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Pasin T, Dogruoz Karatekin B. Determinants of social participation in people with disability. PLoS One 2024; 19:e0303911. [PMID: 38768173 PMCID: PMC11104585 DOI: 10.1371/journal.pone.0303911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/03/2024] [Indexed: 05/22/2024] Open
Abstract
PURPOSE In this study, it is aimed to determine personal wellbeing and social participation levels across different physical disability types and levels of mobility. METHODS A sample of 85 individuals with physical disabilities, excluding those with mental disabilities were included. Sociodemographics, mobility of the participants, cause, duration of disability were recorded. Personal Wellbeing Index-Adult (PWI-A) scale was used for the assessment of wellbeing and Keele Assessment of Participation (KAP) for social participation. RESULTS Female, single, unemployed subjects and individuals with neurologic disability showed significantly higher median KAP-scores(p = 0.009, p = 0.050, p<0.001, p = 0.050, respectively).The median KAP-score of the independently mobile group was significantly lower compared to the other two groups (p = 0.001). The factors affecting KAP were determined as employment, mobility level and personal wellbeing (p = 0.002, p = 0.024, p = 0.050, respectively). CONCLUSION Mobility level, employment and personal wellbeing are the determinants of social participation in people with disabilities. Neurological disability, female gender, being single, unemployment and mobility limitations are factors that reduce social participation.
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Affiliation(s)
- Tugce Pasin
- Department of Physical Medicine and Rehabilitation, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Bilinc Dogruoz Karatekin
- Department of Physical Medicine and Rehabilitation, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
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2
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Kumar MM. Eating Disorders in Youth with Chronic Health Conditions: Clinical Strategies for Early Recognition and Prevention. Nutrients 2023; 15:3672. [PMID: 37686703 PMCID: PMC10490114 DOI: 10.3390/nu15173672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023] Open
Abstract
Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions. In this review, clinical strategies are provided to support youth with chronic health conditions through early recognition of eating disorder behaviors and prompt referral to treatment, which is important for a better prognosis. Suggestions are also given to mitigate their risk of developing eating disorders by proactively addressing risk factors and offering thoughtful anticipatory guidance that promotes a positive relationship with food and eating.
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Affiliation(s)
- Maya Michelle Kumar
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA 92123, USA
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Hill JC, Stokes LE, Higgins KK. Career Transitions Caused by Chronic Illness: A Career Construction Perspective. REHABILITATION RESEARCH, POLICY, AND EDUCATION 2022. [DOI: 10.1891/re-21-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose:People living with chronic illness face significant challenges with employment. This study explores the impact of participating in the Career Construction Interview (CCI) on the career exploration of individuals facing a forced career transition due to the onset or exacerbation of a chronic illness.Method:An instrumental multiple case study design was used in this qualitative study. A purposeful, homogeneous sample of three female adults was used to gain multiple perspective of forced career transitions. The participants were within 2 years of their diagnosis or exacerbation of one or more chronic health conditions and had to change their career because of the impact of their condition(s).Results:Eight open codes and five axial codes were discovered through the process of constant comparative analysis. For this study one open code (CCI experience) and five axial codes will be discussed.Conclusions:This study found patterns related to chronic illness and career and that the Career Construction Interview was helpful to the participants in assisting them with making decisions about potential careers and options for employment. Implications for rehabilitation counseling practice and suggestions for future research.
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Huang M, Hou Y, Li W, Wang G, Gu G, Xia Q. Mental health in children with living donor liver transplantation: a propensity score-matched analysis. Child Adolesc Psychiatry Ment Health 2022; 16:94. [PMID: 36447259 PMCID: PMC9707263 DOI: 10.1186/s13034-022-00516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This study explored mental health of pediatric patients with living donor liver transplantation. METHODS A total of 741 children who successfully underwent living donor liver transplantation from 2009 to 2019 enrolled in this study. Participants were aged between 3 and 12 years (mean age = 5.28; SD = 2.01). The Strengths and Difficulties Questionnaire was used to evaluate emotional and behavioral problems. Parents completed the 5-item World Health Organization Well-Being Index and reported their child's height, weight, sleep duration, parent-child interactions, home environment, physical activities, and time spent on screen exposure. Propensity score matching method was used to generate a control group from 20,934 healthy children. Univariate analysis and multiple logistic regression analyses were used to identify the correlational factors in children's mental health following a liver transplantation. RESULTS Compared to healthy children, patients after liver transplantation were prone to emotional problems, hyperactivity, and peer problems. Moreover, parental mental health, physical activity, and family environment were identified as factors associated with mental health of pediatric liver transplant patients. CONCLUSION The findings highlight the need to focus on mental health of pediatric transplant patients, increase support for parents, and strengthen positive parent-child interactions.
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Affiliation(s)
- Mingzhu Huang
- grid.16821.3c0000 0004 0368 8293Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 Pujian Road, Pudong New District, 200128 Shanghai, China
| | - Yuchen Hou
- grid.16821.3c0000 0004 0368 8293Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 Pujian Road, Pudong New District, 200128 Shanghai, China ,grid.59053.3a0000000121679639Department of General Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230021 Hefei, China
| | - Wen Li
- grid.412633.10000 0004 1799 0733Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, 400052 Zhengzhou, China
| | - Guanghai Wang
- Pediatric Translational Medicine Institution, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 200127, Shanghai, China. .,MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, 200092, Shanghai, China. .,Shanghai Center for Brain Science and Brain-Inspired Technology, 201602, Shanghai, China.
| | - Guangxiang Gu
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 Pujian Road, Pudong New District, 200128, Shanghai, China. .,Department of Liver Transplantation, Sun Yet-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, 510080, Guangzhou, China.
| | - Qiang Xia
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 Pujian Road, Pudong New District, 200128, Shanghai, China.
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Noyek S, Davies C, Champagne M, Batorowicz B, Fayed N. Emotional Well-Being of Children and Youth with Severe Motor and Communication Impairment: A Conceptual Understanding. Dev Neurorehabil 2022; 25:554-575. [PMID: 35900109 DOI: 10.1080/17518423.2022.2099997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Children and youth with severe motor and communication impairment (SMCI) have difficulty providing self-expression through typical speech, writing with a paper and pencil, or using a standard keyboard. Their emotional expressions can be missed by peers and novel caregivers. PURPOSE To describe the indicators and components of emotional experiences for children/youth with SMCI. METHODS Primary guardians of nine children/youth with SMCI were involved in photo/video data collection and follow-up qualitative interviews. Twenty-one familiar people (e.g., friends, family members, and/or care team) participated in semi-structured qualitative interviews. RESULTS A conceptual understanding of emotional well-being specific to the population has been developed consisting of nine themes, encompassed by four domains i) Core Attributes, ii) Personal Experiences, iii) Surroundings, iv) Expression and Reception. CONCLUSIONS Emotional experiences of children/youth with SMCI are diversely expressed. Primary guardian and familiar person insight can be amplified to positively impact care and participation.
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Affiliation(s)
- Samantha Noyek
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Claire Davies
- Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Maude Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Beata Batorowicz
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Kudrina I, Bartlett G, Pagé MG, Shir Y, Tourian L, Choinière M, Vedel I. Transitional Pain Care in Quebec: Did We Forget Our Youths? A Brief Research Report. FRONTIERS IN PAIN RESEARCH 2022; 3:885570. [PMID: 35712447 PMCID: PMC9197181 DOI: 10.3389/fpain.2022.885570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Adolescents and young adults (AYAs) represent a unique population with distinct psycho-social risks and care needs. About 10% of AYAs live with chronic pain (CP) and transition to adult pain care between 16 and 25 years of age. These transitions in care happen simultaneously with other bio-psycho-social changes and require flexible multi-disciplinary support models. As it stands, transitional pain care appears suboptimal, fragmented, and opportunistic in Quebec (Canada). The objective of this Brief Report is, therefore, to present our study findings and propose a multi-disciplinary transitional framework vision applicable to AYAs living with CP. Data were collected using a sequential-consensual qualitative design with a longitudinal participatory component. The consecutive stages of this work included an exploratory stage, semi-structured interviews with primary care providers, and inter-disciplinary deliberative stakeholder consultation groups. The deductive inductive thematic approach and the three-level Health Care Transition Research Consortium's theoretical framework were used to analyze the data. A representative group of stakeholders discussed findings from the first two steps, made fifteen actionable recommendations and formulated their vision of a transitional pain care model that can be further adapted in other settings. The study results present important insights into various psycho-social factors associated with transitional pain care for AYAs.
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Affiliation(s)
- Irina Kudrina
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
- *Correspondence: Irina Kudrina
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, United States
| | - M. Gabrielle Pagé
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, QC, Canada
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Yoram Shir
- Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
| | - Leon Tourian
- Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
- Department of Psychiatry, McGill University Health Center, Montreal, QC, Canada
| | - Manon Choinière
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, QC, Canada
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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Noyek S, Vowles C, Batorowicz B, Davies C, Fayed N. Direct assessment of emotional well-being from children with severe motor and communication impairment: a systematic review. Disabil Rehabil Assist Technol 2020; 17:501-514. [PMID: 32878502 DOI: 10.1080/17483107.2020.1810334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Explore methods used in peer-reviewed literature for obtaining self-expression of well-being information from children with severe motor and communication impairment (SMCI). MATERIALS AND METHODS A comprehensive search was conducted on 22 August 2019 through academic databases: CINAHL; Embase; MEDLINE; PsycINFO; InSpec; Compendex. Search strategies were informed by keywords under the following areas: (1) population: children with SMCI, (2) assessment methods: alternative to natural speech, paper and pencil report or standardized keyboard use (e.g., eye gaze) and (3) target information: well-being (e.g., quality of life). Studies were excluded if they focused on individuals over 25-years old, exclusively autism or typically developing children. RESULTS Non-duplicate studies of 10,986 were screened; 49 studies met inclusion criteria. Most studies used high-tech methods of self-expression in a single context (n = 17). Familiar partners play a significant role in self-expression; 18 studies required a familiar partner for children with SMCI to self-express. Thirty-five studies involved children self-expressing to solely adults, in comparison to 14 studies which involved peers. CONCLUSION Findings highlight the advancement of high-tech communication devices restricted to application in single contexts. Familiar partner knowledge of children with SMCI has the potential to be shared with others (e.g., respite care providers), enhancing both caregiver and child well-being. Future research that would enhance the literature could explore the assessment of emotional well-being for application in various contexts using multimodal methods. Opportunities for children with SMCI to express their emotional well-being can further influence the understanding and enhancement of participation, social connections, and experiences.IMPLICATIONS FOR REHABILITATIONUse of lower tech methods of self-expression to obtain information directly from children with severe motor and communication impairment (SMCI) remain more feasible in home and school contexts.By utilizing familiar partners' experiences and knowledge of the child, respite care providers, novel support workers, and others involved in the lives of children with SMCI can become further informed.Current high-tech methods for obtaining the emotional expressions of children with SMCI may benefit from incorporating multimodal approaches including lower tech methods, to be feasibly applied in real world contexts where well-being takes place.Further research on this topic is imperative to enable children with SMCI to self-express their emotional well-being which can enhance participation, activities, social connections, and experiences.
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Affiliation(s)
- Samantha Noyek
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Caryn Vowles
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, Canada
| | - Beata Batorowicz
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Claire Davies
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Abstract
The Trials and Tribulations of an Adolescent Patient with End-Stage Renal Disease
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Affiliation(s)
- John M. Burkart
- Wake Forrest University, Winston–Salem, North Carolina, U.S.A
| | - Beth Piraino
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
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Parks AC, Williams AL, Kackloudis GM, Stafford JL, Boucher EM, Honomichl RD. The Effects of a Digital Well-Being Intervention on Patients With Chronic Conditions: Observational Study. J Med Internet Res 2020; 22:e16211. [PMID: 31922491 PMCID: PMC6996718 DOI: 10.2196/16211] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/01/2019] [Accepted: 12/10/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Chronic conditions account for 75% of health care costs, and the impact of chronic illness is expected to grow over time. Although subjective well-being predicts better health outcomes, people with chronic conditions tend to report lower well-being. Improving well-being might mitigate costs associated with chronic illness; however, existing interventions can be difficult to access and draw from a single theoretical approach. Happify, a digital well-being intervention program drawing from multiple theoretical traditions to target well-being, has already been established as an efficacious means of improving well-being in both distressed and nondistressed users. OBJECTIVE This study aimed to compare change in well-being over time after using Happify for users with and without a chronic condition. METHODS Data were obtained from Happify users, a publicly available digital well-being program accessible via website or mobile phone app. Users work on tracks addressing a specific issue (eg, conquering negative thoughts) composed of games and activities based on positive psychology, cognitive behavioral therapy, and mindfulness principles. The sample included 821 users receiving at least 6 weeks' exposure to Happify (ranging from 42 to 179 days) who met other inclusion criteria. As part of a baseline questionnaire, respondents reported demographic information (age and gender) and whether they had any of the prespecified chronic conditions: arthritis, diabetes, insomnia, multiple sclerosis, chronic pain, psoriasis, eczema, or some other condition (450 reported a chronic condition, whereas 371 did not). Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction. To evaluate changes in well-being over time, a mixed effects linear regression model was fit for subjective well-being, controlling for demographics and platform usage. RESULTS At baseline, users with a chronic condition had significantly lower subjective well-being (mean 38.34, SD 17.40) than users without a chronic condition (mean 43.65, SD 19.13). However, change trajectories for users with or without a chronic condition were not significantly different; both groups experienced equivalent improvements in well-being. We also found an effect for time from baseline (b=0.071; SE=0.010; P<.01) and number of activities completed (b=0.03; SE=0.009; P<.01), and a 2-way interaction between number of activities completed and time from baseline (b=0.0002; SE=0.00006; P<.01), such that completing more activities and doing so over increasingly longer periods produced improved well-being scores. CONCLUSIONS Data from this study support the conclusion that users with a chronic condition experienced significant improvement over time. Despite reporting lower subjective well-being on the whole, their change trajectory while using Happify was equivalent to those without a chronic condition. Consistent with past research, users who completed more activities over a longer period showed the most improvement. In short, the presence of a chronic condition did not prevent users from showing improved well-being when using Happify.
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10
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Courtwright SE, Flynn Makic MB, Jones J. Emotional wellbeing in youth: A concept analysis. Nurs Forum 2019; 55:106-117. [PMID: 31677158 DOI: 10.1111/nuf.12404] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this concept analysis is to report a synthesis of the extant literature and define emotional wellbeing in youth as a concept of emerging importance. BACKGROUND Emotional wellbeing is a national research priority in the United States. It is not well defined nor understood in the context of its ontology, mechanisms, biomarkers, or promotion. As a result, interventional research cannot be adequately informed. DESIGN A comprehensive review of the literature was conducted to inform the sample. DATA SOURCE The scientific databases PubMed, Cochrane Library, Ovid Medline, PsycINFO, NCBI, Allied and Complementary Medicine, EMBASE, EBSCO, JAMAevidence, CINAHL, Joanna Briggs Institute, and Reporter were queried. REVIEW METHODS The Walker and Avant method was utilized to analyze the resultant sample for common themes of antecedents, attributes, and consequences of emotional wellbeing. RESULTS Seventeen scientific research studies were included in the final sample. CONCLUSION Attributes of emotional wellbeing in youth include overall positive emotions, positive self-esteem, and resilience. Antecedents are safe and stable nurturing relationships; family and social connectedness, hope, and positive body-image. The consequences of emotional wellbeing in youth include self-efficacy, self-actualization, the presence of positive health behaviors, and the absence of high-risk behaviors.
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Affiliation(s)
| | - Mary Beth Flynn Makic
- Adult Gerontology Clinical Nurse Specialist Program, University of Colorado College of Nursing, Aurora, Colorado
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11
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Healy H, Rigby P. Promoting Independence for Teens and Young Adults with Physical Disabilities. The Canadian Journal of Occupational Therapy 2019. [DOI: 10.1177/000841749906600508] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The transition to adult roles and responsibilities poses unique challenges for young people with physical disabilities. The Independence Programme (TIP) assists youths to meet these challenges. TIP is client-centred and addresses each participant's occupational performance problems. Participants live in a student residence located near shops, restaurants and other businesses for 20 consecutive days during TIP. This paper describes TIP and results from the evaluation of one summer's programme. Ten youths with physical disabilities, such as cerebral palsy, participated. The programme was evaluated using interviews with each participant at the beginning and end of the programme, and at a four month follow-up with the Canadian Occupational Performance Measure (COPM) (Law et al., 1994a). Participants made clinically important changes in performance and satisfaction of their identified occupations. They rated this programme as the best experience of the summer. Participants valued the opportunities to learn about and access environmental supports, to assume greater independence, and to develop connectedness with peers.
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Affiliation(s)
- Helen Healy
- Recreation and Education Programme at Bloorview
MacMillan Centre, 350 Rumsey Road, Toronto, Ontario, M4G 1R8
| | - Patricia Rigby
- Department of Occupational Therapy, University of
Toronto, and Professional Advisor for Occupational Therapy at Bloorview MacMillan
Centre, Toronto, Ontario
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Huurre T, Aro H. The Psychosocial Weil-Being of Finnish Adolescents with Visual Impairments versus those with Chronic Conditions and those with no Disabilities. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x0009401003] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Taina Huurre
- Tampere School of Public Health, University of Tampere, and National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, FIN-00300 Helsinki, Finland
| | - Hillevi Aro
- Tampere School of Public Health, University of Tampere, and National Public Health Institute, Department of Mental Health and Alcohol Research
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Gubelmann A, Berchtold A, Barrense-Dias Y, Akre C, Newman CJ, Suris JC. Youth With Chronic Conditions and Risky Behaviors: An Indirect Path. J Adolesc Health 2018; 63:785-791. [PMID: 30254008 DOI: 10.1016/j.jadohealth.2018.06.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare risk behaviors between youths living with a chronic condition (CC) and their healthy peers, controlling for condition severity. METHODS Data were drawn from the baseline wave of the GenerationFRee study (students aged 15-24 years in postmandatory education) during the 2014-2015 school year. The sample (N = 5,179) was divided into youths with CC without limitations (N = 536; 10.4%), youths with limitations (N = 114; 2.2%), and a control group (CG; N = 4,529; 87.4%). Groups were compared on internalizing (perceived health status, vision of their future, emotional wellbeing) and externalizing behaviors (substance use, gambling, excessive internet use, disordered eating, violent and antisocial acts) controlling for potential confounders. Statistical analyses were carried out through structural equation modeling. Results are given as unstandardized coefficients. RESULTS Overall, CC youths showed an association with internalizing behaviors (coefficient: .78) but not with externalizing behaviors. In fact, the connection with externalizing behaviors was indirect via the internalizing behaviors (.32). CC Youths reporting psychological issues were more likely to adopt every externalizing behavior. Analyzing separately youths with CC limiting daily life activities and those without limitations, the results did not change substantially. However, the association with internalizing behaviors was much higher for those reporting limitations (2.18 vs. .42). CONCLUSIONS Our results show that the link between suffering from a CC and adopting risk behaviors is indirect through internalizing behaviors. Health professionals should address emotional wellbeing and perception of the future rather than focus exclusively on the effects of risk behaviors on specific diseases.
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Affiliation(s)
- Alicia Gubelmann
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - André Berchtold
- Institute of Social Sciences & NCCR LIVES, University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christina Akre
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christopher J Newman
- Pediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Joan-Carles Suris
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
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14
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Patterson C, So S, DeAngelis M, Ghent E, Southmayd D, Carpenter C. Physical activity experiences in children post-liver transplant: Developing a foundation for rehabilitation interventions. Pediatr Transplant 2018; 22:e13179. [PMID: 29575295 DOI: 10.1111/petr.13179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 12/26/2022]
Abstract
Physical Activity (PA) plays an important role in the physical and psychosocial health of children and is beneficial in the treatment and prevention of comorbidities associated with transplantation. Despite this, PA participation in pediatric liver transplant recipients remains low compared to healthy peers. This qualitative-focused mixed-methods study explored the PA experiences and parental perception of these experiences, including perceived facilitators and barriers to PA in children post-liver transplant. Eighteen participants (9 children [median age 10.8 years] and 9 parents) took part in semi-structured interviews and completed the PedsQL Multidimensional Fatigue Scale and PAQ. Most children reported they were physically active (PAQ median 3.08 [IQR] 2.60-3.51), participating in PA for its enjoyment, regardless of their level of motor proficiency. Levels of fatigue (median 65.28 [IQR] 56.25-90.97) were higher than healthy norms and impacted PA participation in some children. Children and parents perceived PA as central to post-transplant recovery and valued its social and mental health benefits; however, parents struggled with ongoing uncertainty and perceived physical vulnerability of their child. This study indicates the need for continuing PA support and education and provides valuable information for family-centered interventions to increase PA and improve health outcomes in children post-transplant.
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Affiliation(s)
- Catherine Patterson
- Rehabilitation Medicine, Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie So
- Rehabilitation Medicine, Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Maria DeAngelis
- Department of Pediatrics, Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily Ghent
- Department of Social Work, Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Degen Southmayd
- Rehabilitation Medicine, Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Christine Carpenter
- Graduate Department of Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
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Abstract
This study examines the relative risk for suicide attempts (SA) among high-school students self-identifying with one or more disability classifications (nine); assesses the extent to which youth with disabilities are disproportionately vulnerable to risk factors that predict suicidal behavior among all adolescents; and explores whether disability status adds to risk for SA after accounting for a comprehensive set of known risk and protective factors for SA. Analyses using Wisconsin's 2012 Dane County Youth Assessment Survey data found that youth in each disability category were 3-9 times more likely to report suicide attempt(s) relative to peers, and the endorsement of multiple disabilities tripled the risk SA relative to youth reporting a single disability. Some disability sub-groups, including youth reporting autism spectrum disorder, hearing, and vision impairments reported surprisingly high rates of SA. While youth with disabilities reported disproportionate exposure to adversity in every life domain examined, similar to youth reporting SA, disability status added unique risk for suicidal behavior. This suggests that disability may be a 'fundamental cause' of suicidal behavior, a question that requires further investigation.
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Clery P, Stahl D, Ismail K, Treasure J, Kan C. Systematic review and meta-analysis of the efficacy of interventions for people with Type 1 diabetes mellitus and disordered eating. Diabet Med 2017; 34:1667-1675. [PMID: 28887815 DOI: 10.1111/dme.13509] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2017] [Indexed: 01/07/2023]
Abstract
AIM To examine the types of interventions currently available for people with Type 1 diabetes mellitus and their effectiveness. BACKGROUND The prevalence of disordered eating in people with Type 1 diabetes mellitus is twice that in their counterparts without diabetes, and is associated with worse biomedical outcomes and greater mortality. METHODS Medline, Embase, PsycINFO, the Cochrane Library, PubMed and OpenGrey databases were searched up to August 2016 to identify studies on interventions in people with Type 1 diabetes-associated disordered eating. For the systematic review, intervention components were identified and their effectiveness was examined. For the meta-analysis, the pooled effect sizes of glycaemic control (HbA1c ) between pre- and post-treatment in treatment and comparison groups were calculated using a random effects model. RESULTS Of 91 abstracts reviewed, six studies met the inclusion criteria, of which three had appropriate data for the meta-analysis (n = 118). The pooled effect size was -0.21 95% CI (-0.58 to 0.16; where negative values represent an improvement in HbA1c levels), indicating no statistically significant improvement in the treatment group compared with comparison group. Inpatient therapy appeared to be the most effective treatment, and this had multiple components including cognitive behavioural therapy, psychoeducation and family therapy. CONCLUSION Limited or no improvement in glycaemic control and disordered eating symptoms was observed in people with Type 1 diabetes-associated disordered eating who were receiving currently available interventions. The present review suggests that developing an intensive intervention with a joint focus on both disordered eating and diabetes management is needed for this complex patient group.
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Affiliation(s)
- P Clery
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Stahl
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - K Ismail
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Kan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Hackett J, Johnson B, Shaw KL, McDonagh JE. Friends United: An Evaluation of an Innovative Residential Self-Management Programme in Adolescent Rheumatology. Br J Occup Ther 2016. [DOI: 10.1177/030802260506801206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Independence in activities of daily living, self-advocacy and peer support are important aspects of adolescent development. These skills are potentially affected by chronic rheumatic diseases and are worthy of attention by occupational therapists and other members of the multidisciplinary team. An innovative 4-day residential programme for young people diagnosed with chronic rheumatic disease, known as the ‘Independence Break’, was evaluated in order to determine its perceived benefits. The participants were invited to complete a brief evaluation form immediately after the trip to determine the benefits of participation in the programme. The levels of continuing social contact within the group were established 4 months later during a subsequent telephone call. Thirty young people (median age 14 years) attended the 4-day programme and reported friendship and improved performance in activities of daily living as the major benefits. The majority stayed in touch with at least one other person, with more girls staying in touch than boys. The preferred method of communication was text messaging. Overall, the programme was perceived to be a valuable experience and offered the young people an opportunity to develop informal peer support networks. The potential of text messaging within adolescent rheumatology is also highlighted.
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Slyck MV, Stem M, Zak-Place J. Promoting Optimal Adolescent Development through Conflict Resolution Education, braining, and Practice. COUNSELING PSYCHOLOGIST 2016. [DOI: 10.1177/0011000096243004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this article is to examine how the problem-solving approach taken by the emerging field of youth-oriented conflict resolution is developmentally appropriate for a full range of adolescents and thereby promotes optimal development. The application of conflict resolution modalities to adolescents is conceptualized within an educational/developmental, preventive, and remedial framework that provides the context for reviewing the positive effects of conflict resolution on adolescents. A comprehensive approach to the use of conflict resolution modalities with adolescents as a basis for promoting optimal development is proposed, with attention given to the issues of culture and diversity. The potential interface between the fields of counseling and conflict resolution and the role that counseling psychologists can play in the development of this emerging field is discussed.
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Affiliation(s)
| | - Marilyn Stem
- University at Albany, State University of New York
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Abstract
Adolescent development is the normal process of transition from childhood to adulthood. Adolescents with transplants make the transition from pediatric to adult care within the context of other transitions in cognition, emotional attachments, autonomy, self-identity, sexuality, physical changes, life philosophy, and education/vocation. Healthcare providers can reduce their frustrations with this age group and optimize their care by understanding the impact of adolescent development on the transition process. In a busy clinic, attention to developmental issues can take on a low priority, but this does not have to be time consuming and may involve more of a perspective change than anything else. Both the adult and pediatric teams should remember that development does not stop at the time of transfer of care.
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Affiliation(s)
- Miriam Kaufman
- University of Toronto and the Hospital for Sick Children, Toronto, Ontario
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20
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Suryavanshi MS, Yang Y. Clinical and Economic Burden of Mental Disorders Among Children With Chronic Physical Conditions, United States, 2008-2013. Prev Chronic Dis 2016; 13:E71. [PMID: 27236382 PMCID: PMC4885682 DOI: 10.5888/pcd13.150535] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The prevalence of chronic physical and mental disorders is increasing among children and adolescents in the United States. In this study, we investigated the association between mental health disorders and chronic physical conditions among children, and we assessed whether having mental disorders is associated with increased health care costs for children with chronic physical conditions, using Medical Expenditure Panel Survey data from 2008 through 2013. METHODS Children aged 5 to 17 with at least 1 chronic physical condition were included in the study. Chronic physical conditions and mental disorders were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes. We used logistic regression to assess the relationship between mental disorders and chronic physical conditions, and we used generalized linear models with gamma distribution and log link to estimate direct medical costs. RESULTS Of 42,130 children, 4,640 had at least 1 chronic physical condition. After controlling for sociodemographic and health care access characteristics, we found that children with at least 1 chronic physical condition were 62% more likely to have a mental health disorder than were children without chronic physical conditions (odds ratio = 1.62; 95% confidence interval [CI], 1.37-1.92). Having a mental disorder was a significant predictor of total health care cost (β = 0.64; 95% CI, 0.43-0.85; P < .001). The adjusted annual incremental cost due to mental disorders among children with chronic physical conditions was $2,631 (P < .001). CONCLUSION Having chronic physical conditions in childhood is a significant predictor of mental health disorders and total health care expenditures.
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Affiliation(s)
- Manasi S Suryavanshi
- Department of Pharmacy Administration, The University of Mississippi School of Pharmacy, University, Mississippi
| | - Yi Yang
- Department of Pharmacy Administration and Center for Pharmaceutical Marketing and Management, The University of Mississippi School of Pharmacy, Faser Hall, Room 234, University, MS 38677.
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Filce HG, LaVergne L. Absenteeism, educational plans, and anxiety among children with incontinence and their parents. THE JOURNAL OF SCHOOL HEALTH 2015; 85:241-250. [PMID: 25731198 DOI: 10.1111/josh.12245] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 07/31/2014] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Children with incontinence have more absenteeism, poorer academic performance, and potential social difficulties during the school years. These children and their parents are at risk for illness-related anxiety. Whereas educational plans are designed to remediate educational, medical, and social-emotional barriers at school, little research has explored the relationship among absenteeism, educational plans, and anxiety for this population. METHODS Eighty-three families provided demographic information and completed either the Revised Children's Manifest Anxiety Scale Second Edition (RCMAS-2) or the Adult Manifest Anxiety Scale (AMAS-A). A multiple regression analysis was conducted to determine the relationships among these variables. RESULTS Children with chronic illness resulting in incontinence had greater than expected rates of absenteeism. A high level of absenteeism was a significant predictor of parental anxiety, but not child anxiety. Over one third reported having no plan in place to support the child's needs at school. However, when a plan was present, it had no impact on child or parental anxiety. CONCLUSIONS Absenteeism contributes to familial anxiety and educational difficulties. Despite the potential for educational plans to support these children at school, these plans are underutilized for children with incontinence. This population requires more attention to their academic and social-emotional well-being at school.
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Affiliation(s)
- Hollie G Filce
- Curriculum, Instruction and Special Education, University of Southern Mississippi, 118 College Drive, No. 5057, Hattiesburg, MS 39406-0001.
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Anderson V, Gomes A, Greenham M, Hearps S, Gordon A, Rinehart N, Gonzalez L, Yeates KO, Hajek CA, Lo W, Mackay M. Social competence following pediatric stroke: contributions of brain insult and family environment. Soc Neurosci 2015; 9:471-83. [PMID: 25040432 DOI: 10.1080/17470919.2014.932308] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Limited information is available regarding predictors of psychosocial difficulties in children following stroke. This study aimed to (i) compare social competence of children with arterial ischemic stroke (AIS) to those with chronic illness and healthy controls and (ii) investigate the contribution of stroke pathology, neurological outcome and environment. Thirty-six children with AIS > 12 months prior to recruitment were compared with children with chronic illness (asthma) (n = 15) and healthy controls (n = 43). Children underwent intellectual assessment, and children and parents completed questionnaires to assess social competence. Children with AIS underwent MRI scan and neurological evaluation. Child AIS was associated with poorer social adjustment and participation, and children with AIS were rated as having more social problems than controls. Lesion volume was not associated with social outcome, but subcortical stroke was linked to reduced social participation and younger stroke onset predicted better social interaction and higher self-esteem. Family function was the sole predictor of social adjustment. Findings highlight the risk of social impairment following pediatric stroke, with both stroke and environmental factors influencing children's social competence in the chronic stages of recovery. They indicate the potential for intervention targeting support at the family level.
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Affiliation(s)
- Vicki Anderson
- a Child Neuropsychology , Murdoch Childrens Research Institute , Melbourne , Australia
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23
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McGee MG. Peer victimization as a mediator of the relationship between disability status and psychosocial distress. Disabil Health J 2014; 8:250-7. [PMID: 25457460 DOI: 10.1016/j.dhjo.2014.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/20/2014] [Accepted: 09/26/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Youth with disabilities experience greater levels of peer victimization and psychosocial distress than non-disabled youth. However, the extent to which exposure to peer victimization mediates the relationship between disability status and psychosocial distress is unknown. OBJECTIVE To determine whether the relationship between disability status and psychological distress was mediated by exposure to peer victimization, and if so, whether the mediation effects of peer victimization on psychosocial distress was moderated by sex. METHODS This cross-sectional study involved a series of regressions to test for mediation and moderated mediation using complex survey data from 6664 Oregon 11th graders. RESULTS Peer victimization partially mediated the relationship between disability status and psychosocial distress. Sex, however, did not significantly moderate the mediating effects of peer victimization on psychosocial distress. CONCLUSION Exposure to peer victimization mediated the relationship between disability status and psychosocial distress; there was little support for sex as a moderator.
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Affiliation(s)
- Marjorie G McGee
- Graduate School of Social Work, Portland State University, Portland, OR 97207-0751, USA; Graduate School of Education, Portland State University, Portland, OR 97207-0751, USA.
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Abstract
We assessed worries of 162 German adolescents with visual impairment. Most adolescents reported low levels of worry. Nonetheless, about 25% showed moderate to high levels of worry related to a further decline of vision and not finding the right romantic partner. While adolescents with visual impairment reported lower levels of worry than an age- and gender-matched sample of sighted adolescents, adolescents with stronger visual impairment worried more than those with lower levels of visual impairment. In addition, higher levels of worry were associated with more depressive symptoms and, in part, with less optimism, negative changes of vision in recent years, higher age, and worse grades at school. Possible reasons for the inconsistent associations of visual impairment with levels of worry are discussed.
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25
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Denny S, de Silva M, Fleming T, Clark T, Merry S, Ameratunga S, Milfont T, Farrant B, Fortune SA. The prevalence of chronic health conditions impacting on daily functioning and the association with emotional well-being among a national sample of high school students. J Adolesc Health 2014; 54:410-5. [PMID: 24210897 DOI: 10.1016/j.jadohealth.2013.09.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 09/17/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE This study aims to describe the prevalence of self-reported chronic health conditions among high school students in New Zealand, the extent to which the condition impacts on their activities and socialization, and to explore the association between the level of impact of the illness or disability and the emotional well-being of students with chronic health conditions. METHODS A two-stage cluster sample of 9,107 students (Years 9-13) from 96 New Zealand high schools participated in a 2007 health survey using internet tablets. Students were asked about any chronic illness or disabilities lasting more than 6 months, the impact of the illness or disabilities on their daily activities and socialization, and their depressive symptoms (RADS-SF) and emotional well-being (WHO-5). RESULTS Almost one in five students (18%) reported a chronic health condition. Among them, 28% reported an impact of their illness or disability on their activities, and 8% reported an impact on their ability to socialize. High levels of depressive symptoms were found among students with chronic health conditions reporting that their illness or disability impacts their activities (18%) or their ability to socialize (40%), and this was significantly higher than among students without chronic health conditions (10%). CONCLUSIONS Our findings suggest that there is a large group of adolescents with chronic health conditions for whom their illness or disability has an impact on their daily activities and ability to socialize with their peers. These students are more likely to experience emotional distress and require support and opportunities for healthy youth development.
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Affiliation(s)
- Simon Denny
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand.
| | - Mandy de Silva
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Theresa Fleming
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Terryann Clark
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | | | - Taciano Milfont
- Centre for Applied Cross-Cultural Research, School of Psychology, Victoria University of Wellington, New Zealand
| | - Bridget Farrant
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Sarah A Fortune
- School of Population Health, University of Auckland, Auckland, New Zealand
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26
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Abstract
Transfer of care is when a patient and his or her medical records move from one provider to another at a distinct point in time. By contrast, transition of care is a gradual process of change in knowledge, attitudes and behaviour through which the adolescent can learn to assume personal responsibility for his or her health care. IBD is a prevalent disorder, often diagnosed during childhood. Because mortality of this condition is fortunately low, children diagnosed with IBD will, at some point, transition from a paediatric to adult health-care model. Paediatric and adult health-care paradigms, including IBD-specific care, are different in a number of key areas and it is becoming increasingly apparent that young adults with chronic illness often face challenging transitions, resulting in compromised physical and emotional health outcomes. In the past decade, refining the processes related to transition of care for adolescents with chronic medical conditions has gained traction as an important public health initiative. The aim of this paper is to review concepts pertinent to transition of management for adolescents and young adults with IBD, and to review the current literature and evidence supporting transitional care in paediatric IBD.
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Hatami G, Motamed N. Life Satisfaction in children and adolescents with beta thalassemia major in southwest Iran. Electron Physician 2014; 6:759-67. [PMID: 25763142 PMCID: PMC4324286 DOI: 10.14661/2014.759-767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 09/25/2013] [Accepted: 12/10/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Beta thalassemia major has a considerable impact on quality of life. The purpose of this study was to determine the life satisfaction of beta-thalassemic children and adolescents compared to healthy controls. METHODS This research, conducted in 2009, was a controlled, cross-sectional study in which beta-thalassemic patients, who were being followed-up by the Thalassemic Center in Bushehr, a city in southern Iran, were compared with a healthy control group. The Multi-dimensional Student Life Satisfaction Scale (MSLSS) was used to measure the participants' quality of life in five domains. The chi-squared test, t-test, Pearson's Product Moment Correlation, and multiple regression analysis were used for the statistical analyses. RESULTS The unadjusted mean scores of three of the domains, i.e., school, friends, and living environment, and the total score of five domains, i.e., school, friends, living environment, family, and self, were significantly higher in thalassemic patients than in the control group (P < 0.05). These significant differences were persistent after adjusting the mean scores of the three domains and the total score of the five domains for age, gender, and educational level. CONCLUSION The thalassemic patients were more satisfied with life than the healthy controls in Bushehr. Many factors may be responsible for this finding. The results of this study suggest that the attitude of parents and society concerning assigning responsibility to patients should be assessed. The assessment should include comparing the satisfaction with life of thalassemic patients with that of their healthy siblings and conducting national studies on the quality of life of thalassemic patients and their satisfaction with life.
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Affiliation(s)
- Gissou Hatami
- Assistant Professor of Pediatrics, Department of Pediatrics, Ali-e- Asghar Pediatric Center, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Niloofar Motamed
- Associate Professor of Community Medicine, Department of Community Medicine, Faculty of Medicine, Bushehr University of Medical Sciences, Moallem Street, Bushehr, Iran
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Abstract
Therapeutic breakthroughs have transformed HIV into an illness that is routinized within the clinic. It is unclear, however, how these breakthroughs shape the lives of newly infected adolescents who are beginning to receive what will be life-long care and treatment. The reframing of HIV as no longer exceptional influences the lived experience of urban adolescents, whose futures must shift to incorporate expectations that they live a full life with HIV. They must now manage the clinical demands of a chronic and infectious disease, while navigating the transition from adolescence to a 'normal' adulthood, which, for some, means completing education, findings jobs, and building careers. Drawing on ethnographic research conducted in Baltimore, Maryland, I examine the tensions adolescents face as their experiences with HIV conflict with policy makers and researchers' reframing of HIV as a disease like any other.
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Affiliation(s)
- Morgan M Philbin
- a HIV Center for Clinical and Behavioral Studies , Columbia University, and New York State Psychiatric Institute , USA
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Yeung P, Towers A. An exploratory study examining the relationships between the personal, environmental and activity participation variables and quality of life among young adults with disabilities. Disabil Rehabil 2013; 36:63-73. [DOI: 10.3109/09638288.2013.777808] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Woods SB, Farineau HM, McWey LM. Physical health, mental health, and behaviour problems among early adolescents in foster care. Child Care Health Dev 2013; 39:220-7. [PMID: 22329484 DOI: 10.1111/j.1365-2214.2011.01357.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Adolescents with chronic illness in the general population are at increased risk of mental health and behaviour problems. Depression is also associated with delinquency. Adolescents in foster care are more at risk for chronic illness and mental health issues. We investigated whether adolescents in long-term foster care with chronic illness have associated higher rates of internalizing and externalizing problems and delinquency. We also investigated if depression mediates the relationship between physical health and externalizing behaviours. METHODS Data are from the National Survey of Child and Adolescent Well-Being; adolescents age 11 and older residing in long-term foster care (n = 188). Children whose caregivers reported on the occurrence of a chronic illness were compared using anova on internalizing and externalizing subscale scores and total scores of the Youth Self Report (YSR) and Child Behavior Checklist (CBCL), and modified Self-Report of Delinquency (MSRD) scores of delinquency and total number of delinquent acts. Bootstrapping analyses were used to test our hypothesis that depressive symptoms (Children's Depression Inventory) function as a mediator. RESULTS Adolescents with a chronic illness reported greater internalizing (YSR: F = 7.069, P = 0.009; CBCL: F = 4.660, P = 0.032) and externalizing (YSR: F = 5.878, P = 0.016; CBCL: F = 3.546, P = 0.061) problems, a greater number of delinquent acts (6.66, F = 5.049, P = 0.026) and heightened overall delinquency (F = 5.049, P = 0.026). Depression significantly mediated the effects of overall health on delinquency (95% CI, 0.03-1.76). CONCLUSIONS It is important to consider the complex interrelationships between physical health, mental health, and behaviour for adolescents in foster care. These findings support the need for comprehensive services for these youths, including specialized assessments and collaboration between protective services and healthcare systems.
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Affiliation(s)
- S B Woods
- Department of Family and Child Sciences, College of Human Sciences, The Florida State University, Tallahassee, FL 32306, USA.
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Withers AL. Management issues for adolescents with cystic fibrosis. Pulm Med 2012; 2012:134132. [PMID: 22991662 PMCID: PMC3444048 DOI: 10.1155/2012/134132] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 08/15/2012] [Indexed: 11/17/2022] Open
Abstract
The healthy adolescent will encounter major changes in biological and psychosocial domains. The adolescent period can be greatly affected by a chronic illness. Cystic fibrosis is a terminal illness that can significantly affect an adolescent's biological, mental and psychosocial health. This paper discusses general issues to consider when managing an adolescent with a chronic medical condition, and specifically how cystic fibrosis may impact upon puberty, body image, risk-taking behaviours, mental health, independence, nonadherence, reproductive health, transition, lung transplantation, and end of life care.
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Affiliation(s)
- Adelaide Lindsay Withers
- Department of Respiratory Medicine, Princess Margaret Children's Hospital, Level 3, Harry Boan Building, Roberts Road, Subiaco, WA 6009, Australia
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32
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Quick VM, McWilliams R, Byrd-Bredbenner C. Case-control study of disturbed eating behaviors and related psychographic characteristics in young adults with and without diet-related chronic health conditions. Eat Behav 2012; 13:207-13. [PMID: 22664398 DOI: 10.1016/j.eatbeh.2012.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 01/30/2012] [Accepted: 02/21/2012] [Indexed: 11/29/2022]
Abstract
Young adults with diet-related chronic health conditions (DRCHCs; i.e., type 1 diabetes, celiac disease, cystic fibrosis, inflammatory bowel diseases, irritable bowel syndrome) face challenges complying with dietary restrictions required to effectively manage their health condition. These restrictions could put them at risk for disturbed eating. The purpose of this study was to determine if young adults with and without DRCHCs differed with regard to disturbed eating behaviors and related psychographics characteristics (i.e., body image attributes, mental disorders, intrapersonal characteristics and sociocultural environment [i.e., media and family]). Each DRCHC participant (cases=166) was matched to 4 healthy participants (controls=664) based on gender and BMI (±0.50 BMI units). Conditional logistic regression analyses indicate cases were twice as likely to have been diagnosed by a healthcare provider with an eating disorder (p=0.08, OR=1.99, CI(90) [1.03-3.83]). Cases were significantly more likely to use Inappropriate Compensatory Behaviors to manage their weight, i.e., excessive exercise (p=0.04, OR=1.41, CI(95) [1.02-1.94]) and misuse medication (p=0.04, OR=1.14, CI(95) [1.00-1.29]) than controls. Depression and anxiety were significantly higher, and health status was significantly poorer in cases compared with controls. DRCHC participants were less likely to report feeling body image pressures from the media, placed a greater value on their health, used social diversion, and recalled a greater emphasis being placed on their mothers' weights and mealtimes being less structured than control participants. Findings indicate that nutrition and other healthcare professionals should incorporate screening DRCHC patients for disturbed eating behaviors and eating disorders in their standards of care.
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Affiliation(s)
- Virginia M Quick
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA.
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Outcome in early adolescent idiopathic scoliosis after deformity correction: assessed by SRS-22, psychometric and generic health measures. J Pediatr Orthop B 2012; 21:317-21. [PMID: 22495615 DOI: 10.1097/bpb.0b013e32835368bf] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to examine the health status of early adolescent patients with idiopathic scoliosis using depression-anxiety scales, a generic Quality-of-Life Inventory as well as the Scoliosis Research Society-22 (SRS-22) questionnaire to search for the most comprehensive approach for the measurement of outcomes. Thirty-seven early adolescent patients with idiopathic scoliosis were analyzed within 6-12 months of the postoperative time period. There was no statistically significant correlation between the total score of SRS-22 and the total scores of the pediatric quality-of-life inventory. However, the total scores of SRS-22 were positively correlated with the self-esteem level and negatively correlated with the depression level and State-Trait Anxiety Inventory for Children scores. In early adolescents with idiopathic scoliosis deformity correction, SRS-22 may be inadequate in terms of mental health and physical activity parameters to evaluate overall quality of life.
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Transition to adult care for youth with special health care needs. Paediatr Child Health 2011; 12:785-93. [PMID: 19030468 DOI: 10.1093/pch/12.9.785] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kariuki M, Honey A, Emerson E, Llewellyn G. Mental health trajectories of young people after disability onset. Disabil Health J 2011; 4:91-101. [DOI: 10.1016/j.dhjo.2010.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/20/2010] [Accepted: 08/20/2010] [Indexed: 10/18/2022]
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Ghandour RM, Perry DF, Kogan MD, Strickland BB. The medical home as a mediator of the relation between mental health symptoms and family burden among children with special health care needs. Acad Pediatr 2011; 11:161-9. [PMID: 21306969 DOI: 10.1016/j.acap.2010.12.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 12/28/2010] [Accepted: 12/29/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study explores the role of medical home as a mediator of the relationship between emotional and behavioral difficulties among CSHCN and financial- and employment-related burden experienced by their families. METHODS Data were obtained from the 2005-2006 NS-CSHCN, a nationally representative cross-sectional survey of 40 465 CSHCN. Family burden was measured using parent-reported financial problems and changes in family member employment resulting from the child's needs. Emotional and behavioral symptoms were reported by parents using 3 binary items capturing difficulty with depression, anxiety, disordered eating, and emotional or behavior problems. Medical home was measured according to the framework of the American Academy of Pediatrics. Bivariate and multivariate analyses were used to explore the role of medical home in the relation between mental health symptoms and family burden. RESULTS A smaller proportion of CSHCN with emotional or behavioral difficulties had a medical home or related components compared to CSHCN generally, and a greater proportion of their families experienced burdens. Multivariate analyses showed that the mediated effect of care coordination on the relation between emotional or behavioral symptoms and family burden explained 18% to 35% of the total effect of these symptoms on financial problems and employment changes. Overall medical home access explained 16% to 28% of the total effect of symptoms on burden. CONCLUSIONS Medical home access, and care coordination in particular, may partially mediate the relation between emotional and behavioral symptoms and financial hardship. Future efforts to implement the medical home model may benefit from an increased focus on care coordination as a means of reducing these burdens.
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Affiliation(s)
- Reem M Ghandour
- Office of Epidemiology, Policy and Evaluation, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland 20857, USA.
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Nicholas DB, Picone G, Selkirk EK. The lived experiences of children and adolescents with end-stage renal disease. QUALITATIVE HEALTH RESEARCH 2011; 21:162-173. [PMID: 20833832 DOI: 10.1177/1049732310382789] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Relatively little is known about how children perceive and manage end-stage renal disease (ESRD) in daily life. To address this gap in the literature, the experiences and perceptions of children with ESRD were examined in this study. Study design comprised ethnographic interviews with 25 children and adolescents ages 7 to 18 years. Semistructured interviews were audiotaped, transcribed verbatim, and subjected to content analysis. Participants received a range of ESRD treatments including transplantation and dialysis. Findings indicate that ESRD has a profound impact on children. They described a range of challenges and experiences including not feeling "normal"; developing ESRD knowledge; frequent absence from school; gaining responsibility for ESRD care; relying on family, friends, and health care providers; and adjusting despite adversity. These findings depict a multifaceted, dynamic perspective engendered in tensions as children and adolescents grapple with adversity yet experience personal growth and resiliency. Implications and recommendations for clinical practice and research are discussed.
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Affiliation(s)
- David B Nicholas
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada.
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Honey A, Emerson E, Llewellyn G. The mental health of young people with disabilities: impact of social conditions. Soc Psychiatry Psychiatr Epidemiol 2011; 46:1-10. [PMID: 19894012 DOI: 10.1007/s00127-009-0161-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2009] [Accepted: 10/20/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Young people with disabilities have poorer mental health than their non-disabled peers. However, people with disabilities are more likely than others to experience financial hardship and low social support, both of which have been linked with poor mental health outcomes. This article explores the extent to which the relatively poor mental health of young people with disabilities is related to the social conditions in which they live. METHODS Secondary analysis was performed on Wave 6 (2006) of the survey of Household Income and Labour Dynamics in Australia (HILDA). This nationally representative sample included 3,392 young Australians, aged 15-29, of whom 475 reported having a long-term health condition, impairment or disability. RESULTS Young people with disabilities reported poorer mental health than their non-disabled peers. However, this relationship was moderated by both social adversity and social support, with minimal differences in mental health observed between the groups under conditions of high social support and low financial hardship. DISCUSSION The results suggest that disability represents a potential adversity that may be exacerbated or ameliorated by the effects of wealth/financial hardship and social support. CONCLUSION It may be possible to improve the mental health of disabled people by addressing their social exclusion.
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Affiliation(s)
- Anne Honey
- Australian Family and Disability Studies Research Collaboration, Faculty of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW, 1825, Australia.
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Rapley P, Davidson PM. Enough of the problem: a review of time for health care transition solutions for young adults with a chronic illness. J Clin Nurs 2010; 19:313-23. [PMID: 20500270 DOI: 10.1111/j.1365-2702.2009.03027.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES In this article, we critically assess the state of the science of transition care in chronic conditions using diabetes care as an exemplar and provide a case for the adoption of the principles of the Chronic Care Model in driving health care reform. BACKGROUND Globally, there is an increasing burden of chronic conditions including among adolescents and young adults. As a consequence adolescents are transitioning, at an increasing rate, from paediatric services into mainstream adult services, which are often ill equipped to meet their needs. DESIGN Integrative literature review. METHODS An integrative literature review method was used to summarise key issues facing adolescents with chronic illness and generate strategies for improving health care services. CONCLUSION Strengthening the capacity for transitioning from a service that is family focused to one with an individual orientation requires a paradigmatic shift and clear identification of roles and responsibilities in the health care system. The absence of empirically developed models of care, in a context of growing need, signals the importance of ongoing discussion, debate and research. IMPLICATIONS FOR CLINICAL PRACTICE There is a need for a change in philosophical orientation to promote service provision on the basis of need, rather than a model based on diagnosis and chronology. Nurses and other health professionals need to increase their awareness of issues facing adolescents with chronic conditions making the transition to adult health services.
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Affiliation(s)
- P Rapley
- School of Nursing and Midwifery, Curtin University of Technology, Perth, WA, Australia
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Orban LA, Stein R, Koenig LJ, Conner LC, Rexhouse EL, Lewis JV, LaGrange R. Coping strategies of adolescents living with HIV: disease-specific stressors and responses. AIDS Care 2010; 22:420-30. [PMID: 20146110 DOI: 10.1080/09540120903193724] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined disease-specific stressors and coping responses employed by youth with HIV. Data were analyzed from Adolescent Impact, a multi-site study of 166 adolescents infected with HIV in three major US cities. Participants identified HIV-related stressors during a face-to-face interview. Coping strategies were measured using the adolescent version of the Kidcope. Emotional and behavioral functioning were assessed with the Youth or Adult Self Report symptom checklists. Medication-related stressors were most common (30%) and reported more often by perinatally infected youth, whereas youth infected through risk behaviors reported more disclosure-related stressors. Passive emotional regulation was perceived as the most used and most helpful coping strategy overall. Youth reporting medication adherence-related stressors used resignation most frequently. A two-factor model (Passive and Active Coping) emerged. The Passive Coping factor included strategies that do not directly approach the problem, whereas Active Coping included strategies that involve an active approach. Youth with moderately advanced disease (CD4 200-500 cells/mm(3)) used a Passive Coping style more often than healthier youth (CD4 > 500 cells/mm(3)). Additionally, Passive Coping was associated with greater emotional and behavioral problems. Youth infected with HIV may benefit from interventions promoting adaptive coping responses to HIV-specific stressors, particularly medication adherence.
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Barnes AJ, Eisenberg ME, Resnick MD. Suicide and self-injury among children and youth with chronic health conditions. Pediatrics 2010; 125:889-95. [PMID: 20385631 DOI: 10.1542/peds.2009-1814] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Chronic conditions may be associated with suicide risk. This study aimed to specify the extent to which youth chronic conditions are at risk for suicidality and self-harm. METHODS Logistic regression was used to estimate odds of self-harm, suicidal ideation, and suicide attempts in 10- to 19-year-olds with and without chronic physical and/or mental health conditions. RESULTS Independent of race, socioeconomic status, absent parent, special education status, substance use, and emotional distress, youth with co-occurring chronic physical and mental conditions (n = 4099) had significantly higher odds of self-harm (odds ratio [OR]: 2.5 [99% confidence interval (CI): 2.3-2.8), suicidal ideation (OR: 2.5 [99% CI: 2.3-2.8), and suicide attempts (OR: 3.5 [99% CI: 3.1-3.9]) than healthy peers (n = 106,967), as did those with chronic mental conditions alone (n = 8752). Youth with chronic physical conditions alone (n = 12,554) were at slightly elevated risk for all 3 outcomes. Findings were similar among male and female youth, with a risk gradient by grade. CONCLUSIONS Chronic physical conditions are associated with a slightly elevated risk for self-harm, suicidal thinking, and attempted suicide; chronic mental conditions are associated with an increased risk for all 3 outcomes. Co-occurring chronic physical and mental conditions are associated with an increased risk for self-harm and suicidal ideation that is similar to the risk in chronic mental conditions and with an attempted suicide risk in excess of that predicted by the chronic mental health conditions alone. Preventive interventions for these youth should be developed and evaluated.
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Affiliation(s)
- Andrew J Barnes
- University of Minnesota, Department of Pediatrics, Division of Academic General Pediatrics, Minneapolis, MN 55414, USA.
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Psychological correlates of child and adolescents with familial Mediterranean fever. Rheumatol Int 2010; 31:837-8. [DOI: 10.1007/s00296-010-1405-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Accepted: 02/27/2010] [Indexed: 10/19/2022]
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Starkey K, Wade T. Disordered eating in girls with Type 1 diabetes: Examining directions for prevention. CLIN PSYCHOL-UK 2010. [DOI: 10.1080/13284201003660101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Karina Starkey
- School of Psychology, Flinders University , Adelaide, South Australia, Australia
| | - Tracey Wade
- School of Psychology, Flinders University , Adelaide, South Australia, Australia
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Ghandour RM, Kogan MD, Blumberg SJ, Perry DF. Prevalence and correlates of internalizing mental health symptoms among CSHCN. Pediatrics 2010; 125:e269-77. [PMID: 20083529 DOI: 10.1542/peds.2009-0622] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study provides nationally representative prevalence estimates of internalizing mental health symptoms among children with special health care needs (CSHCN) and identifies significant covariates of these symptoms by using multivariate regression. Internalizing symptoms include feeling anxious and depressed. METHODS Data were obtained from the 2005-2006 National Survey of Children with Special Health Care Needs, a nationally representative, parent-reported, cross-sectional survey of 40 465 CSHCN. The presence of internalizing mental health symptoms was assessed by using 2 binary items capturing whether a child had or experienced difficulty with depression, anxiety, disordered eating, or other emotional problems. The odds of experiencing internalizing symptoms were assessed by using multivariate regression, controlling for sociodemographic, health-related, and burden-related covariates. RESULTS A total of 31.9% of CSHCN 3 to 17 years of age experienced internalizing mental health symptoms. Multivariate logistic regression showed internalizing symptoms to be strongly associated with female gender, older age, and frequent activity limitations, as well as externalizing mental health symptoms and conditions with behavioral components. Children with behavior problems had 6 times the odds of internalizing symptoms (adjusted odds ratio [aOR]: 5.95 [95% confidence interval [CI]: 5.30-6.69]), whereas children with autism spectrum disorder had 3 times the odds (aOR: 3.00 [95% CI: 2.39-3.77]). Increased odds of symptoms also were associated with frequent headaches (aOR: 1.76 [95% CI: 1.45-2.13]) and chronic pain (aOR: 1.46 [95% CI: 1.22-1.75]). Odds of symptoms were greater for children living in households that experienced employment changes or financial burdens resulting from the children's needs. CONCLUSIONS Internalizing mental health symptoms are common among CSHCN. Findings may help caregivers focus screening and prevention efforts for high-risk groups in this heterogeneous population.
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Affiliation(s)
- Reem M Ghandour
- DrPH, MPA, Maternal and Child Health Bureau, Office of Data and Program Development, Parklawn Building, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA.
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Abstract
OBJECTIVE Children with medical conditions often experience a combination of positive and negative social interactions with parents and friends. Adult research examining cross-domain buffering effects has documented that supportive social ties can make up for shortcomings in other social relationships. This study examined whether negative effects of strained relationships with loved ones can be buffered when children feel supported by individuals in different support networks (i.e., cross-domain buffering effects). METHOD Children with Type I diabetes (n = 56), chronic asthma (n = 54), and cystic fibrosis (n = 17) completed questionnaires during an outpatient hospital visit that assessed perceptions of support and strain from parents and friends, quality of life, self-concept, and emotional/behavioral difficulties. Parental strain was conceptualized as parental overprotection and parental rejection. RESULTS Hierarchical regression analyses showed that friend support buffered the adverse effects of parental strain on child quality of life, self-concept, and emotional/behavioral difficulties. Interestingly, parental support did not buffer the negative effects of experiencing strained relationships with friends; only main effects on outcome were found. These findings partially support our hypotheses of cross-domain buffering. CONCLUSIONS In this study, friendships were a protective factor for children who experienced strained relationships with parents. In contrast, although parent support had a direct impact on child outcome, it did not make up for feeling rejected by friends. Because close relationships are often strained during medical stressors, findings underscore the importance of promoting social connectedness in chronically ill children to maximize opportunities for experiencing positive social relationships.
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Berney-Martinet S, Key F, Bell L, Lépine S, Clermont MJ, Fombonne E. Psychological profile of adolescents with a kidney transplant. Pediatr Transplant 2009; 13:701-10. [PMID: 18992062 DOI: 10.1111/j.1399-3046.2008.01053.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To describe the psychological profile of renal transplant adolescents compared to healthy peers and to adolescents with CKD, three groups of adolescents aged 12-18 yr were selected: TX, CX, and adolescents with CKD. Psychiatric symptoms and disorders were evaluated through direct interviews (K-SADS-PL) and self-report questionnaires (YSR and CBCL). Forty TX (14 LRD and 26 DD transplant recipients), 40 CX and 20 CKD were included. Twelve of 40 (30%) TX, three of 20 (15%) CKD, and three of 40 (7.5%) CX had a history of learning difficulties (p = 0.03). Compared to CX, TX had lower total YSR competencies score (p = 0.028) and lower total CBCL competencies score (p = 0.003). Twenty-six of 40 (65%) TX, 12 of 20 (60%) CKD and 15 of 40 (37.5%) CX (p = 0.038) met DSM-IV diagnostic criteria for lifetime psychiatric disorder, with rates of depressive disorder of 35% among TX and CKD compared to 15.2% among CX (p = 0.043). Eight of 40 (20%) TX had a history of simple phobia. Nine of 40 (22.5%) TX met diagnostic criteria for ADHD as compared to one of 20 (5%) CKD and three of 40 (7.5%) CX. In the TX group, we found no significant differences in educational and psychiatric variables between LRD and DD. In conclusion, we found a high prevalence of psychiatric morbidity (depression, phobia, ADHD), educational impairment and social competence problems in the TX group. CKD scored in between TX and CX on most measures.
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Emotional health of Canadian and Finnish students with disabilities or chronic conditions. Int J Rehabil Res 2009; 32:154-61. [PMID: 19458524 DOI: 10.1097/mrr.0b013e32831e452e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to investigate the dimensions of emotional health in two population-based groups (Finland and Canada) of adolescents (ages 13 and 15 years) who self-identify as having a disability or chronic condition, as conceptualized by the WHO International Classification of Functioning, Disability and Health. Data from the 2002 WHO Health Behaviour in School-aged Children survey were used to compare the prevalence of emotional health (items on feeling low, feeling nervous) within and between countries. Eighteen percent of the Canadian and Finnish samples indicated they had a long-time disability, illness or medical condition. Canadian adolescents with disability or chronic conditions felt low significantly more frequently than their classmates without disability or chronic conditions. In both countries, students with disabilities who had more than one functional difficulty were significantly more likely to report feeling low and nervous. These results illustrate that the severity of disability as measured by the number of functional difficulties, and not merely the presence of disability or chronic condition, or particular functional difficulties, may play an important role in the emotional health of adolescents. Health promotion programs may use this information to guide practice to support the emotional health of students with disabilities.
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Sällfors C, Hallberg LRM. Fitting into the prevailing teenage culture: A grounded theory on female adolescents with chronic arthritis. Int J Qual Stud Health Well-being 2009. [DOI: 10.1080/17482620802431862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kinavey C. Adolescents Born with Spina Bifida: Experiential Worlds and Biopsychosocial Developmental Challenges. ACTA ACUST UNITED AC 2009; 30:147-64. [DOI: 10.1080/01460860701728352] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kay C, Davies J, Gamsu D, Jarman M. An Exploration of the Experiences of Young Women Living with Type 1 Diabetes. J Health Psychol 2009; 14:242-50. [DOI: 10.1177/1359105308100208] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this research was to explore young women's experience of living with type 1 diabetes. Nine young women aged between 18 and 24 took part in semi-structured interviews. Data were analysed using Interpretive Phenomenological Analysis. Four main super-ordinate themes emerged; `the relationship with the body', `personal challenges', `the impact of relationships' and `changing and adapting'. These themes provide a deeper understanding of the issues faced by young women with type 1 diabetes. The implications for clinical practice are discussed.
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Affiliation(s)
| | | | - Deborah Gamsu
- Health and Medical Division, Psychological Health Sheffield, UK
| | - Maria Jarman
- Health and Medical Division, Psychological Health Sheffield, UK
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