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Somers C, McCusker C, Prendeville P, Kelleher S. The centrality of healthcare and education interactions - An Interpretive Phenomenological Analysis of experiences of parents of children with Ehlers-Danlos Syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 151:104789. [PMID: 38959623 DOI: 10.1016/j.ridd.2024.104789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/23/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Ehlers-Danlos Syndrome (EDS) is a rare group of connective tissue disorders and, as such, the diagnosis can often be delayed. While emerging research indicates that there may be adverse psychosocial consequences for the child, little is known about the processes behind such outcomes, including the psychosocial impact of this rare disease on family life. AIMS To extend our understanding, we examined the lived experiences of parenting a child with EDS. METHODS Four parents recruited from a specialist child development clinic participated in semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis RESULTS: Three superordinate themes were identified: (1) Challenges Associated with hEDS, (2) Interactions with Professionals and (3) "Pulling and Pacing": Life with EDS. DISCUSSION This is one of the first qualitative studies to gain an insight into the lived experiences of parenting a child with EDS. Findings had systemic implications. Specifically, we demonstrate the need for raising awareness in health and educational professionals about how to better support families to support the child, as well as the importance of promoting effective advocacy skills in parents.
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Affiliation(s)
- Carol Somers
- University College Cork, College Road, Cork, Ireland
| | | | - Paula Prendeville
- Enable Ireland Cork, Lavanagh Centre, Curraheen Road, Co., Cork, Ireland; University College Dublin, Belfield, Dublin 4, Ireland
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Abildgaard Hansen O, Clemensen J, Beier CP, Pors Klinting G, Smith AC, Kaas Larsen M. Being an adolescent with epilepsy during the transition from pediatric to adult hospital care: A qualitative descriptive study. Epilepsy Behav 2024; 155:109780. [PMID: 38640727 DOI: 10.1016/j.yebeh.2024.109780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The transition from pediatric to adult care is challenging for adolescent patients despite numerous recommendations in recent decades. However, the perspective of the patients is sparsely investigated. AIM To explore the experiences and needs of adolescents with epilepsy (AWE) during the transition from pediatric to adult hospital care. METHODS We conducted 15 semi-structured interviews with AWEs aged 13-20 years and 10 h of field observations of consultations. Interviews were audio-recorded, transcribed, anonymized, and entered into NVivo (version 12, QSR International) with the transcribed field notes. Data were analyzed using systematic text condensation. RESULTS Three themes were identified: (1) Navigating epilepsy in everyday life; (2) The difficult balance between concealment and openness about epilepsy; and (3) Being seen as an individual and not an illness. AWEs' needs in transition are closely associated with their experiences and perceptions of illness, treatment, consultations, and seizures. Notably, AWEs reveal a significant concern about being overlooked beyond their medical condition in appointments. CONCLUSIONS This study highlights the vulnerability and challenges of AWEs transitioning to adult care. Overall, AWEs seek understanding, acceptance, and autonomy in managing their epilepsy and transitioning to adult care. Their experiences underscore the importance of holistic support and communication in healthcare settings. A concerted effort from healthcare professionals (HCP) is necessary to foster the recognition of AWEs as individuals with distinct personalities, needs, and capabilities.
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Affiliation(s)
- Ole Abildgaard Hansen
- Department of Neurology, Odense University Hospital, Odense, Denmark; Open Patient Data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Innovative Medical Technology, University of Southern Denmark, Denmark.
| | - Jane Clemensen
- Centre for Innovative Medical Technology, University of Southern Denmark, Denmark; Hans Christian Andersen Hospital for Children and Adolescents, Odense University Hospital, Odense, Denmark
| | - Christoph P Beier
- Department of Neurology, Odense University Hospital, Odense, Denmark; Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
| | | | - Anthony C Smith
- Centre for Innovative Medical Technology, University of Southern Denmark, Denmark; Centre for Online Health, The University of Queensland, Australia; Centre for Health Services Research, The University of Queensland, Australia
| | - Malene Kaas Larsen
- Department of Surgery, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark
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Gunawardana S, Jayarajah U, Ahmed SF, Seneviratne SN. Health-Related Quality of Life in Children and Adolescents With Congenital Adrenal Hyperplasia: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab 2024; 109:1618-1629. [PMID: 38332657 DOI: 10.1210/clinem/dgae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To conduct a systematic review (SR) and meta-analysis (MA) on health-related quality-of-life (QoL) and associated factors among children/adolescents with congenital adrenal hyperplasia (CAH). METHOD Following registration in the PROSPERO International Prospective Register of Systematic Reviews(reg no: CRD42022313389), Google Scholar, PubMed, LILACS, Cochrane, and Scopus databases were searched up to March 5, 2022, using predefined search strategy/MESH terms to identify original studies describing/assessing self-reported/parent-reported health-related QoL in patients with CAH ≤21 years. Methodological quality was assessed by Newcastle-Ottawa Quality Assessment Scale (NOS), and heterogeneity by I2 statistics. MA assessed mean difference (MD) in QoL between children/adolescents with CAH and healthy children/adolescents. RESULTS Among 1308 publications, the 12 studies eligible for the SR (CAH n = 781) showed NOS scales of 3 to 7/9, and the 6 eligible for MA (CAH n = 227) showed moderate-considerable heterogeneity. MA showed that parent-reported psychosocial QoL (MD 9.9 [-12.6,7.3], P ≤ .001) {consisting of school (MD 7.4[-12.2, -2.5], P = .003), emotional (MD 5.6 [-10.2, -0.9], P = .02) and social domains (MD 4.3 [-8.1, -0.5], P = .03), and self-reported school domain QoL (MD 8.5 [-15.9, -1.2], P = .02) was lower in children/adolescents with CAH while parent-reported and self-reported physical QoL were similar to controls.Factors associated with lower QoL among children/ adolescents with CAH included poor disease control, poor medication compliance, and complications including hyperpigmentation, virilization, hypertension, hospital admission, and urinary incontinence. CONCLUSION Based on available data, children/adolescents with CAH had preserved physical QoL but impaired psychosocial QoL, especially in the school domain. Factors associated with lower QoL included poor disease control and disease/treatment-related complications. There is a need for further high-quality research that investigates the relationship between disease control, provision of psychosocial support, and improvement in QoL in children/adolescents with CAH.
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Affiliation(s)
| | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Syed Faisal Ahmed
- Samson Gemmell Chair of Child Health, University of Glasgow, Glasgow G12 8QQ, UK
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Varesio C, Zanaboni MP, Pasca L, Provenzi L, Ferraris C, Tagliabue A, Pezzotti E, Carpani A, Veggiotti P, DE Giorgis V. Novel insight into GLUT1 deficiency syndrome: screening for emotional and behavioral problems in youths following ketogenic diet. Minerva Pediatr (Torino) 2024; 76:189-196. [PMID: 33820407 DOI: 10.23736/s2724-5276.21.05923-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Glucose transporter type 1 deficiency syndrome (GLUT1DS) is a rare disorder with a broad spectrum of neurological manifestations. The ketogenic diet (KD) is, to date, the gold standard treatment. Behavioral problems, well recognized in patients with chronic conditions, have not been, so far, deeply investigated in GLUT1DS patients. We performed an exploratory study to assess the risk of emotional and behavioral problems and investigated the potential role of influencing factors related to the pathology itself or KD treatment. METHODS This was a mono-center retrospective study involving youths with GLUT1Ds treated with KD and a group of migraine patients age- and gender-matched. Patients were included if the main caregiver completed the Child Behavior Check List 6-18 (CBCL). Descriptive statistics for demographic and clinical data and questionnaire scores were computed. Correlational analyses were used to assess the potential associations of clinical variables and age and time from KD introduction with CBCL scores in GLUT1DS patients. RESULTS We enrolled nine youths with GLUT1DS and 9 with migraine. In the GLUT1DS group, none of the mean scores of the CBCL items fell within the borderline/clinical range, except for social problems located in the borderline range. Investigation for influencing factors revealed the patient's age related to withdrawn/depressive (r=0.709, P=0.032) and social problems (r=.684, P=0.042). Time from the introduction of KD was related to social problems (r=.827, P=0.006). From the comparison with the scores obtained from migraine patients, significantly higher scores emerged in the latter group in internalizing problems (Z=-2.48, P=0.01), externalizing problems (Z=-3.49, P<0.001), anxious/depressed subscale (Z=-2.37, P=0.014), somatic complaints subscale (Z=-2.624, P=0.008), aggressive behavior subscale (Z=-2.539, P=0.011). CONCLUSIONS Although highly exploratory in its nature, this study provides a novel insight into GLUT1DS. Our data suggested that the risk for internalizing problems in GLUT1DS youths was related to higher age and higher time elapsed from KD introduction. They occurred at a sub-clinical level, making them difficult to detect, if not expressly and systematically investigated.
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Affiliation(s)
- Costanza Varesio
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy -
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy -
| | - Martina P Zanaboni
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Ludovica Pasca
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livio Provenzi
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Cinzia Ferraris
- Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Pavia, Italy
| | - Anna Tagliabue
- Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Pavia, Italy
| | - Elena Pezzotti
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Adriana Carpani
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Pierangelo Veggiotti
- Unit of Pediatric Neurology, Vittore Buzzi Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Valentina DE Giorgis
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
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Twomey C, McGonigle E, Solebo AL. Co-Creation of a Novel Childhood Onset Rare Disease Self-Care Support Tool. Acad Pediatr 2024; 24:369-372. [PMID: 37743014 DOI: 10.1016/j.acap.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/01/2023] [Accepted: 09/16/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Christine Twomey
- Rheumatology Department (C Twomey and AL Solebo), Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Enda McGonigle
- Division of Medicine, University College Cork School of Medicine (E McGonigle), Cork, Ireland; Ophthalmology Department (E McGonigle and AL Solebo), Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Ameenat Lola Solebo
- Rheumatology Department (C Twomey and AL Solebo), Great Ormond Street Hospital for Children NHS Trust, London, UK; Ophthalmology Department (E McGonigle and AL Solebo), Great Ormond Street Hospital for Children NHS Trust, London, UK; Population, Policy and Practice Programme (AL Solebo), UCL GOS Institute of Child Health, London, UK.
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Igler EC, Austin JE, Sejkora EKD, Davies WH. Friends' Perspective: Young Adults' Reaction to Disclosure of Chronic Illness. J Clin Psychol Med Settings 2024; 31:197-207. [PMID: 37195582 PMCID: PMC10189708 DOI: 10.1007/s10880-023-09956-2] [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: 03/03/2023] [Indexed: 05/18/2023]
Abstract
Chronic illness can negatively impact adolescents' and young adults' social support. Social support can buffer the negative impact of living with chronic illness. The purpose of this study was to test the acceptability of a hypothetical message to promote social support after a recent diagnosis of a chronic illness. Young adults (18-24; m = 21.30; N = 370), the majority of which were Caucasian, college-students, and female, were asked to read one of four vignettes and to imagine this situation happened while they were in high school. Each vignette contained a hypothetical message from a friend diagnosed with a chronic illness (cancer, traumatic brain injury, depression, or eating disorder). Participants answered forced-choice and free-response questions asking about the likelihood they would contact or visit the friend, and feelings about receiving the message. A general linear model was used to assess quantitative results, and qualitative responses were coded using the Delphi coding method. Participants responded positively, reporting a high likelihood to contact the friend, and feeling glad to receive the message regardless of vignette viewed; however, those who read the eating disorder vignette were significantly more likely to express discomfort. In qualitative responses, participants described positive emotions associated with the message and desire to support the friend. However, participants reported significantly greater discomfort with the eating disorder vignette. The results provide evidence for the potential of a short, standardized disclosure message to promote social support following chronic illness diagnosis with some additional considerations for those recently diagnosed with an eating disorder.
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Affiliation(s)
- Eva C Igler
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
- Department of Psychology, Minnesota Epilepsy Group PA, 2427 Fairview Ave N, Suite 100, Roseville, MN, USA.
| | - Jillian E Austin
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ellen K D Sejkora
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - W Hobart Davies
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Seiffge-Krenke I, Volz M. Effectiveness of psychodynamic treatment: Comparing trajectories of internalizing and externalizing psychopathology of adolescents in treatment, healthy and physically ill adolescents. Dev Psychopathol 2024; 36:478-493. [PMID: 36744527 DOI: 10.1017/s0954579422001341] [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: 02/07/2023]
Abstract
Effectiveness of psychodynamic therapy for adolescents in reducing internalizing and externalizing psychopathology was determined by comparing treated adolescents (86 sessions) with the normative developmental progression in two groups without treatment: healthy and diabetic adolescents. In a three-wave longitudinal study, n = 531 adolescents (n = 303 patients, n = 119 healthy, n = 109 diabetics) and their mothers filled out psychopathology questionnaires (Youth Self-Report and Child Behavior Checklist). Latent growth curve modeling and multilevel modeling were used to analyze and compare within-person symptoms changes across groups. Analyses showed a significant reduction over the course of treatment for internalizing (Cohen's d = .90-.92) and externalizing (d = .58-.72) symptoms, also when the developmental progression of both control groups was accounted for (d = .48-.76). Mothers reported lower levels than their children in internalizing symptoms (p ≤ .01) while this discrepancy increased over time for treated adolescents (p = .02). Results established the effectiveness of psychodynamic treatment for adolescents both with externalizing and internalizing symptoms in comparison with growth and change in nonclinical samples. Cross-informant differences and age-specific trajectories require attention in psychotherapy treatment and research.
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Affiliation(s)
| | - Matthias Volz
- Department of Psychology, University of Kassel, Kassel, Germany
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Sayegh CS, Brammer WA, Wright SM, Wee CP, Sherer S. Pilot Study of Group Interpersonal Psychotherapy for Depression Among Young People With Chronic Illness. Am J Psychother 2023; 76:93-99. [PMID: 36908229 DOI: 10.1176/appi.psychotherapy.20210042] [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: 03/14/2023]
Abstract
OBJECTIVE Interpersonal psychotherapy (IPT) is an evidence-based treatment for depression, demonstrating efficacy with adolescents and young adults. Social support is proposed to be an important treatment component and may be helpful for adolescents and young adults with chronic illness. The authors sought to assess the feasibility of delivering IPT to this population and to examine changes in depressive symptoms and perceived social support. METHODS An open-label feasibility trial of group-based IPT was conducted for adolescents and young adults with chronic illness (N=17). The 12-session group IPT was concurrent with group members' individual psychotherapy, and group IPT was focused on providing support in navigating interpersonal challenges related to the participants' chronic illness. Participants completed questionnaires assessing depressive symptoms and social support before treatment, midtreatment (6 weeks), and after treatment (12 weeks). Generalized estimating equation models, adjusted for repeated measures, were used to assess changes in depressive symptoms and social support over the course of treatment. RESULTS Deidentified clinical examples illustrated how IPT was practiced in a community mental health setting. Evidence for the feasibility of group IPT was mixed. Although participants had poor session attendance, there was a significant decrease in depressive symptoms (β=-2.94, 95% CI=-5.30 to -0.59, p=0.014) and a significant increase in perceived social support (β=4.24, 95% CI=0.51 to 7.98, p=0.026) by the end of treatment. CONCLUSIONS IPT may help address depressive symptoms and enhance social support among adolescents and young adults with chronic illness. Further research and adaptation are needed to address feasibility challenges in delivering group IPT to this population.
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Affiliation(s)
- Caitlin S Sayegh
- Children's Hospital Los Angeles, Los Angeles (all authors); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles (Sayegh, Sherer)
| | - Whitney A Brammer
- Children's Hospital Los Angeles, Los Angeles (all authors); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles (Sayegh, Sherer)
| | - Stephanie M Wright
- Children's Hospital Los Angeles, Los Angeles (all authors); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles (Sayegh, Sherer)
| | - Choo Phei Wee
- Children's Hospital Los Angeles, Los Angeles (all authors); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles (Sayegh, Sherer)
| | - Sara Sherer
- Children's Hospital Los Angeles, Los Angeles (all authors); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles (Sayegh, Sherer)
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Bai N, Yin M, Zhang H, Li Z. The experiences of adolescents and young adults with epilepsy: A systematic review and meta-synthesis of qualitative studies. Epilepsy Behav 2023; 140:109086. [PMID: 36804848 DOI: 10.1016/j.yebeh.2023.109086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Epilepsy is one of the most common and severe chronic neurological disorders and is associated with psychosocial problems. Several qualitative studies have investigated the experiences of adolescents and young adults with epilepsy. However, the findings were conflicting to some extent. This study examined and synthesized qualitative research data to understand the experiences of adolescents and young adults living with epilepsy, improving the development of targeted interventions and enhancing these experiences. OBJECTIVE To synthesize qualitative evidence about the experiences of adolescents and young adults suffering from epilepsy. METHODS This systematic review and qualitative evidence synthesis used the Joanna Briggs methodology for qualitative systematic reviews [1]. PubMed, PsychINFO, EMBASE, and Web of Science were searched for studies indexed until March 2022. Qualitative data were extracted, analyzed, and aggregated using meta-synthesis. RESULTS Seventeen studies were included in the review. Three distinct themes were identified: "impact of epilepsy," "emotions associated with epilepsy," and "self-management of epilepsy." The results show that adolescents and young adults with epilepsy develop different strategies to manage epilepsy and associated problems. CONCLUSION The results improved our understanding of the experiences of adolescents and young adults suffering from epilepsy. Several approaches are encouraged to improve these experiences and the quality of life, including granting more autonomy to affected children, providing individualized care and advice, improving public awareness of epilepsy to avoid stigma, and strengthening legal frameworks to safeguard the rights of affected people.
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Affiliation(s)
- Nan Bai
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Min Yin
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Huiyue Zhang
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Zheng Li
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; School of Nursing, Lanzhou University, Lanzhou, China.
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Mental Health and Health-Related Quality of Life in Austrian Adolescents with Chronic Physical Health Conditions: Results from the MHAT Study. J Clin Med 2023; 12:jcm12051927. [PMID: 36902714 PMCID: PMC10003709 DOI: 10.3390/jcm12051927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Chronic physical health conditions (CPHC) are on the rise in younger age groups and might have a negative impact on children and adolescents. In a representative sample of Austrian adolescents aged 10-18 years, internalizing, externalizing, and behavioral problems were assessed cross-sectionally using the Youth Self-Report and health-related quality of life (HrQoL) using the KIDSCREEN questionnaire. Sociodemographic variables, life events, and chronic illness specific parameters were considered as associated variables with mental health problems in individuals with CPHC. Of 3469 adolescents, 9.4% of girls and 7.1% of boys suffered from a chronic pediatric illness. Of these individuals, 31.7% and 11.9% had clinically relevant levels of internalizing and externalizing mental health problems, respectively, compared to 16.3% and 7.1% adolescents without a CPHC. Anxiety, depression, and social problems were twice as high in this population. Medication intake due to CPHC and any traumatic life-event were related to mental health problems. All HrQoL domains were deteriorated in adolescents with a double burden of mental and CPHC, whereas adolescents with a CPHC without mental health problems did not differ significantly from adolescents without a chronic illness. Targeted prevention programs for adolescents with a CPHC are urgently needed to prevent mental health problems in the long term.
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van Schelven F, van der Meulen E, Wessels E, Boeije HR. Let Us Talk Treatment: Using a Digital Body Map Tool to Examine Treatment Burden and Coping Strategies Among Young People with a Chronic Condition. Patient Prefer Adherence 2023; 17:517-529. [PMID: 36891325 PMCID: PMC9987530 DOI: 10.2147/ppa.s400702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023] Open
Abstract
PURPOSE Treatment for a chronic condition can pose a heavy burden on young people and affect their quality of life. The present study examined young people's experiences with treatment burden and their coping strategies. PATIENTS AND METHODS The body mapping method was employed, in which a life-sized outline of someone's body is traced and populated with visual representations, symbols and words. For the present study, a digital tool for body mapping was developed. This is a chat robot which helps young people make a body map by asking questions about their lives, wellbeing and the influence of their treatment on this. In two series of three workshops, ten young people (16 to 25 years) with a chronic, somatic condition created individual body maps using this tool. The body maps were discussed in the group to obtain insight into experiences with treatment burden. The findings were analysed using thematic analysis. In all stages of the study, two adolescents with a chronic condition were involved as co-researchers. RESULTS The results show that young people with a chronic condition experience considerable treatment burden. Although treatment reduces their symptoms, it also leads to physical and emotional side-effects, restrictions of meaningful activities, issues with future planning, reduced independence, and autonomy and loneliness. Young people apply several strategies to cope with this burden, such as seeking support from others, focusing on the positive, ignoring treatment advice, and seeing a psychologist. CONCLUSION Treatment burden is a subjective experience and not merely based on the number or types of treatment. It is therefore vital that young people with a chronic condition discuss their experiences with their care provider. This can help to tailor treatment decisions to their lives and needs.
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Affiliation(s)
- Femke van Schelven
- Department Perspective of Patients and Clients in Healthcare, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Correspondence: Femke van Schelven, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513, CR, the Netherlands, Email
| | | | - Elise Wessels
- JongPIT, Amsterdam, the Netherlands
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Hennie R Boeije
- Department Perspective of Patients and Clients in Healthcare, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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Alexandridis D, Nijhof SL, van der Rijst VG, van der Neut DY, Spijkerman R, Stevens GWJM, Bakkes SCJ, Lesscher HMB, van den Eijnden RJJM, van der Ent CK, van den Berg G, Peeters M. A cross-sectional study on gaming intensity and social vulnerability in adolescents that have a chronic condition. Front Public Health 2023; 11:1128156. [PMID: 37139357 PMCID: PMC10149830 DOI: 10.3389/fpubh.2023.1128156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
Background Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD). Methods Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition. Results No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group. Conclusion Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers.
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Affiliation(s)
- Dionysis Alexandridis
- Multimedia Group, Interaction Division, Department of Computer Science, Faculty of Science, Utrecht University, Utrecht, Netherlands
- *Correspondence: Dionysis Alexandridis
| | - Sanne L. Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Vincent G. van der Rijst
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Damian Y. van der Neut
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Renske Spijkerman
- Parnassia Addiction Research Centre (PARC, Brijder Addiction Treatment), The Hague, South Holland, Netherlands
| | - Gonneke W. J. M. Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Sander C. J. Bakkes
- Multimedia Group, Interaction Division, Department of Computer Science, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Heidi M. B. Lesscher
- Department of Population Health Sciences, Division of Behavioural Neuroscience, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Regina J. J. M. van den Eijnden
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Cornelis K. van der Ent
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Gerrit van den Berg
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
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13
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Müller R, Aghdassi AA, Kruse J, Lerch MM, Rach C, Simon P, Salloch S. Lived Experience of Hereditary Chronic Pancreatitis - A Qualitative Interview Study. Chronic Illn 2022; 18:818-833. [PMID: 34559012 PMCID: PMC9643816 DOI: 10.1177/17423953211039774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Hereditary chronic pancreatitis is a rare condition characterized by intermittent acute episodes of pancreatitis and long-term impairment of pancreatic functions. However, the subjective perspective of individuals affected by hereditary chronic pancreatitis has been little studied. This qualitative study investigates the experience of hereditary chronic pancreatitis patients and their relatives because the awareness of the needs of those affected is an essential component of a patient-centered management of chronic conditions. METHODS Semi-structured qualitative interviews were conducted with hereditary chronic pancreatitis patients and their relatives. Data were analysed using qualitative content analysis. The concepts of 'biographical contingency,' 'biographical disruption' and the 'shifting perspectives model' served as theoretical frameworks. RESULTS A total of 24 participants (17 patients, 7 relatives) were interviewed individually. Four main themes were identified: (1) The unpredictable clinical course of hereditary chronic pancreatitis; (2) hereditary chronic pancreatitis as a devastating experience; (3) hereditary chronic pancreatitis as part of a normal life; and (4) being reduced to hereditary chronic pancreatitis. DISCUSSION The 'shifting perspectives model' of chronic illness covers the four dimensions adequately and can serve as a theoretical model to explain hereditary chronic pancreatitis patients' experience. A better understanding of the patients and their families' experience and the shifting character of hereditary chronic pancreatitis can help healthcare professionals to tailor the care to meet the needs of those affected.
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Affiliation(s)
- Regina Müller
- Institute of Ethics and History of Medicine, University of Tuebingen, Tübingen, Germany.,Institute of Ethics and History of Medicine, 60634University Medicine Greifswald, Greifswald, Germany
| | - Ali A Aghdassi
- Department of Medicine A, 221223University Medicine Greifswald, Greifswald, Germany
| | - Judith Kruse
- Institute of Ethics and History of Medicine, 60634University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine A, 221223University Medicine Greifswald, Greifswald, Germany
| | - Christoph Rach
- Department of Psychiatry, Psychotherapy and Psychosomatics, 84491Agaplesion Markus Hospital, Frankfurt am Main, Germany
| | - Peter Simon
- Department of Medicine A, 221223University Medicine Greifswald, Greifswald, Germany
| | - Sabine Salloch
- Institute of Ethics, 88782History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
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14
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Hill JC, Stokes LE, Higgins KK. Career Transitions Caused by Chronic Illness: A Career Construction Perspective. REHABILITATION RESEARCH, POLICY, AND EDUCATION 2022. [DOI: 10.1891/re-21-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose:People living with chronic illness face significant challenges with employment. This study explores the impact of participating in the Career Construction Interview (CCI) on the career exploration of individuals facing a forced career transition due to the onset or exacerbation of a chronic illness.Method:An instrumental multiple case study design was used in this qualitative study. A purposeful, homogeneous sample of three female adults was used to gain multiple perspective of forced career transitions. The participants were within 2 years of their diagnosis or exacerbation of one or more chronic health conditions and had to change their career because of the impact of their condition(s).Results:Eight open codes and five axial codes were discovered through the process of constant comparative analysis. For this study one open code (CCI experience) and five axial codes will be discussed.Conclusions:This study found patterns related to chronic illness and career and that the Career Construction Interview was helpful to the participants in assisting them with making decisions about potential careers and options for employment. Implications for rehabilitation counseling practice and suggestions for future research.
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15
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Iannello NM, Inguglia C, Silletti F, Albiero P, Cassibba R, Lo Coco A, Musso P. How Do Religiosity and Spirituality Associate with Health-Related Outcomes of Adolescents with Chronic Illnesses? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013172. [PMID: 36293751 PMCID: PMC9603522 DOI: 10.3390/ijerph192013172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/12/2023]
Abstract
The aim of the current scoping review was to explore the associations between religious and spiritual factors and the health-related outcomes of adolescents with chronic illnesses, as well as to investigate possible mechanisms accounting for these relationships. In total, 20 studies meeting the eligibility criteria were reviewed after performing a search of the Scopus, Web of Science, and PubMed databases. The results suggested that religious and spiritual beliefs, thoughts, and practices (e.g., spiritual coping activities) might have both beneficial and deleterious effects on the way adolescents deal with their medical condition, on their psychosocial adjustment, on their mental and physical health, and on their adherence to treatments. Mediating and moderating mechanisms explaining these relations were also evidenced. Suggestions for future research and practical implications for healthcare professionals are provided in the concluding section of this work.
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Affiliation(s)
| | - Cristiano Inguglia
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Fabiola Silletti
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy
| | - Paolo Albiero
- Department of Developmental Psychology and Socialisation, University of Padua, 35121 Padova, Italy
| | - Rosalinda Cassibba
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy
| | - Alida Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Pasquale Musso
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy
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16
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Chronic Conditions and School Participation of First-Year University Students—HOUSE ULisbon Study. CHILDREN 2022; 9:children9091397. [PMID: 36138706 PMCID: PMC9497637 DOI: 10.3390/children9091397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022]
Abstract
Students with chronic conditions (CC) tend to experience several barriers in terms of their school participation and performance. Therefore, the present study aims to explore the factors related to the time of diagnosis of CC (recent/non-recent), the barriers to participation and academic success (health condition, people’s attitude towards CC and school physical environment), the physical and mental health (physical/psychological symptoms and concerns) and school-related variables (relationship with teachers and peers), regarding the school participation of first-year students with CC. This work is part of the HOUSE-Colégio F3 Project, University of Lisbon, which includes 1143 first-year university students from 17 Faculties and Institutes of the University of Lisbon. In this specific study, only the subsample of 207 students with CC was considered, 72.4% of which were female, aged between 18 and 54 years (M = 20.00; SD = 4.83). The results showed that students with a recent diagnosis of CC and students with school participation affected by the CC were those who presented more negative indicators regarding barriers to school participation, physical and mental health, and school-related variables. A greater impact of CC in terms of school participation was associated with having a recent diagnosis, with people’s attitude towards CC and with the health condition as barriers, with more psychological symptoms and worse relationships with teachers and peers. This is a relevant message for the organization of health services for students with CC at the beginning of their university studies, especially since they are often displaced from home and managing their health conditions alone (in many cases, for the first time).
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17
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Teela L, Verhagen LE, Gruppen MP, Santana MJ, Grootenhuis MA, Haverman L. Including the voice of paediatric patients: Cocreation of an engagement game. Health Expect 2022; 25:1861-1871. [PMID: 35751406 PMCID: PMC9327851 DOI: 10.1111/hex.13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/18/2022] [Accepted: 05/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Engaging patients in health care, research and policy is essential to improving patient‐important health outcomes and the quality of care. Although the importance of patient engagement is increasingly acknowledged, clinicians and researchers still find it difficult to engage patients, especially paediatric patients. To facilitate the engagement of children and adolescents in health care, the aim of this project is to develop an engagement game. Methods A user‐centred design was used to develop a patient engagement game in three steps: (1) identification of important themes for adolescents regarding their illness, treatment and hospital care, (2) evaluation of the draft version of the game and (3) testing usability in clinical practice. Adolescents (12–18 years) were engaged in all steps of the development process through focus groups, interviews or a workshop. These were audio‐recorded, transcribed verbatim and analysed in MAXQDA. Results (1) The important themes for adolescents (N = 15) were included: visiting the hospital, participating, disease and treatment, social environment, feelings, dealing with staff, acceptation, autonomy, disclosure and chronically ill peers. (2) Then, based on these themes, the engagement game was developed and the draft version was evaluated by 13 adolescents. Based on their feedback, changes were made to the game (e.g., adjusting the images and changing the game rules). (3) Regarding usability, the pilot version was evaluated positively. The game helped adolescents to give their opinion. Based on the feedback of adolescents, some last adjustments (e.g., changing colours and adding a game board) were made, which led to the final version of the game, All Voices Count. Conclusions Working together with adolescents, All Voices Count, a patient engagement game was developed. This game provides clinicians with a tool that supports shared decision‐making to address adolescents' wishes and needs. Patient or Public Contribution Paediatric patients, clinicians, researchers, youth panel of Fonds NutsOhra and patient associations (Patient Alliance for Rare and Genetic Diseases, Dutch Childhood Cancer Organization) were involved in all phases of the development of the patient engagement game—from writing the project plan to the final version of the game.
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Affiliation(s)
- Lorynn Teela
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands.,Child development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Lieke E Verhagen
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mariken P Gruppen
- Department of General Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria J Santana
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Martha A Grootenhuis
- Psychosocial Research and Care Innovation, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lotte Haverman
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands.,Child development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
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18
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Odintsova M, Lubovsky D, Gusarova E, Ivanova P. Adolescent Resilience Profiles (on the Example of Adolescents with Congenital, Acquired Disabilities and Healthy Peers). КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The problem of the research is important in the context of psychological assistance and interaction with adolescents with disabilities. The study aimed to carry out a comparative analysis of the resilience profiles of adolescents with congenital (cerebral palsy), acquired disabilities (oncology, rheumatic diseases) and healthy peers. The study involved 51 adolescents with cerebral palsy, 61 with oncological diseases, 51 with rheumatic diseases and 86 conditionally healthy adolescents aged 13 to 18 years old. In total it embraced 249 teenagers (mean age 14.94+1.48), of which 128 were male and 121 were female. There were used the following methods: the “Victimity” questionnaire (M.A. Odintsova, N.P. Radchikova), “Resilience Test” (E.N. Osin, E.I. Rasskazova) and “COPE” questionnaire (E.I. Rasskazova, T.O. Gordeeva, E.N. Osin). The study revealed significant differences in the resilience profiles of adolescents from different groups: healthy teenagers are mainly characterized by unstable and resilient profiles; adolescents with oncology and rheumatic diseases — by all three profiles; adolescents with cerebral palsy — by victim and unstable ones. The female part of the sample, unlike the male part, are characterized by unstable and victim profiles. The most significant differences in groups with different resilience profiles were found in coping strategies related to the dysfunctional coping style. The use of coping strategies: behavioral disengagement, mental disengagement, concentration on emotions and humor leads to a decrease in resilience in the boys of the entire sample. Concentration on emotions, behavioral disengagement, mental disengagement, and infrequent use of active coping are predictors of reduced resilience
in girls.
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Affiliation(s)
| | | | | | - P.A. Ivanova
- Moscow State University of Psychology & Education graduate
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19
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Chronic illness in childhood and early adolescence: A longitudinal exploration of co-occurring mental illness. Dev Psychopathol 2021; 33:885-898. [PMID: 32362290 DOI: 10.1017/s0954579420000206] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chronic health conditions are hypothesized to disrupt the typical trajectory of child and adolescent development, and subsequently lead to increased levels of mental illness. However, due to methodological limitations in existing studies, this theory remains to be fully substantiated by empirical research. This study aimed to more thoroughly test hypotheses in the field. This study used data from the Avon Longitudinal Study of Parents and Children to examine the co-occurrence of mental illness among children with chronic illness in late childhood into early adolescence and explore mediating factors in these outcomes. Children with chronic health problems presented with a disproportionate rate of psychiatric illness at 10 years, and these chronic health problems continued to be associated with poor mental health outcomes at 13 years and 15 years. These outcomes were mediated by high levels of peer victimization and health-related school absenteeism. This study suggests that chronic illness may impact on functioning and social development in early adolescence, and consequently lead to increased rates of mental illness. Examining rates of school absenteeism and peer victimization may be key to identifying children at risk over time.
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20
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Volz M, Ehrenthal JC, Seiffge-Krenke I. Does clinically relevant psychopathology in adolescents necessarily require treatment or does it "grow out"? Psychother Res 2021; 32:525-538. [PMID: 34132164 DOI: 10.1080/10503307.2021.1939457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To determine the treatment effect of psychodynamic therapy for adolescents in comparison to normative developmental progression in two groups without treatment: healthy adolescents and adolescents with juvenile diabetes. RESEARCH DESIGN AND METHODS In a 3-wave longitudinal study, n = 531 adolescents (n = 303 treated adolescents, n = 119 healthy, n = 109 with diabetes) and their parents filled out psychopathology questionnaires (Youth Self-Report [YSR] and Child Behaviour Checklist [CBCL]). Growth curve modeling (GCM) was used to examine within-person change in psychopathology while controlling for stable between-person differences. RESULTS GCM analyses revealed significant within-person reductions in patients' YSR and CBCL (d = 1.02-1.99) at the end of treatment. When accounted for the control groups' developmental progression (d = .14-.94), patients' within-person change remained significantly higher (d = .48-.82). In all three groups, parents rated the severity of psychopathology significantly lower, and within-person change significantly higher than the adolescents him/herself. CONCLUSIONS Psychodynamic therapy led to a significant symptom reduction in treated adolescents and was superior to development-related symptom changes occurring in the two control groups. Hence, clinically relevant symptoms in adolescents do not "grow out", but require psychotherapeutic treatment. Differences between adolescents and their parents in the evaluation of symptom severity and change require attention in psychotherapy treatment and research.
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Affiliation(s)
- Matthias Volz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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21
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Health-Related Quality of Life of Children with Congenital Adrenal Hyperplasia: A Mixed Methods Study. J Pediatr Nurs 2021; 58:88-94. [PMID: 33497929 DOI: 10.1016/j.pedn.2021.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/23/2020] [Accepted: 01/11/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE The purpose of this study was to examine the health-related quality of life (HRQOL) of female children with CAH as reported by children and their caregivers. DESIGN AND METHODS A convergent mixed methods design was selected whereby quantitative and qualitative results were merged to provide a comprehensive understanding of HRQOL of children. Semi-structured interviews were conducted with 20 child-caregiver dyads. The full sample of child-caregiver dyads (N = 25) completed KINDL-R questionnaires, which provided a quantitative measure of children's HRQOL. RESULTS Children and their caregivers reported good overall HRQOL. Children scored significantly lower on the KINDL-R School subscale compared to their caregivers. Associations were observed between the HRQOL score from one graphic rating scale item and the child's other health issues and child's diagnosis. Themes emerging from the child and caregiver interviews were health-related quality of life, impact of stigma on psychological well-being, information-sharing and disclosure of CAH, and improving the quality of life of children with CAH. CONCLUSION This mixed methods study provided evidence to understand the health and complex needs of children with CAH. IMPLICATIONS Clinicians may better support children and caregivers by expanding the focus beyond medication management to include: 1) psychological support and resources (i.e., developmentally appropriate coping and adaptation strategies); 2) continuous education for clinical staff, school nurses, emergency medical transport staff, and providers; and 3) public awareness beyond the clinic and hospital settings.
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22
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Othman N, Wong YY, Lean QY, Mohd Noor N, Neoh CF. Factors affecting self-management among adolescents and youths with type 2 diabetes mellitus: A meta-synthesis. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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23
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Synnes O, Orøy AJ, Råheim M, Bachmann L, Ekra EMR, Gjengedal E, Høie M, Jørgensen E, Michaelsen RKA, Sundal H, Vatne S, Lykkeslet E. Finding ways to carry on: stories of vulnerability in chronic illness. Int J Qual Stud Health Well-being 2020; 15:1819635. [PMID: 32954979 PMCID: PMC7534264 DOI: 10.1080/17482631.2020.1819635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 10/31/2022] Open
Abstract
Purpose: In this study, we explore the lived experiences of chronic illness in four groups of patients; children with asthma, adolescents with diabetes, young adults with depression, and adult patients with chronic, obstructive pulmonary disease (COPD). Persons living with chronic illness are often designated as vulnerable. This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth. Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups. Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic illness can be alleviated or seen as resources. Considered together, the stories underscore how ´finding ways to carry on´ in chronic illness requires interpretational work. By calling upon resources among significant others, in the surroundings and in oneself, the narrator can find ways of interpreting living with chronic illness that might open towards a hopeful future.
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Affiliation(s)
- Oddgeir Synnes
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Aud Jorun Orøy
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Målfrid Råheim
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Liv Bachmann
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Else Mari Ruberg Ekra
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Eva Gjengedal
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Magnhild Høie
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Else Jørgensen
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | | | - Hildegunn Sundal
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Solfrid Vatne
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Else Lykkeslet
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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D'Amanda CS, Nolen R, Huryn LA, Turriff A. Psychosocial impacts of Mendelian eye conditions: A systematic literature review. Surv Ophthalmol 2020; 65:562-580. [DOI: 10.1016/j.survophthal.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 01/07/2023]
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25
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Trettin B, Hansen J, Bygum A. The impact of adolescents' everyday life experiences on their primary hyperhidrosis treatment - a qualitative study. J DERMATOL TREAT 2020; 33:928-934. [PMID: 32628056 DOI: 10.1080/09546634.2020.1789541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Hyperhidrosis is a disease affecting around 5% of the western population. The qualitative field within hyperhidrosis among adolescents has been sparsely investigated. The aim of this study was to investigate the impact of adolescent hyperhidrosis patients' everyday life experiences on their hyperhidrosis treatment. METHODS Qualitative, semi-structured interviews were carried out. In total, 10 adolescents, aged 12-18 years, participated in the study. Data were analyzed using a set of inseparable activities as described by Van Manen. RESULTS Three main themes were identified to represent common shared experiences across participants. The first theme was related to the impact of hyperhidrosis on the physical and psychological dimensions of life as it negatively affected both physical abilities and one's self-concept. Having hyperhidrosis was experienced as living a life in secrecy, characterized by individual routines for concealment and isolation in order to protect social identity. CONCLUSION The large negative impact of hyperhidrosis on adolescents is a strong justification for treatment of the disease. The substantial emotional distress suggests that treatment may need to include psychological support.
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Affiliation(s)
- Bettina Trettin
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
| | - Julie Hansen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Anette Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
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26
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Al-Yateem N, Subu MA, Al-Shujairi A, Alrimawi I, Ali HM, Hasan K, Dad NP, Brenner M. Coping among adolescents with long-term health conditions: a mixed-methods study. ACTA ACUST UNITED AC 2020; 29:762-769. [PMID: 32649257 DOI: 10.12968/bjon.2020.29.13.762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Adolescents with long-term health conditions may be at risk of developing psychological comorbidities and adopting ineffective coping mechanisms if they are not adequately supported at home or school. AIM To understand the strategies adolescents use when dealing with challenging health situations, and gain an in-depth understanding of the characteristics of their preferred care environment if they have unexpected health crises. DESIGN The study used a concurrent mixed-methods design, with data gathered between January and May 2019. Descriptive and non-parametric tests were used to analyse quantitative and qualitative data. RESULTS 'Problem-focused disengagement' was the most-often used coping strategy. The second and third most common strategies were 'problem-focused engagement' and 'emotion-focused engagement'. Finally, girls tended to adopt more negative coping strategies than boys. The analysis revealed that most adolescents preferred home over school as the care environment because these caring agents were close and available, knew how to care for them and had the resources to provide or access care, and listened and understood them. CONCLUSION Adolescents adopted disengagement and negative coping strategies early in their attempts to cope with stressful events before adopting more positive strategies. This is alarming, especially as school health services are not sufficiently supportive of adolescents at times of stress and illness. Adolescents often perceive school providers as unavailable and lacking knowledge about their health needs.
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Affiliation(s)
- Nabeel Al-Yateem
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Muhammad Arsyad Subu
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Arwa Al-Shujairi
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Intima Alrimawi
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Hend Mohd Ali
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Khadija Hasan
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Nawal Peer Dad
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Maria Brenner
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
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Enggaard H, Laugesen B, Zoffmann V, Lauritsen MB, Jørgensen R. Adolescents' Perceptions of Living With Co-Existing ADHD and Medical Disorder in Denmark. J Pediatr Nurs 2020; 53:e129-e135. [PMID: 32229051 DOI: 10.1016/j.pedn.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 01/10/2023]
Abstract
AIM The study aim was to explore adolescents' with co-existing ADHD and medical disorder (MD) perceptions of everyday life and support from parents and healthcare professionals. DESIGN AND METHODS In this qualitative study, 10 adolescents aged 13-17 years diagnosed with ADHD and a MD were included from a general pediatric hospital clinic and a child and adolescent psychiatric hospital clinic. Data obtained through semi-structured interviews were analyzed using thematic analysis. RESULTS The adolescents' perceptions were categorized into four themes: 1) ADHD perceived as part of the adolescent's self-understanding - yet with daily frustrations, 2) MD perceived as an interruption in everyday life, 3) ADHD and MD - an overlooked dual task, and 4) the need for supportive relationships in navigating ADHD and MD. CONCLUSION Living with co-existing ADHD and MD is a complex dual task, as ADHD and MD interfere with each other in everyday life. However, the adolescents overlook the dual task as they believe their difficulties would be resolved if the MD was eliminated. Moreover, supportive relationships are essential in navigating the complexities in living with co-existing ADHD and MD. Nevertheless, the adolescents take a passive role in the encounters with the healthcare professionals, whereas they are more active in encounters with peers, parents and teachers. PRACTICE IMPLICATIONS Healthcare professionals treating and caring for adolescents with co-existing ADHD and MD need interventions facilitating patient involvement in a patient-centered approach to support both adolescents and healthcare professionals in recognizing the dual task of having co-existing ADHD and MD.
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Affiliation(s)
- Helle Enggaard
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Nursing & Research Program for Children and Youth at Risk and Inequalities in Life Opportunities, University College Northern Denmark, Aalborg, Denmark.
| | - Britt Laugesen
- Danish Centre of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Vibeke Zoffmann
- The Research Unit for Women's and Children's Health, University Hospital Copenhagen, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marlene Briciet Lauritsen
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Zheng K, Abraham C, Bruzzese JM, Smaldone A. Longitudinal Relationships Between Depression and Chronic Illness in Adolescents: An Integrative Review. J Pediatr Health Care 2020; 34:333-345. [PMID: 32171610 PMCID: PMC7313149 DOI: 10.1016/j.pedhc.2020.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Depression is prevalent among adolescents with chronic illness. However, little is known about how depression affects chronic illness over time. This review aimed to synthesize longitudinal relationships between depression and disease control, self-management behaviors, illness-related morbidity, and quality of life. METHOD Four databases were searched, including PubMed, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and EMBASE. Inclusion criteria were cohort studies examining depression among adolescents aged 10-21 years with a chronic illness and studies published in English. Study quality was appraised using the Newcastle-Ottawa scale and data was synthesized by the outcome. RESULTS Of the 3,463 articles identified, 11 were included in the review. For adolescents with diabetes, increased depressive symptoms predicted decreased metabolic control and monitoring, medication adherence, quality of life, and increased hospitalization. Studies on cystic fibrosis, congenital heart disease, sickle cell disease, and juvenile idiopathic arthritis were limited but demonstrated that depressive symptoms affected the quality of life, disability, pain, and hospitalization rates/costs. DISCUSSION Evidence supports the need for mental health care strategies suitable for adolescents with chronic illness. Future research is needed to examine the effects of depressive symptoms across diversified chronic illness populations.
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Affiliation(s)
- Katherine Zheng
- Columbia University School of Nursing, 560 W. 168 Street, New York, NY 10032
| | - Cilgy Abraham
- Columbia University School of Nursing, 560 W. 168 Street, New York, NY 10032
| | - Jean-Marie Bruzzese
- Columbia University School of Nursing, 560 W. 168 Street, New York, NY 10032
| | - Arlene Smaldone
- Columbia University School of Nursing, 560 W. 168 Street, New York, NY 10032
- College of Dental Medicine, Columbia University, 622 W. 168 Street, New York, NY 10032
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Steinberg H. Distance and acceptance: Identity formation in young adults with chronic health conditions. ADVANCES IN LIFE COURSE RESEARCH 2020; 44:100325. [PMID: 36726244 DOI: 10.1016/j.alcr.2020.100325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 06/18/2023]
Abstract
Health has long been a chief concern of life course researchers, especially in examining early life. Research on chronic conditions and their impact on individual identity often center on biographical disruption or the idea of a bifurcation of "before and after" identities. This research examines identity formation in young adults with chronic health conditions that began in childhood, a population that continues to grow. This study focuses on young adults' narrative identities, both regarding how young adults describe the transition to adulthood and how cultural ideals of young adulthood and actors from institutions influence how they describe themselves. This study uses 22 in-depth qualitative interviews to reveal how young adults distance themselves from their conditions or move to acceptance through the narratives they tell about their health, feelings, and behaviors. This research suggests that identity confirmation by others forms an integral part of the nexus of health and the life course, shaping how adolescents make the transition into young adulthood. Social support from actors in institutions gives room to some young adults with chronic conditions to integrate their conditions into their narrative identities. This study reveals the social nature of young adult identities, and how cultural ideals guide them, precisely because it uses cases of young adults who must transition to adulthood in alternative ways.
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Affiliation(s)
- Hillary Steinberg
- University of Colorado Boulder, UCB 327 Ketchum 195, Boulder, CO, 80309, United States.
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Igler EC, Sejkora EK, Austin JE, Davies WH. Friendship changes following a friend's school absence after serious illness or injury. J Child Health Care 2020; 24:233-245. [PMID: 31146538 DOI: 10.1177/1367493519853437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Social support is vital in helping adolescents cope following a serious illness or injury, though it is not known how their healthy peers react to potential changes in the nature of their friendships during this time. In this questionnaire-based study, emerging adults in the community indicated whether they had an experience with a friend's serious illness during adolescence and responded to structured and open-ended questions about their experience. Participants reported diminished contact with friends following diagnosis, such as decreased frequency of visits and communication. Participants most commonly cited logistical issues, such as transportation, and their friend's emotional and/or physical functioning as barriers to staying connected. Friends reported a mixture of positive and negative experiences associated with a friend's illness. The communication barriers highlighted provide a potential focus for intervention. Results suggest positive communication promotion with healthy friends may be an important path to enhance social support after a serious illness diagnosis or injury.
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Affiliation(s)
- Eva C Igler
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Ellen Kd Sejkora
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jillian E Austin
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - W Hobart Davies
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Turriff A, Nolen R, D'Amanda C, Biesecker B, Cukras C, Sieving PA. "There Are Hills and Valleys": Experiences of Parenting a Son With X-Linked Retinoschisis. Am J Ophthalmol 2020; 212:98-104. [PMID: 31765628 DOI: 10.1016/j.ajo.2019.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/12/2019] [Accepted: 11/19/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore the experiences of parents of sons with X-linked retinoschisis (XLRS). DESIGN Mixed methods-qualitative interviews with quantitative survey. METHODS Parents of sons with XLRS who were evaluated at the National Eye Institute between December 2017 and January 2019 were eligible for this study. Participation involved engaging in a semistructured interview and completing a survey assessing optimism, anxiety, personality traits, and sociodemographics using valid and reliable scales. Interview transcripts were coded and analyzed thematically, and scales were scored and used descriptively. RESULTS Eleven mothers and 8 fathers from 13 families participated. Optimism, anxiety, and personality traits fell into the normative ranges for the scales. Parents described a process of continuous adaptation to their son's condition. The initial diagnosis was characterized by shock, grief, and "devastation" for most parents. Maternal guilt was common, but usually lessened over time. As parents adjusted to life postdiagnosis, they attempted to achieve a state of normalcy while balancing a desire to protect their sons. Significant sources of stress included decisions around sports participation and driving. Among all parents, the fear of retinal detachment was an ongoing concern. Most parents did identify perceived benefits from their experiences, such as feelings of gratitude or family cohesion. CONCLUSIONS Most parents viewed XLRS as a significant challenge in their sons' lives, but one that could be overcome. Clinical encounters may be enhanced for families with XLRS by providing accurate information, preparing families for potential challenges, anticipating stressful decisions, and meeting other families with XLRS.
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Martins A, Bennister L, Fern LA, Gerrand C, Onasanya M, Storey L, Wells M, Whelan JS, Windsor R, Woodford J, Taylor RM. Development of a patient-reported experience questionnaire for patients with sarcoma: the Sarcoma Assessment Measure (SAM). Qual Life Res 2020; 29:2287-2297. [PMID: 32227293 DOI: 10.1007/s11136-020-02481-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2020] [Indexed: 01/26/2023]
Abstract
PURPOSE The aim of the study was to develop a patient-reported outcome measure for patients with sarcoma-the Sarcoma Assessment Measure (SAM). METHODS AND RESULTS The systematic development of SAM included a three-stage, mixed-methods study using semi-structured interviews, focus groups and questionnaires, with all stages involving patients from across the United Kingdom. In-depth interviews were conducted with 121 patients (50% male; aged 13-82; with soft tissue sarcoma (62%), bone tumours (28%) and gastrointestinal stromal tumours (10%)). Content analysis of the interview transcripts identified 1415 post-diagnosis experience statements. Experience statements were reviewed, repetition was removed and sentences were refined to form 395 'items' which were included in an Item Reduction Questionnaire (IRQ) grouped as physical, emotional, social and financial wellbeing and sexuality. The IRQ was completed by 250 patients who rated each item on importance and worry. Items with a mean score above 5 (6 in the emotional domain) were removed, which reduced the list to 166 items. After review by the research team, 23 clinicians and 34 patients, 66 items were retained to test content validity. Items with a content validity ratio of < .33 were removed. Cognitive interviews were conducted with 10 patients on the final 22 items to test comprehension. Minor changes were made to four. CONCLUSION SAM comprises of 22 items reflecting physical, emotional, social, financial wellbeing and sexuality. This systematic process of using patient experience to develop the content of SAM will ensure that it measures what is important to patients.
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Affiliation(s)
- Ana Martins
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Lindsey Bennister
- Patient Representative, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Lorna A Fern
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Craig Gerrand
- London Sarcoma Service, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| | - Maria Onasanya
- Patient Representative, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Lesley Storey
- Department of Psychology, Birmingham City University, Curzon Building, Birmingham, B4 7BD, UK
| | - Mary Wells
- Nursing Directorate, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK
| | - Jeremy S Whelan
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Rachael Windsor
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Julie Woodford
- London Sarcoma Service, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
| | - Rachel M Taylor
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK. .,UCLH Cancer Clinical Trials Unit, 1st Floor East, 250 Euston Road, London, NW1 2PG, UK.
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Denford S, van Beurden S, O'Halloran P, Williams CA. Barriers and facilitators to physical activity among children, adolescents, and young adults with cystic fibrosis: a systematic review and thematic synthesis of qualitative research. BMJ Open 2020; 10:e035261. [PMID: 32086360 PMCID: PMC7045130 DOI: 10.1136/bmjopen-2019-035261] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Physical activity is widely recommended in the treatment and management of cystic fibrosis (CF). Despite the numerous physical and psychological benefits, many young people with CF are not achieving the recommended levels of physical activity. The aim of this systematic review was to identify and synthesise available qualitative investigations exploring the motives for, barriers to and facilitators of physical activity among young people with CF. METHODS The following six electronic databases were systematically searched: Applied Social Sciences Index and Abstracts (ASSIA), CINAH, EMBASE, MEDLINE, MEDLINE-in-process, PsycINFO up to August 2019. Keywords were used to identify qualitative research that explored engagement in physical activity among young people with CF. Titles and abstracts were screened by two independent reviewers, and potentially relevant articles were retrieved in full. Articles were eligible for inclusion if they employed any qualitative method and recruited participants under the age of 24 years with CF. Risk of bias of included studies was assessed via the Critical Appraisal Skills Programme. Results were synthesised using a thematic approach. RESULTS Seven studies met our inclusion criteria and were included in the review. Overall, studies were of moderate to high quality. Thematic synthesis identified nine main themes that encompass motives for, barriers to and facilitators of physical activity among young people with CF. These were (1) Perceptions of physical activity. (2) Value attributed to physical activity. (3) Social influences. (4) Competing priorities. (5) Fluctuating health. (6) Normality. (7) Control beliefs. (8) Coping strategies. (9) Availability of facilities. Previous reviews have been unable to identify intervention characteristics that influence physical activity behaviour. CONCLUSIONS This review provides detailed information on the physical (biological-clinical), psychological, social and environmental influences on physical activity behaviour, thus providing numerous targets for future interventions. This in turn could facilitate promotion of physical activity among young people with CF.
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Affiliation(s)
- Sarah Denford
- Children's Health & Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Samantha van Beurden
- Children's Health & Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Paul O'Halloran
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Craig Anthony Williams
- Children's Health & Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
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Goldman-Mellor S, Phillips D, Brown P, Gruenewald P, Cerdá M, Wiebe D. Emergency Department Use and Inpatient Admissions and Costs Among Adolescents With Deliberate Self-Harm: A Five-Year Follow-Up Study. Psychiatr Serv 2020; 71:136-143. [PMID: 31575352 PMCID: PMC7002213 DOI: 10.1176/appi.ps.201900153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Self-harm rates among U.S. adolescents have risen substantially. Health and social outcomes among contemporary self-harming youths are infrequently tracked and poorly understood. This study investigated long-term health service utilization (emergency department [ED] visits and inpatient admissions) and inpatient costs among a recent cohort of adolescents with deliberate self-harm. METHODS This retrospective cohort study used statewide, all-payer, longitudinally linked discharge data from California. All residents ages 10-19 presenting to EDs in 2010 with deliberate self-harm (N=5,396) were compared with two control groups: a random sample of adolescent ED patients with other complaints, matched on sex, age, residential zip code, and month of index visit (general control patients, N=14,921), and matched ED patients with psychiatric complaints but no self-harm (psychiatric control patients, N=15,835). Outcomes included 5-year rates of ED visits, inpatient admissions, and inpatient costs, overall and for psychiatric and nonpsychiatric complaints separately. RESULTS Self-harm patients' ED use, inpatient admissions, and inpatient costs were significantly higher than those of general control patients (by 39%, 81%, and 21%, respectively), when the analysis controlled for confounding demographic and utilization characteristics. Associations mostly persisted, although smaller in magnitude, in comparisons between self-harm and psychiatric control patients. Psychiatric and nonpsychiatric complaints contributed to self-harming adolescents' excess health service utilization and costs. CONCLUSIONS Deliberate self-harm among adolescents was found to be associated with long-lasting and costly patterns of health service utilization, often but not exclusively for psychiatric complaints. Future research should investigate the pathways underlying these associations and incorporate service utilization as a key patient outcome.
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Affiliation(s)
- Sidra Goldman-Mellor
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Dwena Phillips
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Paul Brown
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Paul Gruenewald
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Magdalena Cerdá
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Deborah Wiebe
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
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Vanclooster S, Van Hoeck K, Peremans L, Bilsen J, Van Der Werff Ten Bosch J, Laureys G, Paquier P, Jansen A. Reintegration into school of childhood brain tumor survivors: a qualitative study using the International Classification of Functioning, Disability and Health – Children and Youth framework. Disabil Rehabil 2020; 43:2610-2620. [DOI: 10.1080/09638288.2019.1708484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | | | - Lieve Peremans
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Johan Bilsen
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Geneviève Laureys
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Philippe Paquier
- Center for Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anna Jansen
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Pediatric Neurology Unit, UZ Brussel, Brussels, Belgium
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Moon JH. An Investigation into Chronic Conditions and Diseases in Minors to Determine the Socioeconomic Status, Medical Use and Expenditure According to Data from the Korea Health Panel, 2015. Osong Public Health Res Perspect 2020; 10:343-350. [PMID: 31897363 PMCID: PMC6927417 DOI: 10.24171/j.phrp.2019.10.6.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objectives This study compared the socioeconomic status, medical use and expenditures for infants (1–5 years), juveniles (6–12 years), and adolescents (13–19 years) with a chronic condition or disease to determine factors affecting health spending. Methods Data from 3,677 minors (< 20 years old, without disabilities) were extracted from the Korea Health Panel (2015) database. Results Minors with chronic conditions or diseases were older (juveniles, and adolescents; p < 0.001), and included a higher proportion of Medicaid recipients (p = 0.004), a higher use of hospital outpatient care (p < 0.001), and higher medical expenditure (p < 0.001) compared to minors without chronic conditions or diseases. Boys were more likely to have a chronic condition or disease than girls (p = 0.036). Adolescents and juveniles were more likely than infants to have a chronic condition or disease (p = 0.001). Medicaid recipients were more likely to have a chronic condition or disease than those who were not Medicaid recipients (p = 0.008). Minors who had been hospital outpatients were more likely to have a chronic condition or disease, compared with minors who had not been an outpatient (p = 0.001). Having a chronic condition or disease, was a factor increasing medical expenditure (p = 0.001). Medical expenditure was higher in infants than in juveniles and adolescents (p = 0.001). Infants had higher rates of medical use when compared with juveniles and adolescents (p = 0.001). Conclusion These findings suggest that systematic health care management for minors with chronic conditions or diseases, is needed.
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Affiliation(s)
- Jong-Hoon Moon
- Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
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Marcotte J, Grandisson M, Piquemal C, Boucher A, Rheault MÈ, Milot É. Supporting Independence at Home of People with Autism Spectrum Disorder: Literature Review. The Canadian Journal of Occupational Therapy 2019; 87:100-116. [PMID: 31826662 DOI: 10.1177/0008417419890179] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND. The integration of a life environment enabling people with autism spectrum disorder (ASD) to fully exercise their independence must be well prepared. PURPOSE. Review and describe interventions intended to develop the independence at home of people with ASD. METHOD. The PRISMA method was used to perform a systematic review based on 19 keywords, grouped under three concepts: (a) population age (adolescents and adults), (b) diagnosis (ASD), and (c) independence. FINDINGS. Seven effective interventions were identified in the 20 selected articles: (a) video self-modeling, (b) video modeling, (c) behavioural interventions, (d) video prompting, (e) transition planning program, (f) training in the use of a cognitive aid, and (g) social skills group. IMPLICATIONS. The results of this review will help guide practitioners in the implementation of interventions that foster the development of independence at home of people with ASD.
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Carroll L, Graff C, Wicks M, Diaz Thomas A. Living with an invisible illness: a qualitative study exploring the lived experiences of female children with congenital adrenal hyperplasia. Qual Life Res 2019; 29:673-681. [PMID: 31823183 DOI: 10.1007/s11136-019-02350-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Many chronic illnesses are self-evident. However, disorders like congenital adrenal hyperplasia (CAH) are invisible to the naked eye and unnoticeable to others. Therefore, invisible illness is often a shared, misconstrued experience for children with CAH, their caregivers, and the medical community. This experience, along with its lack of awareness and added stigma, may impact overall quality of life (QOL) of such individuals. To facilitate our understanding of QOL of children with CAH, we must first explore their subjective experiences. This study aimed to capture their lived experiences and provide recommendations to support children with CAH. METHODS We conducted semi-structured interviews with 20 female children with CAH between 7 and 18 years and their caregivers. Interviews were transcribed verbatim, checked for accuracy, and independently coded by the first and second author. Content analysis was used to organize data so that codes could be condensed into categories and themes. Differences around code, category, and theme description were reconciled. RESULTS Participants' experiences were described in five themes: (1) Making sense of the situation; (2) Emotional and psychological impact of an invisible illness; (3) Normalcy; (4) Disclosure of diagnosis; and (5) Improving the care of children with CAH CONCLUSION: Exploring children's views about living with an invisible illness illuminated individual aspects contributing to our in-depth understanding of experiences of children with CAH. Ongoing education and awareness of CAH is necessary to help mitigate the stigma associated with living with CAH.
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Affiliation(s)
- Lacretia Carroll
- College of Nursing, University of Tennessee Health Science Center, 920 Madison Avenue, 5th floor, Memphis, TN, 38163, USA. .,University of Tennessee Health Science Center, 920 Madison Avenue, Suite 570, Memphis, TN, 38163, USA.
| | - Carolyn Graff
- College of Nursing, University of Tennessee Health Science Center, 920 Madison Avenue, 5th floor, Memphis, TN, 38163, USA
| | - Mona Wicks
- College of Nursing, University of Tennessee Health Science Center, 920 Madison Avenue, 5th floor, Memphis, TN, 38163, USA
| | - Alicia Diaz Thomas
- Department of Pediatric Endocrinology, Le Bonheur Children's Hospital, 51 North Dunlap, Memphis, TN, 38103, USA
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Gathercole K. Managing cystic fibrosis alongside children's schooling: Family, nurse and teacher perspectives. J Child Health Care 2019; 23:425-436. [PMID: 30590956 DOI: 10.1177/1367493518814930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The treatment regimen for children with cystic fibrosis (CF) is vast and is usually undertaken in the family home. Managing CF coincides with other important family routines such as children's participation in education. There is a dearth of research that considers family routines that may influence, and be influenced by how CF is managed. To address this gap, this patient-led study examined how families manage CF alongside children's education in England. Semi-structured interviews were conducted with 14 participants comprising 5 children and young people with CF, 4 parents, 2 CF nurse specialists and 3 teachers. The results revealed that CF routines were organized to minimize disruption to education, although families experienced challenges in meeting all daily health and education demands. Families chose between children doing their treatments or participating in school activities when doing both were not feasible. Treatments were sometimes a barrier to education participation and children's learning. Families found treatment routines restrictive upon children's friendships. Education is a priority for families, which affects how they manage CF. CF clinical teams should consider bidirectional influences between important family routines and families' management of CF, when planning appropriate treatment regimens.
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Affiliation(s)
- Katie Gathercole
- Faculty of Education, Social Sciences and Law, School of Education, University of Leeds, Leeds, UK
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Zheng K, Bruzzese JM, Smaldone A. Illness acceptance in adolescents: A concept analysis. Nurs Forum 2019; 54:545-552. [PMID: 31313315 DOI: 10.1111/nuf.12368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To strengthen the theoretical understanding of illness acceptance in adolescents and to inform healthcare strategies geared toward supporting adolescents with chronic illness. BACKGROUND Illness acceptance is associated with positive health outcomes. Though well understood in adults with chronic illness, less is known about how this phenomenon ensues in adolescents. Adolescents may have a difficult time accepting an illness due to their unique developmental needs. Consequently, they are vulnerable to poor health outcomes. DESIGN Concept analysis. DATA SOURCES A literature search through 2 databases (PubMed and PsycINFO) and a hand-search through Google were conducted to identify uses of the concept. REVIEW METHODS The Walker and Avant method of concept analysis. RESULTS Four attributes of illness acceptance were identified: understanding of illness, overcoming limitations, normalization, and readiness for responsibility. Antecedents that predisposed illness acceptance included peer and family support, disease management education, and developmental readiness. Positive consequences of illness acceptance included high self-esteem, improved quality of life, resilience, identity formation, and better disease control. CONCLUSIONS Establishing a standardized conceptual understanding of how illness acceptance ensues in adolescents can enable nurses and other health professionals to tailor developmentally appropriate care strategies and optimize the overall quality of life for this unique patient population.
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Affiliation(s)
| | | | - Arlene Smaldone
- Columbia University School of Nursing, New York, New York.,College of Dental Medicine, Columbia University, New York, New York
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Jeminiwa RN, Hohmann NS, Fox BI. Developing a Theoretical Framework for Evaluating the Quality of mHealth Apps for Adolescent Users: A Systematic Review. J Pediatr Pharmacol Ther 2019; 24:254-269. [PMID: 31337988 DOI: 10.5863/1551-6776-24.4.254] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess adolescents' preferred mobile app features and to propose a framework for evaluating health-related mobile apps for adolescents. METHODS PubMed, CINAHL, PsycINFO, ERIC, HealthIT.gov, and ClinicalTrials.gov were systematically searched in August 2017. Studies pertaining to app development, feasibility, or usability that reported preferred app features and rating criteria on mHealth (mobile health) apps intended for adolescents were included. Quality assessment was performed using the Mixed Methods Appraisal Tool. Qualitative synthesis was performed to develop themes reflecting best practices for evaluating the quality of mHealth apps for adolescents. Using a grounded theory approach, we constructed a theoretical framework of rating criteria that can be used to inform development of an evaluation tool for mHealth apps targeted to adolescents. RESULTS Thirteen articles were included. Most commonly preferred features include ability to track test results or self-management progress, connect to social media, and gain points or prizes through app gamification. Common rating criteria include degree of app customizability, ease of use, visual appeal, and interactivity. Five emerging dimensions were used in the theoretical framework: Technical Quality; Engagement; Support System; Autonomy; and Safety, Privacy, and Trust. CONCLUSIONS We found that adolescents prefer mHealth apps that are customizable, offer peer support through social media, sustain engagement via gamification, and support the ability to visualize health trends via simplified graphs. Findings may help in the development of mHealth apps that are preferred by adolescents, as well as the development of a quality evaluation tool for mHealth apps targeted to this population.
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Long E, Barrett T, Lockhart G. Chronic health conditions and adolescent friendship: perspectives from social network analysis. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0293/ijamh-2018-0293.xml. [PMID: 31352433 DOI: 10.1515/ijamh-2018-0293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 02/12/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The current study uses methods from social network analysis to examine the relationship between chronic health conditions (CHCs) and adolescent friendships. Particular attention is given to the processes of peer marginalization, peer withdrawal and homophily related to CHCs. METHODS Exponential random graph models were used to investigate the extent to which a CHC is associated with patterns in adolescent friendship connections, while controlling for important social network properties and covariates. The study uses cross-sectional data from six small US high schools (n = 461) within the National Longitudinal Study of Adolescent to Adult Health. RESULTS Findings demonstrate no significant differences between adolescents with CHCs and adolescents without CHCs in the number of incoming friendship nominations (peer marginalization) or outgoing friendship nominations (peer withdrawal). In addition, similarity in CHCs (homophily) was not significantly related to friendship between two individuals. CONCLUSIONS In sum, the presence of an adolescent CHC was not significantly associated with adolescent social network structure, including peer marginalization, peer withdrawal, and homophily related to CHCs, after controlling for alternative social network processes. Although previous literature suggests that adolescents with CHCs experience negative social consequences, the current findings demonstrate that the social network structure of adolescents with CHCs did not differ significantly from that of their peers without CHCs. Thus, findings from the current study suggest that CHCs are not related to objective reductions in social connections.
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Affiliation(s)
- Emily Long
- Utah State University, Department of Psychology, 2810 Old Main Hill, Logan, UT 84321, USA, Phone: +406-249-8709; Fax: +435-797-1448
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Are non-psychiatric hospitalisations before self-harm associated with an increased risk for suicide among young people? J Psychosom Res 2019; 120:96-101. [PMID: 30929715 DOI: 10.1016/j.jpsychores.2019.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to investigate any increased risk for suicide in young people with admission for self-harm and if the risk is further increased due to somatic inpatient admissions before a first act of self-harm. METHODS This register study included 16,235 cases in the ages 16-24, with a first admission for self-harm, and 32,465 matched controls. All admissions and diagnoses were recorded from the year preceding cases first admission for self-harm. Subjects were followed until death or end of study, registering the cause of death for all deceased. Group differences were analysed using survival analysis with death by suicide as primary outcome. RESULTS In cases with a previous somatic admission, the risk for death by suicide during the study period was higher than in cases without a somatic admission (457 and 316 suicides per 100,000 people and year, respectively, p = 0.01). For cases with a somatic admission, the hazard ratio was 1.43 (95% confidence interval 1.04-1.98) compared with those without somatic admissions (controlled for age, sex and psychiatric admission). Survival of cases with a previous somatic admission compared with those without was 98.4% versus 99.2% after the first year, 97.8% versus 98.9% after the second year, and 95.5% versus 96.9% after the tenth year. CONCLUSIONS This study suggests that admission for physical illness before self-harm is associated with a higher risk for suicide among young people, and that their contact with healthcare due to physical problems could provide an opportunity to detect suicide risk.
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Survonen A, Salanterä S, Näntö‐Salonen K, Sigurdardottir AK, Suhonen R. The psychosocial self-efficacy in adolescents with type 1 diabetes. Nurs Open 2019; 6:514-525. [PMID: 30918702 PMCID: PMC6419123 DOI: 10.1002/nop2.235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 10/29/2018] [Accepted: 11/20/2018] [Indexed: 01/09/2023] Open
Abstract
AIM To analyse psychosocial self-efficacy in adolescents with type 1 diabetes, evaluate associations between self-efficacy and metabolic control and background variables and determine psychometric properties of the Finnish Diabetes Empowerment Scale (Fin-DES-28). DESIGN A descriptive correlational survey. METHODS The data were collected with the Finnish Diabetes Empowerment Scale from 13-16-year-old adolescents with type 1 diabetes (N = 189, 34%) in one university hospital district area in 2014. RESULTS The level of psychosocial self-efficacy was quite good. The highest scores were in managing the psychosocial aspects of diabetes, followed by assessing dissatisfaction and readiness to change and setting and achieving diabetes goals. The self-efficacy did not correlate with metabolic control or background variables. A positive association was found between self-efficacy and understanding of diabetes and its treatment, adjustment of diabetes to life and the relationship with the doctor and the nurse. The internal consistency of the Finnish Diabetes Empowerment Scale was adequate. The low response rate limits generalization.
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Affiliation(s)
- Anne Survonen
- Department of Nursing Science, Turku University HospitalUniversity of TurkuTurkuFinland
| | - Sanna Salanterä
- Department of Nursing Science, Turku University HospitalUniversity of TurkuTurkuFinland
| | | | - Arun K. Sigurdardottir
- School of Health SciencesUniversity of AkureyriAkureyriIceland
- Akureyri HospitalAkureyriIceland
| | - Riitta Suhonen
- Department of Nursing ScienceUniversity of Turku and Turku University Hospital, and City of Turku, Welfare DivisionTurkuFinland
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Rasmussen GS, Kragballe K, Maindal HT, Lomborg K. Caring for young people with moderate to severe psoriasis: an interpretive description of parental perspectives. J DERMATOL TREAT 2019; 31:227-234. [PMID: 30835580 DOI: 10.1080/09546634.2019.1590523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Psoriasis often sets on during childhood or adolescence, when parents have great importance for the young people's self-management, well-being, and quality of life. The aim of this study was to understand parents' perspectives on young people's daily life with psoriasis in order to improve adolescents' self-management.Method: Adopting interpretive, description methodology (ID), focus group discussion, and interviews were conducted with eight parents of adolescents with psoriasis. The analysis was inductive with an iterative comparative approach. Main themes conveying participants' perceptions were identified for constructing a coherent narrative of parents' perspectives on their young people's transition with psoriasis through adolescence.Results: Parents initially perceived psoriasis mainly a physical and treatment-related burden and not until late realized its socio-emotional impact. They eventually found themselves balancing between declining treatment due to fear of side effects and acknowledging the impact on their young people's quality of life and their desire for effective treatment.Conclusions: Caring for young people with psoriasis is a stressful process involving experimental learning to understand and manage the complexity of psoriasis and its impact on adolescents' emotional and social life. Future research should consider integration of shared decision-making and self-management support interventions in routine daily care as focus points.
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Affiliation(s)
| | - Knud Kragballe
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Kirsten Lomborg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Kirk S, Hinton D. "I'm not what I used to be": A qualitative study exploring how young people experience being diagnosed with a chronic illness. Child Care Health Dev 2019; 45:216-226. [PMID: 30652354 DOI: 10.1111/cch.12638] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood long-term conditions are usually diagnosed in infancy or early childhood. Little is known about the particular experiences and needs of young people who receive a chronic illness diagnosis during adolescence or late childhood. This paper will examine this experience in relation to multiple sclerosis (MS), which is increasingly being diagnosed before adulthood. AIMS To explore how young people experience an MS diagnosis. METHODS Qualitative study using a grounded theory approach. In-depth interviews were conducted with 21 young people diagnosed with MS. Participants were recruited through health service and voluntary sector organizations in the United Kingdom. RESULTS Young people's pre-illness normality was disrupted by the diagnosis of a chronic illness (MS). Participants experienced their body as changed physically, cognitively, and emotionally and as changeable due to symptom unpredictability. This influenced how participants perceived and presented their identity, disrupted their relationships, and altered their future biography. Young people developed strategies to manage their condition and identities in order to incorporate MS into their current and future lives, which required continual illness and identity work in response to changing symptoms, social contexts, and relationships. CONCLUSIONS Although young peoples' experience of living with chronic illness has been widely explored, the aftermath of diagnosis has been underresearched from their perspective. This study contributes to this knowledge gap by illuminating how young people experience a chronic illness diagnosis and negotiate the resulting changes to their identity, relationships, and future. The findings suggest that young people need preparation and support in disclosing their diagnosis to others. Professionals supporting young people with long-term conditions need to work closely with specialist mental health services to ensure that they receive appropriate emotional support. Schools have an important role in ensuring young people with long-term conditions achieve their academic potential and receive appropriate careers advice.
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Affiliation(s)
- Susan Kirk
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Denise Hinton
- School of Health Sciences, University of Manchester, Manchester, UK
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Chew J, Carpenter J, Haase AM. Living with epilepsy in adolescence-A qualitative study of young people's experiences in Singapore: Peer socialization, autonomy, and self-esteem. Child Care Health Dev 2019; 45:241-250. [PMID: 30693552 DOI: 10.1111/cch.12648] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/23/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Systematic reviews of quantitative research on the effects of childhood epilepsy have established its association with higher levels of psychiatric diagnosis, externalizing and internalizing problems, lower health-related quality of life, social competence, and poorer academic achievements, compared with their peers. However, much less is known about young people's experiences of living with epilepsy and its impact on their development from their own perspectives. METHODS Semistructured interviews were conducted with 15 young people aged between 13 and 16 years. Participants were recruited as part of a larger mixed methods study examining individual and family influences on outcomes for young people with epilepsy. These young people attended an epilepsy clinic in KK Women's and Children's Hospital, Singapore. The framework approach to data management and analyses involved both inductive and deductive generation of themes. RESULTS Findings from young people's interviews provided in-depth descriptions of stressful circumstances encountered. Interconnectedness between severity of the impairment and its impact on key developmental tasks, such as independence, autonomy, and social development, were emphasized. Seizures and illness-related demands disrupted their day-to-day functioning and challenged their abilities to meet these tasks. In addition to these impairment effects, young people's experiences of social exclusion were also affected by social and environmental factors, which act as systemic barriers to participation. In turn, this has an effect on their self-esteem. Nevertheless, young people reported positive experiences, such as support from both family and friends, which served as protective factors against the stress of living with a chronic medical condition. CONCLUSION The demands of epilepsy affect various domains of young people's lives. In order to obtain a holistic understanding of young people's inclusion or exclusion to participation, it is necessary to consider impairment effects, barriers to doing, and barriers to being.
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Affiliation(s)
- Judith Chew
- Medical Social Work Department, KK Women's and Children's Hospital, Singapore
| | - John Carpenter
- Social Work and Applied Social Science, School for Policy Studies, University of Bristol, Bristol, UK
| | - Anne M Haase
- School for Policy Studies, University of Bristol, Bristol, UK.,Centre for Exercise, Nutrition and Health, School for Policy Studies, University of Bristol, UK.,Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center
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A Critical Review of the Impact of Sarcoma on Psychosocial Wellbeing. Sarcoma 2019; 2019:9730867. [PMID: 30911268 PMCID: PMC6397984 DOI: 10.1155/2019/9730867] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/11/2022] Open
Abstract
Background Previous reviews of outcomes in specific sarcoma populations suggest patients have poor quality of life. In most of these reviews, there is a predominant focus on physical function rather than psychosocial outcome. The aim of this review was to describe the psychosocial impact of diagnosis and treatment on patients with all types of sarcoma. Methods Searches were conducted through six electronic databases for publications of any study design using a validated patient-reported outcome measure reporting the psychosocial impact in this population. Results Eighty-two studies fulfilled the inclusion criteria. Most (65%) were assessed of being of reasonable quality. The most common aspect of psychosocial wellbeing measured was quality of life (80%). Due to the heterogeneity of methods, outcomes, and populations, it was not possible to make definitive conclusions. It seems there is an improvement in the physical aspects of quality of life over time but not in psychosocial function or mental health. There was no change in mental health scores, but patients reported an improvement in adjusting to normal life. There are no differences according to the type of surgery patients receive, and psychosocial outcomes tend to be poorer than the general population. There is no consistency in identifying the factors that predict/influence psychosocial wellbeing. Conclusion The published literature does not provide a clear understanding of the impact of sarcoma diagnosis and treatment on psychosocial wellbeing. Instead, the review demonstrates a need for well-designed studies in this area and a more consistent approach to the measurement of patient-reported outcomes, which include psychosocial domains. Recommendations for future research have been proposed.
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Puwar T, Saxena D, Yasobant S, Savaliya S. Noncommunicable Diseases among School-going Adolescents: A Case Study on Prevalence of Risk Factors from Sabarkantha District of Gujarat, India. Indian J Community Med 2019; 43:S33-S37. [PMID: 30686872 PMCID: PMC6324039 DOI: 10.4103/ijcm.ijcm_117_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: The increasing burden of noncommunicable diseases (NCDs) and large proportion of adolescent population in India; crafts the dynamics of NCD risk factors. Most of the NCD risk factors are behaviorally acquired which are due to change in lifestyle during adolescent age groups. Objective: This study aims to determine the prevalence of risk factors among school-going adolescents in one of district of Gujarat state, India. Subjects and Methods: This is a cross-sectional study conducted among sampled schools of Sabarkantha district of Gujarat, India, during September–December 2016. A total of 484 school-going adolescents were screened for body weight, height, blood pressure, and some information of sociodemographic, lifestyle habits, and family history were collected through a structured questionnaire in vernacular language. Data were managed with SPSS version 20. Results: This study documents that not having fruits and not doing physical activities daily are the major risk factors of NCDs among school-going adolescents of Sabarkantha district, Gujarat. In addition to this, also it has been documented that there are differential standards for body mass index (BMI) available for adolescents and have been used extensively in various studies. This study provides an insight to these three major BMI standards and their differences in measurement for the school-going adolescents. Conclusions: This study recommends promoting healthier practices for prevention of NCD lifestyle risk factors among school-going adolescents and it also recommends standardizing the BMI measurements for adolescents for India.
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Affiliation(s)
- Tapasvi Puwar
- Department of Epidemiology, Indian Institute of Public Health Gandhinagar, Gujarat, India
| | - Deepak Saxena
- Department of Epidemiology, Indian Institute of Public Health Gandhinagar, Gujarat, India
| | - Sandul Yasobant
- Center for Development Research (ZEF), University of Bonn, Bonn, Germany
| | - Shital Savaliya
- Department of Epidemiology, Indian Institute of Public Health Gandhinagar, Gujarat, India
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Wicks S, Berger Z, Camic PM. It's how I am . . . it's what I am . . . it's a part of who I am: A narrative exploration of the impact of adolescent-onset chronic illness on identity formation in young people. Clin Child Psychol Psychiatry 2019; 24:40-52. [PMID: 30789046 DOI: 10.1177/1359104518818868] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In Western society, identity formation is argued to be one of the key developmental tasks of adolescence. Despite implications for adolescent development, research into chronic illness (CI) onset during this period has been notably sparse. This study aimed to explore how diagnosis impacts on the developmental tasks of adolescence, what role adolescent-onset CI plays in identity formation, and how adolescents incorporate the diagnosis into their identity using a narrative analysis. Individual semi-structured interviews were carried out with eight young people aged 14 to 19years who lived with a diagnosis of a CI diagnosed between the ages of 12 and 16 years. Five core narrative themes emerged: walking a different path, tolerating contradiction, a changed interface with others, locating power and a fluid relationship. Narratives were considered to have been influenced by factors such as the interview context and dominant social narratives concerning health and illness. Adolescent-onset CI was found to have a significant, though not exclusively negative, impact on developmental tasks. The findings are discussed in relation to existing literature and potential clinical implications.
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Affiliation(s)
| | - Zoe Berger
- 2 Psychological Services, Great Ormond Street Hospital NHS Foundation Trust, UK
| | - Paul M Camic
- 3 Salomons Centre for Applied Psychology, Canterbury Christ Church University, UK
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