The goal of this thesis is to gain additional knowledge on wishes of older persons on personalized healthcare and to explore possibilities to further implement personalized healthcare in general... Show moreThe goal of this thesis is to gain additional knowledge on wishes of older persons on personalized healthcare and to explore possibilities to further implement personalized healthcare in general practice. This thesis consists of two parts: in the first part the impact of health complaints on daily life as experienced by older persons is explored. Additionally, their expectations concerning GP services are mapped. Opportunities to improve care provided by general practices to community-dwelling older persons are described in the second part. The opinions of older persons provided valuable input for the studies.The ideas explored may contribute to further improvement of personalized healthcare in general practices for older persons living at home and can be used to set up larger studies to further explore these results. From the perspective of older persons, this would address the desire to be more involved in their own healthcare. This could lead to a better appreciation of older patients’ goals in clinical practice, while enhancing the motivation and feeling of responsibility of older patients for their own health complaints (e.g. experiencing a sense of control). GPs and other health professionals can benefit from being better informed of their older patients’ health situation. Show less
Ploeg, M.A. van der; Poortvliet, R.K.E.; Blijswijk, S.C.E. van; Elzen, W.P.J. den; Peet, P.G. van; Ruijter, W. de; ... ; Gussekloo, J. 2021
Background: Providing older persons with information about their health status may increase their involvement in their own health and enhance self-management. However, we need a better... Show moreBackground: Providing older persons with information about their health status may increase their involvement in their own health and enhance self-management. However, we need a better understanding of how older persons view their personal results after completing a screening questionnaire on complex health, of their (lack of) motivation and their subsequent action.Methods: In this qualitative study community-dwelling older persons (>= 80 years,n = 13) who completed a screening questionnaire on complex health problems were interviewed regarding their perception of the results, the actions they considered taking and their personal motivations. Data were analysed thematically (qualitative content analyses).Results: Participants expressed interest in feedback, as an objective questionnaire might substantiate their own views regarding their personal health. They were mostly unsurprised by the results and/or had already taken precautions and were therefore not inclined to undertake additional action. They admitted difficulty with and appreciated advice from a professional regarding preparation of an action plan. Unexpected negative results would lead them to discuss matters with family and/or their general practitioner, provided they had a good relationship with their GP.Conclusion: Older people were interested in direct feedback regarding their screening questionnaire results and in subsequent advice on possible additional measures. General practices could consider inviting older persons to complete a screening questionnaire and discuss activities and personal goals. This information could serve to better shape future interventions aimed at increasing self-management amongst older persons. Show less
BACKGROUND AND OBJECTIVE Cutaneous warts are common in primary schoolchildren; however, knowledge on the routes of transmission of human papillomavirus (HPV) causing warts is scarce. This study... Show moreBACKGROUND AND OBJECTIVE Cutaneous warts are common in primary schoolchildren; however, knowledge on the routes of transmission of human papillomavirus (HPV) causing warts is scarce. This study examines the association between the degree of HPV exposure and incidence of warts in primary schoolchildren to support evidence-based recommendations on wart prevention. METHODS In this prospective cohort study, the hands and feet of all children in grades 1 to 7 (aged 4-12 years) of 3 Dutch primary schools were inspected for the presence of warts at baseline and after 11 to 18 months of follow-up. Data on the degree of HPV exposure included information obtained from parental questionnaires: preexistent warts, warts in family, prevalence of warts at baseline in the class, and use of public places (eg, swimming pools). RESULTS Of the 1134 eligible children, 97% participated; the response rate from parental questionnaires was 77%, and loss to follow-up was 9%. The incidence for developing warts was 29 per 100 person-years at risk (95% confidence interval [CI] 26-32). Children with a white skin type had an increased risk of developing warts (hazard ratio [HR] 2.3, 95% CI 1.3-3.9). Having family members with warts (HR 2.08, 95% CI 1.52-2.86) and wart prevalence in the class (HR 1.20 per 10% increase, 95% CI 1.03-1.41) were independent environmental risk factors. CONCLUSIONS The degree of HPV exposure in the family and school class contributes to the development of warts in schoolchildren. Preventive recommendations should focus more on limiting HPV transmission in families and school classes, rather than in public places. Show less
