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Papers by Anneke van WErsch

Journal of Bodywork and Movement Therapies, 2017

The European health psychologist, Dec 31, 2016

Background: In a randomised controlled trial, patients admitted to hospital with an exacerbation ... more Background: In a randomised controlled trial, patients admitted to hospital with an exacerbation of COPD were risk-assessed with the DECAF prognostic tool, and low-risk patients assigned to Hospital at Home (HAH) or usual hospital care (UHC). HAH treats patients in their own home by hospital staff, and may improve clinical care and reduce costs, provided it is acceptable to those involved. Method: We aimed to explore patients’ and carers’ experiences of HAH and UHC through semi-structured interviews. Thirty patients were interviewed (15 HAH and 15 UHC) and 14 carers. Thematic analysis was performed as set out by Braun and Clark (2006). Findings: Six themes (including subthemes) are presented. HAH improves patients’ overall well-being (and shortens recovery, provides freedom and improves sleep). HAH facilitates positive relationships between patients and nurses (with respect to personalised relationships and patient/carer information and education). HAH is more convenient for patients (and for visitors and reduces visitors’ costs). Discharge from HAH differs from UHC, manifest by challenges in appropriately discontinuing treatment. HAH is safe. There is a lack of carer-burden with HAH. Discussion: Patients experienced HAH as safe and beneficial to their overall well-being. Counterintuitively, carers of HAH patients did not report an increase in carer-burden and prefer not to relinquish their carer role (though some objected to the term “carer”). Of 44 participants interviewed, 41 stated a preference for HAH. Following the national recommendation that the DECAF score be used in all UK hospitals, these results support the national implementation of our HAH model.

CRC Press eBooks, Jul 21, 2023

Bulletin Du Cancer, Jun 1, 2016

Cette étude préliminaire explore l'impact psychologique et conjugal d'une reconstruction mammaire... more Cette étude préliminaire explore l'impact psychologique et conjugal d'une reconstruction mammaire (ou de son absence) chez des femmes ayant eu une mastectomie suite à un cancer du sein. L'étude a été réalisée grâce à un outil de recherche communautaire innovant et français sur le cancer : les Seintinelles. Soixante-neuf femmes traitées pour un cancer du sein et en couple ont participé, réparties en 3 groupes : 19 sans reconstruction mammaire, 24 avec reconstruction mammaire immédiate et 26 avec reconstruction mammaire différée. Elles ont complété des questionnaires en ligne mesurant la satisfaction et les regrets concernant la décision liée à la reconstruction mammaire, la qualité de vie suite à la chirurgie mammaire (EORTC-BRR), l'état émotionnel (POMS) et l'intimité conjugale (PAIR). Le recrutement par l'intermédiaire des Seintinelles a eu l'avantage d'avoir été rapide et national, mais le profil des participantes semble particulier puisque nos sujets étaient plus jeunes que les femmes touchées par un cancer du sein et avaient davantage été confrontées à un cancer du sein dans leur famille. Les résultats montrent que les femmes sont satisfaites de leur choix (peu de regrets), ont un vécu émotionnel comparable et de bonnes relations conjugales. Cependant, les femmes sans reconstruction mammaire recommanderaient moins leur décision et étaient moins satisfaites du résultat esthétique, comparé aux femmes avec reconstruction. Ces résultats soulignent que l'impact psychologique et conjugal semble comparable chez les femmes avec et sans reconstruction. De futures études sont nécessaires pour mieux comprendre la place du conjoint dans le recours à une reconstruction mammaire.

Quality in health care, Mar 1, 2001

Background-Consumer involvement in clinical guidelines has long been advocated although there are... more Background-Consumer involvement in clinical guidelines has long been advocated although there are few empirical accounts of attempts to do so. It is therefore not surprising that there is a lack of clarity about how and when to involve consumers and what to expect from them within the process of guideline development. Methods-The North of England evidence based guideline development programme has used four diVerent methods of consumer involvement. Results-When individual patients were included in a guideline development group they contributed infrequently and had problems with the use of technical language. Although they contributed most in discussions of patient education, their contributions were not subsequently acted on. In a "one oV" meeting with a group of patients there were again reported problems with medical terminology and the group were most interested in sections on patient education and self management. However, their understanding of the use of scientific evidence in order to contribute to a more cost eVective health care remained unclear. In a workshop it was possible to explain the technical elements of guideline development to patients who could then engage with such a process and make relevant suggestions as a consequence. However, this was relatively resource intensive. A patient advocate within a guideline development group felt confidence to speak, was used to having discussions with health professionals, and was familiar with the medical terminology. Conclusions-Consumers should be involved in all stages of guideline development. While this is possible, it is not straightforward. There is no one right way to accomplish this and there is a clear need for further work on how best to achieve it.

Even though years of research on the male contraceptive pill have been conducted, a marketable pr... more Even though years of research on the male contraceptive pill have been conducted, a marketable product is still absent from the arsenal of male and female products of contraception. In this paper, the following psychosocial and cultural factors have been elicited from the literature in order to reveal explanations for this delay: acceptability, trust, fear of side-effects, perceptions of contraceptive responsibility and fear of losing connotations of masculinity. Regardless of cultural variation, overall there seems to be a positive attitude towards the acceptability of male contraceptive for both males and females, especially males in stable relationships. Some indication shows that the media have played an important role in distorting the results of research regarding male and female trust. Ongoing and future researches into several projects on psychosocial and cultural factors are described. Keywords Acceptability • Attitudes • Contraceptive responsibility • Male pill • Masculinity • Psychosocial factors psychosociale globale qui distingue les hommes les uns des autres dans la compréhension de la contraception hormonale masculine.

Neuro-oncology, Sep 1, 2010

OBJECTIVE: Multidrug resistance (MDR) remains a major obstacle to successful chemotherapeutic tre... more OBJECTIVE: Multidrug resistance (MDR) remains a major obstacle to successful chemotherapeutic treatment of cancer and can be caused by overexpression of P-glycoprotein, the MDR1 gene product. P-glycoprotein (P-gp) recognizes several chemotherapeutic agents as a substrate and prevents their accumulation. Among them, both technetium-99-sestamibi and technetioum-99-tetrofosmin (99m Tc-TF) are single photon emission computed tomography tracers. 99m Tc-MIBI uptake has been proven in vitro and in vivo to inversely correlate with P-gp levels of tumors. In vitro studies have shown that 99m Tc-TF is influenced in a lesser degree from the P-gp expression, thus may be superior to 99m Tc-MIBI for brain tumor imaging. In the present study, we evaluated in vivo whether 99m Tc-TF uptake correlates with P-gp levels in gliomas. MATERIALS AND METHODS: Eighteen patients (10 males, 8 females, mean age 57.3 years) with histologically confirmed glioma were included in the study. There were 13 glioblastoma multiforme cases, 2 anaplastic astrocytomas, 2 anaplastic oligodendrogliomas, and 1 low grade astrocytoma. Brain SPECT by 99m Tc-TF was performed within a week prior to surgical excision and the expression of P-gp was assessed by immunohistochemistry. Radiotracer accumulation was assessed by a semiquantitative method of image analysis, calculating the lesion-to-normal (L/N) uptake ratio. RESULTS: The tracer uptake ranged from faint to profound (mean L/ N ¼ 8.2, range 1.8-20). The P-gp expression ranged from 0% to 45%. Using Spearman's rho analysis we found no correlation between tracer uptake (L/ N) and P-gp expression (P ¼ .21, r ¼ .538). CONCLUSION: The present data suggest that 99m Tc-TF uptake is not influenced by P-gp expression in gliomas. Thus, 99m Tc-TF constitute a suitable radiotracer for gliomas imaging.

Introduction Complementary medicine in context Beliefs and explanations: Experimental and non-exp... more Introduction Complementary medicine in context Beliefs and explanations: Experimental and non-experimental psychology Research and research methods in complementary and alternative medicine Stress, appraisal, coping, moderators and stress management Managing chronic illness Conclusion

The European health psychologist, Dec 31, 2017

Background: Hereditary Angioedema (HAE) is caused by a deficiency in the C1 inhibitor triggering ... more Background: Hereditary Angioedema (HAE) is caused by a deficiency in the C1 inhibitor triggering episodes of edema. These attacks are life threatening due to inflammation of the larynx. HAE effects up to 1 in 100,000 so little is known about the psychological impact. The study was designed to investigate how living with HAE impacts on the patient’s mental health. Methods: Patients will be over 18 with a diagnosis of HAE and living in the UK, they will be recruited through HAE UK by an online survey. A mixed measures design will be used, incorporating the generalised anxiety disorder assessment (GAD-7) and the Depression Scale (CES-D10). Participants will be invited to share an account of any information they perceive as relevant; a thematic analysis will analyse the accounts. Thirty participants are anticipated; of these 5 with the poorest mental and 5 who have coped the best will be invited for interview, which will be analysed through descriptive phenomenology. Expected results: The questionnaire results are expected to reveal that 40% of the participants are experiencing depression and high levels of anxiety due to attacks, especially of the larynx. Those HAE patients who are able to control attacks may report low levels. The interviews might reveal that patients who experience numerous and severe attacks will report poorer mental health than those who can control their attacks. Current stage of work: awaiting ethics approval Discussion: There might be a link between patients with HAE and mental health which needs further examination.

International journal of gynecological and obstetrical research, Feb 15, 2015

Objective : The clinical radical treatment of gynecological cancer has been characterised as defe... more Objective : The clinical radical treatment of gynecological cancer has been characterised as defeminising women, with ignoring impacts on sexual functioning in intimate relationships. This research examined the psychological factors regarding this disease and its treatment for women and their sexuality across four main cancer types two years after recovering from gynecological cancer. Methods : Seventy-five cancer patients with a mean age at diagnosis of 51 (SD=15.3) gave their consent. Of these, eighteen participants (24%) had experienced endometrial, 25(33%) ovarian, 11(15%) vulva and 21(28%) cervical cancer. Sexual and relationship satisfaction were assessed with Golombok Rust Inventory of Sexual Satisfaction (GRISS) and the Relationship Assessment Scale (RAS). Results : Of the 53 women in intimate relationships who completed full datasets, only 4 (8%) returned to normal sexual activity and were sexually satisfied, 49 (92%) were not. Nonetheless, 50 (86%) of participants reported their relationship as satisfactory. The cancer effecting sexual activity the most was endometrial, which effects have been reported as anorgasmia and vaginismus, however all groups were dissatisfied with the lack of frequency of sexual activity. Although cancer needs urgent treatment with the most desirable outcome in terms of physical heath, more emphasis is needed on caring for women’s sexuality in the recovering process.

The European health psychologist, 2017

Background: In a RCT patients admitted with an acute exacerbation of their COPD were randomised t... more Background: In a RCT patients admitted with an acute exacerbation of their COPD were randomised to receive Hospital at Home (HAH) or usual care (UC) identified at low risk of death by the DECAF score. DECAF allows for the inclusion of more patients than previous trials (of importance, 45-53% of hospitalised patients). In this trial we sought to identify positive drivers and potential barriers of HAH care pathway. Methods: 89 semi-structured interviews with: patients, those who declined participation, carers, clinicians, nurses and managers who were purposely selected to ensure diversity. Thematic-Construct Analysis was employed. Findings: ‘Positive drivers’ were divided into two sub-constructs ‘Availability of home comforts and maintaining independence’ and ‘Confidence in the continuity of care’. ‘Potential Barriers’ were grouped into two sub-constructs ‘Personal preferences’ and ‘Resistance to change’. Nurses cited increased workload and responsibility (with experience, viewed posi...