptive kidney transplantation. Clin Transplant 2022; 36:e14757. [PMID: 35716362 PMCID: PMC9788192 DOI: 10.1111/ctr.14757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/14/2022] [Accepted: 06/11/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Work can have a major positive impact on health and wellbeing. Employment of kidney transplant recipients (KTR) of working age is much lower than in the general population. The first aim of this study was to examine the impact of a preemptive kidney transplantation (PKT) on employment, in addition to other possible influencing factors. The second aim was to explore differences in work ability, absenteeism and work performance among employed KTR with different types of transplantations. METHODS A cross-sectional survey study was conducted between 2018 and 2019 in nine Dutch hospitals. PKT as potential predictor of employment was examined. Furthermore, work ability, absenteeism and loss of work performance were compared between employed preemptive recipients with a living donor (L-PKT) and non-preemptive recipients with a living donor (L-nPKT) and with a deceased donor (D-nPKT). RESULTS Two hundred and twenty four KTR participated; 71% reported having paid work. Paid work was more common among PKT recipients (82% vs. 65% in L-nPKT and 55% in D-nPKT) and recipients who were younger (OR .950, 95%CI .913-.989), had no comorbidities (1 comorbidity: OR .397, 95%CI .167-.942; 2 comorbidities: OR .347, 95%CI .142-.844), had less fatigue (OR .974, 95%CI .962-.987) and had mentally demanding work tasks (only in comparison with physically demanding tasks, OR .342, 95%CI .145-.806). If recipients were employed, D-nPKT recipients worked fewer hours (mean 24.6±11.3 vs. PKT 31.1±9.6, L-nPKT 30.1±9.5) and D-nPKT and L-nPKT recipients received more often supplemental disability benefits (32 and 33.3%, respectively) compared to PKT recipients (9.9%). No differences were found for self-reported ability to work, sick leave (absenteeism) and loss of work performance with the exception of limitations in functioning at work. CONCLUSIONS Preemptive kidney transplantation recipients with a kidney from a living donor are employed more often, work more hours per week (only in comparison with D-nPKT) and have a partial disability benefit less often than nPKT recipients. More knowledge regarding treatments supporting sustainable participation in the labor force is needed as work has a positive impact on recipients' health and wellbeing and is also beneficial for society as a whole.
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Affiliation(s)
- Annemieke Visser
- Department of Applied Health ResearchHealth SciencesUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Manna A. Alma
- Department of Applied Health ResearchHealth SciencesUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Stephan J. L. Bakker
- Department of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Frederike J. Bemelman
- Department of NephrologyUniversity of Amsterdam's Faculty of MedicineAmsterdamThe Netherlands
| | - Stefan P. Berger
- Department of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | | | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational MedicineUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Luuk B. Hilbrands
- Department of NephrologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Dorien S. M. Standaar
- Department of NephrologyUniversity of Amsterdam's Faculty of MedicineAmsterdamThe Netherlands
| | - Roy E. Stewart
- Department of Health Sciences, Community and Occupational MedicineUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Ron T. Gansevoort
- Department of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Jansen J, Boot CRL, Alma MA, Brouwer S. Exploring Employer Perspectives on Their Supportive Role in Accommodating Workers with Disabilities to Promote Sustainable RTW: A Qualitative Study. J Occup Rehabil 2022; 32:1-12. [PMID: 35166974 DOI: 10.1007/s10926-021-10019-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE Employers play an important role in facilitating sustainable return to work (RTW) by workers with disabilities. The aim of this qualitative study was to explore how employers who were successful in retaining workers with disabilities at work fulfilled their supportive role, and which facilitators were essential to support these workers throughout the RTW process. METHODS We conducted a semi-structured interview study among 27 employers who had experience in retaining workers with disabilities within their organization. We explored the different phases of RTW, from the onset of sick leave until the period, after 2-years of sick-leave, and when they can apply for disability benefit. We analyzed data by means of thematic analysis. RESULTS We identified three types of employer support: (1) instrumental (offering work accommodations), (2) emotional (encouragement, empathy, understanding) and (3) informational (providing information, setting boundaries). We identified three facilitators of employer support (at organizational and supervisor levels): (1) good collaboration, including (in)formal contact and (in)formal networks; (2) employer characteristics, including supportive organizational culture and leadership skills; and (3) worker characteristics, including flexibility and self-control. CONCLUSIONS Employers described three different possible types of support for the worker with disabilities: instrumental, emotional, and informational. The type and intensity of employer support varies during the different phases, which is a finding that should be further investigated. Good collaboration and flexibility of both employer and worker were reported as facilitators of optimal supervisor/worker interaction during the RTW process, which may show that sick-listed workers and their supervisors have a joint responsibility for the RTW process. More insight is needed on how this supervisor/worker interaction develops during the RTW process.
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Affiliation(s)
- J Jansen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - C R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, VU University Amsterdam, Amsterdam Public Health Research institute, Amsterdam, the Netherlands
| | - M A Alma
- Department of Health Sciences, Applied Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Luning-Koster MN, Alma MA, van den Boogaard J, Verheij NP, van der Mei SF, Landsman JA, Reijneveld SAM. [Experience of first COVID-19 patients in Northern part of the Netherlands: Information provision, source investigation, contact tracing and home isolation]. Ned Tijdschr Geneeskd 2022; 166:D6469. [PMID: 35138745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of this study was to investigate how patients experience the information, the source investigation and contact tracing and the measures in isolation at the start of a pandemic. DESIGN Secondary analysis of semi-structured interviews was conducted as part of a larger exploratory mixed-methods study on COVID-19 patient experiences. METHODS Semi-structured interviews were conducted with 29 people from Friesland and Groningen who tested positive for SARS-CoV-2 between 9 March and 3 April 2020, recruited via maximum variation sampling. Thematic analysis was used. RESULTS The following themes emerged from the analysis: 1) Information: Conflicting information by different advisors led to a lack of clarity. Patients admitted to hospital usually felt uninformed about the rules of home isolation after discharge. 2) Investigation into the source of infection: For most it was unclear whether and how this investigation took place. Some expected feedback on their suggestions. 3) Informing contacts: Not everyone felt able to inform the right contacts. Some felt stigmatized. 4) Living with the measures in home isolation: The recommended living rules were often not fully applied. Some patients felt insufficiently supported. CONCLUSION Our study shows that not all COVID-19 patients felt well cared for at the start of the outbreak. Scaling down monitoring by the public health service can mean that questions about source and contact investigation and isolation remain unanswered or are answered by others. This leads to conflicting information and non-compliance with measures. The supervision of patients in isolation should be better guarded.
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Wedema D, Siero J, Korevaar EL, Wardenaar KJ, Alma MA, Schoevers RA. Storytelling and training to advance individual recovery skills (STAIRS). A feasibility study of a blended program to support personal recovery among patients with a major depressive disorder in remission. Front Psychiatry 2022; 13:984104. [PMID: 36213919 PMCID: PMC9539704 DOI: 10.3389/fpsyt.2022.984104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Because major depressive disorder (MDD) has a strong negative impact on patients' lives, well-designed treatment programs are needed that address the lasting effects of MDD. Previous work has shown that such programs should not only focus on symptomatic recovery, but also on the subsequent personal recovery process. Currently, few programs with this specific focus exist. Therefore, this study aimed to assess the feasibility of a newly developed blended program to support the personal recovery process of MDD patients: Storytelling and Training to Advance Individual Recovery Skills (STAIRS). STAIRS is a program using peer support and guidance by experts by experience and clinicians, which can be added to regular depression treatment when symptomatic recovery is almost reached. Topics addressed in this program are: (1) effects of depression and treatment; (2) structure; (3) (self) stigma; (4) self-image; (5) meaning of life; (6) connection to others; (7) physical health; (8) relaxation; and (9) preventing relapse. Experiences with the STAIRS program were collected from five participating patients with questionnaires and a focus-group interview, as well as from four trainers using semi-structured interviews. Participants valued the topics addressed in STAIRS, the used working methods, the presence of an expert by experience and the ability to share experiences with peers. The use of an online platform and the involvement of others is seen as potentially supportive but turned out to be more challenging. Perceived effects of STAIRS include positive changes in participants' daily lives and their contacts with others. Overall, the results indicate that when implemented accessibly, STAIRS is a promising and feasible program to foster personal recovery among patients recovering from MDD.
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Affiliation(s)
- David Wedema
- Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Joanieke Siero
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Eliza L Korevaar
- Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Klaas J Wardenaar
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Robert A Schoevers
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Folkersma W, Veerman V, Ornée DA, Oldehinkel AJ, Alma MA, Bastiaansen JA. Patients' experience of an ecological momentary intervention involving self-monitoring and personalized feedback for depression. Internet Interv 2021; 26:100436. [PMID: 34430220 PMCID: PMC8371226 DOI: 10.1016/j.invent.2021.100436] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
Experts in clinical mental health research count on personalized approaches based on self-monitoring and self-management to improve treatment efficacy in psychiatry. Among other things, researchers expect that Ecological Momentary Interventions (EMI) based on self-monitoring and personalized feedback will reduce depressive symptoms. Clinical trial findings have, however, been conflicting. A recent trial (ZELF-i) investigated whether depression treatment might be enhanced by an add-on EMI with self-monitoring items and feedback focused on positive affect and activities (Do-module) or on negative affect and thinking patterns (Think-module). There was no statistical evidence that this EMI impacted clinical or functional outcomes beyond the effects of regular care, regardless of module content. In apparent contrast, 86% of the participants who completed the intervention indicated they would recommend it to others. In the present study, we used in-depth interviews (n = 20) to better understand the EMI's personal and clinical benefits and downsides. A thematic analysis of the interviews generated six areas of impact with various subthemes. In line with the trial results, few participants reported behavioral changes or symptom improvement over time; the self-assessments mainly amplified momentary mood, in either direction. The most often mentioned benefits were an increase in self-awareness, insight, and self-management (e.g., a stronger sense of control over complaints). Consistently, these domains received the highest ratings in our evaluation questionnaire (n = 89). Furthermore, the EMI instilled a routine into the days of individuals without regular jobs or other activities. Participants reported few downsides. The experiences were rather similar between the two modules. This study suggests that EMI might contribute to health by helping individuals deal with their symptoms, rather than reducing them. Measures on self-awareness, insight, and self-management should be more emphatically involved in future EMI research.
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Affiliation(s)
| | - Vera Veerman
- Synaeda Psycho Medisch Centrum, Leeuwarden, the Netherlands
| | - Daan A. Ornée
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands
| | - Albertine J. Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Manna A. Alma
- Applied Health Sciences, Department of Health Sciences, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Jojanneke A. Bastiaansen
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands,Corresponding author at: Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.
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van der Mei SF, Alma MA, de Rijk AE, Brouwer S, Gansevoort RT, Franssen CFM, Bakker SJL, Hemmelder MH, Westerhuis R, van Buren M, Visser A. Barriers to and Facilitators of Sustained Employment: A Qualitative Study of Experiences in Dutch Patients With CKD. Am J Kidney Dis 2021; 78:780-792. [PMID: 34118302 DOI: 10.1053/j.ajkd.2021.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/02/2021] [Indexed: 02/06/2023]
Abstract
RATIONALE & OBJECTIVE Although patients with chronic kidney disease (CKD) are at risk for work disability and loss of employment, not all experience work disruption. We aimed to describe the barriers to and facilitators of sustained employment experienced by Dutch patients with CKD. STUDY DESIGN Qualitative study using semistructured interviews. SETTING & PARTICIPANTS 27 patients with CKD glomerular filtration rate categories 3b-5 (G3b-G5) from 4 nephrology outpatient clinics in The Netherlands. ANALYTICAL APPROACH Content analyses with constant comparison of interview data based on the International Classification of Functioning, Disability and Health framework. RESULTS Participants were 6 patients with CKD G3b-G4, 8 patients receiving maintenance dialysis, and 13 patients with functioning kidney transplants. We identified health-related barriers (symptoms, physical toll of dialysis/transplantation, limited work capacity) and facilitators (few physical symptoms, successful posttransplantation recovery, absence of comorbidities, good physical condition), personal barriers (psychological impact, limited work experience) and facilitators (positive disposition, job satisfaction, work attitude, person-job fit), and environmental barriers and facilitators. Environmental barriers were related to nephrology care (waiting time, use of a hemodialysis catheter) and work context (reorganization, temporary contract, working hours, physical demands); environmental facilitators were related to nephrology care (personalized dialysis, preemptive transplant), work context (large employer, social climate, job requiring mental rather than physical labor, flexible working hours, adjustment of work tasks, reduced hours, remote working, support at work, peritoneal dialysis exchange facility), and support at home. Occupational health services and social security could be barriers or facilitators. LIMITATIONS The study sample of Dutch patients may limit the transferability of these findings to other countries. CONCLUSIONS The wide range of barriers and facilitators in all International Classification of Functioning, Disability and Health components suggests great diversity among patients and their circumstances. These findings underline the importance of personalized nephrology and occupational health care as well as the importance of individually tailored workplace accommodations to promote sustained employment for patients with CKD.
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Affiliation(s)
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, Groningen
| | - Angelique E de Rijk
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, Groningen
| | | | | | | | - Marc H Hemmelder
- Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden
| | - Ralf Westerhuis
- University Medical Center Groningen, University of Groningen; Dialysis Center Groningen, Groningen
| | - Marjolijn van Buren
- Department of Internal Medicine, HagaHospital, The Hague; Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke Visser
- Department of Health Sciences, Applied Health Research, Groningen
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13
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Landsman JA, Verheij NP, Alma MA, van den Boogaard J, Luning-Koster M, Evenboer KE, van der Mei SF, Reijneveld SA. [COVID-19: recovering at home is not easy]. Ned Tijdschr Geneeskd 2020; 164:D5358. [PMID: 33332052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To gain insight into 1) the symptoms and the disease process of healthcare professionals (HCPs) who tested positive for COVID-19 and were not hospitalized because of mild symptoms, 2) the impact on their psychological well-being and 3) the experiences with (after) care and infection prevention measures. DESIGN Explorative mixed-methods study. METHOD The municipal public health services of Groningen and Fryslân invited all HCPs aged above 18 years who tested positive for COVID-19 between March 18th and April 3rd 2020 to fill out an online questionnaire (n = 109), on average one month after diagnosis. 18 HCPs participated in telephone interviews. RESULTS Almost all HCPs mentioned fatigue as a long-term symptom, less frequently mentioned were, among other things, feeling physically weak and having a cold. Nearly half of them did not have a fever, two-thirds experienced stress. HCPs with comorbidity had more symptoms. The interviews showed that stress in particular occurred in families with children and because of uncertainty about the duration of infectiousness, with lack of good (after)care. Respondents experienced many negative reactions of people in their environment that felt stigmatizing. The isolation at home was considered bearable. CONCLUSION A COVID-19 infection has a significant impact on physical and mental health, even in HCPs with mild symptoms. Persistent fatigue in particular hinders patients' functioning. The absence of fever in almost half of the respondents is remarkable, as well as the negative impact on psychological well-being. HCPs are also dissatisfied with after-care. Infection prevention measures were relatively well-adhered too.
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Affiliation(s)
- J A Landsman
- UMCG, afd. Gezondheidswetenschappen, Groningen
- Contact: J. A. Landsman
| | - N P Verheij
- UMCG, afd. Gezondheidswetenschappen, Groningen
| | - M A Alma
- UMCG, afd. Gezondheidswetenschappen, Groningen
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Abstract
BACKGROUND Although symptomatic remission is considered the optimal outcome in depression, this is not always achieved. Furthermore, symptom indicators do not fully capture patients' and clinicians' perspectives on remission. Broader indicators of (partial) remission from depression should be considered. AIMS To investigate relevant outcomes of depression treatment in specialist care from patients' and clinicians' perspectives and to investigate whether these perspectives differ from each other. METHOD Three focus groups with 11 patients with depression and seven semi-structured interviews with clinicians were conducted exploring their perspectives on remission. All interviews were audio-recorded and transcribed verbatim. We analysed the transcripts thematically using the phenomenologist approach. RESULTS Independently, both patients and clinicians perceived the following outcomes relevant: restoring social functioning and interpersonal relations, regaining quality of life and achieving personal goals. All clinicians emphasised symptom reduction and satisfaction with treatment as relevant outcomes, whereas the former was not an obvious theme in patients. Unlike clinicians, patients made a clear distinction between treatment outcomes in first versus recurrent/chronic depression. CONCLUSIONS Classically defined study outcomes based on symptom resolution only partly reflect issues considered important by patients and clinicians in specialist depression treatment. Incorporating patients' and clinicians' perspectives in the development of measurable end-points makes them more suitable for use in trials and subsequent translation to clinical practice. Furthermore, evaluating patients' perspectives on treatment outcomes helps in the development of tailored interventions according to patients' needs.
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Affiliation(s)
- Kaying Kan
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands
| | - Frederike Jörg
- GGZ Friesland, Research Department, Leeuwarden; and University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands
| | - Erik Buskens
- University Medical Center Groningen, Department of Epidemiology, Groningen; and University of Groningen, Faculty of Economics and Business, the Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands
| | - Manna A Alma
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Applied Health Research, Groningen, the Netherlands
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Deden AC, Alma MA, Van Zelst-Stam WAG. [Understanding the diagnostic delay in rare diseases]. Ned Tijdschr Geneeskd 2020; 164:D4157. [PMID: 32395952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
According to the European definition, rare diseases are life-threatening or chronically debilitating conditions that affect only 5 out of 10,000 people in the European Union. It is estimated that there are around 6000-8000 different rare diseases, affecting 6-8% of the population in the course of their lives. For the Netherlands, this means that about 1 million people are affected by a rare disease, or one in 17 people. Patients with rare diseases indicate that they often have a long and uncertain diagnostic journey behind them, while the first symptoms present in childhood in 75% of the rare diseases. In this perspective, we discuss some of the results from the research report 'Scherperzicht op diagnostischevertragingbijzeldzameaandoeningen' in which the diagnostic journey for patients with rare diseases is mapped out with figures. We also make recommendations to speed up the diagnostic process for patients with rare diseases.
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Affiliation(s)
- A C Deden
- Radboudumc, afd. Genetica, Nijmegen en UMCG, afd. Genetica, Groningen
| | - M A Alma
- UMCG/RUG, afd. Toegepast Gezondheidsonderzoek, Groningen
- Contact: M.A. Alma
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Alma MA, Groothoff JW, Melis-Dankers BJM, Suurmeijer TPBM, Van der Mei SF. The Effectiveness of a Multi-Disciplinary Group Rehabilitation Program on the Psychosocial Functioning of Elderly People who are Visually Impaired. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x1310700101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The pilot study reported here determined the effectiveness of a multidisciplinary group rehabilitation program, Visually Impaired Elderly Persons Participating (VIPP), on psychosocial functioning. Methods The single-group pretest–posttest pilot study included 29 persons with visual impairments (aged 55 and older) who were referred to a low-vision rehabilitation center. The VIPP intervention (20 weekly meetings) consisted of four components (practical training; education, social interaction, counseling, and training in problem-solving skills; individual and group goal setting; and a home-based exercise program). Psychosocial adaptation to vision loss, helplessness, self-efficacy, mental health, and fear of falling were used as indicators of psychosocial functioning and were assessed at the baseline, halfway, immediately after completion of the intervention, and at the six-month follow-up. Results Directly after the intervention, the participants’ adaptation to vision loss (ES = 0.57), self-efficacy (ES = 0.50), and mental health (ES = 0.39) improved compared to the baseline. Moreover, helplessness and a generic and vision-specific fear of falling decreased (ES = 0.26, ES = 0.20, and ES = 0.24, respectively). The six-month follow-up measure indicated improved adaptation to vision loss (ES = 0.54), a lesser feeling of helplessness (ES = 0.53), better mental health (ES = 0.22), and a lesser vision-specific fear of falling (ES = 0.27). In contrast, a decrease in self-efficacy (ES = 0.14) and an increase in the generic fear of falling (ES = 0.18) were found. Discussion The tentative conclusion of this small-scale pilot study is that the VIPP program benefits psychosocial functioning in both the short and long term. Implications for practitioners The study showed that low-vision rehabilitation centers could implement multidisciplinary group rehabilitation programs, such as VIPP, to improve the psychosocial functioning of elderly people who are visually impaired.
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Affiliation(s)
- Manna A. Alma
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Johan W. Groothoff
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, the Netherlands
| | - Bart J. M. Melis-Dankers
- Clinical physicist, Center of Expertise for Blind and Partially Sighted People, Royal Dutch Visio, Rijksstraatweg61, 9752 AC Haren, the Netherlands
| | - Theo P. B. M. Suurmeijer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, the Netherlands
| | - Sijrike F. Van der Mei
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, the Netherlands
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Alma MA, Van der Mei SF, Feitsma WN, Groothoff JW, Van Tilburg TG, Suurmeijer TPBM. [Loneliness and self-management abilities in the visually impaired elderly]. Tijdschr Gerontol Geriatr 2013; 44:132-142. [PMID: 23695945 DOI: 10.1007/s12439-013-0027-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. METHODS In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. RESULTS The prevalence of loneliness among the visually impaired elderly was higher compared to the reference group (50% vs 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. DISCUSSION The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, since SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness. An adapted version of this paper was published in Journal of Aging and Health, doi: 10.1177/0898264311399758.
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Affiliation(s)
- M A Alma
- Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen, Disciplinegroep Gezondheidswetenschappen, Sector F, Gezondheidswetenschappen, The Netherlands.
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Alma MA, Groothoff JW, Melis-Dankers BJM, Post MWM, Suurmeijer TPBM, van der Mei SF. Effects of a multidisciplinary group rehabilitation programme on participation of the visually impaired elderly: a pilot study. Disabil Rehabil 2012; 34:1677-85. [DOI: 10.3109/09638288.2012.656795] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
PURPOSE To assess determinants of social participation among visually impaired older adults. METHODS This cross-sectional study included visually impaired persons (≥55 years; n = 173) who were referred to a low-vision rehabilitation center. Determinants (i.e., sociodemographic, physical, social and psychological factors, and personal values) of participation were identified in four domains of participation: (1) domestic life; (2) interpersonal interactions and relationships; (3) major life areas; and (4) community, social, and civic life. Study participants completed telephone interviews. RESULTS Age, physical fitness, and helplessness were determinants of participation in domestic life. Social network size was associated with participation in major life areas. The personal value attached to participation (i.e., perceived importance) was a determinant of participation in interpersonal interactions and relationships, major life areas, and community, social and civic life. Vision-related characteristics (i.e., self-perceived vision and degree of visual impairment) were not associated with participation. CONCLUSIONS Across the participation domains, perceived importance is a major determinant of social participation among visually impaired older adults. Physical health along with social and psychological status, also affect participation. Knowing how participation is determined can be used to develop rehabilitation interventions to enhance participation of visually impaired older adults.
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Affiliation(s)
- Manna A Alma
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
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Alma MA, Van der Mei SF, Feitsma WN, Groothoff JW, Van Tilburg TG, Suurmeijer TPBM. Loneliness and self-management abilities in the visually impaired elderly. J Aging Health 2011; 23:843-61. [PMID: 21398572 DOI: 10.1177/0898264311399758] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. METHOD In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. RESULTS The prevalence of loneliness among the visually impaired elderly was higher compared with the reference group (50% vs. 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. DISCUSSION The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, as SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness.
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Affiliation(s)
- Manna A Alma
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, Netherlands.
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Abstract
PURPOSE To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. METHOD This cross-sectional study included visually impaired elderly persons (≥55 years; n = 173) who were referred to a low-vision rehabilitation centre. Based on the International Classification of Functioning, Disability and Health (ICF) participation in: (1) domestic life, (2) interpersonal interactions and relationships, (3) major life areas, and (4) community, social and civic life was assessed by means of telephone interviews. In addition, we assessed perceived participation restrictions. RESULTS Comparison with reference data of the elderly showed that visually impaired elderly persons participated less in heavy household activities, recreational activities and sports activities. No differences were found for the interpersonal interactions and relationships domain. Participants experienced restrictions in household activities (84%), socializing (53%), paid or voluntary work (92%), and leisure activities (88%). CONCLUSIONS Visually impaired elderly persons participate in society, but they participate less than their peers. They experience restrictions as a result of vision loss. These findings are relevant, since participation is an indicator for successful aging and has a positive influence on health and subjective well-being.
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Affiliation(s)
- Manna A Alma
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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