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39. Minimizing Population Health Loss in Times of Scarce Surgical Capacity During the Coronavirus Disease 2019 Crisis and Beyond: A Modeling Study

Author

Bangma, Chris, Beetz, Ivo, Bindels, Patrick, Brandt-Kerkhof, Alexandra, van Diepen, Danielle, Dirven, Clemens, Galema, Tjebbe, Goudzwaard, Jeanette, Hazes, Mieke, Lagarde, Sjoerd, Polinder-Bos, Harmke, Roes, Eva Maria, Takkenberg, Hanneke, van Vledder, Mark, Gravesteijn, Benjamin, Krijkamp, Eline, Busschbach, Jan, Geleijnse, Geert, Helmrich, Isabel Retel, Bruinsma, Sophie, van Lint, Céline, van Veen, Ernest, Steyerberg, Ewout, Verhoef, Kees, van Saase, Jan, Lingsma, Hester, and Baatenburg de Jong, Rob

Published
2021
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40. Surgical prioritization based on decision model outcomes is not sensitive to differences between the health-related quality of life values estimates of physicians and citizens

Author

van Alphen, Anouk M.I.A., Krijkamp, Eline M., Gravesteijn, Benjamin Y., Baatenburg de Jong, Robert J., Busschbach, Jan J., van Alphen, Anouk M.I.A., Krijkamp, Eline M., Gravesteijn, Benjamin Y., Baatenburg de Jong, Robert J., and Busschbach, Jan J.

Abstract

Purpose: Decision models can be used to support allocation of scarce surgical resources. These models incorporate health-related quality of life (HRQoL) values that can be determined using physician panels. The predominant opinion is that one should use values obtained from citizens. We investigated whether physicians give different HRQoL values to citizens and evaluate whether such differences impact decision model outcomes. Methods: A two-round Delphi study was conducted. Citizens estimated HRQoL of pre- and post-operative health states for ten surgeries using a visual analogue scale. These values were compared using Bland–Altman analysis with HRQoL values previously obtained from physicians. Impact on decision model outcomes was evaluated by calculating the correlation between the rankings of surgeries established using the physicians’ and the citizens’ values.Results: A total of 71 citizens estimated HRQoL. Citizens’ values on the VAS scale were − 0.07 points (95% CI − 0.12 to − 0.01) lower than the physicians’ values. The correlation between the rankings of surgeries based on citizens’ and physicians’ values was 0.96 (p < 0.001). Conclusion: Physicians put higher values on health states than citizens. However, these differences only result in switches between adjacent entries in the ranking. It would seem that HRQoL values obtained from physicians are adequate to inform decision models during crises.

Published
2024

41. Psychosocial screening instruments to assist support consultants in patients with cancer

Author

Driessen, Helen Pieternel Antonie, van der Rijt, Carin C. D., Busschbach, Jan J., Elfrink, Erna J., Kranenburg, Leonieke W., Driessen, Helen Pieternel Antonie, van der Rijt, Carin C. D., Busschbach, Jan J., Elfrink, Erna J., and Kranenburg, Leonieke W.

Abstract

ObjectivesAround 30% of patients with cancer suffer from psychosocial problems requiring formal care; however, these problems are often not identified. Support consultants may play a role in identifying these problems. This study investigates the feasibility of using validated screening instruments to assist support consultants in identifying psychosocial problems.MethodsProspective observational study focusing on patients visiting support consultants at hospital-affiliated centres for information and support. The feasibility of using screening instruments was assessed based on the percentage of patients willing to participate. For these patients, possible psychosocial problems were objectified, and referral to formal care was assessed.ResultsOut of 227 eligible patients at IntermeZZo, 48 participated (21.1%). At PATIO, over 141 consultations took place and 27 patients participated. Main reason for non-participation was that patients did not feel such a need. The majority showed elevated scores, indicating possible psychosocial problems and around half were referred. Respecting the individual needs of patients and offering them with what benefits them is crucial, including screening instruments does not match their needs nor did support consultants feel it was appropriate in certain cases.ConclusionGiven the low percentage of questionnaires administered, it does not seem feasible to systematically administer them to patients visiting support consultants.

Published
2024

43. Cancer centre information and support services and patient needs:participatory action research study

Author

Driessen, Helen P.A., Busschbach, Jan J.V., Elfrink, Erna J., van der Rijt, Carin C.D., Paardekooper, Gabriël M.R.M., den Hollander, Corine J., Kranenburg, Leonieke W., Driessen, Helen P.A., Busschbach, Jan J.V., Elfrink, Erna J., van der Rijt, Carin C.D., Paardekooper, Gabriël M.R.M., den Hollander, Corine J., and Kranenburg, Leonieke W.

Abstract

Objectives:Clear information and supportive care are necessary for oncology patients and their relatives to manage the disease (trajectory). Centres for information and support aim to address their needs by offering informal and non-medical formal services. This study evaluated whether the centres’ services offered meet the needs of its visitors, and whether there is interest for these among oncology patients treated at affiliated hospitals.Methods:In this participatory action research, interviews were conducted among visitors of two centres (Patient Information Center Oncology (PATIO) and IntermeZZo) and among patients treated at the affiliated hospitals. Visitors were interviewed to share their experiences regarding the centres’ services offered. Patients from the hospitals were interviewed about their interest in such support. Data were collected during three different periods and adjustments were made to the centres’ services between measurements. Results:111 (PATIO) and 123 visitors (IntermeZZo) were interviewed, and 189 and 149 patients at the respective hospitals. Reasons to visit PATIO/IntermeZZo were to relax (93.1%), seek professional advice (54.6%) and meet peers (36.3%). Visitors indicated that the visits met their needs (99.1%), citing the accessible support and the expertise in oncology. 20% of patients interviewed at the hospitals expressed interest in visiting PATIO/ IntermeZZo. The majority of patients (89.6%) considered these centres an integral part of their treatment process. These findings were stable over time. Conclusions:Patients and their relatives highly value the services of hospital-affiliated centres for information and support. Future research should address how such centres best be integrated in the Dutch healthcare system.

Published
2024

45. Patient knowledge in anaesthesia: Psychometric development of the RAKQ–The Rotterdam anaesthesia Knowledge questionnaire.

Author

van den Heuvel, Sander F., van Eeren, Hester, Hoeks, Sanne E., Panasewicz, Anna, Jonker, Philip, Ismail, Sohal Y., van Busschbach, Jan J., Stolker, Robert Jan, and Korstanje, Jan-Wiebe H.

Subjects
ITEM response theory, PREOPERATIVE education, PSYCHOMETRICS, EXPLORATORY factor analysis, EPIDURAL anesthesia
Abstract

The transition from in-person to digital preoperative patient education requires effective methods for evaluating patients' understanding of the perioperative process, risks, and instructions to ensure informed consent. A knowledge questionnaire covering different anaesthesia techniques and instructions could fulfil this need. We constructed a set of items covering common anaesthesia techniques requiring informed consent and developed the Rotterdam Anaesthesia Knowledge Questionnaire (RAKQ) using a structured approach and Item Response Theory. A team of anaesthetists and educational experts developed the initial set of 60 multiple-choice items, ensuring content and face validity. Next, based on exploratory factor analysis, we identified seven domains: General Anaesthesia–I (regarding what to expect), General Anaesthesia–II (regarding the risks), Spinal Anaesthesia, Epidural Anaesthesia, Regional Anaesthesia, Procedural sedation and analgesia, and Generic Items. This itemset was filled out by 577 patients in the Erasmus MC, Rotterdam, and Albert Schweitzer Hospital, Dordrecht, the Netherlands. Based on factor loadings (≥0.25) and considering clinical relevance this initial item set was reduced to 50 items, distributed over the seven domains. Each domain was processed to produce a separate questionnaire. Through an iterative process of item selection to ensure that the questionnaires met the criteria for Item Response Theory modelling, 40 items remained in the definitive set of seven questionnaires. Finally, we developed an Item Response Theory model for each questionnaire and evaluated its reliability. 1-PL and 2-PL models were chosen based on best model fit. No item misfit (S-χ2, p<0.001 = misfit) was detected in the final models. The newly developed RAKQ allows practitioners to assess their patients' knowledge before consultation to better address knowledge gaps during consultation. Moreover, they can decide whether the level of knowledge is sufficient to obtain digital informed consent without face-to-face education. Researchers can use the RAKQ to compare new methods of patient education with traditional methods. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Impact of clinical severity on treatment response in a randomized controlled trial comparing day hospital and intensive outpatient mentalization‐based treatment for borderline personality disorder

Author

Smits, Maaike L., primary, Feenstra, Dine J., additional, Blankers, Matthijs, additional, Kamphuis, Jan H., additional, Bales, Dawn L., additional, Dekker, Jack J. M., additional, Verheul, Roel, additional, Busschbach, Jan J. V., additional, and Luyten, Patrick, additional

Published
2024
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