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Shani M, van Zalk MHW. Love beyond gluten: self-esteem, illness identity, and social support in romantic rejection concerns among adolescents with celiac disease. Front Psychol 2024; 15:1335201. [PMID: 38831945 PMCID: PMC11144883 DOI: 10.3389/fpsyg.2024.1335201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Fear of stigmatization, high perceived partner burden, or refraining from self-disclosure may manifest in romantic rejection concerns among adolescents with celiac disease (CD), potentially impacting their health-related quality of life (HRQOL). This study examined the prevalence, predictors, and consequences of romantic rejection concerns among adolescents and young adults with CD. Methods A cross-sectional online survey was conducted among 165 German adolescents and young adults (aged 14-22) with self-reported CD. Participants completed measures of romantic rejection concerns, illness identity, self-esteem, peer support, and CD-specific HRQOL. Results Participants reported moderate levels of concerns about the impact of CD on their romantic relationships, with no significant gender differences. Participants involved in romantic relationships expressed lower concerns of rejection, but similar preference for a "gluten-free partner." Hierarchical regression analysis revealed that higher illness acceptance and peer support predicted lower rejection concerns. Significant interactions emerged between self-esteem and illness acceptance, and between self-esteem and peer support. Higher illness acceptance predicted fewer rejection worries only among those with high self-esteem, while peer support played a mitigating role only for those with low self-esteem. Romantic rejection concerns significantly predicted lower CD-specific HRQOL across all domains. Discussion Anxieties about CD's impact on romantic relationships are prevalent among adolescents and may hinder their HRQOL. The findings highlight the complex interplay between self-esteem, illness identity, and social support in shaping romantic concerns. Targeted interventions focusing on peer support and fostering positive illness identity are recommended to alleviate rejection fears and improve HRQOL among youth with CD.
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Affiliation(s)
- Maor Shani
- Department of Developmental Psychology, Institute for Psychology, Osnabrück University, Osnabrück, Germany
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Lee SL, Wu LM, Lin SY, Chen TH, Lin WT. Cross-cultural translation and validation of the Chinese version Distress Tolerance Scale for adolescents with chronic physical disease. Child Care Health Dev 2024; 50:e13270. [PMID: 38706405 DOI: 10.1111/cch.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/18/2024] [Accepted: 03/31/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15-item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. METHODS The 15-item English version DTS was translated into a Chinese version using the translation guidelines for cross-cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item-total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. RESULTS The two-factor nine-item Chinese version DTS for Adolescents with CPD (C-DTS-A) was developed. Lower scores of the C-DTS-A were significantly associated with higher diabetes distress, poorer self-management, and worse glycaemic control; their correlation coefficients sequentially were -.40, .17 and -.23. Cronbach's α and the test-retest reliability of the two-factor C-DTS-A ranged from .81 to .87 and from .79 to .89, respectively. CONCLUSION The two-factor nine-item C-DTS-A with good cross-cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD.
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Affiliation(s)
- Shu-Li Lee
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shu-Yuan Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tzu-Han Chen
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neonatal Intensive Care Unit, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-Ting Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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3
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Dijkstra JN, Rasing NB, Boon HTM, Altena-Rensen S, Cup EHC, Lanser A, Siemann IJ, van Engelen BG, Erasmus CE, Voermans NC. Quality of life and support needs in children, adolescents, and young adults with facioscapulohumeral dystrophy, a mixed-method study. Eur J Paediatr Neurol 2024; 50:64-73. [PMID: 38692157 DOI: 10.1016/j.ejpn.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/26/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND AND OBJECTIVES Quality of life (QoL) in children with facioscapulohumeral dystrophy (FSHD) seems plausible decreased. Little is known about factors influencing QoL in children with FSHD. Our objective is to explore factors contributing to the QoL of children, adolescents, and young adults with FSHD, to describe how they experience life with FSHD, and to report their support needs. METHODS We performed a mixed-method study with individual age-appropriate semi-structured interviews assessing QoL in children, adolescents, and young adults with FSHD and their parents. To characterize the sample, quantitative data on QoL, pain, fatigue, and participation were collected. Interview data was analyzed using a thematic analysis. RESULTS Fourteen patients participated (age between 9 and 26 years old, eight males and six females). The degree of FSHD severity, as indicated by the FSHD-score, did not correlate with QoL. Older children had a lower QoL than younger children. Children and adolescents strived for normality regardless of physical discomfort. Phenotypical features of FSHD led to insecurity aggravated by hurtful comments of others. The unpredictability of disease progression and its implications for career and parenthood choices led to a generalized feeling of uncertainty about the future. Support was found within family and friends. Participants expressed a need for peer support and psychological support as well as recommending it to others. DISCUSSION Quality of life in childhood FSHD is diminished caused by their physical limitations, altered appearance, fear of social rejection, and uncertainty of the disease progression in the future. A fear of social rejection most likely contributes to striving for normality regardless of physical discomfort. Support should be focused on acceptance and coping with hurtful comments. It should preferably be individualized, easily accessible and not offered as therapy but rather as tutoring for children.
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Affiliation(s)
- Jildou N Dijkstra
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nathaniël B Rasing
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Helena T M Boon
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sandra Altena-Rensen
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands
| | - Edith H C Cup
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Center, Nijmegen, the Netherlands
| | - Anke Lanser
- Patient Representative and Chairman FSHD Advocacy Group, Patient Organization for Muscular Diseases Spierziekten Nederland, Baarn, the Netherlands
| | - Ietske J Siemann
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Baziel G van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Corrie E Erasmus
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
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Barratt M, Bail K, Lewis P, Paterson C. Nurse experiences of partnership nursing when caring for children with long-term conditions and their families: A qualitative systematic review. J Clin Nurs 2024; 33:932-950. [PMID: 37953488 DOI: 10.1111/jocn.16924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/25/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
AIM To explore the experiences of partnership nursing among nurses when caring for children and young people with long-term conditions, and their families. BACKGROUND Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision-making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing. DESIGN A qualitative systematic review followed Joanna Briggs Institute meta-aggregation approach and has been reported according to PRISMA guidelines. METHODS A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre-determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted. FINDINGS A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision-making principles to deliver individualised care. CONCLUSION Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse-parent and dyadic nurse-child partnerships. Future practice development that creates a three-way triadic partnership may aid therapeutic relationships and shared decision-making. IMPLICATIONS FOR CLINICAL PRACTICE Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision-making.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate and University of Canberra Level 3, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury, New South Wales, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate and University of Canberra Level 3, Canberra Hospital, Canberra, Australian Capital Territory, Australia
- Prehabilitation, Activity, Cancer, Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
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Aydemir N, Sakman ÖK, Delil Ş, Özkara Ç. Determinants of felt-stigma in adolescents with epilepsy: Is it the same story? Seizure 2023; 113:34-40. [PMID: 37952261 DOI: 10.1016/j.seizure.2023.11.001] [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: 09/22/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE The present study aimed to investigate previously researched variables in adult people with epilepsy (PWE), which include felt stigma, perceived overprotection, concealment of epilepsy, and epilepsy-related concerns for adolescents with epilepsy (AWE). Another goal was to determine the reported levels of these variables and explore the relationships among them, as well as their associations with demographic and clinical factors. Additionally, we also investigated whether clinical and demographic variables create significant changes in these variables. Lastly, we aimed to determine the variables that predict felt-stigma in AWE. METHODS On hundred and nineteen AWE aged between 10 and 18 were included in the study by using convenience sampling. Participants received the scales and demographic information form either in face to face meeting or via a Zoom session. RESULTS Nearly half of the participants stated high level of felt stigma, perceived overprotection and concealment of epilepsy, while more than half reported concerns about their future/occupational prospects. Also, felt stigma had significant relations with concealment of epilepsy and concerns related to epilepsy. Early adolescents were under more risk for perceived overprotection, while late adolescents had higher concerns related to future/occupation. Females reported more felt stigma. Finally, felt stigma was predicted by concealment, concerns related to future/occupation, and concerns related to social life. CONCLUSION The variables that explain the felt-stigma in AWE appear to be quite similar to those in adult PWE.
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Affiliation(s)
- Nuran Aydemir
- Faculty of Letters, Department of Psychology, Istanbul University, Istanbul, Turkiye.
| | | | - Şakir Delil
- Faculty of Medicine, Department of Neurology, Istanbul Cerrahpaşa University, Istanbul, Turkiye
| | - Çiğdem Özkara
- Faculty of Medicine, Department of Neurology, Istanbul Cerrahpaşa University, Istanbul, Turkiye
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Israelsson-Skogsberg Å, Palm A, Lindahl B, Markström A, Ekström M. Young adults' narratives about living with home mechanical ventilation - a phenomenological hermeneutical study. Disabil Rehabil 2023:1-8. [PMID: 37933171 DOI: 10.1080/09638288.2023.2278187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE An increasing number of children and young adults with complex medical conditions and respiratory failure are treated with home mechanical ventilation (HMV). The current study aimed to describe how young adults using HMV experience their everyday life with the ventilator, their physical impairments and their opportunities for an educational and professional career. MATERIALS AND METHODS Data were collected via narrative interviews with nine young HMV users (3 females and 6 males, aged 18-31 years) in their homes. Two were ventilated invasively, six were ventilated non-invasively and one was treated with continuous positive airway pressure (CPAP) via facemask. Data were analysed using a phenomenological hermeneutical method. RESULT A multi-professional team contributed to participants' safety and ability to participate in society through higher education and professional work. A good and valuable life, mostly feeling healthy were experienced but also prejudice and stiffened social society structures. CONCLUSION The findings of this study prove the importance of having long-standing access to a competent and supportive available multi-professional healthcare team when living with a long-term complex condition. These teams provided well-functioning human and technological support in everyday lives.
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Affiliation(s)
- Åsa Israelsson-Skogsberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Andreas Palm
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Agneta Markström
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Neuropediatric Karolinska Institutet, Stockholm, Sweden
| | - Magnus Ekström
- Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden
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Finlay-Jones AL, Parkinson A, Sirois F, Perry Y, Boyes M, Rees CS. Web-Based Self-Compassion Training to Improve the Well-Being of Youth With Chronic Medical Conditions: Randomized Controlled Trial. J Med Internet Res 2023; 25:e44016. [PMID: 37703081 PMCID: PMC10534292 DOI: 10.2196/44016] [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: 11/03/2022] [Revised: 06/04/2023] [Accepted: 06/26/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Up to one-third of young people live with chronic physical conditions (eg, diabetes, asthma, and autoimmune disease) that frequently involve recurrent pain, fatigue, activity limitations, stigma, and isolation. These issues may be exacerbated as young people transition through adolescence. Accordingly, young people with chronic illness are at a high risk of psychological distress. Accessible, evidence-based interventions for young people with chronic illnesses are urgently needed to improve well-being, support adaptation, and enhance daily functioning. Self-compassion, which is an adaptive means of relating to oneself during times of difficulty, is a promising intervention target for this population. OBJECTIVE This study aims to test the efficacy of a 4-week, self-guided, web-based self-compassion training program for improving well-being among young Australians (aged 16-25 years) living with a chronic medical condition. The primary outcomes were self-compassion, emotion regulation difficulties, and coping; the secondary outcomes were well-being, distress, and quality of life. We also sought to test whether changes in primary outcomes mediated changes in secondary outcomes and gather feedback about the strengths and limitations of the program. METHODS We conducted a single-blind, parallel-group, randomized controlled trial comparing a 4-week, fully automated, web-based self-compassion training program with a waitlist control. Participants were recruited via the internet, and outcomes were self-assessed at 4 (T1) and 12 weeks (T2) after the baseline time point via a web-based survey. A mixed methods approach was used to evaluate the program feedback. RESULTS Overall, 151 patients (age: mean 21.15, SD 2.77 years; female patients: n=132, 87.4%) were randomized to the intervention (n=76, 50.3%) and control (n=75, 49.7%) groups. The loss-to-follow-up rate was 47.4%, and program use statistics indicated that only 29% (22/76) of young people in the experimental group completed 100% of the program. The main reported barrier to completion was a lack of time. As anticipated, treatment effects were observed for self-compassion (P=.01; partial η2=0.05; small effect); well-being (P≤.001; partial η2=0.07; medium effect); and distress (P=.003; partial η2=0.054; small-medium effect) at the posttest time point and maintained at follow-up. Contrary to our hypotheses, no intervention effects were observed for emotion regulation difficulties or maladaptive coping strategies. Improvements in adaptive coping were observed at the posttest time point but were not maintained at follow-up. Self-compassion, but not emotion regulation difficulties or coping, mediated the improvements in well-being. CONCLUSIONS Minimal-contact, web-based self-compassion training can confer mental health benefits on young people with chronic conditions. This group experiences substantial challenges to participation in mental health supports, and program engagement and retention in this trial were suboptimal. Future work should focus on refining the program content, engagement, and delivery to optimize engagement and treatment outcomes for the target group. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry 12619000572167; https://tinyurl.com/5n6hevt. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-020-8226-7.
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Affiliation(s)
- Amy Louise Finlay-Jones
- Youth Mental Health Team, Telethon Kids Institute, Nedlands, Australia
- School of Population Health, Curtin University, Bentley, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Asha Parkinson
- Youth Mental Health Team, Telethon Kids Institute, Nedlands, Australia
- School of Population Health, Curtin University, Bentley, Australia
| | - Fuschia Sirois
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Yael Perry
- Youth Mental Health Team, Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Mark Boyes
- School of Population Health, Curtin University, Bentley, Australia
| | - Clare S Rees
- School of Population Health, Curtin University, Bentley, Australia
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Rasalingam A, Brekke I, Stenberg U, Haaland-Øverby M, Helseth S. 'Struggling to participate in everyday life': emerging adults' experiences of living with long-term health challenges. BMC Public Health 2023; 23:1368. [PMID: 37460986 PMCID: PMC10353226 DOI: 10.1186/s12889-023-16291-6] [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: 02/17/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
AIM To gain a deeper understanding of the experiences of participation in the everyday life of emerging adults living with long-term health challenges and how this influences their own quality of life. METHODS Using an explorative study design, data were collected through in-depth interviews with a sample of 12 young people aged 18-29 years living with long-term health challenges in Norway. FINDINGS The analysis identified one overarching theme of struggling to participate in everyday life, and four subthemes: the notion of being independent but also dependent, experiencing mismatch between needs and support, experiencing deprivation of spontaneity and feeling uncertain about the future. The emerging adults experienced difficulties with participation in key areas of life such as education, employment and leisure activities. Associated symptoms of their diagnosis, limited physical abilities and lack of sufficient support made it hard to participate in everyday life the way they aspired to. CONCLUSION The challenges of living with a long-term health challenge as an emerging adult contributed to limitations in participation in different areas of life that was perceived as important for their quality of life.
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Affiliation(s)
- Anurajee Rasalingam
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
| | - Idunn Brekke
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Una Stenberg
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway
| | - Mette Haaland-Øverby
- National advisory unit on learning and mastery in health, Oslo university hospital, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Zheng H, Bornman J, Granlund M, Zhao Y, Huus K. Participation of children with long-term health conditions compared to that of healthy peers: A cross-sectional comparative study. Scand J Occup Ther 2023; 30:334-343. [PMID: 35132920 DOI: 10.1080/11038128.2022.2035815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Knowledge is limited on attendance and involvement of perceived participation of children with long-term health conditions. AIMS To evaluate the perceived participation of children with long-term health conditions and to compare their participation with that of healthy peers. MATERIAL AND METHODS A cross-sectional comparative study was designed using self-reported data from 65 children with long-term health conditions and from 65 healthy peers, utilising the simplified Chinese version of Picture My Participation (PMP-C; Simplified). RESULTS The frequency scores of children with long-term health conditions were significantly lower than those of healthy peers in terms of attendance for the total domain and for 13 activity items. The involvement scores of children with long-term health conditions were significantly lower than those of healthy children in 3 items. There was a strong correlation between rank orders of the most important activities for the two groups (r = 0.83). CONCLUSIONS Children with long-term health conditions participated less in activities compared to healthy children. Further studies are required to investigate factors of the participation of children. SIGNIFICANCE The PMP-C (Simplified) offered an opportunity for children to express their own perspectives of participation based on their individual experience of the activity.
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Affiliation(s)
- Hong Zheng
- CHILD Research Group, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Juan Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Mats Granlund
- CHILD Research Group, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Karina Huus
- CHILD Research Group, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Helgeson VS, Berg CA, Raymaekers K. Topical Review: Youth With Type 1 Diabetes: What Is the Role of Peer Support? J Pediatr Psychol 2023; 48:176-180. [PMID: 36383198 DOI: 10.1093/jpepsy/jsac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/17/2022] Open
Abstract
The literature on the role of peer support for psychological well-being and disease management among youth with type 1 diabetes (T1D) is mixed. In this topical review, we use self-determination theory (SDT) as a framework to understand the conditions under which peer support is helpful or unhelpful regarding psychological well-being and diabetes management. We briefly review the literature to support our claim that existing research on peer support is inconsistent. A primary reason for the inconsistency is that previous work largely focuses on diabetes instrumental and informational support from peers, which have the potential to threaten SDT needs for autonomy, competence, and relatedness. Instrumental and informational support may set youth with T1D apart from peers at a time when fitting in with peers is crucial. Instead, we argue that emotional support from and companionship with peers best meet the SDT need of relatedness while not posing direct threats to autonomy or competence. We also note that some youth have extremely high needs for relatedness such that they prioritize connecting with peers over diabetes management. We conclude by calling for more research to adopt a SDT theory approach to examine the role of peer support in the lives of youth with T1D and for health care professionals to expand their focus from the specifics of diabetes to the broader social context.
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Affiliation(s)
| | | | - Koen Raymaekers
- KU Leuven, Leuven, Belgium.,Fonds Wetenschappelijk Onderzoek, Brussels, Belgium
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11
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Bagge-Petersen CM. Living Ambivalently with Chronic Illness. Med Anthropol 2023; 42:191-205. [PMID: 36745582 DOI: 10.1080/01459740.2023.2174023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Mobile health smartphone applications (mHealth apps) enable patients to monitor how chronic illness interconnects with their everyday life. I explore, through focus group discussions, how such monitoring makes sense to pediatric and young patients and parents in Denmark. These groups explicate how they live both with and without chronic illness by distinguishing between when to focus on which aspects of it. I argue that this relationship with chronic illness produces parent's, children's, and young people's ambivalent attitudes toward mHealth apps that promote illness monitoring "anywhere" and at "any time."
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Affiliation(s)
- Claudia M Bagge-Petersen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
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12
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Stotsky MV, Henning E. Commentary: Developing a Measure of Inpatient Rehabilitation Treatment Beliefs and Expectations for Youth With Chronic Illness. J Pediatr Psychol 2023; 48:14-16. [PMID: 35997553 DOI: 10.1093/jpepsy/jsac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/17/2023] Open
Affiliation(s)
- Mimi V Stotsky
- Department of Behavioral Psychology, Kennedy Krieger Institute, USA.,Johns Hopkins University School of Medicine, USA
| | - Ellen Henning
- Department of Behavioral Psychology, Kennedy Krieger Institute, USA
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Heath G, Screti C, Pattison H, Knibb R. Understanding the impact of 'wish-granting' interventions on the health and well-being of children with life-threatening health conditions and their families: A systematic review. J Child Health Care 2022; 26:479-497. [PMID: 33966480 DOI: 10.1177/13674935211016712] [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: 11/16/2022]
Abstract
This review aimed to explore how wish-granting interventions impact on the health and well-being of children with life-threatening health conditions and their families, using any study design. Six electronic databases (Medline; PsycINFO; CINAHL; Embase; AMED and HMIC) were systematically searched to identify eligible research articles. Studies were critically appraised using a Mixed Methods Appraisal Tool. Findings were synthesized narratively. 10 papers were included, reporting studies conducted across five countries, published from 2007 to 2019. Study designs were diverse (four quantitative; two qualitative and four mixed method). Results indicated improvements to physical and mental health, quality of life, social well-being, resilience and coping for wish children, parents and siblings. In conclusion, wish-granting interventions can positively impact health and therefore should not be discouraged; however, more research is needed to define and quantify the impact of wish fulfilment and to understand how it can be maximized.
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Affiliation(s)
- Gemma Heath
- School of Psychology, 1722Aston University, Birmingham, UK
| | | | - Helen Pattison
- School of Psychology, 1722Aston University, Birmingham, UK
| | - Rebecca Knibb
- School of Psychology, 1722Aston University, Birmingham, UK
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14
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Knight LSW, Ridge B, Staffieri SE, Craig JE, Prem Senthil M, Souzeau E. Quality of life in children with glaucoma: a qualitative interview study in Australia. BMJ Open 2022; 12:e062754. [PMID: 35858727 PMCID: PMC9305814 DOI: 10.1136/bmjopen-2022-062754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Childhood glaucoma is a chronic vision-threatening condition that may significantly impact an individual's psychosocial well-being. There is a paucity of literature investigating the quality of life (QoL) in children with glaucoma. The aim of this study was to investigate and report on the QoL issues encountered by children with glaucoma. DESIGN This is a qualitative interview study. Data were collected through semistructured interviews. NVivo V.12 software (QSR International Pty Ltd, Melbourne, Australia) was used to analyse and code data to identify QoL themes. The prominence of QoL themes was determined by the number of children who raised issues connected to the corresponding theme. SETTING Interviews were conducted via telephone or videoconferencing between April 2020 and July 2021. PARTICIPANTS Eighteen children with glaucoma, aged 8-17 years, who resided in Australia, were recruited from the Australian and New Zealand Registry of Advanced Glaucoma. RESULTS Median child age was 12.1 years (IQR: 9.7-14.5 years) and 33% were female. Seven QoL themes were identified: 'coping', 'inconveniences' and 'emotional well-being' were more prominent themes than 'symptoms', 'ocular health concerns', 'social well-being' and 'autonomy'. Adaptive coping strategies included resilience throughout clinical examinations and establishing positive relationships with ophthalmologists. These minimised inconveniences related to clinic waiting times and pupillary dilatation. External to the clinical setting, children often dissociated from their glaucoma but struggled with glare symptoms and feeling misunderstood by fellow peers. Older children aged 13-17 years commonly disengaged from their glaucoma care and expressed an unwillingness to attend ophthalmic appointments. Older children further raised issues with career options, obtaining a driver's licence and family planning under the theme of autonomy. CONCLUSIONS The psychosocial impact of childhood glaucoma extends beyond the clinical environment and was minimised using coping strategies. Older children may require additional social and ophthalmic support as they transition into adulthood.
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Affiliation(s)
- Lachlan S W Knight
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia
- Department of Ophthalmology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Sandra E Staffieri
- Department of Ophthalmology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Ophthalmology, University of Melbourne, Department of Surgery, Parkville, Victoria, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Mallika Prem Senthil
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia
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15
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Barratt M, Bail K, Paterson C. Children living with long-term conditions and their experiences of partnership in nursing care: An integrative systematic review. J Clin Nurs 2022. [PMID: 35768938 DOI: 10.1111/jocn.16429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/01/2022] [Accepted: 06/09/2022] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVE To describe the experiences of nursing care and partnership nursing as expressed by children living with long-term conditions. BACKGROUND Children with long-term conditions have higher rates of hospitalisations and adverse events in hospital, yet little is known about their experiences of nursing care. How children perceive partnership in care with their families and nurses is of interest in the achievement of safe and effective care DESIGN: An integrative review following Joanna Briggs Institute protocols for systematic reviews. METHOD An integrative review was chosen following Joanna Briggs Institute protocols for systematic reviews. A total of 5150 articles were screened, with 251 full-text publications reviewed. A total of 21 studies were included, three mixed-method studies and 18 qualitative studies. This review has been reported as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Four integrated findings were identified: "Children are aware of their surroundings and needs," "Children value positive communication," "Children want to be recognised as an individual in the triadic relationship, and this can be done through nurses using tailored play;" and "Children seek a shared decision-making process." DISCUSSION Children wanted to be seen as an individual in Children and Young People's nursing as well as a child who craves security, fun and comfort, both from their families and nursing staff. Children described observing partnership between nursing staff and parents but felt uninvolved, with some children craving more knowledge and power to better understand their long-term condition. RELEVANCE TO CLINICAL PRACTICE Further research is required on how Children and Young People's nursing staff can better support children and empower them to be active members in the shared decision-making process if the child wishes to be involved.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia.,Prehabilitation, Activity, Cancer Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia.,Robert Gordon University, Aberdeen, UK
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16
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Teela L, Verhagen LE, Gruppen MP, Santana MJ, Grootenhuis MA, Haverman L. Including the voice of paediatric patients: Cocreation of an engagement game. Health Expect 2022; 25:1861-1871. [PMID: 35751406 PMCID: PMC9327851 DOI: 10.1111/hex.13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/18/2022] [Accepted: 05/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Engaging patients in health care, research and policy is essential to improving patient‐important health outcomes and the quality of care. Although the importance of patient engagement is increasingly acknowledged, clinicians and researchers still find it difficult to engage patients, especially paediatric patients. To facilitate the engagement of children and adolescents in health care, the aim of this project is to develop an engagement game. Methods A user‐centred design was used to develop a patient engagement game in three steps: (1) identification of important themes for adolescents regarding their illness, treatment and hospital care, (2) evaluation of the draft version of the game and (3) testing usability in clinical practice. Adolescents (12–18 years) were engaged in all steps of the development process through focus groups, interviews or a workshop. These were audio‐recorded, transcribed verbatim and analysed in MAXQDA. Results (1) The important themes for adolescents (N = 15) were included: visiting the hospital, participating, disease and treatment, social environment, feelings, dealing with staff, acceptation, autonomy, disclosure and chronically ill peers. (2) Then, based on these themes, the engagement game was developed and the draft version was evaluated by 13 adolescents. Based on their feedback, changes were made to the game (e.g., adjusting the images and changing the game rules). (3) Regarding usability, the pilot version was evaluated positively. The game helped adolescents to give their opinion. Based on the feedback of adolescents, some last adjustments (e.g., changing colours and adding a game board) were made, which led to the final version of the game, All Voices Count. Conclusions Working together with adolescents, All Voices Count, a patient engagement game was developed. This game provides clinicians with a tool that supports shared decision‐making to address adolescents' wishes and needs. Patient or Public Contribution Paediatric patients, clinicians, researchers, youth panel of Fonds NutsOhra and patient associations (Patient Alliance for Rare and Genetic Diseases, Dutch Childhood Cancer Organization) were involved in all phases of the development of the patient engagement game—from writing the project plan to the final version of the game.
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Affiliation(s)
- Lorynn Teela
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands.,Child development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Lieke E Verhagen
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mariken P Gruppen
- Department of General Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria J Santana
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Martha A Grootenhuis
- Psychosocial Research and Care Innovation, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lotte Haverman
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands.,Child development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
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17
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Montali L, Zulato E, Cornara M, Ausili D, Luciani M. Barriers and facilitators of type 1 diabetes self-care in adolescents and young adults. J Pediatr Nurs 2022; 62:136-143. [PMID: 34561133 DOI: 10.1016/j.pedn.2021.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/12/2021] [Accepted: 09/12/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE This study explores the disease experience of adolescents and young adults with T1DM focusing on the barriers and facilitators that characterise their disease self-care. Self-care requires complex decision making and cooperation between patients, their families, the healthcare team, and the social support system. Personal and social factors affect self-care, and specific challenges impact adolescents and young adults, putting them at a higher risk of poor glycaemic control and more severe complications. DESIGN AND METHODS The study uses a qualitative description approach. Twenty-two people (15 women; 10-30 years old; 2-24 years from diagnosis) were purposefully recruited through snowballing techniques. Data were collected with semi-structured interviews and analysed inductively with semantic thematic analysis. RESULTS Four themes and nine subthemes conceptualise the patients' experience as a life-long journey that has its difficult beginning at the time of diagnosis and continues through the resolution of the initial crisis by integrating disease at the identity level and acquiring expertise. Technology and social environment act both as self-care barriers and facilitators. CONCLUSIONS Findings highlight the importance of designing and improving technology related to diabetes accounting for patients' experiences. Second, it is imperative to work towards a de-stigmatisation of diabetes. Finally, health professionals should work with people with T1DM on the psychological aspects of the disease and identity integration. PRACTICE IMPLICATIONS Diabetes-related technology should promote usability and acceptability while addressing visibility and device burden issues. Clinicians should pay particular attention during the transition from the paediatric to the adult centres and offer global assessments and treatment.
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Affiliation(s)
- Lorenzo Montali
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy.
| | - Edoardo Zulato
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy.
| | - Mattia Cornara
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy.
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, Italy.
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, Italy.
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18
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Bagge-Petersen CM, Langstrup H, Larsen JE, Frølich A. Critical user-configurations in mHealth design: How mHealth-app design practices come to bias design against chronically ill children and young people as mHealth users. Digit Health 2022; 8:20552076221109531. [PMID: 35733878 PMCID: PMC9208037 DOI: 10.1177/20552076221109531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
Mobile health smartphone applications (mHealth-apps) are increasingly emerging to assist children's and young people's management of chronic conditions. However, difficulties persist in applying design approaches in mHealth projects that return apps that are useful to this group. In this article, we explore ethnographically two self-proclaimed ‘user-driven’ projects designing mHealth apps for Danish patients below the age of 18 living with, respectively, haemophilia and rheumatoid arthritis. These projects initially included the perspectives of children and young people to inform the designs, however, eventually launched the final apps for adult patients only. Through a concept of ‘critical user-configuration’, we examine the projects’ challenges with attuning the designs to children and young people and how these drove their exclusion as users of the emerging mHealth apps. Critical user-configuration draws attention to critical moments in design practices where significant shifts in user-configurations take place, shaping who can become a user. More specifically, we uncover three critical moments: where mHealth projects expand the group of prospective users; where test subjects are selected; and where data governance systems and digital health infrastructures are mobilised in the design process. Throughout these critical moments, there is a drift from user-driven to data-driven design approaches which increasingly exclude groups of users who are less datafiable – in our case children and young people. We argue that besides giving voice to minors in mHealth design processes, we need to be mindful of the design practices that become decisive for – often implicitly – who can be configured as a user.
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Affiliation(s)
- Claudia M Bagge-Petersen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Langstrup
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob E Larsen
- Department of Applied Mathematics and Computer Science, Section for Cognitive Systems, Technical University of Denmark, Lyngby, Denmark
| | - Anne Frølich
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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19
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Yang J, Shafran R, Bennett S, Jolly A. An investigation into the psychosocial impact of therapeutic recreation summer camp for youth with serious illness and disability. Clin Child Psychol Psychiatry 2021; 26:1111-1123. [PMID: 34233139 DOI: 10.1177/13591045211028539] [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: 11/15/2022]
Abstract
OBJECTIVES This study aimed to evaluate the impact on emotional, social, physical and educational functioning of a therapeutic recreation camp provided by 'Over The Wall', a UK charity for children and young people with chronic illness or disability. METHOD Two hundred and sixty four people registered to attend camp were sent the Pediatric Quality of Life Inventory version Child Self-Report Scale before camp, immediately after camp, 1 month after camp and 3 months after camp. RESULTS Of those invited to participate, 178 children completed the pre-camp survey (67% response rate). Of those, 105 completed both the post-camp 1 and pre-camp questionnaires (59% of pre-camp respondents), and 60 of those participants subsequently completed the 1-month post-camp questionnaire as well (34% of pre-camp respondents). Only 32 participants completed the 3-month follow-up data (18% of pre-camp respondents). Across the first three timepoints (pre-Camp, post-Camp and 1 month follow-up), a repeated measures ANOVA indicated a significant improvement in emotional and social functioning, but not physical or school functioning (p < 0.05). Post-hoc analyses on pre-camp and post-camp scores revealed small-medium effect sizes of 0.317 and 0.272 for emotional and social functioning, respectively. DISCUSSION The therapeutic recreation summer camp provided for children and young people with health challenges had a significant, positive impact on emotional and social functioning. Such camps can therefore be considered as having empirical support for their aims. Further work is warranted to increase the response rate to establish the longer term impact of the camps and the wider impact of the camps on the wider family.
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Affiliation(s)
- Jacquelyn Yang
- UCL Division of Psychiatry, 4919University College London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 4919University College London, UK
| | - Sophie Bennett
- UCL Great Ormond Street Institute of Child Health, 4919University College London, UK
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20
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Kever A, Leavitt VM. Assessing diagnosis disclosure and concealment in multiple sclerosis: Development and initial validation of the DISCO-MS survey. Mult Scler 2021; 28:247-256. [PMID: 34498517 DOI: 10.1177/13524585211037581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with multiple sclerosis (MS) regularly report making strategic decisions about whether to share their diagnosis or keep it a secret; for many, this represents a key stressor. Surprisingly, the impact of disclosure and concealment are understudied in MS and a formal measurement instrument is lacking. We developed the Diagnosis Disclosure and Concealment in MS (DISCO-MS) survey, a self-assessment tool evaluating (1) frequency of concealment behaviors and (2) expected consequences of diagnosis disclosure in persons with MS. METHODS A systematic mixed-methods process was used for the design and initial validation of the DISCO-MS. Associations of DISCO-MS responses to demographics, clinical variables, and mood were examined in 204 participants with MS. RESULTS The 39-item DISCO-MS shows good psychometric characteristics. Approximately 25% of respondents conceal their diagnosis, particularly in professional settings. Higher concealment behaviors were associated with younger age, shorter disease duration, and lower physical disability. Nearly 50% of respondents believed that talking openly about their diagnosis might have undesirable professional and interpersonal consequences. Younger age, higher depression, and higher anxiety were associated with greater expectations of negative consequences. CONCLUSION Development and validation of the DISCO-MS presents the first step toward systematic study of the impact of DISCO on people with MS.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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21
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Kelada L, Molloy CJ, Hibbert P, Wiles LK, Gardner C, Klineberg E, Braithwaite J, Jaffe A. Child and caregiver experiences and perceptions of asthma self-management. NPJ Prim Care Respir Med 2021; 31:42. [PMID: 34504105 PMCID: PMC8429661 DOI: 10.1038/s41533-021-00253-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/19/2021] [Indexed: 02/07/2023] Open
Abstract
Asthma is the most common chronic condition of childhood. Self-management is integral to good asthma control. This qualitative paper explores how children with asthma and their parents perceive asthma, their experience with asthma, and how they manage symptoms, preventions and medications within and outside the home. We undertook 15 focus groups with 41 school-aged (6-11 years) children with asthma and 38 parents. Parents and their children attended the same focus groups. We used thematic analysis to analyse the transcripts. Our findings show the impact asthma can have on children's social and emotional wellbeing and highlight how reliant school-aged children are on their parents to effectively manage their asthma. Parents reported being unsure when their child's symptoms warranted visiting their doctor or hospital. Schools were identified as a source of difficulty regarding asthma management; families reported that children may be self-conscious about their asthma and using their inhaler at school. School policies and teachers' lack of asthma knowledge were reported to exacerbate children's reluctance to use their inhaler at school. Our results have implications for the design and implementation of children's self-management interventions for their asthma, particularly when they are at school and away from their parents.
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Affiliation(s)
- Lauren Kelada
- grid.1005.40000 0004 4902 0432School of Women’s and Children’s Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW Australia ,grid.414009.80000 0001 1282 788XKids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW Australia
| | - Charlotte J. Molloy
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia ,grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Peter Hibbert
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia ,grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Louise K. Wiles
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia ,grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Claire Gardner
- grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.1014.40000 0004 0367 2697Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Emily Klineberg
- grid.416088.30000 0001 0753 1056Ministry of Health, NSW Health, St Leonards, NSW Australia
| | - Jeffrey Braithwaite
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia
| | - Adam Jaffe
- grid.1005.40000 0004 4902 0432School of Women’s and Children’s Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW Australia ,grid.414009.80000 0001 1282 788XRespiratory Department, Sydney Children’s Hospital, Randwick, NSW Australia ,grid.414009.80000 0001 1282 788XAiming for Asthma Improvement in Children, Sydney Children’s Hospital, Randwick, NSW Australia
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22
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Wilson C, Stock J. 'Social media comes with good and bad sides, doesn't it?' A balancing act of the benefits and risks of social media use by young adults with long-term conditions. Health (London) 2021; 25:515-534. [PMID: 34080463 PMCID: PMC8424608 DOI: 10.1177/13634593211023130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Young adults are frequent users of social media, but the help and hindrance of social media for living well with long-term conditions (LTCs) in young adulthood is little-researched. The aim of this paper was to explore the experiences of social media use amongst young adults with LTCs. Interviews with 15 young adults with LTCs explored their experiences of using social media more broadly and in relation to online health communities. Social media came with both 'good and bad sides' which required a balancing act to manage (overarching theme), as reflected in the following subthemes: (1) Relationships: reducing social isolation versus need for face-to-face contact; (2) Comparisons: normalising versus negative (upward) comparisons; (3) Community: fitting in versus feeling left out; (4) Emotions: inspiring versus distress contagion; and (5) Knowledge: exchanging useful information versus fear of decline. The findings highlight the importance of young adults' self-reflection/awareness of social media's impact on their wellbeing, identifying when limited or increased use may be preferable. Whilst there is a 'good' to social media such as increased feelings of belonging and connection, this should not be the sole focus of future self-management interventions; as its use also contributes to feelings of distress, fear and not fitting in, and participants desire face-to-face contact.
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23
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Shaw KL, Baldwin L, Heath G. 'A confident parent breeds a confident child': Understanding the experience and needs of parents whose children will transition from paediatric to adult care. J Child Health Care 2021; 25:305-319. [PMID: 32602355 DOI: 10.1177/1367493520936422] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transitional care for young people with long-term conditions emphasizes the importance of supporting parents, particularly in relation to promoting adolescent healthcare autonomy. Yet, little practical guidance is provided, and transitional care remains suboptimal for many families. This study aimed to examine how parents understand and experience their caregiving role during their child's transition to adult services, to identify parents' needs, and to inform service improvements. Focus groups were undertaken with parents of young people with brittle asthma, osteogenesis imperfecta, or epilepsy. Data were analysed using interpretative phenomenological analysis. Participants (n = 13) described how their parenting roles extended beyond what they consider usual in adolescence. These roles were presented as time consuming, stressful, and unrelenting but necessary to protect children from harm in the face of multiple risks and uncertainties. Such protective strategies were also perceived to hinder adolescent development, family functioning, and their own development as midlife adults. Finding a balance between protecting immediate health and long-term well-being was a major theme. Participants called for improved support, including improved service organization. Recommendations are provided for working with parents and young people to manage the risks and uncertainties associated with their condition, as part of routine transitional care.
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Affiliation(s)
- Karen L Shaw
- Institute of Applied Health Research, 1724University of Birmingham, UK
| | - Lydia Baldwin
- College of Medical and Dental Sciences, 1724University of Birmingham, UK
| | - Gemma Heath
- Institute of Human Sciences, 8695University of Wolverhampton, UK
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24
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Raymaekers K, Helgeson VS, Prikken S, Vanhalst J, Moons P, Goossens E, Berg CA, Luyckx K. Diabetes-specific friend support in emerging adults with type 1 diabetes: Does satisfaction with support matter? J Behav Med 2021; 44:402-411. [PMID: 33677767 DOI: 10.1007/s10865-021-00211-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/19/2021] [Indexed: 01/24/2023]
Abstract
Youth with type 1 diabetes (T1D) must adhere to a complex treatment regimen to prevent health complications. Friends may provide diabetes-specific support to help youth manage diabetes, but evidence on whether youth benefit from diabetes-specific friend support is inconclusive. The present study first investigated whether satisfaction with friend support was linked to psychological distress and diabetes management. Second, it was investigated whether self-esteem mediated these relations. To this end, 324 Dutch-speaking emerging adults (17-28 years) with T1D completed questionnaires on diabetes-specific friend support, self-esteem, diabetes-specific distress, depressive symptoms, and self-care. HbA1c values were obtained from patients' physicians. Receiving diabetes-specific support from friends was associated with more diabetes-specific distress, but not for youth who were satisfied with the received support. Diabetes-specific friend support was not associated with other outcomes. Self-esteem did not mediate these relations. These results suggest that associations between diabetes-specific friend support and diabetes management are limited and that support satisfaction should be taken into consideration when examining the role of friend support for youth with T1D.
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Affiliation(s)
- Koen Raymaekers
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3717, 3000, Leuven, Belgium.
- Fonds Wetenschappelijk Onderzoek, Flanders, Belgium.
| | | | - Sofie Prikken
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3717, 3000, Leuven, Belgium
- Fonds Wetenschappelijk Onderzoek, Flanders, Belgium
| | | | - Philip Moons
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3717, 3000, Leuven, Belgium
- University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Eva Goossens
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3717, 3000, Leuven, Belgium
- Fonds Wetenschappelijk Onderzoek, Flanders, Belgium
- Center for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3717, 3000, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
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25
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Abstract
Objective The purpose of this qualitative pilot study was to evaluate drawing, narration, color use, and meaning through discussion to increase insight surrounding youth's lived experience with type 1 diabetes. Methods This qualitative study reflects a convenience sample of 20 (female = 12, male = 8) youth aged 8 to 15 years with an established diagnosis of type 1 diabetes. During a nonclinic session, 3 drawings-self-portrait, face of diabetes, and future self-portrait-were created. Interviews were completed with an art therapist or clinic nurse practitioner using a standardized script. Results All "face" of diabetes drawings depicted images separate from self. The most frequent color noted was gray, due to pencil use. No significant difference in disclosures or dialogue were observed between interviews conducted by the art therapist or nurse practitioner. Emerging themes noted: diabetes is unpredictable and stigmatizing, causes fears, and impacts daily life, yet discussions evidenced overall coping and resilience. Conclusions Drawing during clinic visits enhances communication and understanding of youth's lived experience. Findings offer clinical benefit when managing care and support for chronic health conditions.
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Affiliation(s)
- Shari K Liesch
- Medical College of Wisconsin, Children's Hospital of Wisconsin-Fox Valley, Neenah, WI, USA
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26
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Nap-van der Vlist MM, Berkelbach van der Sprenkel EE, Nijhof LN, Grootenhuis MA, van der Ent CK, Swart JF, van Royen-Kerkhof A, van Grotel M, van de Putte EM, Nijhof SL, Kars MC. Daily life participation in childhood chronic disease: a qualitative study on the child's and parent's perspective. BMJ Paediatr Open 2021; 5:e001057. [PMID: 34079917 PMCID: PMC8137215 DOI: 10.1136/bmjpo-2021-001057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/10/2021] [Accepted: 04/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To understand how a child with a stable chronic disease and his/her parents shape his/her daily life participation, we assessed: (1) the parents' goals regarding the child's daily life participation, (2) parental strategies regarding the child's participation and () how children and their parents interrelate when their goals regarding participation are not aligned. METHODS This was a qualitative study design using a general inductive approach. Families of children 8-19 years with a stable chronic disease (cystic fibrosis, autoimmune disease or postcancer treatment) were recruited from the PROactive study. Simultaneous in-depth interviews were conducted separately with the child and parent(s). Analyses included constant comparison, coding and categorisation. RESULTS Thirty-one of the 57 invited families (54%) participated. We found that parents predominantly focus on securing their child's well-being, using participation as a means to achieve well-being. Moreover, parents used different strategies to either support participation consistent with the child's healthy peers or support participation with a focus on physical well-being. The degree of friction between parents and their child was based on the level of agreement on who takes the lead regarding the child's participation. CONCLUSIONS Interestingly, parents described participation as primarily a means to achieve the child's well-being, whereas children described participation as more of a goal in itself. Understanding the child's and parent's perspective can help children, parents and healthcare professionals start a dialogue on participation and establish mutual goals. This may help parents and children find ways to interrelate while allowing the child to develop his/her autonomy.
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Affiliation(s)
| | | | - Linde N Nijhof
- Paediatrics, Wilhelmina Children's Hospital University Medical Centre, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Psycho-oncology, Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - Cornelis K van der Ent
- Cystic Fibrosis Center and Department of Pediatric Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joost F Swart
- Paediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annet van Royen-Kerkhof
- Paediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martine van Grotel
- Oncology, Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - Elise M van de Putte
- Paediatrics, Wilhelmina Children's Hospital University Medical Centre, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Paediatrics, Wilhelmina Children's Hospital University Medical Centre, Utrecht, The Netherlands
| | - Marijke C Kars
- Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
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27
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“My ADHD Hellbrain”: A Twitter Data Science Perspective on a Behavioural Disorder. JOURNAL OF DATA AND INFORMATION SCIENCE 2020. [DOI: 10.2478/jdis-2021-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Purpose
Attention deficit hyperactivity disorder (ADHD) is a common behavioural condition. This article introduces a new data science method, word association thematic analysis, to investigate whether ADHD tweets can give insights into patient concerns and online communication needs.
Design/methodology/approach
Tweets matching “my ADHD” (n=58,893) and 99 other conditions (n=1,341,442) were gathered and two thematic analyses conducted. Analysis 1: A standard thematic analysis of ADHD-related tweets. Analysis 2: A word association thematic analysis of themes unique to ADHD.
Findings
The themes that emerged from the two analyses included people ascribing their brains agency to explain and justify their symptoms and using the concept of neurodivergence for a positive self-image.
Research limitations
This is a single case study and the results may differ for other topics.
Practical implications
Health professionals should be sensitive to patients’ needs to understand their behaviour, find ways to justify and explain it to others and to be positive about their condition.
Originality/value
Word association thematic analysis can give new insights into the (self-reported) patient perspective.
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28
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Rasalingam A, Fegran L, Brekke I, Helseth S. Young people with long-term health challenges experiences in transition to adulthood: A qualitative metasynthesis. J Adv Nurs 2020; 77:595-607. [PMID: 33245156 DOI: 10.1111/jan.14641] [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] [Received: 06/19/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this study was to describe the experiences of the transition to adulthood for young people with long-term health challenges. DESIGN The metasynthesis approach was based on the guidelines by Sandelowski and Barroso for synthesizing qualitative research. DATA SOURCES Seven electronic databases: CINAHL, Medline, Embase, PsycINFO, Web of Science, Scopus, and SocIndex were searched on 6-10 February 2020. REVIEW METHODS Studies were critically appraised using the Joanna Briggs critical appraisal tool. Qualitative data were extracted, meta-summarised, then meta-synthesized. FINDINGS Nineteen qualitative studies were included in this review. Six themes illustrated experiences in the transition to adulthood: wishing for an 'ordinary' life, significance of close network, working towards independence, in need of systemic resources and services, psychosocial challenges and keeping a positive attitude. CONCLUSION Young people with long-term health challenges wished for as 'ordinary' a life as possible in the future. In the transition to adulthood, they gradually gained more competence in self-management skills and knowledge and strived to become more independent. By having a positive attitude and using other coping strategies, young people can work on some of the difficulties they experience in this phase. However, to achieve and maintain independence young people with long-term health challenges are dependent on the support of a close network and systemic support and services. IMPACT The findings highlight the need to help alleviate the fears and worries of young people with long-term health challenges and create opportunities for successful transition to adulthood by increased awareness and interventions from policy-makers and professionals in the health and social system.
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Affiliation(s)
- Anurajee Rasalingam
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Idunn Brekke
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Division of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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29
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Woodgate RL, Tennent P, Barriage S, Legras N. The centrality of disclosure decisions to the illness experience for youth with chronic conditions: A qualitative study. J Health Psychol 2020; 27:521-533. [PMID: 32985894 PMCID: PMC8832564 DOI: 10.1177/1359105320962242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper is to illuminate findings of disclosure experiences for youth living with chronic illness using a non-categorical approach. The findings were derived from a larger qualitative study framed by social constructivist grounded theory that sought to understand youth’s involvement in healthcare decision-making in the context of chronic illness. Fifty-four youth participated in the study, ranging from 9 to 24 years. Three main themes representing the youth’s perspectives and experiences of disclosing chronic illness were identified: (1) disclosure is central to the illness experience; (2) spectrum of disclosure; and (3) navigating others’ reactions to disclosure. The findings reinforce that more emphasis on decisions related to disclosing illness in research and clinical care for youth with chronic conditions is warranted.
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30
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Moore DA, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, Heyman I, Anderson R, Dickens C, Viner R, Bennett S, Logan S, Lockhart F, Thompson Coon J. Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses. Health Technol Assess 2020; 23:1-164. [PMID: 31122334 DOI: 10.3310/hta23220] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). DATA SOURCES For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. REVIEW METHODS The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen's d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. RESULTS Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive-behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention-LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. LIMITATIONS Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. CONCLUSIONS There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001716. FUNDING The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
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Affiliation(s)
- Darren A Moore
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Michael Nunns
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Liz Shaw
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Morwenna Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Erin Walker
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tamsin Ford
- Child Mental Health Group, University of Exeter Medical School, Exeter, UK
| | - Ruth Garside
- The European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Obi Ukoumunne
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Penny Titman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- University College London Institute of Child Health, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rob Anderson
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Chris Dickens
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Russell Viner
- University College London Institute of Child Health, London, UK
| | - Sophie Bennett
- University College London Institute of Child Health, London, UK
| | - Stuart Logan
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Fiona Lockhart
- Biomedical Research Centre Patient & Public Involvement Group, University College London Hospitals, London, UK
| | - Jo Thompson Coon
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
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31
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Trettin B, Hansen J, Bygum A. The impact of adolescents' everyday life experiences on their primary hyperhidrosis treatment - a qualitative study. J DERMATOL TREAT 2020; 33:928-934. [PMID: 32628056 DOI: 10.1080/09546634.2020.1789541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Hyperhidrosis is a disease affecting around 5% of the western population. The qualitative field within hyperhidrosis among adolescents has been sparsely investigated. The aim of this study was to investigate the impact of adolescent hyperhidrosis patients' everyday life experiences on their hyperhidrosis treatment. METHODS Qualitative, semi-structured interviews were carried out. In total, 10 adolescents, aged 12-18 years, participated in the study. Data were analyzed using a set of inseparable activities as described by Van Manen. RESULTS Three main themes were identified to represent common shared experiences across participants. The first theme was related to the impact of hyperhidrosis on the physical and psychological dimensions of life as it negatively affected both physical abilities and one's self-concept. Having hyperhidrosis was experienced as living a life in secrecy, characterized by individual routines for concealment and isolation in order to protect social identity. CONCLUSION The large negative impact of hyperhidrosis on adolescents is a strong justification for treatment of the disease. The substantial emotional distress suggests that treatment may need to include psychological support.
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Affiliation(s)
- Bettina Trettin
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
| | - Julie Hansen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Anette Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
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32
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Enggaard H, Laugesen B, Zoffmann V, Lauritsen MB, Jørgensen R. Adolescents' Perceptions of Living With Co-Existing ADHD and Medical Disorder in Denmark. J Pediatr Nurs 2020; 53:e129-e135. [PMID: 32229051 DOI: 10.1016/j.pedn.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 01/10/2023]
Abstract
AIM The study aim was to explore adolescents' with co-existing ADHD and medical disorder (MD) perceptions of everyday life and support from parents and healthcare professionals. DESIGN AND METHODS In this qualitative study, 10 adolescents aged 13-17 years diagnosed with ADHD and a MD were included from a general pediatric hospital clinic and a child and adolescent psychiatric hospital clinic. Data obtained through semi-structured interviews were analyzed using thematic analysis. RESULTS The adolescents' perceptions were categorized into four themes: 1) ADHD perceived as part of the adolescent's self-understanding - yet with daily frustrations, 2) MD perceived as an interruption in everyday life, 3) ADHD and MD - an overlooked dual task, and 4) the need for supportive relationships in navigating ADHD and MD. CONCLUSION Living with co-existing ADHD and MD is a complex dual task, as ADHD and MD interfere with each other in everyday life. However, the adolescents overlook the dual task as they believe their difficulties would be resolved if the MD was eliminated. Moreover, supportive relationships are essential in navigating the complexities in living with co-existing ADHD and MD. Nevertheless, the adolescents take a passive role in the encounters with the healthcare professionals, whereas they are more active in encounters with peers, parents and teachers. PRACTICE IMPLICATIONS Healthcare professionals treating and caring for adolescents with co-existing ADHD and MD need interventions facilitating patient involvement in a patient-centered approach to support both adolescents and healthcare professionals in recognizing the dual task of having co-existing ADHD and MD.
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Affiliation(s)
- Helle Enggaard
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Nursing & Research Program for Children and Youth at Risk and Inequalities in Life Opportunities, University College Northern Denmark, Aalborg, Denmark.
| | - Britt Laugesen
- Danish Centre of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Vibeke Zoffmann
- The Research Unit for Women's and Children's Health, University Hospital Copenhagen, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marlene Briciet Lauritsen
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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33
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Reliability and Validity of a Chinese-Version Normalization Assessment Measure for Primary Caregivers of Children With Cancer. Cancer Nurs 2020; 43:311-318. [DOI: 10.1097/ncc.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Nap-van der Vlist MM, Kars MC, Berkelbach van der Sprenkel EE, Nijhof LN, Grootenhuis MA, van Geelen SM, van der Ent CK, Swart JF, van Royen-Kerkhof A, van Grotel M, van de Putte EM, Nijhof SL. Daily life participation in childhood chronic disease: a qualitative study. Arch Dis Child 2020; 105:463-469. [PMID: 31748222 DOI: 10.1136/archdischild-2019-318062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/01/2019] [Accepted: 11/03/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Opportunities to participate in daily life have improved considerably for children with chronic disease. Nevertheless, they still face challenges associated with their ever-present illness affecting every aspect of their lives. To best help these children, we aimed to assess the child's own perspective on participation and the main considerations that affect participation in a stable phase of disease. METHODS Qualitative study design was applied. Semistructured, indepth interviews were conducted and analysed by a general inductive approach using constant comparison, coding and categorisation. Children 8-18 years old with a chronic disease were recruited from a cohort study involving cystic fibrosis, autoimmune disease and post-treatment paediatric cancer. RESULTS 31 of the 56 (55%) invited patients participated. From the perspective of children with chronic disease, participation is considered more than merely engaging in activities; rather, they view having a sense of belonging, the ability to affect social interactions and the capacity to keep up with peers as key elements of full participation. Some children typically placed a higher priority on participation, whereas other children typically placed a higher priority on their current and/or future needs, both weighing the costs and benefits of their choices and using disclosure as a strategy. CONCLUSIONS Enabling full participation from the child's perspective will help realise patient-centred care, ultimately helping children self-manage their participation. Caregivers can stimulate this participation by evaluating with children how to achieve a sense of belonging, active involvement and a role within a peer group. This requires active collaboration between children, healthcare providers and caregivers.
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Affiliation(s)
- Merel M Nap-van der Vlist
- Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marijke C Kars
- Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | | | - Linde N Nijhof
- Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Psycho-oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Stefan M van Geelen
- Education Centre, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis K van der Ent
- Cystic Fibrosis Center and Department of Pediatric Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joost F Swart
- Paediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annet van Royen-Kerkhof
- Paediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martine van Grotel
- Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Elise M van de Putte
- Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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35
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Shorey S, Ng ED. The Lived Experiences of Children and Adolescents with Non-Communicable Disease: A Systematic Review of Qualitative Studies. J Pediatr Nurs 2020; 51:75-84. [PMID: 31926405 DOI: 10.1016/j.pedn.2019.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/13/2019] [Accepted: 12/20/2019] [Indexed: 12/15/2022]
Abstract
PROBLEM Children and adolescents with non-communicable disease face more difficulties in achieving developmental milestones than their healthy peers, which affect their life and overall wellbeing. A non-disease-specific approach is important in identifying common challenges faced by children and adolescents across multiple non-communicable diseases. ELIGIBILITY CRITERIA Qualitative studies reporting first-hand accounts of children and adolescents aged 4 to19 years with non-communicable disease. SAMPLE A library search was conducted in five electronic databases (CINAHL, Embase, PsycINFO, PubMed, Scopus, and ProQuest Dissertations and Theses) for original qualitative English language papers. Fifty-five articles met the inclusion criteria and were subjected to a two-step meta-synthesis. RESULTS Initial reports of negative emotional experiences and disease perceptions were mixed with gradual acceptances of their diseases and positive coping strategies. Children and adolescents with non-communicable disease all desired a normal life, but physical limitations often led to social exclusions and self-imposed restrictions. Although most were highly appreciative of the support received from family, friends, and healthcare providers, they still struggled with disease management, the need for autonomy, and the fear of illness disclosure. CONCLUSIONS The impacts of non-communicable disease on children and adolescent's lives suggest a need for joint efforts between parents, clinicians, and educators to ensure children and adolescents' positive development of the self, acceptance and positive coping. IMPLICATIONS This review is able to inform the development of future educational and psychosocial intervention programs in the school and healthcare setting, and also encourages a revision of education policies to be more flexible and accommodating.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Marston HR, Niles-Yokum K, Earle S, Gomez B, Lee DM. OK Cupid, Stop Bumbling around and Match Me Tinder: Using Dating Apps Across the Life Course. Gerontol Geriatr Med 2020; 6:2333721420947498. [PMID: 32844104 PMCID: PMC7418241 DOI: 10.1177/2333721420947498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/31/2020] [Accepted: 07/07/2020] [Indexed: 12/21/2022] Open
Abstract
Social connectedness, sex, and intimacy are all factors associated with positive aging, facing individuals in society across the life course. Phenomenal technological developments in the 21st century have led to the increased use of smartphones, mobile apps, and dating apps for a myriad of services, and engagements. This paper focuses on two specific cohorts' who have the opportunity to engage with dating apps, older adults and young citizens with life-limiting or life-threatening conditions, and highlights issues related to the intersection of technology, societal constructions of age, disability, and online dating.
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Affiliation(s)
| | | | - Sarah Earle
- The Open University, Milton Keynes, Buckinghamshire, UK
| | | | - David M. Lee
- Manchester Metropolitan University, Didsbury, Manchester, UK
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37
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The Social Context and Illness Identity in Youth with Type 1 Diabetes: A Three-Wave Longitudinal Study. J Youth Adolesc 2019; 49:449-466. [DOI: 10.1007/s10964-019-01180-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
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38
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McKenna J, Bray L, Doyle S. Parental experiences of their child's vulvovaginitis: a qualitative interview study. J Pediatr Urol 2019; 15:659.e1-659.e5. [PMID: 31451410 DOI: 10.1016/j.jpurol.2019.07.018] [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] [Received: 11/07/2018] [Accepted: 07/23/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Vulvovaginitis is described as a common self-limiting paediatric gynaecological condition. Parents' experiences of their child being diagnosed with this condition and subsequent treatment have not previously been described. AIM The aim of this study was to explore parents' experiences of their child's diagnosis and management of vulvovaginitis. STUDY DESIGN The study was conducted in the north west of England over a two-year period. Qualitative data were generated by semistructured in-depth interviews. Mothers of nine children with vulvovaginitis consented to participate. Data were analysed using thematic analysis. RESULTS The analysis of the data resulted in four themes: trauma and uncertainty of initial symptoms, seeking a diagnosis; an uncertain journey, managing the symptoms; a process of trial and error and managing the impact; keeping it private. Parents experienced a difficult and protracted journey to their child's diagnosis and were involved in a process of trial and error to try and monitor and manage what can be a difficult ongoing condition. DISCUSSION Clinical reports suggest that vulvovaginitis is a minor childhood condition; this is not necessarily the perceptions and experiences of parents, who can experience uncertainty and ongoing difficulty after their child's diagnosis. CONCLUSION The diagnosis of vulvovaginitis can have a major and ongoing impact on children's and their family's lives.
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Affiliation(s)
- J McKenna
- Nurse Education, Edge Hill University, Ormskirk, UK.
| | - L Bray
- Child Health Literacy, Edge Hill University, Ormskirk, UK
| | - S Doyle
- Child Health Literacy, Edge Hill University, Ormskirk, UK
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Jordan A, Joseph-Williams N, Edwards A, Holland-Hart D, Wood F. "I'd Like to Have More of a Say Because It's My Body": Adolescents' Perceptions Around Barriers and Facilitators to Shared Decision-Making. J Adolesc Health 2019; 65:633-642. [PMID: 31395512 DOI: 10.1016/j.jadohealth.2019.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Adolescents living with long-term conditions (LTCs) often feel as though they are left out of discussions and decisions with healthcare professionals, which can give them the impression that their views are not important. Research around decision-making during clinical encounters often fails to represent adolescents' perspectives. This study explores adolescents' perceptions and experiences, focusing on identifying the perceived barriers to, and facilitators for, their involvement in shared decision-making (SDM). METHODS Nineteen adolescents (aged 13-19 years) with LTCs were recruited from endocrinology, rheumatology, neurology, and nephrology clinics. Participatory qualitative interviews were conducted using life grids and pie charts, and transcripts were analyzed thematically. RESULTS Four overarching themes and nine sub-themes were identified which describe barriers and facilitators around SDM. Adolescents need to feel, as though their involvement is supported by parents and healthcare professionals, that their contribution to the decision-making process is important and will yield a positive outcome. Adolescents often feel it is their right to be involved in decisions that affect them but also feel as though the adults' contributions to the decisions are considered more valuable. Adolescents need to feel capable of being involved, in terms of being able to understand and process information about the available options and ask appropriate questions. CONCLUSIONS This work highlights a number of ways SDM can be facilitated between healthcare practitioners and adolescents with LTCs. Identifying the needs of adolescents with LTCs is necessary for optimizing the SDM process and to support them during healthcare consultations.
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Affiliation(s)
- Amber Jordan
- Cardiff University, Heath Park Campus, Heath Park, Cardiff, United Kingdom.
| | | | - Adrian Edwards
- Cardiff University, Heath Park Campus, Heath Park, Cardiff, United Kingdom
| | | | - Fiona Wood
- Cardiff University, Heath Park Campus, Heath Park, Cardiff, United Kingdom
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Tuohy E, Rawdon C, Gallagher P, Glacken M, Murphy N, Swallow V, Lambert V. Children and young people's experiences and perceptions of self-management of type 1 diabetes: A qualitative meta-synthesis. Health Psychol Open 2019; 6:2055102919877105. [PMID: 31555459 PMCID: PMC6751535 DOI: 10.1177/2055102919877105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The aim of this review was to conduct a meta-synthesis of the experiences and perceptions of self-management of type 1 diabetes of children and young people living with type 1 diabetes (CYPDs). Six databases were systematically searched for studies with qualitative findings relevant to CYPDs' (aged 8-18 years) experiences of self-management. A thematic synthesis approach was used to combine articles and identify analytical themes. Forty articles met the inclusion criteria. Two analytical themes important to CYPDs' experiences and perceptions of self-management were identified: (1) negotiating independence and (2) feeling in control. The synthesis contributes to knowledge on contextual factors underpinning self-management and what facilitates or impedes transition towards autonomous self-management for CYPDs.
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Affiliation(s)
| | | | | | | | - Nuala Murphy
- Children's Health Ireland at Temple Street, Ireland
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Sligo J, Jones B, Davies C, Egan R, Ingham T, Hancox RJ, Richards R. The experiences of young people with chronic illness in New Zealand: A qualitative study. Child Care Health Dev 2019; 45:660-669. [PMID: 31209899 DOI: 10.1111/cch.12696] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/06/2019] [Accepted: 06/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Around 10% of young people suffer from chronic health conditions, and their health care needs are different from those of children or adults. Most research about young people's chronic illness focuses on specific conditions, on younger children's experience, and on the perspectives of parents. This study explored the experiences of young people with two very different chronic conditions (asthma and cancer) and their perception of the New Zealand health system's response to their needs. METHODS This was a collaborative research process where eight young co-researchers who had asthma or cancer were employed to work alongside the research team to develop protocols, interview peers, and assist with analysis. The challenges of this process are described in the article. Twenty-one young people between ages 15 and 27 from two urban areas of New Zealand participated in semistructured open-ended interviews about their health care experiences. Sixteen participants were female, and five male. Eleven of the participants had finished cancer treatment (with an average of 3.6 years since diagnosis), and 10 had asthma. Purposeful sampling meant that 80% of the participants with asthma were identified as Māori and the other participants identified with a range of other ethnic groups. Data were thematically coded, and coresearchers were consulted to derive the ultimate findings. RESULTS Chronic illness disrupted the trajectory of young people's lives and had significant effects on their relationships. The New Zealand health system generally did not respond well to the needs of these young people, but many encountered extraordinary individuals who supported them effectively. The experiences of some indigenous participants indicate that health professionals require effective cultural competence training. CONCLUSIONS This study provides insights into how young people with very different conditions experience the health system. Young people should be consulted and actively included in decision making about making health systems responsive to their diverse needs.
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Affiliation(s)
- Judith Sligo
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Bernadette Jones
- Department of Medicine, University of Otago, Wellington (UOW), Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Wellington, New Zealand
| | - Richard Egan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Tristram Ingham
- Department of Medicine, University of Otago, Wellington (UOW), Wellington, New Zealand
| | - Robert J Hancox
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Rosalina Richards
- Centre for Pacific Health, Va'a o Tautai, Health Science Divisional Office, Health Sciences Division, University of Otago, Dunedin, New Zealand
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Ghio D, Muller I, Greenwell K, Roberts A, McNiven A, Langan SM, Santer M. 'It's like the bad guy in a movie who just doesn't die': a qualitative exploration of young people's adaptation to eczema and implications for self-care. Br J Dermatol 2019; 182:112-118. [PMID: 31021418 PMCID: PMC6972719 DOI: 10.1111/bjd.18046] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Eczema is a common childhood inflammatory skin condition, affecting more than one in five children. A popular perception is that children 'outgrow eczema', although epidemiological studies have shown that, for many, eczema follows a lifelong episodic course. OBJECTIVES To explore the perceptions of young people about the nature of their eczema and how these perceptions relate to their self-care and adapting to living with eczema. METHODS This is a secondary inductive thematic analysis of interviews conducted for Healthtalk.org. In total 23 interviews with young people with eczema were included. Of the 23 participants, 17 were female and six male, ranging from 17 to 25 years old. RESULTS Participants generally experienced eczema as an episodic long-term condition and reported a mismatch between information received about eczema and their experiences. The experience of eczema as long term and episodic had implications for self-care, challenging the process of identifying triggers of eczema flare-ups and evaluating the success of treatment regimens. Participants' experiences of eczema over time also had implications for adaptation and finding a balance between accepting eczema as long term and hoping it would go away. This linked to a gradual shift in treatment expectations from 'cure' to 'control' of eczema. CONCLUSIONS For young people who continue to experience eczema beyond childhood, a greater focus on self-care for a long-term condition may be helpful. Greater awareness of the impact of early messages around 'growing out of' eczema and provision of high-quality information may help patients to manage expectations and support adaptation to treatment regimens. What's already known about this topic? There is a common perception that people 'grow out of' eczema, but for many people eczema follows a lifelong episodic course. Qualitative work has shown that parents can find that being told their child will grow out of eczema is dismissive, and that they have difficulty with messages about 'control not cure' of eczema. It is unclear how young people perceive their eczema and the implications of this perception for their adaptation and self-care. What does this study add? The message that many people 'grow out of' eczema has a potentially detrimental effect for young people where the condition persists. This has implications for young people's perceptions of their eczema, their learning to self-care and how they adapt to living with eczema and eczema treatments. What are the clinical implications of this work? Clinicians need to promote awareness among young people that eczema is a long-term episodic condition in order to engage them with effective self-care. Young people transitioning to self-care need evidence-based information that is specific and relatable to them.
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Affiliation(s)
- D Ghio
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - I Muller
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - K Greenwell
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, U.K
| | - A Roberts
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, U.K
| | - A McNiven
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, U.K
| | - S M Langan
- Faculty of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine, London, U.K.,Health Data Research U.K., London, U.K
| | - M Santer
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K
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Adams JS, Chien AT, Wisk LE. Mental Illness Among Youth With Chronic Physical Conditions. Pediatrics 2019; 144:peds.2018-1819. [PMID: 31201229 DOI: 10.1542/peds.2018-1819] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Youth with chronic physical conditions (CPCs) may be at greater risk for developing chronic mental health conditions (MHCs), and limitations in the ability to engage in developmentally appropriate activities may contribute to the risk of MHCs among youth with CPCs. We compared the risk of incident MHCs in youth with and without CPCs and explored whether activity limitations contribute to any such association. METHODS The 2003-2014 Medical Expenditure Panel Survey provided a nationally representative cohort of 48 572 US youth aged 6 to 25 years. We calculated the 2-year cumulative incidence of MHCs overall and by baseline CPC status. Cox proportional hazard models were used to estimate the association between CPCs and incident MHCs, adjusting for sociodemographic characteristics. Stepwise models and the Sobel test evaluated activity limitations as a mediator of this relationship. RESULTS The 2-year cumulative incidence of MHCs was 7.8% overall, 11.5% in youth with CPCs (14.7% of sample), and 7.1% in those without. The adjusted risk of incident MHCs was 51% greater (adjusted hazard ratio 1.51; 95% confidence interval 1.30-1.74) in youth with CPCs compared with those without. Activity limitations mediated 13.5% of this relationship (P < .001). CONCLUSIONS This nationally representative cohort study supports the hypotheses that youth with CPCs have increased risk for MHCs and that activity limitations may play a role in MHC development. Youth with CPCs may benefit from services to bolster their ability to participate in developmentally important activities and to detect and treat new onset MHCs.
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Affiliation(s)
- John S Adams
- Department of Pediatrics, Cambridge Health Alliance, Cambridge, Massachusetts; .,Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts; and
| | - Alyna T Chien
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts; and.,Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Lauren E Wisk
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts; and.,Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
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Michaud V, Achille M, Chainey F, Phan V, Girardin C, Clermont MJ. Mixed-methods evaluation of a transition and young adult clinic for kidney transplant recipients. Pediatr Transplant 2019; 23:e13450. [PMID: 31062926 DOI: 10.1111/petr.13450] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/07/2019] [Accepted: 04/01/2019] [Indexed: 01/13/2023]
Abstract
The aims of the present study were to describe the experiences of kidney transplant patients attending a young adult clinic or a regular adult clinic, to explore similarities and differences between the groups, and to conduct an evaluation of the clinical and psychosocial outcomes of the young adult clinic, by comparing these outcomes to those of the regular adult clinic. A mixed-methods design combining qualitative and quantitative data was used. Empirically validated questionnaires measuring self-determination theory variables, quality of life, and adherence were distributed to all consenting patients attending the YAC (n = 17) and RAC (n = 16). Semi-structured interviews were conducted with a subsample of the first (n = 10) and second group (n = 8), and analyzed using thematic analysis. Clinical outcomes were retrieved from medical records. Descriptive, correlational, and comparative analyses were performed. We found clinically significant differences on tacrolimus blood levels variability, self-reported adherence, and physical quality of life. Small and medium effect sizes were detected. No statistical differences were found. Statistically significant correlations were found between self-determination theory variables and both physical quality of life and different measures of adherence. Four themes characterized patients' experiences: resilience; relational needs and the therapeutic alliance; quest for balance; and quest for normalcy. The young adult clinic seems to meet its initial objectives and to make a difference particularly in the early period post-transition, but over time what matters most for patients is therapeutic alliance. Mental health issues need to be better addressed, and special attention should be paid to youths transplanted in an adult setting.
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Affiliation(s)
- Vanessa Michaud
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Marie Achille
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Fanie Chainey
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Véronique Phan
- Department of Pediatric Nephrology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Catherine Girardin
- Department of Nephrology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Marie-José Clermont
- Department of Pediatric Nephrology, CHU Sainte-Justine, Montreal, Quebec, Canada
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Kirk S, Hinton D. "I'm not what I used to be": A qualitative study exploring how young people experience being diagnosed with a chronic illness. Child Care Health Dev 2019; 45:216-226. [PMID: 30652354 DOI: 10.1111/cch.12638] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood long-term conditions are usually diagnosed in infancy or early childhood. Little is known about the particular experiences and needs of young people who receive a chronic illness diagnosis during adolescence or late childhood. This paper will examine this experience in relation to multiple sclerosis (MS), which is increasingly being diagnosed before adulthood. AIMS To explore how young people experience an MS diagnosis. METHODS Qualitative study using a grounded theory approach. In-depth interviews were conducted with 21 young people diagnosed with MS. Participants were recruited through health service and voluntary sector organizations in the United Kingdom. RESULTS Young people's pre-illness normality was disrupted by the diagnosis of a chronic illness (MS). Participants experienced their body as changed physically, cognitively, and emotionally and as changeable due to symptom unpredictability. This influenced how participants perceived and presented their identity, disrupted their relationships, and altered their future biography. Young people developed strategies to manage their condition and identities in order to incorporate MS into their current and future lives, which required continual illness and identity work in response to changing symptoms, social contexts, and relationships. CONCLUSIONS Although young peoples' experience of living with chronic illness has been widely explored, the aftermath of diagnosis has been underresearched from their perspective. This study contributes to this knowledge gap by illuminating how young people experience a chronic illness diagnosis and negotiate the resulting changes to their identity, relationships, and future. The findings suggest that young people need preparation and support in disclosing their diagnosis to others. Professionals supporting young people with long-term conditions need to work closely with specialist mental health services to ensure that they receive appropriate emotional support. Schools have an important role in ensuring young people with long-term conditions achieve their academic potential and receive appropriate careers advice.
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Affiliation(s)
- Susan Kirk
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Denise Hinton
- School of Health Sciences, University of Manchester, Manchester, UK
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Liesch SK, Elertson KM. Drawing as a Communication Modality in Clinic. J Pediatr Nurs 2018; 43:137-138. [PMID: 30316616 DOI: 10.1016/j.pedn.2018.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Shari K Liesch
- Medical College of Wisconsin Milwaukee, WI, USA/Children's Hospital of Wisconsin - Fox Valley, Neenah, WI, USA; University of Wisconsin - Oshkosh, WI, USA
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Rankin D, Harden J, Barnard K, Bath L, Noyes K, Stephen J, Lawton J. Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study. BMC Endocr Disord 2018; 18:71. [PMID: 30316299 PMCID: PMC6186043 DOI: 10.1186/s12902-018-0302-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND When children with type 1 diabetes approach adolescence, they are encouraged to become more involved in diabetes self-management. This study explored the challenges pre-adolescent children encounter when self-managing diabetes and the factors which motivate and enable them to take on new diabetes-related tasks. A key objective was to inform the support offered to pre-adolescent children. METHODS In-depth interviews using age-appropriate questioning with 24 children (aged 9-12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach. RESULTS Children reported several barriers to taking on self-management tasks. As well as seeking respite from managing diabetes, children described relying on their parents to: perform the complex maths involved in working out carbohydrate content in food; calculate insulin doses if they did not use a bolus advisor; and administer injections or insert a cannula in hard-to-reach locations. Children described being motivated to take on diabetes tasks in order to: minimise the pain experienced when others administered injections; alleviate the burden on their parents; and participate independently in activities with their peers. Several also discussed being motivated to take on diabetes-management responsibilities when they started secondary school. Children described being enabled to take on new responsibilities by using strategies which limited the need to perform complex maths. These included using labels on food packaging to determine carbohydrate contents, or choosing foods with carbohydrate values they could remember. Many children discussed using bolus advisors with pre-programmed ratios and entering carbohydrate on food labels or values provided by their parents to calculate insulin doses. Several also described using mobile phones to seek advice about carbohydrate contents in food. CONCLUSIONS Our findings highlight several barriers which deter children from taking on diabetes self-management tasks, motivators which encourage them to take on new responsibilities, and strategies and technologies which enable them to become more autonomous. To limit the need to perform complex maths, children may benefit from using bolus advisors provided they receive regular review from healthcare professionals to determine and adjust pre-programmed insulin-to-carbohydrate ratios. Education and support should be age-specific to reflect children's changing involvement in self-managing diabetes.
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Affiliation(s)
- David Rankin
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Jeni Harden
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Katharine Barnard
- BHR Ltd, 42 Kilmiston Drive, Portchester, Fareham, Hants, PO16 8EG and Faculty of Health & Social Science, Bournemouth University, Royal London House, Bournemouth, BH1 3LT UK
| | - Louise Bath
- Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF UK
| | - Kathryn Noyes
- Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF UK
| | - John Stephen
- Child Health Department, Borders General Hospital, Melrose, TD6 9BS UK
| | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
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Hughes M, Savage E, Andrews T. Playing the game: How young people moderate influences in accommodating asthma in their lives. J Child Health Care 2018. [PMID: 29534606 DOI: 10.1177/1367493518761010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article presents moderating influences, one of the sub-core categories from the theory of accommodating interruptions. This theory emerged in the context of young people who have asthma, explaining how they develop behaviours in their everyday lives (Hughes 2014; Hughes et al., 2017). The aim of this research was to develop a theory on the behaviours of young people who have asthma, in relation to the impact of asthma on the lives and the issues affecting them. This research was undertaken using a classic grounded theory approach. Data were collected through in-depth interviews, participant diaries and clinic consultations with young people aged 11-16 years who had asthma for over one year. Moderating influence accounts for how social influences and social culture affect what young people who have asthma wish to achieve and how they want to be perceived by others. Young people moderate influences by their features or attributes in order to meet their own needs.
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Affiliation(s)
- Mary Hughes
- 1 School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,2 School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Eileen Savage
- 2 School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Tom Andrews
- 2 School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Rankin D, Harden J, Barnard KD, Stephen J, Kumar S, Lawton J. Pre-adolescent children's experiences of receiving diabetes-related support from friends and peers: A qualitative study. Health Expect 2018; 21:870-877. [PMID: 29961962 PMCID: PMC6186536 DOI: 10.1111/hex.12802] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2018] [Indexed: 12/11/2022] Open
Abstract
Background While pre‐adolescent children with type 1 diabetes receive most support from their parents/caregivers, others also contribute to their care. This study explored pre‐adolescent children's experiences of receiving diabetes‐related support from friends and peers. The objective was to identify how children could be better supported by their friends and peers to undertake diabetes self‐management. Methods In‐depth interviews with 24 children (aged 9‐12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach. Results Children gave mixed accounts of their experiences of speaking to their school/class about diabetes with some indicating that this had resulted in unwanted attention. Most individuals reported that other children had a limited understanding of diabetes and sometimes acted in insensitive ways or said things they found upsetting. Virtually all children described having a small number of close friends who were interested in learning about diabetes and provided them with support. These friends provided support in three overlapping ways, as “monitors and prompters,” “helpers” and “normalizers.” While some children described benefiting from meeting peers with type 1 diabetes, most indicated that they would prefer to develop friendships based on shared interests rather than a common disease status. Discussion and conclusions Friends and peers provide several kinds of support to pre‐adolescent children with diabetes. Health professionals could consider ways to assist small friendship groups to undertake monitoring and prompting, helping and normalizing roles. Parents, schools and health professionals could explore ways to normalize self‐management practices to better support children with diabetes in school settings.
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Affiliation(s)
- David Rankin
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Jeni Harden
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Lendahls L, Edvardsson I. The Health and Well-Being among Children with Diabetes and Low HbA1c—A Qualitative Study in Sweden. Health (London) 2018. [DOI: 10.4236/health.2018.105044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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