De flexibele interface een samenwerking tussen wetenschappers, programmeurs, patiënten en zorgprofessionals

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1 De flexibele interface een samenwerking tussen wetenschappers, programmeurs, patiënten en zorgprofessionals Project groep: Harriette Riese, Judith Rosmalen, Fionneke Bos, Marieke Wichers, ilab, RoQua en UCP

2 Experience sampling techniques Feedback effectively reduces depressive symptoms (Kramer et al World Psychiatry) Case-study Date van der Veen & Harriette Riese bij paniek (Kroeze et al J Person- Oriented research) Personalized warning signals may be deduced (Wichers, Groot et al Psychother &) Psychologists and psychiatrists want to use it for monitoring and diagnostics

3 What do patients and clinicians think? -6 focus groups and 15 personal interviews -participation of 22 patients and 20 clinicians May more rapidly signal problem areas of particular patient May give more insight in behaviours/contexts influencing symptoms May increase motivation for behavorial change May facilitate conversation between clinician and patient: ESM as tool for communication May add to personal control on treatment/recovery process May help reducing biases in memory while reporting mood /problems Clinician needs to take time to discuss results with patients Patients needs access to own personal data Data interpretation with caution Is an extra tool, not holy grail

4 Implementation experiments Additional ESM diagnostics implemented in psychiatric care: psychosis Psychiatrists can mark specific questions that they want to have examined; For example: How often does patient experience symptoms? Does daily context influence level of symptoms? How does daily life look like? How does patient deal with hallucinations? Wim Veling

5 Hearing voices Psychosis diagnostics Fionneke Bos How often and to what extent does patient feel suspicious? Is context associated with symptoms of patient? Being physically active

6 Psychosis diagnostics What activities are present in daily life of patient? Sport 9% Hobby 7% Going out 5% Something quiet 7% Talking 7% Work/study 5% No obs 2% Other 4% Something intimate 4% Whatsappen 7% travelling4% Doing nothing 7% Friends 7% Self-care 4% Housekeeping 4% Eating 7% Social media 7% How does patient respond to voices and how does that relate to voice hearing a moment later? What is the best strategy for this patient? Do what voices tell 21x Say something back 12 x Listen to music 6x Talk/sing 12 x Seek distraction 5x Sport 6x joint/alcohol 6x Take medication 14 x Take substances 5x Something else 5x I did not hear voices 6x Voices one moment later

7 Bipolar diagnostics and monitoring Design: 20 bipolar patients who monitored experiences for 4 months They receive report on their changes in symptoms.and a report on what precisely preceded episodes of depression or mania

8 Flexible ESM interface for implementation Harriette Riese, Fionneke Bos Judith Rosmalen, Marieke Wichers Wim Veling (psychose), Date van der Veen (dwang/angst), Benno Haarman (stemming) en patiënten Erwin Veermans, Hester van Wijk Ando Emerencia Ingediend voor innovatieprijs Zorg

9 Design choice Flexible ESM interface for implementation -random beep design -fixed beep design -Daily questions -Weekly/monthly questions personalized diary Valid design for purpose Valid order of items Possibility of personal items Details design Number measurement moments Duration Start date domains Sleep Mood Somatic symptoms Psychological symptoms Contextual factors Treatment factors Personal reports Clinician patient choose their type of feedback and choose variables for feedback And combinations of variables (e.g. context and frq of specific symptom in that context)

10 Flexible ESM interface: domains Stemming (NA, PA; verplicht) (hypo) manie: Spraakzaam, contact zoeken, snelle gedachtes Onrust/agitatie: gespannen, gejaagd, prikkelbaar Overprikkeling (concentratie, chaos in hoofd) Stress: Gestrest voelen, onplezierige situaties, spanning over toekomst Angst: veiligheid, vermijding, controle Stemmen Andere psychotische ervaringen Lichamelijke klachten Anhedonie en initiatief: (fysieke) activiteiten, zin in contact, zin in morgen, lusteloos voelen (Sociale) omgeving: Waar ben ik. Met wie ben ik? En hoe ervaar ik dat. Middelen en bijwerkingen: (medicatie, roken, drank, cannabis, etc) Cognities: Piekeren, zelfbeeld

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