Biomedical subjects

P M Rijken

Publications and source records attributed to P M Rijken.

6 recordsLinked to original sources

PubMed2006

Does trust in health care influence the use of complementary and alternative medicine by chronically ill people?

BACKGROUND: People's trust in health care and health care professionals is essential for the effectiveness of health care, especially for chronically ill people, since chronic diseases are by definition (partly) incurable. Therefore, it may be understandable that chronically ill people turn to complementary and alternative medicine (CAM), often in addition to regular care. Chronically ill people use CAM two to five times more often than non-chronically ill people. The trust of chronically ill people in health care and health care professionals and the relationship of this with CAM use have not been reported until now. In this study, we examine the influence of chronically ill people's trust in health care and health care professionals on CAM use. METHODS: The present sample comprises respondents of the 'Panel of Patients with Chronic Diseases' (PPCD). Patients (>or=25 years) were selected by GPs. A total of 1,625 chronically ill people were included. Trust and CAM use was measured by a written questionnaire. Statistical analyses were t tests for independent samples, Chi-square and one-way analysis of variance, and logistic regression analysis. RESULTS: Chronically ill people have a relatively low level of trust in future health care. They trust certified alternative practitioners less than regular health care professionals, and non-certified alternative practitioners less still. The less trust patients have in future health care, the more they will be inclined to use CAM, when controlling for socio-demographic and disease characteristics. CONCLUSION: Trust in future health care is a significant predictor of CAM use. Chronically ill people's use of CAM may increase in the near future. Health policy makers should, therefore, be alert to the quality of practising alternative practitioners, for example by insisting on professional certification. Equally, good quality may increase people's trust in public health care.

Adult↗

PubMed2001

Work adjustments among the chronically ill.

Work(place) adjustments can help restore the work capacity of persons with a chronic disease. This study aims to quantify the presence of work adjustments among chronically ill workers in the Netherlands, and to investigate the extent to which the presence of work adjustments are related to the experience of work-interfering problems, disease characteristics or work characteristics. Data for this study are derived from the Dutch Panel of Patients with Chronic Diseases. The results discussed here relate to data collected in 1999 from a representative sample of 556 working people with various chronic somatic diseases. Of the work-interfering problems, the ones related to physical disabilities, concentration or memory deficits and transportation emerged as the most important factors related to the presence of either immaterial (i.e. not material) or material work adjustments. In addition, higher age and lower educational level were associated with a higher probability of immaterial adjustments; pain, attack frequency and physical demands of the job were important predictors of material work adjustments.

Adolescent↗

PubMed1999

Podiatric care for diabetic patients with foot problems: an observational study.

The aims of this study were to describe podiatric care for diabetic patients with foot problems and to explore the changes in knowledge, self-care behaviour and physical functioning after podiatric care. The treatment characteristics of 26 diabetic patients referred to podiatry were assessed. Prior to the first podiatric visit (T1) and 20 weeks later (T2) these patients filled in a structured questionnaire and performed a six-minute walking test. In half the number of patients preventive goals were set and strived for by general education about the diabetic foot and advice on footwear and self-care behaviour. With regard to treatment, reduction of pain was the most frequently selected goal. To achieve this reduction, a variety of interventions was applied. After podiatric care, patients reported having less severe foot pain and some improvements in functional ability and self-care behaviour were found. This study offers clues to start controlled clinical trials on the effectiveness of podiatry for diabetic patients. Trials should not only be directed to (the role of podiatry in) ulcer healing; it may be even more significant to study its effectiveness for the purpose of prevention and treatment of early-stage diabetic foot symptoms.

Activities of Daily Living↗

PubMed1998

Clinical experience of rehabilitation therapists with chronic diseases: a quantitative approach.

OBJECTIVES: To provide an overview of the numbers of patients with selected chronic diseases treated by rehabilitation therapists (physical therapists, occupational therapists, exercise therapists and podiatrists). The study was performed to get quantitative information on the degree to which rehabilitation therapists are experienced in the treatment of chronically ill patients. METHODS: Secondary analyses were performed on several databases containing representative data on patients treated by rehabilitation therapists. Rates per 1000 patients in the populations of these rehabilitation therapists and 90% confidence intervals were computed for patients with the following diagnoses: ischaemic heart diseases, stroke, rheumatoid arthritis, osteoarthritis, osteoporosis, multiple sclerosis, Parkinson's disease, epilepsy, headache syndromes, COPD/asthma, diabetes mellitus and chronic back pain (the size of the latter group could only be assessed in physical therapy in primary care). RESULTS: The largest group of chronically ill patients treated by physical therapists in primary care are patients with chronic back pain (82 per 1000). Stroke patients are the most common chronically ill patients treated by physical therapists in institutional care (157 per 1000) and by occupational therapists in institutional (358 per 1000) and noninstitutional care (246 per 1000). These therapists also see a variety of other chronically ill patients. Exercise therapists and podiatrists treat less patients with the selected chronic diseases.

Adult↗

PubMed1998

Clinical and functional correlates of foot pain in diabetic patients.

PURPOSE: Patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot pain and several functional impairments and disabilities were explored. METHOD: The research group consisted of 29 diabetic patients with any symptoms possibly associated with a diabetic foot, who were referred to podiatry. The relationships between several clinical measures and foot pain were analysed by means of Mann-Whitney U-tests. In addition, Spearman rank correlations coefficients were computed to assess the relationships between foot pain and measures of functional health. RESULTS: Diabetic patients suffering from sensory neuropathy experience more severe foot pain. Furthermore, patients with more severe foot pain experience more fatigue, more disabilities in walking and a lower level of affective well-being. CONCLUSION: Based on these findings this paper concludes that foot pain in diabetic patients is an important impairment which deserves further scientific attention.

Adolescent↗

PubMed1997

[Indications for management in long-term, physically unexplained fatigue symptoms].

In meetings arranged by the minister of Public Health, Welfare and Sports between general practitioners and specialists concerning chronic fatigue syndrome (CFS), suggestions for the diagnosis, treatment and assistance and support of patients with protracted physically unexplained fatigue symptoms, were established in the light of current scientific insight. The term 'CFS' is applicable in cases of fatigue complaints, of at least 6 months' standing, reported by the patient himself and evaluated medically, for which no physical explanation has been found and which cause considerable disabilities in professional social and/or personal functioning. The management depends on the duration of the illness. A distinction is made between an acute phase (up to one month after the first consultation; the policy is mostly expectative), a subacute phase (until 6 months after the onset of the complaints and disabilities; the management is aimed at making the patient accept the condition and persuading him or her to make an effort to promote health) and a chronic phase (from 6 months after the onset of the complaints and disabilities; the management is aimed at health-promoting behaviour and cognitions). Further (laboratory) examinations are useful only if the symptoms have not disappeared after one month (this is the case in approximately 20% of the patients); such examinations may be useful in older patients earlier. It is important that the CFS patient learns to realize that it is useless to continue to spend energy on searching for causes and possible therapies, but that he should try to promote his own health, for instance by means of a quantified programme of activities linked to a time schedule (instead of to a level of fatigue).

Clinical Protocols↗