The studies in this thesis aim to increase understanding of the effects of various characteristics of scientific news about a common chronic disease, i.e., diabetes, on the cognitive responses (e.g., emotions, attitudes, intentions) of diabetes patients. The research questions presented in this thesis are guided by the Health Belief Model, a theoretical framework developed to explain and predict healthrelated behaviours based on an individual’s beliefs and attitudes. The model asserts that perceived barriers to a recommended health behavior, advantages of the behavior, self-efficacy in executing the behavior, and disease severity and personal susceptibility to the disease are important predictors of a health behavior. Communication is one of the cues to action (i.e., stimuli) that may trigger the decision-making process relating to accepting a medical or lifestyle recommendation.
Comparisons of visual perception, response-selection, and response-execution performance were made between Type 2 diabetes mellitus patients and a matched nondiabetic control group. 10 well-controlled male patients with Type 2 diabetes without diabetic complications (M age 58 yr.) and an age and IQ-matched non-diabetic control group consisting of 13 male healthy volunteers (M age 57 yr.) were included. Significant differences were found only between the two groups on response-selection performance, which concerns the selection and preparation of an appropriate motor action.
From the publisher's site: "Trial design: Self-management plays a central role in diabetes management. However, not all patients are able to translate the health care providers’ recommendations for effective self-management in daily life. Diabetes Education and Self-management to Increase Empowerment (DESTINE) primarily investigates the effects of group education program Proactive Interdisciplinary Self-Management (PRISMA) in primary care treated people with Type 2 Diabetes Mellitus (T2DM) on the use of an online care platform. Methods: The DESTINE study has a randomized controlled design (1:1). 200 patients with T2DM using an online care platform called e-Vita will receive either PRISMA in addition to usual care or usual care only. The primary endpoint of this study is usage of the e-Vita platform. The secondary endpoints are participation in the consultation with the care provider, adherence to oral diabetes medications, and a selection of self-reported and clinical measures. After six months, both groups will receive PRISMA in a 6 month extension phase. Discussion: PRISMA focuses on aligning treatment goals from different health care providers while the individual patient remains in the lead. The goal is to shift patients from being an information receiver towards applying self-management and becoming empowered health care participants. Though recognized as important; theoretically based group education is still not routinely offered in the Netherlands. In the future, depending on the study results, e-Vita and PRISMA could be implemented in regular diabetes care. Trial registration: Current Controlled Trials NTR4693. (aut. ref.)"
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In Europe nearly 10% of the population suffers from diabetes and almost 1% from Rheumatoid Arthritis which can lead to serious problems with mobility and active participation, especially in the ageing population. Pedorthists deliver personalised designed and manufactured orthopaedic footwear or insoles for these patients. However, despite their often laborious efforts upfront, the industry has very little means to quantify how successful the fitting and function of a shoe is. They have to rely on subjective, qualitative measures such as client satisfaction and diminishing of complaints. Although valuable, the need for objective quantitative data in this field is growing. Foot plantar pressure and shear forces are considered major indicators of potential foot problems. Devices to measure plantar pressure slowly gain terrain as providers of objective quantitative data to guide orthotic design and manufacturing. For shear forces however, measuring devices are not yet commercial available. Although shear forces are considered as a major contributor to ulcer formation in diabetic feet, their exact role still requires elucidation and quantification. This project aims to develop a prototype of an in-shoe wearable device that measures both shear forces and pressure using state-of-the-art developments in sensor technologies, smart textiles and wireless data transfer. The collaboration of pedorthists’ small and medium-sized enterprises (SME)’s with medical device engineering companies, knowledge institutes,technical universities and universities of applied sciences in this project will bring together the different fields of expertise required to create an innovative device. It is expected that the tool will be beneficial to improve the quality of pedorthists’ services and potentially reduce health insurance costs. Furthermore, it can be used in new shear forces research and open new business potential. However, the eventual aim is to improve patient care and help maintain personal mobility and participation in society.
