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Objective: To study the effect of an Internet-based personal health record on the empowerment of patients undergoing IVF. Design: Randomized clinical trial. Setting: Patients undergoing IVF and intracytoplasmic sperm injection (ICSI) in an academic research environment. Patient(s): We selected patients who were undergoing an IVF or ICSI treatment, have an Internet connection, and speak fluent Dutch. Intervention(s): An Internet-based personal health record that provides patients with general and personal information concerning their given treatment and that also provides facilities for communication with fellow patients and physicians. Main Outcome Measure(s): Patient empowerment (measured as a multidimensional concept consisting of self-efficacy, actual and perceived knowledge, and involvement in the decision process), patient satisfaction, meaning of infertility problems, social support, anxiety, and depression. Result(s): A total of 91 female and 89 male participants were suitable for analysis. No significant differences were observed in per person change in patient empowerment. We did not find any significant differences regarding per person change in patient satisfaction, the meaning of infertility problems, social support, anxiety, and depression. Conclusion(s): Usage of the personal health record did not have any effects on patient empowerment, but, at the same time, the study did not find that the personal health record had any significant adverse effects either. [Copyright &y& Elsevier]

Parental decisional conflict and decisional regret are aspects in parental adjustment to childhood elective surgery. This study assessed correlates of parental decisional regret in parents of young boys treated for hypospadias. Parents of 261 boys treated for hypospadias at the Radboudumc between 2006 and 2014 were approached to complete questionnaires on socio-demographics, clinical details, postoperative outcomes, decisional conflict and decisional regret. Of the 97 participating parents, 50.5% reported some form of decisional regret, in 11.3% this was moderate to strong. Decisional conflict (β =.68, p <.001) and psychosocial behavior problems of the child (β =.20, p <.05) significantly predicted decisional regret. Demographic and medical variables did not correlate with parental decisional regret. A substantial number of parents report some form of decisional regret regarding the elective surgery for hypospadias in their child. Although most parents only show mild forms of regret, in the perspective of discussions on this surgery in early childhood, future research could shed more light on the interrelationship between medical and psychosocial factors in the process of decision-making around surgery, in boys with hypospadias and their parents. Summary Table Predictors of parental Decisional Regret (n = 97). Summary Table R2 F p Regression.52 49.86 <.01 Β SE t p Decisional conflict.68.10 9.41 <.01 Psychosocial behavior.20.15 2.74.01 [ABSTRACT FROM AUTHOR]

To determine whether maternal depressive symptoms at multiple time points during pregnancy are associated with infant wheezing in the first 2 years of life to assess etiologically relevant time windows. We included Dutch women participating in the PRIDE Study with delivery in 2013–2019. Maternal depressive symptoms were assessed with the Hospital Anxiety and Depression Scale and Edinburgh Depression Scale at enrollment and in gestational weeks 17 and 34. The International Study of Asthma and Allergies in Childhood questionnaire was used to assess infant wheezing biannually postpartum. Adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were estimated with modified Poisson regression. Among 5294 pregnancies included, maternal depressive symptoms in gestational weeks 15–22 was associated with any wheezing in the first 2 years of life (RR 1.36, 95% CI 1.04–1.78) and with current wheezing at 12 (RR 1.29, 95% CI 1.03–1.61) and 18 months (RR 1.33, 1.04–1.69). Depressive symptoms in gestational weeks 32–35 seemed to be associated with any wheezing reported at two years (RR 1.27, 95% CI 0.96–1.69) and current wheezing at 12 months (RR 1.28, 95% CI 1.02–1.60). Four trajectories of depressive symptoms were identified. Only the trajectory with increasing symptoms throughout pregnancy seemed to be associated with infant wheezing (RR 1.36, 95% CI 0.97–1.89). Maternal depressive symptoms in mid- and late pregnancy may be associated with development of infant wheezing, particularly those with onset in the second half of pregnancy. Research is needed to identify biological pathways and associations with more objective, long-term respiratory morbidity. [ABSTRACT FROM AUTHOR]

Hospitals and clinics develop Internet strategies to emancipate and empower their patient population. At Radboud University Nijmegen Medical Centre, we developed an Internet-based personal health record that provides patients with general and personal information about their treatment and that provides facilities for communication with fellow patients and with physicians. Because not much is known about information and communication needs of IVF and ICSI patients in relation to their treatment, we observed the intensity of use of this personal health record during the various stages of IVF treatment. We measured the numbers of page views and the number of contributions to the chat room. Data regarding Website use and treatment schedules were available for 51 couples. These couples generated 25,420 page views and posted 11,403 utterances. Two-way analysis of variance showed that significant individual changes occurred in the intensity of use during the different stages of the treatment. During the stages in which there is no contact between the patient and the clinic, patients make use of the Website''s communication functions. This reflects the patients'' need for continued communication and support during the last stages of treatment, a service that IVF clinics traditionally cannot or do not provide. [Copyright &y& Elsevier]