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Amsterdam-Zuidoost, Netherlands

Vonk Noordegraaf A.,EMGO Institute for Health and Care Research | Huirne J.A.F.,EMGO Institute for Health and Care Research | Brolmann H.A.M.,EMGO Institute for Health and Care Research | Van Mechelen W.,EMGO Institute for Health and Care Research | And 3 more authors.
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2011

Objective: To generate structured detailed uniform convalescence recommendations after gynaecological surgery by a modified Delphi method amongst experts and a representative group of physicians. Design: Modified Delphi study. Setting: Expert physicians recruited by their respective medical boards and employed at different hospitals, doctor's surgeries and healthcare services. Population: Twelve experts (five gynaecologists, two general practitioners [GPs] and five occupational physicians [OPs]) and a representative sample of 63 medical doctors. Methods: Multidisciplinary detailed recommendations for graded resumption of relevant activities after uncomplicated hysterectomy (laparoscopic supracervical, total laparoscopic/laparoscopic-assisted, vaginal and abdominal hysterectomies) and laparoscopic adnexal surgery were developed. Recommendations were based on a literature review and a modified Delphi procedure among 12 experts, recruited in collaboration with the participating medical boards of gynaecologists, GPs and OPs. Main outcome measures: A multidisciplinary consensus of at least 67% on the relevant detailed convalescence recommendations in relation to hysterectomy and laparoscopic adnexal surgery. Results: Out of initially 65 activities, the expert panel judged 38 activities relevant for convalescence recommendations. Consensus for all activities was achieved after four Delphi rounds and two group discussions. The recommendations were judged as feasible by a representative sample of 26 gynaecologists, 19 GPs and 18 OPs. Conclusions: Consensus between gynaecologists, GPs and OPs was achieved on all relevant convalescence recommendations regarding hysterectomy (abdominal, vaginal and laparoscopic) and laparoscopic adnexal surgery. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology.


Achterberg T.J.,University of Amsterdam | Wind H.,University of Amsterdam | Wind H.,Research Center for Insurance Medicine | Frings-Dresen M.H.W.,University of Amsterdam
Disability and Rehabilitation | Year: 2012

Purpose: To define the most important factors for the work participation of the young disabled according to experts. Method: A Delphi study was conducted with internet questionnaires. Health-related, personal and environmental factors known from literature were presented to insurance physicians and labour experts. The experts assessed whether a factor was important for the work participation of the young disabled. New factors added by the experts in the first round were assessed in the second round. Factors assessed as important by at least 80% of the experts were input for the last round, in which the experts chose the ten most important factors. Results: Participation included 156 experts in the first round and 91 experts in the last round. They selected 44 of 92 factors as important. Severity of limitations, type of limitations and motivation were placed by more than 55% of the experts on their top-ten list to be assessed in a plan to help the young disabled participate in work. Conclusion: Severity and type of limitations and motivation are considered to be the most important factors for the work participation of the young disabled and should be included in a participation plan. Implications for Rehabilitation As young disabled experience barriers when entering the labour market, knowledge of influencing factors is necessary to help them successfully participate in work. According to experts the disease-related severity and type of limitations and the personal factor motivation are the most important factors to know to help these young disabled to participate in work. © 2012 Informa UK, Ltd.


Vlasveld M.C.,Netherlands Institute of Mental Health and Addiction | Vlasveld M.C.,VU University Amsterdam | Van Der Feltz-Cornelis C.M.,Netherlands Institute of Mental Health and Addiction | Van Der Feltz-Cornelis C.M.,University of Tilburg | And 8 more authors.
Journal of Occupational Rehabilitation | Year: 2012

Introduction: Long-term sickness absence is a major public health and economic problem. Evidence is lacking for factors that are associated with return to work (RTW) in sick-listed workers. The aim of this study is to examine factors associated with the duration until full RTW in workers sick-listed due to any cause for at least 4 weeks. Methods: In this cohort study, health-related, personal and job-related factors were measured at entry into the study. Workers were followed until 1 year after the start of sickness absence to determine the duration until full RTW. Cox proportional hazards regression analyses were used to calculate hazard ratios (HR). Results: Data were collected from N = 730 workers. During the first year after the start of sickness absence, 71% of the workers had full RTW, 9.1% was censored because they resigned, and 19.9% did not have full RTW. High physical job demands (HR.562, CI.348-.908), contact with medical specialists (HR.691, CI.560-.854), high physical symptoms (HR.744, CI.583-.950), moderate to severe depressive symptoms (HR.748, CI.569-.984) and older age (HR.776, CI.628-.958) were associated with a longer duration until RTW in sick-listed workers. Conclusions: Sick-listed workers with older age, moderate to severe depressive symptoms, high physical symptoms, high physical job demands and contact with medical specialists are at increased risk for a longer duration of sickness absence. OPs need to be aware of these factors to identify workers who will most likely benefit from an early intervention. © The Author(s) 2011.


Vlasveld M.C.,Netherlands Institute of Mental Health and Addiction | Vlasveld M.C.,VU University Amsterdam | Van Der Feltz-Cornelis C.M.,Netherlands Institute of Mental Health and Addiction | Van Der Feltz-Cornelis C.M.,University of Tilburg | And 8 more authors.
British Journal of Psychiatry | Year: 2012

Randomised controlled trial to evaluate the effectiveness of collaborative care in a Dutch occupational healthcare setting: 126 workers on sick leave with major depressive disorder were randomised to usual care (n = 61) or collaborative care (n = 65). After 3 months, collaborative care was more effective on the primary outcome measure of treatment response (i.e. reduction in symptoms of ≥50%) on the Patient Health Questionnaire-9 (PHQ-9). However, the groups did not differ on the PHQ-9 as a continuous outcome measure. Implications of these results are discussed.


Cornelius B.L.R.,Research Center for Insurance Medicine | Cornelius B.L.R.,University of Groningen | Cornelius B.L.R.,Social Security Institute | Groothoff J.W.,University of Groningen | And 4 more authors.
BMC Public Health | Year: 2013

Background: Screening for mental disorders among disability claimants is important, since mental disorders seem to be seriously under-recognized in this population. However, performance of potentially suitable scales is unknown. We aimed to evaluate the psychometric properties of three scales, the 10- and 6-item Kessler Psychological Distress Scale (K10, K6) and the 12-item General Health Questionnaire (GHQ-12), to predict present state mental disorders, classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4 §ssup§ th §esup§ Edition (DSM-IV) among disability claimants. Methods. All scales were completed by a representative sample of persons claiming disability benefit after two years sickness absence (n=293). All diagnoses, both somatic and mental, were included. The gold standard was the Composite International Diagnostic Interview (CIDI 3.0) to diagnose present state DSM-IV disorder. Cronbach's α, sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and the areas under the Receiver Operating Characteristic curve (AUC) were calculated. Results: Cronbach's alpha's were 0.919 (K10), 0.882 (K6) and 0.906 (GHQ-12). The optimal cut-off scores were 24 (K10), 14 (K6) and 20 (GHQ-12). The PPV and the NPV for the optimal cut point of the K10 was 0.53 and 0.89, for the K6 0.51 and 0.87, and for the GHQ-12 0.50 and 0.82. The AUC's for 30-day cases were 0.806 (K10; 95% CI 0.749-0.862), 0.796 (K6; 95% CI 0.737-0.854) and 0.695 (GHQ-12; 95% CI 0.626-0.765). Conclusions: The K10 and K6 are reliable and valid scales to screen for present state DSM-IV mental disorder. The optimal cut-off scores are 24 (K10) and 14 (K6). The GHQ-12 (optimal cut-off score: 20) is outperformed by the K10 and K6, which are to be preferred above the GHQ-12. The scores on separate items of the K10 and K6 can be used in disability assessment settings as an agenda for an in-depth follow-up clinical interview to ascertain the presence of present state mental disorder. © 2013 Cornelius et al.; licensee BioMed Central Ltd.

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