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Qin X, Zhang A, Zhao X, Zhou T, Xia Z, Yu G. Investigation and Analysis of the Current Status of Health-Related Quality of Life in Adolescents with Hemophilia in Hubei Province. Br J Hosp Med (Lond) 2024; 85:1-12. [PMID: 39212560 DOI: 10.12968/hmed.2024.0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Aims/Background Reliable health-related quality of life data are critical in developing countries, in order to advocate for government agencies to develop national hemophilia care programmes. This study aims to explore the current status and influencing factors of health-related quality of life among adolescents with hemophilia in Hubei Province, so as to provide empirical data for professionals. Methods A total of 84 children with hemophilia aged 8 to 18, who were registered in Tongji Hemophilia Treatment Center and Hubei Hemophilia Home, were selected using a cluster sampling method. The "General Situation Questionnaire of Hemophiliac Adolescents", designed by Tongji Hemophilia Treatment Center, and "the Chinese version of Canadian hemophilia outcomes-kid's life assessment tool (CHO-KLAT)", were used for this study conducted from June 1, 2022 to December 30, 2022. Results 82 completed questionnaires were included. The average age of the 82 adolescents was 13.04 ± 3.29 years and all were males. Among them, 67 were hemophilia A and 15 were hemophilia B. 61 cases were severe type, 19 were moderate type and 2 cases were mild type. The average total score of the CHO-KLAT for adolescents with hemophilia in Hubei Province was 49.49, which was lower than their counterparts in developed countries. The statistically significant influencing factors included residence, annual family income, and disease type. Conclusion This study provides empirical data support for the health management of adolescents with hemophilia, highlighting the importance of improving medical resource access, transfusion convenience, and psychological support in enhancing the quality of life for this group. The results emphasize the need for healthcare systems and policymakers to take specific measures to address these factors to improve the treatment and care conditions for adolescents with hemophilia.
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Affiliation(s)
- Xiuli Qin
- Nursing Department, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ai Zhang
- Children's Hematology/Oncology Unit, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xin Zhao
- Nursing Department, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Zhou
- Nursing Department, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhili Xia
- Nursing Department, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Genzhen Yu
- Nursing Department, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Male C, Ay C, Crevenna R, Eichinger S, Feistritzer C, Füller R, Haushofer A, Kurringer A, Neumeister P, Puchner S, Rettl J, Schindl T, Schuster G, Schwarz R, Sohm M, Streif W, Thom K, Wagner B, Wissmann E, Zwiauer K, Pabinger I. [Treatment of haemophilia in Austria]. Wien Klin Wochenschr 2024; 136:75-102. [PMID: 38743098 DOI: 10.1007/s00508-024-02370-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
This guideline is intended to provide practical guidance for the diagnosis and treatment of haemophilia in Austria. Few randomized controlled interventional trials are available addressing the treatment of haemophilia, therefore recommendations are usually based on low level of evidence and represent expert consensus.This guideline is based on the WFH guideline, published in 2020, and adapted according to the national circumstances and experience.It includes recommendations and suggestions for diagnosis and follow-up visits and pharmacological therapies for treatment and prophylaxis. Further topics comprise special aspects in children and adults with severe haemophilia, outcome measurement, and management of trauma, special bleedings and interventions, including dental procedures, inhibitors, management of haemophilia carriers, and psychosocial aspects.
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Affiliation(s)
- Christoph Male
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
| | - Cihan Ay
- Abteilung für Hämatologie und Hämostaseologie, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Wien, Österreich
| | - Richard Crevenna
- Universitätsklinik für Physikalische Medizin, Rehabilitation und Arbeitsmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Sabine Eichinger
- Abteilung für Hämatologie und Hämostaseologie, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Wien, Österreich
| | - Clemens Feistritzer
- Abteilung für Innere Medizin V - Hämatologie und Onkologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Robert Füller
- Österreichische Hämophilie Gesellschaft, Wien, Österreich
| | - Alexander Haushofer
- Institut für Medizinische und Chemische Labordiagnostik, Klinikum Wels-Grieskirchen, Wels-Grieskirchen, Österreich
| | - Andreas Kurringer
- Abteilung für Kinder- und Jugendheilkunde, Landeskrankenhaus Bregenz, Bregenz, Österreich
| | - Peter Neumeister
- Klinische Abteilung für Hämatologie, Medizinische Universität Graz, Graz, Österreich
| | - Stephan Puchner
- Klinische Abteilung für Orthopädie, Universitätsklinik für Orthopädie und Unfallchirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Joachim Rettl
- Abteilung für Innere Medizin und Hämatologie und internistische Onkologie, Klinikum Klagenfurt, Klagenfurt, Österreich
| | - Thomas Schindl
- Österreichische Hämophilie Gesellschaft, Wien, Österreich
| | | | - Rudolf Schwarz
- Abteilung für Kinder- und Jugendheilkunde, Landesklinikum Amstetten, Universität Wien, Wien, Österreich
| | - Michael Sohm
- Universitätsklinik für Kinder- und Jugendheilkunde, Universitätsklinikum St. Pölten, St. Pölten, Österreich
| | - Werner Streif
- Department Kinder- und Jugendheilkunde, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Katharina Thom
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Barbara Wagner
- Universitätsklinik für Physikalische Medizin, Rehabilitation und Arbeitsmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Eva Wissmann
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Karl Zwiauer
- Universitätsklinik für Kinder- und Jugendheilkunde, Universitätsklinikum St. Pölten, St. Pölten, Österreich
| | - Ingrid Pabinger
- Abteilung für Hämatologie und Hämostaseologie, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Wien, Österreich
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Sayegh CS, Iverson E, MacDonell KK, Wu S, Belzer M. Youth perspectives on mobile health adherence interventions: A qualitative study guided by the supportive accountability model. PATIENT EDUCATION AND COUNSELING 2024; 119:108079. [PMID: 37995490 PMCID: PMC10842772 DOI: 10.1016/j.pec.2023.108079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/04/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE We applied a Supportive Accountability Model lens to understand how youth view remote human coaching versus automated reminders targeting medication adherence. METHODS We used thematic analysis to interpret (N = 22) youths' responses to semi-structured interviews after 12 weeks of mobile health intervention. RESULTS Participants reported that both coaching and automated reminders prompted them to take medication, improving their adherence. Participants found coaching helpful because they developed routines and strategies, were motivated to avoid disappointing their coach, and felt their coach cared for them. Automated support could be motivational for some but demanded less engagement. Participants described phone calls as disruptive to their daily lives, but conducive to developing a personal connection with their coach, whereas texts were easier and more flexible. Youth emphasized that individual preferences often differ. CONCLUSION Human coaching was viewed as a more potent, engaging adherence intervention than automated reminders, although individual needs and preferences differed. Phone calls may enhance the experience of supportive accountability for adherence, but also pose greater acceptability and usability barriers than texting. PRACTICE IMPLICATIONS Intervention developers should provide opportunities for youth to make personal connections with human adherence supporters and attend to youth preferences for communication modality.
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Affiliation(s)
- Caitlin S Sayegh
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA; Division of General Pediatrics, Children's Hospital Los Angeles, USA; Department of Pediatrics, University of Southern California Keck School of Medicine, USA.
| | - Ellen Iverson
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA; Department of Pediatrics, University of Southern California Keck School of Medicine, USA
| | - Karen K MacDonell
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, USA
| | - Shinyi Wu
- University of Southern California Dworak-Peck School of Social Work, USA; Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, USA
| | - Marvin Belzer
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA; Department of Pediatrics, University of Southern California Keck School of Medicine, USA
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Bray EA, George A, Everett B, Salamonson Y, Ramjan LM. Feasibility and Acceptability of a Codesigned Health Care Transition Intervention for Young People With Spinal Cord Injuries. Top Spinal Cord Inj Rehabil 2023; 29:89-97. [PMID: 38076288 PMCID: PMC10644856 DOI: 10.46292/sci22-00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Due in part to medical complications, adults with a pediatric onset spinal cord injury (SCI) are at higher risk of experiencing dissatisfaction with life and lower perceived physical health when compared to their peers with no disability. To support the prevention of medical complications, young people with SCI must successfully transition to adult health care. Health care transition (HCT) interventions can support young people with chronic conditions in their move to adult health care. Objectives To evaluate the feasibility and acceptability of a web-based HCT intervention codesigned with young people with SCI and parents/caregivers. Methods Semi-structured individual interviews were conducted online with young people with SCI and parents/caregivers who transitioned or were preparing for the transition from pediatric to adult health care. Interviews were also conducted with health care professionals. The interviews were analyzed using a hybrid deductive and inductive qualitative content analysis process. Feasibility and acceptability were measured using Bowen and colleagues' framework, which includes eight focus areas: acceptability, demand, implementation, practicality, adaption, integration, expansion, and limited efficacy. Results Overall, participants responded positively to the intervention and believed that it would be useful to young people with SCI and parents/caregivers. Two areas of Bowen et al.'s framework, implementation and integration, require further consideration in terms of how to embed the intervention into the current transition process. Conclusion This study found the HCT intervention to be an innovative approach to support young people with SCI and their parent/caregivers that demonstrates promise in the areas of feasibility and acceptability.
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Affiliation(s)
- Emily Alice Bray
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- Ingham Institute Applied Medical Research, Liverpool, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- Ingham Institute Applied Medical Research, Liverpool, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Lucie M. Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- Ingham Institute Applied Medical Research, Liverpool, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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Bray EA, Everett B, George A, Salamonson Y, Ramjan LM. Co-designed healthcare transition interventions for adolescents and young adults with chronic conditions: a scoping review. Disabil Rehabil 2022; 44:7610-7631. [PMID: 34595986 DOI: 10.1080/09638288.2021.1979667] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE To determine the scope of published literature on healthcare transition (HCT) interventions that have been co-designed with adolescents and young adults with chronic conditions, and to undertake feasibility assessments. METHODS Using Scopus, CINAHL, Medline-Ovid, Cochrane and PsycINFO databases, publications that included a HCT intervention to support paediatric to adult healthcare transition were included. Study location, design, population, description of the intervention, co-design methods, feasibility evidenced using Bowen and colleagues' framework, and outcome measures were extracted for review. RESULTS A total of 21 studies were included, relating to 17 co-designed HCT interventions that ranged across multiple medical specialties. There was no standard HCT intervention; characteristics, format and delivery mode varied. Only three studies reported a detailed description of the co-design method(s) used and none reported on the facilitators or barriers. Among the studies, five of Bowen and colleagues' eight dimensions of feasibility were measured. CONCLUSIONS Despite the co-design process being neither described or evaluated extensively, all co-designed HCT interventions included in this review were considered to be feasible. Nevertheless, HCT interventions varied in their format and delivery method making it difficult to compare between them. Furthermore, interventions were often condition-specific and not representative of the extensive range of chronic conditions.Implications for RehabilitationHealthcare transition interventions can improve adherence to care, health outcomes, ongoing rehabilitation, and quality of life of adolescents and young adults with chronic conditions.Healthcare transition interventions should maximise long-term functioning and prioritise rehabilitation aimed at enhancing independence and self-management skills, while reducing hospitalisations.The engagement of individuals with lived experience in the co-design of interventions has been strongly advocated as it brings unique knowledge and experience to the research process.Minimal attention has been given to the involvement of adolescents and young adults with chronic conditions in the development of healthcare transition interventions, however, healthcare transition interventions co-designed with adolescents and young adults with chronic conditions are both feasible and acceptable.
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Affiliation(s)
- Emily Alice Bray
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Lucie M Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
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Breakey VR, Gupta A, Johnston DL, Portwine C, Laverdiere C, May SL, Dick B, Hundert A, Nishat F, Killackey T, Nguyen C, Lalloo C, Stinson J. A Pilot Randomized Control Trial of Teens Taking Charge: A Web-based Self-management Program for Adolescents with Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:366-378. [PMID: 35759365 DOI: 10.1177/27527530211068778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: There is a lack of self-management tools for adolescents with cancer (AWC). This study evaluated the feasibility of Teens Taking Charge Cancer, a web-based self-management program. Methods: A pilot randomized control trial (RCT) was conducted across 4 pediatric oncology clinics. AWC (12-18 years) and their caregivers were randomized to either the intervention or control group. All were asked to complete 12 website modules over 12 weeks (at their own pace) and received monthly calls from health coaches. The intervention website was based on cognitive behavioral principals, designed as an interactive self-guided online program, while the control consisted of education and included links to 12 general cancer websites. Outcome assessments occurred at enrollment and 12 weeks post-intervention. The primary outcomes included rate of accrual and retention, adherence to the protocol, acceptability and satisfaction with intervention using questionnaire and semi-structured interviews, adverse events and engagement with the intervention. Results: Eighty-one teen-caregiver dyads were enrolled with a retention rate of 33%. In the intervention group 46% (n = 18) logged in at least once over the 12-week period. A mean of 2.4 of 12 modules (SD 3.0) were completed; and no one completed the program. Thirty-three percent of caregivers in the intervention logged into the website at least once and none completed the full program. Discussion: The results from this pilot study suggest that the current design of the Teens Taking Charge Cancer RCT lacks feasiblity. Future web-based interventions for this group should include additional features to promote uptake and engagement with the program.
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Affiliation(s)
| | - Abha Gupta
- 7315The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada
| | | | - Carol Portwine
- 103398McMaster Children's Hospital, Hamilton, ON, Canada
| | - Caroline Laverdiere
- Department of Pediatrics, 5622University of Montreal, Centre hospitalier universitaire Sainte-Justine (CHU Sainte-Justine), Montréal, QC, Canada
| | - Sylvie Le May
- Faculté des sciences infirmières, Université de Montréal, Montreal, QC, Canada
| | - Bruce Dick
- Department of Anesthesiology & Pain Medicine, Division of Pain and Medicine, 7979University of Alberta, Edmonton, AB, Canada
| | - Amos Hundert
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Fareha Nishat
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Tieghan Killackey
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Cynthia Nguyen
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Chitra Lalloo
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Jennifer Stinson
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Long JC, Best S, Nic Giolla Easpaig B, Hatem S, Fehlberg Z, Christodoulou J, Braithwaite J. Needs of people with rare diseases that can be supported by electronic resources: a scoping review. BMJ Open 2022; 12:e060394. [PMID: 36581982 PMCID: PMC9438091 DOI: 10.1136/bmjopen-2021-060394] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Rare diseases are characterised by low incidence, often with little evidence for effective treatments. Isolated patients and specialist centres for rare diseases are increasingly connected, thanks to the internet. This scoping review aimed to identify issues facing people with a rare disease that authors report may be addressed by electronic resources (mobile applications, websites, social media platforms, telehealth and online portals). DESIGN Scoping review guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. DATA SOURCES Medline, Embase and PsycInfo were searched, supplemented by hand searches of selected journals, in July 2021. ELIGIBILITY CRITERIA Peer-reviewed literature in English was searched using terms for rare disease (incidence <1:2000), electronic modalities (eg, mobile phone) and patient support terms. No date limit was set. Conference abstracts were included. DATA EXTRACTION AND SYNTHESIS Data extracted: rare disease/group of diseases, name of the e-resource, need identified in the patient cohort, features of the e-resource, any other findings or observations of interest. From this, a framework was developed synthesising features across diseases and resources. RESULTS Seventy-two papers were found (from 383). Fifty-six electronic resources were described in 64 papers, while 12 papers were exploratory studies. Cystic fibrosis (n=28) was the most frequently addressed, followed by haemophilia (n=16).Four domains and 23 subdomains of needs were extracted from the papers. The domains of needs were: support for self-management, access to high-quality information, access to appropriate specialist services, and social support. Subdomains are sometimes related to needs of individual rare diseases (eg, social isolation due to infection risk in people with cystic fibrosis). Fifteen electronic resources were identified that supported parents of children with rare disorders. CONCLUSIONS While it can be argued that rare diseases, per se, may be no less distressing or onerous to care for than a high prevalence disease, rare diseases have unique features: the lengthy odyssey to find a diagnosis, then appropriate specialists, the lack of evidence around effective treatments, guidelines or access to knowledgeable general health service providers. Designers of electronic resources are urged to consult key stakeholders to enhance the effectiveness and usability of resources for people with a rare disease.
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Affiliation(s)
- Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Stephanie Best
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Australian Genomics, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Bróna Nic Giolla Easpaig
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Sarah Hatem
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Zoe Fehlberg
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Australian Genomics Health Alliance, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Christodoulou
- Brain and Mitochondrial Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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8
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Doucet S, Splane J, Luke A, Asher KE, Breneol S, Pidduck J, Grant A, Dionne E, Scott C, Keeping‐Burke L, McIsaac J, Gorter JW, Curran J. Programmes to support paediatric to adult healthcare transitions for youth with complex care needs and their families: A scoping review. Child Care Health Dev 2022; 48:659-692. [PMID: 35170064 PMCID: PMC9543843 DOI: 10.1111/cch.12984] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/17/2022] [Accepted: 02/07/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND An increasing number of children have complex care needs (CCN) that impact their health and cause limitations in their lives. More of these youth are transitioning from paediatric to adult healthcare due to complex conditions being increasingly associated with survival into adulthood. Typically, the transition process is plagued by barriers, which can lead to adverse health consequences. There is an increased need for transitional care interventions when moving from paediatric to adult healthcare. To date, literature associated with this process for youth with CCN and their families has not been systematically examined. OBJECTIVES The objective of this scoping review is to map the range of programmes in the literature that support youth with CCN and their families as they transition from paediatric to adult healthcare. METHODS The review was conducted in accordance with the Joanna Briggs Institute's methodology for scoping reviews. A search, last run in April 2021, located published articles in PubMed, CINAHL, ERIC, PsycINFO and Social Work Abstracts databases. RESULTS The search yielded 1523 citations, of which 47 articles met the eligibility criteria. A summary of the article characteristics, programme characteristics and programme barriers and enablers is provided. Overall, articles reported on a variety of programmes that focused on supporting youth with various conditions, beginning in the early or late teenage years. Financial support and lack of training for care providers were the most common transition program barriers, whereas a dedicated transition coordinator, collaborative care, transition tools and interpersonal support were the most common enablers. The most common patient-level outcome reported was satisfaction. DISCUSSION This review consolidates available information about interventions designed to support youth with CCN transitioning from paediatric to adult healthcare. The results will help to inform further research, as well as transition policy and practice advancement.
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Affiliation(s)
- Shelley Doucet
- Centre for Research in Integrated CareUniversity of New BrunswickSaint JohnNew BrunswickCanada
| | - Jennifer Splane
- Centre for Research in Integrated CareUniversity of New BrunswickSaint JohnNew BrunswickCanada,Faculty of HealthDalhousie UniversityHalifaxNova ScotiaCanada
| | - Alison Luke
- Centre for Research in Integrated CareUniversity of New BrunswickSaint JohnNew BrunswickCanada
| | - Kathryn E. Asher
- Centre for Research in Integrated CareUniversity of New BrunswickSaint JohnNew BrunswickCanada
| | - Sydney Breneol
- School of NursingDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Amy Grant
- Nova Scotia Health AuthorityHalifaxNova ScotiaCanada
| | - Emilie Dionne
- St. Mary's Research Centre & Family MedicineMcGill UniversityMontrealQuebecCanada
| | | | - Lisa Keeping‐Burke
- Department of Nursing and Health SciencesUniversity of New BrunswickSaint JohnNew BrunswickCanada
| | - Jessie‐Lee McIsaac
- Faculty of Education and Department of Child and Youth StudyMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Jan Willem Gorter
- Pediatric Rehabilitation MedicineUniversity Medical Centre UtrechtUtrechtThe Netherlands,Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Janet Curran
- School of NursingDalhousie UniversityHalifaxNova ScotiaCanada
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9
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Pape L, Ernst G. Health care transition from pediatric to adult care: an evidence-based guideline. Eur J Pediatr 2022; 181:1951-1958. [PMID: 35084548 PMCID: PMC9056438 DOI: 10.1007/s00431-022-04385-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
For consistent quality of treatment of young people with chronic health care needs, a structured health care transition (HCT) from pediatric medicine to adult medical care is essential. Currently, most countries have no guidelines on HCT based on systematic evidence research. To close this gap, guidance to support HCT was developed in Germany. Twenty-two experts in the management of adolescents and young adults with different chronic conditions and three patient representatives were invited to take part in the guideline group. Based on a systematic literature search recommendations for HCT were drafted. Where evidence was lacking, recommendations were developed using collective expert consensus. The consensus process was independently moderated using a Delphi approach. The final draft was reviewed and endorsed by all major German medical societies. The clinical recommendations provide guidance for all chronic somatic diseases. After assessment of HCT readiness, an individualized plan for HCT should be drawn up. Key elements here are a responsible coordinator, age-adapted patient education, involvement of caregivers, web-based interventions, joint visits, and a structured summary for the receiving physician. The aim is the gradual transfer of responsibility for disease management to the young person themselves. Conclusion: As only a few randomized controlled studies on HCT are available, evidence-based statements are possible for some but not all areas of HCT. However, this guideline may help to develop globally accepted standards. These standards should be established and implemented. The aim should be a reimbursement by individual national health systems to allow appropriate support for young people. What is Known: • Health care transition from pediatric to adult care is primarily organized in local settings, partly based on disease-specific guidelines. •There have been no national guidelines in Germany until now. What is New: • Here we present the general evidence-based guidelines of the German Association of Scientific Medical Societies for health care transition. • These might serve as a blueprint for further national or international health care transition guidelines.
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Affiliation(s)
- Lars Pape
- Society for Transition Medicine, Hannover, Germany
- Children’s Clinic II, Essen University Hospital, Univ. of Duisburg-Essen, Essen, Germany
| | - Gundula Ernst
- Society for Transition Medicine, Hannover, Germany
- Research and Teaching Unit Medical Psychology, Hannover Medical School, Hannover, Germany
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Digital Technologies for Children and Parents Sharing Self-Management in Childhood Chronic or Long-Term Conditions: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121203. [PMID: 34943399 PMCID: PMC8700031 DOI: 10.3390/children8121203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 12/09/2021] [Indexed: 01/20/2023]
Abstract
Worldwide, the prevalence of chronic (or long-term) conditions in children and young people from birth to 18 years (children) is increasing. Promoting competent and effective self-management skills early in the trajectory is important to improve adherence to treatment and optimise quality of life. Successful self-management, therefore, requires parents and children who are developmentally able to develop a range of complex skills, including the use of digital technologies. This scoping review aimed to identify primary research investigating digital technologies for children and parents sharing self-management in childhood chronic illnesses. A comprehensive search of electronic databases was conducted. Nineteen papers were included, assessed for quality and methodological rigour using the Hawker tool and thematically analysed. Three themes were identified: (i) the feasibility and acceptability of using technology, (ii) the usability of technologies and (iii) the effect of technologies on adherence and self-management skills. The results indicate that technologies such as mobile apps and websites can assist the management of long-term conditions, are an acceptable method of delivering information and can promote the development of effective self-management skills by parents and children. However, future technology design must include children and parents in all stages of development.
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Newton AS, March S, Gehring ND, Rowe AK, Radomski AD. Establishing a Working Definition of User Experience for eHealth Interventions of Self-reported User Experience Measures With eHealth Researchers and Adolescents: Scoping Review. J Med Internet Res 2021; 23:e25012. [PMID: 34860671 PMCID: PMC8686463 DOI: 10.2196/25012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/27/2021] [Accepted: 09/23/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Across eHealth intervention studies involving children, adolescents, and their parents, researchers have measured user experience to assist with intervention development, refinement, and evaluation. To date, no widely accepted definitions or measures of user experience exist to support a standardized approach for evaluation and comparison within or across interventions. OBJECTIVE We conduct a scoping review with subsequent Delphi consultation to identify how user experience is defined and measured in eHealth research studies, characterize the measurement tools used, and establish working definitions for domains of user experience that could be used in future eHealth evaluations. METHODS We systematically searched electronic databases for published and gray literature available from January 1, 2005, to April 11, 2019. We included studies assessing an eHealth intervention that targeted any health condition and was designed for use by children, adolescents, and their parents. eHealth interventions needed to be web-, computer-, or mobile-based, mediated by the internet with some degree of interactivity. We required studies to report the measurement of user experience as first-person experiences, involving cognitive and behavioral factors reported by intervention users. We appraised the quality of user experience measures in included studies using published criteria: well-established, approaching well-established, promising, or not yet established. We conducted a descriptive analysis of how user experience was defined and measured in each study. Review findings subsequently informed the survey questions used in the Delphi consultations with eHealth researchers and adolescent users for how user experience should be defined and measured. RESULTS Of the 8634 articles screened for eligibility, 129 articles and 1 erratum were included in the review. A total of 30 eHealth researchers and 27 adolescents participated in the Delphi consultations. On the basis of the literature and consultations, we proposed working definitions for 6 main user experience domains: acceptability, satisfaction, credibility, usability, user-reported adherence, and perceived impact. Although most studies incorporated a study-specific measure, we identified 10 well-established measures to quantify 5 of the 6 domains of user experience (all except for self-reported adherence). Our adolescent and researcher participants ranked perceived impact as one of the most important domains of user experience and usability as one of the least important domains. Rankings between adolescents and researchers diverged for other domains. CONCLUSIONS Findings highlight the various ways in which user experience has been defined and measured across studies and what aspects are most valued by researchers and adolescent users. We propose incorporating the working definitions and available measures of user experience to support consistent evaluation and reporting of outcomes across studies. Future studies can refine the definitions and measurement of user experience, explore how user experience relates to other eHealth outcomes, and inform the design and use of human-centered eHealth interventions.
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Affiliation(s)
- Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Sonja March
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Nicole D Gehring
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Arlen K Rowe
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Ashley D Radomski
- Knowledge Institute for Child and Youth Mental Health and Addictions, Ottawa, ON, Canada.,CHEO (Children's Hospital of Eastern Ontario) Research Institute, Ottawa, ON, Canada
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Brondi S, Palareti L, Mazzetti G. Comprehensive care for haemophilia: A literature review for improving institutional cooperation. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2021. [DOI: 10.1080/20479700.2019.1652415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sonia Brondi
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna Bologna, Italy
| | - Laura Palareti
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna Bologna, Italy
| | - Greta Mazzetti
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna Bologna, Italy
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Ravens E, Becker J, Pape L, Ernst G. Psychosocial benefit and adherence of adolescents with chronic diseases participating in transition programs: a systematic review. JOURNAL OF TRANSITION MEDICINE 2020. [DOI: 10.1515/jtm-2020-0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AbstractChronically ill young people must transition to the adult health care service after their 18th birthday. The transition from child centred paediatric care to the adult health care service is not simply limited to the change from familiar structures to something unknown, but includes the entire process of growing up, of individuals becoming independent from their parents and taking responsibility for their own disease management. Young people are at particular risk of losing the connection to medical care during this phase and the transition of young people with chronic conditions is associated with a high risk of declining adherence and worsening health status. Studies suggest that transition programs might be helpful, yet there is no evidence as to whether risks can be reduced or which intervention components are particularly conducive to better outcome. This study aimed to identify transition-specific interventions and evaluate their effect on the improvement of psychosocial parameters, such as health related quality of life and adherence of patients. A systematic literature review was conducted. Electronic databases (Cochrane, Embase, Pubmed, Web of Science) were searched by two independent reviewers for intervention studies aiming to improve transition. Grey literature was also searched. Studies were included if they evaluated transition-specific interventions aiming to improve psychosocial or adherence parameters of participants aged 12 years and older suffering from a chronic condition. Both controlled trials and studies with measurements before an after the intervention were included. The GRADE approach was used to assess the quality of evidence. The inclusion criteria was met by forty studies. Patients suffered from different chronic conditions, such as inflammatory bowel disease, type 1 diabetes or juvenile idiopathic arthritis. Transition interventions used several program components, such as transition coordinators, patient education programs or web-based interventions. Outcomes included quality of life, transition-specific knowledge, adherence and loss to follow up. Thirty-eight studies showed beneficial effects in the intervention group, respectively after intervention. The overall study quality was low. A large number of studies evaluating transition-specific interventions was included. Transition-specific interventions seem to have beneficial effects on psychosocial outcomes and adherence. The promotion of health literacy, appointment arrangement service and the use of technical elements (websites, SMS) seem to be particularly helpful in the transition process. As the patient population was diverse, the results can be transferred to other diseases. Even though the overall study quality was poor, it is possible to draw some conclusions. Future studies should aim to include large numbers of patients over extended periods of time in order to assess long-term outcomes.
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Affiliation(s)
- Esther Ravens
- Institute of Medical Psychology, Hannover Medical School, Hannover, Germany
- Departement of Paediatric Nephrology, Hannover Medical School, Hannover, Germany
| | - Johanna Becker
- Institute of Medical Psychology, Hannover Medical School, Hannover, Germany
- Departement of Paediatric Nephrology, Hannover Medical School, Hannover, Germany
| | - Lars Pape
- Departement of Paediatric Nephrology, Hannover Medical School, Hannover, Germany
| | - Gundula Ernst
- Institute of Medical Psychology, Hannover Medical School, Hannover, Germany
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Palareti L, Melotti G, Cassis F, Nevitt SJ, Iorio A. Psychological interventions for people with hemophilia. Cochrane Database Syst Rev 2020; 3:CD010215. [PMID: 32187661 PMCID: PMC7080553 DOI: 10.1002/14651858.cd010215.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Managing hemophilia is challenging both in terms of medical treatment and its broad impact on many aspects of the individual's life, including self-perception. Several psychosocial issues are potentially relevant in the clinical management of hemophilia, including it being a chronic and incurable condition; e.g. people with hemophilia must adapt to optimally interact with peers and to practice sports - even choosing a sport represents an issue for perceived limitations, expectations and cultural influences on the individual and their family. People with hemophilia can react by denying their condition and its manifestations and not adhering to treatment. Due to the complexity of relationships surrounding genetic diseases, parents and relatives may have their own issues that contribute to making life easier or more difficult for the person with hemophilia. Anxiety, sadness and depression resulting in mental health disorders are reported in this population and may influence quality of life (QoL) depending on cultural background, religious beliefs, family support and other variables. OBJECTIVES Primarily to assess the effectiveness of psychological therapies for improving the ability of people with hemophilia to cope with their chronic condition. SEARCH METHODS We aimed to identify trials from the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, Embase and PsycINFO, CINAHL, MEDLINE and trial registries. We searched reference lists of included publications. Most recent search of the Group's register: 13 June 2019. SELECTION CRITERIA Randomized controlled trials (RCTs) and quasi-RCTs in people with hemophilia of any age or gender, type A or B, any severity, with or without inhibitors, with or without HIV or hepatitis C virus. All psychological interventions for promoting emotional, intellectual and spiritual wellness. Individual, group or family group therapy interventions were eligible. DATA COLLECTION AND ANALYSIS We independently assessed trials, extracted data and assessed the risk of bias and assessed the quality of the evidence using GRADE. MAIN RESULTS Seven trials were included (362 participants randomized, data from 264 participants available for analysis); six of parallel design and one a partial cross-over design. One multicenter trial was conducted in Canada; the remaining six were single centre undertaken in the UK, USA, Iran and in the Netherlands. All trials had a high risk of bias for participant blinding and use of patient-reported outcomes. Evidence was retrieved on four interventions: psycho-education (DVD plus information booklet versus information booklet alone; computerised learning versus no intervention); cognitive therapy (auto-hypnosis (self-hypnosis) versus control); and behavioural therapy (relaxation (progressive or self control) versus no treatment). We also aimed to assess psychodynamic therapy and systemic therapy, but no trials were identified. Heterogeneity of the outcome measures and measurements precluded meta-analyses. No trial reported the cost of the psychological intervention and family adjustment. DVD plus information booklet compared to information booklet alone One trial (108 participants) showed coping strategies may lower pre-contemplation scores and negative thoughts, mean difference (MD) -0.24 (95%CI -0.48 - 0.00, low-certainty evidence), however, other measures of coping strategies in the same trial suggest little or no difference between groups, e.g. contemplation, MD (-0.09, 95%CI -0.32 - 0.14, low-certainty evidence). The same trial measured QoL and showed little or no difference between treatment groups for the physical domain, MD 0.59 (95% CI -3.66 to 4.84, low-certainty evidence), but may improve scores in the mental health domain for those receiving the booklet plus DVD compared to booklet alone, MD (4.70, 95% CI 0.33 to 9.07, low-certainty evidence). Mood or personal well-being were not reported. Computerised learning compared to no intervention Two trials (57 participants) reported on interventions aimed at children and adolescents and their impact on promoting a sense of self-efficacy (primary outcome 'Mood and personal well-being'), but only one showed an increase, MD 7.46 (95%CI 3.21 to 11.71, 17 participants, very low-certainty evidence); the second did not report control group data. One trial (30 participants) showed the intervention did not improve self-efficacy in adults, but appropriate data could not be extracted. Two trials (47 participants) reported coping strategies; one only reported within-group differences from baseline, the second showed an increase from baseline in coping strategies in the Internet program group compared to the no intervention group (disease-specific knowledge, MD 2.45 (95% CI 0.89 to 4.01); self-management ability and transition readiness, MD 19.90 (95% CI 3.61 to 36.19; low-certainty evidence). One trial reported QoL but with insufficient information to calculate changes from baseline; no difference in post-treatment scores was seen between groups, MD -8.65, 95% CI -18.30 to 1.00, very low-certainty evidence). Auto-hypnosis (self-hypnosis) compared to control There were two older trials that reported on this intervention (50 participants) focusing mainly on the secondary outcome 'physical health'; only one trial reported the primary outcome 'mood and personal well-being' (only within-group differences in the treatment group). Coping strategies and QoL were not assessed in the trials. Relaxation (progressive or self control) compared to no treatment Only one trial (seven participants) from 1985, was included which focused on 'physical health' and did not report on any of our primary outcomes. AUTHORS' CONCLUSIONS Not all of the seven included trials analysed the effects of the interventions on our primary outcomes (mood and personal well-being, coping strategies and QoL). Three trials were conducted in the 1970s and 1980s using techniques of auto-hypnosis or relaxation and, in accordance with the needs and therapeutic possibilities of the time, they focused on secondary outcomes, e.g. frequency of bleeding (physical health) and adherence to the intervention. The four newer trials assessed psycho-educational interventions all mediated by the use of technologies (DVD or computer) and often created according to age needs of the target group. In these cases, attention was shifted to our pre-defined primary outcomes. This review has identified low- and very low-certainty evidence, prompting caution in its interpretation. The major problem we encountered was the heterogeneity of trial designs, of interventions and of outcome measures used across the trials. We strongly suggest that researchers consider developing a core outcome set to streamline future research; randomization was proven to be safe and acceptable, and blinding should be considered for those assessing patient-reported outcomes.
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Affiliation(s)
- Laura Palareti
- University of BolognaDepartment of Education Studies “G.M. Bertin”Via Filippo Re, 6BolognaItaly40126
| | - Giannino Melotti
- University of BolognaDepartment of Education Studies “G.M. Bertin”Via Filippo Re, 6BolognaItaly40126
| | - Frederica Cassis
- FMUSPHemophilia Centre of Hospital Das ClinicasUmburanas street 307San PabloSao PauloBrazil05464000
| | - Sarah J Nevitt
- University of LiverpoolDepartment of BiostatisticsBlock F, Waterhouse Building1‐5 Brownlow HillLiverpoolUKL69 3GL
| | - Alfonso Iorio
- McMaster UniversityDepartment of Health Research Methods, Evidence and Impact (HEI)1280 Main Street WestCRL ‐ 140HamiltonONCanadaL8S 4K1
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15
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Tornivuori A, Tuominen O, Salanterä S, Kosola S. A systematic review on randomized controlled trials: Coaching elements of digital services to support chronically ill adolescents during transition of care. J Adv Nurs 2020; 76:1293-1306. [PMID: 32030792 DOI: 10.1111/jan.14323] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 12/20/2019] [Accepted: 01/30/2020] [Indexed: 12/14/2022]
Abstract
AIMS To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. DESIGN Systematic review without meta-analysis. DATA SOURCES MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. REVIEW METHODS Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. CONCLUSION E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. IMPACT Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.
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Affiliation(s)
- Anna Tornivuori
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Outi Tuominen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Sanna Salanterä
- Department of Nursing science, University of Turku, Turku University Hospital , Turku, Finland
| | - Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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16
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Low JK, Manias E. Use of Technology-Based Tools to Support Adolescents and Young Adults With Chronic Disease: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2019; 7:e12042. [PMID: 31322129 PMCID: PMC6670279 DOI: 10.2196/12042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 04/30/2019] [Accepted: 06/10/2019] [Indexed: 01/15/2023] Open
Abstract
Background With the large amount of material that is readily available on the internet, there are endless opportunities for electronic health–literate patients to obtain and learn new information. Although novel, a Web- or mobile-based program can be a powerful way to engage adolescents and young adults (AYAs). The ongoing engagement of AYAs with chronic disease is vital not only to empower them but also to ensure a smooth transition from pediatric to adult health care. Objective This study aimed to evaluate the current evidence on Web- or mobile-based interventions designed for AYAs. Methods This review was registered with PROSPERO: CRD42018096487. A systematic search of MEDLINE Complete, EMBASE, and CINAHL Complete was conducted on April 10, 2019, for studies that examined the perspectives of transition-age patients about technology-based interventions, the process involved in intervention development, or the evaluation of intervention efficacy. For each study, the comprehensiveness of reporting was appraised. The Downs and Black checklist was used for intervention efficacy trials, the Standards for Reporting Qualitative Research checklist was used for qualitative work, and a 16-item tool developed by Tong et al was used for questionnaire research. Results The search uncovered 29 relevant studies, which included qualitative studies (n=14), intervention efficacy studies (n=7), questionnaire studies (n=4), mixed qualitative and questionnaire studies (n=2), and a mixed qualitative and pilot randomized controlled trial study (n=1). The reporting comprehensiveness score of questionnaires was rated considerably lower (n=6, 13%-57% [2/16-8/14]) than the scores of intervention efficacy trials (n=8, 48%-85% [13/27-23/27]) and qualitative research (n=17, 40%-93% [8.5/21-19.5/21]). AYAs were receptive to obtaining information via a website or mobile app. An intervention was more likely to be perceived as useful by AYAs when there was a concerted effort to involve AYAs and subject matter experts in the process of intervention design, as opposed to relying solely on the AYAs or the experts alone. The preferred medium of intervention delivery varied greatly for AYAs, ranging from static text to audiovisual materials. However, AYAs considered being concise was the most important aspect. Across different conditions, AYAs were interested in receiving information on diverse topics, such as anxiety and stress management, dealing with insurance, and having social relationships. Patients also requested for disease-specific information, such as weather forecasts and pollen levels for patients with asthma and information related to the pretransplant period for organ transplant recipients. Meta-analyses showed no significant group differences across time on quality of life, self-efficacy, and self-management. Conclusions Owing to the lack of intervention efficacy trials, no conclusion can be drawn if an intervention delivered via a mobile app is better than that delivered via a website. However, through this systematic review, it is confirmed that AYAs were receptive to receiving medical information electronically.
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Affiliation(s)
- Jac Kee Low
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Burwood, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Burwood, Australia
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17
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Qian W, Lam TTN, Lam HHW, Li CK, Cheung YT. Telehealth Interventions for Improving Self-Management in Patients With Hemophilia: Scoping Review of Clinical Studies. J Med Internet Res 2019; 21:e12340. [PMID: 31293241 PMCID: PMC6652120 DOI: 10.2196/12340] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/14/2019] [Accepted: 06/03/2019] [Indexed: 01/19/2023] Open
Abstract
Background The introduction of home therapy for hemophilia has empowered patients and their families to manage the disease more independently. However, self-management of hemophilia is demanding and complex. The uses of innovative interventions delivered by telehealth routes such as social media and Web-based and mobile apps, may help monitor bleeding events and promote the appropriate use of clotting factors among patients with hemophilia. Objective This scoping review aims to summarize the literature evaluating the effectiveness of telehealth interventions for improving health outcomes in patients with hemophilia and provides direction for future research. Methods A search was conducted in Ovid MEDLINE, EMBASE, and PubMed databases for studies that (1) focused on patients with hemophilia A or B; (2) tested the use of remote telehealth interventions via the internet, wireless, satellite, telephone, and mobile phone media on patients and caregivers; and (3) reported on at least one of the following patient-/caregiver-focused outcomes related to empowering patients/caregivers to be active decision makers in the emotional, social, and medical management of the illness: quality of life, monitoring of bleeding episodes, joint damage or other measures of functional status, medication adherence, and patients’ knowledge. Implementation outcomes (user metrics, cost saving, and accuracy of electronic records) were also evaluated. Reviews, commentaries, and case reports comprising ≤10 cases were excluded. Results Sixteen articles fulfilled the inclusion criteria. The majority of the interventions (10/16, 62%) evaluated both implementation outcomes and patient-/caregiver-focused outcomes. User performance and accuracy and comprehensiveness of electronic records were also measured in most studies (4/16, 87%). The components of the interventions were rather homogenous and typically involved electronic logging and reminders for prophylactic infusions, reporting of spontaneous and traumatic bleeding events, monitoring of infusion product usage and home inventory, and real-time communication with health care professionals and hemophilia clinics. Telemedicine-supported education and information interventions seemed to be particularly effective among adolescent and young adult patients. Although the patients reported improvements in their health-related quality of life and perception of illness, telemonitoring devices did not appear to have a significant effect on quantifiable health outcomes such as joint health. Longitudinal studies seemed to suggest that the response and adherence rates to recording decreased over time. Conclusions Preliminary evidence from this review suggests that telehealth-delivered interventions could feasibly improve patients’ adherence to medication use and promote independence in disease management. Given the complexity and resources involved in developing a mature and established system, support from a dedicated network of hemophilia specialists and data managers will be required to maintain the technology, improve adherence to prophylactic treatment and recording, and validate the electronic data locally.
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Affiliation(s)
- Wenji Qian
- School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China, Shanghai, China
| | - Teddy Tai-Ning Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | | | - Chi-Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Paediatric Haematology & Oncology, Hong Kong Children's Hospital, Hong Kong, China (Hong Kong)
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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18
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Reen GK, Muirhead L, Langdon DW. Usability of Health Information Websites Designed for Adolescents: Systematic Review, Neurodevelopmental Model, and Design Brief. J Med Internet Res 2019; 21:e11584. [PMID: 31012856 PMCID: PMC6658246 DOI: 10.2196/11584] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/12/2018] [Accepted: 02/11/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Adolescence is a unique developmental period characterized by biological, social, and cognitive changes, as well as an interest in managing one's own health care. Many adolescents use the internet to seek health care information. However, young people face barriers before they can understand and apply the health information that they access on the web. It is essential that usability of adolescent health websites on the internet is improved to help adolescents overcome these barriers and allow them to engage successfully with web-based health care content. OBJECTIVE The aim of this review was to synthesize the usability of specific health information websites. These findings were mapped onto the adolescent neurodevelopmental profile, and a design brief based on the findings was developed to tailor future websites for specific adolescent requirements. METHODS A systematic search conducted using PubMed, PsycINFO, and Education Resources Information Center (ERIC) identified 25 studies that assessed the usability of health information websites. Adolescent feedback was collected by a mixture of surveys, focus groups, interviews, and think-aloud procedures. RESULTS A majority of the information websites were developed for specific health issues that may be relevant to adolescents. The most preferred website features were interactive content such as games and quizzes, as well as videos, images, audio clips, and animations. Participants also preferred communicating with other adolescents with similar conditions or learning about their experience through real stories and testimonials. Adolescents found it difficult to use health information websites if they contained too much text, were too cluttered, or had features that made it difficult to access. The findings are considered in the context of adolescent social processes, low tolerance of delayed gratification, and attraction to novelty and mapped onto a neurodevelopmental model of adolescence. CONCLUSIONS Young people's feedback can determine usability and content that make a health information website easy or informative to use. Neurodevelopmental profiles and the users' specific preferences and skills should be addressed in future development of health information websites for adolescents.
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Affiliation(s)
- Gurpreet Kaur Reen
- Royal Holloway, University of London, Egham, United Kingdom.,University of Oxford, Oxford, United Kingdom
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19
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Sun HL, Breakey VR, Straatman L, Wu JK, Jackson S. Outcomes indicators and processes in transitional care in adolescents with haemophilia: A Delphi survey of Canadian haemophilia care providers. Haemophilia 2019; 25:296-305. [PMID: 30817086 DOI: 10.1111/hae.13699] [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: 12/19/2017] [Revised: 03/19/2018] [Accepted: 01/21/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION It is unclear which outcome indicators should be used to measure the success of haemophilia transition programs, and what are key elements of a haemophilia transition program to ensure success. AIM To establish by expert consensus a list of important and feasible outcome indicators of successful haemophilia transition, and a list of key elements of transition planning. METHODS A modified two-stage Delphi survey was developed and disseminated among a panel of Canadian interdisciplinary haemophilia care providers. Participants were asked to rate the importance and feasibility of outcome indicators of effective haemophilia transition and elements of haemophilia transition program. In the second round, participants were asked to choose the top five outcomes suitable for inclusion in a core outcome set of transition effectiveness, and the top five elements that are important and feasible for implementation within the next 5 years. RESULTS In total, 34/73 (47%) of participants completed the first round and 33 completed the second round, representing a variety of disciplines. Top outcome indicators recommended for a core outcome set include measurement of adherence, change in bleeding rate, self-efficacy skills, haemophilia knowledge, patient and caregiver satisfaction, time gap between last paediatric and first adult clinic, and number of emergency room or hospital admissions. Fourteen elements of transition achieved consensus in importance ratings, while eight were felt to be feasible for implementation within next 5 years. CONCLUSIONS Results will contribute towards the development of a haemophilia transition outcome instrument and provide guidance for future studies of the effectiveness of transition programs.
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Affiliation(s)
- Haowei Linda Sun
- Division of Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Vicky R Breakey
- Division of Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Lynn Straatman
- Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John K Wu
- Division of Hematology, Oncology and Bone Marrow Transplant, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon Jackson
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Lee Mortensen G, Strand AM, Almén L. Adherence to prophylactic haemophilic treatment in young patients transitioning to adult care: A qualitative review. Haemophilia 2019; 24:862-872. [PMID: 30485633 DOI: 10.1111/hae.13621] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 09/23/2018] [Indexed: 02/06/2023]
Abstract
Recombinant prophylactic treatment (PTX) has greatly improved morbidity, mortality and health-related quality of life (HRQoL) in patients with severe haemophilia. Yet, treatment adherence appears suboptimal in adolescents and young adults with haemophilia (YWH). Young patients experience major biopsychosocial changes challenging their adherence through the transition from parental to self-care, from paediatric to adult care. In clinical practice, a systematic approach to transition is rarely used and there is little evidence on best practices. This qualitative review was based on a systematic literature search including quantitative as well as qualitative research reports to examine all relevant factors influencing adherence to PTX in YWH. We aimed to gain comprehensive insight into main drivers and barriers to adherence by exploring them in the context of YWH's disease perceptions, characteristics, HRQoL and needs. The outcome is an overview of the latest published recommendations to support treatment adherence in YWH during the transition from family-oriented care to self-care and from paediatric to adult care. The literature suggests that adherence to PTX is best supported when individual patient needs and preferences are taken into consideration when planning treatment. Preserving normality is a main priority in young patients making it crucial to support patients from early childhood in considering PTX as enabling rather than hindering a normal social and physically active life. Education in self-management should include psychosocial support of patients as well as caregivers. This requires systematic transition planning including milestone assessments and ongoing multidisciplinary support until full self-management is secured.
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Resseguier N, Rosso-Delsemme N, Beltran Anzola A, Baumstarck K, Milien V, Ardillon L, Bayart S, Berger C, Bertrand MA, Biron-Andreani C, Borel-Derlon A, Castet S, Chamouni P, Claeyssens Donadel S, De Raucourt E, Desprez D, Falaise C, Frotscher B, Gay V, Goudemand J, Gruel Y, Guillet B, Harroche A, Hassoun A, Huguenin Y, Lambert T, Lebreton A, Lienhart A, Martin M, Meunier S, Monpoux F, Mourey G, Negrier C, Nguyen P, Nyombe P, Oudot C, Pan-Petesch B, Polack B, Rafowicz A, Rauch A, Rivaud D, Schneider P, Spiegel A, Stoven C, Tardy B, Trossaërt M, Valentin JB, Vanderbecken S, Volot F, Voyer-Ebrard A, Wibaut B, Leroy T, Sannie T, Chambost H, Auquier P. Determinants of adherence and consequences of the transition from adolescence to adulthood among young people with severe haemophilia (TRANSHEMO): study protocol for a multicentric French national observational cross-sectional study. BMJ Open 2018; 8:e022409. [PMID: 30049701 PMCID: PMC6067371 DOI: 10.1136/bmjopen-2018-022409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/08/2018] [Accepted: 06/14/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Severe haemophilia is a rare disease characterised by spontaneous bleeding from early childhood, which may lead to various complications, especially in joints. It is nowadays possible to avoid these complications thanks to substitutive therapies for which the issue of adherence is major. The transition from adolescence to adulthood in young people with severe haemophilia is a critical period as it is associated with a high risk of lack of adherence to healthcare, which might have serious consequences on daily activities and on quality of life. METHODS AND ANALYSIS We present the protocol for a cross-sectional, observational, multicentric study to assess the differences between adolescents and young adults with severe haemophilia in France through the transition process, especially on adherence to healthcare. This study is based on a mixed methods design, with two complementary and consecutive phases, comparing data from a group of adolescents (aged 14-17 years) with those from a group of young adults (aged 20-29 years). The quantitative phase focuses on the determinants (medical, organisational, sociodemographic and social and psychosocial and behavioural factors) of adherence to healthcare (considered as a marker of the success of transition). The qualitative phase explores participants' views in more depth to explain and refine the results from the quantitative phase. Eligible patients are contacted by the various Haemophilia Treatment Centres participating in the French national registry FranceCoag. ETHICS AND DISSEMINATION The study was approved by the French Ethics Committee and by the French National Agency for Medicines and Health Products Safety (number: 2016-A01034-47). Study findings will be disseminated to the scientific and medical community in peer-reviewed journals and presented at scientific meetings. Results will be popularised to be communicated via the French association for people with haemophilia to participants and to the general public. TRIAL REGISTRATION NUMBER NCT02866526; Pre-results.
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Affiliation(s)
| | - Natacha Rosso-Delsemme
- LPCPP, Aix Marseille Unviersity, Aix-en-Provence, France
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
| | | | - Karine Baumstarck
- CERESS, Aix Marseille University, Marseille, France
- FranceCoag Network, Marseille, France
| | - Vanessa Milien
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
- FranceCoag Network, Marseille, France
| | - Laurent Ardillon
- Haemophilia Treatment Centre, University Hospital of Tours, Tours, France
| | - Sophie Bayart
- Haemophilia Treatment Centre, University Hospital of Rennes, Rennes, France
| | - Claire Berger
- Haemophilia Treatment Centre, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Marie-Anne Bertrand
- Haemophilia Treatment Centre, University Hospital of Besançon, Besançon, France
| | | | | | - Sabine Castet
- Haemophilia Treatment Centre, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre Chamouni
- Haemophilia Treatment Centre, University Hospital of Rouen, Rouen, France
| | | | | | - Dominique Desprez
- Haemophilia Treatment Centre, University Regional Hospital of Strasbourg, Strasbourg, France
| | - Céline Falaise
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
| | - Birgit Frotscher
- Haemophilia Treatment Centre, University Hospital of Nancy, Nancy, France
| | - Valérie Gay
- Haemophilia Treatment Centre, Hospital of Chambery, Chambery, France
| | - Jenny Goudemand
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Yves Gruel
- Haemophilia Treatment Centre, University Hospital of Tours, Tours, France
| | - Benoît Guillet
- Haemophilia Treatment Centre, University Hospital of Rennes, Rennes, France
| | - Annie Harroche
- Haemophilia Treatment Centre, Hospital Necker, Assistance Publique—Hopitaux de Paris, Paris, France
| | - Abel Hassoun
- Haemophilia Treatment Centre, Hospital of Simone Veil d’Eaubonne, Montmorency, France
| | - Yoann Huguenin
- Haemophilia Treatment Centre, University Hospital of Bordeaux, Bordeaux, France
| | - Thierry Lambert
- Haemophilia Treatment Centre, Hospital Bicêtre, Assistance Publique—Hopitaux de Paris, Paris, France
| | - Aurélien Lebreton
- Haemophilia Treatment Centre, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Anne Lienhart
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Lyon, France
| | - Michèle Martin
- Haemophilia Treatment Centre, University Hospital of Nancy, Nancy, France
| | - Sandrine Meunier
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Lyon, France
| | - Fabrice Monpoux
- Haemophilia Treatment Centre, University Hospital of Nice, Nice, France
| | - Guillaume Mourey
- Haemophilia Treatment Centre, University Hospital of Besançon, Besançon, France
| | - Claude Negrier
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Lyon, France
| | - Philippe Nguyen
- Haemophilia Treatment Centre, University Hospital of Reims, Reims, France
| | - Placide Nyombe
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Caroline Oudot
- Haemophilia Treatment Centre, University Hospital of Limoges, Limoges, France
| | | | - Benoît Polack
- Haemophilia Treatment Centre, University Hospital of Grenoble, Grenoble, France
| | - Anne Rafowicz
- Haemophilia Treatment Centre, Hospital of Versailles, Versailles, France
- Haemophilia Treatment Centre, Hospital Bicêtre, Assistance Publique—Hopitaux de Paris, Paris, France
| | - Antoine Rauch
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Delphine Rivaud
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Pascale Schneider
- Haemophilia Treatment Centre, University Hospital of Rouen, Rouen, France
| | - Alexandra Spiegel
- Haemophilia Treatment Centre, University Regional Hospital of Strasbourg, Strasbourg, France
| | - Cecile Stoven
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Brigitte Tardy
- Haemophilia Treatment Centre, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Marc Trossaërt
- Haemophilia Treatment Centre, University Hospital of Nantes, Nantes, France
| | | | - Stéphane Vanderbecken
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Fabienne Volot
- Haemophilia Treatment Centre, University Hospital of Dijon, Dijon, France
| | | | - Bénédicte Wibaut
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Tanguy Leroy
- CERESS, Aix Marseille University, Marseille, France
- Social Psychology Research Group (GRePS EA 4163), Lumière Lyon 2 University, Lyon, France
| | - Thomas Sannie
- French Patients' Association for People with Haemophilia (AFH), Paris, France
| | - Hervé Chambost
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
- FranceCoag Network, Marseille, France
| | - Pascal Auquier
- CERESS, Aix Marseille University, Marseille, France
- FranceCoag Network, Marseille, France
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Breakey VR, Bouskill V, Nguyen C, Luca S, Stinson JN, Ahola Kohut S. Online Peer-to-Peer Mentoring Support for Youth with Hemophilia: Qualitative Needs Assessment. JMIR Pediatr Parent 2018; 1:e10958. [PMID: 31518296 PMCID: PMC6715049 DOI: 10.2196/10958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To support adolescents through transition from pediatrics to adult care, health care providers and families help teens gain knowledge and develop self-management skills. Peer mentoring can provide meaningful support and has been associated with improved health outcomes in patients with other chronic conditions. Peer mentoring is an appealing way to provide support, but it is imperative to consider the unique needs of adolescents to ensure its success. OBJECTIVE The objective of our study was to identify the peer mentoring wants and needs of youth with hemophilia in order to guide the development of a new program. METHODS In this qualitative study, we interviewed a convenience sample of youth with hemophilia from 2 Canadian hemophilia treatment centers. Two iterative cycles of audiorecorded, semistructured individual interviews were conducted. Descriptive statistics and content analyses were used to organize data into categories that reflected emerging themes. RESULTS In total, we recruited 23 participants aged 12-20 years, with a mean age of 14.91 (2.57) years. When asked about program design, participants weighed the importance of flexibility in delivery (eg, Web-based, in person, text messaging [short message service]), content (eg, structured vs unstructured), frequency of sessions, and length of the program. Participants identified some potential challenges such as scheduling issues, comfort level for disease discussion, and discordant mentor-mentee personality types. The program was viewed as a positive medium for connecting peers with hemophilia. CONCLUSIONS Adolescents with hemophilia expressed interest in a peer mentoring program and provided valuable insight that will be applied in the development of a peer mentoring program for youth with hemophilia.
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Affiliation(s)
- Vicky R Breakey
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, ON, Canada.,Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Vanessa Bouskill
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Cynthia Nguyen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie Luca
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer N Stinson
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sara Ahola Kohut
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
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23
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Cuesta-Barriuso R, López-Pina JA, Nieto-Munuera J, Sagarra-Valls G, Panisello-Royo JM, Torres-Ortuño A. Effectiveness of the Medtep Hemophilia online platform for adherence to prophylactic treatment in haemophilia patients: Results from a 1-year observational study. Haemophilia 2018; 24:452-459. [DOI: 10.1111/hae.13444] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/26/2022]
Affiliation(s)
- R. Cuesta-Barriuso
- Department of Physiotherapy, School of Biomedical and Health Sciences; European University of Madrid; Madrid Spain
- Real Fundación Victoria Eugenia; Madrid Spain
- Fishemo Federación Española de Hemofilia-Fedhemo; Madrid Spain
| | - J. A. López-Pina
- Department of Basic Psychology and Methodology; Faculty of Psychology; University of Murcia; Murcia Spain
| | - J. Nieto-Munuera
- Department of Psychiatry and Social Psychology; Faculty of Medicine; University of Murcia; Murcia Spain
| | | | | | - A. Torres-Ortuño
- Department of Psychiatry and Social Psychology; Faculty of Medicine; University of Murcia; Murcia Spain
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24
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Gray WN, Reed-Knight B, Morgan PJ, Holbrook E, Kugathasan S, Saeed SA, Denson LA, Hommel KA. Multi-Site Comparison of Patient, Parent, and Pediatric Provider Perspectives on Transition to Adult Care in IBD. J Pediatr Nurs 2018. [PMID: 29525216 DOI: 10.1016/j.pedn.2018.01.008] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE This multi-site study examines patient, parent, and pediatric provider perspectives on what is most important for successful transition. DESIGN AND METHODS Using the Transition Readiness Assessment Questionnaire, 190 participants recruited from two pediatric IBD centers selected the top five skills they considered "most important for successful transition." Rankings were summarized and compared by group. RESULTS While patients, parents, and clinicians all identified "calling the doctor about unusual changes in health" and "taking medications correctly and independently" as being important, each stakeholder group qualitatively and statistically differed in terms of transition readiness skills emphasized. Patients endorsed "calling the doctor about unusual changes in health" and "being knowledgeable about insurance coverage," as being most important to successful transition while parents emphasized health monitoring and problem solving. Pediatric providers emphasized adherence to treatment and reporting unusual changes in health. There were statistically significant differences in endorsement rates across participants for seven transition readiness skills. Patients agreed with providers 80% of the time and with their parents 40% of the time. Parent-provider agreement was 60%. CONCLUSIONS Although there was some overlap across groups, areas of emphasis differed by informant. Patients emphasized skills they need to learn, parents emphasized skills they most likely manage for their children, and providers emphasized skills that directly impact their provision of care. PRACTICE IMPLICATIONS Patient, parent, and provider beliefs all need to be considered when developing a comprehensive transition program. Failure to do so may result in programs that do not meet the needs of youth with IBD.
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Affiliation(s)
- Wendy N Gray
- Auburn University, Department of Psychology, Auburn, AL, United States; Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, OH, United States.
| | - Bonney Reed-Knight
- Children's Healthcare of Atlanta, Atlanta, GA, United States; Emory University School of Medicine, Department of Pediatrics, Atlanta, GA, United States; GI Care for Kids, Atlanta, GA, United States
| | - Pamela J Morgan
- Dayton Children's Hospital, Department of Pediatric Gastroenterology, Dayton, OH, United States
| | - Erin Holbrook
- Cincinnati Children's Hospital Medical Center, Schubert-Martin Pediatric IBD Center, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati, OH, United States
| | - Subra Kugathasan
- Emory University School of Medicine, Department of Pediatrics, Atlanta, GA, United States
| | - Shehzad A Saeed
- Dayton Children's Hospital, Department of Pediatric Gastroenterology, Dayton, OH, United States
| | - Lee A Denson
- Cincinnati Children's Hospital Medical Center, Schubert-Martin Pediatric IBD Center, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati, OH, United States; University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, United States
| | - Kevin A Hommel
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, OH, United States; University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, United States
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25
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Transition from paediatric to adult ophthalmology services: what matters most to young people with visual impairment. Eye (Lond) 2017; 32:406-414. [PMID: 28937148 DOI: 10.1038/eye.2017.203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/04/2017] [Indexed: 11/08/2022] Open
Abstract
PurposeTo identify the views and experiences and thus the transition-related needs of young people with visual impairment (VI), so as to inform future practice and policies.Patients and methodsQualitative study of 17 young people aged 16-19 years (ie the conventional transition age threshold) with VI (best-corrected acuity logMAR worse than 0.48) and without additional impairments, drawn from a sampling frame of paediatric ophthalmology patients attending Great Ormond Street Hospital and Moorfields Eye Hospital (London, UK). In-depth, semistructured interviews were conducted to elicit their experiences, preferences, and attitudes towards transitioning within health care. Qualitative thematic analysis identified themes related to participants' experience of transition.ResultsEight of 17 participants had transitioned out of paediatric ophthalmology services, 7 had not, and 2 were unsure. Their views and experiences varied. Only 2 of those who had transitioned preferred their prior paediatric service, and 1 still in a paediatric services did not want to transition. Age-appropriate communication and physical clinical environment were two key components of care, both associated with greater confidence to self-manage health care in the future as an adult. Emotional attachment to paediatric services/teams was associated with reluctance to transition.ConclusionsGeneric guidance on transition is broadly applicable to children/young people with VI. Age-appropriate communication and appropriate physical clinical environments may be optimally delivered through adolescent ophthalmology services bridging paediatric and adult provision. Lack of research on transitions in paediatric ophthalmology has thus far restricted intervention studies; our findings serve to aid in developing an evidence base to achieve this.
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26
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Dietrich JE, Yee DL, Santos XM, Bercaw-Pratt JL, Kurkowski J, Soni H, Lee-Kim YJ, Shah MD, Mahoney D, Srivaths LV. Assessment of an Electronic Intervention in Young Women with Heavy Menstrual Bleeding. J Pediatr Adolesc Gynecol 2017; 30:243-246. [PMID: 27751907 DOI: 10.1016/j.jpag.2016.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/22/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED STUDY OBJECTIVE, DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Bleeding disorders (BD) occur in up to 50% of adolescents with heavy menstrual bleeding (HMB). This presents unique challenges to health care providers because of the complexity of treating the condition and such complexity can result in difficulty with patients understanding basic information about their condition, limit communication with medical providers, and patient compliance. The aim of the study was to use an electronic approach to enhance patient compliance with medications used to treat their HMB, and to provide educational access to adolescents with BD. This was a prospective cohort study involving patients in a Young Women's Bleeding Disorder Clinic at a single children's hospital. Subjects were given an iPod Touch (Apple Inc, Cupertino, CA) device (ITD), preloaded with the iPeriod (Winkpass Creations) application. Participants recorded information about their BD that they learned about on BD Web sites, and menses, and medications. Electronic and charted data were collected to monitor compliance with prescribed treatment regimens. All ITD allowed Wi-Fi access to allow teens to explore BD Web sites and knowledge was assessed. RESULTS Twenty-three of 45 subjects completed the study. The mean age was 14.1 ± 1.9 years. Subjects who were compliant with the ITD (group 1), charted on baseline symptoms, menstrual flow (83.3%), cramps (100%, 23/23), breakthrough bleeding (95.6%, 22/23), mood (95.6%, 22/23), and medication use (91.7%) for a mean of 9.3 ± 3.1 months. Subjects who were nonusers (group 2) did not report on symptoms, their condition, or medication use in the device (n = 22). More than 75% (17/23) of subjects in group 1 used hormones alone or hormones with antifibrinolytic agents to control HMB. No subjects stopped or missed medications who were in group 1 intentionally, and also there were 9 enrollees within this same group who missed a medication related to awaiting the prescription to be filled from pharmacy. In group 2, 17 enrollees missed medications, resulting in 19% (4/22) of these enrollees being admitted to hospital for 1-2 days. In addition, enrollees in group 2 missed more medications on average compared with group 1. No subjects in group 1 required admission for HMB treatment failure during the study period, compared with those in group 2 (P = .006). All subjects in group 1 reported accessing Web sites using their ITD to learn about their BD. Groups 1 and 2 did not differ in the number of medications that were prescribed during the time frame (P = .77) or the number of follow-up clinic visits (P = .49). Furthermore, those in group 1 reported fewer breakthrough bleeding episodes than those in group 2 according to clinic notes (P = .03). Users of the ITD were given a set of knowledge questions. Group 2 subjects were not consistent users of the ITD use and did not complete the knowledge questions. Group 1 and 2 could not be compared with regard to knowledge as a result. CONCLUSION ITD is an excellent tool for adolescents with HMB and BD to allow self-monitoring, provider monitoring, and improve educational access through engaging technology; compliance with device use was associated with several parameters suggestive of improved clinical outcomes.
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Affiliation(s)
- Jennifer E Dietrich
- Division of Pediatric and Adolescent Gynecology Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
| | - Donald L Yee
- Division of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Xiomara M Santos
- Division of Pediatric and Adolescent Gynecology Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Jennifer L Bercaw-Pratt
- Division of Pediatric and Adolescent Gynecology Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Jennifer Kurkowski
- Division of Pediatric and Adolescent Gynecology Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Heather Soni
- Division of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Youngna J Lee-Kim
- Division of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Mona D Shah
- Division of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Donald Mahoney
- Division of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Lakshmi V Srivaths
- Division of Pediatric Hematology and Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
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27
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Breakey VR, Harris L, Davis O, Agarwal A, Ouellette C, Akinnawo E, Stinson J. The quality of information about sickle cell disease on the Internet for youth. Pediatr Blood Cancer 2017; 64. [PMID: 27786409 DOI: 10.1002/pbc.26309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/19/2016] [Accepted: 09/05/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescence is a vulnerable time for teens with sickle cell disease (SCD). Although there is evidence to support the use of web-based education to promote self-management skills in patients with chronic illnesses, the quality of SCD-related information on the Internet has not been assessed. PROCEDURE A website review was conducted to appraise the quality, content, accuracy, readability, and desirability of online information for the adolescents with SCD. Relevant keywords were searched on the most popular search engines. Websites meeting predetermined criteria were reviewed. The quality of information was appraised using the validated DISCERN tool. Two physicians independently rated website completeness and accuracy. Readability of the sites was documented using the simple measure of gobbledygook (SMOG) scores and the Flesch Reading Ease (FRE). The website features considered desirable by youth were tracked. RESULTS Search results yielded >600 websites with 25 unique hits meeting criteria. The overall quality of the information was "fair" and the average DISCERN rating score was 50.1 (±9.3, range 31.0-67.5). Only 12 of 25 (48%) websites had scores >50. The average completeness score was 20 of 29 (±5, range 12-27). No errors were identified. The mean SMOG score was 13.04 (±2.80, range 10.21-22.85) and the mean FRE score was 46.05 (±11.47; range 17.50-66.10), suggesting that the material was written well beyond the acceptable reading level for patient education. The websites were text-heavy and lacked the features that appeal to youth (chat, games, videos, etc.). CONCLUSION Given the paucity of high-quality health information available for the teens with SCD, it is essential that additional online resources be developed.
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Affiliation(s)
- Vicky R Breakey
- Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Lauren Harris
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Omar Davis
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Arnav Agarwal
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine (AA), Faculty of Nursing (JS), University of Toronto, Toronto, Ontario, Canada
| | - Carley Ouellette
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth Akinnawo
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine (AA), Faculty of Nursing (JS), University of Toronto, Toronto, Ontario, Canada
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28
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Limperg P, Haverman L, Beijlevelt M, van der Pot M, Zaal G, de Boer W, Fijnvandraat K, Peters M, Grootenhuis MA. Psychosocial care for children with haemophilia and their parents in the Netherlands. Haemophilia 2017; 23:362-369. [DOI: 10.1111/hae.13186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
- P.F. Limperg
- Psychosocial Department; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - L. Haverman
- Psychosocial Department; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - M. Beijlevelt
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - M. van der Pot
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - G. Zaal
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - W.A. de Boer
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - K. Fijnvandraat
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - M. Peters
- Department of Pediatric-Hematology; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
- Hemophilia Comprehensive Care Treatment Centre; Academic Medical Centre (AMC); Amsterdam The Netherlands
| | - M. A. Grootenhuis
- Psychosocial Department; Emma Children's Hospital; Academic Medical Centre (AMC); Amsterdam The Netherlands
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Abstract
Adolescents with chronic pain are often socially isolated, having never met others with chronic pain, and often feel misunderstood by healthy peers. Adolescence is a sensitive period for developing one's sense of self and autonomy, which often occurs in the context of peer relationships. This developmental process is disrupted in adolescents when their chronic pain interferes with their social interactions. Peer mentoring is proposed as a developmentally timely intervention. The aim of this study is to develop and test the feasibility, acceptability, and impact of the iPeer2Peer program. The iPeer2Peer program is a tailored peer mentorship program that provides modeling and reinforcement by peers (trained young adults with chronic pain aged 18-25 years who have learned to successfully manage their pain). This program aimed to enhance self-management of chronic pain in adolescents through 10 Skype video calls over the course of 8 weeks. A pilot randomized controlled trial design using waitlist controls was used in an adolescent chronic pain sample. Twenty-eight adolescents aged 14.8 ± 1.6 years (93% female) completed the trial (intervention: n = 12; control n = 16). Three adolescents completed the intervention after completing their participation in the control arm. The iPeer2Peer program was feasible and acceptable, provided the adolescents were given more time to complete all 10 calls. When compared with controls, adolescents who completed the iPeer2Peer program had significant improvement in self-management skills and their coping efforts were more successful. The iPeer2Peer program is a promising peer mentoring intervention that complements standard care for adolescents with chronic pain.
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Abstract
Prophylactic clotting-factor regimens reduce the occurrence of bleeding episodes and maintain joint health in individuals with moderate and severe hemophilia. However, these outcomes are only achieved with adherence to prescribed prophylaxis regimens. There are several types of barriers to adherence related to key patient, condition, treatment, health-care system, and/or socioeconomic variables. Notably, health-care professionals may not prescribe prophylaxis if they perceive that a patient will be nonadherent. Prophylactic treatment strategies should be developed with the patient and family, focused on individualized treatment goals. Personalized strategies are needed to reinforce the importance of and encourage confidence in administering the regular infusions required for prophylactic therapy. These strategies may include verbal and written information delivered by health-care professionals, peers, and inter-active media. The advent of extended half-life clotting factors requiring less frequent infusion may improve adherence.
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Affiliation(s)
- Courtney D Thornburg
- Hemophilia and Thrombosis Treatment Center, Rady Children’s Hospital, San Diego, CA
- Correspondence: Courtney D Thornburg, Rady Children’s Hospital, 3020 Children’s Way – MC 5035, San Diego, CA 92123, USA, Tel +1 858 966 5811, Email
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31
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Bal MI, Sattoe JNT, Roelofs PDDM, Bal R, van Staa A, Miedema HS. Exploring effectiveness and effective components of self-management interventions for young people with chronic physical conditions: A systematic review. PATIENT EDUCATION AND COUNSELING 2016; 99:1293-1309. [PMID: 26954345 DOI: 10.1016/j.pec.2016.02.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/25/2016] [Accepted: 02/23/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To systematically explore the effectiveness and effective components of self-management interventions. METHODS Study selection criteria were: Original articles in English published between 2003 and 2015; focusing on youth with chronic conditions; describing self-management interventions; with clear outcome measures; using RCT design. The random effects analysis was applied in which standardized mean differences per study were calculated. RESULTS 42 RCTs were included. Interventions focused on medical management, provided individually in clinical settings or at home by mono-disciplinary teams showed a trend in improving adherence. Interventions delivered individually at home by mono-disciplinary teams showed a trend in improving dealing with a chronic condition. CONCLUSIONS AND PRACTICAL IMPLICATIONS Adherence could be improved through interventions focused on medical management, provided individually in a clinical or home setting by a mono-disciplinary team. Interventions focused on dealing with a chronic condition might be provided individually, through telemedicine programs facilitating peer-support. These intervention elements seemed effective irrespective of diagnosis, and may therefore act as good starting points for further research into and for improvement of self-management support for youth with chronic conditions in pediatric care. Results underlined the need to systematically develop and evaluate self-management interventions, since this may provide more evidence for effectiveness and effective intervention components.
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Affiliation(s)
- Marjolijn I Bal
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
| | - 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.
| | - 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.
| | - 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.
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
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32
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Schrijvers LH, Schuurmans MJ, Fischer K. Promoting self-management and adherence during prophylaxis: evidence-based recommendations for haemophilia professionals. Haemophilia 2016; 22:499-506. [DOI: 10.1111/hae.12904] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/29/2022]
Affiliation(s)
- L. H. Schrijvers
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht the Netherlands
| | - M. J. Schuurmans
- Nursing Science; Faculty of Health Care; University of Applied Science; Utrecht the Netherlands
- Nursing Science; University Medical Center Utrecht; Utrecht the Netherlands
| | - K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht the Netherlands
- Julius Centre for Health Sciences and Primary Care; University Medical Center; Utrecht The Netherlands
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33
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Hersh AO. Dr. Hersh replies. J Rheumatol 2015; 42:902. [PMID: 25934881 DOI: 10.3899/jrheum.150043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Aimee O Hersh
- Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, University of Utah, Salt Lake City, Utah, USA.
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34
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Schrijvers LH, Kars MC, Beijlevelt-van der Zande M, Peters M, Schuurmans MJ, Fischer K. Unravelling adherence to prophylaxis in haemophilia: a patients' perspective. Haemophilia 2015; 21:612-21. [PMID: 25858411 DOI: 10.1111/hae.12660] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 11/27/2022]
Abstract
Given the lifelong therapy in haemophilia patients, insight in non-adherence behaviour from a patient perspective is important to understand patients' difficulties with the following treatment recommendations. The aim of this study was to clarify the process underlying adherence (behaviour) to prophylactic treatment, from a patients' perspective. To develop a grounded theory, a qualitative study using individual in-depth interviews was performed to understand experiences, perceptions and beliefs concerning adherence to prophylaxis. From two Dutch treatment centres, 21 adults with haemophilia using prophylaxis were interviewed. Patients were asked how they experience their task to administer prophylaxis and how they adhere to this. The interviews were transcribed, coded and analysed in an iterative process, leading to the development of the grounded theory. Adherence was determined by the position of prophylaxis in life. The position of prophylaxis was determined by the perception of prophylaxis and the ability to exert prophylaxis. Patients' perception was influenced by two main factors: acceptance of haemophilia and feeling/fearing symptoms. The ability to exert prophylaxis was influenced by understanding haemophilia and prophylaxis and planning/infusion skills. The combination of different perceptions and skills led to four main positions of prophylaxis in life: (i) prophylaxis integrated in life, (ii) prophylaxis according to doctors' advice, struggling with irregular situations, (iii) prophylaxis is too much to handle, (iv) prophylaxis is a confrontation with illness. The adherence level gradually decreased from position 1 to 4. This information can be used to design tailored interventions to promote adherence.
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Affiliation(s)
- L H Schrijvers
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, the Netherlands
| | - M C Kars
- Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands
| | | | - M Peters
- Haemophilia Treatment Centre, Academical Medical Center Amsterdam, Amsterdam, the Netherlands
| | - M J Schuurmans
- Faculty of Health Care, Nursing Science, University of Applied Science, Utrecht, the Netherlands.,Nursing Science, University Medical Center Utrecht, Utrecht, the Netherlands
| | - K Fischer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands
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35
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Limperg PF, Peters M, Colland VT, van Ommen CH, Beijlevelt M, Grootenhuis MA, Haverman L. Reliability, validity and evaluation of the Haemophilia Coping and Perception Test. Haemophilia 2015; 21:e243-e246. [DOI: 10.1111/hae.12650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 11/27/2022]
Affiliation(s)
- P. F. Limperg
- Psychosocial Department; Emma Children's Hospital; Academic Medical Center; Amsterdam The Netherlands
| | - M. Peters
- Department of Pediatric-Hematology; Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Amsterdam The Netherlands
| | - V. T. Colland
- Psychosocial Department; Emma Children's Hospital; Academic Medical Center; Amsterdam The Netherlands
| | - C. H. van Ommen
- Department of Pediatric-Hematology; Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Amsterdam The Netherlands
| | - M. Beijlevelt
- Department of Pediatric-Hematology; Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Amsterdam The Netherlands
| | - M. A. Grootenhuis
- Psychosocial Department; Emma Children's Hospital; Academic Medical Center; Amsterdam The Netherlands
| | - L. Haverman
- Psychosocial Department; Emma Children's Hospital; Academic Medical Center; Amsterdam The Netherlands
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