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Chahal N, Rush J, Lardizabal A, Nobile R, Delayun C, Collins T, Thorne S, McCrindle BW. Kawasaki disease: patients' transition journey and recommendations for adult care. Cardiol Young 2024; 34:793-802. [PMID: 37830370 DOI: 10.1017/s1047951123003578] [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] [Indexed: 10/14/2023]
Abstract
BACKGROUND Children who develop coronary artery aneurysms after Kawasaki disease are at risk for cardiovascular morbidity, requiring health care transition and lifelong follow-up with an adult specialist. Follow-up losses after health care transition have been reported but without outcome and patient experience evaluation. OBJECTIVE The Theoretical Domains Framework underpinned our aim to explore the required self-care behaviours and experiences of young adults' post-health care transition. METHODS A qualitative description approach was used for virtual, 1:1 interviews with 11 participants, recruited after health care transition from a regional cardiac centre in Ontario. Directed content analysis was employed. RESULTS Health, psychosocial, and lifestyle challenges were compounded by a sense of loss. Six themes emerged within the Theoretical Domains Framework categories. Participants offered novel health care transition programme recommendations. CONCLUSIONS The realities of health care transition involve multiple, overlapping stressors for young adults with Kawasaki disease and coronary artery aneurysms. Our findings will inform a renewed health care transition programme and will include outcome evaluation.
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Affiliation(s)
- Nita Chahal
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Janet Rush
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Arnelle Lardizabal
- Cardiovascular Surgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rita Nobile
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Christian Delayun
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
| | - Tanveer Collins
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
| | - Sara Thorne
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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2
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Prikken S, Luyckx K, Raymaekers K, Raemen L, Verschueren M, Lemiere J, Vercruysse T, Uyttebroeck A. Identity formation in adolescent and emerging adult cancer survivors: a differentiated perspective and associations with psychosocial functioning. Psychol Health 2023; 38:55-72. [PMID: 34311645 DOI: 10.1080/08870446.2021.1955116] [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: 10/20/2022]
Abstract
OBJECTIVE Identity formation was investigated in adolescent and emerging adult cancer survivors from a (neo-)Eriksonian perspective by comparing survivors to control participants. In survivors, associations between identity and clinical/demographical variables and general and illness-specific functioning were investigated. DESIGN Childhood cancer survivors (n = 125; Mage: 19.54; 47% male) were matched on age and gender with healthy controls (2:1). MAIN OUTCOME MEASURES All participants completed identity questionnaires. Survivors reported on demographics, well-being (depressive symptoms, life satisfaction, physical functioning), and illness-specific experiences (PTSS, illness centrality, cancer self-identity, benefit finding, cancer-related worries). Medical records provided clinical information. RESULTS Survivors did not differ from controls on identity synthesis or confusion or on the identity statuses resulting from cluster analysis on the identity dimensions (achievement, foreclosure, moratorium, diffusion). Identity synthesis related to better well-being and illness experiences, whereas confusion related to worse well-being and illness experiences. Youth in moratorium and diffusion reported lower well-being and more negative illness experiences. Associations between identity and demographical and clinical characteristics were inconsistent. CONCLUSIONS This study revealed no significant differences in identity formation between cancer survivors and controls. However, survivors who struggle in their identity quest should be identified as they are at risk for poorer well-being and negative illness experiences.
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Affiliation(s)
- Sofie Prikken
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussel, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Koen Raymaekers
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussel, Belgium
| | - Leni Raemen
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium
| | - Margaux Verschueren
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussel, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Trui Vercruysse
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
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3
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John AS, Jackson JL, Moons P, Uzark K, Mackie AS, Timmins S, Lopez KN, Kovacs AH, Gurvitz M. Advances in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: A Practical Approach to Transition Program Design: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2022; 11:e025278. [PMID: 35297271 PMCID: PMC9075425 DOI: 10.1161/jaha.122.025278] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is now expected that most individuals with congenital heart disease will survive to adulthood, including those with complex heart conditions. Maintaining lifelong medical care requires those with congenital heart disease to eventually transfer from pediatric to adult-oriented health care systems. Developing health care transition skills and gaining independence in managing one's own health care is imperative to this process and to ongoing medical and psychosocial success. This scientific statement reviews the recent evidence regarding transition and provides resources, components, and suggestions for development of congenital heart disease transition programs with the goals of improving patient knowledge, self-management, and self-efficacy skills to the level they are capable to eventually integrate smoothly into adult-oriented health care. Specifically, the scientific statement updates 3 sections relevant to transition programming. First, there is a review of specific factors to consider, including social determinants of health, psychosocial well-being, and neurocognitive status. The second section reviews costs of inadequate transition including the public health burden and the impairment in individual quality of life. Finally, the last section discusses considerations and suggestions for transition program design including communication platforms, a family-centered approach, and individual models. Although this scientific statement reviews recent literature surrounding transitions of care for individuals with congenital heart disease there remain significant knowledge gaps. As a field, we have yet to determine ideal timing and methods of transition, and barriers to transition and transfer remain, particularly for the underserved populations. The consequences of poor health care transition are great and garnering outcomes and information through organized, multifaceted, collaborative approaches to transition is critical to improving the lifelong care of individuals with congenital heart disease.
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Lim SH, Oh WO, Yeom IS. Validity and Reliability of the Sense of Coherence Scale among Korean Adolescents with Chronic Diseases. J Pediatr Nurs 2021; 61:e22-e28. [PMID: 33888391 DOI: 10.1016/j.pedn.2021.04.007] [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: 10/15/2020] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study adapted the Sense of Coherence (SOC) Scale for Korean adolescents with chronic diseases and evaluated its psychometric properties. PURPOSE This study aimed to validate the Sense of Coherence Scale for Korean adolescents with Chronic Disease (SOC-AC). DESIGN AND METHODS This study employed the cross-sectional design. In total, 144 adolescents with chronic diseases (age: 15.07 ± 1.62 years; 58% male) responded to the study questionnaire, which included the 13-item SOC scale (SOC-13) and the 10-item Children's Depression Inventory. The SOC-13 was shortened to create the 10-item SOC-AC. Through an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). RESULTS Following the EFA, two items (Item 8 and 13) with low factor loadings were deleted. Further, following the CFA, one item (Item 2) with a high modification index was deleted. The resulting 10-item SOC-AC exhibited a 3-factor structure comprising the subscales of meaningfulness (Item 4, 7, and 12), comprehensibility-manageability (Item 3, 5, 9, and 11), and resilience (Item 1, 6, and 10). The internal consistency of the SOC-AC was 0.868; the Cronbach's alpha values were 0.765, 0.78, and 0.529 for the meaningfulness, comprehensibility-manageability, and resilience subscales. The Pearson's correlation coefficient for the association between the SOC-13 and depression showed acceptable criterion-related validity (r = -0.436, p < .0001). CONCLUSIONS These findings indicate that the SOC-AC has satisfactory psychometric properties and that it is useful for assessing SOC in adolescents with chronic diseases. PRACTICE IMPLICATION This study revealed the utility of the examined scale to measure SOC as a means of health promotion and care in adolescents with chronic diseases.
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Affiliation(s)
| | - Won-Oak Oh
- College of Nursing, Korea University, South Korea.
| | - In Sun Yeom
- Department of Pediatric Neurosurgery, Severance Children's Hospital, Yonsei University Health System, South Korea.
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5
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Moons P, Bratt EL, De Backer J, Goossens E, Hornung T, Tutarel O, Zühlke L, Araujo JJ, Callus E, Gabriel H, Shahid N, Sliwa K, Verstappen A, Yang HL, Thomet C. Transition to adulthood and transfer to adult care of adolescents with congenital heart disease: a global consensus statement of the ESC Association of Cardiovascular Nursing and Allied Professions (ACNAP), the ESC Working Group on Adult Congenital Heart Disease (WG ACHD), the Association for European Paediatric and Congenital Cardiology (AEPC), the Pan-African Society of Cardiology (PASCAR), the Asia-Pacific Pediatric Cardiac Society (APPCS), the Inter-American Society of Cardiology (IASC), the Cardiac Society of Australia and New Zealand (CSANZ), the International Society for Adult Congenital Heart Disease (ISACHD), the World Heart Federation (WHF), the European Congenital Heart Disease Organisation (ECHDO), and the Global Alliance for Rheumatic and Congenital Hearts (Global ARCH). Eur Heart J 2021; 42:4213-4223. [PMID: 34198319 PMCID: PMC8560210 DOI: 10.1093/eurheartj/ehab388] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/06/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022] Open
Abstract
The vast majority of children with congenital heart disease (CHD) in high-income countries survive into adulthood. Further, paediatric cardiac services have expanded in middle-income countries. Both evolutions have resulted in an increasing number of CHD survivors. Expert care across the life span is necessitated. In adolescence, patients transition from being a dependent child to an independent adult. They are also advised to transfer from paediatrics to adult care. There is no universal consensus regarding how transitional care should be provided and how the transfer should be organized. This is even more challenging in countries with low resources. This consensus document describes issues and practices of transition and transfer of adolescents with CHD, accounting for different possibilities in high-, middle-, and low-income countries. Transitional care ought to be provided to all adolescents with CHD, taking into consideration the available resources. When reaching adulthood, patients ought to be transferred to adult care facilities/providers capable of managing their needs, and systems have to be in place to make sure that continuity of high-quality care is ensured after leaving paediatric cardiology.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Box 7001, B-3000 Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Sweden.,Department of Paediatrics and Child Health, University of Cape Town, South Africa.,ESC Association of Cardiovascular Nursing and Allied Professions (ACNAP)
| | - Ewa-Lena Bratt
- Institute of Health and Care Sciences, University of Gothenburg, Sweden.,Department of Paediatric Cardiology, Queen Silvia's Children's Hospital, Gothenburg, Sweden.,Association for European Paediatric and Congenital Cardiology (AEPC)
| | - Julie De Backer
- Department of Cardiology and Center for Medical Genetics, Ghent University Hospital, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium.,ESC Working Group on Adult Congenital Heart Disease (WG ACHD)
| | - Eva Goossens
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Box 7001, B-3000 Leuven, Belgium.,ESC Association of Cardiovascular Nursing and Allied Professions (ACNAP).,Association for European Paediatric and Congenital Cardiology (AEPC).,Research Foundation Flanders (FWO), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, Division of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
| | - Tim Hornung
- Paediatric and Congenital Cardiology Service, Starship Children's Hospital, Auckland, New Zealand.,Cardiac Society of Australia and New Zealand (CSANZ)
| | - Oktay Tutarel
- ESC Working Group on Adult Congenital Heart Disease (WG ACHD).,Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Liesl Zühlke
- Department of Paediatrics and Child Health, University of Cape Town, South Africa.,Division of Paediatric Cardiology, Red Cross War Memorial Childreńs Hospital, Cape Town, South Africa.,Division of Cardiology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Pan-African Society of Cardiology (PASCAR)
| | - John Jairo Araujo
- Department of Pediatric and Adult Congenital Heart Disease, Somer Incare Cardiovascular Center, Medellin, Colombia.,Inter-American Society of Cardiology (IASC)
| | - Edward Callus
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,European Congenital Heart Disease Organisation (ECHDO)
| | - Harald Gabriel
- ESC Working Group on Adult Congenital Heart Disease (WG ACHD).,Department of Cardiology, Medical University of Vienna, Austria
| | - Nauman Shahid
- Global Alliance for Rheumatic and Congenital Hearts (Global ARCH)
| | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, South Africa.,CHI, Faculty of Health Sciences, University of Cape Town, South Africa.,World Heart Federation (WHF)
| | - Amy Verstappen
- Global Alliance for Rheumatic and Congenital Hearts (Global ARCH)
| | - Hsiao-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Asia-Pacific Pediatric Cardiac Society (APPCS)
| | - Corina Thomet
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Box 7001, B-3000 Leuven, Belgium.,ESC Association of Cardiovascular Nursing and Allied Professions (ACNAP).,Center for Congenital Heart Disease, University Hospital Inselspital, Department of Cardiology, University of Bern, Switzerland.,International Society for Adult Congenital Heart Disease (ISACHD)
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Van Bulck L, Luyckx K, Goossens E, Moons P. Identity formation in adults with congenital heart disease: What have we learned so far? INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2021.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Calandri E, Graziano F, Borghi M, Bonino S, Cattelino E. The Role of Identity Motives on Quality of Life and Depressive Symptoms: A Comparison Between Young Adults With Multiple Sclerosis and Healthy Peers. Front Psychol 2020; 11:589815. [PMID: 33304300 PMCID: PMC7701240 DOI: 10.3389/fpsyg.2020.589815] [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: 08/04/2020] [Accepted: 10/15/2020] [Indexed: 02/03/2023] Open
Abstract
The diagnosis of a chronic illness during young adulthood represents a non-normative life transition influencing the identity definition process, as well as the individual psychological adjustment. The study examined if relationships between identity motives (self-esteem, efficacy, continuity, distinctiveness, belonging, and meaning), health-related quality of life, and depressive symptoms differ between healthy young adults and young adults diagnosed with multiple sclerosis (MS). Two hundred one people (101 MS patients and 100 healthy controls), aged 18-35 years, completed a self-report questionnaire. Young adults with MS reported lower health-related quality of life and lower efficacy motive than their healthy peers. Among MS patients, high meaning was related to lower depressive symptoms, whereas high continuity and high belonging were related to higher health-related quality of life than in healthy controls. The study highlights the relevance of identity motives for the adjustment to MS and has implications for psychological interventions with young patients.
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Affiliation(s)
| | - Federica Graziano
- Department of Psychology, University of Torino, Turin, Italy
- Cosso Foundation, Turin, Italy
| | - Martina Borghi
- Cosso Foundation, Turin, Italy
- CRESM (Regional Referral Multiple Sclerosis Centre) – “San Luigi Gonzaga” Hospital – Orbassano, Turin, Italy
| | - Silvia Bonino
- Department of Psychology, University of Torino, Turin, Italy
- Cosso Foundation, Turin, Italy
| | - Elena Cattelino
- Department of Human and Social Sciences, University of Aosta Valley, Aosta, Italy
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8
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Nasr AS, Rehm RS. Understanding the Long-Term Impact of Living-Related Liver Transplantation on Youth and Young Adults and their Family. J Pediatr Nurs 2020; 55:217-223. [PMID: 32966961 DOI: 10.1016/j.pedn.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The purpose of this mixed methods study was to better understand the long term impact of living-related liver donation (LRLD) on youth and young adult (YYA) recipients and their family. DESIGN AND METHODS Semistructured interviews were conducted with YYA, aged 11-18 years, who received a living donation from a parent. Interviews were audiotaped, transcribed, and analyzed to aggregate themes that represented the participants' views as live-liver recipients. An ethnographic process was conducted to understand the participants' social behavior. At interview, participants completed a demographics questionnaire and the Youth Quality of Life Instrument-Research Version (YQOL-R). RESULTS Thirteen adolescents were interviewed; six were re-interviewed as key informants. Three major categories were created from the data: Developing Identity, Redefining Family Relationships, Feeling Gratitude to Donors. The overarching theme was Resiliency. Findings from the YQOL-R showed no difference in overall scores or separate domains when compared with a reference population with no chronic illness. CONCLUSION Qualitative and quantitative data highlight the positive effect that LRLD can have on pediatric patients as they transition from childhood to adolescence to young adulthood. PRACTICE IMPLICATIONS As pediatric transplant centers in the United States soon mark 30 years of performing live-liver donation, recipients are becoming adults and understanding more clearly that the long-term effects of such donations will lead to improvements in future care.
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Affiliation(s)
- Annette S Nasr
- Nursing Research and Evidence-Based Practice, Stanford Children's Hospital, United States; University of California at San Francisco School of Nursing, Department of Family Health Care Nursing, CA, United States; Stanford School of Medicine, CA, United States.
| | - Roberta S Rehm
- University of California at San Francisco School of Nursing, Department of Family Health Care Nursing, CA, United States
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9
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Bell CJ, Spruit JL, Kavanaugh KL. Exposing the Risks of Social Media Recruitment in Adolescents and Young Adults with Cancer: #Beware. J Adolesc Young Adult Oncol 2020; 9:601-607. [DOI: 10.1089/jayao.2020.0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cynthia J. Bell
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | | | - Karen L. Kavanaugh
- Department of Nursing Research and Evidence Based Practice, Children's Wisconsin, Milwaukee, Wisconsin, USA
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10
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Kaniušonytė G, Truskauskaitė-Kunevičienė I, Žukauskienė R, Crocetti E. Knowing Who You Are for Not Feeling Lonely? A Longitudinal Study on Identity and Loneliness. Child Dev 2019; 90:1579-1588. [PMID: 31347159 DOI: 10.1111/cdev.13294] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In adolescence, both identity concerns and feelings of loneliness are of utmost importance to the experiences of young people. Yet, a theoretically grounded hypothesis that identity and loneliness are developmentally related has never been tested. Thus, the aim of this study was to disentangle the longitudinal associations between identity processes in educational and interpersonal domains and loneliness in adolescence. The sample consisted of 632 Lithuanian adolescents (53.2% girls; Mage = 14.32; SDage = 1.09) participating in a four-wave study with 6-month intervals between assessments. Cross-lagged analyses revealed reciprocal associations between identity processes and loneliness in the educational domain and unidirectional effects of adolescents' reconsideration of commitment on loneliness in the interpersonal domain.
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11
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Claes L, Boekaerts E, Verschueren M, Boukaert W, Luyckx K. Identity statuses in prebariatric patients with obesity: Associations with eating disorder symptoms, psychological complaints, and coping behaviour? EUROPEAN EATING DISORDERS REVIEW 2019; 27:410-420. [PMID: 31020776 DOI: 10.1002/erv.2681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/12/2019] [Accepted: 03/29/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In the present study, we focused on the associations between identity processes/statuses and eating and general psychopathology and coping in prebariatric patients suffering from morbid obesity. METHOD Our sample consisted of 369 prebariatric patients (68.8% female) who filled out self-report questionnaires to assess identity processes, eating and general psychopathology, and coping. RESULTS Concerning identity processes, ruminative exploration was positively related to eating-related and general psychopathology and maladaptive coping, whereas commitment processes were protective against psychopathology and maladaptive coping. Based on cluster analyses, we identified five identity statuses, being achievement, foreclosure, moratorium, diffusion, and an undifferentiated status, showing some heterogeneity within the prebariatric patient group. Patients in the diffused and moratorium statuses reported more eating and general psychopathology and more maladaptive coping compared with prebariatric patients of the other statuses. CONCLUSIONS Given the clinical vulnerability to psychopathology of patients in the moratorium and diffused statuses, it would be advisable to increase the psychological help in their prebariatric and postbariatric trajectories.
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Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University Antwerp, Wilrijk, Belgium
| | - Els Boekaerts
- Obesity Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | | | - Wim Boukaert
- Obesity Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
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12
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Pinquart M, Pfeiffer JP. Identity Development in German Adolescents with and without Visual Impairments. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x1310700503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The study reported here assessed the exploration of identity and commitment to an identity in German adolescents with and without visual impairments. Methods In total, 178 adolescents with visual impairments (blindness or low vision) and 526 sighted adolescents completed the Ego Identity Process Questionnaire. Results The levels of identity exploration and making commitments, as well as the distribution of identity statuses, did not differ between the two groups. However, adolescents with congenital visual impairments showed lower levels of identity exploration than their peers with acquired visual impairments. In addition, more severe disability was associated with less exploration of identity. Furthermore, levels of identity exploration and commitment varied by age, parental education, levels of social support, and levels of problem behavior. Discussion The findings indicate that adolescents with visual impairments do not fall behind sighted adolescents in developing a sense of identity. Implications for practitioners Adolescents who are congenitally blind or have a high level of disability may need support in exploring and accessing information on future opportunities.
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Affiliation(s)
- Martin Pinquart
- Department of Psychology, Philipps University, Gutenbergstrasse 18, D-35032 Marburg, Germany
| | - Jens P. Pfeiffer
- Department of Psychology, Philipps University and Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Marburg
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13
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Aujoulat I, Dechêne S, Lahaye M. Non-disease Specific Health Promotion Interventions for Chronically Ill Adolescents in Medical Settings: A Systematic Review. Front Public Health 2018; 6:301. [PMID: 30555811 PMCID: PMC6282057 DOI: 10.3389/fpubh.2018.00301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/01/2018] [Indexed: 11/27/2022] Open
Abstract
Adolescents with chronic conditions are highly likely to encounter physical, social and psychological difficulties that can threaten their overall wellbeing and health. As any other adolescent, they need to be helped to tackle the non-medical determinants of their health. This is the aim of primary prevention and general health promotion interventions. The present paper aims to review any hospital-based intervention that strives to promote general health in chronically ill teenagers. A systematic process of search and screening revealed four articles that presented and evaluated non-disease specific interventions that explicitly aimed to promote the overall health of chronically ill teenagers in clinical settings. Congruently with health promotion principles and values, the interventions described in our selection of articles targeted positive health determinants, in terms of personal skills and attitudes that contribute to psychosocial resiliency. The clinical relevance and feasibility of developing non-disease specific health promotion interventions in clinical settings was confirmed. However, the lack of relevant reported details did not allow us to highlight the key factors and mechanisms associated with successful interventions for health promotion targeted at chronically ill adolescents attending health care settings. Moreover, the design of the included studies varied in quality: number of participants, presence of a post-test and a follow-up, use of validated questionnaires, etc. Well-conducted non-disease specific clinical health promotion interventions still remain an under-investigated area of research, and maybe even of practice.
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Affiliation(s)
- Isabelle Aujoulat
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Sophie Dechêne
- MRCPsych, Department of Child Psychiatry, Institute of Health and Society, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Magali Lahaye
- Department of Pediatric Hematology and Oncology, Institute of Health and Society, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Bell CJ, Bell RA, Zebrack B, Kato I, Morse A, Borinstein SC. Measuring Development of Adolescent and Young Adult Cancer Patients: An Integrative Review of Available Instruments. J Adolesc Young Adult Oncol 2018; 7:270-282. [DOI: 10.1089/jayao.2017.0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cynthia J. Bell
- College of Nursing, Wayne State University, Detroit, Michigan
| | | | - Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Ikuko Kato
- Department of Oncology and Pathology, Wayne State University School of Medicine, Detroit, Michigan
| | - Alyssa Morse
- College of Nursing, Wayne State University, Detroit, Michigan
| | - Scott C. Borinstein
- Department of Pediatrics, Division of Hematology Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
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Berg AE, Meyers LL, Dent KM, Rothwell EW, Everitt MD. Psychological impact of sports restriction in asymptomatic adolescents with hypertrophic cardiomyopathy, dilated cardiomyopathy, and long QT syndrome. PROGRESS IN PEDIATRIC CARDIOLOGY 2018. [DOI: 10.1016/j.ppedcard.2018.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Illness identity in young adults with refractory epilepsy. Epilepsy Behav 2018; 80:48-55. [PMID: 29414558 DOI: 10.1016/j.yebeh.2017.12.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/30/2017] [Accepted: 12/30/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Refractory epilepsy is an intrusive condition with important implications for daily functioning in emerging and young adulthood. The present study examined the degree to which refractory epilepsy is integrated in one's identity, and examined how such a sense of illness identity was related to health-related quality of life (HRQOL). METHODS A total of 121 18- to 40-year-old patients with refractory epilepsy (56.2% women) completed self-report questionnaires assessing the four illness identity states of acceptance, enrichment, engulfment, and rejection (Illness Identity Questionnaire (IIQ)); HRQOL (Quality of Life in Epilepsy Inventory - 31); and seizure frequency and severity (Liverpool Seizure Severity Scale (LSSS)). Illness identity scores were compared with a sample of 191 patients with a nonneurological chronic disease (congenital heart disease). Hierarchical regression analyses were conducted to assess the predictive value of illness identity for HRQOL when simultaneously controlling for demographic and clinical features. RESULTS Patients with refractory epilepsy scored higher on rejection and engulfment and lower on acceptance when compared with patients with congenital heart disease. Further, seizure severity and number of medication side-effects were positively related to engulfment and negatively to acceptance. Finally, when simultaneously controlling for various demographic and clinical variables, illness identity significantly predicted HRQOL (with engulfment being the strongest and most consistent predictor). CONCLUSION The extent to which patients with refractory epilepsy succeed in integrating their illness into their identity may have important implications for HRQOL. Clinicians should be especially attentive for signs that patients feel engulfed by their epilepsy.
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Oris L, Luyckx K, Rassart J, Goubert L, Goossens E, Apers S, Arat S, Vandenberghe J, Westhovens R, Moons P. Illness Identity in Adults with a Chronic Illness. J Clin Psychol Med Settings 2018; 25:429-440. [DOI: 10.1007/s10880-018-9552-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Rassart J, Apers S, Kovacs AH, Moons P, Thomet C, Budts W, Enomoto J, Sluman MA, Wang JK, Jackson JL, Khairy P, Cook SC, Subramanyan R, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Rempel GR, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White KS, Callus E, Kutty S, Luyckx K. Illness perceptions in adult congenital heart disease: A multi-center international study. Int J Cardiol 2017; 244:130-138. [DOI: 10.1016/j.ijcard.2017.06.072] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 06/01/2017] [Accepted: 06/19/2017] [Indexed: 01/02/2023]
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da Costa AC, Rodrigues FS, da Fonte PP, Rosenblatt A, Innes NPT, Heimer MV. Influence of sense of coherence on adolescents' self-perceived dental aesthetics; a cross-sectional study. BMC Oral Health 2017; 17:117. [PMID: 28818059 PMCID: PMC5561566 DOI: 10.1186/s12903-017-0405-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
Background Sense of coherence (SOC) is a psychosocial factor capable of influencing perception of health, improving one’s ability to manage life. It is the central construct of salutogenesis. SOC allows for identification and mobilization of resources to effectively manage or solve problems, promoting health and quality of life. Using Wilson-Cleary’s conceptual model we hypothesized that SOC might contribute to self-perception of dental aesthetics. The aim of this study was to investigate whether SOC levels were related to self-perception of dental aesthetics against assessed normative orthodontic treatment need among adolescents. Methods A cross-sectional study was conducted with 615 male and female adolescents aged 12 to 15 years. Data collection comprised socio-demographic and socio-economic characteristics, SOC (SOC 13), self-perceived dental aesthetics (Oral Aesthetic Subjective Impact Scale), and assessment of orthodontic treatment need (Dental Aesthetic Index). Statistical analysis involved Pearson’s chi-square test, Kruskal-Wallis test, Mann-Whitney test and multiple linear regression. Spearman’s correlation coefficient was calculated for the determination of the strength of correlations among the numerical variables. The level of significance was set at 5% (p < 0.05). Results 50.1% of the participants were classified as having a high SOC (≥ median). Overall, SOC was associated with self-perceived dental aesthetics (p = 0.048). In the adolescents with no orthodontic treatment need, those with a low SOC perceived their dental aesthetics more negatively than those with high levels of SOC. The multiple regression analysis demonstrated an inverse relationship between SOC and: 1) age (p = 0.007), SOC being higher in the younger age group; 2) self-perceived dental aesthetics (p = 0.001), a higher SOC being associated with those who had a positive dental self-perception. Conclusions SOC was associated with self-perceived dental aesthetics and adolescents with a high SOC were more likely to perceive their dental aesthetics more positively. SOC did not seem to influence self-perception of dental aesthetics in adolescents who were clinically assessed as having an orthodontic treatment need, however, in those where there was no orthodontic treatment need, a low SOC was associated with a negative self-perception of dental appearance.
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Verschueren M, Luyckx K, Kaufman EA, Vansteenkiste M, Moons P, Sleuwaegen E, Berens A, Schoevaerts K, Claes L. Identity Processes and Statuses in Patients with and without Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2016; 25:26-35. [PMID: 27790863 DOI: 10.1002/erv.2487] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 11/07/2022]
Abstract
Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age-matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non-suicidal self-injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Erin A Kaufman
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Maarten Vansteenkiste
- Department of Developmental, Social, and Personality Psychology, Ghent University, Ghent, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - Ellen Sleuwaegen
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
- Psychiatrisch Ziekenhuis Duffel, Antwerp, Belgium
| | - Ann Berens
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
- Psychiatrisch Ziekenhuis Duffel, Antwerp, Belgium
| | | | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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Marino BS, Cassedy A, Drotar D, Wray J. The Impact of Neurodevelopmental and Psychosocial Outcomes on Health-Related Quality of Life in Survivors of Congenital Heart Disease. J Pediatr 2016; 174:11-22.e2. [PMID: 27189685 DOI: 10.1016/j.jpeds.2016.03.071] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 03/04/2016] [Accepted: 03/28/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Bradley S Marino
- Divisions of Cardiology and Critical Care Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
| | - Amy Cassedy
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Dennis Drotar
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jo Wray
- Critical Care and Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
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Oris L, Rassart J, Prikken S, Verschueren M, Goubert L, Moons P, Berg CA, Weets I, Luyckx K. Illness Identity in Adolescents and Emerging Adults With Type 1 Diabetes: Introducing the Illness Identity Questionnaire. Diabetes Care 2016; 39:757-63. [PMID: 26989179 DOI: 10.2337/dc15-2559] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/20/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The current study examined the utility of a new self-report questionnaire, the Illness Identity Questionnaire (IIQ), which assesses the concept of illness identity, or the degree to which type 1 diabetes is integrated into one's identity. Four illness identity dimensions (engulfment, rejection, acceptance, and enrichment) were validated in adolescents and emerging adults with type 1 diabetes. Associations with psychological and diabetes-specific functioning were assessed. RESEARCH DESIGN AND METHODS A sample of 575 adolescents and emerging adults (14-25 years of age) with type 1 diabetes completed questionnaires on illness identity, psychological functioning, diabetes-related problems, and treatment adherence. Physicians were contacted to collect HbA1c values from patients' medical records. Confirmatory factor analysis (CFA) was conducted to validate the IIQ. Path analysis with structural equation modeling was used to examine associations between illness identity and psychological and diabetes-specific functioning. RESULTS CFA indicated that the IIQ has a clear factor structure, meaningfully differentiating four illness identity dimensions. Rejection was related to worse treatment adherence and higher HbA1c values. Engulfment was related to less adaptive psychological functioning and more diabetes-related problems. Acceptance was related to more adaptive psychological functioning, fewer diabetes-related problems, and better treatment adherence. Enrichment was related to more adaptive psychological functioning. CONCLUSIONS The present findings underscore the importance of the concept of illness identity. A valid and reliable measure, the IIQ, is introduced to measure four illness identity dimensions in individuals with type 1 diabetes. These four illness identity dimensions were uniquely related to psychological and diabetes-specific functioning.
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Affiliation(s)
| | | | | | | | | | - Philip Moons
- KU Leuven, Leuven, Belgium University of Gothenburg, Gothenburg, Sweden
| | | | - Ilse Weets
- Free University of Brussels, Brussels, Belgium
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Hanghøj S, Boisen KA, Schmiegelow K, Hølge-Hazelton B. A Photo Elicitation Study on Chronically Ill Adolescents' Identity Constructions During Transition. Glob Qual Nurs Res 2016; 3:2333393616631678. [PMID: 28462329 PMCID: PMC5342639 DOI: 10.1177/2333393616631678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/29/2015] [Accepted: 12/30/2015] [Indexed: 01/18/2023] Open
Abstract
Adolescence is an important phase of life with increasing independence and identity development, and a vulnerable period of life for chronically ill adolescents with a high occurrence of insufficient treatment adherence. We conducted four photo elicitation focus group interviews with 14 adolescents (12-20 years) with juvenile idiopathic arthritis to investigate identity constructions during transition. Using a discourse analysis approach, six identity types were identified distributed on normal and marginal identities, which were lived either at home (home arena) or outside home with peers (out arena). Most participants positioned themselves as normal in the out arena and as ill in the home arena. Few participants positioned themselves as ill in an out arena, and they described how peers perceived this as a marginal and skewed behavior. This study contributes to a better understanding of why it can be extremely difficult to live with a chronic illness during adolescence.
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Affiliation(s)
- Signe Hanghøj
- Rigshospitalet and University of Copenhagen, Denmark
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24
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Neurological and Psychosocial Development in Adolescence. CONGENITAL HEART DISEASE AND ADOLESCENCE 2016. [DOI: 10.1007/978-3-319-31139-5_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Parental and peer support in adolescents with a chronic condition: a typological approach and developmental implications. J Behav Med 2015; 39:107-19. [PMID: 26369633 DOI: 10.1007/s10865-015-9680-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/07/2015] [Indexed: 12/20/2022]
Abstract
Research has consistently demonstrated that contextual support is crucial towards the psychological functioning of adolescents with chronic conditions. However, the literature has predominantly focused on parental support instead of adopting an integrated approach to parental and peer support. The present manuscript with two longitudinal studies in adolescents with Type 1 diabetes and congenital heart disease examined the extent to which different clusters of maternal, paternal, and peer support at baseline were related to well- and ill-being over time. In both studies, four clusters emerged: combined support, parental support, peer support, and lack of support. Follow-up longitudinal analyses indicated that especially combined support from parents and peers proved to be of crucial importance towards psychological functioning. The present studies demonstrated the value of a typological approach for assessing social support in adolescents with chronic conditions. In addition to focusing on parental support, future research should assess peer support as well in these adolescents.
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Abstract
Adolescents with congenital heart disease (CHD) are a rapidly growing population with complex medical needs and psychosocial challenges. Identity formation is an important developmental task accomplished during the teenage years. This article reviews different aspects of ongoing care that pertain to teenagers with CHD, with a particular focus on primary care issues and a summary of recommendations from various scientific societies. A successful smooth transition to the adult health care setting should achieve 2 important goals: to prevent loss of follow-up and to foster and encourage self-care behaviors.
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Affiliation(s)
- Pooja Gupta
- Division of Cardiology, The Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201-2119, USA.
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Bertoletti J, Marx GC, Hattge Júnior SP, Pellanda LC. Quality of life and congenital heart disease in childhood and adolescence. Arq Bras Cardiol 2013; 102:192-8. [PMID: 24676375 PMCID: PMC3987336 DOI: 10.5935/abc.20130244] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 09/26/2013] [Indexed: 01/09/2023] Open
Abstract
Advances in cardiac surgery techniques and early diagnosis have enabled the increased
survival of individuals with congenital heart disease. The investigation of the
quality of life in children and adolescents with congenital heart disease provides
complementary information to clinical data that can assist in decision making on the
part of health professionals. Although many studies have been conducted to
investigate the quality of life of children and adolescents with congenital heart
disease, the results prove to be contradictory; while some studies show that
congenital heart disease can impact the quality of life, others describe a better
perception of quality of life among children and adolescents who suffer from the
disease when compared with healthy control subjects. The purpose of this study is to
review the literature on the assessment of health related quality of life in children
and adolescents with congenital heart disease, in order to systematize the existing
knowledge on this topic today. It is observed that research seeks to investigate
aspects of personality in cardiac patients, their coping strategies used and
perceived social support, aiming at better understanding the association of these
variables with the level of quality of life in this population.
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Affiliation(s)
- Juliana Bertoletti
- Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Porto Alegre, RS, Brasil
| | | | | | - Lucia Campos Pellanda
- Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Porto Alegre, RS, Brasil
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Apers S, Luyckx K, Rassart J, Goossens E, Budts W, Moons P. Sense of coherence is a predictor of perceived health in adolescents with congenital heart disease: A cross-lagged prospective study. Int J Nurs Stud 2013; 50:776-85. [DOI: 10.1016/j.ijnurstu.2012.07.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 07/02/2012] [Accepted: 07/06/2012] [Indexed: 12/01/2022]
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Rassart J, Luyckx K, Apers S, Goossens E, Moons P. Identity dynamics and peer relationship quality in adolescents with a chronic disease: the sample case of congenital heart disease. J Dev Behav Pediatr 2013. [PMID: 23027135 DOI: 10.1097/dbp.] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Identity formation has been found to relate to psychosocial and disease-specific functioning in chronically ill adolescents. Therefore, examining antecedent factors of identity formation in this population is needed. The main goal of the present longitudinal study was to examine how peer relationship quality influenced identity formation in adolescents with congenital heart disease (CHD). METHOD Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven. A total of 429 adolescents (14-18 years) with CHD participated at time 1; 401 were matched on gender and age with community controls recruited at secondary schools. Adolescents completed questionnaires on identity and peer relationship quality. Nine months later, at time 2, 382 patients again completed these questionnaires. RESULTS Adolescents with CHD were generally found to be as competent as controls in addressing the task of identity formation. Moreover, the importance of peer relationships for identity formation was demonstrated. Supportive peer relationships positively influenced the process of identifying with the identity commitments made. Furthermore, such relationships protected adolescents from getting stuck in the exploration process. Finally, reciprocal pathways were uncovered; a maladaptive exploration process was also found to negatively affect peer relationships. CONCLUSION The present study found peer relationship quality to be an important antecedent factor of identity formation in adolescents with CHD. Future research should investigate how changes in peer relationships and identity relate to well-being in these patients.
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Affiliation(s)
- Jessica Rassart
- School of Psychology and Child and Adolescent Development, Department of Psychology, Catholic University of Leuven, Leuven, Belgium.
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Abstract
The success of modern therapies in congenital heart disease has produced a large and growing population of adults with congenital heart disease as a chronic condition. Such success increasingly raises a host of ethical issues, from resource utilization to end of life decision-making. The importance of a multidisciplinary approach to the care of adult congenital heart disease (ACHD) patients has been emphasized for some time, but addressing the challenges in this population requires a broad range of ethical expertise as well. This paper is based on a conference entitled "Ethical and Policy Challenges in Pediatric and Adult Congenital Heart Disease" held in March of 2012. Herein, we present a compilation of the ethics priorities in ACHD discussed at the conference, including ethical aspects of clinical care, ethics research and policy development in the areas of providing clinical care for challenging ACHD patients, improving transitions from pediatric to adult healthcare systems, advance care planning, and addressing costs.
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Affiliation(s)
- James N Kirkpatrick
- Cardiovascular Medicine Division, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Goossens E, Luyckx K, Mommen N, Gewillig M, Budts W, Zupancic N, Moons P. Health risk behaviors in adolescents and emerging adults with congenital heart disease: psychometric properties of the Health Behavior Scale-Congenital Heart Disease. Eur J Cardiovasc Nurs 2013; 12:544-57. [DOI: 10.1177/1474515113475934] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Eva Goossens
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
- PhD fellowship of the Research Foundation Flanders, Belgium
| | - Koen Luyckx
- School of Psychology and Child and Adolescent Development, KU Leuven, Belgium
| | - Nele Mommen
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
| | - Marc Gewillig
- Department of Paediatric Cardiology, University Hospitals Leuven, Belgium
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
| | - Nele Zupancic
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
- Department of Nursing and Midwifery, Leuven University College, Belgium
| | - Philip Moons
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
- Heart Centre, Rigshospitalet, Copenhagen, Denmark
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Luyckx K, Goossens E, Rassart J, Apers S, Vanhalst J, Moons P. Parental support, internalizing symptoms, perceived health status, and quality of life in adolescents with congenital heart disease: influences and reciprocal effects. J Behav Med 2012. [DOI: 10.1007/s10865-012-9474-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rassart J, Luyckx K, Goossens E, Apers S, Klimstra TA, Moons P. Personality traits, quality of life and perceived health in adolescents with congenital heart disease. Psychol Health 2012; 28:319-35. [PMID: 23035857 DOI: 10.1080/08870446.2012.729836] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study investigated how the big five personality traits were related to quality of life and perceived health in adolescents with congenital heart disease (CHD). Adolescents with CHD were selected from the database of paediatric and congenital cardiology of the University Hospitals Leuven. A total of 366 adolescents (15-20 years) participated; 364 were matched on sex and age with community controls. Adolescents' personality was assessed using the quick big five, quality of life was measured using a linear analogue scale and several domains of perceived health were assessed using the paediatric quality of life inventory. Adolescents with CHD displayed similar big five levels as controls, except for a lower score on extraversion. Whereas disease-specific domains of perceived health were mainly related to emotional stability, several traits contributed to patients' quality of life and generic perceived health. Hence, the present findings demonstrate that the Big Five is a valuable framework for examining linkages between personality and disease adaptation in chronic disease populations. Moreover, these findings underscore the importance of examining patients' personality to shed light on their daily functioning. Future research should explore potential mechanisms detailing how personality influences disease adaptation over time in these patients.
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Affiliation(s)
- Jessica Rassart
- Faculty of Psychology, School Psychology and Child and Adolescent Development, University of Leuven, Leuven, Belgium.
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The experience of being diagnosed with hypertrophic cardiomyopathy through family screening in childhood and adolescence. Cardiol Young 2012; 22:528-35. [PMID: 22272577 DOI: 10.1017/s1047951111002101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIM To describe the experiences of children and adolescents being screened positive for hypertrophic cardiomyopathy and how this impacts their daily life. BACKGROUND Hypertrophic cardiomyopathy is a hereditary disease and the most common medical cause of sudden death in childhood and adolescence. This is the reason for recommending screening in children with an affected first-degree relative. A diagnosis of hypertrophic cardiomyopathy implies lifestyle modifications, restrictions that may bring profound changes to the daily life of the affected individual. DESIGN This is a descriptive qualitative interview study. METHODS We interviewed 13 asymptomatic children or adolescents diagnosed with hypertrophic cardiomyopathy through family screening 12-24 months after the diagnosis. Analysis was conducted with qualitative content analysis. RESULTS Children described an involuntary change, which affected their daily life with limitations and restrictions in life, both in the individual and social context. Lifestyle recommendations had the most severe impact on daily life and affected their social context. They tried to navigate in a world with new references, and after reorientation they felt hope and had faith in the future. CONCLUSIONS Children diagnosed with hypertrophic cardiomyopathy through family screening went through an involuntary change resulting in limitations and restrictions in life. This study indicates that there is a need for support and that healthcare professionals have to consider the specific needs in these families. Our findings thus give guidance in how best to improve support to the patients and their family. Diagnosis in asymptomatic children should be accompanied by ideally multi-professional follow-up, focusing not only on medical issues.
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Rassart J, Luyckx K, Klimstra T, Moons P. The importance of studying personality in individuals with congenital heart disease. Eur J Cardiovasc Nurs 2012; 11:261-2. [DOI: 10.1177/1474515112458045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jessica Rassart
- Faculty of Psychology, School Psychology and Child and Adolescent Development, University of Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology, School Psychology and Child and Adolescent Development, University of Leuven, Leuven, Belgium
- Fund for Scientific Research Flanders (FWO), Brussels, Belgium
| | - Theo Klimstra
- Faculty of Psychology, School Psychology and Child and Adolescent Development, University of Leuven, Leuven, Belgium
- Fund for Scientific Research Flanders (FWO), Brussels, Belgium
| | - Philip Moons
- Center for Health Services and Nursing Research, University of Leuven, Leuven, Belgium
- Division of Congenital and Structural Cardiology, University Hospitals of Leuven, Leuven, Belgium
- The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark
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Klimstra TA, Crocetti E, Hale WW, Kolman AI, Fortanier E, Meeus WH. Identity formation in juvenile delinquents and clinically referred youth. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY-REVUE EUROPEENNE DE PSYCHOLOGIE APPLIQUEE 2011. [DOI: 10.1016/j.erap.2011.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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