Wensing, M. (Michel)

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    Social support and health in diabetes patients: an observational study in six european countries in an era of austerity
    (Public Library of Science, 2015) Vassilev, I. (Ivo); Christos, L. (Lionis); Serrano-Gil, M. (Manuel); Wensing, M. (Michel); Foss, C. (Christina); Portillo, M.C. (María Carmen); Koetsenruijter, J. (Jan); Van-Lieshout, J. (Jan); Todorova, E. (Elka); Ruud-Knutsen, I. (Ingrid); Mujika, A. (Agurtzane); Rogers, A. (Anne); Roukova, P. (Poli); Kennedy, A. (Anne); Angelaki, A. (Agapi)
    Introduction Support from individual social networks, community organizations and neighborhoods is associated with better self-management and health outcomes. This international study examined the relative impact of different types of support on health and health-related behaviors in patients with type 2 diabetes. Methods Observational study (using interviews and questionnaires) in a sample of 1,692 type 2 diabetes patients with 5,433 connections from Bulgaria, Greece, Netherlands, Norway, Spain, and the United Kingdom. Outcomes were patient-reported health status (SF-12), physical exercise (RAPA), diet and smoking (SDCSCA). Random coefficient regression models were used to examine linkages with individual networks, community organizations, and neighborhood type (deprived rural, deprived urban, or affluent urban). Results Patients had a median of 3 support connections and 34.6% participated in community organizations. Controlled for patients’ age, sex, education, income and comorbidities, large emotional support networks were associated with decrease of non-smoking (OR = 0.87). Large practical support networks were associated with worse physical and mental health (B = -0.46 and -0.27 respectively) and less physical activity (OR = 0.90). Participation in community organizations was associated with better physical and mental health (B = 1.39 and 1.22, respectively) and, in patients with low income, with more physical activity (OR = 1.53). Discussion Participation in community organizations was most consistently related to better health status. Many diabetes patients have individual support networks, but this study did not provide evidence to increase their size as a public health strategy. The consistent association between participation in community organizations and health status provides a clear target for interventions and policies.
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    Stakeholders in support systems for self-care for chronic illness: the gap between expectations and reality regarding their identity, roles and relationships
    (2017) Vassilev, I. (Ivo); Serrano, M. (Manuel); Christos, L. (Lionis); Wensing, M. (Michel); Foss, C. (Christina); Portillo, M.C. (María Carmen); Todorova, E. (Elka); Ruud-Knutsen, I. (Ingrid); Mujika, A. (Agurtzane); Rogers, A. (Anne); Roukova, P. (Poli); Pumar-Mendez, M.J. (María Jesús); Regaira, E. (Elena)
    Background and objective: The spread of self-care holds the promise of containing chronic illness burden. Falling within the framework of a FP7 collaborative research project, this paper reports the views of key informants from six countries regarding who the main stakeholders are at different levels in the support system for self-care for patients with chronic illness (SSSC) and how they accomplish their role and collaborate. Methods: 90 Interviews with purposefully selected key informants from Bulgaria, Greece, the Netherlands, Norway, Spain and United Kingdom were conducted. Interviews involved government and local authorities, politicians, academics, health professionals and private sector representatives. Interviewers followed an expert opinion-based guide. Analysis involved a cross-country examination with thematic analysis and framework method techniques. Results Key informants described the ideal SSSC as inclusive, interdependent and patient-centred. The following main stakeholders in SSSC were identified: patients, governments, health-care professionals, associations, private companies and the media. In the current SSSCs, collaboration among stakeholders within and across different levels was said to be lacking. Patients were seen as playing a passive subordinate role based on the following: their own attitudes; the paternalistic and medicalized attitudes of the health-care professionals; their misrepresentation by patient associations; and their exposure to the damaging influences of media and industries. Conclusions Making SSSC patient-centred constitutes the greatest challenge for European authorities. Strategies must be revised for promoting patient participation. They should undergo changes so as to promote industry and media social responsibility and patient association advocacy capacity.