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Context in source publication
Context 1
... Stepped care means that persons are in the first instance treated at the lowest appropriate service level, only stepping up to more intensive or specialist services as clinically required, and with the ability to step down to less intensive care as part of a recovery pathway. 67 • Figure 4 shows an illustration of the stepped-care principle developed by NICE (National Institute for Health and Care Excellence) for the treatment of persons diagnosed with depression. An essential feature of stepped care is that it is self-correcting as it implies a scheduled review to detect and act on non-improvement for the person with mental problems. ...
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Citations
... Another remarkable finding of our study is that in Belgium, patients reported significantly worse EF (73.3) compared to the Netherlands (79.2) and compared to all other countries averaged. One possible explanation could lie in the fact that the prevalence of mental illness in Belgian citizens, in general, has been shown to be among the highest in Europe [54]. The findings of our study indicate that the prevention and treatment of mental health issues remain challenging to the Belgian health system which needs additional attention from healthcare providers, specifically in cancer care. ...
Background
People with advanced cancer often suffer from various symptoms, which can arise from the cancer itself and its treatment, the illness experience, and/or co-morbid conditions. Important patient-reported outcomes such as functional status, symptom severity, and quality of life (QoL) might differ between countries, as countries vary with regard to contextual factors such as their healthcare system.
Purpose
To assess self-reported emotional functioning, physical functioning, symptoms, and overall QoL in patients with advanced lung or colorectal cancer from six European countries, particularly in relation to their country of residence.
Methods
We used baseline patient data from the ACTION trial, including socio-demographic and clinical data as well as patient-reported data regarding functioning, symptoms, and overall QoL (EORTC QLQ-C15-PAL).
Results
Data from 1117 patients (55% lung cancer stage III/IV, 45% colorectal cancer stage IV) were used. The highest (worst) average symptom score was found for fatigue. We found similarities but also important differences in the outcomes across countries. The best scores (the highest for emotional functioning and QoL, the lowest for symptoms) were reported by Dutch and Danish patients. Belgian patients reported relatively low emotional functioning.
Conclusion
The optimization of functioning, symptom relief, and overall QoL should be important objectives of healthcare professionals who take care of patients with advanced cancer. There are similarities, but also substantial differences across countries in functional status, symptoms, and overall QoL. Policymakers should take these differences into account and invest in offering health care catered to the needs of their population.
... Psychologists, psychiatrists and other mental health services are perceived by one fifth of Belgian inhabitants to be rather unaffordable to very unaffordable; among the lowest income group this figure reaches 35% (EQLS, 2016). Possible explanations for this include the fact that mental healthcare generally requires more frequent consultations and the fact that only consultations with a psychiatrist or in a mental healthcare centre are reimbursed for adults (Kohn et al., 2016). However, in the federal budget for 2018, EUR 22.5 million are reserved for the treatment of mild mental health problems, and by the end of 2018 a reimbursement system for psychological care will be implemented (De Standaard, 2018b). ...
https://ec.europa.eu/social/main.jsp?advSearchKey=ESPNhc_2018&mode=advancedSubmit&catId=22&policyArea=0&policyAreaSub=0&country=0&year=0
... In this regard, it is also worth mentioning that the profession of clinical psychologists is recently properly regulated in Belgium, and proposals have been worked out to reorganise the reimbursement system allowing better access for psychotherapy [31]. In addition, the Flemish minister of health and social affairs recently introduced pilot studies in which psychologists are funded to work integrated within GPs' practices. ...
Although current guidelines recommend collaborative care for severely depressed patients, few patients get adequate treatment. In this study we aimed to identify the thresholds for interdisciplinary collaboration amongst practitioners when treating severely depressed patients. In addition, we aimed to identify specific and feasible steps that may add to improved collaboration amongst first and second level Belgian health care providers when treating depressed patients. In two standard focus groups (n = 8; n = 12), general practitioners and psychiatrists first outlined current practice and its shortcomings. In a next phase, the same participants were gathered in nominal groups to identify and prioritise steps that could give rise to improved collaboration. Thematic analyses were performed. Though some barriers for interdisciplinary collaboration may seem easy to overcome, participants stressed the importance of certain boundary conditions on a macro-(e.g., financing of care, secure communication technology) and meso-level (e.g., support for first level practitioner). Findings are discussed against the background of frameworks on collaboration in healthcare and recent developments in mental health care.
