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619 results on '"Zuidema, Sytse U."'

21. Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer’s Disease at the Memory Clinic: The BEAT-IT Study

Author

Eikelboom, Willem S., van den Berg, Esther, Coesmans, Michiel, Goudzwaard, Jeannette A., Koopmanschap, Marc, Lazaar, Najoua, van Bruchem-Visser, Rozemarijn L., Driesen, Jan J. M., den Heijer, Tom, Hoogers, Susanne, de Jong, Frank Jan, Mattace-Raso, Francesco, Thomeer, Elsbeth C., Vrenken, Suzanne, Vroegindeweij, Lilian J. H. M., Zuidema, Sytse U., Singleton, Ellen H., van Swieten, John C., Ossenkoppele, Rik, and Papma, Janne M.

Subjects
Psychiatry and Mental health, Clinical Psychology, General Neuroscience, General Medicine, Geriatrics and Gerontology
Abstract

Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer’s disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. Methods: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12). Results: The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs. Conclusion: The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.

Published
2023

23. Effects of a Multidisciplinary Intervention on the Presence of Neuropsychiatric Symptoms and Psychotropic Drug Use in Nursing Home Residents WithYoung-Onset Dementia: Behavior and Evolution of Young-Onset Dementia Part 2 (BEYOND-II) Study

Author

Appelhof, Britt, Bakker, Christian, de Vugt, Marjolein E., van Duinen-van den IJssel, Jeannette C.L., Zwijsen, Sandra A., Smalbrugge, Martin, Teerenstra, Steven, Verhey, Frans R.J., Zuidema, Sytse U., and Koopmans, Raymond T.C.M.

Published
2019
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31. An exploration of relocation initiatives deployed within and between nursing homes: a qualitative study.

Author

Broekharst, Damien S. E., Stoop, Annerieke, Achterberg, Wilco P., Caljouw, Monique A. A., on behalf of the RELOCARE Consortium, Luijkx, Katrien G., Verbeek, Hilde, Hamers, Jan P. H., Schols, Jos M. G. A., de Boer, Bram, Urlings, Judith H. J., Brouwers, Mara, Landeweer, Elleke G. M., Luijendijk, Dika H. J., Schreuder, Miranda C., Zuidema, Sytse U., Perry, Marieke, Koopmans, Raymond T. C. M., and Groen, Wim G.

Subjects
NURSING care facilities, HOME nursing, MEDICAL personnel, QUALITATIVE research, INFORMATION sharing
Abstract

Background: Relocations within and between nursing homes often induce stress, anxiety, and depression in residents and cause additional workload for and burnout in staff. To prevent this, many nursing homes deploy pre-transition initiatives, bridging initiatives, and post-transition initiatives to support residents and staff during the relocation process. As little is known about these initiatives, this study aims to explore the pre-relocation, bridging and post-relocation initiatives used for relocations within and between nursing homes. Methods: In seven Dutch nursing homes, eight focus groups were conducted with two to six participants (N = 37) who were actively involved in relocation processes in different roles (i.e., managers, healthcare professionals, support staff, client council members, residents and family). The focus groups were conducted based on a predefined topic list and lasted approximately 60 min. The transcripts were recorded, transcribed verbatim and analysed using thematic coding. Results: Nursing homes had to be inventive in developing relocation initiatives as neither shared guidelines nor knowledge exchange on this topic were available. A total of thirty-seven relocation initiatives were identified in these seven nursing homes. Nineteen pre-relocation initiatives were identified, of which eight emphasized information and engagement, three highlighted training and practice and eight stressed orientation and visualization. Seven bridging initiatives were identified, of which four emphasized coordination and continuity and three highlighted entertainment and celebration. Eleven post-relocation initiatives were identified, of which seven emphasized evaluation and troubleshooting and four highlighted change and adjustment. Conclusion: The identified relocation initiatives were developed unassisted by nursing homes, due to a lack of shared guidelines, knowledge exchange and mutual learning on this topic. Therefore, it may be expedient and more effective to develop general guidelines for relocations within and between nursing homes in collaboration with nursing homes. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Well-being, multidisciplinary work and a skillful team: essential elements of successful treatment in severe challenging behavior in dementia.

Author

van Voorden, Gerrie, Koopmans, Raymond T.C.M., Smalbrugge, Martin, Zuidema, Sytse U., van den Brink, Anne M.A., Persoon, Anke, Oude Voshaar, Richard C., and Gerritsen, Debby L.

Subjects
TREATMENT of dementia, WELL-being, MEDICAL quality control, PSYCHIATRIC drugs, ATTITUDES of medical personnel, MEDICAL personnel, PATIENT-centered care, TREATMENT effectiveness, HEALTH care teams, PROFESSIONAL competence, PSYCHOSOCIAL factors, RESEARCH funding, SUCCESS
Abstract

Conceptualize successful treatment of persons with dementia and severe challenging behavior as perceived by professionals. In this concept mapping study 82 experts in dementia care participated. The study followed two phases of data collection: (1) an online brainstorm where participants completed the focus prompt: 'I consider the treatment of people with severe challenging behavior in dementia successful if.'; (2) individual sorting and rating of the collected statements followed by data analysis using multidimensional scaling and hierarchical cluster analysis, resulting in a concept map. Three clusters were identified, the first addressing treatment outcomes and the latter two addressing treatment processes, each divided into sub-clusters: (1) well-being, comprising well-being of the person with dementia and all people directly involved; (2) multidisciplinary analysis and treatment, comprising multidisciplinary analysis, process conditions, reduction in psychotropic drugs, and person-centered treatment; and (3) attitudes and skills of those involved, comprising consistent approach by the team, understanding behavior, knowing how to respond to behavior, and open attitudes. Successful treatment in people with dementia and severe challenging behavior focuses on well-being of all people involved wherein attention to treatment processes including process conditions is essential to achieve this. [ABSTRACT FROM AUTHOR]

Published
2023
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33. Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer's Disease at the Memory Clinic:The BEAT-IT Study

Author

Eikelboom, Willem S., van den Berg, Esther, Coesmans, Michiel, Goudzwaard, Jeannette A., Koopmanschap, Marc, Lazaar, Najoua, van Bruchem-Visser, Rozemarijn L., Driesen, Jan J.M., den Heijer, Tom, Hoogers, Susanne, de Jong, Frank Jan, Mattace-Raso, Francesco, Thomeer, Elsbeth C., Vrenken, Suzanne, Vroegindeweij, Lilian J.H.M., Zuidema, Sytse U., Singleton, Ellen H., van Swieten, John C., Ossenkoppele, Rik, Papma, Janne M., Eikelboom, Willem S., van den Berg, Esther, Coesmans, Michiel, Goudzwaard, Jeannette A., Koopmanschap, Marc, Lazaar, Najoua, van Bruchem-Visser, Rozemarijn L., Driesen, Jan J.M., den Heijer, Tom, Hoogers, Susanne, de Jong, Frank Jan, Mattace-Raso, Francesco, Thomeer, Elsbeth C., Vrenken, Suzanne, Vroegindeweij, Lilian J.H.M., Zuidema, Sytse U., Singleton, Ellen H., van Swieten, John C., Ossenkoppele, Rik, and Papma, Janne M.

Abstract

BACKGROUND: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. OBJECTIVE: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. METHODS: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12). RESULTS: The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs. CONCLUSION: The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.

Published
2023

34. Soundscape Awareness Intervention Reduced Neuropsychiatric Symptoms in Nursing Home Residents With Dementia:A Cluster-Randomized Trial With MoSART+

Author

Kosters, Janouk, Janus, Sarah I.M., van den Bosch, Kirsten A., Andringa, Tjeerd C., Hoop, E. Oomen de, de Boer, Michiel R., Elburg, Ronald A.J., Warmelink, Steven, Zuidema, Sytse U., Luijendijk, Hendrika J., Kosters, Janouk, Janus, Sarah I.M., van den Bosch, Kirsten A., Andringa, Tjeerd C., Hoop, E. Oomen de, de Boer, Michiel R., Elburg, Ronald A.J., Warmelink, Steven, Zuidema, Sytse U., and Luijendijk, Hendrika J.

Abstract

Objectives: Auditory environments as perceived by an individual, also called soundscapes, are often suboptimal for nursing home residents. Poor soundscapes have been associated with neuropsychiatric symptoms (NPS). We evaluated the effect of the Mobile Soundscape Appraisal and Recording Technology sound awareness intervention (MoSART+) on NPS in nursing home residents with dementia. Design: A 15-month, stepped-wedge, cluster-randomized trial. Every 3 months, a nursing home switched from care as usual to the use of the intervention. Intervention: The 3-month MoSART+ intervention involved ambassador training, staff performing sound measurements with the MoSART application, meetings, and implementation of microinterventions. The goal was to raise awareness about soundscapes and their influence on residents. Setting and participants: We included 110 residents with dementia in 5 Dutch nursing homes. Exclusion criteria were palliative sedation and deafness. Methods: The primary outcome was NPS severity measured with the Neuropsychiatric Inventory–Nursing Home version (NPI-NH) by the resident's primary nurse. Secondary outcomes were quality of life (QUALIDEM), psychotropic drug use (ATC), staff workload (workload questionnaire), and staff job satisfaction (Maastricht Questionnaire of Job Satisfaction). Results: The mean age of the residents (n = 97) at enrollment was 86.5 ± 6.7 years, and 76 were female (76.8%). The mean NPI-NH score was 17.5 ± 17.3. One nursing home did not implement the intervention because of staff shortages. Intention-to-treat analysis showed a clinically relevant reduction in NPS between the study groups (−8.0, 95% CI –11.7, −2.6). There was no clear effect on quality of life [odds ratio (OR) 2.8, 95% CI –0.7, 6.3], psychotropic drug use (1.2, 95% CI 0.9, 1.7), staff workload (−0.3, 95% CI –0.3, 0.8), or staff job satisfaction (−0.2, 95% CI –1.2, 0.7). Conclusions and Implications: MoSART+ empowered staff to adapt the local soundscape, and the inte

Published
2023

37. Early recognition and treatment of neuropsychiatric symptoms to improve quality of life in early Alzheimer’s disease: protocol of the BEAT-IT study

Author

Eikelboom, Willem S., Singleton, Ellen, van den Berg, Esther, Coesmans, Michiel, Mattace Raso, Francesco, van Bruchem, Rozemarijn L., Goudzwaard, Jeannette A., de Jong, Frank Jan, Koopmanschap, Marc, den Heijer, Tom, Driesen, Jan J. M., Vroegindeweij, Lilian J. H. M., Thomeer, Elsbeth C., Hoogers, Susanne E., Dijkstra, Anke A., Zuidema, Sytse U., Pijnenburg, Yolande A. L., Scheltens, Philip, van Swieten, John C., Ossenkoppele, Rik, and Papma, Janne M.

Published
2019
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38. Feasibility, usability and clinical value of intensive longitudinal diary assessments in older persons with cognitive impairment and depressive symptoms.

Author

Zuidersma, Marij, Müller, Fabiola, Snippe, Evelien, Zuidema, Sytse U., and Oude Voshaar, Richard C.

Subjects
COGNITION disorders, PILOT projects, USER-centered system design, ACTIGRAPHY, DIARY (Literary form), SURVEYS, SLEEP, MENTAL depression, QUESTIONNAIRES, RESEARCH funding
Abstract

To evaluate the feasibility, usability and clinical value of daily diary assessments combined with actigraphy in older persons with cognitive impairment. For 63 days, patients ≥60 years with cognitive impairments filled out a daily diary (including standardized questionnaires and cognitive test battery), and wore an actiwatch (sleep). After the study, participants and clinicians received personal feedback about patterns and daily triggers of depressive symptoms, sleep and cognitive performance. We assessed feasibility (participation rate, compliance and subjective burden), usability (variability and floor- or ceiling effects) and clinical value for patients and their clinicians (questionnaires). Of 96 eligible patients, 13 agreed to participate (13.5%). One patient dropped out after 2 days, another after 37 days, and another did not complete the cognitive test battery. Compliance rate was high (6.7-10% missing values). Subjective burden was relatively low. Time-series data showed sufficient variability and no floor- or ceiling effects, except for one relevant ceiling effect on the One Back task. The personal feedback report was considered insightful by 4 out of 11 participants and 5 out of 7 clinicians. Daily assessments are suitable for a minority of cognitively impaired older persons, but is helpful to increase insight into their symptoms. [ABSTRACT FROM AUTHOR]

Published
2023
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46. Psychotropic drug treatment for agitated behaviour in dementia: what if the guideline prescribing recommendations are not sufficient? A qualitative study

Author

Dijk, Margaretha T, Tabak, Sarah, Hertogh, Cees M P M, Kok, Rob M., van Marum, Rob J, Zuidema, Sytse U, Sizoo, Eefje M, Smalbrugge, Martin, Elderly care medicine, APH - Aging & Later Life, APH - Quality of Care, and Life Course Epidemiology (LCE)

Subjects
Psychotropic Drugs, Aging, General Medicine, non-guideline treatment, decision making, older people, agitated behaviour in dementia, Physicians, qualitative, Quality of Life, focus group, Humans, Dementia, Practice Patterns, Physicians', Geriatrics and Gerontology, Aged
Abstract

Background Agitation is a common challenging behaviour in dementia with a negative influence on patient’s quality of life and a high caregiver burden. Treatment is often difficult. Current guidelines recommend restrictive use of psychotropic drug treatment, but guideline recommendations do not always suffice. Objective To explore how physicians decide on psychotropic drug treatment for agitated behaviour in dementia when the guideline prescribing recommendations are not sufficient. Methods We conducted five online focus groups with a total of 22 elderly care physicians, five geriatricians and four old-age psychiatrists, in The Netherlands. The focus groups were thematically analysed. Results We identified five main themes. Transcending these themes, in each of the focus groups physicians stated that there is ‘not one size that fits all’. The five themes reflect physicians’ considerations when deciding on psychotropic drug treatment outside the guideline prescribing recommendations for agitated behaviour in dementia: (1) ‘reanalysis of problem and cause’, (2) ‘hypothesis of underlying cause and treatment goal’, (3) ‘considerations regarding drug choice’, (4) ‘trial and error’ and (5) ‘last resort: sedation’. Conclusion When guideline prescribing recommendations do not suffice, physicians start with reanalysing potential underlying causes. They try to substantiate and justify medication choices as best as they can with a hypothesis of underlying causes or treatment goal, using other guidelines, and applying personalised psychotropic drug treatment.

Published
2022

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