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Biomedical subjects

J J Rasker

Publications and source records attributed to J J Rasker.

At least 19 recordsLinked to original sources
PubMed2006

Validation of a Dutch translation of the fibromyalgia impact questionnaire.

OBJECTIVES: To validate a Dutch translation of the fibromyalgia impact questionnaire (FIQ). MATERIALS AND METHODS: Data were taken from two randomized clinical trials on Spa treatment and venlafaxine in fibromyalgia (FM). Participants completed the Dutch FIQ and a set of validated questionnaires for general health (RAND-36), depression (Beck depression inventory, BDI), pain (McGill pain questionnaire, MPQ) and fatigue (checklist individual strength, CIS). Internal consistency within the FIQ item 'physical functioning' was studied using Cronbach's alpha. Test-retest reliability was studied with intra-class-correlation (ICC) in a subsample of 76 control subjects over a 3 month period without specific intervention. Construct validity was evaluated by correlating the FIQ to other questionnaires. Sensitivity to change was studied using standardized response means (SRM). RESULTS: The study sample consisted of 213 women and 11 men (mean age 47 yrs, mean disease duration 11 yrs). Cronbach's alpha for the item 'physical functioning' was 0.91, indicating high internal consistency. Test-retest reliability was acceptable, with ICC ranging from 0.45 for 'morning tiredness' to 0.71 for 'physical function'. FIQ correlated significantly with the RAND-36, with Spearman's rho ranging from -0.60 to -0.70 for items measuring the same concept. Similar patterns of correlation were seen with MPQ, BDI and CIS. Sensitivity to change was sufficient, with SRM after Spa treatment ranging from 0.3 for 'work days missed' to 0.9 for 'days felt good'. Similar SRM were found in the venlafaxine trial for patients reporting general improvement. CONCLUSION: The Dutch FIQ is a valid instrument for measuring health status in FM, showing sufficient reliability, construct validity and responsiveness.

Activities of Daily Living↗
PubMed2005

Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life.

OBJECTIVES: To study the effect of a combination of thalassotherapy, exercise and patient education in people with fibromyalgia. METHODS: Patients with fibromyalgia, selected from a rheumatology out-patient department and from members of the Dutch fibromyalgia patient association, were pre-randomized to receive either 2(1/2) weeks of treatment in a Tunisian spa resort, including thalassotherapy, supervised exercise and group education (active treatment) or treatment as usual (control treatment). Primary outcome measure was health-related quality of life, measured with the RAND-36 questionnaire. Secondary measures included the Fibromyalgia Impact Questionnaire, the McGill Pain Questionnaire, the Beck Depression Inventory, tender point score and a 6-min treadmill walk test. RESULTS: Fifty-eight participants receiving the active treatment reported significant improvement on RAND-36 physical and mental component summary scales. For physical health, differences from the 76 controls were statistically significant after 3 months, but not after 6 and 12 months. A similar pattern of temporary improvement was seen in the self-reported secondary measures. Tender point scores and treadmill walk tests improved more after active treatment, but did not reach significant between-group differences, except for walk tests after 12 months. CONCLUSIONS: A combination of thalassotherapy, exercise and patient education may temporarily improve fibromyalgia symptoms and health-related quality of life.

Adult↗
PubMed2004

A system of networks and continuing education for physical therapists in rheumatology: a feasibility study.

PURPOSE: To evaluate the feasibility of regional physical therapy networks including continuing education in rheumatology. The aim of these networks was to improve care provided by primary care physical therapists by improving specific knowledge, technical and communicative skills and the collaboration with rheumatologists. METHODS: In two regions in The Netherlands continuing education (CE) programmes, consisting of a 5-day postgraduate training course followed by bimonthly workshops and teaching practices, were organised simultaneously. Network activities included consultations, newsletters and the development of a communication guideline. Endpoint measures included the participation rate, compliance, quality of the CE programme, teaching practices, knowledge, network activities, communication, number of patients treated and patient satisfaction. RESULTS: Sixty-three physical therapists out of 193 practices (33%) participated in the project. They all completed the education programmes and were formally registered. All evaluations of the education programmes showed positive scores. Knowledge scores increased significantly directly after the training course and at 18 months. A draft guideline on communication between physical therapists and rheumatologists was developed, and 4 newsletters were distributed. A substantial proportion of physical therapists and rheumatologists reported improved communication at 18 months. The mean number of patients treated by physical therapists participating in the networks increased significantly. Patients' satisfaction scores within the networks were significantly higher than those from outside the networks at 18 months. CONCLUSIONS: Setting up a system of networks for continuing education for physical therapists regarding the treatment of patients with rheumatic diseases is feasible. Further research will focus on the effectiveness of the system and its implementation on a larger scale.

Journal Article↗
PubMed2004

Sensitivity to change of AIMS2 and AIMS2-SF components in comparison to M-HAQ and VAS-pain.

OBJECTIVE: To examine sensitivity to change of Dutch versions of AIMS2 (arthritis impact measurement scales-2) and AIMS2-SF (short form) components, in comparison with M-HAQ (modified health assessment questionnaire) and the 100 mm visual analogue scale for pain (VAS-pain) in patients with rheumatoid arthritis. METHODS: 218 patients participated in a study on patient education. Participants completed the Dutch AIMS2, M-HAQ, and VAS-pain at baseline and after one year; 165 completed both assessments. The education programme did not have any effect on health status. Patients were classified according to change over one year in their responses to the AIMS2 question about general health perception: improved health (n = 32), no change (n = 101), and poorer health (n = 32). Changes in scores over one year were tested with paired t tests, and standardised response means were calculated for AIMS2 and AIMS2-SF components, M-HAQ total score, and VAS-pain in the three classifications of change in health perception. RESULTS: AIMS2 and AIMS2-SF physical, symptom, and affect components showed similar sensitivity to change. The physical and symptom components performed better than M-HAQ and VAS-pain. AIMS2 and AIMS2-SF social interaction and role components were not sensitive to changes in general health perception. The role component was only applicable in 63 patients, because the others were unemployed, disabled, or retired. CONCLUSIONS: AIMS2-SF is a good alternative to the AIMS2 long form for the assessment of health status in rheumatoid arthritis, and is preferable to M-HAQ and VAS-pain. Use of the AIMS2-SF makes it easier and less costly to collect data and reduces the burden on patients.

Adult↗
PubMed2003

Fibromyalgia and the therapeutic domain. A philosophical study on the origins of fibromyalgia in a specific social setting.

OBJECTIVES: Fibromyalgia has always attracted controversy. Wolfe states that fibromyalgia will always exist regardless of the name given to the syndrome. Hadler describes fibromyalgia as a form of illness behaviour escalated by labelling. However, we believe that fibromyalgia, as other functional somatic syndromes, is not waiting below the surface until it becomes manifest by labelling. METHODS: We developed our hypothesis on the relationship between a specific social setting (called the therapeutic domain) and fibromyalgia using empirical philosophical arguments based on Foucault and Hacking. A therapeutic domain is a real and heterogeneous medical domain in which people, their thoughts and practices, and medical technology in any form coexist and communicate. In this domain blood is aspirated, radiographs are taken and classification criteria are made and applied. It is a domain where patient and therapist have initiated a relationship, which is influenced by the media and political pressure. This results in a looping effect where classification criteria and images give structure to perceptions and form the description for human behaviour; the person thus diagnosed (!) constantly has to grow into the conformity of these classification criteria, which also have to be constantly revised. The fibromyalgia concept becomes manifest in an individual as non-specific aches and pains along with other features. RESULTS: In other times and settings this resulted in analogue syndromes like railway spine, telegraph wrists, neurocirculatory asthenia or perhaps repetitive strain injury. In the application of American College of Rheumatology fibromyalgia classification criteria, labels and medical technology it is possible that invisible experiences manifest themselves in a therapeutic domain. It is not only a phenotype induced by the physician, but in this domain a certain power creates reality making the 'disease' become manifest. CONCLUSION: The only certainty in fibromyalgia is that it is still being diagnosed. For prevention and treatment of fibromyalgia, doctors as well as politicians and media have to start by fundamentally changing the therapeutic domain. In such a renewed setting, fibromyalgia cannot become manifest in an individual and thus fibromyalgia syndrome can no longer exist. A firm public message that symptoms can be psychological in origin to prevent their spread, as Wessely recently stated in the comparable case of mass psychogenic illness, is only a part of the answer.

Fibromyalgia↗
PubMed2003

Psychometric properties of a Dutch short form of the Arthritis Impact Measurement Scales 2 (Dutch-AIMS2-SF).

OBJECTIVE: To evaluate the reliability and validity of a Dutch version of the Arthritis Impact Measurement Scales 2 short form (AIMS2-SF) and examine the agreement between the AIMS2 and AIMS2-SF in rheumatoid arthritis (RA) patients. METHODS: Data were collected from 587 RA patients from three studies. Patients completed the Dutch-AIMS2, Modified Health Assessment Questionnaire (M-HAQ), and Visual Analogue Scale for pain (VAS-pain), and clinical data were collected to calculate the Disease Activity Score 28 (DAS28). Short-form component scores were calculated from the AIMS2 long-form data. In addition, a Modified Symptom component score was calculated by replacing item 42 with item 38 as was suggested by Haavardsholm et al. [7] for the Norwegian version. RESULTS: The internal consistency of the Physical, Symptom and Affect components was good (Cronbach's alpha= 0.75-0.87), moderate for the Role component (alpha=0.62) but rather low for the Social Interaction (0.51) component. Replacing item 33 with item 31 of the long-form AIMS2 increased internal consistency for the Social Interaction component to 0.63. Test-retest reliability of the AIMS2-SF components was high (intraclass correlation coefficients >0.70). Mean scores of the AIMS2-SF were generally close to those from the AIMS2, but the limits of agreement were rather wide. Both the Modified Symptom and Modified Social Interaction components showed better agreement than the original short-form components. Plots of differences between AIMS2 and AIMS2-SF against the mean of the two scores for the five components showed that the differences varied over the range of the measurements. Factor analysis confirmed the three-factor structure, with a physical, psychological and social dimension that has been found for the Dutch-AIMS2 long form. Correlations of the AIMS2-SF components with M-HAQ total score, functional class, VAS-pain and DAS28 were very similar to the correlations for the original AIMS2. CONCLUSION: The Dutch-AIMS2-SF, with Modified Symptom and Social Interaction components has good psychometric properties, similar to those of the Dutch-AIMS2 long form.

Adult↗
PubMed2002

Patient education for adults with rheumatoid arthritis.

BACKGROUND: Because of the unpredictability people with arthritis face on a daily basis, patient education programmes have become an effective complement to traditional medical treatment giving people with arthritis the strategies and the tools necessary to make daily decisions to cope with the disease. OBJECTIVES: To assess the effectiveness of patient education interventions on health status in patients with rheumatoid arthritis. SEARCH STRATEGY: We searched MEDLINE, EMBASE and PsycINFO and the Cochrane Controlled Trials Register. A selection of review articles (see references) were examined to identify further relevant publications. There was no language restriction. SELECTION CRITERIA: Randomised controlled trials (RCT's) evaluating patient education interventions that included an instructional component and a non-intervention control group; pre- and post-test results available separately for RA, either in the publication or from the studies' authors; and study results presented in full, end-of-study report. MAIN RESULTS: Twenty-four studies with relevant data were included. We found significant effects of patient education at first follow-up for scores on disability, joint counts, patient global assessment and psychological status. Physician global assessment was not assessed in any of the included studies. The two separate dimensions of psychological status: anxiety and depression showed no significant effects, nor did the dimensions of pain and disease activity. At final follow up no significant effects of patient education were found. REVIEWER'S CONCLUSIONS: Patient education as provided in the studies reviewed here had moderate short-term effects on patient global assessment, and small short-term effects on disability, joint counts and psychological status. There were no long-term benefits.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2001

Rheumatology outpatient nurse clinics: a valuable addition?

OBJECTIVES: "Transmural rheumatology nurse clinics," where nursing care is provided under the joint responsibility of a home care organization and a hospital, were recently introduced into Dutch health care. This article gives insight into outcomes of the transmural rheumatology nurse clinics. METHODS: Patients with rheumatologic conditions who attended a transmural nurse clinic, in addition to receiving regular care, were compared with patients with rheumatologic conditions who received regular care only. The main outcome measures were the need for rheumatology-related information, the use of aids and adaptations, the use of health care services, and daily functioning. RESULTS: Attending a transmural nurse clinic does not influence patients' need for information, the application of practical aids and adaptations, or daily functioning. However, attending a transmural nurse clinic does result in more contacts with rheumatologists and occupational therapists. CONCLUSIONS: Attending transmural nurse clinics does not result in major differences in outcomes compared with regular care. Further studies are needed to appreciate the long-term effects of transmural nurse clinics.

Humans↗
PubMed2000

Perceptions about perceived functional disabilities and pain of people with rheumatoid arthritis: differences between patients and their spouses and correlates with well-being.

OBJECTIVE: In this study we examined the differences in perceptions of the patient's health status between rheumatoid arthritis (RA) patients and their spouses, and correlates of these differences with patients' and spouses' well-being. METHODS: A sample of 188 couples with one member receiving treatment for RA were selected from the rheumatology clinics in Twente, The Netherlands. The mean age of both RA patients and spouses was 56 years. Respondents completed questionnaires, including estimations of both patients and spouses on the patient's functional disabilities and pain, and scales on affect and marital commitment for patients and spouses. RESULTS: Differences in estimations of patients and spouses were considerable. Both over- and underestimations of the patient's functional disabilities by the spouse were associated with the patient's poorer mental health status. Overestimations of the patient's functional disabilities were associated with poorer mental health among spouses. CONCLUSION: It is essential that any support intended by the spouse is in accordance with the patient's needs. If the patient's condition is misperceived by the spouse, this can lead to ineffective and inappropriate support being given.

Activities of Daily Living↗
PubMed2000

Educational issues in rheumatology.

Musculoskeletal conditions are the most common cause of severe long-term pain and physical disability, affecting hundreds of millions of people around the world. Nearly a quarter of all consultations in primary care are concerned with rheumatic disease, yet undergraduate education in rheumatology is under-developed all over the world and does not get the attention it deserves. This has important consequences for the early diagnosis of rheumatic disease and the proper care of rheumatic patients in general, as well as for the esteem of rheumatology as a profession. Because the high prevalence and impact of rheumatic disease are not reflected in medical curricula, the International League of Associations for Rheumatology developed the Undergraduate Medical Education in Rheumatology 2000 Project. The project embodies three fundamental concepts: (1) to convince medical faculties and schools educating health professionals world wide that skills in examination, a knowledge of the management of musculoskeletal disease and a positive attitude to disability are the basis of good medical practice; (2) that rheumatology is valuable for acquiring skills in problem-solving, clinical reasoning and understanding basic genetic, immunological and biochemical mechanisms, as illustrated by rheumatic disease; and (3) to orient these programmes to the needs of individual patients in the context of the population at large, knowing that 20% of all primary care consultations involve musculoskeletal disease. The movement of doctors throughout the world, especially within Europe, is leading to initiatives to harmonize standards of specialist training. The importance of ensuring the highest standard of clinical care, achieving the greatest gain in health alongside a rapid advance in knowledge and clinical practice, is increasing the priority for continuing medical education and methods to ensure that doctors remain competent at all stages of their career.

Education, Medical↗
PubMed2000

The general public's knowledge and perceptions about rheumatic diseases.

OBJECTIVE: In the Netherlands, the mass media pay little attention to rheumatic diseases. For this reason, it might be assumed that in general people know very little about rheumatic diseases and thus have an unrealistic image of them. The purpose of this study was to gain insight into the general public's knowledge and perceptions regarding rheumatic diseases in the Netherlands. METHODS: A questionnaire was sent by mail to a random sample of 1800 Dutch homes; the response was 658. Questions mainly focused on knowledge, attitudes, behavioural intentions and use of the mass media with regard to rheumatic diseases. RESULTS: The respondents gave the right answer to a mean of 8.2 statements out of 17 true/false statements regarding factual knowledge of rheumatic diseases. Respondents particularly underestimated the prevalence of rheumatic diseases and were unaware of several rheumatic disorders. Most respondents had rarely used the mass media to gain information about rheumatic diseases, but they did show a moderate interest in acquiring information. Knowledge correlated positively with the respondents' level of education, acquaintance with rheumatic patients, and use of the mass media. Knowledge correlated negatively with the idea that rheumatic patients are themselves able to influence the course of their disease. In general, respondents judged rheumatic diseases to be rather serious but did not feel very frightened or vulnerable of becoming a rheumatic patient. Fear of rheumatic diseases correlated positively with interest in information about rheumatic diseases, intentions of visiting a doctor if experiencing rheumatic complaints and helping rheumatic patients in daily life. CONCLUSIONS: This study found that the public in general do not know very much about rheumatic diseases, but they do have a moderate desire for more information about them. Furthermore, they do not feel frightened of being confronted with a rheumatic disorder. More information about rheumatic diseases in the media might lead to better knowledge and perception of rheumatic diseases among the general public.

Adult↗
PubMed1999

Media coverage of chronic diseases in the Netherlands.

OBJECTIVE: Little is known about the quantity or quality of information on rheumatic diseases provided by the mass media. The aim of this study was to gain insight into the media coverage of rheumatic diseases compared with other chronic diseases in the Netherlands. MATERIALS AND METHODS: Newspaper articles, magazine articles, and medical television programs that appeared or were broadcast during a 1-year period, and contained information on rheumatic diseases, heart disease, cancer, chronic lung disease, or diabetes mellitus, were selected for content analysis. For each article and program, it was determined whether coverage concentrated on treatment, influence of lifestyle, scientific progress, or disease consequences. It was also determined whether professional experts and patients were featured. RESULTS: Nine hundred seventeen newspaper articles, 304 magazine articles, and 163 medical programs were found. Most dealt with cancer (43%) and heart disease (37%). The amount of media attention given to each of the five disease categories was found to correspond with mortality but not with prevalence. The contents of the articles and programs differed significantly according to disease topic. The main focus in rheumatic diseases was on patients' experiences, as well as regular and alternative medications. In heart disease and cancer, the main focus was on professional medical viewpoints, operations, and mortality, whereas in chronic lung disease and diabetes it was on treatments in the context of regular medications, scientific progress, and incurability. The influence of lifestyle on the disease process was mentioned most often in connection with diabetes, rheumatic disease, and chronic lung disease. CONCLUSIONS: The amount of attention a disease category received from the media depended on its fatality rates and not on its prevalence. Heart disease and cancer were portrayed as being more serious than the more lingering diseases. Surprisingly, the proportion of articles and programs that included the influence of lifestyle in their coverage was lowest for cancer and heart disease. More frequent and more accurate coverage of chronic diseases, especially rheumatic diseases, is needed if their image is to be brought into line with their importance for and impact on the community.

Chronic Disease↗