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Jong, Miek C.
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Jong, M. C., Boers, I., van Wietmarschen, H., Busch, M., Naafs, M. C., Kaspers, G. J. L. & Tissing, W. J. E. (2019). Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer. Supportive Care in Cancer
Open this publication in new window or tab >>Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer
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2019 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: To develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use ofcomplementary and alternative medicine (CAM) for cancer care.

Methods: This study had a mixed research design. The needs of parents were investigated by survey and focus group. Asystematic review and meta-analysis were performed on the effectiveness of CAM using Grading of RecommendationsAssessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatmentfor pain was developed.

Results: Parents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broadspectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Metaanalysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared withstandard care (MD, − 1.37; 95% CI, − 1.60, − 1.15; P < 0.00001) and attention control (MD, − 1.13; 95% CI, − 1.34, − 0.94;P < 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, − 0.77; 95% CI, − 1.82, 0.28;P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a websitebased decision aid.

Conclusions: An evidence-based decision aid was developed to support parents of children with cancer in making decisions aboutCAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaintsand to evaluate its use in practice

Keywords
Pediatric oncology, Systematic review, Meta-analysis, Hypnotherapy, Procedural pain, Decision-making
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-37139 (URN)10.1007/s00520-019-05058-8 (DOI)
Note

This article is distributed under the terms of the CreativeCommons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)

Available from: 2019-09-09 Created: 2019-09-09 Last updated: 2019-09-09Bibliographically approved
Jong, M. C., Boers, I., van Wietmarschen, H. A., Tromp, E., Busari, J. O., Wennekes, R., . . . Vlieger, A. M. (2019). Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study. European Journal of Pediatrics, 178(2), 147-154
Open this publication in new window or tab >>Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study
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2019 (English)In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 178, no 2, p. 147-154Article in journal (Refereed) Published
Abstract [en]

Many children suffer from headaches. Since stress may trigger headaches, effective techniques to cope with stress are needed. We investigated the effectiveness of two mind-body techniques, transcendental meditation (TM) or hypnotherapy (HT), and compared them with progressive muscle relaxation (PMR) exercises (active control group). Children (9–18 years) suffering from primary headaches more than two times per month received either TM (N = 42), HT (N = 45) or PMR (N = 44) for 3 months. Primary outcomes were frequency of headaches and ≥ 50% reduction in headaches at 3 and 9 months. Secondary outcomes were adequate relief, pain coping, anxiety and depressive symptoms, somatisation and safety of treatment. Groups were comparable at baseline. Headache frequency was significantly reduced in all groups from 18.9 days per month to 12.5 and 10.5 at respectively 3 and 9 months (p < 0.001), with no significant differences between the groups. Clinically relevant headache reduction (≥ 50%) was observed in 41% and 47% of children at 3 and 9 months respectively, with no significant differences between the groups. No differences were observed in secondary outcome measures between the intervention groups. No adverse events were reported. Conclusion: All three techniques reduced primary headache in children and appeared to be safe. Trial registration: NTR 2955, 28 June 2011 (www.trialregister.nl)

What is Known:

• Stress may be an important trigger for both tension type headache and migraine in children.

• Good data are lacking on the effect of transcendental meditation, hypnotherapy or progressive muscle relaxation as possible stress-reducing therapies in children with primary headaches.

What is New:

• Three non-pharmacological techniques, i.e., transcendental meditation, hypnotherapy and progressive muscle relaxation exercises, all result in a clinically significant reduction of headaches and use of pain medication.

• No large differences between the three techniques were found, suggesting that children can choose either one of the three techniques based on personal preferences. 

Keywords
Children, Headache, Hypnotherapy, Meditation, Pain, Relaxation
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-35088 (URN)10.1007/s00431-018-3270-3 (DOI)000456203500004 ()30357468 (PubMedID)
Note

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)

Available from: 2018-12-07 Created: 2018-12-07 Last updated: 2019-02-15Bibliographically approved
Jong, M. C., Busch, M. & Baars, E. W. (2019). Integrative medicine in Dutch curative and long-term healthcare centres: Mapping the field. European Journal of Integrative Medicine, 28, 14-19
Open this publication in new window or tab >>Integrative medicine in Dutch curative and long-term healthcare centres: Mapping the field
2019 (English)In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 28, p. 14-19Article in journal (Refereed) Published
Abstract [en]

Introduction: Little is known about integration of Complementary and Alternative Medicine (CAM) in the Dutch healthcare system. The aim of the present study was to investigate how Integrative Medicine (IM) is practiced and how CAM is integrated with conventional medicine in curative and long-term healthcare centres in the Netherlands.

Methods: A mixed methodology was applied, including a systematic internet search, an online survey and focus groups among healthcare professionals. Results: Most hospitals (92%) offered some form of CAM to treat anxiety (72%), restlessness (68%), pain (65%), sleeping problems (50%), stress (48%) and fatigue (36%). Mostly offered modalities were relaxation exercises (88%), art therapy (44%) and mindfulness (42%). Similar percentages of CAM use were found in other healthcare centres. Most CAM modalities were implemented without organizational vision, guidelines or protocols. Only 5% of implemented CAM was labelled as IM. Focus groups with health care professionals revealed the need to increase knowledge and to develop a vision for integration of CAM with conventional medicine, as well as to support effectiveness research in this area.

Conclusions: This study is the first in the Netherlands to quantitatively map the extent of CAM integration in conventional health care. The number of CAM interventions offered at conventional health care settings was surprisingly high. However, integration was fragmented. Guidelines, education and research programs are needed to further integration of CAM, preferably organised in a Dutch Consortium for IM.

National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-36657 (URN)10.1016/j.eujim.2019.04.003 (DOI)
Available from: 2019-07-08 Created: 2019-07-08 Last updated: 2019-07-08Bibliographically approved
Jong, M., Kristiansen, L., Jong, M. C. & Falkenberg, T. (2019). Integrative Nursing in Sweden (2ed.). In: Mary Koithan; Mary Jo Kreitzer (Ed.), Integrative Nursing: (pp. 652-662). New York: Oxford University Press
Open this publication in new window or tab >>Integrative Nursing in Sweden
2019 (English)In: Integrative Nursing / [ed] Mary Koithan; Mary Jo Kreitzer, New York: Oxford University Press, 2019, 2, p. 652-662Chapter in book (Refereed)
Abstract [en]

This chapter describes the existing “core” of caring/nursing in the Nordic tradition and how that can be merged with the concepts of integrative nursing to form a vision and strategy for the future. Terms such as integrative nursing are unfamiliar among nurses in Sweden, but the concepts of holistic care and healing have been taught for a long time and are well integrated in education and legislation. This chapter discusses possible barriers, such as the level of decision-making in Swedish healthcare as well as the role and attitude towards legislation in the light of the dominant biomedical paradigm. Further discussion explores how integrative nursing may serve as a bridge between the caring, nursing, and biomedical perspectives in its effort to identify and construct evidence from the basis and understanding of complex interventions and complex systems science. Practical steps for progression are identified and suggested.

Place, publisher, year, edition, pages
New York: Oxford University Press, 2019 Edition: 2
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-35882 (URN)978-0-19-085104-0 (ISBN)
Available from: 2019-03-27 Created: 2019-03-27 Last updated: 2019-08-20Bibliographically approved
Jong, M. C., Lown, A., Schats, W., Otto, H. R. & Jong, M. (2019). Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review. BMJ Open, 9(8)
Open this publication in new window or tab >>Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 8Article in journal (Refereed) Published
Abstract [en]

Introduction: Long-term childhood cancer survivors are at risk for frailty and have significant health-related issues in adulthood. Various health promotion interventions have been proposed to enhance quality of life including wilderness therapy, which applies the impact of nature on health in a therapeutic context. Previous studies have described positive outcomes linked with various wilderness-related therapies for cancer survivors. However, there is no clarity on the role these therapies play in childhood cancer. The current scoping review aims to systematically map the concept, content and outcome of wilderness therapy for childhood cancer survivors.

Methods and analysis: This review will be guided by the Joanna Briggs Institute Reviewers’ manual for scoping reviews. A systematic literature search using medical subject headings (MeSH) and text words related to wilderness therapy and childhood cancer survivors will be performed in EMBASE, ERIC, Medline, Psycinfo, CINAHL, Scopus, Web of Science, SPORTDiscus and Svemed+, Sociological Abstracts, supplemented by grey literature searches. Eligible quantitative and qualitative studies will be screened, included, assessed for quality and extracted for data by two reviewers independently. Results will be described in a narrative style, reported in extraction tables and diagrams, and where appropriate in themes and text.

Ethics and dissemination: This study describes a protocol for a scoping review that will undertake secondary analysis of data already published in literature and is therefore exempt from medical ethical review. The scoping review will inform understanding of the benefits and risks of wilderness therapy for childhood cancer survivors, their families, practitioners, clinicians and researchers, and will help elucidate the steps necessary for building its evidence base going forward. Results will be published in a peer-reviewed scientific journal.

National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-37096 (URN)10.1136/bmjopen-2019-030544 (DOI)
Available from: 2019-09-04 Created: 2019-09-04 Last updated: 2019-09-04Bibliographically approved
van Vliet, M., Jong, M. C. & Jong, M. (2018). A Mind Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World. Global Qualitative Nursing Research, 5
Open this publication in new window or tab >>A Mind Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World
2018 (English)In: Global Qualitative Nursing Research, ISSN 2333-3936, Vol. 5Article in journal (Refereed) Published
Abstract [en]

Despite increased recognition of self-care and self-awareness as core competences for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind-Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: "ability to be more present," "increased perception and awareness of self," and "connection on a deeper level with others." Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.

Keywords
professional education, lived body, empathy, holistic care, resilience, self-care, stress, nurse–patient communication, doctor– patient communication, phenomenology
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-34910 (URN)10.1177/2333393618805340 (DOI)000447783900001 ()30349869 (PubMedID)2-s2.0-85065005043 (Scopus ID)
Available from: 2018-11-19 Created: 2018-11-19 Last updated: 2019-07-08Bibliographically approved
Jong, M. C., Boers, I., van der Velden, A. P. S., van der Meij, S., Goker, E., Timmer-Bonte, A. N. J. & van Wietmarschen, H. A. (2018). A Randomized Study of Yoga for Fatigue and Quality of Life in Women with Breast Cancer Undergoing (Neo) Adjuvant Chemotherapy. Journal of Alternative and Complementary Medicine, 24(9-10), 942-953
Open this publication in new window or tab >>A Randomized Study of Yoga for Fatigue and Quality of Life in Women with Breast Cancer Undergoing (Neo) Adjuvant Chemotherapy
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2018 (English)In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 24, no 9-10, p. 942-953Article in journal (Refereed) Published
Abstract [en]

Objectives: To compare the effectiveness of yoga added to standard care (SC) versus SC only, in women with breast cancer during chemotherapy. Design: A multicenter pragmatic, randomized controlled study. Settings/Location: Three hospitals in the Netherlands. Subjects: Women with stage I-III breast cancer undergoing chemotherapy. Interventions: Women were randomized either to a program based on Dru Yoga, once a week yoga sessions for 12 weeks (N=47), or SC only (N=36). Outcome measures: Primary outcome fatigue (Multidimensional Fatigue Inventory [MFI]; general fatigue) and secondary outcomes fatigue (MFI, Fatigue Quality List [FQL]), quality of life (30-item Quality of Life Questionnaire-C of the European Organization for Research and Treatment of Cancer [EORTC-QLQ-C-30]) and psychological distress (Hospital Anxiety Depression Scale [HADS], Impact of Events Scale [IES]) were measured at baseline (T0), 3 months (T1), and 6 months (T2) and analyzed on observed cases. Other outcomes were adequate relief, reintegration to work, and adverse events. Results: No significant differences were found in general fatigue at T1 (MFI: yoga; 14.64.5 vs. SC; 14.2 +/- 4.2, p=0.987). Similar findings were observed for other fatigue (sub)scales of MFI and FQL and functional domains of EORTC. With respect to EORTCs symptom scales, women in the yoga group reported significantly less nausea and vomiting compared with SC at T2 (p=0.004), but not at T1 (p=0.807). Depressive symptoms were significantly lower with yoga at T1 (HADS: yoga; 4.7 +/- 4.1 vs. SC; 5.1 +/- 4.2, p=0.031). More women in the yoga group experienced adequate relief compared with SC at T1 (yoga; 51% vs. SC; 19%) and had returned to work at T2 (yoga; 53% vs. SC; 23%). No adverse events were reported with yoga. Conclusions: A Dru-based yoga program failed to demonstrate a significant beneficial effect on fatigue. Possible favorable effects of the yoga program on nausea and vomiting and early return to work in breast cancer survivors warrant further research.

Keywords
breast cancer, depressive symptoms, fatigue, quality of life, stress reduction, yoga
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-34729 (URN)10.1089/acm.2018.0191 (DOI)000445455600012 ()30247961 (PubMedID)2-s2.0-85054025500 (Scopus ID)
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2018-12-04Bibliographically approved
Jong, M. C., Boers, I., Tissing, W. J., Naafs, M. C. & Busch, M. (2018). An evidence-based decision aid on complementary medicine for parents of children with cancer. Paper presented at 11th European Public Health Conference. Ljubljana, Slovenia, 28 November - 1 December, 2018. European Journal of Public Health, 28, 395-395
Open this publication in new window or tab >>An evidence-based decision aid on complementary medicine for parents of children with cancer
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2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 395-395Article in journal, Meeting abstract (Other academic) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-36165 (URN)000461384201473 ()
Conference
11th European Public Health Conference. Ljubljana, Slovenia, 28 November - 1 December, 2018
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-05-20Bibliographically approved
Wietmarschen, H., Tjaden, B., van Vliet, M., Battjes-Fries, M. & Jong, M. C. (2018). Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study. BJGP Open, 2(4)
Open this publication in new window or tab >>Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study
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2018 (English)In: BJGP Open, ISSN 2398-3795, Vol. 2, no 4, p. 11Article in journal (Refereed) Published
Abstract [en]

Background Primary care physicians are subjected to a high workload, which can lead to stress and a high incidence of burnout. A mindfulness training course was developed and implemented for primary care physicians to better cope with stress and improve job functioning.

Aim To gain insight into the effects of the mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians.

Design & setting A pragmatic mixed-methods pre–post design in which physicians received 8 weeks of mindfulness training.

Method Participants completed validated questionnaires on perceived stress (Perceived Stress Scale [PSS]), self-compassion (Self-Compassion Scale [SCS]), and self-reflection (Groningen Reflection Ability Scale [GRAS]) before the training, directly after, and 6 months later. Semi-structured interviews were conducted with six participants after the training and a content analysis was performed to gain in depth understanding of experiences.

Results A total of 54 physicians participated in the study. PSS was reduced (mean difference [MD] -4.5, P<0.001), SCS improved (MD = 0.5, P<0.001), and GRAS improved (MD = 3.3, P<0.001), directly after the 8-week training compared with before training. Six months later, PSS was still reduced (MD = -2.9, P = 0.025) and SCS improved (MD = 0.7, P<0.001). GRAS did not remain significant (MD = 2.5, P = 0.120). Qualitative analysis revealed four themes: being more aware of their own feelings and thoughts; being better able to accept situations; experiencing more peacefulness; and having more openness to the self and others.

Conclusion Mindfulness training might be an effective approach for improving stress resilience, self-compassion, and self-reflection in primary care physicians.

Publisher
p. 11
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-35218 (URN)10.3399/bjgpopen18X101621 (DOI)
Available from: 2018-12-14 Created: 2018-12-14 Last updated: 2019-01-23Bibliographically approved
Klein-Laansma, C. T., Rutten, A. L., Jansen, J. P., van Wietmarschen, H. & Jong, M. C. (2018). Evaluation of a Prognostic Homeopathic Questionnaire for Women with Premenstrual Disorders. Complementary Medicine Research, 25(3), 173-182
Open this publication in new window or tab >>Evaluation of a Prognostic Homeopathic Questionnaire for Women with Premenstrual Disorders
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2018 (English)In: Complementary Medicine Research, ISSN 2504-2092, Vol. 25, no 3, p. 173-182Article in journal (Refereed) Published
Abstract [en]

Background/Aims: Validation of treatments with individually prescribed homeopathic medicines is a challenging task. A prognostic homeopathic patient questionnaire containing 140 keynote symptoms (highly characteristic of a specific homeopathic medicine) and an electronic algorithm to process the answers were used in 2 clinical studies. The algorithm outcome, based on total symptom scores, indicated 1 of 11 pre-selected homeopathic medicines for women with premenstrual syndrome and premenstrual dysphoric disorder (PMS/PMDD). Aims were (1) to estimate the prognostic values of keynote symptoms and (2) to evaluate the reliability of the homeopathic medicine ranking in the algorithm outcome.

Methods: The prevalence of specific keynote symptoms was calculated in 145 women diagnosed with PMS/PMDD and in 40 included women with favorable outcomes using 1 of the 11 homeopathic medicines. Likelihood ratios (LRs) of the keynote symptoms were calculated. Pearson's correlations were calculated between 2 sets of total algorithm scores for 11 homeopathic medicines, obtained at 2 time points.

Results: (1) A positive prognostic value (LR >= 1.5) was found in 34 keynote symptoms with a prevalence of 10-40%, with 10 symptoms already being connected to the corresponding homeopathic medicine in the algorithm. For example, the symptom 'common cold of the nose before menstruation' indicated Magnesium carbonicum with LR = 7.47 (confidence interval (CI) 3.90-14.28). (2) Pearson's correlations for the reliability evaluation varied from 0.69 to 0.84.

Conclusions: Recommendations can be made to improve the PMS algorithm with more accurate keynote symptoms. The prognostic questionnaire proved a reliable tool to rank 11 homeopathic medicines by total scores, based on keynote symptoms. This PMS algorithm can be used for the treatment of PMS/PMDD in clinical practice.

Keywords
Premenstrual, PMS/PMDD, Homeopathy, Questionnaire, Prognostic factor, Likelihood ratio, Reliability
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-33504 (URN)10.1159/000487318 (DOI)000437467300010 ()29550829 (PubMedID)2-s2.0-85044384792 (Scopus ID)
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2019-03-26Bibliographically approved
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