Tessa Magnée

Nivel – Research for better care | NIVEL

The aim of this thesis was to monitor mental health care in Dutch general practices in recent years. In 2014, a reform of the Dutch mental health care system was introduced. Since this reform, general practitioners (GPs) are expected to only refer patients with a (suspected) psychiatric disorder or at high risk for (self) harm. All other patients w...

Praktijkondersteuners huisarts ggz (poh’s-ggz) zijn niet meer weg te denken uit de huisartsenpraktijk. Ruim tien jaar zien ze inmiddels patiënten met psychische, relationele of werkgerelateerde klachten, die meestal niet lang op een eerste consult hoeven te wachten. Zijn poh’s-ggz tevreden met de inhoud van hun werk? En hoe verloopt de samenwerking...

De Landelijke Vereniging POH-GGZ is sinds haar oprichting in 2013 snel gegroeid. In 2022 telt de vereniging ruim 1800 POH’s-GGZ. Dat veel leden vrouw zijn komt vast niet als een verrassing. Maar wist je ook al dat relatief veel leden in Gelderland wonen? En dat de meesten drie dagen per week werken, 9 consulten per dag hebben en vooral volwassen pa...

ACHTERGROND De overheid beoogt de huisartsenzorg voor psychische problemen te versterken om de geestelijke gezondheidszorg (ggz) betaalbaar te houden. Belangrijke maatregelen waren de introductie van de functie van de praktijkondersteuner huisarts ggz (poh-ggz) in 2008 en de invoering van de basis-ggz in 2014 met een nieuw verwijsmodel. DOEL Onde...

Background The stringent lockdown measures and limited physical access to GP care at the start of COVID-19 pandemic resulted into a decrease of mental health consultations. It raised concerns about the access of patients with mental health problems. The aim of this study is to investigate the mental health GP consultations amongst patients from dep...

Aim To explore how patients and general practice professionals in low-income neighborhoods experienced the increase of remote care during COVID-19. Background As the GP (general practitioner) is the first point of contact in Dutch health care, there are concerns about access to remote care for patients from low-income neighborhoods. Now that gener...

Background Due to stringent lock-down measures imposed during COVID-19 pandemic the access to the primary care dropped significantly. This study aims to investigate the impact on GP consultations for diabetes mellitus (DM) and COPD during the pandemic. Methods In an observational study from January 2018-June 2022, anonymized medical records of 379...

Introduction: Randomized controlled trials have demonstrated the effectiveness of workplace smoking cessation programs. However, with low participation rates reported, it is important to understand the barriers and facilitators for the reach and participation of employees in workplace smoking cessation programs. The objective of the present study i...

Background Worldwide the Covid-19 pandemic resulted in drastic behavioral measures and lockdowns. Vaccination is widely regarded as the true and only global exit strategy; however, a high vaccination coverage is needed to contain the spread of the virus. Vaccination rates among young people are currently lacking. We therefore studied the experience...

Background Little is known about smoking cessation among gender minority populations compared to cis-gender individuals (whose gender matches their sex assigned at birth). We examined differences between smokers from gender minority populations, cis-women, and cis-men in heaviness of smoking, quit intentions, use of cessation assistance, quit attem...

Objectives Remote consultations were common in general practice during the COVID-19 pandemic. This approach may have affected access to GP care for people with low socio-economic status: this group has a high prevalence of chronic conditions and a higher mortality rate due to COVID-19. This study explores the association of sociodemographic and hea...

Samenvatting De COVID-19-vaccinatiegraad in Nederland is niet gelijk verdeeld: in sommige wijken blijft de vaccinatiegraad achter. Dat leidt tot individuele gezondheidsrisico’s en belasting van de zorgketen. Een verklaring hiervoor is dat een gelijke aanpak ( equality -aanpak) niet altijd tot gelijke uitkomsten leidt, terwijl er op landelijk niveau...

Veel huisartsen hebben te weinig tijd om patiënten die chronisch benzodiazepines, antidepressiva of opioïden gebruiken, te begeleiden bij het afbouwen van die medicatie. In een online vragenlijstonderzoek gaven zowel huisartsen als POH’s-ggz aan dat de POH-ggz daar goed bij zou kunnen helpen. Veel POH’s-ggz hebben al enige ervaring met afbouwbegele...

Sex and gender are determinants of health outcomes across an individual’s life course. However, often in health research and practice, sex and gender considerations are either overlooked or confounded. Recent developments in health research and practice ask for the inclusion of sex and gender considerations within health research and practice. This...

Introduction: Cervical cancer is the fourth most common form of cancer among women. Smoking tobacco seems to be a risk factor for the development of cervical intra-epithelial neoplasia (CIN) and cervical cancer, but the exact role of smoking in the process of cervical carcinogenesis is not known. The aim of this study is to investigate the relation...

In de gezondheidszorg wordt lang nog niet altijd rekening gehouden met gezondheidsverschillen tussen mannen en vrouwen. Waar kunnen praktijkondersteuners en praktijkverpleegkundigen rekening mee houden?

We weten dat een acute, ernstige somatische aandoening zoals een longontsteking, een enorme impact kan hebben op het lichamelijk en cognitief functioneren. Ook maanden nadat patiënten beter zijn verklaard. Over de impact van COVID-19 op het cognitief functioneren is nog weinig bekend. De schaarse wetenschappelijke literatuur geeft aanwijzingen dat...

The comic book aims to illustrate how sex and gender can influence the health of people and to create knowledge, enthusiasm, and discussions among health professionals and researchers. We hope that our comics will create awareness and help you consider how sex and gender can influence health research and the health of communities and individuals....

Randomized studies have shown that financial incentives can significantly increase the effect of smoking cessation treatment in company settings. Evidence of effectiveness alone is, however, not enough to ensure that companies will offer this intervention. Knowledge about the barriers and facilitators for implementation in the workplace is needed,...

Background Experiential peers are increasingly involved in the development and delivery of interventions for individuals who are engaged in delinquent behavior. Experiential peer support, which is the provision of support to an individual engaged in delinquent behavior by someone who has previously also practiced such behavior, is one such applicat...

De Psycholoog

Jeugdzorginstelling Schakenbosch ging vanaf 2018 een integrale samenwerking aan met de FACT-teams in de regio Rijnmond. De gemeente Rotterdam vroeg onderzoeksinstituut IVO een onderzoek uit te voeren naar deze samenwerking. Doel is het in kaart brengen van de eerste ervaringen van professionals met de nieuwe werkwijze. De resultaten bieden input vo...

Background: Dutch policy aims to strengthen mental health care in general practices, to keep health care affordable. Recently, a new function (mental health nurses) and a new referral model for patients with mental health problems were introduced. AIM: To explore to what extent the volume of mental health care in Dutch general practices has increa...

De invoering van de basis-ggz had een grote invloed op de zorg voor patiënten met psychische problemen in de huisartsenpraktijk. In de periode 2010-2014 kregen zowel huisartsen als praktijkondersteuners-ggz steeds meer patiënten met psychische problemen op consult. Poh’s-ggz namen geen patiënten over van de huisarts, maar leverden vooral aanvullend...

Background Although the recovery of patients suffering from low back pain is highly context dependent, patient preferences about treatment options are seldom incorporated into the therapeutic plan. Shared decision-making (SDM) offers a tool to overcome this deficiency. The reinforcement by the general practitioner (GP) of a ‘shared’ chosen therapy...

Purpose: The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses. Antidepressant prescriptions are very common in general practice, but are often not in line with recommendations. The recent introduction of mental health nur...

Background A reform of Dutch mental health care aimed to substitute care from specialized care to general practice. Since 1 January 2014, Dutch general practitioners (GPs) are no longer allowed to refer patients without a psychiatric disorder to mental health care. Patients with non-complex psychological problems should be treated within general p...

Sinds de introductie van de prak-tijkondersteuner geestelijke ge-zondheidszorg (poh-ggz) in 2008 om binnen de huisartsenpraktijk meer psychische problematiek te kunnen behandelen, groeide het aantal poh's-ggz flink. In 2010 beschikte 20% van de praktijken over een poh-ggz, in 2015 was dit ruim 80%. Ook de wachttijden namen toe. In een LHV-enquête u...

Background: Efficient screening questionnaires are useful in general practice. Computerized adaptive testing (CAT) is a method to improve the efficiency of questionnaires, as only the items that are particularly informative for a certain responder are dynamically selected. Objective: The objective of this study was to test whether CAT could impr...

Background Substitution is the shift of care from specialized health care to less expensive and more accessible primary health care. It seems promising for restraining rising mental health care costs. The goal of this study was to investigate a potential for substitution of patients with psychological or social problems, but without severe psychiat...

1 ONDERZOEK De huisarts speelt een steeds belangrijkere rol in de gees-telijke gezondheidszorg. Niet alleen is de huisarts poort-wachter voor de tweede lijn en dus verantwoordelijk voor de triage, steeds vaker ook is de huisartsenpraktijk zelf de plek waar mensen met psychische klachten behandeld worden. Sinds de invoering van de basis-GGZ in 2014...

Objective: We conducted a clustered randomised controlled trial to study the effects of shared decision making (SDM) on patient recovery. This study aims to determine whether GPs trained in SDM and reinforcing patients' treatment expectations showed more trained behaviour during their consultations than untrained GPs. Methods: We compared 86 con...

Objectives To investigate care for patients with psychological or social problems provided by mental health nurses (MHNs), and by general practitioners (GPs) with and without MHNs. Design An observational study with consultations recorded by GPs and MHNs. Setting Data were routinely recorded in 161–338 Dutch general practices between 2010 and 201...

De zorg voor patiënten met psychische en sociale klachten is sinds de introductie van de basis-GGZ in 2014 ingrijpend veranderd. Patiënten met (lichte) psychologische klachten en sociale problemen dienen te worden behandeld in de huisartsenpraktijk. De huisarts wordt daarbij ondersteund door de Praktijkondersteuner GGZ (POH-GGZ). In deze factsheet...

Objective: The objective of this study was to examine mental health care provided by general practitioners and by mental health nurses working in general practices. Design: Observational research. Method: We analysed how many consultations with patients with mental health problems were recorded in Dutch general practices in the period 2010-201...

Context: Reducing health inequalities is a policy priority in many developed countries. Little is known about effective strategies to reduce inequalities in obesity and its underlying behaviors. The goal of the study was to investigate differential effectiveness of interventions aimed at obesity prevention, the promotion of physical activity or a...

Sinds de invoering van de basis-GGZ per 1 januari 2014 is er veel veranderd in de zorg voor volwassen patiënten met een psychische en sociale hulpvraag. Patiënten met (lichte) psychische of sociale problematiek komen niet meer in aanmerking voor behandeling binnen de gespecialiseerde zorg, maar dienen binnen de huisartsenpraktijk te worden behandel...

Sex differences in event-related potentials were examined in 23 women and 24 men during a mental rotation task. We found an early (130-400 ms) and a late (400-700 ms) ERP mental rotation effect. The late rotation effect, which is thought to indicate the onset of the cognitive process of mental rotation, emerged about 100 ms earlier in men than in w...