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Biomedical subjects

Robbert Sanderman

Publications and source records attributed to Robbert Sanderman.

At least 37 records · Page 2Linked to original sources
PubMed2005

The relationship between self-efficacy and self-reported physical functioning in chronic obstructive pulmonary disease and chronic heart failure.

In this study, the authors investigated whether self-reported physical functioning of patients with chronic obstructive pulmonary disease (COPD) and chronic systolic heart failure (CHF) was primarily explained by illness-specific differences related to diagnosis or whether more generic factors also contributed to their physical functioning. Consecutive patients with COPD (n = 56; mean age = 67.8, SD = 8.5) and CHF (n = 65; mean age = 60.0, SD = 10.2)from the outpatient clinics of a university hospital and a general hospital completed a self-report questionnaire, including the Rand-36 Health Survey, Cantril's ladder, the Mastery scale, the Perceived Health Competence Scale, and the Self-efficacy scale. COPD patients scored significantly worse in self-reported physical and psychological functioning and perceived health competence than did patients with CHF Regression analysis revealed that both the diagnosis and the illness severity contributed to self-reported physical functioning, although self-efficacy explained the main part of physical functioning. Therefore, important aims in the treatment of patients with COPD and CHF should be not only improving physical functioning but also enhancing self-efficacy.

Adaptation, Psychological↗
PubMed2004

One-year follow-up effects of diabetes rehabilitation for patients with prolonged self-management difficulties.

The aim of this study is to determine effects and the role of facilitators of empowerment of a Multidisciplinary Intensive Education Programme (MIEP) for diabetic patients with prolonged self-management difficulties. Glycemic control (HbA1c), health-related quality of life (HR-QoL) and facilitators of empowerment (health locus of control and coping) were measured in 99 participants of MIEP at baseline (T0), 3 (T1) and 12 months (T2) follow-up and in 231 non-referred consecutive outpatients. HbA1c improved at T2, although initial improvement was partially lost. Patients improved in most HR-QoL domains, without any relapse at T2. At T2, participants no longer differed from the average outpatients in any outcome. Initially, the HbA1c of men and women improved equally, but at T2 women consolidated improvement, whereas men relapsed. After MIEP, patients became more empowered (both at T1 and T2), explaining additional variance in HR-QoL improvement. The aim of MIEP to empower patients, rather than trying to solve problems for them seems effective.

Adaptation, Psychological↗
PubMed2004

The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy.

Many studies have reported that cancer patients who show difficulties maintaining perceptions of control report more psychological distress than patients who are higher in control. Besides perceptions of control, feelings of illness uncertainty have also been regarded as a predictor of psychological distress. Given these strong relationships between perceptions of low control and high illness uncertainty and psychological distress, the present study examined whether an informational self-management intervention (booklet) could moderate this relationship. The booklet contained general and specific information about cancer and cancer treatment, information about possible coping strategies, and social comparison information, which consisted of short stories of other patients. Prior to radiotherapy, 209 patients with cancer completed baseline measures, including control and illness uncertainty. After completing radiotherapy, patients were randomly allocated to receive either a booklet (experimental group; N=103) or no booklet (control group; N=106). Three months after the intervention, aspects of psychological distress were assessed, including tension, anger, depression, fatigue and vigour. The results supported our hypotheses and suggested that a self-management intervention is relevant in reducing the relationship between control and illness uncertainty before radiotherapy and psychological distress after radiotherapy. This seems important, especially for high-risk patients who perceive little control and much illness uncertainty.

Adaptation, Psychological↗
PubMed2004

Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress.

When one member of a couple develops a serious illness, the lives of both partners are likely to be affected. Interventions directed at both partners are generally lacking, however. In the present study, a brief counseling program directed at couples confronted with cancer was evaluated. The intervention focused mainly on the exchange of social support and help between both partners and was aimed at restoring perceptions of equity. Couples were randomly assigned to an experimental group or a waiting-list group. After the intervention, both patients and their partners reported lower levels of perceptions of underinvestment and overbenefit, and higher levels of relationship quality. Moreover, among patients psychological distress decreased after the intervention. These effects were generally maintained until follow-up three months later. Associations between perceptions of equity and relationship quality and psychological distress were also examined.

Adult↗
PubMed2004

The role of age at the onset of cancer in relation to survivors' long-term adjustment: a controlled comparison over an eight-year period.

The goal of the study was to explore the role of age in survivors' long-term adjustment to cancer (n = 155). Data, both quantitative and qualitative, was assessed at 3 months, 15 months, and 8 years after diagnosis. A reference group from the general population (n = 120) was included to be able to distinguish the effects of cancer from those of aging. The findings showed that, in the first year after diagnosis, survivors' physical functioning (especially in those aged 45-65 years) was strongly affected by cancer. In the long term, their physical functioning was more affected by aging. Regarding psychological functioning, survivors younger than 65 years reported more depressive symptoms than similar-aged references, but only at 3 months after diagnosis. In the long term, younger survivors reported more cancer-related thoughts and a greater search for meaning in the cancer experience than older survivors. Overall, the findings provide an intriguing description of the complex and interwoven processes of age and aging in the process of adjustment to cancer.

Adaptation, Psychological↗
PubMed2004

Diabetes rehabilitation: development and first results of a Multidisciplinary Intensive Education Program for patients with prolonged self-management difficulties.

For a number of diabetes patients regular care may be insufficient. A Multidisciplinary Intensive Education Program (MIEP), based on the empowerment approach, has been developed to help patients obtain their treatment goals (adequate self-management, glycemic control and quality of life). The aim of this pilot study is to determine the effects of MIEP and it's mechanisms of influence. MIEP consisted of 12 days group-sessions and individual counseling. At baseline and 3-months follow-up, blood-glucose (HbA1c), quality of life, health locus of control, distress, and knowledge were obtained (N = 51). Paired T-tests and regression analyses were conducted. HbA1c, and knowledge improved significantly, patients rated themselves healthier and were more internal and less powerful others oriented. Baseline scores explained effects in HbA1c, and quality of life. Locus of control significantly contributed in effects on quality of life. MIEP benefited patients with prolonged self-management difficulties, and this form of care seems to complement regular care.

Attitude to Health↗
PubMed2004

Psychological functioning in cancer patients treated with radiotherapy.

Although many side-effects of radiotherapy (RT) are physical, previous studies have shown that patients, when treated with RT, also experience psychological problems. This review describes the psychological functioning of cancer patients prior to, during, and after RT. Moreover, we examined whether medical factors are related to psychological functioning. Using Medline and Psychlit databases over the period 1980-2002, 45 articles were studied for this review. Although some global trends were found, studies revealed great variability in psychological functioning prior to, during, and after RT. Longitudinal studies should include pre-, during, and post-RT assessments of psychological functioning and also take into account the previous psychological stability of the patient.

Anxiety↗
PubMed2004

Psychological distress in couples dealing with colorectal cancer: gender and role differences and intracouple correspondence.

OBJECTIVES: This longitudinal study examined patterns of psychological distress in couples facing colorectal cancer within 6 months after surgery. In addition, correspondence in psychological distress was investigated between patients and their spouses, taking into account the gender of the patient. METHOD: The study had a longitudinal design, involving three assessment points; (T1) within 2 weeks after surgery, (T2) 3 months after baseline and (T3) 6 months after baseline. At T1, respondents were asked to indicate how they felt during the week prior to surgery. At T2 and T3, respondents reported their feelings during the preceding week. Psychological distress was measured using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) in 137 couples. RESULTS: Concerning the week prior to surgery, females reported more distress being a patient, whereas males reported more distress being a spouse. In comparison with a reference group, females as well as males, regardless of their role, showed increased levels of psychological distress prior to surgery. At 3 and 6 months following surgery, increased levels of distress continued to exist in females, whereas males' distress returned to normal levels. Neither within female-patient couples, nor within male-patient couples, were associations between patients' and spouses' distress found. CONCLUSION: We demonstrated a considerable impact of the cancer diagnosis on both female and male patients and their spouses before and 3 months after surgery. Six months after surgery, females, in particular, appear to be vulnerable to distress.

Colorectal Neoplasms↗
PubMed2003

The role of depressive symptoms in recovery from injuries to the extremities in older persons. A prospective study.

BACKGROUND: Previous research suggested that depressive symptoms play a role in recovery after hip fracture. However none of these studies were prospective and included only patients with hip fractures. OBJECTIVE: To examine the effect of depressive symptoms on the recovery of (instrumental) activities of daily living after fall-related injuries to the extremities in older persons. DESIGN: Prospective cohort study. METHODS: Data were collected from 168 older persons at baseline, prior to their injuries (hip fractures, other fractures or contortions and dislocations), and 8 weeks, 5 months and 12 months after their accident. Hierarchical multiple regression analysis was used to study the impact of depressive symptoms (as assessed with the Hospital Anxiety and Depression Scale; HADS) on disability (as assessed with the Groningen Activity Restriction Scale; GARS) after the injury while adjusting for several covariates. RESULTS: Depressive symptoms at baseline were not predictive for disability after the injury when covariates were taken into account. However, depressive symptoms 8 weeks after the fall were significantly related to disability at 8 weeks, 5 months and even 12 months after the injury. In addition, disability levels before the injury were highly predictive for recovery later on. Severity of injury was particularly predictive for disability at 8 weeks while age (which may generally represent the amount of physiological reserve) predicted disability at 5 and 12 months after the injury. Cognitive functioning 8 weeks post-injury was, in contrast to previous research, not predictive for recovery when covariates were taken into account. CONCLUSIONS: Pre-injury levels of disability and post-injury depressive symptoms are associated with recovery and may warrant concern and special attention in clinical practice.

Accidental Falls↗
PubMed2003

Audiotaped social comparison information for cancer patients undergoing radiotherapy: differential effects of procedural, emotional and coping information.

The present study focused on the effects of social comparison information on subjective understanding of radiation therapy, validation of emotions, and self-efficacy of cancer patients undergoing radiation therapy. The effects of three different audiotapes, containing different kinds of social comparison information, were examined. On the procedural tape a man and woman discussed their illness and radiation treatment, on the emotion tape they focused on the emotional aspects of these issues, and on the coping tape they focused on the way they had been coping. The effects of these tapes were measured on subjective understanding about radiation therapy, validation and recognition of emotions, self-efficacy, and mood. The results indicate positive effects of the tapes, especially of the procedural and the coping tape. These audiotapes increased understanding of radiation therapy, self-efficacy and the feeling of validation of emotions. Therefore, these tapes may be an important supplement to existing patient education information. Possible explanations and practical implications are discussed.

Adaptation, Psychological↗
PubMed2003

The role of social support and self-esteem in the presence and course of depressive symptoms: a comparison of cancer patients and individuals from the general population.

The key focus of this longitudinal study in the Netherlands was to determine the role of social support (i.e. perceived availability of emotional support, lack of received problem-focused emotional support, and negative interactions) and positive and negative self-esteem in depressive symptoms in 475 recently diagnosed cancer patients and 255 individuals without cancer from the general population. Patients and the comparison group were interviewed and filled in a questionnaire at two points in time: 3 months (T1) and 15 months (T2) after diagnosis. The results indicated that social support and self-esteem were weakly to moderately related to each other. Negative self-esteem was more strongly related to all three types of social support, compared to positive self-esteem. Regression analyses showed that social support and self-esteem were independently related to depressive symptoms (concurrently), such that lower levels of social support and self-esteem were strongly associated with higher levels of depressive symptoms. This finding suggests that these two resources supplement each other additively. A longitudinal analysis showed that social support and self-esteem also predicted future levels of depressive symptoms, although the explained variance was much lower than in a cross-sectional analysis. Comparisons between cancer patients and the comparison group generally revealed no significant differences between the two groups in the associations of social support and self-esteem with depressive symptoms. The only exception was a lack of problem-focused emotional support. At three months after diagnosis, a lack of this type of support, characterised by reassuring, comforting, problem-solving, and advice, was more strongly related to depressive symptoms in patients than in the comparison group.

Adult↗
PubMed2003

Depression in older people after fall-related injuries: a prospective study.

BACKGROUND: objectives of the study were i) to describe changes in depression in independently living people aged 57 or older with fall-related injuries, and ii) to examine the effect of incomplete recovery of physical functions on depression one year post-injury. METHOD: prospective cohort-study, including a pre-injury baseline and post-injury assessments at 8 weeks, 5 months and one year. The sample consisted of 159 patients who sustained various kinds of fall-related injuries to the limbs. Physical functioning was measured by the Groningen Activity Restriction Scale, depression by the Hospital Anxiety and Depression Scale. Additional variables in the study were age, gender, chronic medical conditions and severity of the injury (three level-groups). Pre- and post-injury levels of depression were compared by using Student's t-test and effect size indices. Hierarchical multivariate regression analysis was used to examine the contribution of change in physical functioning between baseline and one year post-injury to depression one year post-injury. RESULTS: severity of the injury was not associated with depression. Mean depression levels of all patients remained stable until 5 months post-injury but increased between 5 months and one year. Physical functioning decreased between baseline and 8 weeks post-injury, increased between 8 weeks and 5 months but did not change after 5 months. One year post-injury, both disability and depression were higher than at baseline. Change in physical functioning between baseline and one year post-injury accounted for 19% of the variance in depression explained by the regression model. CONCLUSIONS: depressive reactions did not occur as long as patients experienced improvement in physical functioning but became manifest as recovery appeared to stagnate. No significant differences in this respect were found between hip fracture patients and patients with other injuries.

Accidental Falls↗
PubMed2003

The role of perceived control in the process of older peoples' recovery of physical functions after fall-related injuries: a prospective study.

This study examined the predictive role of perceived control in recovery of physical functions after fall-related injuries in a cohort of 165 older people who had completed preinjury baseline assessments including physical functioning and perceived control. Follow-up assessments of functioning were made at 8 weeks, 5 months, and 12 months. Indicators for perceived control were mastery and self-efficacy expectations. Physical functioning referred to self-reported difficulties with activities of daily living. Covariates included age, gender, level of education, preinjury health status, preinjury levels of social support and disability, and, additionally, the severity of the injury. Separate regression equations were estimated with disability as outcome at 8 weeks, 5 months, and 12 months post injury. Although significant at 8 weeks and borderline significant at 5 months post injury, the predictive role of perceived control appeared to be comparatively small. Preinjury levels of disability were highly predictive for disability at 8 weeks, 5 months, and 12 months post injury. The severity of the injury is the predominant contributor to disability in the short term but becomes insignificant over time, whereas the influence of age on recovery becomes important after 5 months.

Accidental Falls↗
PubMed2003

Structure and reliability of Ware's Patient Satisfaction Questionnaire III: patients' satisfaction with oncological care in the Netherlands.

BACKGROUND: The present study examined the structure and reliability of the Dutch version of the Patient Satisfaction Questionnaire III (PSQ III). The PSQ III was designed to measure technical competence, interpersonal manner, communication, time spent with doctor, financial aspects, and access to care. In the Dutch version, the financial items were left aside because these are not appropriate for the Dutch socialized system. OBJECTIVES: The main objectives were to assess response bias, the number of dimensions needed to describe the PSQ III items, and the reliability of the scales. In addition, distribution characteristics were examined and norm scores to interpret satisfaction scores in an oncological setting were presented. RESEARCH DESIGN: A cross-sectional survey study.SUBJECTS The study was comprised of 1594 cancer patients from eight hospitals. MEASURES: The Dutch version of the PSQ III. RESULTS: Approximately 14% of the respondents were found to demonstrate considerable response bias. Confirmative factor analyses were performed to test three theoretical models with a varying number of dimensions among those participants who did not demonstrate response bias. The original structure did not fit the data well, but support was found for a three-factor model (with interpersonal manner, communication, and time spent with doctor loading on one factor instead of separate factors) and a one-dimensional model. CONCLUSIONS: The PSQ III seems to be an appropriate measure of cancer patients' satisfaction, with the note that the number of dimensions may vary for different patient groups and/or care settings and that it is important to be aware of response bias.

Aged↗
PubMed2003

Cognitive adaptation: a comparison of cancer patients and healthy references.

OBJECTIVES: Taylor's theory of cognitive adaptation proposes that adjustment depends on the ability to sustain and modify illusions (i.e. unrealistic optimism, exaggerated perceptions of control, and self-aggrandizement) that buffer against threats but also against possible future setbacks. Because the question of whether cancer patients show these illusions has received little attention, the present study compared patients' perceptions of optimism, control, and self-esteem at different stages of the cancer process with that of healthy references. The effects of these perceptions on psychological distress were also assessed. DESIGN: The present study has a longitudinal design. Including a group of healthy references enabled us to draw more firm conclusions about the effect of cancer upon cognitive perceptions. METHODS: The participants were 67 cancer patients and 50 healthy references. Patients filled out questionnaires prior to their first radiotherapy (T1), at 2 weeks (T2), and at 3 months (T3) after completing radiotherapy. Healthy references were assessed at similar intervals. RESULTS: T tests revealed that patients experienced significantly higher levels of optimism and self-esteem than the healthy reference group. Concerning control, no group differences were found. Importantly, regression analyses showed that lower levels of optimism and control at T1 were predictive of feelings of anxiety at T3. Lower perceived control also predicted depressive symptoms. CONCLUSION: Results support the theory of cognitive adaptation in that patients are indeed able to respond to cancer with high levels of optimism and self-esteem and that lower levels of optimism and control are predictive of psychological distress.

Adaptation, Psychological↗
PubMed2002

Long-term effects of a group support program and an individual support program for informal caregivers of stroke patients: which caregivers benefit the most?

In this article, we report the long-term outcomes of an intervention for informal caregivers who are the main provider of stroke survivors' emotional and physical support. Based on the stress-coping theory of Lazarus and Folkman two intervention designs were developed: a group support program and individual home visits. Both designs aimed at an increase in caregivers' active coping and knowledge, reducing caregivers' strain and improving well-being and social support. Caregivers were interviewed before entering the program, and 1 and 6 months after completion of the program. After 6 months, 100 participants remained in the group program, 49 in the home visit program, and 38 in the control group. Multiple stepwise regression analysis was used to determine the effects of the interventions. In the long-term, the interventions (group program and home visits together) contributed to a small to medium increase in confidence in knowledge and the use of an active coping strategy. The amount of social support remained stable in the intervention groups, whereas it decreased in the control group. The same results were found when only the group program was compared with the control group. However, no significant differences between the home visit group and the participants in the group support program were found. Younger female caregivers benefit the most from the interventions. They show greater gains in confidence in knowledge about patient-care and the amount of social support received compared with other caregivers.

Aged↗
PubMed2002

Failing in spousal caregiving: The 'identity-relevant stress' hypothesis to explain sex differences in caregiver distress.

OBJECTIVES: This study examined a possible explanation for the frequently reported finding that female caregivers perceive more psychological distress than do male caregivers. Our 'identity-relevant stress' hypothesis asserts that feelings of incompetence with respect to caregiving are more strongly associated with psychological distress in women than in men. Women who feel competent with respect to caregiving may report levels of distress as low as that of male caregivers. DESIGN: This study has a cross-sectional design. METHODS: Psychological distress (CES-D) was measured in 32 female and 36 male partners of patients suffering from various types of cancer. Furthermore, partners' perceptions of caregiving performance and patients' perceptions of partners' supportive and unsupportive behaviour were assessed. RESULTS: Only among female partners were self-efficacy and personal accomplishment regarding caregiving found to be positively linked to distress. Also, in contrast to male partners, female partners reported more distress when they acted less supportively. CONCLUSION: The difference in psychological distress between female and male caregivers seems to be carried by a subgroup of partners who feel that they are not doing a very good job at caregiving.

Journal Article↗