In this thesis we aimed to investigate the burden of axial spondyloarthritis (axSpA) in an early phase. We have emphasized three main themes: (1) the value of a positive family history of SpA; (2)... Show moreIn this thesis we aimed to investigate the burden of axial spondyloarthritis (axSpA) in an early phase. We have emphasized three main themes: (1) the value of a positive family history of SpA; (2) the impact of axSpA on health outcomes in an early phase of axSpA; and (3) illness perceptions and coping strategies of patients with axSpA.We have shown that when broad HLA-B27 testing is not useful, the presence of a positive family history of axSpA or uveitis could be used to predict HLA-B27 positivity in patients suspected of axSpA. We have demonstrated that health-related quality of life work productivity, and daily activities are seriously impacted even in the earliest phase of the axSpA and remain substantial over time. We have further shown that illness perceptions are important in the relationship between back pain and health outcomes in patients with axSpA. Our results suggest that illness perceptions and coping strategies do not change spontaneously and are rather independent of a decrease in disease status in patients with early axSpA.The knowledge and insights of this thesis could help us in making a timely diagnosis, providing treatment sooner, and exploring additional treatment options, which in turn could hopefully reduce the burden of axSpA. Show less
By implementation of MRI-based staging, selective preoperative radiotherapy and surgical resection according to the TME-principle, the outcomes for patients with locally advanced rectal cancer have... Show moreBy implementation of MRI-based staging, selective preoperative radiotherapy and surgical resection according to the TME-principle, the outcomes for patients with locally advanced rectal cancer have improved considerably over the last decades. This has led to an increased focus on quality of life, functional outcomes and shared decision making. In this thesis, novel treatment options for patients with locally advanced rectal cancer are evaluated, including watch and wait for patients with a complete response after chemoradiotherapy as well as a total neoadjudant therapy (TNT) approach. Also quality of life and the importance patients assign to several outcome measures after ungoqing treatment for rectal cancer themselves are described. Show less
The current knowledge on ABI is focused on children and the physical and cognitive outcomes. Fatigue is one of the most reported symptoms after ABI. The current thesis focuses on the adolescent... Show moreThe current knowledge on ABI is focused on children and the physical and cognitive outcomes. Fatigue is one of the most reported symptoms after ABI. The current thesis focuses on the adolescent and young adult age group and the impact of ABI on fatigue, physical activity and participation. Show less
