The aim of this dissertation was to investigate whether and how E-health can help to improve health care for individuals with eating disorder symptoms. The main goal was to evaluate two E-health... Show moreThe aim of this dissertation was to investigate whether and how E-health can help to improve health care for individuals with eating disorder symptoms. The main goal was to evaluate two E-health interventions: e-community ‘Proud2Bme’ and fully automated Internet-based intervention ‘Featback’. The effectiveness and cost-effectiveness of Featback with and without therapist support in comparison to a waiting was examined in a randomized controlled trial. Furthermore, potential moderators and mediators were investigated: what works for whom and what is the psychological mechanism that explains how Featback achieves its beneficial effects? Also, all online therapist communication within the Featback intervention was qualitatively examined. What did therapists actually do within the online support sessions as offered in addition to Featback? And can therapist behaviors predict participants’ outcome and satisfaction? Finally, this dissertation includes a systematic review of treating eating disorders over the Internet, as well a chapter about the emerging findings, issues, and opportunities regarding E-health for eating disorders in the past few years (2013-2015). How effective are Internet-based self-help interventions, -treatment, and -relapse prevention programs? What is the potential of Smartphone applications in treating eating disorders? What are the opportunities and challenges for the development and implementation of E-health for eating disorders? Show less
Asthma is a common non-communicable respiratory disease. In this thesis we analysed three different management strategies for adult patients with asthma in primary care. In the first, we targeted... Show moreAsthma is a common non-communicable respiratory disease. In this thesis we analysed three different management strategies for adult patients with asthma in primary care. In the first, we targeted the currently recommended aim of __Controlled asthma__, which means patients experience hardly any symptoms. The second targeted __Partly Controlled asthma__, which allowed some symptoms. The third additionally used a FeNO-measurement to assess current control. Aiming for Partly Controlled asthma significantly reduced medication usage compared to Controlled asthma, while exacerbation-rate, quality of life and asthma control were similar. FeNO-guided Controlled asthma also significantly reduced medication usage compared to Controlled asthma and additionally significantly improved asthma control compared to Partly Controlled asthma. Aiming for FeNO-guided Controlled asthma is therefore the optimal strategy. In this thesis we also analysed daily measurements of symptoms and peak-flow, which are recorded in Written Asthma Action Plans, or in apps. Hereby we were able to predict future asthma exacerbations several days in advance with reasonable accuracy. Finally, we compared an online assessment of asthma control by a questionnaire with the results of the same questionnaire assessed by a practice nurse. We showed that asthma control is perceived as better when interacting with a caregiver than by online self-assessment. Show less
