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H van der Ploeg

Publications and source records attributed to H van der Ploeg.

6 recordsLinked to original sources

[End-of-life decisions in seriously ill patients: the position of intensive care nurses].

Intensive care units regularly have patients in whom a curative treatment plan is changed to palliative treatment. This does not only concern the medical and technical aspects, but also medical-ethical problems and questions relating to communication and organization. All these play a part in making a correct assessment. It is logical that nurses play an important part in this process as they have the most contact with the patient and his/her family. The optimalization of collaboration between doctors and nurses by means of the mutual exchange of information unique to each different discipline as well as acknowledging one another's talents and skills, forms the basis of good communication and organization concerning end-of-life decisions. It is useful to formalize this collaboration by means of multidisciplinary discussions.

Critical Care↗

Exploring differences between subgroups of multiple sclerosis patients in health-related quality of life.

Health-related quality of life (HRQoL) questionnaires finding increasing use in medicine, but still only few publications have reported on HRQoL in patients with multiple sclerosis (MS). Because of its progressive and disabling nature, the disease has a considerable effect on HRQoL. To facilitate the interpretation of scores for the heterogeneous MS population, we explored differences between subgroups of MS out-patients (n = 90) on two HRQoL instruments: the Medical Outcome Study Short Form-36 and the Disability and Impact Profile. Three disease-related characteristics were studied: severity of MS, time since diagnosis, and MS progression in the past 6 months. The results show that each of these have an effect on one or more aspects of HRQoL. Thus, the longer the disease duration and the more severe and progressive the MS, the lower is the patient's experienced HRQoL.

Adult↗

Using the Short Form-36 with multiple sclerosis patients in five countries: a cross-cultural comparison.

Questionnaires measuring health-related quality of life are increasingly used in international studies of medical effectiveness. It is important to know if data from these instruments are comparable across countries. We initiated a collaboration among five research groups--from the USA, The Netherlands, Belgium, France, and the UK--in the field of health-related quality of life in multiple sclerosis. All groups used the 36-item Short Form Health Survey. The goal of our study was to make a cross-cultural comparison. In the five countries under study the sample size varied from 50 to 134 patients with multiple sclerosis. The survey was completed by a total of 457 patients, who were heterogeneous in relation to age, duration of illness, severity and type of multiple sclerosis. There appeared to be major differences among the samples in scores on each of the eight scales. These findings may be influenced by differences in method of recruitment, demographic and disease-related characteristics, administration, and cultural factors. After having performed a number of analyses, it appeared that the differences were mainly attributable to sampling effects; however, cultural influences could not be excluded.

Adult↗

Psychological functioning in primary progressive versus secondary progressive multiple sclerosis.

Psychological functioning in two types of multiple sclerosis (MS) patients is assessed: primary progressive (PP) and secondary progressive (SP) patients. On the basis of differences in clinical course and underlying pathology we hypothesized that primary progressive patients and secondary progressive patients might have different psychological functioning. Seventy patients treated in an MS centre were examined cross-sectionally. Forty had an SP course of MS and 30 a PP course. The 33 male and 37 female patients had a mean age of 48.4 years (SD 11.2) and mean age of onset of MS of 30.7 years (SD 11.1). Patients completed questionnaires measuring among others the following aspects of psychological functioning: depression (BDI, SCL-90), anxiety (STAI, SCL-90), agoraphobia (SCL-90), somatic complaints (SCL-90), hostility (SCL-90) and attitude towards handicap (GHAS). Patients with a PP-MS scored significantly better on 5 out of 14 subscales than patients with SP-MS (p < .05). On the basis of our operationalizations of psychological functioning, the findings support the conclusion that on average 18 years after diagnosis of MS, amongst patients attending an MS unit, primary progressive patients were found to have better psychological functioning.

Adaptation, Psychological↗

Reliability of two measures of health-related quality of life in patients with multiple sclerosis.

Multiple sclerosis is a chronic neurological disease which can cause a variety of symptoms (motor and sensory impairment, visual problems, bladder and bowel problems, sexual dysfunction, and decline in cognitive function). Both the Medical Outcome Study Short Form-36, a generic questionnaire regarding health-related quality of life, and the Disability and Impact Profile, a similar questionnaire developed for people with chronic diseases, are used regularly to assess patients with multiple sclerosis. Over a 6-mo. interval 187 patients with multiple sclerosis completed these questionnaires twice. Internal consistency of both questionnaires at Times 1 and 2 was .60 or above for all eight scales of the Medical Outcome Study Short Form-36 and five scales of the Disability and Impact Profile. Estimates of test-retest reliability for three scales of the Medical Outcome Study Short Form-36 were below .60, but for all scales of the Disability and Impact Profile were .60 or higher. The two questionnaires appeared to be reliable for our sample of patients with multiple sclerosis.

Adult↗

Preconditions for sensitivity in measuring change: visual analogue scales compared to rating scales in a Likert format.

In a study of preconditions of responsiveness, we examined the variances obtained by two different ways of responding to questionnaire items. Subjects were 168 first-year medical students. They all completed a questionnaire of nine items. The original Likert-like scoring was (partially) replaced by visual analogue scoring in three quarters of the questionnaires. For three items the analogue form had a significantly greater variance than the discrete form, but no discrete item had a significantly greater variance than its analogue counterpart. Assuming that a greater variance was indicative for a greater responsiveness, our findings provide some support for the preferred use of analogue scales over discrete response categories in the measurement of changes over time.

Adult↗