Community-Dwelling and Recently Widowed Older Adults: Effects of Spousal Loss on Psychological Well-Being, Perceived Quality of Life, and Health-Care Costs.

This study is on the effects of spousal loss among older adults who continue to live independently after bereavement. Little longitudinal studies focus on this group, which is of special interest, since in many countries, care policy and system reform are aimed at increasing independent living among older adults. Using longitudinal data from a Dutch public data repository, we investigate the effects of spousal loss on psychological well-being, perceived quality of life, and (indication of) yearly health-care costs. Of the respondents who had a spouse and were living independently (N = 9,400) at baseline, the majority had not lost their spouse after 12 months (T12, n = 9,150), but 2.7% (n = 250) had lost their spouse and still lived independently. We compared both groups using multivariate regression (ordinary least squares) analyses. The results show that spousal loss significantly lowers scores on psychological well-being and perceived quality of life, but we found no effect on health-care costs.

[Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review]. / Stigmatisering van patiënten met een verslaving en de gevolgen voor de hulpverlening: een systematisch literatuuronderzoek.

BACKGROUND: Healthcare professionals are crucial in the identification and accessibility to treatment for people with substance use disorders. AIM: Objective of this literature review is to assess health professionals' attitudes towards patients with substance use disorders and to examine the consequences of these attitudes on healthcare delivery for these patients. METHOD: PubMed, Psycinfo and Embase were systematically searched for articles published between 2000-2011. Reviews, commentaries and letters were excluded, as were studies originating from non-Western countries. The search process yielded 1562 citations. After selection and quality assessment 28 studies were included. RESULTS: Health professionals generally have negative attitudes towards patients with substance use disorders. They perceive violence, manipulation, and poor motivation as impeding factors in the healthcare delivery for these patients. Health professionals also lack adequate education, training and support structures in working with this patient group. Negative attitudes of health professionals diminish patients' feelings of empowerment and subsequently treatment outcomes. Health professionals have a more task-oriented approach (e.g. less personal engagement and diminished empathy) in the delivery of healthcare for these patients. CONCLUSION: This review indicates that negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients. However, few studies have evaluated the consequences of health professionals' negative attitudes towards patients with substance use disorders.

The BeweegKuur programme: a qualitative study of promoting and impeding factors for successful implementation of a primary health care lifestyle intervention for overweight and obese people.

BACKGROUND: The aim of the study was to identify promoting and impeding factors for successful implementation of a Dutch primary health care-based lifestyle programme called 'BeweegKuur'. BeweegKuur aims to increase the physical activity and change the diet of people at increased health risk due to overweight or obesity. OBJECTIVE: To determine perceived promoting and impeding factors in the implementation of the BeweegKuur programme for overweight and obese people. METHODS: This study consisted of 3 focus group meetings with intervention participants, 15 interviews with health care professionals (HCPs) and 1 focus group session with dieticians. The interviews and focus groups were recorded and transcribed verbatim. The data were analysed with the Nvivo qualitative research software package. RESULTS: For some intervention participants, the invitation to participate in BeweegKuur came unexpectedly, as they had not been diagnosed with an illness. HCPs were aware of this and took time to explain to participants that the programme was appropriate and safe for them. Participants as well as professionals were generally positive about the feasibility of the programme for overweight and obese people. CONCLUSIONS: HCPs as well as intervention participants were motivated to participate in the programme, and generally indicated that the intervention was in accordance with their needs. The multidisciplinary approach and the combination of physical activity and dietary behaviour change can make the BeweegKuur programme a success if potential impeding factors like those identified in the present study are overcome.