1
|
Farre A, Lunt L, Lee R, Verstappen S, McDonagh JE. Addressing education and employment outcomes in the provision of healthcare for young people with physical long-term conditions: A systematic review and mixed methods synthesis. PATIENT EDUCATION AND COUNSELING 2023; 112:107765. [PMID: 37086594 DOI: 10.1016/j.pec.2023.107765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To identify and synthesise the experiences and benefits of addressing vocational issues in the provision of healthcare for young people (YP) with long-term conditions (LTCs). METHODS We searched 10 bibliographic databases. Restrictions were applied on publication date (1996-2020) and language (English). Two reviewers independently screened records against eligibility criteria. Articles reporting relevant qualitative and/or quantitative research were included. Quality appraisal was undertaken following study selection. Qualitative data were synthesised thematically, and quantitative data narratively. A cross-study synthesis integrated qualitative and quantitative findings. RESULTS 43 articles were included. Thematic synthesis of qualitative studies (n = 23) resulted in seven recommendations for intervention (psychological support; information/signposting; skills training; career advice; healthcare-school/workplace collaboration; social support; flexible/responsive care). The narrative synthesis summarised results of 17 interventions (n = 20 quantitative studies). The cross-study synthesis mapped interventions against recommendations. Transitional care was the intervention type that most comprehensively met our proposed recommendations. CONCLUSIONS Evidence from YP perspectives highlights that vocational development is an important area to address in healthcare provision. Robust intervention studies in this area are lacking. PRACTICE IMPLICATIONS Our evidence-based recommendations for intervention can support health professionals to better address vocational issues/outcomes. With minimal adaptations, transitional care interventions would be particularly well suited to deliver this.
Collapse
Affiliation(s)
- Albert Farre
- School of Health Sciences, University of Dundee, Dundee, UK.
| | - Laura Lunt
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rebecca Lee
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Suzanne Verstappen
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Janet E McDonagh
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK; Department of Paediatric and Adolescent Rheumatology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
2
|
Lindsay S, Fuentes K, Tomas V, Hsu S. Ableism and Workplace Discrimination Among Youth and Young Adults with Disabilities: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:20-36. [PMID: 35976480 DOI: 10.1007/s10926-022-10049-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Young people with disabilities are persistently under-employed and experience concerning rates of discrimination and ableism in looking for work and within the workplace. Focusing on youth is salient because rates of ableism are often higher among younger ages compared to older. The objective of this systematic review was to explore the experiences and impact of workplace discrimination and ableism among youth and young adults with disabilities. METHODS Systematic searches of seven databases from 2000 to 2021 were conducted. Four reviewers independently applied the inclusion criteria, extracted the data and rated the study quality. RESULTS Of the 39 studies meeting our inclusion criteria, they represented 516,281 participants across eight countries over a 20-year period. The findings highlight the rates of workplace ableism, factors affecting workplace ableism (i.e., type of disability, gender, education level, lack of employers' knowledge about disability), ableism in job searching and anticipated ableism. The review also noted the impact of workplace ableism, which included pay discrimination, lack of job supports and social exclusion, job turnover and unemployment, and discrimination allegations and charges. CONCLUSIONS Our findings reveal the stark prevalence of workplace ableism among youth and young adults with disabilities. There is an urgent need for further in-depth research to understand youth's lived experiences of ableism and the development of solutions to address it so they can be included in a meaningful and respectful way in the workplace.
Collapse
Affiliation(s)
- Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.
| | - Kristina Fuentes
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Vanessa Tomas
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Shaelynn Hsu
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Min M, Hancock DG, Aromataris E, Crotti T, Boros C. Experiences of living with Juvenile Idiopathic Arthritis: a qualitative systematic review. JBI Evid Synth 2021; 20:60-120. [PMID: 34669687 DOI: 10.11124/jbies-21-00139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to investigate the available qualitative evidence to enhance understanding of the experiences of children, young adults, and their carers living with Juvenile Idiopathic Arthritis in any setting. INTRODUCTION Juvenile Idiopathic Arthritis is the most common chronic rheumatic disease in childhood. Despite the availability of effective treatments, persistent pain, growth retardation, physical disability, and psychological problems can occur. This may reduce the quality of life for Juvenile Idiopathic Arthritis patients by negatively affecting their family, educational, and social well-being. Patient-centered management and care for Juvenile Idiopathic Arthritis patients requires increasing attention to their self-reported quality of life and experiences, in addition to clinically measured disease activity. Furthermore, taking care of children with Juvenile Idiopathic Arthritis may have negative impacts on the lives of their carers and families. The experiences of carers have been poorly understood and studied. This review describes experiences and perspectives from patients and carers in order to inform the needs of families throughout their Juvenile Idiopathic Arthritis journey. INCLUSION CRITERIA Studies describing the experiences of patients aged <21 years who have been diagnosed with Juvenile Idiopathic Arthritis according to the International League of Associations for Rheumatology criteria, as well as the experiences of their carers, have been considered. METHODS A comprehensive search using PubMed, CINAHL, Embase, PsycINFO, Web of Science, and Google Scholar, as well as relevant conference proceedings of the American College of Rheumatology (ACR; 2018-2019), the European Pediatric Rheumatology Congress (PReS) 2018, the European League Against Rheumatism (EULAR; 2018-2019), and the Asia Pacific League of Associations for Rheumatology (APLAR; 2018-2019), was undertaken in December 2020 to identify pertinent published and unpublished studies. Studies published in English from 2001 to 2020 were included. The JBI approach to study selection, critical appraisal, data extraction, and data synthesis was used. RESULTS Ten studies were included in this review. A total of 61 findings were extracted and aggregated to form 12 categories. From the 12 categories, five synthesized findings were developed: i) Self-management of Juvenile Idiopathic Arthritis requires pain management, medication management, and the acquisition of knowledge and professional support; ii) A promising relationship with health care professionals but unbalanced access to services; iii) Parental financial burden and their adjustment to maintain family happiness; iv) Patients and parents support the web-based approach to communicate and develop self-management skills and acknowledge the importance of clinical trials; v) Desire to live a normal life without prejudice from school, social settings, and the workplace. CONCLUSIONS This review has provided a comprehensive overview of experiences and perceptions of Juvenile Idiopathic Arthritis patients and their parents. It is important to understand what they need to know and understand about the disease. This review also highlights the importance of appropriate web-based programs, career counseling, infrastructures, and school facilities. Findings in this review can guide future policy and practice in order to improve care for families and children with Juvenile Idiopathic Arthritis. Further research is required to develop management strategies for medication intolerance and evaluate the longitudinal benefits of relevant Juvenile Idiopathic Arthritis programs. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42019133165).
Collapse
Affiliation(s)
- Ming Min
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia University of Adelaide Discipline of Paediatrics, Women's and Children's Hospital, Adelaide, SA, Australia Women's and Children's Hospital Department of Rheumatology, Adelaide, SA, Australia JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | | | | | | | | |
Collapse
|
4
|
Kelly A, Niddrie F, Tunnicliffe DJ, Matus Gonzalez A, Hanson C, Jiang I, Major G, Singh-Grewal D, Tymms K, Tong A. Patients' attitudes and experiences of transition from paediatric to adult healthcare in rheumatology: a qualitative systematic review. Rheumatology (Oxford) 2021; 59:3737-3750. [PMID: 32413124 DOI: 10.1093/rheumatology/keaa168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/19/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES We aimed to describe patients' attitudes and experiences of transition from paediatric to adult healthcare in rheumatology to inform patient-centred transitional care programmes. METHODS We searched MEDLINE, EMBASE, PsycINFO and CINAHL to August 2019 and used thematic synthesis to analyse the findings. RESULTS From 26 studies involving 451 people with juvenile-onset rheumatic conditions we identified six themes: a sense of belonging (comfort in familiarity, connectedness in shared experiences, reassurance in being with others of a similar age, desire for normality and acceptance); preparedness for sudden changes (confidence through guided introductions to the adult environment, rapport from continuity of care, security in a reliable point of contact, minimizing lifestyle disruptions); abandonment and fear of the unknown (abrupt and forced independence, ill-equipped to hand over medical information, shocked by meeting adults with visible damage and disability, vulnerability in the loss of privacy); anonymous and dismissed in adult care (deprived of human focus, sterile and uninviting environment, disregard of debilitating pain and fatigue); quest for autonomy (controlled and patronized in the paediatric environment, liberated from the authority of others, freedom to communicate openly); and tensions in parental involvement (overshadowed by parental presence, guilt of excluding parents, reluctant withdrawal of parental support). CONCLUSION Young people feel dismissed, abandoned, ill-prepared and out of control during transition. However, successful transition can be supported by preparing for changes, creating a sense of belonging and negotiating parental involvement and autonomy. Incorporating patient-identified priorities into transitional services may improve satisfaction and outcomes in young people with juvenile-onset rheumatic conditions.
Collapse
Affiliation(s)
- Ayano Kelly
- College of Health and Medicine, Australian National University.,Department of Rheumatology, The Canberra Hospital, Canberra, ACT.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead
| | - Fiona Niddrie
- Department of Rheumatology, Bone and Joint Centre, Royal Newcastle Centre/John Hunter Hospital, Newcastle
| | - David J Tunnicliffe
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead.,Sydney School of Public Health, The University of Sydney, Sydney
| | | | - Camilla Hanson
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead.,Sydney School of Public Health, The University of Sydney, Sydney
| | - Ivy Jiang
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead.,School of Medicine, University of New South Wales, Randwick
| | - Gabor Major
- Department of Rheumatology, Bone and Joint Centre, Royal Newcastle Centre/John Hunter Hospital, Newcastle.,School of Medicine and Public Health, University of Newcastle, Newcastle
| | - Davinder Singh-Grewal
- Department of Rheumatology, Bone and Joint Centre, Royal Newcastle Centre/John Hunter Hospital, Newcastle.,Department of Rheumatology, The Children's Hospital at Westmead, Westmead.,Discipline of Paediatrics and Child Health, The University of Sydney, Sydney.,School of Maternal and Child Health, University of New South Wales, Randwick.,Department of Rheumatology, Liverpool Hospital, Liverpool, NSW
| | - Kathleen Tymms
- College of Health and Medicine, Australian National University.,Department of Rheumatology, The Canberra Hospital, Canberra, ACT.,Canberra Rheumatology, Canberra, ACT, Australia
| | - Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead.,Sydney School of Public Health, The University of Sydney, Sydney
| |
Collapse
|
5
|
van Gulik EC, Verkuil F, Barendregt AM, Schonenberg-Meinema D, Rashid ANS, Kuijpers TW, van den Berg JM, Hoving JL. Experiences, perspectives and expectations of adolescents with juvenile idiopathic arthritis regarding future work participation; a qualitative study. Pediatr Rheumatol Online J 2020; 18:33. [PMID: 32293467 PMCID: PMC7158382 DOI: 10.1186/s12969-020-00429-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/03/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Having Juvenile idiopathic Arthritis (JIA) has widespread implications for a person's life. Patients have to deal with recurring arthritis, characterized by pain often accompanied by a loss of energy. Since JIA often persists into adulthood, patients with JIA are likely to encounter difficulties in their working life. We expect that the experiences in school life may be comparable to the barriers and opportunities which patients affected by JIA encounter in adult working life. Therefore, the aim of this study was to elicit the experiences during school life and the perspectives and expectations regarding future work participation of adolescents with JIA. METHODS This study used individual, semi-structured interviews and followed a predefined interview guide. Participants between 14 and 18 years of age (n = 22) were purposively selected to achieve a broad range of participant characteristics. Open coding was performed, followed by axial coding and selective coding. RESULTS Great differences were seen in the support and understanding that adolescents received in dealing with JIA at school, leisure activities and work. Varying approaches were mentioned on how to pursue a desired vocation. Perspectives regarding disclosure varied. Participants wished to be approached like any other healthy adolescent. Expectations regarding work participation were positively expressed. CONCLUSION This study showed that participants often disregarded having JIA when making plans for their future career. Facilitating an open discussion about the possible limitations accompanying JIA with educators and employers might prevent overburden and increase the chance of starting a career which would accommodate the patient with JIA in the near and distant future.
Collapse
Affiliation(s)
- E. Charlotte van Gulik
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Floris Verkuil
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Anouk M. Barendregt
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Dieneke Schonenberg-Meinema
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Amara Nassar-Sheikh Rashid
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Taco W. Kuijpers
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - J. Merlijn van den Berg
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Jan L. Hoving
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Department Coronel Institute of Occupational Health. Amsterdam Public Health research institute, P.O. Box 22700, Amsterdam, DE NL-1100 The Netherlands ,Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
| |
Collapse
|
6
|
Beatson A, Riedel A, Chamorro-Koc M, Marston G, Stafford L. Encouraging young adults with a disability to be independent in their journey to work: A segmentation and application of Theory of Planned Behaviour approach. Heliyon 2020; 6:e03420. [PMID: 32099929 PMCID: PMC7030989 DOI: 10.1016/j.heliyon.2020.e03420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/17/2019] [Accepted: 02/12/2020] [Indexed: 11/27/2022] Open
Abstract
This study investigates how young adults with disabilities can be encouraged to be independent in their travel to work and thus, transition more smoothly into the workforce. Using cluster analysis, we identify three segment groups of young adults with physical disabilities. The Theory of Planned Behaviour is then applied to examine differences and identify strategies that could provide assistance and support to these groups of workers in their travel to work. This study is the first to segment this group of workers and identify strategies to mitigate the often-unique challenges they face in their physical journey to work.
Collapse
Affiliation(s)
- Amanda Beatson
- QUT Business School, Queensland University of Technology, Brisbane, 4000, Australia
| | - Aimee Riedel
- University of Sunshine Coast Business School, Southbank, Brisbane, Australia
| | | | - Greg Marston
- School of Social Science, University of Queensland, St Lucia, Queensland 4072, Australia
| | - Lisa Stafford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4000, Australia
| |
Collapse
|
7
|
Farre A, Ryan S, McNiven A, McDonagh JE. The impact of arthritis on the educational and early work experiences of young people: a qualitative secondary analysis. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0240/ijamh-2018-0240.xml. [PMID: 30851159 DOI: 10.1515/ijamh-2018-0240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/16/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Young people's transition into adulthood is intertwined with the worlds of education and work. Poor health in adolescence has been associated with poorer education and employment outcomes in adulthood. This paper explores the impact of arthritis on the educational and early work experiences of young people with arthritis. METHODS We undertook a supplementary secondary analysis of a qualitative dataset comprising narrative and semi-structured interviews of 39 young people who had been diagnosed with arthritis in childhood, adolescence or young adulthood. RESULTS Our findings illustrate how young people living with arthritis are faced with a range of added disruptions and challenges in their educational/vocational lives. There is an important element of resilience associated with the process of making a career choice and acting upon personal aspirations. Appropriate support and flexibility in the workplace/educational setting can enable successful outcomes, but disclosure is not a straightforward process for young people living with arthritis. CONCLUSIONS It is paramount that health providers consistently and effectively address self-advocacy skills with the young person, particularly during educational and vocational transitions. Alongside this, there is the need to further strengthen the health-school/work interface to ensure that young people living with chronic illness can meet their full potential in adulthood.
Collapse
Affiliation(s)
- Albert Farre
- University of Dundee, School of Nursing and Health Sciences, Dundee, UK
| | - Sara Ryan
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Abigail McNiven
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Janet E McDonagh
- University of Manchester, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK.,Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
8
|
Lindsay S, Cagliostro E, Carafa G. A systematic review of workplace disclosure and accommodation requests among youth and young adults with disabilities. Disabil Rehabil 2017; 40:2971-2986. [PMID: 28797182 DOI: 10.1080/09638288.2017.1363824] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The objective of this systematic review is to critically appraise the literature on disability disclosure and workplace accommodations for youth and young adults with disabilities. METHODS Systematic searches of nine international databases identified 27 studies meeting our inclusion criteria. These studies were analyzed with respect to the characteristics of the participants, methodology, results of the studies and the quality of the evidence. RESULTS Among the 27 studies, 18,419 participants (aged 14-33, mean 23.9 years) were represented across seven countries. Barriers to disability disclosure and requests for workplace accommodations were found at the individual (i.e., disability type, severity, poor self-concept, and advocacy skills), employment (i.e., type of industry, and working conditions, lack of supports), and societal levels (i.e., stigma/discrimination). Facilitators of disability disclosure included individual factors (i.e., knowledge of supports and workplace rights, self-advocacy skills), employment (i.e., training/supports, effective communication with employers, realizing the benefits of accommodations), and societal factors (i.e., positive attitudes toward people with disabilities). There was little consensus on the processes and timing of how disability should be discussed in the workplace among youth with disabilities. CONCLUSIONS Our findings highlight the complexities of disability disclosure for youth with disabilities. More studies are needed to explore issues of workplace disclosure and accommodations for young people to improve disclosure strategies and the process of providing appropriate accommodations. Implications for Rehabilitation Clinicians, educators, and parents should support youth to become self-aware and build self-advocacy skills so they can make an informed decision about how and when to disclose their condition to employers. Clinicians, educators, and employers should help youth with disabilities to understand the benefits of disclosing their disability, and educate them on the supports available so they can remain healthy and productive in the workplace. Clinicians should advocate for employers to create a positive and supportive environment where youth feel comfortable disclosing their condition.
Collapse
Affiliation(s)
- Sally Lindsay
- a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada.,b Bloorview Research Institute , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| | - Elaine Cagliostro
- b Bloorview Research Institute , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| | - Gabriella Carafa
- c Child Development Program , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| |
Collapse
|
9
|
Hanson H, Hart RI, Thompson B, McDonagh JE, Tattersall R, Jordan A, Foster HE. Experiences of employment among young people with juvenile idiopathic arthritis: a qualitative study. Disabil Rehabil 2017; 40:1921-1928. [DOI: 10.1080/09638288.2017.1323018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Helen Hanson
- Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth I. Hart
- Department of Health Sciences, University of York, York, UK
| | - Ben Thompson
- Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Janet E. McDonagh
- Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Rachel Tattersall
- Rheumatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Alison Jordan
- Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Helen E. Foster
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Paediatric Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
10
|
Shaw KL, Hackett JL, Southwood TR, McDonagh JE. The Prevocational and Early Employment Needs of Adolescents with Juvenile Idiopathic Arthritis: The Occupational Therapy Perspective. Br J Occup Ther 2016. [DOI: 10.1177/030802260606901103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the study was to explore the prevocational needs of adolescents with juvenile idiopathic arthritis (JIA) from the perspective of occupational therapists and to examine the role of occupational therapy in addressing these. A questionnaire was distributed to members of occupational therapy organisations (n = 494) to assess the perceived importance of addressing prevocational issues for adolescents with JIA and the respondents' knowledge, confidence and perceived role. The questionnaire was completed by 175 (35.4%) individuals. The results showed that although the occupational therapists felt that they were an appropriate profession to address the vocational needs of adolescents, they reported limited knowledge and confidence to do so. Significant unmet training needs were highlighted. This study echoes previous calls for vocational issues to be addressed within adolescent rheumatology and provides evidence that occupational therapy is well placed to coordinate this area of need.
Collapse
|
11
|
"Sometimes I feel like a pharmacist": identity and medication use among adolescents with juvenile arthritis. Pediatr Rheumatol Online J 2016; 14:57. [PMID: 27756328 PMCID: PMC5070126 DOI: 10.1186/s12969-016-0117-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Taking medicines as intended is difficult for everybody, but young people going through adolescence have greater problems than adults and younger children. One of the most important things that happen during the teenage years is the development of individual identities, which might not remain constant during this time and can be affected deeply by the diagnosis of a long-term condition. The aim of this study was to examine the relationships between identity and medication use among young people with juvenile arthritis. METHODS A prospective qualitative study was undertaken to collect private online 'blog' style data from young people (aged 11-19 years) with juvenile arthritis, and their parents, to examine their views about their condition, identity, medication and use of health services. Participants were identified from a large paediatric hospital in the UK. RESULTS Young people (n = 21) with a median age 14 years (range 11-17 years) posted a median (range) of 8 (1-36) blogs and parents (n = 6) posted 4 (1-12) blogs. Young people gave a strong sense of both private and public identity that was intertwined with their arthritis and treatment. It was evident that young people's self-care was intrinsically linked to their attempts to maintain a sense of individually and socially constructed definitions of normality. The act of taking medication, and the consequences (positive or negative) of that act, had an impact both personally and socially. CONCLUSIONS Young people with juvenile arthritis reflect on their medication as a factor affecting their perception of themselves. Acknowledging the roles of both personal and social identity will be important in any strategies to support optimal medication use. This includes an understanding of the identity transformations that young people can experience and how decision-making may be affected by their attempts to retain pre-diagnosis identities and/or develop new social identities.
Collapse
|
12
|
Jetha A, Badley E, Beaton D, Fortin PR, Shiff NJ, Gignac MAM. Unpacking Early Work Experiences of Young Adults With Rheumatic Disease: An Examination of Absenteeism, Job Disruptions, and Productivity Loss. Arthritis Care Res (Hoboken) 2016; 67:1246-1254. [PMID: 25892130 DOI: 10.1002/acr.22601] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/09/2015] [Accepted: 04/14/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine work absenteeism, job disruptions, and perceived productivity loss and factors associated with each outcome in young adults living with systemic lupus erythematosus (SLE) and juvenile arthritis (JA). METHODS One hundred forty-three young adults, ages 18-30 years with SLE (54.5%) and JA (45.5%), completed an online survey of work experiences. Demographic, health (e.g., fatigue, disease activity), psychosocial (e.g., independence, social support), and work context (e.g., career satisfaction, job control, self-disclosure) information was collected. Participants were asked about absenteeism, job disruptions, and perceived productivity loss in the last 6 months. Log Poisson regression analyses examined factors associated with work outcomes. RESULTS A majority of participants (59%) were employed and reported a well-managed health condition. Employed respondents were satisfied with their career progress and indicated moderate job control. More than 40% of participants reported absenteeism, job disruptions, and productivity loss. Greater job control and self-disclosure, and less social support, were related to a higher likelihood of absenteeism. More disease activity was related to a greater likelihood of reporting job disruptions. Lower fatigue and higher job control were associated with a reduced likelihood of a productivity loss. CONCLUSION Young adult respondents with rheumatic disease experienced challenges with employment, including absenteeism, job disruptions, and productivity loss. While related to greater absenteeism, job control could play a role in a young person's ability to manage their health condition and sustain productive employment. Greater attention should also be paid to understanding health factors and social support in early work experiences.
Collapse
Affiliation(s)
- Arif Jetha
- Dalla Lana School of Public Health, University of Toronto, and Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Elizabeth Badley
- Dalla Lana School of Public Health, University of Toronto, and Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Dorcas Beaton
- Institute for Work and Health and St. Michaels Hospital, Toronto, Ontario, Canada
| | - Paul R Fortin
- Centre Hospitalier Universitaire de Québec and Faculté de Médecine de L'Université Laval, Quebec City, Quebec, Canada
| | | | - Monique A M Gignac
- Dalla Lana School of Public Health, University of Toronto, Toronto Western Research Institute, and Institute for Work and Health, Toronto, Ontario, Canada
| |
Collapse
|
13
|
Jetha A. The impact of arthritis on the early employment experiences of young adults: A literature review. Disabil Health J 2014; 8:317-24. [PMID: 25600476 DOI: 10.1016/j.dhjo.2014.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 10/17/2014] [Accepted: 12/14/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Young adulthood is an important transitional life phase that can determine a person's career trajectory. To date, little research has examined the influence of arthritis on early work experiences. OBJECTIVES This literature review aims at examining the impact of arthritis on the early career phase of young adults and identifying the barriers to employment. METHODS Two independent reviewers searched bibliographic databases for arthritis conditions and a series of employment-related keywords and subject headings. Information on authors, publication year; study design, sample characteristics (e.g., number of participants, age, gender, arthritis type); work outcomes measured; and specific barriers to employment was recorded. RESULTS Nine studies were uncovered in the review. All studies examined young people with juvenile arthritis (9 of 9 studies) and consisted of sample sizes with less then 150 participants (6 of 9 studies) who were primarily recruited from clinics (7 of 9 studies). All were cross-sectional designs. Employment status was primarily examined and ranged from 11% to 71%. Although not always statistically significant, young adults with arthritis were less likely to be employed when compared to their healthy peers. Greater disease severity, less educational attainment and being female were related to not participating in paid work. CONCLUSION This review brings to light the paucity of studies examining the early employment experiences of young adults with arthritis. There is a need to expand research to contribute to recommendations for sustained and productive employment across the working life course.
Collapse
Affiliation(s)
- Arif Jetha
- Dalla Lana School of Public Health, University of Toronto, Canada; Arthritis, Community, Research & Evaluation Unit, Toronto Western Research Institute, Canada.
| |
Collapse
|
14
|
Jetha A, Badley E, Beaton D, Fortin PR, Shiff NJ, Rosenberg AM, Tucker LB, Mosher DP, Gignac MA. Transitioning to Employment with a Rheumatic Disease: The Role of Independence, Overprotection, and Social Support. J Rheumatol 2014; 41:2386-94. [DOI: 10.3899/jrheum.140419] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To examine perceived independence, overprotection, and support, and their association with the employment participation of young adults with rheumatic disease.Methods.One hundred and forty-three young adults, ages 18 to 30 years, with systemic lupus erythematosus (54.5%) and juvenile arthritis (45.5%) completed a 30-min online questionnaire of their work and education experiences. Information collected was demographic, health (e.g., pain, fatigue, disease activity), work context (e.g., career satisfaction, helpfulness of job accommodation/benefits, and workplace activity limitations), and psychosocial (e.g., independence, social support, and overprotection). Log-Poisson regression analysis examined factors associated with employment status.Results.Over half of respondents were employed (59%) and 26% were enrolled in school. Respondents reported moderate to high perceptions of independence and social support. However, 27% reported that “quite a bit” to “a great deal” of overprotection characterized their relationships with those closest to them. At the bivariate level, employed participants and those indicating greater perceived independence reported greater social support and less overprotection. Multivariable analysis revealed that being employed was associated with older age, more job accommodations/benefits perceived as being helpful, and greater perceived independence.Conclusion.This is one of the first studies examining the employment of young adults with rheumatic diseases. Findings highlight the importance of psychosocial perceptions such as independence and overprotection, in addition to support related to working. Additional research is needed to better understand the role of those close to young adults with rheumatic diseases in supporting independence and encouraging employment.
Collapse
|
15
|
Affiliation(s)
- Janet E McDonagh
- Birmingham Children’s Hospital NHS Foundation Trust, Steelhouse Lane, Birmingham, UK
| | | |
Collapse
|
16
|
|