The experience of living with a chronic illness during adolescence: a critical review of the literature

Exploring the information needs of adolescents and their parents throughout the kidney transplant continuum

CONTEXT

Adolescents are at higher risk for organ loss than are all other age groups, but no studies have been conducted to examine the specific information needs of adolescents. A better understanding of adolescents' information needs is essential for developing programs tailored to their unique requirements.

OBJECTIVE

To explore information needs of adolescents who have undergone kidney transplantation in order to inform development of an education program.

DESIGN

A qualitative descriptive design was used. Focus groups (n = 2) were conducted by using a semistructured interview guide. Transcribed data were organized into categories that reflected emerging themes by using simple content analysis.

PARTICIPANTS AND SETTING

A convenience sample of 8 adolescents (50% female) who varied in age, donor type, and time since transplantation were recruited from a large Canadian tertiary care pediatric center.

RESULTS

Adolescents articulated that the process of undergoing kidney transplant was very stressful and affected all aspects of their lives. In particular, adolescents identified 4 main stressors: changes in body image, wanting to be normal, pain, and breakdown in communication processes. The 2 strategies that assisted adolescents in coping with these stressors were (1) gaining knowledge about the transplantation process and (2) experiencing understanding through social support. They wanted information provided to them gradually throughout the transplant experience with choices given as to how they receive the information.

CONCLUSION

Adolescents were united in their call for information, self-management strategies, and meaningful social support to better manage their kidney transplant and prepare for transition to adult health care.

Exploring the Information Needs of Adolescents and Their Parents Throughout the Kidney Transplant Continuum

Context

Adolescents are at higher risk for organ loss than are all other age groups, but no studies have been conducted to examine the specific information needs of adolescents. A better understanding of adolescents' information needs is essential for developing programs tailored to their unique requirements.

Objective

To explore information needs of adolescents who have undergone kidney transplantation in order to inform development of an education program.

Design

A qualitative descriptive design was used. Focus groups (n = 2) were conducted by using a semistructured interview guide. Transcribed data were organized into categories that reflected emerging themes by using simple content analysis.

Participants and Setting

A convenience sample of 8 adolescents (50% female) who varied in age, donor type, and time since transplantation were recruited from a large Canadian tertiary care pediatric center.

Results

Adolescents articulated that the process of undergoing kidney transplant was very stressful and affected all aspects of their lives. In particular, adolescents identified 4 main stressors: changes in body image, wanting to be normal, pain, and breakdown in communication processes. The 2 strategies that assisted adolescents in coping with these stressors were (1) gaining knowledge about the transplantation process and (2) experiencing understanding through social support. They wanted information provided to them gradually throughout the transplant experience with choices given as to how they receive the information.

Conclusion

Adolescents were united in their call for information, self-management strategies, and meaningful social support to better manage their kidney transplant and prepare for transition to adult health care.

Parenting adolescents with cystic fibrosis: the adolescents' and young adults' perspectives

BACKGROUND

When suffering from cystic fibrosis (CF), a number of problems may arise during adolescence; for example, poor adherence. The problems may be attributed to the adolescent being insufficiently prepared for adult life. Research on different ways of parenting adolescents with CF and the influence of different parenting styles on the adolescents' adherence to treatment is still limited.

AIM

The aim of this study was to identify the types of parental support that adolescents and young adults with CF want and find helpful in terms of preparing them for adult life.

METHODS

Sixteen Danish adolescents with CF, aged 14-25, participated in the study. Two focus group interviews were carried out, one for 14-18-year-olds and one for 19-25-year-olds. Individual interviews were conducted, with three subjects. Using interpretive description strategy, a secondary analysis of the interview data was conducted.

RESULTS

The adolescents and young adults wanted their parents educated about the adolescent experience. They wanted their parents to learn a pedagogical parenting style, to learn to trust them, and to learn to gradually transfer responsibility for their medical treatment. Additionally, the adolescents noted that meeting other parents may be beneficial for the parents.

CONCLUSION

The findings of this study suggest that adolescents and young adults with CF want their parents to be educated about how to handle adolescents with CF and thereby sufficiently prepare them for adult life.

Experiences and barriers to Health-Related Quality of Life following liver transplantation: a qualitative analysis of the perspectives of pediatric patients and their parents

This paper examines health-related quality of life (HRQOL) experiences and barriers facing young people who have received a liver transplant (LT). Semi-structured qualitative interviews were conducted with children and adolescents who have undergone LT and their parents. Findings indicate that LT fosters substantially improved child and adolescent HRQOL; however, young people also experience challenges such as difficulties with medication compliance, self-management of care routines, physical activity restrictions, and undesirable medical procedures. Implications and recommendations for clinical practice and research are discussed.

The stories of young people living with a liver transplant

Adolescence is a difficult time for those with chronic illness because of the constraints of the illness on developmental tasks. Little is known about the impact liver transplantation has during adolescence. In this study we aimed to explore, in their own words, young people's lived experience of life after transplantation. We used semistructured interviews to collect narrative data, and used a purposive sample of 14 young people in early, middle, and late adolescence, transplanted for a range of chronic, acute, and metabolic liver diseases. We analyzed the transcripts using a framework in which analysis progresses through a five-stage process of matrices. Six main themes emerged, related to relationships, affect on schooling, tiredness and fatigue, acceptance of the burden of medication, communication with health professionals, and view of the future. These findings add new insight into the transplantation experience, which might lead to improvements in care and help direct further research in this important aspect of clinical care.

Psychosocial symptoms and competence among adolescents with inflammatory bowel disease and their peers

BACKGROUND

The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the adolescents themselves among patients with inflammatory bowel disease (IBD) in relation to population-based controls.

METHODS

Standardized Achenbach questionnaires-Child Behavior Checklist (CBCL) for the parents and Youth Self-Report (YSR) for the adolescents-were sent to Finnish families of adolescents with IBD (age 10-18 years), and their controls matched for age, gender, and place of residence. The final study group comprised 160 adolescents with IBD and 236 controls with their parents, respectively.

RESULTS

According to parent reports, adolescents with IBD had more symptoms of anxious/depressed mood (P < 0.001), withdrawn/depressed mood (P < 0.05), social problems (P < 0.05), thought problems (P < 0.001), somatic complaints (P < 0.001), and lower competence (P < 0.05) than population-based controls. Unexpectedly, there was no group difference in the amount of self-reported psychosocial symptoms, somatic complaints, or competence between adolescents with IBD and their peers. However, adolescents with severe IBD reported significantly more emotional problems (P < 0.001) than those with mild symptoms or controls.

CONCLUSIONS

According to parents, adolescents with IBD have more emotional problems, social problems, thought problems, and lower competence than their population-based peers. Self-perceived severity of the IBD symptoms is associated with a larger amount of parent and self-reported emotional symptoms. Complementary methods should be used while assessing the psychosocial well-being of adolescents with IBD as questionnaires alone may be insufficient.