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Driscoll CFB, Holmbeck GN. Self-Management in Youth With Spina Bifida: Associations With Parent Factors in the Context of a Summer Camp Intervention. J Pediatr Psychol 2023; 48:51-66. [PMID: 35751436 DOI: 10.1093/jpepsy/jsac058] [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: 11/15/2021] [Revised: 05/16/2022] [Accepted: 06/10/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To investigate cross-sectional and longitudinal associations between parent factors and self-management for youth with spina bifida (SB). METHODS Participants were 89 camper-parent dyads recruited for a summer camp program for youth with SB (Myouthage = 12.2 years); 48 of these families participated across 2 years. Campers and parents completed assessments at Time 1 (pre-camp) and Time 3 (post-camp) for one or two summers. Parents reported on demographics, their own adjustment, perceptions, attitudes, and behaviors, and youth condition-related responsibility and task mastery. Youth also reported on condition-related responsibility. Hierarchical multiple regression analyses and multilevel modeling were used to examine relationships between parent factors and youth self-management. RESULTS Parents' expectations for future goal attainment were positively associated with camper responsibility and task mastery, and these associations were moderated by camper age (only significant for older campers). When examining changes over one summer, parental expectations for the future were significantly associated with changes in campers' condition-related task mastery. When examining trajectories across summers, parental perception of child vulnerability was negatively associated with the slope of condition-related responsibility and parents' expectations for future goal attainment were positively associated with the slope of task mastery. CONCLUSIONS Parent perceptions and behaviors may be important targets for assessment and intervention when promoting condition-related independence for youth with SB.
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Affiliation(s)
- Colleen F Bechtel Driscoll
- Department of Child and Adolescent Psychiatry, NYU Langone Health, USA.,Department of Psychology, Loyola University Chicago, USA
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Logan LR, Sawin KJ, Bellin MH, Brei T, Woodward J. Self-management and independence guidelines for the care of people with spina bifida. J Pediatr Rehabil Med 2021; 13:583-600. [PMID: 33252094 PMCID: PMC7838981 DOI: 10.3233/prm-200734] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Self-management and independence behaviors are associated with improved health conditions common to spina bifida such as skin integrity and bowel and bladder management. While most children with spina bifida ultimately achieve basic self-care behaviors, (e.g., dressing appropriately, planning activities with peers, or cooking pre-planned meals), they often lag 2-5 years behind their typically-developing peers in these activities [1]. Valid and reliable condition-specific assessments of self-management and independence are critical to optimizing outcomes for this population. Partnerships among parents, clinicians, and youths with spina bifida are essential to implementing tailored interventions based on these assessments. The guidelines delineated in this article are informed by current self-management research for people with spina bifida and offer recommendations to promote self-management and independence across the lifespan.
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Affiliation(s)
- Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, Upstate Medical University, Syracuse, NY, USA
| | - Kathleen J. Sawin
- Self-Management Science Center, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Timothy Brei
- Division of Developmental Medicine, Department of Pediatrics, University of Washington School of Medicine and Seattle Children’s Hospital, Seattle, WA, USA
| | - Jason Woodward
- University of Cincinnati College of Medicine, Division of Developmental and Behavioral Pediatrics Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Ohanian DM, Kritikos TK, Clark OE, Shirkey KC, Starnes M, Holmbeck GN. Stress and Coping in Youth With Spina Bifida: A Brief Longitudinal Study in a Summer Camp Setting. Front Psychol 2021; 12:682169. [PMID: 34408702 PMCID: PMC8366057 DOI: 10.3389/fpsyg.2021.682169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction It is well established that youth with chronic conditions experience elevated levels of stress; the manner in which they respond to or cope with this stress is likely to impact both health and psychosocial outcomes. The current study examined stress and coping in youth and young adults with spina bifida (SB) using the response to stress questionnaire-SB version (RSQ-SB; Connor-Smith et al., 2000). Methods Data were collected as part of a camp-based psychosocial intervention for children (ages 7–13), adolescents (ages 14–19), and young adults (ages 20–38) with SB. Participants completed the RSQ-SB as well as questionnaires assessing demographics and condition severity. Data were collected prior to camp (T1) and 1 month (T2) after camp ended. Self-report data were collected from adolescents and young adults; parents of children and adolescents reported on their child’s stress and coping. Ratios of primary control coping, secondary control coping, disengagement coping, involuntary engagement, and involuntary disengagement coping were calculated. Descriptive statistics and t-tests were utilized to describe coping and stress responses and to determine potential change over time. T-tests were also used to compare youth and parent reported coping styles with those of youth with type 1 diabetes (T1D) and sickle cell disease (SCD). Associations between demographic/disease factors and coping styles were also examined. Results Parent and youth report indicated that youth with SB tend to use primary control coping. Youth with SB use more primary control coping and less disengagement coping compared to youth with SCD and youth with T1D. Few significant changes in coping were found between T1 and T2. IQ and socioeconomic status were significantly associated with coping styles. Conclusion Youth with SB use more primary control coping compared to other coping methods and as compared to other pediatric populations. Future studies should examine mechanisms by which primary control coping is advantageous for youth with SB. Future interventions should be more focused on promoting adaptive coping behaviors and be tailored to developmental age and access to resources.
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Affiliation(s)
- Diana M Ohanian
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Tessa K Kritikos
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Olivia E Clark
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Kezia C Shirkey
- Department of Psychology, North Park University, Chicago, IL, United States
| | - Meredith Starnes
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Grayson N Holmbeck
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
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Sawin KJ, Margolis RHF, Ridosh MM, Bellin MH, Woodward J, Brei TJ, Logan LR. Self-management and spina bifida: A systematic review of the literature. Disabil Health J 2021; 14:100940. [PMID: 32980287 DOI: 10.1016/j.dhjo.2020.100940] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Self-management is critical to optimizing the health of individuals with a chronic condition or disability and is, therefore, a central concept in individual and family-centered healthcare delivery. The purpose of this review is to report the state of the science of self-management for individuals with spina bifida (SB) from a lifespan perspective. OBJECTIVE This review will summarize the (a) development and use of self-management skills and behaviors across the life span, (b) factors related to self-management behaviors, (c) development of generic or condition-specific measures of self-management used with a spina bifida population, and (d) development and/or outcomes of interventions to improve self-management in SB. METHODS The search strategy was limited to primary research articles published between 2003 and 2019 and followed PRISMA guidelines. The databases searched included: PubMed, CINAHL, PsycINFO, Web of Science, Cochrane, and Google Scholar. Studies that addressed self-management concepts in individuals throughout the life span and published in English were included. RESULTS The search yielded 108 citations and 56 articles met inclusion/exclusion criteria. A systematic narrative synthesis was reported. The level of evidence identified was primarily Level III articles of good quality. Multiple demographic, environmental, condition and process factors were related to self-management behaviors. SB self-management instruments and intervention development and testing studies were identified. CONCLUSIONS This review provides a synthesis of the state of the science of self-management including factors related to self-management behaviors, preliminary evidence of instruments for use in SB, factors important to consider in the development and testing of future interventions, and gaps in the literature.
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Affiliation(s)
- Kathleen J Sawin
- Nurse Scientist, Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Corporate Center, Suite 140, 999 N 92nd St, Wauwatosa, WI, 53226, USA; Center Scientist, Self-Management Science Center, College of Nursing, University of Wisconsin-Milwaukee, USA.
| | - Rachel H F Margolis
- School of Social Work, University of Maryland, 525 W. Redwood Street, Baltimore, MD, 21201, USA.
| | - Monique M Ridosh
- Marcella Niehoff School of Nursing, Loyola University Chicago, 2160 S. First Avenue, Building 115, Room 345, Maywood, PhD, RN, IL, 60153, USA.
| | - Melissa H Bellin
- School of Social Work, University of Maryland, 525 W. Redwood Street, Baltimore, MD, 21201, USA.
| | - Jason Woodward
- Assistant Professor of Internal Medicine and Pediatrics, University of Cincinnati College of Medicine, Division Developmental and Behavioral Peds, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 4002, Cincinnati, OH, 45229, USA.
| | - Timothy J Brei
- Department of Pediatrics, Division of Developmental Pediatrics, Seattle Children's Hospital and University of Washington School of Medicine, 4800 Sand Point Way NE O.C.840, Seattle, WA, 98105, USA.
| | - Lynne Romeiser Logan
- Department of PM&R, Upstate Medical University, 750 E Adams St, Syracuse, NY, 13210, USA.
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Driscoll CFB, Ohanian DM, Ridosh MM, Stern A, Wartman EC, Starnes M, Holmbeck GN. Pathways by which Maternal Factors are Associated With Youth Spina Bifida-Related Responsibility. J Pediatr Psychol 2020; 45:610-621. [PMID: 32337548 DOI: 10.1093/jpepsy/jsaa020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Achieving condition-related autonomy is an important developmental milestone for youth with spina bifida (SB). However, the transfer of condition-related responsibility to these youth can be delayed due to parent factors. This study aimed to investigate two potential pathways by which maternal factors may be associated with condition-related responsibility among youth with SB: (a) Maternal adjustment → perception of child vulnerability (PPCV) → youth condition-related responsibility; and (b) Maternal PPCV → overprotection → youth condition-related responsibility. METHODS Participating youth with SB (N = 140; Mage=11.4 years, range = 8-15 years) were recruited as part of a longitudinal study; data from three time points (each spaced 2 years apart) from the larger study were used. Mothers reported on personal adjustment factors, PPCV, and overprotection. An observational measure of overprotection was also included. Mothers, fathers, and youth with SB reported on youths' degree of responsibility for condition-related tasks. Analyses included age, lesion level, IQ, and the dependent variables at the prior wave as covariates. RESULTS Bootstrapped mediation analyses revealed that PPCV significantly mediated the relationship between maternal distress and youth responsibility for medical tasks such that higher levels of distress at Time 1 predicted higher levels of PPCV at Time 2 and lower youth medical responsibility at Time 3. Furthermore, self-reported maternal overprotection significantly mediated the relationship between maternal PPCV and youth responsibility for medical tasks. CONCLUSIONS Maternal personal distress, PPCV, and self-reported overprotection are interrelated and affect youth's condition-related responsibility. Interventions for mothers of youth with SB that target these factors may improve both maternal and youth outcomes.
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Affiliation(s)
| | | | | | - Alexa Stern
- Psychology Department, Loyola University Chicago
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Peycelon M, Szymanski KM, Francesca Monn M, Salama AK, Risk H, Cain MP, Misseri R. Adherence with bladder irrigation following augmentation. J Pediatr Urol 2020; 16:33.e1-33.e8. [PMID: 31796294 DOI: 10.1016/j.jpurol.2019.10.029] [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: 09/16/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patients with bladder augmentation (BA) are routinely counseled to irrigate their bladders daily. However, reports of adherence with this regimen are lacking. OBJECTIVE To evaluate adherence to a bladder irrigation protocol and identify risk factors associated with adherence among adults with spina bifida (SB) and BA. STUDY DESIGN Adults with SB after BA followed in a multidisciplinary clinic were identified (2017-2019). All patients or caregivers were taught the importance of and the technique for the bladder irrigation protocol prior to and after BA. Patient demographics (age, gender, ambulatory status, and presence of a caregiver in clinics) and surgical details (type of BA, age at surgery, length of follow-up, presence of a catheterizable channel, position of stoma, bladder neck surgery, presence of Malone antegrade colonic enema or ventriculo-peritoneal shunt, and number of stone surgeries) were obtained from the medical record. Patients reported other variables in a standardized clinic questionnaire. Answers were confirmed by health care providers. The variables included who performs clean intermittent catheterization (CIC), size of catheter, frequency of CIC, use of overnight catheterization, difficulties with CIC, number of UTIs, and continence per urethra and per catheterizable channel. Adherence to bladder irrigation was also assessed in the questionnaire. ‛Strict adherence' was defined as bladder irrigation performed ≥6 times/week with ≥120 mL of saline. For statistical analysis, a more lenient definition of ‛higher adherence' was used: bladder irrigation ≥2 times/week with at least 60 mL. ‛Lower adherence' was defined as ≤1 time/week or with less than 60 mL. Factors associated with ‛higher adherence' were assessed with non-parametric tests (Bonferroni-corrected p-value: 0.002). RESULTS Adherence was assessed in 87 eligible patients (60.9% females; mean age of 28.8 ± 8.2 years). No patient (0.0%) reported ‛strict adherence', and 62 and 25 patients (71.3% and 28.7%) reported ‛higher' and ‛lower' adherence' to bladder irrigation, respectively. Nine patients (10.3%) in the ‛lower adherence' group did not irrigate at all. No variables were statistically significant on univariate analysis, including previous bladder stone surgery or having a channel (p ≥ 0.01). On exploratory analysis, higher adherence was only associated with self-catheterizations versus those performed by caregivers (76.7% vs 33.3%, p = 0.01). CONCLUSIONS Adherence to a bladder irrigation protocol in adults with SB and BA is poor. A history of bladder stones requiring surgery and the presence of a catheterizable channel do not appear to affect adherence. It remains unclear why some patients are more likely than others to irrigate their bladders. Future work will focus on methods to improve adherence.
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Affiliation(s)
- Matthieu Peycelon
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA; Reference Center for Rare Diseases (CRMR), Malformations Rares des Voies Urinaires (MARVU), Université de Paris, Sorbonne Paris Cité. 48, Boulevard Sérurier, Paris, France
| | - Konrad M Szymanski
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA
| | - M Francesca Monn
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA
| | - Amr K Salama
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA
| | - Hillary Risk
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA
| | - Mark P Cain
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA
| | - Rosalie Misseri
- Department of Pediatric Urology of Riley Children Hospital, Indiana University, School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, USA.
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Stiles-Shields C, Anderson L, Driscoll CFB, Ohanian DM, Starnes M, Stern A, Yunez J, Holmbeck GN. Technology usage and barriers to the use of behavioral intervention technologies in adolescents and young adults with spina bifida. J Pediatr Rehabil Med 2020; 13:675-683. [PMID: 32986627 DOI: 10.3233/prm-190652] [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] Open
Abstract
PURPOSE The majority of behavioral intervention technologies (BITs) have been designed and targeted towards the general population (i.e., typically-developing individuals); thus, little is known about the use of BITs to aid those with special needs, such as youth with disabilities. The current study assessed adolescents and young adults with spina bifida (AYA-SB) for: 1) their technology usage, and 2) anticipated barriers to using technology to help manage their health. METHODS AYA-SB completed a survey of their media and technology usage. A card sorting task that ranked and grouped anticipated barriers to using a mobile app to manage health was also completed. Ranked means, standard deviations, and the number of times a barrier was discarded were used to interpret sample rankings. RESULTS AYA-SB reported less frequent technology and media use than the general population. However, differences emerged by age, with young adults endorsing higher usage than their younger counterparts. Top concerns focused on usability, accessibility, safety, personal barriers due to lack of engagement, technological functioning, privacy, and efficacy. CONCLUSIONS AYA-SB appear to be selective users of technology. It is therefore critical that the design of BITs address their concerns, specifically aiming to have high usability, accessibility, and engagement.
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Affiliation(s)
- Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, USA
| | - Lara Anderson
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | | | - Diana M Ohanian
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Meredith Starnes
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Alexa Stern
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Jessica Yunez
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
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DRISCOLL COLLEENFBECHTEL, MURRAY CAITLINB, HOLBEIN CHRISTINAE, STILES-SHIELDS COLLEEN, CUEVAS GINA, HOLMBECK GRAYSONN. Camp-based psychosocial intervention dosage and changes in independence in young people with spina bifida. Dev Med Child Neurol 2019; 61:1392-1399. [PMID: 30980543 PMCID: PMC7590995 DOI: 10.1111/dmcn.14250] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
AIM To examine associations between camp-based intervention dosage and changes in independence-related skills for young people with spina bifida. METHOD Participants were 110 individuals (mean age [SD] 14y 7mo [6y 1mo], range 6-32y; 66 females, 54 males) who attended a summer camp for individuals with spina bifida between 2 to 6 times (mean 2.40; operationalized as 'dosage'). Parents of young campers (e.g. those <18y) also participated in data collection. Campers and/or parents completed preintervention measures assessing campers' level of medical responsibility, mastery over medical tasks, and social skills. Outcomes included change in preintervention scores from dose 1 to final dose. RESULTS Hierarchical regression analyses with and without covariates (age, IQ, and lesion level at dose 1) revealed that increased dosage was significantly associated with greater parent-reported improvements in campers' medical responsibility and mastery over medical tasks. Increased dosage was also significantly associated with camper-report of increased medical responsibility, but this relationship was no longer significant when including covariates. Intervention dosage was not associated with changes in campers' social skills. INTERPRETATION Repeated participation in a camp-based intervention was associated with improvements in condition-related independence. Future work may focus on the development of interventions to promote improvements in social skills for young people with spina bifida. WHAT THIS PAPER ADDS Participating in an intervention over multiple summers is associated with increases in campers' responsibility for spina bifida-related tasks. Repeated summer camp intervention participation is associated with improved mastery over condition-related tasks for campers with spina bifida. Repeated camp intervention participation is not associated with changes in social skills for campers with spina bifida.
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Affiliation(s)
| | - CAITLIN B MURRAY
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA
| | | | | | - GINA CUEVAS
- Psychology Department, Loyola University Chicago, Chicago, IL
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Choi EK, Jung E, Ji Y, Bae E. A 2-Step Integrative Education Program and mHealth for Self-Management in Korean Children with Spina Bifida: Feasibility Study. J Pediatr Nurs 2019; 49:e54-e62. [PMID: 31519400 DOI: 10.1016/j.pedn.2019.09.002] [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: 06/10/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to develop and test the feasibility of a 2-step self-management program, including onsite integrative education and a mobile health (mHealth) intervention, for children with spina bifida (SB). DESIGN AND METHODS This feasibility study used a quasi-experimental single group pre-and post-test design. The onsite integrative education and the mHealth program, "Glowing Stars™," were developed and then tested for content validity by a panel of experts. The feasibility and user satisfaction were evaluated using factors such as school adjustment, self-management knowledge, self-efficacy, self-management behavior, and quality of life measurement by children aged 10 to 12 years with SB and their parents, from March 2018 to April 2018. RESULTS A total of five children with SB completed this intervention. All children perceived that this program was usable and feasible to maintain self-management behavior. A statistically significant difference was observed in the children's self-management behavior domain between the first and second post-test (p = .043). CONCLUSION This innovative 2-step self-management intervention program complements existing single interventions and confirms the possibility of mHealth technology as an intervention for children with SB. PRACTICE IMPLICATIONS In pediatric nursing, this innovative intervention could be adapted for children with chronic conditions, with a positive effect on self-management.
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Affiliation(s)
- Eun Kyoung Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
| | - Eunyoung Jung
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea.
| | - Yoonhye Ji
- Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Healthcare System, Seoul, South Korea.
| | - Eunjeong Bae
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea.
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Stiles-Shields C, Garcia B, Villota K, Wartman E, Winning AM, Holmbeck GN. Exploring an Existing Weight Management App for Use With Adolescents and Young Adults With Spina Bifida: Usability Study. JMIR Pediatr Parent 2019; 2:e15153. [PMID: 31603432 PMCID: PMC6813487 DOI: 10.2196/15153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Adolescents and young adults with spina bifida (AYA-SBs) have unique user needs, given their variable and complex symptom profile. Owing to multiple barriers to prevention and intervention treatments for secondary conditions (eg, obesity), AYA-SBs may benefit from the use of behavioral intervention technologies (BITs). However, as BITs are often designed and tested with typically developing individuals, it is unclear if existing BITs may be usable for AYA-SBs. OBJECTIVE This study aimed to evaluate the usability of a high-quality, publicly available, weight management-focused mobile BIT (smartphone app) for AYA-SBs. METHODS Overall, 28 AYA-SBs attending a Young Men's Christian Association-based summer camp completed 4 structured usability tasks using a weight management app designed for the general public called My Diet Coach (Bending Spoons). Learnability was measured by (1) time to complete task, (2) number of user errors, and (3) correct entry of data when requested by the app. Satisfaction and general usability were measured via self-reported questionnaires and qualitative feedback following interactions with the app. RESULTS The majority of the sample were able to complete the tasks, with increased completion rates and improved times on second attempts of the tasks (Ps<.05). Errors were common, and discrepancies emerged between quantitative and qualitative feedback such that self-reported measures indicated dissatisfaction but qualitative feedback was generally positive. Suggested improvements to the app included (1) tutorials, (2) simplifying the design, (3) more activity options for those who ambulate by wheelchair, and (4) notifications to prompt use. CONCLUSIONS AYA-SBs were able to learn how to complete specific tasks independently on a weight management app, but design changes consistent with previously proposed user needs were recommended. Rather than designing entirely new BITs, it may be possible to adapt existing technologies to personalize BITs for specific populations such as AYA-SBs.
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Affiliation(s)
- Colleen Stiles-Shields
- Population Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Brittney Garcia
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Kimberly Villota
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Elicia Wartman
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Adrien M Winning
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Grayson N Holmbeck
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
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Sattoe JNT, Bal MI, Roelofs PDDM, Bal R, Miedema HS, van Staa A. Self-management interventions for young people with chronic conditions: A systematic overview. PATIENT EDUCATION AND COUNSELING 2015; 98:704-715. [PMID: 25819373 DOI: 10.1016/j.pec.2015.03.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/17/2014] [Accepted: 03/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To provide a systematic overview of self-management interventions (SMI) for young people with chronic conditions with respect to content, formats, theories, and evaluated outcomes. METHODS Embase, Medline, PsycINFO, Web-of-Science, CINAHL, and Cochrane were searched. Reviews' reference lists were scrutinized. Selected studies were: Original research articles in English published between 2003 and March 2014; about the evaluation of SMI for 7 to 25-year-olds with somatic chronic conditions/physical disabilities; with clear outcomes and intervention descriptions. The classification of medical, role and emotion management served to review content. Formats, theories, and evaluated outcomes were summarized. RESULTS 86 studies were reviewed. Most aimed at medical management and were unclear about theoretical bases. Although a variety of outcomes was evaluated and the distribution over self-management domains was quite unpredictable, outcomes conceptually related to specific content. A content-based framework for the evaluation of self-management interventions is presented. CONCLUSIONS AND PRACTICE IMPLICATIONS SMI relate to self-management tasks and skill-building. Yet, conceptualizations of self-management support often remained unclear and content focuses predominantly on the medical domain, neglecting psycho-social challenges for chronically ill young people. Future evaluations should match outcomes/themes to content and characteristics. Our framework and overview of SMI characteristics and outcomes may assist clinicians in providing self-management support.
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Affiliation(s)
- Jane N T Sattoe
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - Marjolijn I Bal
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus Medical University, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
| | - Roland Bal
- Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
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Psihogios AM, Kolbuck V, Holmbeck GN. Condition Self-Management in Pediatric Spina Bifida: A Longitudinal Investigation of Medical Adherence, Responsibility-Sharing, and Independence Skills. J Pediatr Psychol 2015; 40:790-803. [PMID: 26002195 DOI: 10.1093/jpepsy/jsv044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 04/21/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate rates of medical adherence, responsibility, and independence skills across late childhood and adolescence in youth with spina bifida (SB) and to explore associations among these disease self-management variables. METHOD 111 youth with SB, their parents, and a health professional participated at two time points. Informants completed questionnaires regarding medical adherence, responsibility-sharing, and child independence skills. RESULTS Youth gained more responsibility and independence skills across time, although adherence rates did not follow a similar trajectory. Increased child medical responsibility was related to poorer adherence, and father-reported independence skills were associated with increased child responsibility. CONCLUSIONS This study highlights medical domains that are the most difficult for families to manage (e.g., skin checks). Although youth appear to gain more autonomy across time, ongoing parental involvement in medical care may be necessary to achieve optimal adherence across adolescence.
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Abstract
Spina bifida is a birth defect in which the vertebral column is open, often with spinal cord involvement. The most clinically significant subtype is myelomeningocele (open spina bifida), which is a condition characterized by failure of the lumbosacral spinal neural tube to close during embryonic development. The exposed neural tissue degenerates in utero, resulting in neurological deficit that varies with the level of the lesion. Occurring in approximately 1 per 1,000 births worldwide, myelomeningocele is one of the most common congenital malformations, but its cause is largely unknown. The genetic component is estimated at 60-70%, but few causative genes have been identified to date, despite much information from mouse models. Non-genetic maternal risk factors include reduced folate intake, anticonvulsant therapy, diabetes mellitus and obesity. Primary prevention by periconceptional supplementation with folic acid has been demonstrated in clinical trials, leading to food fortification programmes in many countries. Prenatal diagnosis is achieved by ultrasonography, enabling women to seek termination of pregnancy. Individuals who survive to birth have their lesions closed surgically, with subsequent management of associated defects, including the Chiari II brain malformation, hydrocephalus, and urological and orthopaedic sequelae. Fetal surgical repair of myelomeningocele has been associated with improved early neurological outcome compared with postnatal operation. Myelomeningocele affects quality of life during childhood, adolescence and adulthood, posing a challenge for individuals, families and society as a whole. For an illustrated summary of this Primer, visit: http://go.nature.com/fK9XNa.
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Sattoe JNT, Jedeloo S, van Staa A. Effective peer-to-peer support for young people with end-stage renal disease: a mixed methods evaluation of Camp COOL. BMC Nephrol 2013; 14:279. [PMID: 24359407 PMCID: PMC3878094 DOI: 10.1186/1471-2369-14-279] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 12/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Camp COOL programme aims to help young Dutch people with end-stage renal disease (ESRD) develop self-management skills. Fellow patients already treated in adult care (hereafter referred to as 'buddies') organise the day-to-day program, run the camp, counsel the attendees, and also participate in the activities. The attendees are young people who still have to transfer to adult care. This study aimed to explore the effects of this specific form of peer-to-peer support on the self-management of young people (16-25 years) with ESRD who participated in Camp COOL (CC) (hereafter referred to as 'participants'). METHODS A mixed methods research design was employed. Semi-structured interviews (n = 19) with initiators/staff, participants, and healthcare professionals were conducted. These were combined with retrospective and pre-post surveys among participants (n = 62), and observations during two camp weeks. RESULTS Self-reported effects of participants were: increased self-confidence, more disease-related knowledge, feeling capable of being more responsible and open towards others, and daring to stand up for yourself. According to participants, being a buddy or having one positively affected them. Self-efficacy of attendees and independence of buddies increased, while attendees' sense of social inclusion decreased (measured as domains of health-related quality of life). The buddy role was a pro-active combination of being supervisor, advisor, and leader. CONCLUSIONS Camp COOL allowed young people to support each other in adjusting to everyday life with ESRD. Participating in the camp positively influenced self-management in this group. Peer-to-peer support through buddies was much appreciated. Support from young adults was not only beneficial for adolescent attendees, but also for young adult buddies. Paediatric nephrologists are encouraged to refer patients to CC and to facilitate such initiatives. Together with nephrologists in adult care, they could take on a role in selecting buddies.
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Affiliation(s)
- Jane NT Sattoe
- Centre of Expertise Innovations in Care, Rotterdam University, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
- Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands
| | - Susan Jedeloo
- Centre of Expertise Innovations in Care, Rotterdam University, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - AnneLoes van Staa
- Centre of Expertise Innovations in Care, Rotterdam University, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
- Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands
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Adults with Childhood Onset Disabilities: A Focused Review of Three Conditions. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2013. [DOI: 10.1007/s40141-013-0012-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Maslow GR, Chung RJ. Systematic review of positive youth development programs for adolescents with chronic illness. Pediatrics 2013; 131:e1605-18. [PMID: 23610201 DOI: 10.1542/peds.2012-1615] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The Positive Youth Development (PYD) framework has been successfully used to support at-risk youth. However, its effectiveness in fostering positive outcomes for adolescents with chronic illness has not been established. We performed a systematic review of PYD-consistent programs for adolescents with chronic illness. METHODS Data sources included PubMed, CINAHL, and PsychINFO. Guided by an analytic framework, we searched for studies of PYD-consistent programs serving adolescents and young adults aged 13 through 24 with chronic illness. References were screened iteratively with increasing depth until a focused cohort was obtained and reviewed in full. The authors separately reviewed the studies using structured analysis forms. Relevant study details were abstracted during the review process. RESULTS Fifteen studies describing 14 programs were included in the analysis. Three comprehensive programs included all 3 core components of a PYD program, including opportunities for youth leadership, skill building, and sustained connections between youth and adults. Four programs were primarily mentoring programs, and 7 others focused on youth leadership. Programs served youth with a variety of chronic illnesses. The quality and type of evaluation varied considerably, with most reporting psychosocial outcomes but only a few including medical outcomes. CONCLUSIONS The PYD-consistent programs identified in this review can serve as models for the development of youth development programs for adolescents with chronic illness. Additional study is needed to evaluate such programs rigorously with respect to both psychosocial and health-related outcomes. PYD-consistent programs have the potential to reach youth with chronic illness and promote positive adult outcomes broadly.
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Affiliation(s)
- Gary R Maslow
- Division of Primary Care Pediatrics, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA.
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Holbein CE, Murray CB, Psihogios AM, Wasserman RM, Essner BS, O'Hara LK, Holmbeck GN. A camp-based psychosocialiIntervention to promote independence and social function in individuals with spina bifida: moderators of treatment effectiveness. J Pediatr Psychol 2013; 38:412-24. [PMID: 23435204 DOI: 10.1093/jpepsy/jst003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To replicate and extend O'Mahar and colleagues' (O'Mahar, K., Holmbeck, G. N., Jandasek, B., & Zuckerman, J. [2010]. A camp-based intervention targeting independence among individuals with spina bifida. Journal of Pediatric Psychology, 35, 848-856) findings in a new and larger sample of youth and young adults with spina bifida who participated in a modified camp-based intervention targeting independence and social skills. Moderators of intervention effectiveness and clinical significance were examined. METHOD In all, 119 campers aged 7-41 years participated in an intervention that included goal setting and interactive workshops. Campers and parents completed measures of campers' goal attainment, independence, and social functioning at preintervention and postintervention; counselors reported on campers' goal attainment daily throughout the intervention. RESULTS Parents and campers reported improvements in campers' goal attainment, management of health-related self-care, and independence. Although benefits were found for most campers, cognitive functioning and family income moderated some outcomes. Campers who improved most on their social goals perceived the intervention to be more effective. CONCLUSIONS Further support is provided for the effectiveness of a camp-based intervention targeting independence and social skills for individuals with spina bifida. More attention should be directed toward those with cognitive difficulties and low-income backgrounds.
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Affiliation(s)
- Christina E Holbein
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL 60660, USA.
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