1
|
Knock M, Carpenter DM, Thomas KC, Lee C, Adjei A, Lowery J, Coyne I, Garcia N, Sleath B. Disseminating a health information website to teens using a three-pronged approach with social media outreach. PEC INNOVATION 2024; 4:100288. [PMID: 38766572 PMCID: PMC11101743 DOI: 10.1016/j.pecinn.2024.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/02/2024] [Accepted: 05/04/2024] [Indexed: 05/22/2024]
Abstract
Objective To disseminate iuveo.org, a new health information website, primarily to teens in the United States using a three-pronged approach of social media, in-person, and emails. Methods Dissemination methods included a combination of in-person, email, and social media campaigns starting in August 2022 to reach teens and stakeholders focused on teen health. Following the Social Marketing Theory framework, a social media campaign was implemented utilizing Instagram and X (formerly Twitter). Website analytics, including monthly usage of iuveo, was measured utilizing Google Analytics. The intrinsic analytics from X and Instagram were also tracked. Results From August 2022-July 2023, iuveo attracted 1338 unique users to the website. In the same time frame, 1085 accounts were reached on Instagram, and 14,367 impressions were received on X. Most website users (84.8%) were classified as 'direct' acquisition, meaning that they directly typed in the URL or clicked on a link, and 7.3% of users visited iuveo from a social media platform. Conclusion A three-pronged dissemination strategy is beneficial when disseminating a new health information website. Innovation Utilizing a three-pronged approach with a social media campaign based on Social Marketing Theory, a health information website was disseminated to youth in the United States.
Collapse
Affiliation(s)
- McKenna Knock
- UNC Eshelman School of Pharmacy, United States of America
| | - Delesha M. Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, United States of America
| | - Kathleen C. Thomas
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, United States of America
- UNC Cecil G. Sheps Center for Health Services Research, United States of America
| | - Charles Lee
- UNC Eshelman School of Pharmacy, United States of America
| | - Abena Adjei
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, United States of America
| | - Jeremy Lowery
- UNC Eshelman School of Pharmacy, United States of America
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, the University of Dublin College Green, Dublin, Ireland
| | - Nacire Garcia
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, United States of America
- UNC Cecil G. Sheps Center for Health Services Research, United States of America
| | - Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, United States of America
- UNC Cecil G. Sheps Center for Health Services Research, United States of America
| |
Collapse
|
2
|
Wright M, Thomas KC, Carpenter D, Lee C, Coyne I, Garcia N, Adjei A, Sleath B. Co-designing a website with and for youth, so they can better manage their health. PEC INNOVATION 2023; 2:100164. [PMID: 37384159 PMCID: PMC10294082 DOI: 10.1016/j.pecinn.2023.100164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 06/30/2023]
Abstract
Objective To co-design a website aimed to empower youth to ask questions to encourage productive, meaningful conversations with their health care providers. Methods The research team recruited adolescent stakeholders (ages 11-17) through flyers distributed at local Young Men's Christian Association (YMCA) locations, clinics, and school nurses. Eleven adolescents who had at least one chronic medical condition were selected as members of the two youth advisory boards. Youth participated in five co-design meetings to give input on website content and refinement over a two-and-a-half-year period. The youth reviewed the website in various stages of development. Results Youth wanted a website with simple, straightforward language that would be understood by someone between the ages of 11-17 years with a reputable URL. The website content includes ADHD, asthma, vaping/smoking, diabetes, seizures, anxiety, panic disorder, depression, addiction, stimulants, bullying, eating disorders, and sexually transmitted infections. Youth wanted general background content, helpful resources, question prompt lists, and videos encouraging youth involvement in care. Conclusions A credible co-designed website with information on different health topics that contains question prompt lists and videos for utilization during health care visits has the potential to increase adolescent involvement in their care. Innovation This website is an innovative intervention aimed at informing and encouraging youth to be more actively involved in their care across a range of healthcare conditions.
Collapse
Affiliation(s)
- Megan Wright
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Kathleen C Thomas
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delesha Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, the University of Dublin College Green, Dublin, Ireland
| | - Nacire Garcia
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abena Adjei
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
3
|
Sayegh CS, Iverson E, Newman C, Tanaka D, Olshansky EF, Wijaya C, Belzer M. Designing an mHealth Roadmap for the Journey to Self-Management: A Qualitative Study with Adolescents and Young Adults Living with Chronic Illness. Chronic Illn 2023; 19:65-80. [PMID: 34904870 DOI: 10.1177/17423953211067436] [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: 01/18/2023]
Abstract
OBJECTIVES Adolescents and young adults (AYA) with chronic illnesses often struggle with illness self-management. The objective of this study is to understand how AYA with various chronic illnesses develop self-management skills and which mobile health (mHealth) strategies they believe could be helpful. METHODS Semi-structured interviews were conducted with patients, between 16 to 20 years old, living with at least one chronic illness (N = 19), between 2018 and 2019 in Los Angeles, CA. Three coders completed thematic coding to understand how AYA develop and maintain self-management skills, to inform the development of mHealth interventions appropriate across a variety of chronic conditions. RESULTS Results suggest that AYA develop self-management skills through several strategies, including (1) getting organized, (2) making it work for me and (3) keeping the right mentality. AYA described developing these strategies through: (1) receiving social support, (2) accessing helpful tools and technologies, and (3) going through a maturation process. They provided recommendations for mHealth intervention developers. DISCUSSION The results suggest that an appealing mHealth intervention could support AYA patients in proactively acquiring self-management skills and prevent having to rely on trial and error or uneven access to guidance and support. Interventions should be responsive to individual technology preferences and practices.
Collapse
Affiliation(s)
- Caitlin S Sayegh
- Division of Adolescent and Young Adult Medicine, 5150Children's Hospital Los Angeles, Los Angeles, California, USA.,USC University Center for Excellence in Developmental Disabilities, 5150Children's Hospital Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, 12223University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Ellen Iverson
- Division of Adolescent and Young Adult Medicine, 5150Children's Hospital Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, 12223University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Clarissa Newman
- Department of Population and Public Health Sciences, 12223University of Southern California, Los Angeles, California, USA
| | - Diane Tanaka
- Division of Adolescent and Young Adult Medicine, 5150Children's Hospital Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, 12223University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Ellen F Olshansky
- 115162Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Sue & Bill Gross School of Nursing, 8788University of California Irvine, Los Angeles, California, USA
| | - Clarisa Wijaya
- Department of Psychology, 5116University of Southern California, Los Angeles, California, USA
| | - Marvin Belzer
- Division of Adolescent and Young Adult Medicine, 5150Children's Hospital Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, 12223University of Southern California Keck School of Medicine, Los Angeles, California, USA
| |
Collapse
|
4
|
Self-Management Frameworks for Youth Living with Human Immunodeficiency Virus. Pediatr Clin North Am 2022; 69:759-777. [PMID: 35934498 DOI: 10.1016/j.pcl.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
HIV is now a chronic condition that can be managed. Adolescents and emerging adults represent a large proportion of new diagnoses, but struggle with many aspects of HIV-related self-management. Self-management of HIV is critical to maintaining health and involves retention in HIV care, medication adherence to achieve viral suppression, managing substance use, and sexual and general health-related behaviors. This article describes theoretic frameworks for HIV self-management as adapted for youth and reviews self-management interventions developed to improve health outcomes in youth living with HIV identified from a recent systematic review.
Collapse
|
5
|
Hanghøj S, Boisen KA, Nielsen MF, Pappot H, Hjalgrim LL. A Qualitative Evaluation of the Youth-Check Program: A Psychosocial Intervention Aimed at Young People with Cancer. Semin Oncol Nurs 2022; 38:151268. [DOI: 10.1016/j.soncn.2022.151268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
|
6
|
Blamires J, Dickinson A, Tautolo ES, Byrnes CA. A "pretty normal" life: a qualitative study exploring young people's experience of life with bronchiectasis. Int J Qual Stud Health Well-being 2021; 16:2003520. [PMID: 34793292 PMCID: PMC8604450 DOI: 10.1080/17482631.2021.2003520] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
PURPOSE Bronchiectasis is a chronic respiratory disease that impacts significantly on quality of life for those who have it. There is a paucity of literature exploring the perspectives of children and young people. The aim of this study was to examine the day-to-day life experience of a group of young people with bronchiectasis. METHOD A qualitative study using semi-structured interviews explored fifteen young people's perspectives of life with bronchiectasis. Key themes were identified using an inductive iterative approach through constant comparative analysis guided by Thorne's interpretive description. RESULTS Life with bronchiectasis was conceptualized by participants as "Pretty Normal". This consisted of two co-existing life views which represented how young people balanced the ups and downs of adolescence while learning to accommodate the demands of living with bronchiectasis. Three key thematic elements "sore and tired", 'life interrupted and "looking after self", influenced and challenged these two views of life. CONCLUSIONS Young people with bronchiectasis portray life as being the same as their peers. Despite this, they recognized that the symptoms, interruptions, and self-management responsibilities led them to find ways of coping and integrating their experience into a new and modified view of normal.
Collapse
Affiliation(s)
- Julie Blamires
- School of Clinical Sciences Auckland University of Technology, Northcote, Auckland
| | - Annette Dickinson
- School of Clinical Sciences Auckland University of Technology, Northcote, Auckland
| | - El Shadan Tautolo
- School of Public Health & Interdisciplinary Studies Director-AUT Pacific Health Research Centre, Auckland University of Technology, NZ
| | - Catherine A Byrnes
- Department of Paediatrics; Child and Youth Health, Faculty of Health & Medical Sciences, University of Auckland, Auckland, NZ
| |
Collapse
|
7
|
All in the Family: Child and Adolescent Weight Loss Surgery in the Context of Parental Weight Loss Surgery. CHILDREN 2021; 8:children8110990. [PMID: 34828703 PMCID: PMC8620201 DOI: 10.3390/children8110990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 12/05/2022]
Abstract
Background: Bariatric surgery is the most effective current treatment option for patients with severe obesity. More children and adolescents are having surgery, many whose parents have also had surgery. The current study examines whether parental surgery status moderates the association between perceived social support, emotional eating, food addiction and weight loss following surgery, with those whose parents have had surgery evidencing a stronger relationship between the psychosocial factors and weight loss as compared to their peers. Methods: Participants were 228 children and adolescents undergoing sleeve gastrectomy between 2014 and 2019 at one institution. Children and adolescents completed self-report measures of perceived family social support, emotional eating, and food addiction at their pre-surgical psychological evaluation. Change in body mass index (BMI) from pre-surgery to 3, 6, and 12 months post-surgery was assessed at follow-up clinic visits. Parents reported their surgical status as having had surgery or not. Results: There were no differences in perceived family support, emotional eating, or food addiction symptoms between those whose parents had bariatric surgery and those whose parents did not. There were some moderating effects of parent surgery status on the relationship between social support, emotional eating/food addiction, and weight loss following surgery. Specifically, at 3 months post-surgery, higher change in BMI was associated with lower perceived family support only in those whose parents had not had surgery. More pre-surgical food addiction symptoms were associated with greater weight loss at 3 months for those whose parents had not had surgery, whereas this finding was true only for those whose parents had surgery at 12 months post-surgery. Conclusions: Children and adolescents whose parents have had bariatric surgery may have unique associations of psychosocial factors and weight loss. More research is needed to determine mechanisms of these relationships.
Collapse
|
8
|
Gauci J, Bloomfield J, Lawn S, Towns S, Steinbeck K. Effectiveness of self-management programmes for adolescents with a chronic illness: A systematic review. J Adv Nurs 2021; 77:3585-3599. [PMID: 33630315 DOI: 10.1111/jan.14801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/31/2020] [Accepted: 01/16/2021] [Indexed: 12/14/2022]
Abstract
AIM To assess what is known about the effectiveness of face-to-face self-management programmes designed specifically for adolescents (10-19 years) with a chronic illness. DESIGN A systematic review and synthesis without meta-analysis (SWiM). DATA SOURCES Six international web-based reference libraries were searched with a date range of 1946 to July 2020. REVIEW METHOD The PRISMA statement and SWiM guideline were used for reporting the methods and results. The PICO format was used to develop a focused clinical question and the eligibility criteria of our review. Quality assessment of the included studies was performed using the Cochrane Effective Practice Organisation of Care criteria. RESULTS Eight studies (four randomized controlled trials and four descriptive designs) met the inclusion criteria and were published between 2003 and 2017. Results of the review: Three studies demonstrated measures of illness control which showed initial improvements in adherence as a result of the interventions but failed to demonstrate sustained adherence over time. Booster sessions were identified as an effective strategy to improve adherence, but were often omitted. CONCLUSIONS There is a limited body of evidence on the effectiveness of self-management programmes specifically developed for adolescents with a chronic illness, an important but under researched area. Future research lies in the development of more rigorous studies that focus on quantitative outcome measures for evaluating the effectiveness of self-management programmes to guide the development of future programmes. IMPACT It is crucial for adolescents with a chronic illness to develop independence and the self-management skills required to effectively manage their chronic condition as they transition to adulthood. On current evidence, in planning future self-management interventions should include booster sessions. Nurses with additional training and experience have a key role in supporting adolescents with a chronic illness to develop self-management skills as they assume responsibility for their own healthcare.
Collapse
Affiliation(s)
- Jaunna Gauci
- Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child & Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jacqueline Bloomfield
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sharon Lawn
- Flinders Human Behaviour and Health Research Unit, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Susan Towns
- Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child & Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Katharine Steinbeck
- Discipline of Child & Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
| |
Collapse
|
9
|
Cui C, Li SZ, Zheng XL, Cheng WJ, Ting W. Participation in healthcare behavior by adolescents with epilepsy and factors that influence it during the transition period: A cross-sectional study in China. Epilepsy Behav 2020; 113:107576. [PMID: 33232895 DOI: 10.1016/j.yebeh.2020.107576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the importance of adolescents' participation in the care of their chronic diseases during their transitional period in the healthcare system, the present study investigated the degree of participation in healthcare behavior by Chinese adolescents with chronic epilepsy and identified factors that should be addressed by health interventions. METHODS The study used a convenience sample of 1238 adolescent patients with epilepsy, who were hospitalized in 17 tertiary A-level children or maternal and child specialty hospitals in China between January 2017 and March 2020. Several scales were used to measure their degree of participation in healthcare behavior and the factors that influence it. Data collection was conducted after uniform training of the investigators. The adolescents who met the inclusion and exclusion criteria could scan the QR code of the questionnaire via a mobile phone. RESULTS The age of the participants ranged from 12.2 to 17.8 years (mean 14.2 years), and the sample had a male-to-female ratio of 1.25:1. The patients' average total score of participation in healthcare behavior was 125.58 (SD = 12.25), which was lower than the norm for China. Their scores on the six dimensions of participation were highest for information interaction, followed in descending order by medical decision-making, treatment and care, appeal, diagnosis and treatment decision-making, and questioning supervision. Multiple linear regression found significant associations between health-care participation and five personal and disease variables (gender, age, course of disease, number of comorbid diseases, type of family structure), self-efficacy, and coping styles (cognitive-palliative and acceptance), which explained 52.1% of the variance in patients' total scores on participating in healthcare behavior. CONCLUSIONS The participation of young Chinese patients with epilepsy in transitional healthcare behavior needs to be improved. Participation was positively associated with being female, a longer course of disease, fewer comorbidities, and living in a nuclear family. Patients who used cognitive-palliative and acceptance coping styles and those who had higher self-efficacy also had significantly higher levels of participation in healthcare behavior. The study provides useful reference points for adolescents with chronic disease to participate in healthcare programs, in order to achieve a smooth transition from childhood to adulthood.
Collapse
Affiliation(s)
- Cui Cui
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Shuang-Zi Li
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xian-Lan Zheng
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Jin Cheng
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wang Ting
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
10
|
Jennings M, Guilfoyle A, Green J, Cleary Y, Gowran RJ. Octopus Watch Fosters Family Resilience by Enhancing Occupational Engagement for Children with Spina Bifida and/or Hydrocephalus: Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228316. [PMID: 33182784 PMCID: PMC7697938 DOI: 10.3390/ijerph17228316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children with spina bifida and/or hydrocephalus (SB&/H) often experience difficulties with activities of daily living (ADLs) due to impaired executive functioning, increasing sedentary behaviours. The HeyJoy Octopus watch, a child-friendly icon-based smartwatch could be used as an enabler to promote purposeful ADLs (i.e., goal-orientated ADLs). OBJECTIVE to investigate the effectiveness of the Octopus watch in promoting purposeful ADLs for children living with SB&/H (<8 years). METHODS Mixed-methods engaging parents and children in four phases: (1) Administered demographic questionnaire, semi-structured interview, childhood executive functioning inventory (CHEXI) and the Canadian occupational performance measure (COPM); focus group one introducing the study, information pack using smartwatch and photovoice data collection methods. (2) Measured baseline movement for four days with smartwatch without using functions. (3) Measured activity for 16-days while using the smartwatch. (4) Re-administered assessments and conducted a second focus group based on photovoice narratives. RESULTS movement data recorded for four participants, three of four showed mean activity increase (36%). N-of-1 analyses found one participant showed clear improvement (p = 0.021, r2 = 0.28). Mean inhibition decreased by 16.4%, and mean change in COPM performance and satisfaction scores were 2.1 and 2.4, respectively. The photovoice narrative focus group supports findings evidenced with improved daily routines. CONCLUSIONS The Octopus watch is an innovative early intervention that can promote purposeful ADLs, fostering family resilience by enhancing occupational engagement. Further research is required.
Collapse
Affiliation(s)
- Mark Jennings
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland; (M.J.); (A.G.)
| | - Aoife Guilfoyle
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland; (M.J.); (A.G.)
| | - James Green
- School of Allied Health, Faculty of Education and Health Sciences, Physical Activity for Health (PAfH), Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Yvonne Cleary
- Technical Communication and Instructional Design, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Rosemary Joan Gowran
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology (HIST), University of Limerick, V94 T9PX Limerick, Ireland
- School of Health and Sports Science, University of the Sunshine Coast, Maroochydore DC QLD 4558, Australia
- Assisting Living and Learning (ALL), Institute Maynooth University, Maynooth, W23 VP22 Co. Kildare, Ireland
- Correspondence:
| |
Collapse
|
11
|
Stern A, Winning A, Ohanian D, Driscoll CFB, Starnes M, Glownia K, Holmbeck GN. Longitudinal associations between neuropsychological functioning and medical responsibility in youth with spina bifida: The moderational role of parenting behaviors. Child Neuropsychol 2020; 26:1026-1046. [PMID: 32308112 PMCID: PMC7544676 DOI: 10.1080/09297049.2020.1751098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
For youth with spina bifida (SB), the transfer of medical responsibilities from parent- to self-management is an important component of autonomy development. Youth with SB are at risk for neurocognitive impairments with inattention and executive dysfunction, which may impact their ability to take responsibility for medical tasks. However, adaptive parenting may buffer against the negative impact of executive/attentional dysfunction on levels of medical responsibility. Thus, this study examined the moderating roles of parenting behaviors and child age on the longitudinal associations between neuropsychological functioning and medical responsibility in youth with SB. Participants were recruited as part of a larger, longitudinal study. Youth with SB (N = 89, Mage = 11.10 years) completed a neuropsychological battery of executive functioning and attention measures at Time 1 (T1). Parents reported on youth's executive functioning/attention skills at T1, and child medical responsibility two years later at Time 2 (T2). Observational methods were used to assess parenting behaviors (warmth, behavioral and psychological control) at T1. Attention and cognitive shifting skills at T1 were positively related to child medical responsibility at T2. Two-way interactions between planning/organizing skills and paternal acceptance, and planning/organizing skills and paternal psychological control, were found. A three-way interaction between cognitive shifting skills, maternal acceptance, and child age was found. When conceptualizing risk factors for low medical responsibility in youth with SB, it is important to consider the family context beyond individual, cognitive factors. The results are discussed within the wider context of social-ecological models of medical responsibility.
Collapse
Affiliation(s)
- Alexa Stern
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | - Adrien Winning
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | - Diana Ohanian
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | | | - Meredith Starnes
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | - Karen Glownia
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | | |
Collapse
|
12
|
Hurtubise K, Brousselle A, Camden C. Using collaborative logic analysis evaluation to test the program theory of an intensive interdisciplinary pain treatment for youth with pain‐related disability. PAEDIATRIC AND NEONATAL PAIN 2020; 2:113-130. [PMID: 35548259 PMCID: PMC8975192 DOI: 10.1002/pne2.12018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/09/2020] [Accepted: 03/27/2020] [Indexed: 12/26/2022]
Abstract
Intensive interdisciplinary pain treatment (IIPT) involves multiple stakeholders. Mapping the program components to its anticipated outcomes (ie, its theory) can be difficult and requires stakeholder engagement. Evidence is lacking, however, on how best to engage them. Logic analysis, a theory‐based evaluation, that tests the coherence of a program theory using scientific evidence and experiential knowledge may hold some promise. Its use is rare in pediatric pain interventions, and few methodological details are available. This article provides a description of a collaborative logic analysis methodology used to test the theoretical plausibility of an IIPT designed for youth with pain‐related disability. A 3‐step direct logic analysis process was used. A 13‐member expert panel, composed of clinicians, teachers, managers, youth with pain‐related disability, and their parents, were engaged in each step. First, a logic model was constructed through document analysis, expert panel surveys, and focus‐group discussions. Then, a scoping review, focused on pediatric self‐management, building self‐efficacy, and fostering participation, helped create a conceptual framework. An examination of the logic model against the conceptual framework by the expert panel followed, and recommendations were formulated. Overall, the collaborative logic analysis process helped raiseawareness of clinicians’ assumptions about the program causal mechanisms, identified program components most valued by youth and their parents, recognized the program features supported by scientific and experiential knowledge, detected gaps, and highlighted emerging trends. In addition to providing a consumer‐focused program evaluation option, collaborative logic analysis methodology holds promise as a strategy to engage stakeholders and to translate pediatric pain rehabilitation evaluation research knowledge to key stakeholders.
Collapse
Affiliation(s)
- Karen Hurtubise
- Faculté de Médecine et Sciences de la Santé Université de Sherbrooke Sherbrooke QC Canada
| | - Astrid Brousselle
- Faculté de Médecine et Sciences de la Santé Université de Sherbrooke Sherbrooke QC Canada
- School of Public Administration University of Victoria Victoria BC Canada
| | - Chantal Camden
- Faculté de Médecine et Sciences de la Santé Université de Sherbrooke Sherbrooke QC Canada
- CanChild Centre for Childhood Disability Research McMaster University Hamilton ON Canada
| |
Collapse
|
13
|
Lindsay S, Cagliostro E. A Web-Based Intervention for Youth With Physical Disabilities: Comparing the Role of Mentors in 12- and 4-Week Formats. JMIR Pediatr Parent 2020; 3:e15813. [PMID: 31913132 PMCID: PMC6996779 DOI: 10.2196/15813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/30/2019] [Accepted: 11/07/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Youths with physical disabilities face many barriers in society, including social exclusion, stigma, and difficulties finding employment. Electronic mentoring (e-mentoring) offers a promising opportunity for youths with disabilities and has the potential to improve their inclusion while enhancing career outcomes. However, little is known about the role of mentors in a Web-based e-mentoring format to improve employment outcomes. OBJECTIVE This study aimed to explore the role of mentors in engaging youths in an e-mentoring intervention and to compare and contrast mentors' engagement strategies within a 12- and 4-week format. METHODS This paper drew on a pilot feasibility study, which is a group, Web-based employment readiness intervention involving a discussion forum for youths with physical disabilities. Our intervention involved having trained youth mentors (ie, near-peers who also had a disability) lead Web-based discussion forums while offering peer support and resources, which involved 12 modules completed over both a 12- or 4-week format. We used a mixed method approach including qualitative data (mentor interviews and discussion forum data) and quantitative data (pre-post survey data) comparison. RESULTS A total of 24 youths participated across 3 e-mentoring intervention groups: 9 in the 12-week format (mean age 17.7 years [SD 1.7]) and 15 in the 4-week format (mean age 19.5 years [SD 2.6]), led by 3 trained youth mentors with disabilities, 2 males and 1 female (mean age 22 years [SD 2.64]). Our findings revealed that mentors engaged youths in the e-mentoring program by providing informational, emotional, and tangible support. We noted more instances of mentors providing advice, empathy, and encouragement in the 12-week format compared with the 4-week format. We also found fewer examples of providing advice, developing a rapport, and social support from mentors in the 4-week format. Our findings revealed no significant differences between the 2 groups regarding time spent in the forum, number of logins, number of posts, and self-rated engagement. CONCLUSIONS Mentors in the 12-week and 4-week format engaged participants differently in providing informational and emotional support, although there were no differences in tangible support provided. Mentors reported that the 12-week format was too long and lacked interaction between participants, whereas the 4-week format felt rushed and had fewer detailed responses from mentees. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/resprot.8034.
Collapse
Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Elaine Cagliostro
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| |
Collapse
|
14
|
Cui C, Li SZ, Zheng XL, Cheng WJ, Xia Q. Health Assessment of Chinese Adolescents with Epilepsy in the Preparatory Phase of Transition Process from Pediatric to Adulthood:A Single-Center Study Using the Omaha System. J Pediatr Nurs 2019; 49:e2-e7. [PMID: 31229347 DOI: 10.1016/j.pedn.2019.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Epilepsy is one of the most common childhood-onset neurological disorder characterized by both seizures and the related comorbidities. The preparatory phase in transition refers to a dynamic process of identifying and resolving health issues to ensure seamless continuing care from childhood to adulthood. This study identifies the health issues of the preparatory phase in transition from children to adulthood using the Omaha System. METHODS This prospective, single-center study enrolled 86 adolescents with epilepsy in China. The Problem Classification Scheme and Problem Rating Scale for Outcomes of Omaha System were used to evaluate transition-induced health problems. RESULTS These health problems cover all four domains of the problem classification scheme of the Omaha System, and the specific distribution is related to the type of epilepsy. The results of the four-category classification evaluation showed that the most common health problem is health-related behavioral problems (46.1%), followed by psychosocial problems (23.0%), physiological problems (20.6%), and environmental problems (10.3%). The distribution of these health problems in generalized seizures, focal seizures, and generalized-focal seizures are significantly different (P < 0.01). The results of the outcome rating scale showed that 83.4% of the children had minimal knowledge, 84.2% had inconsistently appropriate behaviors, and 86.7% had moderate symptoms. CONCLUSIONS The health problems of patients with epilepsy during the preparatory phase of transition process from pediatric to adulthood should be emphasized. Identification of health problems though the Omaha System can improve management for adolescents with epilepsy, including prevention, nursing care, social support, and therapeutic interventions.
Collapse
Affiliation(s)
- Cui Cui
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Shuang-Zi Li
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xian-Lan Zheng
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Jin Cheng
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Xia
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
15
|
Lindsay S, Cagliostro E, Stinson J, Leck J. A 4-Week Electronic-Mentoring Employment Intervention for Youth With Physical Disabilities: Pilot Randomized Controlled Trial. JMIR Pediatr Parent 2019; 2:e12653. [PMID: 31518302 PMCID: PMC6716490 DOI: 10.2196/12653] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/07/2019] [Accepted: 02/25/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Youth with disabilities are more likely to live in poverty and be unemployed compared with youth without disabilities. Such trends are often a result of a lack of support, inaccessible jobs, environmental barriers, and discriminatory attitudes toward people with disabilities. Youth with disabilities also face barriers in accessing vocational preparation programs. One encouraging way that could help address challenges that youth encounter is by providing support through electronic mentoring (e-mentoring). OBJECTIVE The objective of this study was to assess the feasibility of a 4-week Web-based peer e-mentoring employment intervention for youth with physical disabilities. METHODS We conducted a pilot randomized controlled trial (RCT) to evaluate our intervention, Empowering youth towards employment. Participants included youth aged 15 to 25 years who were randomly assigned to an experimental (mentored) or control (nonmentored) group. Our intervention involved having trained youth mentors (ie, near peers who also had a disability) lead Web-based discussion forums while offering peer support and resources, which involved 12 modules (3 topics a week for 4 weeks). Primary outcomes focused on implementation (ie, feasibility and acceptability), whereas secondary outcomes focused on effectiveness (ie, measures of self-determination, career maturity, and social support). RESULTS A total of 28 youth (mean age 19.62, SD 3.53; 14/28, 50% female) completed the RCT in 3 intervention groups and 2 control groups (intervention n=18, control n=10). Participants reported satisfaction with the program and that it was feasible and acceptable. Youth's mean engagement level with the program was 6.44 (SD 2.33) for the experimental group and 5.56 (SD 3.53) for controls. Participants in the intervention group did not demonstrate any significant improvements in social support, career maturity, or self-determination compared with those in the control group. No adverse events were reported. CONCLUSIONS The Empowering youth towards employment e-mentoring intervention needs further testing with a larger sample and different length of formats to understand how it may have an impact on employment outcomes for youth with disabilities. TRIAL REGISTRATION ClinicalTrials.gov NCT02522507; https://clinicaltrials.gov/ct2/show/NCT02522507 (Archived by WebCite at http://www.webcitation.org/77a3T4qrE).
Collapse
Affiliation(s)
- Sally Lindsay
- Department of Occupational Science and Occupational Therapy, University of Toronto and Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Elaine Cagliostro
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jennifer Stinson
- Lawrence S Bloomberg Faculty of Nursing, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Joanne Leck
- Telfer School of Management, University of Ottawa, Toronto, ON, Canada
| |
Collapse
|
16
|
Lapp V, Chase SK. How Do Youth with Cystic Fibrosis Perceive Their Readiness to Transition to Adult Healthcare Compared to Their Caregivers' Views? J Pediatr Nurs 2018; 43:104-110. [PMID: 30473151 DOI: 10.1016/j.pedn.2018.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe how perceived stages of change for self-care management skills varies by age in youth with cystic fibrosis in preparation for transition to adult healthcare, to compare caregiver perception of youth readiness for self-care, and age/frequency of transition discussion with provider. DESIGN AND METHODS The Transition Readiness Assessment Questionnaire and a modified version (TRAQ-C) for caregivers were used for data collection. Descriptive statistics, simple linear regression, and t-tests were employed. RESULTS Regression equations suggest that age predicts youth perception of self-care management skill in all five domains on the TRAQ (p ≤ .009). A paired t-test compared the overall TRAQ and TRAQ-C mean scores between dyads. Youth rated themselves significantly higher in perception of self-care skill management (m = 3.187, sd = 0.769) than caregivers (m = 2.490, sd = 0.788; t = 7.408, df = 51, p < .001). Sixteen was the average age of transition discussion for both youth and caregiver. Reported frequency of discussion varied considerably. CONCLUSIONS Although increasing age predicts perception of self-care management, many youth age 18-22 were still only contemplating or starting to learn skills. Skill level perceptions between youth and caregiver differed, but scores from all self-care management domains followed a similar trend. Discussions with providers began later than guidelines recommend and were often not recognized as such by youth. PRACTICE IMPLICATIONS Results underscore the importance of beginning transition discussion and skill evaluation in youth with cystic fibrosis at an early age, incorporating caregivers' perception in the process.
Collapse
Affiliation(s)
- Valerie Lapp
- University of Central Florida, College of Nursing, Orlando, USA; Arnold Palmer Hospital for Children, Orlando, FL, USA.
| | - Susan K Chase
- University of Central Florida, College of Nursing, Orlando, USA.
| |
Collapse
|
17
|
DiDomizio PG, Gillard A. Perceptions of Health Care Professionals on the Effects of Residential Summer Camp in their Patients. J Pediatr Nurs 2018; 40:37-46. [PMID: 29776478 DOI: 10.1016/j.pedn.2018.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 03/09/2018] [Accepted: 03/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE A growing body of literature exists regarding medical specialty camps for children. However, very little of the research focuses on the perspectives of healthcare providers. This study explored perceptions of pediatric healthcare providers on a medical specialty camp for children. DESIGN AND METHODS Interviews with five volunteer physicians and five nurses were conducted and analyzed using inductive content analysis. RESULTS Results showed that healthcare providers perceived camp to be a positive influence on campers' normalization and healthcare ownership, and to strengthen patient-provider relationships. Providers contextualized their assertions by discussing the settings of camp and of patients. However, providers also identified multiple barriers perceived as limiting a camp experience's ability to create lasting changes in patients' attitudes or behaviors. CONCLUSIONS While healthcare providers in this study perceived camp as being a positive opportunity for patients, the potential for long-lasting effects was seen to be hindered by factors external to the camp and changes in patients' attitudes or behaviors can be difficult to ascribe to the camp experience. PRACTICE IMPLICATIONS Healthcare providers can reinforce and extend positive health behavior messages from camp at follow-up appointments. Adding inquiries about camp attendance and experiences to patients' visits can provide healthcare providers with additional insights about patients. Health outcomes before and after camp could be measured to assess change. Camps can send home patient protocols on successes and challenges.
Collapse
Affiliation(s)
- P Galen DiDomizio
- Harriet Lane Pediatric Residency Program at the Johns Hopkins Children's Center, Baltimore, United States
| | - Ann Gillard
- The Hole in the Wall Gang Camp, Ashford, CT, United States.
| |
Collapse
|
18
|
Paniccia A, Colquhoun H, Kirsh B, Lindsay S. Youth and young adults with acquired brain injury transition towards work-related roles: a qualitative study. Disabil Rehabil 2018; 41:1331-1342. [PMID: 29334802 DOI: 10.1080/09638288.2018.1425743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this research was to explore the experiences of youth and young adults with acquired brain injury as they transition towards work-related roles. Little is known about employment experiences among this age group. Understanding their perspectives can inform programs and clinical practice. MATERIALS AND METHODS A descriptive qualitative design, including semi-structured interviews with 14 participants (8 females; 6 males) was used. Interviews were transcribed verbatim and analyzed using an open-coding, thematic approach. RESULTS Three major themes emerged related to the experience of work-related roles: (1) getting to know the new me; (2) navigating support systems; and (3) taking control of my experience. Some participants used coping strategies to acquire and/or maintain work-related roles, while others felt limited by their condition. CONCLUSIONS A variety of work-related roles, people, and environments directly and indirectly influenced the work-related transition of youth and young adults with acquired brain injury. Individuals expressed the importance of acquired brain injury awareness in informing others about their impairments. In fact, a lack of acquired brain injury awareness was often a main reason for receiving less than adequate support and accommodations. Without an understanding of acquired brain injury, people in the lives of these individuals were unable to perceive the legitimacy of acquired brain injury-related impairments. Implications for rehabilitation The purpose of this study is to understand the experiences of youth and young adults with acquired brain injury as they transition into work-related roles. Using these experiences as a guideline can promote acquired brain injury awareness, and contribute to how current interventions are designed and delivered. Clinicians should ensure that youth and young adults with acquired brain injury have access to the resources they need to maximize their independence. Healthcare professionals can play a pivotal role in relaying important acquired brain injury-related education, implementing suitable treatment plans, and providing them with effective tips to help them through their transition. A healthy transition to work-related roles should include ample social support and communication, acquired brain injury-related information that informs the community of acquired brain injury impairments, needs, and recovery trajectory, as well as adequate and consistent coordination within and between the person and the environment.
Collapse
Affiliation(s)
- Alicia Paniccia
- a Rehabilitation Science Institute , University of Toronto , Toronto , Canada.,b Bloorview Research Institute , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| | - Heather Colquhoun
- c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada
| | - Bonnie Kirsh
- c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada
| | - Sally Lindsay
- a Rehabilitation Science Institute , University of Toronto , Toronto , Canada.,b Bloorview Research Institute , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada.,c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada
| |
Collapse
|
19
|
Carter B, Ford K, Bray L, Water T, Arnott J, Tichanow C, Dickinson A. "It's not who I am": Children's experiences of growing up with a long-term condition in England, Australia, and New Zealand. J SPEC PEDIATR NURS 2017; 22. [PMID: 28950047 DOI: 10.1111/jspn.12197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/06/2017] [Accepted: 08/27/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Most studies of growing up with a long-term condition focus on older children and adolescents and are condition-specific. Relatively few studies address the experiences of children in middle childhood or consider their experience across a range of conditions, countries, and health settings. This study aimed to explore children's perceptions and understandings of how their lives are shaped (or not) by a long-term condition and its associated management. DESIGN AND METHODS A qualitative, participatory methodology using autodriven photoelicitation interviews (PEIs) with 45 purposively recruited children (6-12 years) with long-term conditions (e.g., hemophilia, arthritis, Crohn's disease), from England, New Zealand, and Australia was utilized. PEI facilitated the construction of inductively derived understandings of the children's experiences as the children had control over creating and then selecting which photographs to discuss with the researcher. RESULTS Interpretive thematic analysis of the interviews and content analysis of the photographs resulted in an overarching theme, "It's not who I am …" but it is part of me, and three subthemes: getting on with my life; the special value of family, friendship, support, and comfort; and things that get in the way of getting on. Across all ages and the three countries, the children actively projected their self-concept as "well" children and they strove, through their photographs and their accompanying explanations of their lives, to emphasize that they were "normal" children. They were active social agents who demonstrated their capacity to shape parts of their lives interdependently with their parents and the requirements of their condition. PRACTICE IMPLICATIONS Pediatric nurses should be aware of the importance that children with long-term conditions place on projecting and protecting their sense of being normal and ensure that when they engage with children that they take account of the children's understandings and efforts to live a life constrained but not limited by the condition.
Collapse
Affiliation(s)
- Bernie Carter
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Karen Ford
- Centre for Education and Research, Royal Hobart Hospital, Hobart, Australia
| | - Lucy Bray
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Tineke Water
- Auckland University of Technology, Auckland, New Zealand
| | - Janine Arnott
- School of Health, University of Central Lancashire, Preston, UK
| | - Cassandra Tichanow
- Paediatric Outpatient Clinic, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | | |
Collapse
|
20
|
Tseng TJ, Chang AM, Wu CJJ. A randomized control trial of an asthma self-management program for adolescents in Taiwan: A study protocol. Contemp Clin Trials Commun 2017; 8:122-126. [PMID: 29696200 PMCID: PMC5898548 DOI: 10.1016/j.conctc.2017.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/05/2017] [Accepted: 09/14/2017] [Indexed: 11/26/2022] Open
Abstract
Uncontrolled asthma in adolescents can be explained by developmental changes and lack of priority for self-care activities. Limited reports on asthma self-management programs for adolescents to enhance prevention behaviors in Taiwan were found. The protocol paper presents a two-armed, randomized controlled trial aiming to test the effectiveness of a newly developed self-management program for 112 adolescents with asthma in Taiwan. The primary outcome is asthma self-efficacy. Data will be collected at baseline and the week 4. The findings of this study will determine the extent to which a self-management program for adolescents with asthma in Taiwan enhances asthma management self-efficacy, self-management activities in asthma prevention and management, and achievement of well-controlled asthma. Trial Registration No: ACTRN12613001294741.
Collapse
Affiliation(s)
- Tzu-Jung Tseng
- Department of Nursing, Chang Gung University of Science and Technology, No.2, Sec. W., Jiapu Rd., Puzi City, Chiayi County 61363, Taiwan, ROC
| | - Anne M Chang
- Adjunct Professor, School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia
| | - Chiung-Jung Jo Wu
- Associate Professor, School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast.,Visiting Fellow, School of Nursing, Queensland University of Technology, Brisbane, Australia.,Honorary Research Fellow, Royal Brisbane and Women's Hospital, Brisbane (RBWH), Australia.,Honorary Research Fellow, Mater Research Institute-University of Queensland (MRI-UQ), Brisbane, Australia
| |
Collapse
|
21
|
Holley S, Morris R, Knibb R, Latter S, Liossi C, Mitchell F, Roberts G. Barriers and facilitators to asthma self-management in adolescents: A systematic review of qualitative and quantitative studies. Pediatr Pulmonol 2017; 52:430-442. [PMID: 27717193 DOI: 10.1002/ppul.23556] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/18/2016] [Accepted: 08/09/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Many adolescents have poor asthma control and impaired quality of life despite the availability of modern pharmacotherapy. Research suggests that poor adherence to treatment and limited engagement in self-management could be contributing factors. OBJECTIVE To conduct a systematic review of the barriers and facilitators to self-management of asthma reported by adolescents using a narrative synthesis approach to integrate the findings. DESIGN MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for all types of study design. Full papers were retrieved for study abstracts that included data from participants aged 12-18 years referring to barriers or facilitators of asthma self-management behaviors. RESULTS Sixteen studies (5 quantitative and 11 qualitative) underwent data extraction, quality appraisal, and thematic analysis. Six key themes were generated that encompassed barriers and/or facilitators to self-management of asthma in adolescents: Knowledge, Lifestyle, Beliefs and Attitudes, Relationships, Intrapersonal Characteristics, and Communication. CONCLUSIONS There is a pressing need to prepare adolescents for self-management, using age-appropriate strategies that draw on the evidence we have synthesized. Current clinical practice should focus on ensuring adolescents have the correct knowledge, beliefs, and positive attitude to self-manage their illness. This needs to be delivered in a supportive environment that facilitates two-way communication, fosters adolescents' self-efficacy to manage their disease, and considers the wider social influences that impinge on self-management. Pediatr Pulmonol. 2017;52:430-442. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Simone Holley
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Ruth Morris
- NIHR/Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - Sue Latter
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Christina Liossi
- School of Psychology, University of Southampton, United Kingdom.,Department of Paediatric Psychology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Frances Mitchell
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, United Kingdom
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton Faculty of Medicine, Southampton, United Kingdom.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, United Kingdom.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| |
Collapse
|
22
|
Geryk LL, Roberts CA, Sage AJ, Coyne-Beasley T, Sleath BL, Carpenter DM. Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study. JMIR Res Protoc 2016; 5:e229. [PMID: 27923777 PMCID: PMC5174724 DOI: 10.2196/resprot.5932] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/14/2016] [Accepted: 10/28/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Most youth asthma apps are not designed with parent and clinician use in mind, and rarely is the app development process informed by parent or clinician input. OBJECTIVE This study was conducted to generate formative data on the use, attitudes, and preferences for asthma mHealth app features among parents and clinicians, the important stakeholders who support adolescents with asthma and promote adolescent self-management skills. METHODS We conducted a mixed-methods study from 2013 to 2014 employing a user-centered design philosophy to acquire feedback from a convenience sample of 20 parents and 6 clinicians. Participants were given an iPod Touch and asked to evaluate 10 features on 2 existing asthma apps. Participant experiences using the apps were collected from questionnaires and a thematic analysis of audio-recorded and transcribed (verbatim) interviews using MAXQDA. Descriptive statistics were calculated to characterize the study sample and app feature feedback. Independent samples t tests were performed to compare parent and clinician ratings of app feature usefulness (ratings: 1=not at all useful to 5=very useful). RESULTS All parents were female (n=20), 45% were black, 20% had an income ≥US $50,000, and 45% had a bachelor's degree or higher education. The clinician sample included 2 nurses and 4 physicians with a mean practice time of 13 years. Three main themes provided an understanding of how participants perceived their roles and use of asthma app features to support adolescent asthma self-management: monitoring and supervision, education, and communication/information sharing. Parents rated the doctor report feature highest, and clinicians rated the doctor appointment reminder highest of all evaluated app features on usefulness. The peak flow monitoring feature was the lowest ranked feature by both parents and clinicians. Parents reported higher usefulness for the doctor report (t(10)=2.7, P<.02), diary (t(10)=2.7, P<.03), and self-check quiz (t(14)=2.5, P<.02) features than clinicians. Specific participant suggestions for app enhancements (eg, a tutorial showing correct inhaler use, refill reminders, pop-up messages tied to a medication log, evidence-based management steps) were also provided. CONCLUSIONS Parent and clinician evaluations and recommendations can play an important role in the development of an asthma app designed to help support youth asthma management. Two-way asthma care communication between families and clinicians and components involving families and clinicians that support adolescent self-management should be incorporated into adolescent asthma apps.
Collapse
Affiliation(s)
- Lorie L Geryk
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Courtney A Roberts
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Adam J Sage
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Tamera Coyne-Beasley
- Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Betsy L Sleath
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| |
Collapse
|
23
|
Zhou H, Roberts P, Dhaliwal S, Della P. Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review. J Clin Nurs 2016; 25:3113-3130. [PMID: 27145890 PMCID: PMC5096007 DOI: 10.1111/jocn.13326] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. BACKGROUND Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. DESIGN An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. METHODS A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). RESULTS A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. CONCLUSIONS In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be established by stakeholders as a formal channel to monitor patients' outcomes post- transition.
Collapse
Affiliation(s)
- Huaqiong Zhou
- School of Nursing, Midwifery & Paramedicine, Curtin University, Perth, WA, Australia
| | - Pamela Roberts
- School of Nursing, Midwifery & Paramedicine, Curtin University, Perth, WA, Australia
| | - Satvinder Dhaliwal
- School of Nursing, Midwifery & Paramedicine, Curtin University, Perth, WA, Australia
| | - Phillip Della
- School of Nursing, Midwifery & Paramedicine, Curtin University, Perth, WA, Australia.
| |
Collapse
|
24
|
Husarova D, Geckova AM, Blinka L, Sevcikova A, van Dijk JP, Reijneveld SA. Screen-based behaviour in school-aged children with long-term illness. BMC Public Health 2016; 16:130. [PMID: 26861123 PMCID: PMC4746885 DOI: 10.1186/s12889-016-2804-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/01/2016] [Indexed: 11/30/2022] Open
Abstract
Background Evidence is lacking on the screen-based behaviour of adolescents with a chronic condition. The aim of our study was to analyse differences in screen-based behaviour of adolescents by long-term illness, asthma and learning disabilities. Methods We used data from the cross-sectional Health Behaviour of School-aged Children study collected in 2014 among Slovak adolescents (age 13 to 15 years old, N = 2682, 49.7 % boys). We analysed the associations between screen-based behaviour and long-term illness, asthma and learning disabilities using logistic regression models adjusted for gender. Results We found no associations between screen-based behaviour and long-term illness, except that children with asthma had a 1.60-times higher odds of excessively playing computer games than healthy children (95 % confidence interval of odds ratio (CI): 1.11–2.30). Children with learning disabilities had 1.71-times higher odds of risky use of the Internet (95 % CI: 1.19–2.45). Conclusion Adolescents with a long-term illness or with a chronic condition or a learning disability do not differ from their peers in screen-based activities. Exceptions are children with asthma and children with learning disabilities, who reported more risky screen-based behaviour.
Collapse
Affiliation(s)
- Daniela Husarova
- Department of Health Psychology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic.
| | - Andrea Madarasova Geckova
- Department of Health Psychology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Center for Kinanthropology Research, Institute of Active Lifestyle, Faculty of Physical Culture, Palacky University in Olomouc, Tr. Miru 115, Olomouc, 77111, Czech Republic. .,Olomouc University Social Health Institute, Palacky University Olomouc, Tr. Miru 115, Olomouc, 77111, Czech Republic.
| | - Lukas Blinka
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University Brno, Joštova 10, 602 00, Brno, Czech Republic.
| | - Anna Sevcikova
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University Brno, Joštova 10, 602 00, Brno, Czech Republic.
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Olomouc University Social Health Institute, Palacky University Olomouc, Tr. Miru 115, Olomouc, 77111, Czech Republic. .,Department of Community & Occupational Health, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Community & Occupational Health, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| |
Collapse
|
25
|
Meaux JB, Green A, Nelson MK, Huett A, Boateng B, Pye S, Schmid B, Berg A, LaPorte K, Riley L. Transition to Self-Management after Pediatric Heart Transplant. Prog Transplant 2014; 24:226-33. [DOI: 10.7182/pit2014911] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Context Little is known about adolescent transition to self-management after heart transplant. This gap in knowledge is critically important because the consequences of poor self-management are costly and life-threatening, often resulting in nonadherence, rejection, repeated hospitalizations, and poor quality of life. Objective To explore how adolescents and parents perceive their roles in self-management, and how adolescents integrate self-management into their daily lives and navigate the transition from parent-dominated to self-management. Design Qualitative descriptive design, using online focus groups. Setting Online focus groups using itracks, an online qualitative software program. Participants A purposive sample of 4 adolescents, 13 to 21 years old, who were at least 6 months posttransplant, and of 6 parents of adolescent heart transplant recipients. Results Several parallel themes emerged from the parent and adolescent online focus groups. Managing medications was the predominant theme for both parents and adolescents. For the remaining themes, parents and adolescents expressed similar ideas that were categorized into parallel themes, which included staying on top of things/becoming independent, letting them be normal/being normal, and worries and stressors. Conclusions The transition to self-management after heart transplant was a clear goal for both parents and adolescents. The transition is a shared responsibility between parents and adolescents with a gradual shift from parent-directed to self-management. The process of transition was not linear or smooth, and in several instances, parents described efforts to transfer responsibility to the adolescent only to take it back when complications arose. Additional research with a larger sample is needed in order to fully understand adolescent heart transplant recipients' transition to self-management.
Collapse
Affiliation(s)
- Julie B. Meaux
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Angela Green
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Mary Kathryn Nelson
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Amy Huett
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Beatrice Boateng
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Sherry Pye
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Barbara Schmid
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Alex Berg
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Kelci LaPorte
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Linda Riley
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| |
Collapse
|
26
|
Lindsay S. A qualitative synthesis of adolescents' experiences of living with spina bifida. QUALITATIVE HEALTH RESEARCH 2014; 24:1298-1309. [PMID: 25104820 DOI: 10.1177/1049732314546558] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this article, I explore the experiences and perspectives of youth living with spina bifida, the second most common congenital condition in North America, to inform the development of health programs. I undertook a thematic metasynthesis to integrate qualitative evidence across studies examining the experiences of youth with spina bifida. I used 10 electronic databases to search for and review 4,051 abstracts, and identified 12 articles meeting the inclusion criteria. I examined those articles using a constant comparative approach, drawing on concepts of normalcy and biographical disruption to inform understanding of three emergent themes: (a) the medical management of spina bifida; (b) the importance of peer and family relationships (i.e., social support, belonging, and challenges in peer connections); and (c) identity and self-concept (i.e., normalization). This metasynthesis provides insight for youth, parents, and clinicians on areas of life in which youth could use further support.
Collapse
Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| |
Collapse
|
27
|
Lindsay S, Kingsnorth S, Mcdougall C, Keating H. A systematic review of self-management interventions for children and youth with physical disabilities. Disabil Rehabil 2013; 36:276-88. [PMID: 23614359 PMCID: PMC3934376 DOI: 10.3109/09638288.2013.785605] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 02/08/2013] [Accepted: 03/11/2013] [Indexed: 11/13/2022]
Abstract
PURPOSE Evidence shows that effective self-management behaviors have the potential to improve health outcomes, quality of life, self-efficacy and reduce morbidity, emergency visits and costs of care. A better understanding of self-management interventions (i.e. programs that help with managing symptoms, treatment, physical and psychological consequences) is needed to achieve a positive impact on health because most children with a disability now live well into adulthood. METHOD A systematic review of self-management interventions for school age youth with physical disabilities was undertaken to assess their effectiveness. Comprehensive electronic searches using international web-based reference libraries were conducted for peer-reviewed and gray literature published between 1980 and January 2012. Eligible studies examined the effectiveness of self-management interventions for children and youth between 6 and 18 years of age with congenital or acquired physical disabilities. Studies needed to include a comparison group (e.g. single group pre/post-test design) and at least one quantifiable health-related outcome. RESULTS Of the 2184 studies identified, six met the inclusion criteria; two involved youth with spina bifida and four with juvenile arthritis. The majority of the interventions ran several sessions for at least 3 months by a trained interventionist or clinician, had one-to-one sessions and meetings, homework activities and parental involvement. Although outcomes varied between the studies, all of the interventions reported at least one significant improvement in either overall self-management skills or a specific health behavior. CONCLUSIONS While self-management interventions have the potential to improve health behaviors, there were relatively few rigorously designed studies identified. More studies are needed to document the outcomes of self-management interventions, especially their most effective characteristics for children and youth with physical disabilities. Implications for Rehabilitation There is some evidence to suggest that self-management interventions for children and youth with spina bifida and arthritis can improve self-management behaviors and health outcomes. Parents' involvement should be considered in encouraging self-management behaviors at different stages of their child's development. Much work is needed to explore the longer term implications of self-management interventions for youth with physical disabilities as well as the impact on health care utilization.
Collapse
Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation HospitalToronto, ONCanada
- Department of Occupational Science and Occupational Therapy, Graduate Department of Rehabilitation Sciences, University of TorontoToronto, ONCanada
| | | | - Carolyn Mcdougall
- Department of Occupational Science and Occupational Therapy, Graduate Department of Rehabilitation Sciences, University of TorontoToronto, ONCanada
- Centre for Participation and Inclusion, Holland Bloorview Kids Rehabilitation HospitalONCanada
| | - Heather Keating
- Centre for Participation and Inclusion, Holland Bloorview Kids Rehabilitation HospitalONCanada
| |
Collapse
|
28
|
Gibson BE, Mistry B, Smith B, Yoshida KK, Abbott D, Lindsay S, Hamdani Y. Becoming men: Gender, disability, and transitioning to adulthood. Health (London) 2013; 18:95-114. [DOI: 10.1177/1363459313476967] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children and youth with progressive conditions are living longer, and there is increased interest in designing programs that will assist them with “transitioning” to adulthood. Almost none of the transitions research to date, however, has attended to the experiences of disabled boys in “becoming men,” nor has there been critical conceptual work problematizing notions of “normal” adulthood or theorizing the complex, diverse, and gendered experiences of transitioning. In this Canadian study, we investigated the intersectionality of gender, disability, and emerging adulthood with 15 young men with Duchenne muscular dystrophy. Participants created audio diaries and photographs that were explored in in-depth interviews. Using a Bourdieusian lens and Arthur Frank’s notion of the narrative habitus, we examined how participants re/negotiated identities in everyday practices. Our analysis suggested that disability, masculinities, and generational (life stage) identities intersected through “narratives of nondifference,” wherein participants worked to establish identities as typical “guys.” Within limited fields of school and work, participants distanced themselves from the label of “disabled” and discussed their successes and challenges in terms of normative developmental trajectories. We suggest that the pursuit of “normal” is reproduced and reinforced in health and social programs and closes off other narratives and possibilities.
Collapse
Affiliation(s)
- Barbara E Gibson
- University of Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Canada
| | - Bhavnita Mistry
- University of Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Canada
| | | | | | | | - Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | | |
Collapse
|