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  • 1.
    Baars, Erik
    et al.
    Louis Bolk Institute, The Netherlands.
    Jong, Miek C
    Boers, Inge
    Louis Bolk Institute, The Netherlands.
    Nierop, Andreas F.M
    Savelkoul, Huub F
    A comparative in vitro study of the effects of separate and combined products of Citrus e fructibus and Cydonia e fructibus on immunological parameters of seasonal allergic rhinitis2012Ingår i: Mediators of Inflammation, ISSN 0962-9351, E-ISSN 1466-1861, s. Art. no. 109829-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper examined the effects of the combined product, Citrus e fructibus/Cydonia e fructibus (Citrus/Cydonia; Citrus and Cydonia: each 0.01 g/mL), and separate products of Citrus (0.01 g/mL) and Cydonia (0.01 g/mL) on the immunological pathways involved in seasonal allergic rhinitis (SAR). Peripheral blood mononuclear cells (PBMCs) from five healthy and five grass pollen-allergic donors were isolated and analyzed in vitro after polyclonal and allergen-specific stimulation of T cells in the presence of the three extracts. The analyses demonstrated acceptable cell survival with no signs of toxicity. Citrus mainly had a selective effect on reducing allergen-specific chronic inflammatory (TNF-α; Citrus compared to Cydonia and Citrus/Cydonia: −87.4 (                                        𝑃                <                0                .                0                0                1                        ) and −68.0 (                                        𝑃                <                0                .                0                5                        ), resp.) and Th2 pathway activity (IL-5; Citrus compared to Cydonia: −217.8 (                                        𝑃                <                0                .                0                1                        ); while, both Cydonia and Citrus/Cydonia mainly affected the induction of the allergen-specific Th1 pathway (IFN-γ; Cydonia and Citrus/Cydonia compared to Citrus: 3.8 (                                        𝑃                <                0                .                0                1                        ) and 3.0 (                                        𝑃                <                0                .                0                1                        ), resp.). Citrus and Cydonia demonstrated different working mechanisms in the treatment of SAR and the combination product did not demonstrate larger effects than the separate preparations. Further effectiveness and efficacy studies comparing the effects of the products on SAR in vivo are indicated.

  • 2.
    Baars, Erik
    et al.
    Louis Bolk Institute, The Netherlands.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Nierop, Andreas F.M
    Boers, Inge
    Louis Bolk Institute, The Netherlands.
    Savelkoul, Huub F
    Citrus/Cydonia comp. Subcutaneous Injections Versus Nasal Spray for Seasonal Allergic Rhinitis: a Randomized Controlled Trial on Efficacy and Safety2011Ingår i: ISRN Allergy, ISSN 2090-5521, E-ISSN 2090-553X, artikel-id 836051Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Clinical experiences in vitro and clinical studies have demonstrated the curative potency and safety of Citrus/Cydonia compositum in seasonal allergic rhinitis treatment. Objectives. To compare the efficacy and safety of two routes of administration (nasal spray versus subcutaneous injections). Methodology: Design. a national, randomised, comparative clinical trial with two parallel groups. Participants. 23 patients fulfilled the study requirements. Intervention. after a one- or two-week wash-out period, 23 patients were randomized, to a 6-week treatment period. Outcomes. immunological and symptom severity changes and safety. Immunologic outcome assessments were blinded to group assignment. 23 patients were randomized and from 22/23 patients (11 in each group) blood samples were analyzed before and after treatment. Conclusion. Both routes of administration demonstrate immunological and clinical effects, with larger inflammatory and innate immunological effects of the nasal spray route and larger allergen-specific clinical effects of the subcutaneous route, and are safe.

  • 3.
    Boers, I
    et al.
    Louis Bolk Inst, Dept Nutr & Hlth, NL-3971 LA Driebergen, Netherlands.
    Muskiet, F.A
    Univ Med Ctr Groningen, Dept Lab Med, NL-9713 AV Groningen, Netherlands.
    Berkelaar, E
    Univ Gerona, Dept Clin Psycho Neuro Immunol, Girona, Spain.
    Schut, E
    Univ Gerona, Dept Clin Psycho Neuro Immunol, Girona, Spain.
    Penders, R
    Univ Gerona, Dept Clin Psycho Neuro Immunol, Girona, Spain.
    Hoenderdos, K
    Scriptum Commun Nutr, IJsselstein, Netherlands.
    Wichers, H.J
    Wageningen Univ & Res Ctr, Wageningen, Netherlands.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Nutr & Hlth, NL-3971 LA Driebergen, Netherlands.
    Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study2014Ingår i: Lipids in Health and Disease, ISSN 1476-511X, E-ISSN 1476-511X, Vol. 13, nr 160Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The main goal of this randomized controlled single-blinded pilot study was to study whether, independent of weight loss, a Palaeolithic-type diet alters characteristics of the metabolic syndrome. Next we searched for outcome variables that might become favourably influenced by a Paleolithic-type diet and may provide new insights in the pathophysiological mechanisms underlying the metabolic syndrome. In addition, more information on feasibility and designing an innovative dietary research program on the basis of a Palaeolithic-type diet was obtained. METHODS: Thirty-four subjects, with at least two characteristics of the metabolic syndrome, were randomized to a two weeks Palaeolithic-type diet (n = 18) or an isoenergetic healthy reference diet, based on the guidelines of the Dutch Health Council (n = 14). Thirty-two subjects completed the study. Measures were taken to keep bodyweight stable. As primary outcomes oral glucose tolerance and characteristics of the metabolic syndrome (abdominal circumference, blood pressure, glucose, lipids) were measured. Secondary outcomes were intestinal permeability, inflammation and salivary cortisol. Data were collected at baseline and after the intervention. RESULTS: Subjects were 53.5 (SD9.7) year old men (n = 9) and women (n = 25) with mean BMI of 31.8 (SD5.7) kg/m2. The Palaeolithic-type diet resulted in lower systolic blood pressure (-9.1 mmHg; P = 0.015), diastolic blood pressure (-5.2 mmHg; P = 0.038), total cholesterol (-0.52 mmol/l; P = 0.037), triglycerides (-0.89 mmol/l; P = 0.001) and higher HDL-cholesterol (+0.15 mmol/l; P = 0.013), compared to reference. The number of characteristics of the metabolic syndrome decreased with 1.07 (P = 0.010) upon the Palaeolithic-type diet, compared to reference. Despite efforts to keep bodyweight stable, it decreased in the Palaeolithic group compared to reference (-1.32 kg; P = 0.012). However, favourable effects remained after post-hoc adjustments for this unintended weight loss. No changes were observed for intestinal permeability, inflammation and salivary cortisol. CONCLUSIONS: We conclude that consuming a Palaeolithic-type diet for two weeks improved several cardiovascular risk factors compared to a healthy reference diet in subjects with the metabolic syndrome. TRIAL REGISTRATION: Nederlands Trial Register NTR3002.

  • 4. Bredie, S J
    et al.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    No Significant Effect of Ginkgo Biloba Special Extract EGb 761 in the Treatment of Primary Raynaud's Phenomenon: A Randomized Controlled Trial2012Ingår i: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 59, nr 3, s. 215-221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Medicinal treatment of vasospastic Raynaud phenomenon is limited to primarily vasodilator medicines.

    OBJECTIVE:

    To explore the possible beneficial effects and tolerability of 120 mg two times a day of Ginkgo Biloba special extract EGb 761 in patients suffering from Raynaud disease (RD) (primary Raynaud phenomenon).

    METHODS:

    In a placebo-controlled, double-blind, pilot study, 41 patients with RD were randomized to either the active treatment group (EGb 761, n = 21) or placebo group for 10 weeks, after an initial 2-week run-in phase. The primary efficacy variables were self-reported changes of the frequency, duration, and severity of vasospastic attacks between the placebo-controlled run-in phase and the end of the study.

    RESULTS:

    Most of the patients were female, and both groups were perfectly matched with respect to demographic characteristics. The frequency of daily attacks reduced from 3.6 ± 2.3 to 2.4 ± 2.6 (-33%) in the EGb 761 group and from 2.9 ± 2.0 to 2.0 ± 1.8 (-31%) in the placebo group with no significant difference according to the ordinary least squares test (P = 0.3564). Furthermore, no significant differences were found with respect to the duration and severity of vasospastic attacks between the EGb 761 and placebo groups (P = 0.4392 and P = 0.7187, respectively). In all, 17 adverse events (AEs) were reported, 6 AEs from 5 patients in the EGb 761 group and 11 AEs from 8 patients in the placebo group. Serious AEs did not occur.

    CONCLUSION:

    EGb 761 treatment showed an excellent safety profile in patients with RD but could not demonstrate a statistically significant reduction in clinically relevant symptoms compared with placebo.

  • 5.
    Eardley, S.
    et al.
    Complementary and Integrative Medicine Research, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, United Kingdom.
    Bishop, F. L.
    Complementary and Integrative Medicine Research, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, United Kingdom.
    Cardini, F.
    Healthcare and Social Agency of the Emilia Romagna Region, Bologna, Italy.
    Santos-Rey, K.
    Andalusian Health Service, Pain Treatment Unit, Doña Mercedes Primary Care Center, Dos Hermanas, Spain.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ursoniu, S.
    Department of Health, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania.
    Dragan, S.
    Department of Preventive Cardiology, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania.
    Hegyi, G.
    PTE ETK Komplementer Medicina Tanszék, Budapest, Hungary.
    Uehleke, B.
    University of Health and Sports, Berlin, Germany.
    Vas, J.
    Andalusian Health Service, Pain Treatment Unit, Doña Mercedes Primary Care Center, Dos Hermanas, Spain.
    Jupaneant, O.
    Department of Health, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania.
    Citro, M. C.
    Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
    Fønnebø, V.
    National Research Center in CAM (NAFKAM), Institute of Community Medicine, University of Tromsø, Norway.
    Quandt, S. A.
    Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States.
    Lewith, G.
    Complementary and Integrative Medicine Research, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, United Kingdom.
    A pilot feasibility study of a questionnaire to determine European union-wide CAM use2012Ingår i: Forschende Komplementarmedizin, ISSN 1661-4119, Vol. 19, nr 6, s. 302-310Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: No questionnaire specifically measuring the core components of complementary and alternative medicine (CAM) use has been validated for use across European Union (EU) countries. We aimed to determine the face validity, acceptability and the participants' comprehension of a pre-existing questionnaire designed to measure 'CAM use', to provide a comparative, standardised questionnaire for use by health care providers, policy makers and purchasers throughout Europe. Methods: Established procedures were employed to translate the questionnaire into 4 EU languages. The translated questionnaires were piloted on 50 healthy adults from each country who may never have used CAM. 10 participants per country also took part in audio-recorded think aloud interviews about the questionnaire. The interviews were transcribed and analysed in the language in which they were conducted; findings were summarised in English. Questionnaire data were pooled across countries, and patterns of completion and missing data were analysed. Results: The questionnaire was translated into Italian, Spanish, Dutch and Romanian. The mean age of the participants was 43.6 years. 34% were male, 87.4% were either light or heavy CAM users, and 12.6% were non-users. Qualitative analysis identified common problems across countries including a 'hard-to-read' layout, misunderstood terminology and uncertainty in choosing response options. Quantitative analysis confirmed that a substantial minority of respondents failed to follow questionnaire instructions and that some questions had substantial rates of missing data. Conclusions: The I-CAM-Q has low face validity and low acceptability, and is likely to produce biased estimates of CAM use if applied in England, Romania, Italy, The Netherlands or Spain. Further work is required to develop the layout, terms, some response options and instructions for completion before it can be used across the EU. © 2012 S. Karger AG, Basel.

  • 6.
    Jansen, Jean Pierre
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. European Comm Homeopathy, Subcomm Provings, Groningen, Netherlands.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hildingsson, Ingegerd
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Hlth & Nutr, Driebergen, Netherlands.
    A minimum protocol for randomised homeopathic drug proving as basis for further research.2014Ingår i: Forschende Komplementärmedizin, ISSN 1661-4119, E-ISSN 1661-4127, Vol. 21, nr 4, s. 232-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In order to further improve the methodology and quality of data collection in homeopathic drug provings (HDP), there is a need for a minimum standardised HDP protocol. The objective of the present study was to test the feasibility of this type of protocol.

    MATERIALS AND METHODS: The study protocol embraced a multi-centre, randomised, double-blind, placebo-controlled trial with 2 parallel groups. It was approved by an ethics review committee. During the pre-approval phase, discordances between the regulatory and homeopathic requirements for the protocol were checked and solutions found. The study medication was Potentilla anserina. 6 participants received verum and 4 placebo. The resulting symptom list will be published elsewhere. The procedure was accepted by all participants.

    RESULTS: Three important issues were addressed: the requirement to keep all participants blinded; the adverse events reporting to regulatory authorities; and the necessity of a placebo control group. Other issues that need further investigations were identified, e.g. sample size, observation period and dosage regimen.

    CONCLUSIONS: A minimum protocol of a HDP is feasible. All important design elements of HDP could be solved in discussions with the respective regulatory authorities, and participating homeopaths accepted the procedure.

  • 7.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Falkenberg, Torkel
    Karolinska Universitetet.
    Integrative Nursing in Sweden2014Ingår i: Integrative Nursing / [ed] Kreitzer, Mary Jo., Koithan, Mary., Oxford University Press, 2014, s. 515-525Kapitel i bok, del av antologi (Refereegranskat)
  • 8.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ljadas, Karin
    Englund, Erling
    Appelberg, Jonas
    The Effects of Tactile Massage (TM) On Blood Pressure, Heart Rate and Blood Glucose in a Sample of Women Suffering from Primary Insomnia2012Ingår i: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012: , 2012, s. P241-Konferensbidrag (Refereegranskat)
    Abstract [en]

    The overall objective of this pilot study was to study the direct effects of tactile massage (TM) on blood pressure, heart rate and blood glucose in a sample of women suffering from primary insomniaThe study had an experimental prospective design, with a total of 10 women (mean age; 53 years, ±5.4). The participants underwent TM twice a week for six weeks resulting in a total of 120 treatments. For short term effects, systolic and diastolic blood pressure, heartrate and blood glucoses were assessed by the therapist before and after each treatment. Long term assessments were made at baseline, at week 7, and at week 13.As a short term result after the treatment with TM, the participants reached a statistically significant reduction of; systolic blood pressure (-5.5 mmHg, ± 5.0), diastolic blood pressure (-2.0 mmHg, ± 4.4), Heartrate (-5.1 beats per minute, ± 3.4) and blood glucose (-0.2 mmol, ± 0.5). No long term effects with respect to the studied variables can be observed.In summary, we have shown in a normotensive but highly stressed sample of women, that TM has beneficiary effects on parameters of stress and cardiovascular function. In total, 120 TM treatments was analyzed with respect to the objective of the study, but in order to more understand the practical effects, and to more deeply evaluate TM’s place in the modalities of stress reduction, we recommend further studies with larger samples.

  • 9.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Lundqvist, Veronica
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    A cross-sectional study on Swedish licensed nurses’ use, practice, attitudes and knowledge about Complementary and Alternative Medicine (CAM)2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Only a few and relatively outdated population studies with respect to CAM use among the general population in Sweden exists. Those who has been made indicates that CAM usage is relatively high where 30-39% reports lifetime use and 20% use the last year, with massage, Naprapathy and Chiropracy being most common. Nurses are often involved in direct patient care and hold a unique role where issues of CAM can be communicated, but little is known about them as a group on the topic of CAM. Objective: The objective of this cross-sectional study was to describe licensed nurses’ use, practice, attitudes and knowledge about CAM. Method: In a web based survey Licensed Nurses were invited for participation through two different approaches: firstly from the member register of Vårdförbundet (the Swedish Association of Health Professionals), and secondly via a general invitation to formal and informal nursing associations, web communities and workplaces. A total number of 960 nurses responded to the survey, 83% were female and the mean age of the respondents were 46 years (±10.8). Results: Among the respondents, 83.4% reported to have used at least one CAM method within the last two years. The most prevalently used methods are within the categories of massage and Dietary supplements/probiotics/herbal remedies and Mind-Body therapies. Fifteen percent of respondents are practicing some form of CAM method; 69% of those among family and friends, 25% in a private business, and 37% (n=52) within the public health care (mostly different form of massage and mind-body practices). Of the respondents, 11.7% express that they ask patients about CAM use, the most common reason 38% (n=366) not to is lack of knowledge about CAM (and their legal position with respect to CAM). A high proportion (66%) agrees that healthcare personnel should inform clients about CAM treatments when asked about it. Conclusion: Swedish nurses do to a very high extent use different CAM methods for themselves, and also practice it to some degree. In spite of this, due to lack of knowledge, they do not regularly ask or inform patients about CAM methods. From the results of the study we can see that nurses are in need of better training and education about CAM, both in order to be able to meet the needs of the patients, but also for reasons of safety since interactions exist between dietary supplements/probiotics/herbal remedies and conventional drugs.

  • 10.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Gävle Högskola.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Falkenberg, Torkel
    Karolinska Universitetet.
    Integrative Nursing in Sweden2019Ingår i: Integrative Nursing / [ed] Mary Koithan; Mary Jo Kreitzer, New York: Oxford University Press, 2019, 2, s. 652-662Kapitel i bok, del av antologi (Refereegranskat)
    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.

  • 11.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Ljadas, Karin
    Avd Klinisk Fysiologi, Sundsvalls Sjukhus, Landstinget Västernorrland.
    Englund, Erling
    Avd Forskning & Utveckling, Landstinget Västernorrland.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands.
    Appelberg, Jonas
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Avd Forskning & Utveckling, Landstinget Västernorrland.
    Feasibility and Effects of Touch Massage and Nurse Led Sleep Counselling in the Treatment of Primary Insomnia2016Ingår i: Journal of Sleep Disorders: Treatment and care, ISSN 2325-9639, E-ISSN 2325-9639, Vol. 5, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cognitive Behavioral Therapy (CBT) is basically the only evidence based treatment both in short- as well as long term treatment of insomnia. Previous studies suggest that massage may have a role in initiating sleep and relaxation. This pilot study investigated the feasibility and effects of tactile massage (TM) and nurse led sleep counselling (SC) in the treatment of primary insomnia. Method: Thirty women with primary insomnia were randomized into three different groups: TM, SC or ‘care as usual’ (CAU) followed by a six weeks intervention period. Sleep quality was assessed with sleep diary and polysomnography. The results show that it is feasible to treat primary insomnia with TM. ‘Within’ group analysis showed that the TM group experienced significant improvements in measures of subjective sleep, SC and CAU had no improvements. No significant differences were found in the ‘between’ group analysis. Conclusion: On the basis of the findings, we can conclude that it is feasible to use the methods of TM and SC in the treatment of primary insomnia. Especially TM shows preliminary improvements in subjective measures of sleep, results which needs confirmation in full scale research. Based on the observed effects the research protocol/design is recommended to be simplified and also to combine TM and SC as intervention in future studies.

  • 12.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Lundqvist, Veronica
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute Driebergen The Netherlands .
    A cross-sectional study on Swedish licensed nurses’ use, practice, perception and knowledge about Complementary and Alternative Medicine2015Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, s. 642-650Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Only a few and relatively outdated population studies with respect to CAM use among the general population in Sweden exists. Those who has been made indicates that CAM usage is relatively high where 30-39% reports lifetime use and 20% use the last year, with massage, Naprapathy and Chiropracy being most common. Nurses are often involved in direct patient care and hold a unique role where issues of CAM can be communicated, but little is known about them as a group on the topic of CAM.Objective: The objective of this cross-sectional study was to describe licensed nurses’ use, practice, attitudes and knowledge about CAM. Method: In a web based survey Licensed Nurses were invited for participation through two different approaches: firstly from the member register of Vårdförbundet (the Swedish Association of Health Professionals), and secondly via a general invitation to formal and informal nursing associations, web communities and workplaces. A total number of 960 nurses responded to the survey, 83% were female and the mean age of the respondents were 46 years (±10.8).Results: Among the respondents, 83.4% reported to have used at least one CAM method within the last two years. The most prevalently used methods are within the categories of massage and Dietary supplements/probiotics/herbal remedies and Mind-Body therapies. Fifteen percent of respondents are practicing some form of CAM method; 69% of those among family and friends, 25% in a private business, and 37% (n=52) within the public health care (mostly different form of massage and mind-body practices). Of the respondents, 11.7% express that they ask patients about CAM use, the most common reason 38% (n=366) not to is lack of knowledge about CAM (and their legal position with respect to CAM). A high proportion (66%) agrees that healthcare personnel should inform clients about CAM treatments when asked about it.Conclusion: Swedish nurses do to a very high extent use different CAM methods for themselves, and also practice it to some degree. In spite of this, due to lack of knowledge, they do not regularly ask or inform patients about CAM methods. From the results of the study we can see that nurses are in need of better training and education about CAM, both in order to be able to meet the needs of the patients, but also for reasons of safety since interactions exist between dietary supplements/probiotics/herbal remedies and conventional drugs.

  • 13.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Boers, I.
    Louis Bolk Inst, Bunnik, Netherlands.
    Tissing, W. J. E.
    Univ Med Ctr Groningen, Groningen, Netherlands.
    Naafs, M. C.
    VOKK, Nieuwegein, Netherlands.
    Busch, M.
    Van Praag Inst, Utrecht, Netherlands.
    An evidence-based decision aid on complementary medicine for parents of children with cancer2018Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, s. 395-395Artikel i tidskrift (Övrigt vetenskapligt)
  • 14.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad. Louis Bolk Institute, Bunnik, The Netherlands.
    Boers, I.
    Louis Bolk Institute, Bunnik, The Netherlands.
    van Wietmarschen, H. A.
    Louis Bolk Institute, Bunnik, The Netherlands.
    Tromp, E.
    St. Antonius Ziekenhuis, Nieuwegein, The Netherlands.
    Busari, J. O.
    Zuyderland Medisch Centrum, Heerlen, the Netherlands.
    Wennekes, R.
    Zuyderland Medisch Centrum, Heerlen, the Netherlands.
    Snoeck, I.
    Isala, Zwolle, The Netherlands.
    Bekhof, J.
    Isala, Zwolle, The Netherlands.
    Vlieger, A. M.
    St. Antonius Ziekenhuis, Nieuwegein, The Netherlands.
    Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study2019Ingår i: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 178, nr 2, s. 147-154Artikel i tidskrift (Refereegranskat)
    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. 

  • 15.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Nutr & Hlth, Bunnik, Netherlands.
    Boers, Inge
    Louis Bolk Inst, Dept Nutr & Hlth, Bunnik, Netherlands.
    van der Velden, Arjan P. Schouten
    St Jansdal Hosp, Dept Surg, Harderwijk, Netherlands.
    van der Meij, Suzan
    Flevo Hosp, Dept Surg, Almere, Netherlands.
    Goker, Emine
    Alexander Monro Hosp, Breast Canc Clin, Bilthoven, Netherlands.
    Timmer-Bonte, Anja N. J. H.
    Alexander Monro Hosp, Breast Canc Clin, Bilthoven, Netherlands.
    van Wietmarschen, Herman A.
    Louis Bolk Inst, Dept Nutr & Hlth, Bunnik, Netherlands.
    A Randomized Study of Yoga for Fatigue and Quality of Life in Women with Breast Cancer Undergoing (Neo) Adjuvant Chemotherapy2018Ingår i: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 24, nr 9-10, s. 942-953Artikel i tidskrift (Refereegranskat)
    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.

  • 16.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Boers, Inge
    Louis Bolk Institute, Bunnik, The Netherlands.
    van Wietmarschen, Herman
    Louis Bolk Institute, Bunnik, The Netherlands.
    Busch, Martine
    Van Praag Institute, Utrecht, The Netherlands.
    Naafs, Marianne C.
    Netherlands Childhood Cancer Parent Organization VOKK, Nieuwegein, The Netherlands.
    Kaspers, Gertjan J. L.
    Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
    Tissing, Wim J. E.
    Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Department Paediatric OncologyUniversity Medical Center Groningen, Groningen, The Netherlands.
    Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer2019Ingår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339Artikel i tidskrift (Refereegranskat)
    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

  • 17.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    Busch, Martine
    Van Praag Institute, Utrecht, the Netherlands.
    Baars, Erik W.
    Louis Bolk Institute, Bunnik, the Netherlands; University of Applied Sciences, Leiden, the Netherlands.
    Integrative medicine in Dutch curative and long-term healthcare centres: Mapping the field2019Ingår i: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 28, s. 14-19Artikel i tidskrift (Refereegranskat)
    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.

  • 18.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Busch, Martine
    van Praag Institute, Utrecht, Netherlands.
    van de Vijfer, Lucy
    Louis Bolk Institute, Driebergen, Netherlands.
    Baars, Erik
    Louis Bolk Institute, The Netherlands.
    P04.72. Towards a model for integrative medicine in the primary care of patients with chronic joint diseases and allergy2012Ingår i: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012: BMC Complementary and Alternative Medicine. Volume 12 Supplement 1, 2012, s. 342-Konferensbidrag (Refereegranskat)
    Abstract [en]

    PurposeIn the Netherlands, Complementary and AlternativeMedicine (CAM) is offered outside the world of mainstreammedicine. Patients would benefit from an integratedmodel in which CAM is part of main streammedicine so that disclosure of risks, benefits of CAMand credentials of CAM practitioners are sufficientlydealt with. The aim of this 4-year research project is todevelop, implement and evaluate a shared-care model ofIntegrative Medicine in a primary care setting forpatients with chronic joint diseases and allergy.MethodsThis is the first project in the Netherlands where patientorganizations, health care providers and health careinsurers collaborate to achieve an integrative health-caremodel. The project consists of four stages; in stage 1 needsand preferences of patients were investigated. Based onthis outcome, evidence in literature and clinical experiences,an integrated primary care model will be developed(stage 2). The integrated model will be piloted in two primarycare centers in the Netherlands (stage 3) and evaluatedwith respect to outcome (stage 4).ResultsStage 1: A national survey demonstrated CAM use in41% of children with allergy (eczema, asthma) and 71%of adults with chronic joint diseases (arthrosis, rheumatoidarthritis). CAM therapies mostly used werehomeopathy, manual therapies, acupuncture and naturopathy.The majority (74% allergy, 51% joint diseasesgroup) did not actively communicate CAM use withtheir family physician. However, 79% (allergy) and 70%(joint diseases) of patients preferred a physician thatinforms, refers to and collaborates with CAM.ConclusionCAM use among chronically ill patients is high. Althoughmost patients do not communicate CAM with their familyphysician, they have a high preference for a shared-caremodel in primary care. Based on these outcomes, such amodel will be developed and presented at the conference.

  • 19.
    Jong, Miek C
    et al.
    Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands; National Information and Knowledge Centre for Integrative Medicine (NIKIM), Netherlands.
    Busch, Martine
    The van Praag Instituut, Utrecht, The Netherlands; National Information and Knowledge Centre for Integrative Medicine (NIKIM), Netherlands.
    van de Vijfer, Lucy
    Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Fritsma, Jolanda
    Zorgbelang Groningen, Groningen, Netherlands.
    Seldenrijk, Ruth
    Patiënten Platform Complementaire Gezondheidszorg, Netherlands.
    Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain2016Ingår i: Primary Healthcare, ISSN 2167-1079, Vol. 6, nr 2, artikel-id 1000224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Integration of complementary and alternative medicine (CAM) into conventional care is driven by patients’ needs for holistic care. This study aimed to develop a model for integration of CAM into primary healthcare in close collaboration with patients suffering from chronic musculoskeletal pain (CMP). Methods: The study had a qualitative inductive approach following the principles of Grounded Theory, where data were collected and generated via several data sources and steps; individual and focus group interviews and meetings with patients, general practitioners (GPs), CAM practitioners, health insurers and other key informants. Results: Consensus was reached on a model in which shared decision making was introduced to facilitate discussions on CAM between patients and GPs. Guided by evidence and best-practices, GPs refer patients to one of five selected and reimbursed CAM therapies (acupuncture, homeopathy, naturopathy, osteopathy or Tai Chi) and respective practitioner within their integrative network. CAM practitioners report treatment outcome back to the GP who follows-up on the patient for further evaluation. Conclusions: In conclusion, it was feasible to develop a model for integration of CAM into primary healthcare management of CMP that was driven by patients’ needs and obtained consensus of all stakeholders. The model is the first in the Netherlands to provide for integrative health services in primary care. It needs to be tested in a study setting before further implementation is recommended.

  • 20.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Kamegpa Nutrition and Health, Bulgaria.
    Buskin, S.
    International Health Center, Netherlands.
    Ilyenko, L.
    Kholodova, I.
    Burkart, J.
    DHU-Arzneimittel GmbH and Co. KG, Germany.
    Weber, S.
    Keller, T.
    Klement, P.
    DHU-Arzneimittel GmbH and Co. KG, Germany.
    Imunokind - Specialized design homeopathic prevention recurrent IGDP in children2017Ingår i: Pediatriya, ISSN 0479-7876, Vol. 2017-January, nr 1, s. 61-64Artikel i tidskrift (Refereegranskat)
  • 21.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Nutr & Hlth, Netherlands; Natl Informat & Knowledge Ctr Integrat Med NIKIM, Amsterdam, Netherlands.
    Buskin, Stephen L.
    Int Hlth Ctr Hague, The Hague, Netherlands.
    Ilyenko, Lydia
    Russian State Med Univ, Moscow, Russia.
    Kholodova, Irina
    Russian State Med Univ, Moscow, Russia.
    Burkart, Julia
    DHU Arzneimittel GmbH & Co KG, Deutsche Homoopathie Union, Karlsruhe, Germany.
    Weber, Stephan
    Acomed Stat, Leipzig, Germany.
    Keller, Thomas
    Acomed Stat, Leipzig, Germany.
    Klement, Petra
    DHU Arzneimittel GmbH & Co KG, Deutsche Homoopathie Union, Karlsruhe, Germany.
    Effectiveness, safety and tolerability of a complex homeopathic medicinal product in the prevention of recurrent acute upper respiratory tract infections in children: a multicenter, open, comparative, randomized, controlled clinical trial2016Ingår i: Multidisciplinary Respiratory Medicine, ISSN 1828-695X, E-ISSN 2049-6958, Vol. 11, nr 1, artikel-id 19Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The present study was initiated to investigate the effectiveness, safety and tolerability of complex homeopathic CalSuli-4-02 tablets on prevention of recurrent acute upper respiratory tract infections (URTIs) in children, in comparison to another complex homeopathic product. Methods: The study was designed as a prospective, multicenter, randomized, open, clinical trial with two parallel treatment groups at four outpatient pediatric clinics in Russia. Children aged <= 6 years with susceptibility to acute URTIs (>= three occasions during the last 6 months) were randomized to receive either CalSuli-4-02 or a comparator homeopathic product (control group) for 3 weeks. Primary outcome was the frequency of acute URTIs after 3 and 6 months post-treatment follow-up. Secondary endpoints were changes in complaints and symptoms (total and individual scores), treatment satisfaction, antibiotic use, safety and tolerability.

    Results: The intention-to-treat analysis involved 200 children (CalSuli-4-02: N = 99, Control: N = 101). In both treatment groups, the median number of acute URTIs was one for 3 months and two, respectively, for the full 6 months post-treatment (Relative Risk: 0.86 (95 %-CI: 0.72-1.03), p = 0.1099). Seasons had no influence on the outcome. At the end of study, CalSuli-4-02 had overall higher odds of getting lower complaints severity total score (Odds ratio: 1.99 (95 %-CI: 1.31-3.02), p = 0.0012) and showing symptom improvement (Odds ratio: 1.93 (95 %-CI: 1.25-3.00), p = 0.0033). Specifically, the complaint "appetite disorder" and the symptom "child's activities" significantly improved more in the CalSuli-4-02 group (p = 0.0135 and p = 0.0063, respectively). Antibiotic use was decreased in both treatment groups at the study end. Overall assessment for satisfaction with and tolerability of treatment was higher with CalSuli-4-02. A low number of non-serious adverse drug reactions was reported (CalSuli-4-02: N = 4, Control: N = 1). Conclusions: Both complex homeopathic products led to a comparable reduction of URTIs. In the CalSuli-4-02 group, significantly less URTI-related complaints and symptoms and higher treatment satisfaction and tolerability were detected. The observation that the use of antibiotics was reduced upon treatment with the complex homeopathic medications, without the occurrence of complications, is interesting and warrants further investigations on the potential of CalSuli-4-02 as an antibiotic sparing option.

  • 22.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Nutr & Hlth, NL-3972 LA Driebergen, Netherlands.
    Ermuth, Ulrike
    Dermatol Practice, Singen, Germany.
    Augustin, Matthias
    Univ Clin, Hamburg, Germany.
    Plant-based ointments versus usual care in the management of chronic skin diseases: A comparative analysis on outcome and safety2013Ingår i: Complementary Therapies in Medicine, ISSN 0965-2299, E-ISSN 1873-6963, Vol. 21, nr 5, s. 453-459Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To assess the outcome and safety of plant-based ointments versus usual care in the management of chronic skin diseases. Methods: Prospective mono-centric comparative analysis. Patients were recruited at an outpatient dermatology clinic and treated with plant-based ointments or care as usual. Main outcome criterion was the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' at 6, 12 and 24 months. Secondary outcome criteria were quality of life (SF-12 and EQ-5D), patient satisfaction and safety of treatment. Results: A total of 112 patients with chronic skin diseases were evaluated of which 44 were treated with plant-based ointments (PO) and 68 received usual care (UC). The majority of patients suffered from psoriasis (PO: 50%; UC: 56%) or eczema (PO: 41%; UC: 32%) and were treated with homoeopathic topical ointments containing mahonia or cardiospermum or usual care creams containing calcipotriene and corticosteroids. The only significant difference in baseline status between the two groups was in disease severity score (PO: 1.8 +/- 0.7 versus UC: 2.4 +/- 0.8, p=0.0004). After two years, the main outcome of responders to treatment was 52.3% (95%-CI: 36.1-64.9) in the ointment and 41.2% (95%-CI: 20.4-42.2) in the UC group. Change in SF-12 (2 years compared to baseline), adjusted for baseline disease severity, was not significantly different between both groups; PO: 5.4 (95%-CI: 3.4-7.3) versus UC: 3.2 (95%-CI: 1.5-4.9). The adjusted EQ-5D was found to be significantly different between the two groups after two years, in favour of the ointment group; PO: 0.113 (95%-CI: 0.052-0.174) and UC: -0.008 (95%-CI: -0.055-0.038). Other secondary outcome parameters such as patient satisfaction and number of adverse drug reactions were comparable. Conclusions: The outcome of this study suggests at least therapeutic equivalence between plant-based ointments and usual care management of chronic skin diseases. As this non-randomised study was open to selection and other bias, further rigorous studies are needed to demonstrate the effectiveness of these topical products. (C) 2013 Elsevier Ltd. All rights reserved.

  • 23.
    Jong, Miek C
    et al.
    Department Healthcare and Nutrition, Louis Bolk Institute, Hoofdstraat 24, 3972 LA Driebergen, The Netherlands.
    Hofstede, A.M
    Department Healthcare and Nutrition, Louis Bolk Institute, Hoofdstraat 24, 3972 LA Driebergen, The Netherlands.
    Schats, Winnie
    Medical Library, Slotervaart Hospital, Amsterdam, The Netherlands.
    Meijker, J.E.M
    Foundation Health Centers Amsterdam Zuidoost, Amsterdam, The Netherlands.
    Koolen, R
    Department of Psychology, Slotervaart Hospital, Amsterdam, The Netherlands.
    Rosenstiel, Inez
    Department of Pediatrics, Slotervaart Hospital, Amsterdam, The Netherlands.
    Attitudes towards Integrative Medicine among Healthcare Professionals in the Netherlands2011Ingår i: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 3, nr 3, s. e209-e217Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Despite the growing interest for integrative medicine (IM), no data are available about the attitudes of healthcare professionals towards IM.

    Objectives

    To assess the attitudes of healthcare professionals towards IM.

    Methods

    A convenience, volunteer sample was surveyed using a digital 47-item questionnaire on the key components of IM: 1. The doctor–patient relationship; 2. Patients’ responsibility in own healing; 3. Use of CAM therapies; 4. Healing environment.

    Results

    Of the 162 respondents, the majority were part of medical staff (51%), worked in a hospital (39%), in psychiatry/psychology (28%) and were women (54%). Most respondents (98%) believed that IM components: Doctor–patient relationship and patients’ responsibility for own healing process, were of high importance for healthcare. The other IM components, CAM use and healing environment, were found to be of importance by a lower percentage of responders (64% and 70%, respectively). 88% respondents regarded IM an important innovation in healthcare, despite the fact that 63% of them were not familiar with IM. The majority believed that patients should be informed about all possible treatments (94%), including CAM (84%). Of the CAM therapies listed, most considered lifestyle (90%) and mind-body therapies (54%) to be complementary to conventional treatment. Chi-square analysis demonstrated that familiarity with IM and being a female (among others) were predisposing factors for a positive attitude towards IM.

    Conclusions

    This survey among a convenient sample of Dutch healthcare professionals showed a relatively positive attitude towards IM. The outcome of this study may be useful to further implementation of IM in healthcare.

  • 24.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Nutr & Hlth, NL-3972 Driebergen, Netherlands.;Mid Sweden Univ, Dept Hlth Sci, S-85170 Sundsvall, Sweden.;Natl Informat & Knowledge Ctr Integrat Med NIKIM, Amsterdam, Netherlands..
    Ilyenko, Lydia
    Russian State Med Univ, Moscow 117997, Russia.
    Kholodova, Irina
    Russian State Med Univ, Moscow 117997, Russia.
    Verwer, Cynthia
    Louis Bolk Inst, Dept Nutr & Hlth, NL-3972 Driebergen, Netherlands.
    Burkart, Julia
    DHU Arzneimittel GmbH & Co KG, Deutsch Homoopathie Union, D-76227 Karlsruhe, Germany.
    Weber, Stephan
    Acomed Stat, D-04275 Leipzig, Germany.
    Keller, Thomas
    Acomed Stat, D-04275 Leipzig, Germany.
    Klement, Petra
    DHU Arzneimittel GmbH & Co KG, Deutsch Homoopathie Union, D-76227 Karlsruhe, Germany..
    A Comparative Randomized Controlled Clinical Trial on the Effectiveness, Safety, and Tolerability of a Homeopathic Medicinal Product in Children with Sleep Disorders and Restlessness2016Ingår i: Evidence-based Complementary and Alternative Medicine, ISSN 1741-427X, E-ISSN 1741-4288, artikel-id 9539030Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A prospective, multicenter, randomized, open-label, controlled clinical trial was performed to evaluate the effectiveness and safety of the homeopathic product ZinCyp-3-02 in children with sleep disorders for >= one month compared to glycine. Children <= six years old received either ZinCyp-3-02 (N = 89) or comparator glycine (N = 90). After treatment for 28 days, total sleep-disorder-associated complaints severity scores decreased in both groups from median 7.0 (out of maximum 11.0) points to 2.0 (ZinCyp-3-02) and 4.0 (glycine) points, respectively, with overall higher odds of showing improvement for ZinCyp-3-02 (odds ratio: 4.45 (95% CI: 2.77-7.14), p < 0.0001, POM overall treatment related effect). Absence of individual complaints (time to sleep onset, difficulties maintaining sleep, sleep duration, troubled sleep (somniloquism), physical inactivity after awakening, restlessness for unknown reason, and sleep disorders frequency) at study end were significantly higher with ZinCyp-3-02 (all p values < 0.05). More children with ZinCyp-3-02 were totally free of complaints (p = 0.0258). Treatment effectiveness (p < 0.0001) and satisfaction assessments (p < 0.0001) were more favorable for ZinCyp-3-02. Few nonserious adverse drug reactions were reported (ZinCyp-3-02: N = 2, glycine: N = 1) and both treatments were well tolerated. Treatment with the homeopathic product ZinCyp-3-02 was found to be safe and superior to the comparator glycine in the treatment of sleep disorders in children.

  • 25.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Baars, Erik
    Louis Bolk Institute, Dep Health & Nutrition.
    Adverse drug reactions to anthroposophic and homeopathic solutions for injection: a systematic evaluation of German pharmacovigilance databases2012Ingår i: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 21, nr 12, s. 1295-1301Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Medicinal solutions for injection are frequently applied in anthroposophic medicine and homeopathy. Despite their extensive use, there is little data published on the safety of these products. Therefore, we investigated the safety of anthroposophic and homeopathic solutions for injection through a systematic evaluation of adverse drug reactions (ADRs). METHODS: ADRs were extracted from the pharmacovigilance databases of eight German manufacturers. Analysed ADRs included case reports in humans only, (spontaneous) case reports from post-marketing surveillance, literature and clinical/safety trials. RESULTS: Between 2000 and 2009, in total, 303 million ampoules for injection were sold, and 486 case reports were identified, corresponding to a total number of 1180 ADRs. Of all case reports, 71.8% (349/486) included ADRs that were listed (e.g. stated in package leaflet), and 9.5% (46/486) of the reports were classified as serious. The most frequently reported ADRs were pruritus, followed by angioedema, diarrhoea and erythema. A total of 27.3% (322/1180) were localized reactions for example; application or injection site erythema, pain, swelling and inflammation. The overall reporting rate of ADRs associated with injections was less than 4 per 1 million sold ampoules and classified as very rare. CONCLUSIONS: Our systematic evaluation demonstrated that the reporting rate of ADRs associated with anthroposophic and homeopathic solutions for injection is very low. Most reported ADRs were listed, and one quarter consisted of local reactions. These findings suggest a low risk profile for solutions for injection as therapeutically applied in anthroposophic medicine and homeopathy

  • 26.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    van Wietmarschen, H.
    Louis Bolk Inst, Bunnik, Netherlands.
    Staps, S.
    Louis Bolk Inst, Bunnik, Netherlands.
    Needs and strengths of citizens in Amsterdam regarding improving their health and living environment2018Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, s. 39-39Artikel i tidskrift (Övrigt vetenskapligt)
  • 27.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap. The Arctic University of Norway, UiT, Tromsø, Norway.
    Lown, Anne
    University of California San Francisco, San Francisco, California, USA.
    Schats, Winnie
    Netherlands Cancer Institute, Amsterdam, The Netherlands.
    Otto, Heather Rose
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review2019Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 8, artikel-id e030544Artikel i tidskrift (Refereegranskat)
    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.

  • 28.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Pijl, A
    de Gast, H
    Sjöling, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    P02.128. The effects of guided imagery on preoperative anxiety and pain management in patients undergoing Laparoscopic Cholecystectomy in a multi-centre RCT study2012Ingår i: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012. BMC Complementary and Alternative Medicine 2012, 12(Suppl 1): P184 (12 June 2012), BioMed Central, 2012, s. 184-Konferensbidrag (Refereegranskat)
    Abstract [en]

    PurposeLaparoscopic Cholecystectomy (LC) is common practicein treatment of symptomatic gall stones. LC is often associatedwith preoperative anxiety and stress which maynegatively impact postoperative pain perception andrecovery from surgery. The aim of the present study wasto investigate whether a “non-pharmacological” interventionwith guided imagery can reduce preoperative anxiety,postoperative pain perception and medication comparedto standard care in patients undergoing LC.MethodsIn a pragmatic multi-centre randomized controlled study140 patients were randomized to a Guided Imagery (GI)group or control group. The GI group was provided witha CD to practice guided imagery once a day, 7 days priorto surgery. Patients in the control group received standardcare instructions only. Primary outcome measurement wasthe use of postoperative analgesics. Secondary outcomeparameters were preoperative anxiety levels using theAmsterdam Preoperative Anxiety and Information Scale(APAIS), postoperative pain perception (VAS-scale), generalpatient satisfaction (PSQ) and safety (adverse events)with treatment.Results95 out of 140 randomized patients completed the study,43 in the GI and 52 in the control group. The major reasonsfor dropping out were acute LCs or cancellation ofLC. Both groups were highly comparable with respect todemographic data. The majority was female (GI: 77%,Control: 75%). Postoperative morphine use was not significantlydifferent between the GI (15.8±18.5 mg) andcontrol group (12.5±13.6 mg, p=0.34). No significant differenceswere observed in anxiety and postoperative VASscores. Twenty-three percent of patients did exercises1-3 times, 65% 4-7 times and 12% >7 times. Within GIgroup analysis showed significantly less postoperativemorphine use upon better compliance to GI exercises(p=0.02).ConclusionIt is not as simple as replacing a pill with a CD. GuidedImagery seems to reduce postoperative pain medicationonce compliance to imagery exercises is achieved.

  • 29.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Sjöling, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Baars, Eric W
    University of Leiden, The Netherlands.
    Systematic Evaluation of the Safety of Injectables as used in Homeopathic and Anthroposophic Medicine2010Konferensbidrag (Refereegranskat)
  • 30.
    Jong, Miek C.
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Tjaden, B.
    Louis Bolk Inst, Bunnik, Netherlands.
    van Vliet, M.
    Louis Bolk Inst, Bunnik, Netherlands.
    Battjes-Fries, M.
    Louis Bolk Inst, Bunnik, Netherlands.
    van Wietmarschen, H.
    Louis Bolk Inst, Bunnik, Netherlands.
    Health promotion through mindfulness training: a study among Dutch primary care physicians2018Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, s. 346-346Artikel i tidskrift (Övrigt vetenskapligt)
  • 31.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    van de Vijver, Lucy
    Department Healthcare and Nutrition, Louis Bolk Institute, Driebergen, Netherlands.
    Busch, Martine
    Van Praag Institute, Utrecht, Netherlands.
    Fritsma, Jolanda
    Zorgbelang Groningen, Groningen, Netherlands.
    Seldenrijk, Ruth
    Patiënten Platform Complementaire Gezondheidszorg, Netherlands.
    Integration of complementary and alternative medicine in primary care: What do patients want?2012Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 89, nr 3, s. 417-422Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To explore patients' perspectives towards integration of Complementary and Alternative Medicine (CAM) in primary care.

    METHODS: A mixed-methods approach was used. This included a survey on use, attitudes and disclosure of CAM, an e-panel consultation and focus group among patients with joint diseases.

    RESULTS: A total of 416 patients responded to the survey who suffered from osteoarthritis (51%), rheumatoid arthritis (29%) or fibromyalgia (24%). Prevalence of CAM use was 86%, of which 71% visited a CAM practitioner. Manual therapies, acupuncture and homeopathy were most frequently used. A minority (30%) actively communicated CAM use with their General Practitioner (GP). The majority (92%) preferred a GP who informed about CAM, 70% a GP who referred to CAM, and 42% wanted GPs to collaborate with CAM practitioners. Similar attitudes were found in the focus group and upon e-panel consultation.

    CONCLUSIONS: Most patients in primary care want a GP who listens, inquires about CAM and if necessary refers to or collaborates with CAM practitioners.

    PRACTICE IMPLICATIONS: To meet needs of patients, primary care disease management would benefit from an active involvement of GPs concerning CAM communication/referral. This study presents a model addressing the role of patients and GPs within such an integrative approach.

  • 32.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    van Vliet, M
    Huttenhuis, S
    van der Veer, D
    van den Heijkant, S
    Attitudes toward integrative paediatrics: a national survey among youth health care physicians in the Netherlands2012Ingår i: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 12, nr 4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Integrative Medicine (IM) is an emerging field in paediatrics, especially in the USA. The purpose ofthe present study was to assess the attitudes and beliefs of Youth Health Care (YHC) physicians in the Netherlandstoward IM in paediatrics.Methods: In October 2010, a link to an anonymous, self-reporting, 30-item web-based questionnaire was mailed toall members of the Dutch Organisation of YHC physicians. The questionnaire included questions on familiarity withIM, attitudes towards Integrative Paediatrics (IP), use and knowledge of Complementary and Alternative Medicine(CAM), demographic and practice characteristics.Results: A total of 276 YHC physicians (response rate of 27%) responded to the survey. Of the respondents, 52% wasfamiliar with IM and 56% had used some kind of CAM therapy during the past 2 years, of which self-medicatedherbal and/or homeopathic remedies (61%) and supplements (50%) were most frequently mentioned. Most of theYHC physicians (62%) seldom asked parents of clients about CAM use. One third of the YHC physiciansrecommended CAM to their clients. In general, about 50% or more of the respondents had little knowledge of CAMtherapies. Predictors for a positive attitude towards IP were familiarity with IM, own CAM use, asking their clientsabout CAM use and practising one or more forms of CAM therapy. Logistic regression analysis showed that thefollowing factors were associated with a higher recommendation to CAM therapies: own CAM use (odds ratio (OR) =3.8; 95% confidence interval (CI) = 2.1-6.9, p = 0.001) and practising CAM (OR 4.4; 95% CI = 1.6-11.7, p = 0.003).Conclusions: In general Dutch YHC physicians have a relative positive attitude towards IP; more than half of therespondents used one or more forms of CAM and one third recommended CAM therapies. However, the majority ofYHC physicians did not ask their clients about CAM use and seemed to have a lack of knowledge regarding CAM.

  • 33.
    Jong, Miek C
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Verwer, C
    Department Nutrition & Health, Louis Bolk Institute, Driebergen, The Netherlands.
    van de Vijver, Lucy
    Louis Bolk Institute, The Netherlands.
    Klement, P
    Deutsche Homöopathie-Union, DHU-Arzneimittel GmbH & Co. KG, Karlsruhe, Germany.
    Burkart, J
    Deutsche Homöopathie-Union, DHU-Arzneimittel GmbH & Co. KG, Karlsruhe, Germany.
    Baars, Erik
    Louis Bolk Institute, The Netherlands.
    A Randomized Open Comparative Clinical Trial on the Effectiveness, Safety and Tolerability of a Homeopathic Medicinal Product for the Treatment of Painful Teething in Children2015Ingår i: Journal of Alternative & Integrative Medicine, ISSN 2327-5162, Vol. 4, nr 1, artikel-id 1000178Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Homeopathic products are sold over the counter and are often used for treatment of self-limiting complaints in children such as painful teething. Objective: To investigate the effectiveness, safety and tolerability of the homeopathic product ChamBell-5-02, in the treatment of children with painful teething in comparison to another homeopathic product. Design: A multicenter, randomized, open, comparative clinical trial with two parallel treatment groups at three outpatient pediatric clinics in Russia. Methods: Children aged ≤ six years with painful teething were enrolled from March-July 2009 in the study and randomized to receive either ChamBell-5-02 tablets (Dentokind®; intervention group) or homeopathic suppositories (Viburcol®; control group). Exclusion criteria were: fever of ≥38°C and severe comorbidity. Primary effectiveness endpoints were change of total severity scores of subjective complaints (TSSC) and clinical signs (TSCS) rated by investigators after seven days of treatment. Treatment satisfaction and safety (via number of adverse events (AEs)) were assessed. Results: A total of 200 children (100 per group) were included and analyzed. TSSC/ TSCS decreased after the 7- day treatment period from median 7.0 to 1.0/6.0 to 1.0 points in the intervention group and from median 5.0 to 1.0/5.5 to 1.0 points in the control group. Compared to the control group children receiving ChamBell-5-02 had about five/2.5 time higher odds of showing improvement (TSSC/TSCS: odds ratio resulting from proportional odds model was 5.1 (95%-CI: 2.7-9.4, p<0.0001) / 2.5 (95%-CI: 1.5-4.4, p=0.0011). Furthermore the intervention group showed a more favorable outcome regarding treatment satisfaction (ratings very satisfied: intervention group: n=94; control group: n=58). No AEs were recorded in the intervention group. In the control group three mild to moderate, nonserious AEs occurred. Conclusions: Overall it can be concluded that in this study ChamBell-5-02 tablets showed to be effective, safe and well tolerated.

     

  • 34.
    Klein-Laansma, C. T.
    et al.
    Louis Bolk Institute, Department of Health Care and Nutrition, Bunnik, The Netherlands.
    Rutten, A. L. B.
    Independent researcher, Breda, The Netherlands.
    Jansen, J. P. C. H.
    Louis Bolk Institute, Department of Health Care and Nutrition, Bunnik, The Netherlands.
    van Wietmarschen, H.
    Louis Bolk Institute, Department of Health Care and Nutrition, Bunnik, The Netherlands.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute, Department of Health Care and Nutrition, Bunnik, The Netherlands.
    Evaluation of a Prognostic Homeopathic Questionnaire for Women with Premenstrual Disorders2018Ingår i: Complementary Medicine Research, ISSN 2504-2092, Vol. 25, nr 3, s. 173-182Artikel i tidskrift (Refereegranskat)
    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.

  • 35.
    Klein-Laansma, Christien T
    et al.
    Louis Bolk Institute, Bunnik, The Netherlands.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    von Hagens, Cornelia
    University Women's Hospital, Universitätsfrauenklinik Heidelberg, Heidelberg, Germany.
    Jansen, Jean Pierre C H
    Louis Bolk Institute, Bunnik, The Netherlands.
    van Wietmarschen, Herman
    Louis Bolk Institute, Bunnik, The Netherlands.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute, Bunnik, The Netherlands.
    Semi-Individualized Homeopathy Add-On Versus Usual Care Only for Premenstrual Disorders: A Randomized, Controlled Feasibility Study2018Ingår i: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 24, nr 7, s. 684-693Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Premenstrual syndrome and premenstrual dysphoric disorder (PMS/PMDD) bother a substantial number of women. Homeopathy seems a promising treatment, but it needs investigation using reliable study designs. The feasibility of organizing an international randomized pragmatic trial on a homeopathic add-on treatment (usual care [UC] + HT) compared with UC alone was evaluated.

    DESIGN: A multicenter, randomized, controlled pragmatic trial with parallel groups.

    SETTINGS/LOCATION: The study was organized in general and private homeopathic practices in the Netherlands and Sweden and in an outpatient university clinic in Germany.

    SUBJECTS: Women diagnosed as having PMS/PMDD, based on prospective daily rating by the daily record of severity of problems (DRSP) during a period of 2 months, were included and randomized.

    INTERVENTIONS: Women were to receive UC + HT or UC for 4 months. Homeopathic medicine selection was according to a previously tested prognostic questionnaire and electronic algorithm. Usual care was as provided by the women's general practitioner according to their preferences.

    OUTCOME MEASURES: Before and after treatment, the women completed diaries (DRSP), the measure yourself concerns and well-being, and other questionnaires. Intention-to-treat (ITT) and per protocol (PP) analyses were performed.

    RESULTS: In Germany, the study could not proceed because of legal limitations. In Sweden, recruitment proved extremely difficult. In the Netherlands and Sweden, 60 women were randomized (UC + HT: 28; UC: 32), data of 47/46 women were analyzed (ITT/PP). After 4 months, relative mean change of DRSP scores in the UC + HT group was significantly better than in the UC group (p = 0.03).

    CONCLUSIONS: With respect to recruitment and different legal status, it does not seem feasible to perform a larger, international, pragmatic randomized trial on (semi-)individualized homeopathy for PMS/PMDD. Since the added value of HT compared with UC was demonstrated by significant differences in symptom score changes, further studies are warranted.

  • 36.
    Kok, Esther T.
    et al.
    Univ Appl Sci, NL-2333 CK Leiden, Netherlands.;Univ Bristol, Sch Social & Community Med, Ctr Acad Primary Care, Bristol BS8 2PS, Avon, England..
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Dept Healthcare & Nutr, NL-2972 LA Driebergen, Netherlands; Natl Informat & Knowledge Ctr Integrat Med NIKIM, Amsterdam, Netherlands..
    Gravendeel, Barbara
    Univ Appl Sci, NL-2333 CK Leiden, Netherlands.;Naturalis Biodivers Ctr, NL-2333 CR Leiden, Netherlands..
    Van Leeuwen, Willem B.
    Univ Appl Sci, NL-2333 CK Leiden, Netherlands..
    Baars, Erikw.
    Univ Appl Sci, NL-2333 CK Leiden, Netherlands.;Louis Bolk Inst, Dept Healthcare & Nutr, NL-2972 LA Driebergen, Netherlands..
    Resistance to Antibiotics and Antifungal Medicinal Products: Can Complementary and Alternative Medicine Help Solve the Problem in Common Infection Diseases? The Introduction of a Dutch Research Consortium2015Ingår i: Evidence-based Complementary and Alternative Medicine, ISSN 1741-427X, E-ISSN 1741-4288, artikel-id 521584Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The increase of antibiotic resistance worldwide, rising numbers of deaths and costs associated with this, and the fact that hardly any new antimicrobial drugs have been developed during the last decade have increased the interest in Complementary and Alternative Medicine (CAM) therapeutic interventions, if proven safe and effective. Observational studies on clinical CAM practices demonstrate positive effects of treatment of infections with CAM therapies (clinical effects, patient satisfaction) in combination with small percentages of antibiotics prescription. However, Cochrane reviews and other studies demonstrate that in most instances the quality of clinical trials on CAM treatment of infections is currently too low to provide sufficient evidence. Therefore a Dutch consortium on (in vitro and clinical) scientific research on CAM and antibiotic resistance has been formed. The aim and objective of the consortium is to establish an enduring partnership and to develop expertise to further develop and investigate safe and effective CAM treatments for infectious diseases of humans (and animals). A first ongoing project on the development of safe and effective biobased CAM antimycotics in women with (recurrent) vaginal candidiasis infection is introduced.

  • 37.
    Lundberg, Kristina
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Husum Health Center, Västernorrland County Council, Husum.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute, Driebergen, The Netherlands; National Information and Knowledge Center for Integrative Medicine, Amsterdam, The Netherlands.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Health Promotion in Practice—District Nurses׳ Experiences of Working with Health Promotion and Lifestyle Interventions Among Patients at Risk of Developing Cardiovascular Disease2017Ingår i: Explore: The Journal of Science and Healing, ISSN 1550-8307, E-ISSN 1878-7541, Vol. 13, nr 2, s. 108-115Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Health Promotion Practice (HPP) has the objective to promote a healthier lifestyle and reduce the risk of disease. The aim of this study was to examine district nurses׳ experiences of working with health preventive actions among patients with risk factors for cardiovascular disease (CVD), and to identify facilitators and obstacles in HPP. Design/Setting The study was carried out with a qualitative approach where individual semistructured interviews were performed with a total of 12 district nurses in primary care. Data transcripts were analyzed with a manifest content analysis. Findings Five categories were identified. Firstly, informants regarded HPP as the core essence of their work. Secondly, counseling and coaching were reported as crucial elements in working with HPP. Thirdly, informants identified tools such as motivational interviewing (MI) to facilitate HPP. In the fourth category facilitators and barriers of HPP appeared, consisting of both positive and negative attitudes and presence as well as lack of organizational culture and structure. Finally, some informants were dissatisfied with HPP and viewed it as compulsory or as a burden, while others were satisfied and experienced it as a stimulating challenge. Conclusion This study identified that HPP is the core of the district nurses׳ work to promote a healthier lifestyle in individuals with CVD. Organizational structures and culture need to be improved in order to support district nurses to successfully work with HPP. To optimize health promotion and strengthen patients׳ self-care, it is recommended that HPP include holistic elements of care.

  • 38.
    Lundberg, Kristina
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    District Nurses Experiences of Working with Health Promotion and Lifestyle Interventions Among Patients at Risk of Developing Cardiovascular Disease2014Ingår i: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, nr 5, s. A118-A118Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: In preventive health work it is possible to map risk factors at healthy individuals which include information and advice aiming to decrease the risk of developing cardiovascular disease. This preventive health care is in Sweden carried out primarily by the district nurses and they have a key role in promoting health and prevent cardiovascular disease. The aim of the study was to examine district nurses' experiences of working with health promotion among patients with risk factors of cardiovascular disease, and to identify possibilities and obstacles for prevention work in the practical reality.

    Methods: The study has been carried out with a qualitative approach where narrative interviews were performed with a total of 12 district nurses working at health centers in north Sweden. Data transcripts were analyzed with qualitative content analysis.

    Results: The participants express that their work in health promotion is an essence of the job as district nurse. It gives an opportunity to promote healthier lifestyle on an individual level with direct effects on patients' health. Participants are clear about what should be included in the preventive work and mention the topics of diet, exercise, tobacco, alcohol habits and obesity. The district nurses state that education in Motivational Interviewing, (MI), in Physical Activity on Prescription, (PAP) and the colleagues attitudes are important facilitators for making the health promotive work to function in the practical reality. Lack of knowledge (own and among colleagues) and inadequate organizational structures constitute obstacles.

    Conclusion: District nurses are unanimous about what should be included preventive health care. It is experienced as an important part of their duties but has sometimes difficulties to prioritize it. Furthermore, the district nurses consider that knowledge within MI, PAP and the employees' attitudes constitute possibilities while one sees lack of time, negative attitudes and inadequate structures that obstacles for the preventive work.

  • 39.
    Mathie, R. T.
    et al.
    Homeopathy Research Institute, London, UK.
    Van Wassenhoven, M.
    FAMHP (Federal Agency for Medicines and Health Products), Belgium.
    Rutten, L.
    Independent Researcher, United States.
    Klein-Laansma, C. T.
    Louis Bolk Institute, Driebergen, Netherlands.
    Eizayaga, J.
    Maimonides University, Buenos Aires, Argentina.
    Pla i Castellsagué, A.
    European Committee for Homeopathy, Belgium.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute, Driebergen, Netherlands; National Information and Knowledge Centre for Integrative Medicine, Netherlands.
    Manchanda, R. K.
    Central Council for Research in Homoeopathy, India.
    Dantas, F.
    Federal University of Uberlândia, Uberlândia, Brazil.
    Oberbaum, M.
    Shaare Zedek Medical Center, Jerusalem, Israel.
    Frye, J.
    University of Maryland School of Medicine, Baltimore, MD, United States.
    Roniger, H.
    Royal London Hospital for Integrated Medicine, London, United Kingdom.
    Baumgartner, S.
    University of Witten-Herdecke, Germany.
    van Haselen, R.
    International Institute for Integrated Medicine, Kingston, United Kingdom.
    Nicolai, T.
    Independent Researcher, United States.
    Fisher, P.
    Royal London Hospital for Integrated Medicine, London, United Kingdom.
    Model validity of randomised placebo-controlled trials of non-individualised homeopathic treatment2017Ingår i: Homeopathy, ISSN 1475-4916, E-ISSN 1476-4245, Vol. 106, nr 4, s. 194-202Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The comprehensive systematic review of randomised placebo-controlled trials (RCTs) in homeopathy requires examination of a study's model validity of homeopathic treatment (MVHT) as well as its risk of bias (extent of reliable evidence). Objective To appraise MVHT in those RCTs of non-individualised homeopathy that an associated investigation had judged as ‘not at high risk of bias’. Design Systematic review. Methods An assessment of MVHT was ascribed to each of 26 eligible RCTs. Another 49 RCTs were ineligible due to their high risk of bias. Main outcome measures MVHT and the prior risk of bias rating per trial were merged to obtain a single overall quality designation (‘high’, ‘moderate’, ‘low’), based on the GRADE principle of downgrading. Results The trials were rated as ‘acceptable MVHT’ (N = 9), ‘uncertain MVHT’ (N = 10) and ‘inadequate MVHT’ (N = 7); and, previously, as ‘reliable evidence’ (N = 3) and ‘non-reliable evidence’ (N = 23). The 26 trials were designated overall as: ‘high quality’ (N = 1); ‘moderate quality’ (N = 18); ‘low quality’ (N = 7). Conclusion Of the 26 RCTs of non-individualised homeopathy that were judged ‘not at high risk of bias’, nine have been rated ‘acceptable MVHT’. One of those nine studies was designated ‘high quality’ overall (‘acceptable MVHT’ and ‘reliable evidence’), and is thus currently the only reported RCT that represents best therapeutic practice as well as unbiased evidence in non-individualised homeopathy. As well as minimising risk of bias, new RCTs in this area must aim to maximise MVHT and clarity of reporting. 

  • 40.
    Palm, Jürgen
    et al.
    ENT Practice, Röthenbach an der Pegnitz, Germany.
    Kishchuk, Vasyl V.
    ENT Department, Vinnytsia Regional Clinical Hospital Named after M.I. Pirogov, Vinnytsia, Ukraine.
    Ulied, Àngels
    Pediatric Department, CAP Centelles, Centelles, Spain.
    Fernández, Joaquin P.
    ENT and Homeopathy Department, Clinical Tres Torres Clinical Pilar, Barcelona, Spain.
    De Jaegere, Sabine
    Deutsche Homöopathie-Union, DHU-Arzneimittel GmbH & Co. KG, Karlsruhe, Germany.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Department Nutrition & Health, Louis Bolk Institute, Driebergen, The Netherlands; National Information and Knowledge Center on Integrative Medicine (NIKIM), Amsterdam, The Netherlands.
    Keller, Thomas
    ACOMED statistik, Leipzig, Germany.
    Kosakovskyi, Anatolii
    ENT Department, National Children Specialized Hospital OHMATDYT, Kyiv, Ukraine.
    Kompaniiets, Kira
    Medical Center LLC Inter, Lugansk, Ukraine.
    Mityuryayeva-Korniiko, Inga
    Policlinic Department, Children Clinical Hospital No 6 of Pecherskyi District of Kyiv, Kyiv, Ukraine.
    Pukhlik, Sergiy M.
    Department of Otorhinolaryngology, Centre of Reconstructive and Renewal Medicine, University Clinic, Odessa National Medical University, Odessa, Ukraine.
    Tretiakevych, Zoia
    Out-Patient Department, Lugansk Regional Children's Hospital, Lugansk, Ukraine.
    Weber, Stephan
    ACOMED statistik, Leipzig, Germany.
    Wienhold, Karin
    HNOprax, ENT Practice, Wuppertal, Germany.
    Klement, Petra
    Deutsche Homöopathie-Union, DHU-Arzneimittel GmbH & Co. KG, Karlsruhe, Germany.
    Effectiveness of an add-on treatment with the homeopathic medication SilAtro-5-90 in recurrent tonsillitis: An international, pragmatic, randomized, controlled clinical trial2017Ingår i: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 28, s. 181-191Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To investigate the effectiveness and safety of the homeopathic product SilAtro-5-90 in recurrent tonsillitis. Methods In this international, pragmatic, controlled clinical trial, 256 patients (6–60 years) with moderate recurrent tonsillitis were randomized to receive either SilAtro-5-90 in addition to standard symptomatic treatment, or to receive standard treatment only. The primary outcome was the mean time period between consecutive acute throat infections (ATI) within 1 year (analyzed via repeated events analysis). Results During the evaluation year, the risk of getting an ATI was significantly lower (hazard ratio: 0.45, proportional means model, p = 0.0002, ITT) with SilAtro-5-90 compared to control. Tonsillitis-specific symptoms were significantly reduced (p < 0.0001, ITT) and the need of antibiotics to treat acute throat infections (p = 0.0008; ITT) decreased. 3 non-serious adverse drug reactions were reported for SilAtro-5-90. Conclusions An integrative treatment approach where SilAtro-5-90 is given alongside mainstream symptomatic treatment may bring therapeutic benefit to patients suffering from recurrent tonsillitis. Trial registration: ISRCTN registry: Registration number ISRCTN19016626, registered 23 January 2013.

  • 41.
    Pijl, AJ
    et al.
    Department of Anesthesiology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
    de Gast, HM
    Department of Anesthesiology, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hoen, MB
    Department of Anesthesiology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
    Kluyver, EB
    Department of Anesthesiology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
    van der Vegt, MH
    Department of Anesthesiology, Zaans Medisch Centrum, Zaandam, The Netherlands.
    Kanhai, SRR
    Department of Anesthesiology, Sint Lucas Andreas Ziekenhuis, The Netherlands.
    Jong, Miek
    Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands.
    Guided Imagery Intervention does not Affect Surgical Outcome of Patients Undergoing laparoscopic Cholecystectomy: A Multi-Centre, Randomised Controlled Study2016Ingår i: Journal of Patient Care, Vol. 2, nr 3, artikel-id 10000119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:To investigate if a “non-pharmacological” intervention with guided imagery could reduce postoperative analgesic consumption, pain perception and preoperative anxiety, compared to standard care, in patients undergoing laparoscopic cholecystectomy (LC). Methods: A randomized controlled study with two parallel groups was performed at two hospital departments of anesthesiology. A total of 140 patients (≥ 18 years) that were scheduled for LC were randomized to either receive guided imagery (N=70) or standard care instructions (N=70) as a control group. Patients in the guided imagery group were provided a CD to practice guided imagery once a day, 7 days prior to surgery. Primary outcome measurement was post-operative analgesic consumption. Secondary outcomes were preoperative anxiety, post-operative self-rated pain, patient satisfaction and adverse events.Results: Of 140 patients that were randomized, 95 patients completed the study, 43 in the guided imagery group and 52 in the control group. Both groups were comparable at baseline with respect to demographic data. Compliance with intervention was fairly good as 77% of the patients had listened to the CD according to instructions. No significant differences (p=0.34) were observed for postoperative morphine use between the intervention (15.8 ± 18.5 mg) and control group (12.5 ± 13.6 mg). Secondary outcomes such as preoperative anxiety (APAIS: 15.2 ± 5.9 vs. 16.4 ± 5.9; p=0.36)), postoperative pain (VAS: 3.4 ± 1.8 vs. 3.0 ± 1.8; p=0.31) and patient satisfaction (PSQ: 4.1 ± 0.9 vs. 3.9 ± 0.8; p=0.47) also demonstrated no significant differences. No adverse events were reported in both groups.Conclusion: A short preoperative guided imagery intervention demonstrated no additional beneficial effects compared to standard care for patients undergoing LC. It therefore seems not to be as simple as to provide patients with a CD before surgery in order to effectively self-manage postoperative pain.

  • 42. Rosenstiel, Inez
    et al.
    Schats, Winnie
    Bongers, K
    Jong, Miek C
    Healthcare and Nutrition, Louis Bolk Institute, the Netherlands.
    Integrative paediatrics: a Dutch experience2011Ingår i: Focus on Alternative and Complementary Therapies, ISSN 1465-3753, E-ISSN 2042-7166, Vol. 16, nr 1, s. 22-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background  In 2003 a paediatric integrative medicine (IM) clinic was established in the Slotervaart Hospital, the Netherlands. The clinic provides advice and treatment to inpatient and outpatient children, using a shared-care model with complementary therapists. The clinic also provides a limited range of evidence-based complementary modalities for inpatient children, aimed at decreasing pain, fear and stress.

    Objective  To describe the successful integration of CAM and IM within a paediatric department of a Dutch teaching hospital.

    Materials and methods  The clinic was set up through the special interest of the head of the paediatric department, with support from fellow paediatricians, medical specialists, nurses, other staff and hospital board members. A shared-care model with complementary therapists was developed for the outpatient population.

    Results  The clinic is currently run by paediatricians trained in several complementary modalities, and a group of carefully selected and licensed naturopaths, Ayurvedic practitioners, hypnotherapists, massage therapists, homeopaths, osteopaths, acupuncturists and integrative psychology counsellors. There is close collaboration with the medical librarian who maintains a database of IM literature and provides up-to-date evidence-based literature on specific IM topics.

    Conclusions  The clinic enjoys a special position in the Dutch healthcare system, but faces specific and unique challenges. Recruitment and retention of physicians and nurses, who are both knowledgeable and skilled in IM, is an important goal for the continuation of the clinic. Two areas need to be closely addressed in the near future: financial viability and a regulatory framework for CAM practitioners in collaborative hospital settings.

  • 43.
    Sjöling, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Lundberg, Kristina
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Englund, Erling
    Research and Development Centre, County Council of Västernorrland, Sundsvall, Sweden.
    Westman, Anton
    Department of Surgical and Perioperative Sciences, Section of Anesthesiology and Intensive Care, Umeå University, Umeå, Sweden.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Effectiveness of motivational interviewing and physical activity on prescription on leisure exercise time in subjects suffering from mild to moderate hypertension2011Ingår i: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 4, s. Art. no. 352-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:Physical inactivity is considered to be the strongest individual risk factor for poor health in Sweden. It has been shown that increased physical activity can reduce hypertension and the risk of developing cardiovascular diseases. The objective of the present pilot study was to investigate whether a combination of Motivational Interviewing (MI) and Physical Activity on Prescription (PAP) would increase leisure exercise time and subsequently improve health-related variables.METHODS:This pilot study was of a repeated measures design, with a 15 months intervention in 31 patients with mild to moderate hypertension. Primary outcome parameter was leisure exercise time and secondary outcome parameters were changes in blood pressure, Body Mass Index (BMI), waist circumference, lipid status, glycosylated haemoglobin (HbA1c) and maximal oxygen uptake (VO2max). Assessments of the outcome parameters were made at baseline and after 3, 9 and 15 months. RESULTS:Leisure exercise time improved significantly from <60 min/week at baseline to a mean activity level of 300 (+/- 165) minutes/week at 15 months follow up. Furthermore, statistically significant improvements (p<0.05) were observed in systolic (-14,5 +/- 8.3 mmHg) and diastolic blood pressure (-5,1 +/- 5.8 mmHg), heart rate (-4.9 +/- 8.7 beats/min, weight (-1.2 +/- 3.4 kg) BMI -0.6 +/- 1.2 kg/m2), waist circumference (-3.5 +/- 4.1 cm) as well as in VO2max (2.94 +/- 3.8 ml/kg and 0.23, +/- 0.34 lit/min) upon intervention as compared to baseline. CONCLUSIONS:A 15 month intervention period with MI, in combination with PAP, significantly increased leisure exercise time and improved health-related variables in hypertensive patients. This outcome warrants further research to investigate the efficacy of MI and PAP in the treatment of mild to moderate hypertension.

  • 44.
    van Vliet, Marja
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Louis Bolk Institute, the Netherlands.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Busch, Martine
    van Praag Institute, Utrecht, The Netherlands.
    Meijer, Judith E M
    The Netherlands Foundation Health Centers, National Information and Knowledge Center for Integrative Medicine, Netherlands.
    von Rosenstiel, Inès A
    Slotervaart Hospital, National Information and Knowledge Center for Integrative Medicine, Netherlands .
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute, the Netherlands.
    Attitudes, Beliefs, and Practices of Integrative Medicine Among Nurses in the Netherlands2015Ingår i: Journal of Holistic Nursing, ISSN 0898-0101, E-ISSN 1552-5724, Vol. 33, nr 2, s. 110-121Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study assessed the attitude, beliefs, and practices of integrative medicine (IM) among nurses in the Netherlands.

    DESIGN: Subscribers of a Dutch nursing journal were asked to fill in an anonymous, structured, online survey related to the topic under study.

    RESULTS: A total of 355 people responded, of which 37% were familiar with the concept of IM in advance. On completion of the survey, the majority (83%) considered IM as a (very) important innovation in health care. Familiarity (odds ratio = 3.20; 95% confidence interval [1.48, 6.94]) and organization (nursing home compared to hospital (odds ratio = 5.98; 95% confidence interval [1.36, 26.23]) were characteristics associated with a positive attitude toward IM. Between 23% and 46% of respondents encountered obstacles regarding implementation of IM. The main obstacles were lack of support (69% to 78%), means (57% to 85%), and time (63% to 70%).

    CONCLUSIONS: Dutch nurses seem to have relatively positive attitudes and beliefs regarding IM. The outcome of this survey may contribute an increased awareness of the key role that nurses can play in the development and implementation of IM.

  • 45.
    van Vliet, Marja
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    A Barrier Opener for Personal Insights: Nursing and Medical Students Experiences of Participating in an Experiential Mind-Body Skills Program2014Ingår i: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, nr 5, s. A98-A99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aimed to obtain an in-depth understanding on how nursing-, and medical students participating in a Mind-Body Medicine Skills program experienced participation and what the program has meant to them on a personal and a professional level.

    Methods: Based on a qualitative approach, first and second year students were interviewed 3 months after completion of the program. Interviews were analyzed with a qualitative content analysis. As a part of a larger study evaluating the effects on stress, empathy and self-reflection, this qualitative sub-study included 10 nursing students from Mid Sweden University, Sweden, and 10 medical students from University of Utrecht, The Netherlands. The Mind-Body Medicine Skills program was adapted from the program developed at Georgetown University School of Medicine, Washington DC, and included 11 experiential sessions were the students were introduced to different mind-body techniques (mindfulness meditation, guided imagery, bio-feedback etc).

    Results: Data analysis is ongoing and more complete analysis will be presented at the conference. In preliminary analysis an overarching theme has been identified: The Mind-Body Medicine Skills program as a barrier opener of personal insights, and a starting point for a new journey in life. The participants describe how the course have made it possible for them obtain insights about themselves, both by self reflection in relation to experiences and through listening to the stories of the others. It is also described that they currently do not at all times explicitly use the direct techniques, but more separate personalized elements, which they have been able to incorporate in everyday situations: i.e. moments of mindfulness while walking, biking or eating, or taking a moment of breathing and relaxation before dealing with problematic situations with others.

    Conclusion: Participation in the Mind-Body Medicine Skills program can on an individual basis have a deep and profound meaning, stimulating to personal growth.

  • 46.
    van Vliet, Marja
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Effects of a Mind-Body Medicine Skills Program on Perceived Stress, Empathy and Self-Reflection Among Medicine and Nursing Students: A Quantitative Study2014Ingår i: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, nr 5, s. A99-A99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aimed to implement and quantitatively evaluate the Mind-Body Medicine (MBM) Skills program among Dutch medical and Swedish nursing students.

    Methods: The MBM Skills program was piloted among second year medical students at Utrecht University and first year nursing students at Mid Sweden University in the period 2011–2013. During the course, the participating students learned and practiced Mind-Body techniques such as relaxation, meditation, guided imagery, biofeedback, physical exercise, art, music and movement. The effects of the MBM skills program on perceived stress, empathy, and self-reflection were evaluated by the following validated scales: Perceived Stress Scale, Interpersonal Reactivity Index, and Groningen Reflection Ability Scale. Participating students and controls answer(-ed) the different questionnaires at baseline, at the end of the course, and 6 and 12 months later.

    Results: In total, 55 medical students and 49 nursing students have participated in the MBM skills program. Baseline analysis (age, gender, mind-body experience, perceived stress, four subscales of the IRI, and self-reflection) demonstrated that participating nursing students were significantly older (p<0.001), and had higher scores for empathetic concern (p<0.001) and self-reflection (p=0.001) than participating medical students. Further, baseline analysis showed no significant differences in baseline characteristics between intervention and control group for medical students, except from significantly higher levels of perceived stress among controls (p=0.008). Regarding nursing students, no differences were found between intervention and control group, except from significantly higher scores for empathetic concern among participants (p=0.023).

    Conclusion: We have successfully implemented the MBM Skills program for medical and nursing students. Baseline analysis showed that participants of the course were not a selected group, except from perceived stress among medical students and empathetic concern among nursing students. Data on the effects of the MBM skills program on perceived stress, empathic concern and self-reflection are currently being evaluated and will be presented at the conference.

  • 47.
    van Vliet, Marja
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Department of Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlan.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Department of Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlands; National Information and Knowledge Center Integrative Medicine (NIKIM), Amsterdam, the Netherlands.
    Long-term benefits by a mind–body medicine skills course on perceived stress and empathy among medical and nursing students2017Ingår i: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 39, nr 7, s. 710-719Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A significant number of medical students suffer from burnout symptoms and reduced empathy. This controlled, quasi-experimental study aimed to investigate whether a mind–body medicine (MBM) skills course could reduce perceived stress and increase empathy and self-reflection in medical and nursing students.

    Methods: The MBM course (consisting of experiential sessions of mind–body techniques and group reflections) was piloted among Dutch medical students and Swedish nursing students. Main outcome variables were perceived stress (PSS), empathy (IRI subscales perspective taking, fantasy, empathic concern, and personal distress), and self-reflection (GRAS). Participating and control students completed questionnaires at baseline, post-intervention, at 6 and 12 months follow-up.

    Results: Seventy-four medical and 47 nursing students participated in the course. Participating medical students showed significantly increased empathic concern [1.42 (95% CI 0.05, 2.78), p = 0.042], increased fantasy [3.24 (95% CI 1.58, 4.90), p < 0.001], and decreased personal distress [−1.73 (95% CI −3.04, −0.35), p = 0.010] compared to controls until 12 months follow-up. Participating nursing students showed significantly decreased levels of perceived stress [−5.09 (95% CI −8.37, −1.82), p = 0.002] and decreased personal distress [−5.01 (95% CI −6.97, −3.06), p < 0.001] compared to controls until 12 months follow-up.

    Conclusions: This study demonstrated long-term beneficial effects of the MBM course on perceived stress and empathy in medical and nursing students.

  • 48.
    van Vliet, Marja
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Louis Bolk Inst, Bunnik, Netherlands.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Inst, Bunnik, Netherlands.
    Jong, Mats
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    A Mind Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World2018Ingår i: Global Qualitative Nursing Research, ISSN 2333-3936, Vol. 5Artikel i tidskrift (Refereegranskat)
    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.

  • 49. Vlieger, Arine
    et al.
    van Vliet, M
    Jong, Miek C
    Attitudes toward complementary and alternative medicine: a national survey among paediatricians in the Netherlands2011Ingår i: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 170, nr 5, s. 619-624Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the present survey was to assess attitudes, beliefs, experience, referral patterns and desire for education regarding complementary and alternative medicine (CAM) therapies of paediatricians in the Netherlands. In 2009, the link to an anonymous, self-reporting, 30-item web-based questionnaire was mailed to all members of the Dutch Association of Paediatrics. The questionnaire included questions about demographics and practice characteristics, use of CAM by the paediatrician and/or his family, attitudes towards and knowledge of CAM, and inquiries about CAM use in their practice. A total of 343 (24%) paediatricians responded to the survey: 39% had used some kind of CAM therapy themselves during the past 2 years, of which supplements (64%) and herbal and/or homeopathic remedies (30%) were most frequently mentioned. The majority of the paediatricians (62%) seldom asked parents of patients about CAM use. Referrals to CAM doctors were made by approximately 30% of the paediatricians. In general, more than 50% of the surveyed paediatricians had little knowledge of CAM therapies. Predictors for a positive attitude towards CAM were own CAM use (p < 0.0001), age >45 years (p = 0.02) and perceived knowledge level of CAM (p < 0.005). In conclusion, a significant group of Dutch paediatricians has a positive attitude towards CAM and refers patients to CAM therapies. The majority of paediatricians, however, do not ask patients about CAM use and seem to lack sufficient knowledge on CAM.

  • 50.
    Wietmarschen, Herman
    et al.
    Louis Bolk Institute, Bunnik, Netherlands.
    Tjaden, Bram
    Trainer, Aandachtigedokters, Zeist, Netherlands.
    van Vliet, Marja
    Louis Bolk Institute, Bunnik, The Netherlands.
    Battjes-Fries, Marieke
    Louis Bolk Institute, Bunnik, The Netherlands.
    Jong, Miek C.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Louis Bolk Institute, Bunnik, The Netherlands.
    Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study2018Ingår i: BJGP Open, ISSN 2398-3795, Vol. 2, nr 4, s. 11Artikel i tidskrift (Refereegranskat)
    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.

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