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Background: Sternocostoclavicular hyperostosis (SCCH) is a rare, debilitating, chronic inflammatory disorder of the anterior chest wall due to a chronic sterile osteomyelitis of unknown origin. SCCH is largely underdiagnosed and often misdiagnosed. In individual cases it can remain unrecognized for years. The purpose of this study is twofold. Firstly, to evaluate the psychological condition of SCCH patients, both in the sometimes quite extended pre-diagnostic period between first manifestations and confirmed diagnosis of the disease, and in the current situation. Secondly, to investigate the relationships between the pre-diagnostic and the current psychological conditions of confirmed SCCH patients., Methods: Structured interviews were held with 52 confirmed SCCH patients. Questionnaires were included to assess posttraumatic stress symptoms, social support, aspects of pain, illness perceptions, self-reported health status, and quality of life., Results: SCCH patients reported stronger posttraumatic stress symptoms, more unfavorable illness perceptions, lower health status, and poorer quality of life than healthy individuals and patients with other diseases or traumatic experiences. Psychological distress in the pre-diagnostic period was associated with unfavorable conditions in the current situation., Conclusion: SCCH is an illness with serious psychological consequences. Psychological monitoring of patients with unexplained complaints is recommended as long as a diagnosis has not been reached.

Aim: The new budget system for Dutch hospitals makes use of patient groups that are highly homogeneous in terms of diagnosis and treatment combinations (diagnose behandeling combinaties (DBC)). These DBCs are the Dutch DRG variants. The DBC mainly concerns medical care; nursing care is almost regarded as a constant factor. In this study the DBC is linked to the nursing minimum data set for The Netherlands (NMDSN), to explore the degree of homogeneity in terms of nursing care for patient groups that are homogeneous in terms of the DBC., Method: In nine Dutch hospitals, patient information was collected by means of the NMDSN. To answer the question, we performed a secondary data analysis on the NMDSN. First, groups were formed in terms of medical diagnoses as defined in the DBC. Next, explorative statistical analyses were used to form homogeneous groups in terms of nursing diagnoses. These groups were compared in terms of the nursing care interventions and in terms of medical diagnoses., Finding: Some medical diagnoses seem to be homogeneous, others more heterogeneous in terms of nursing care., Discussion and Conclusion: Limitations in the study design hinder a firm conclusion. However, the results discourage the use of the medical DBC for nursing care.