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Bon SBB, Wouters RHP, Bakhuizen JJ, Jongmans MCJ, van den Heuvel-Eibrink MM, Grootenhuis MA. Experiences of pediatric cancer patients (age 12-18 years) with extensive germline sequencing for cancer predisposition: a qualitative study. Eur J Hum Genet 2024; 32:567-575. [PMID: 38409533 PMCID: PMC11061193 DOI: 10.1038/s41431-024-01565-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
This study explored the experiences and needs of adolescents, ranging from 12 to 18 years old, who have recently been diagnosed with cancer and participated in a nationwide germline genetic sequencing study within the context of pediatric oncology. The 21 adolescents in this qualitative interview study viewed genetic sequencing as an integral part of their cancer journey. They often characterized germline sequencing as "good-to-know" without specifying immediate utility. While the adolescents comprehended the significance of germline genetic sequencing, they were less focused on its potential long-term implications. Adolescents expressed a strong desire to be actively engaged in decisions related to genetics. They advocated for a participatory role in genetic decision-making from a young age onwards. They recommended that re-consent should be sought before re-analysis of their genetic data is performed and believe that patients should have the opportunity to provide (re-)consent once they reach adulthood. Moreover, the adolescents emphasized the importance of developing counseling materials that are not only concise but also visually attractive. In conclusion, this study underscores the positive perception that adolescents diagnosed with cancer hold regarding germline genetic sequencing. They articulate a strong interest in being actively involved in genetic decision-making. To address these articulated needs and preferences, we recommend the development of visually engaging counseling materials. These materials should effectively convey both the immediate and long-term implications of genetic sequencing, enabling adolescents with cancer to make informed decisions about genetic sequencing.
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Affiliation(s)
- Sebastian B B Bon
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Roel H P Wouters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jette J Bakhuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marjolijn C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
- Division of Child Health, UMCU-Wilhelmina's Children's Hospital, Utrecht, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Division of Child Health, UMCU-Wilhelmina's Children's Hospital, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Division of Child Health, UMCU-Wilhelmina's Children's Hospital, Utrecht, The Netherlands
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Kasperbauer TJ, Halverson C. Adolescent Assent and Reconsent for Biobanking: Recent Developments and Emerging Ethical Issues. Front Med (Lausanne) 2021; 8:686264. [PMID: 34307413 PMCID: PMC8301072 DOI: 10.3389/fmed.2021.686264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/17/2021] [Indexed: 11/13/2022] Open
Abstract
Research biobanks that enroll minors face important practical, ethical, and regulatory challenges in reconsenting participants when they reach the age of 18. Federal regulations governing research in the United States provide minimal guidance and allow for a range of practices, including waiving the requirement to obtain reconsent. Some commentators have argued that institutional review boards should indeed grant such waivers, given the low risks of biobank-based research and the impracticality of contacting all participants when they turn 18. There is also significant ethical debate about the age at which adolescents can make authentic, autonomous decisions regarding their research participation. This paper reviews these issues in detail, describes the current state of the ethical discussion, and outlines evidence-based policies for enrolling minors into research biobanks.
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Affiliation(s)
- T J Kasperbauer
- Indiana University Center for Bioethics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Colin Halverson
- Indiana University Center for Bioethics, Indiana University School of Medicine, Indianapolis, IN, United States
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Paduca A, Arnaut O, Beschieru E, Lundmark PO, Bruenech JR. Shared decision making and patients satisfaction with strabismus care-a pilot study. BMC Med Inform Decis Mak 2021; 21:109. [PMID: 33771137 PMCID: PMC7995717 DOI: 10.1186/s12911-021-01469-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Strabismus is a complex disease that has various treatment approaches each with its own advantages and drawbacks. In this context, shared decisions making (SDM) is a communication process with the provider sharing all the relevant treatment alternatives, all the benefits, and risks of each procedure, while the patient shares all the preferences and values regarding his/her choices. In that way, SDM is a bidirectional process that goes beyond the typical informed consent. Therefore, it is known a little of the extent to which SDM influences the satisfaction with the treatment outcome along with strabismus patients. To study this correlation, an SDM-Q-9 questionnaire was provided within surgical consultations where treatment decisions were made; the SDM-Q-9 aims to assess the relationship between the post-operative patient's satisfaction and their SMD score. METHODS The study is considered a prospective observational pilot study. Eligible patients were adult patients diagnosed with strabismus, who had multiple treatment options, were given at the right of choice without being driven into a physician's preference. Ninety-three strabismus patients were asked to fill out the SDM-Q-9 questionnaire related to their perception of SDM during the entire period of strabismus treatment. After the treatment, patients were asked to rate their satisfaction level with the surgical outcome as excellent, good, fair, and poor. Descriptive statistics and the linear regression statistical tests (Spearman, Mann Whitney U, and Kriskal-Wallis) were used as analysis tools. RESULTS The average age of the participants was 24, where 50.6% were women. The mean SDM-Q-9 score among patients was 32 (IQR = 3). The postoperative patient satisfaction was rated as being excellent by 16 (17.2%) patients, good by 38 (40.9%), fair by 32 (34.4%), and poor by 7 patients (7.5%). Data analysis by linear regression statistical tests showed a positive correlation between the SDM-Q-9 score and the patient satisfaction related to the surgery outcome (B = 0.005, p < 0.001). Criteria in assessing patients' satisfaction were age, gender, and strabismus type. A positive correlation between SDM and real satisfaction (r = 0.834, p < 0.01) was found with age, and no significant relationship was found while taking into consideration the responder's gender and the strabismus type. CONCLUSIONS Assessing patient satisfaction after choosing a treatment for strabismus method helped us evaluate the gaps in constructive dialogue that would lead to a positive outcome for both patient and clinician. The correlation between the SDM process and the patients' satisfaction with surgery outcome, adjusted by age, has been established. These findings can serve as a springboard to further communicative improvements related to the SDM process and between patients and physicians, thereby consequently leading to patients' satisfaction raise in strabismus care. The study underlines the importance of further analysis and validation of on-ground interactions among the adolescent and adult patients and the clinicians across the strabismus management trajectory. A multicentral study and its validation will follow.
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Affiliation(s)
- Ala Paduca
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway. .,Ophthalmology Department, Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu″, Chişinău, Republic of Moldova.
| | - Oleg Arnaut
- Department of Human Physiology and Biophysics, Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu", Chişinău, Republic of Moldova
| | - Eugeniu Beschieru
- Department of Surgery No.1 "N. Anestiadi", Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu", Chişinău, Republic of Moldova
| | - Per Olof Lundmark
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway
| | - Jan Richard Bruenech
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway
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Carlsson IM, Arvidsson S, Svedberg P, Nygren JM, Viklund Å, Birkeland AL, Larsson I. Creating a communication space in the healthcare context: Children’s perspective of using the eHealth service, Sisom. J Child Health Care 2021; 25:31-43. [PMID: 32048874 PMCID: PMC7897780 DOI: 10.1177/1367493520904804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
According to the United Nation's Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children's perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6-13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children's voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children's needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice.
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Affiliation(s)
- Ing-Marie Carlsson
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden,Ing-Marie Carlsson, Department of Health and Welfare, Halmstad University, SE-823, SE-301 18 Halmstad, Sweden.
| | - Susann Arvidsson
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Åsa Viklund
- Department of Social Work, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Lena Birkeland
- Department of Social Work, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
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Luchtenberg ML, Maeckelberghe ELM, Locock L, Verhagen AAE. Understanding the child-doctor relationship in research participation: a qualitative study. BMC Pediatr 2020; 20:353. [PMID: 32709229 PMCID: PMC7379349 DOI: 10.1186/s12887-020-02243-1] [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: 03/26/2020] [Accepted: 07/08/2020] [Indexed: 01/10/2023] Open
Abstract
Background Children have reported that one reason for participating in research is to help their doctor. This is potentially harmful if associated with coercive consent but might be beneficial for recruitment. We aimed to explore children’s perceptions of the child-doctor relationship in research. Methods This is a multicenter qualitative study with semi structured interviews performed between 2010 and 2011 (United Kingdom) and 2017–2019 (the Netherlands). Interviews took place nationwide at children’s homes. We performed a secondary analysis of the two datasets, combining an amplified analysis aimed to enlarge our dataset, and a supplementary analysis, which is a more in-depth investigation of emergent themes that were not fully addressed in the original studies. All participants had been involved in decisions about research participation, either as healthy volunteers, or as patients. Recruitment was aimed for a purposive maximum variation sample, and continued until data saturation occurred. We have studied how children perceived the child-doctor relationship in research. Interviews were audiotaped or videotaped, transcribed verbatim, and thematically analyzed using Atlas.ti software. Results In total, 52 children were recruited aged 9 to 18, 29 in the United Kingdom and 23 in the Netherlands. Children’s decision-making depended strongly on support by research professionals, both in giving consent and during participation. Often, their treating physician was involved in the research process. Familiarity and trust were important and related to the extent to which children thought doctors understood their situation, were medically competent, showed support and care, and gave priority to the individual child’s safety. A trusting relationship led to a feeling of mutuality and enhanced children’s confidence. This resulted in improving their experiences throughout the entire research process. None of the participants reported that they felt compelled to participate in the research. Conclusions The child-doctor relationship in pediatric research should be characterized by familiarity and trust. This does not compromise children’s voluntary decision but enhances children’s confidence and might result in a feeling of mutuality. By addressing the participation of children as an iterative process during which treatment and research go hand in hand, the recruitment and participation of children in research can be improved.
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Affiliation(s)
- Malou L Luchtenberg
- University of Groningen, Groningen, the Netherlands. .,Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands.
| | | | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom.,Health Experiences Research Group, University of Oxford, Oxford, United Kingdom
| | - A A Eduard Verhagen
- University of Groningen, Groningen, the Netherlands.,Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands
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Sarhan MBA, Shannon HS, Fujiya R, Jimba M, Giacaman R. Psychometric properties of an Arabic-language health literacy assessment scale for adolescents (HAS-A-AR) in Palestine. BMJ Open 2020; 10:e034943. [PMID: 32565456 PMCID: PMC7311025 DOI: 10.1136/bmjopen-2019-034943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Health literacy research in Palestine is limited, and a locally validated tool for use among adolescents has been unavailable until now. Therefore, this study aimed to adapt health literacy assessment scale for adolescents (HAS-A) into Arabic language (HAS-A-AR) and Palestinian context and to investigate its psychometric properties. DESIGN We conducted a cross-sectional household survey using a stratified random sample and household face-to-face interviews. SETTING AND PARTICIPANTS We conducted 1200 interviews with sixth to ninth graders in the Ramallah and al-Bireh district of the West Bank, Palestine in 2017. METHODS We translated and adapted HAS-A to be sensitive to the Palestinian context and tested its psychometric properties. We evaluated face and content validity during the back-translation process and checked for construct validity through exploratory factor analysis (EFA). We tested for internal consistency using Cronbach's alpha, MacDonald's omega test and the greatest lower bound (GLB). Furthermore, we calculated the scale's average inter-item correlation. RESULTS EFA revealed that HAS-A-AR has a similar structure to the original HAS-A. It extracted three factors (communication, confusion and functional health literacy) whose eigenvalues were >1. Together they explained 57% of the total variance. The proportions of adolescents with high levels of communication, confusion and functional health literacy were 45%, 68% and 80%, respectively. Cronbach's alpha, MacDonald's omega and the GLB values for communication subscale were 0.87, 0.88 and 0.90, and they were 0.78, 0.77 and 0.79 for confusion subscale, while they were 0.77, 0.77 and 0.80, respectively, for functional healthy literacy subscale. The average inter-item correlation for the subscales ranged between 0.36 and 0.59. CONCLUSION HAS-A-AR is a valid and reliable health literacy measuring instrument with appropriate psychometric properties. HAS-A-AR is currently available for use among adolescents in Palestine and the surrounding Arab countries with similar characteristics as Palestine, including language, culture and political instability.
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Affiliation(s)
- Mohammed B A Sarhan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Harry S Shannon
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rika Fujiya
- Faculty of Nursing and Medical Care, Keio University, Fugisawa, Kanagawa, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
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McGregor KA, Ott MA. Banking the Future: Adolescent Capacity to Consent to Biobank Research. Ethics Hum Res 2020; 41:15-22. [PMID: 31336038 DOI: 10.1002/eahr.500023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Adolescents are an important population to represent in biobanks. Inclusion of biospecimens from adolescents advances our understanding of the long-term consequences of pediatric disease and allows the discovery of methods to prevent adult diseases during childhood. Consent for biobanking is complex, especially when considering adolescent participation, as it brings up issues that are not present with general clinical research. The development and successful implementation of an adolescent capacity assessment tool applied specifically to biobanking can potentially provide researchers and clinicians with contextualized information on participants' understanding, appreciation, reasoning, and voluntary choice for biobanks. This tool would enhance current studies looking at the role of shared decision-making in biobanking, as well as provide a formal measurement when considering decisions around pediatric and adolescent biobanking participation. This study adapted the MacCAT-CR for use with a hypothetical adolescent biobank study and examines predictors of MacCAT-CR scores on healthy and chronically ill adolescents.
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Affiliation(s)
- Kyle A McGregor
- Assistant professor in child and adolescent psychiatry and medical ethics and serves as the director of pediatric mental health ethics at NYU Langone Health
| | - Mary A Ott
- Professor in the Department of Pediatrics in the Section of Adolescent Medicine at Indiana University School of Medicine
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Larsson I, Svedberg P, Arvidsson S, Nygren JM, Carlsson IM. Parents' experiences of an e-health intervention implemented in pediatric healthcare: a qualitative study. BMC Health Serv Res 2019; 19:800. [PMID: 31690287 PMCID: PMC6833200 DOI: 10.1186/s12913-019-4643-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/16/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The growing field of participation in healthcare has the potential to provide a number of benefits for children, patients, healthcare professionals and also the healthcare systems. According to the Convention on the Rights of the Child (UNCRC), children have the right to participate in their own healthcare and make their voice heard. Children's opportunities for understanding their conditions, sharing their views and participating in decisions regarding their care depend on healthcare professionals but also on parents' ability to communicate and include children. E-health solutions can remove barriers to children's communication with healthcare professionals. The aim of this study was to explore parents' perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments. METHODS The empirical data is based on interviews with 16 parents. In the present study constructivist, grounded theory was chosen as the method. RESULTS The theory of enhancing participation, by orientating communication about healthcare towards the voice of the child instead of the parents, summarizes the process of how the outcome of Sisom for children lead to enhanced participation, by making the child the main actor and an agent in his/her own healthcare. The facilitators for achieving participation in Sisom were four interrelated outcomes; engaging, voice-guarding, raising awareness and integrity preserving. In addition to generating increased participation, it emerged that the use of Sisom also initiated a process, which was evident in all four subcategories that facilitated the child in coping with the experience of having an illness. CONCLUSIONS We conclude, that Sisom orientated communication about healthcare towards the voice of the child instead of the parents as well as including the child in the dialogue with the healthcare professional and thus increasing the child's participation and human rights.
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Affiliation(s)
- Ingrid Larsson
- School of Health and Welfare, Halmstad University, PO Box 823, S-30118 Halmstad, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, PO Box 823, S-30118 Halmstad, Sweden
| | - Susann Arvidsson
- School of Health and Welfare, Halmstad University, PO Box 823, S-30118 Halmstad, Sweden
| | - Jens M. Nygren
- School of Health and Welfare, Halmstad University, PO Box 823, S-30118 Halmstad, Sweden
| | - Ing-Marie Carlsson
- School of Health and Welfare, Halmstad University, PO Box 823, S-30118 Halmstad, Sweden
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Jordan A, Joseph-Williams N, Edwards A, Holland-Hart D, Wood F. "I'd Like to Have More of a Say Because It's My Body": Adolescents' Perceptions Around Barriers and Facilitators to Shared Decision-Making. J Adolesc Health 2019; 65:633-642. [PMID: 31395512 DOI: 10.1016/j.jadohealth.2019.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Adolescents living with long-term conditions (LTCs) often feel as though they are left out of discussions and decisions with healthcare professionals, which can give them the impression that their views are not important. Research around decision-making during clinical encounters often fails to represent adolescents' perspectives. This study explores adolescents' perceptions and experiences, focusing on identifying the perceived barriers to, and facilitators for, their involvement in shared decision-making (SDM). METHODS Nineteen adolescents (aged 13-19 years) with LTCs were recruited from endocrinology, rheumatology, neurology, and nephrology clinics. Participatory qualitative interviews were conducted using life grids and pie charts, and transcripts were analyzed thematically. RESULTS Four overarching themes and nine sub-themes were identified which describe barriers and facilitators around SDM. Adolescents need to feel, as though their involvement is supported by parents and healthcare professionals, that their contribution to the decision-making process is important and will yield a positive outcome. Adolescents often feel it is their right to be involved in decisions that affect them but also feel as though the adults' contributions to the decisions are considered more valuable. Adolescents need to feel capable of being involved, in terms of being able to understand and process information about the available options and ask appropriate questions. CONCLUSIONS This work highlights a number of ways SDM can be facilitated between healthcare practitioners and adolescents with LTCs. Identifying the needs of adolescents with LTCs is necessary for optimizing the SDM process and to support them during healthcare consultations.
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Affiliation(s)
- Amber Jordan
- Cardiff University, Heath Park Campus, Heath Park, Cardiff, United Kingdom.
| | | | - Adrian Edwards
- Cardiff University, Heath Park Campus, Heath Park, Cardiff, United Kingdom
| | | | - Fiona Wood
- Cardiff University, Heath Park Campus, Heath Park, Cardiff, United Kingdom
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Kebbe M, Perez A, Buchholz A, Scott SD, McHugh TLF, Richard C, Dyson MP, Ball GDC. Adolescents' involvement in decision-making for pediatric weight management: A multi-centre, qualitative study on perspectives of adolescents and health care providers. PATIENT EDUCATION AND COUNSELING 2019; 102:1194-1202. [PMID: 30791989 DOI: 10.1016/j.pec.2019.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To explore adolescents' and health care providers' (HCPs) perspectives on adolescents' involvement in decision-making within multidisciplinary clinical care for pediatric weight management. METHODS In this multi-centre, qualitative description study, we purposefully recruited 13-17-year-olds with overweight or obesity and HCPs from two pediatric weight management clinics in Edmonton and Ottawa, Canada. Participants completed one-on-one, in-person, semi-structured interviews (adolescents) or focus groups (HCPs), which were audio-recorded, transcribed verbatim, and managed using NVivo 11. Data were analyzed by two independent researchers using inductive thematic analysis and the congruent methodological approach for group interactions. RESULTS A total of 19 adolescents and 16 HCPs participated. Three themes were identified in relation to adolescents' decision-making for weight management, including (i) conditions for adolescent involvement, (ii) preferences for adolescent involvement, and (iii) extent of parental involvement. CONCLUSIONS Although adolescents and HCPs positively valued adolescents' involvement in making decisions regarding their weight and health, the extent to which adolescents wished to be involved in the decision-making process varied between individuals and families. PRACTICE IMPLICATIONS HCPs are encouraged to include adolescents and families in their health services delivery, including consulting individually with adolescents and tailoring care to their expectations regarding decision-making.
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Affiliation(s)
- Maryam Kebbe
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Arnaldo Perez
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Annick Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Tara-Leigh F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Caroline Richard
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Michele P Dyson
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Geoff D C Ball
- Department of Pediatrics, University of Alberta, Edmonton, Canada.
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Grootens-Wiegers P, Hein I, Staphorst M. Using Children's Voice to Optimize Pediatric Participation in Medical Decision Making. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:14-16. [PMID: 29466122 DOI: 10.1080/15265161.2017.1418928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Irma Hein
- b Academic Medical Center Amsterdam and De Bascule
| | - Mira Staphorst
- c Emma Children's Hospital/Academic Medical Center Amsterdam
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