1
|
Seko Y, Oh A, Curran C, King G. Transitions Theatre: Creating a Research-Based Reader's Theatre With Disabled Youth and Their Families. QUALITATIVE HEALTH RESEARCH 2022; 32:2147-2158. [PMID: 36373512 PMCID: PMC9709532 DOI: 10.1177/10497323221138004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Transition to adult life can be a challenging time for disabled youth and their families. This article describes the collaborative creation of Transitions Theatre, a research-based reader's theatre activity based on narrative interviews with eight disabled youth (aged 17-22) and seven parents. Analysis of these interviews generated two opposing yet interrelated themes. On one hand, youth and families felt lost in transition facing multiple gaps in healthcare, financial support, education, and opportunities for social participation after having "aged out" of the pediatric system. On the other hand, they started cripping "normal" adulthood to envision more inclusive futures wherein disabilities are understood as integral to society. These two themes were transformed into two reader's theatre scripts, one featuring a youth, the other featuring a parent. Seven youth and four parents (six of them were original interview participants) then participated in a Transitions Theatre workshop to read the scripts together and discuss the authenticity and relatability of the scripts. Participant feedback suggested that the reader's theatre method was effective in sharing findings with research participants and stimulating a critical dialogue on how to (re)imagine transition to adulthood. We discuss the importance of implementing inclusive design strategies to make reader's theatre accessible to participants with diverse abilities and preferences.
Collapse
Affiliation(s)
- Yukari Seko
- School of Professional
Communication,
Toronto
Metropolitan University, Toronto, ON,
Canada
- Bloorview Research
Institute, Toronto, ON, Canada
| | - Anna Oh
- Holland Bloorview Kids Rehabilitation
Hospital, Toronto, ON, Canada
| | - C.J. Curran
- London Health Sciences
Centre, London, ON, Canada
| | - Gillian King
- Bloorview Research
Institute, Toronto, ON, Canada
- Department of Occupational Science
and Occupational Therapy, University of
Toronto, Toronto, ON, Canada
| |
Collapse
|
2
|
Brandão MB, Bueno KMP, Silvério APM, Antunes FIT, Feitosa AM, Figueiredo PRP, Mancini MC. "Listen to us!" A qualitative study of adolescents with disabilities to help plan a transition service. Child Care Health Dev 2022; 48:833-841. [PMID: 35229345 DOI: 10.1111/cch.12992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 01/17/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The development and implementation of transition services for adolescents with disabilities should incorporate perceptions of their needs and interests. The aim of the study was to understand the concerns of adolescents with physical disabilities during adolescence and their expectations regarding adulthood to help plan a transition programme in Brazil. METHODS This is a qualitative study, using a phenomenological approach. Eight adolescents with physical disabilities (seven with cerebral palsy, one with muscular dystrophy), aged between 15 and 17 years, participated in two focus groups. Prior to the conduction of the groups, clinicians selected topics related to adolescence and the transition to adulthood, based on their professional experience and available literature. During the focus groups, illustrative images of each topic were presented to the participants. Each adolescent was asked to select five topics that he/she considered important to be discussed in a future transition programme. The participants justified their individual choices and, in groups, reached a consensus on the groups' priorities. This strategy was chosen to motivate the discussion among the participants and to explore their concerns regarding adolescence and transition to adulthood. The focus groups were audio recorded and transcribed for content analysis. RESULTS Three themes emerged from the content analysis: (1) "Adolescents and their social relationships," (2) "Identity formation: self-awareness and development of autonomy," and (3) "What about adulthood?" CONCLUSION The themes revealed conflicts between the adolescents' desire to achieve independence and autonomy and the awareness of their limitations. The interpretation of the results helped structuring the actions of the Adolescence in Focus Programme, with two main actions: promotion of the adolescent's functional performance in daily living activities and assistance with their identity formation and preparation for adulthood.
Collapse
Affiliation(s)
- Marina B Brandão
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kátia M P Bueno
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernanda I T Antunes
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline M Feitosa
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Priscilla R P Figueiredo
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Associação Mineira de Reabilitação, Belo Horizonte, Brazil
| | - Marisa C Mancini
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
3
|
Imamura T, Nakayama T, Nakayama J, Iwasaki N. A Patient with Rett Syndrome Maintained Motor Function by Periodic Rehabilitation Therapy and Proactive Daily Activities. Prog Rehabil Med 2020; 5:20200014. [PMID: 32844127 PMCID: PMC7429559 DOI: 10.2490/prm.20200014] [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] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/01/2020] [Indexed: 12/23/2022] Open
Abstract
Background The motor functions of Rett syndrome patients degrade during the course of the disease. Some patients, however, are able to maintain their motor functions by undertaking exercise programs. Case A 2-year-old girl was diagnosed with Rett syndrome after the identification of a mutation in the gene encoding the methyl-CpG-binding protein. The patient started weekly rehabilitation therapy; however, over time, this reduced to monthly sessions, and subsequently, because of worsening epileptic seizures, even fewer sessions were possible. When the patient was 12 years old, intensive rehabilitation therapy was undertaken for 1 month; therapy involved 80 min of in-hospital therapy on weekdays and walking exercises at home at the weekend. An accelerometer (Actiwatch 2, standard type, Philips Respironics) indicated that more than 60 min of daily training at an intensity of 3 metabolic equivalents (METs) or more was achieved at weekends. The patient took the 10-m walk test, and the average time reduced from 18.6 to 13.5 s and the number of steps reduced from 32 to 23 between the start and finish of the first 1-month intensive training regime. After being discharged from the hospital, the patient maintained walking exercises at school during weekdays and performed more than 50 min/day of activity at at least 3 METs at home on weekends, in addition to a weekly home-visit rehabilitation therapy and the annual in-hospital 1-month rehabilitation therapy. Four years later, the patent's average time and number of steps required to walk 10 m remained lower (12.7 s, 24 steps) than those recorded at the first evaluation. Discussion Periodic rehabilitation therapy and proactive walking exercises at more than 3 METs for a duration of up to 50 min/day were instrumental in maintaining the motor functions of a Rett syndrome patient.
Collapse
Affiliation(s)
| | - Tomohiro Nakayama
- Division of Pediatric Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Junko Nakayama
- Division of Pediatric Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Nobuaki Iwasaki
- Division of Pediatric Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| |
Collapse
|
4
|
Allen D, Scarinci N, Hickson L. The Nature of Patient- and Family-Centred Care for Young Adults Living with Chronic Disease and their Family Members: A Systematic Review. Int J Integr Care 2018; 18:14. [PMID: 30127698 PMCID: PMC6095060 DOI: 10.5334/ijic.3110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 05/09/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND AIM The published literature addressing the nature of patient- and family-centred care (PFCC) among young adults (16-25 years old) living with chronic disease and their family members is diverse. The aim of this systematic review was to collect and interpretatively synthesise this literature to generate a conceptual understanding of PFCC in this age group. METHOD From an initial pool of 10,615 papers, 51 were systematically identified as relevant to the research question and appraised using the Critical Appraisal Skills Programme tools. A total of 24 papers passed the quality appraisal and proceeded to a qualitative meta-synthesis. RESULTS The qualitative meta-synthesis revealed three major elements of PFCC relevant to young adults living with chronic disease and their family members: (1) patients and practitioners felt able to engage with each other on an emotional and social level; (2) patients and families felt empowered to be part of the care process; and (3) patients and families experienced care as effective at addressing their individual needs. CONCLUSION There is agreement among young adult patients and families about what constitutes PFCC in a chronic disease setting, independent of the aetiology of the pathological process. Patients and families also have strong feelings about how practitioners can achieve PFCC in practice. These findings have implications for the delivery of health services to young adults living with chronic disease and their family members.
Collapse
Affiliation(s)
- David Allen
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| | - Nerina Scarinci
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| | - Louise Hickson
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| |
Collapse
|
5
|
McPherson AC, King G, Rudzik A, Kingsnorth S, Gorter JW. Optimizing life success through residential immersive life skills programs for youth with disabilities: study protocol of a mixed-methods, prospective, comparative cohort study. BMC Pediatr 2016; 16:153. [PMID: 27600167 PMCID: PMC5012050 DOI: 10.1186/s12887-016-0694-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/31/2016] [Indexed: 11/22/2022] Open
Abstract
Background Young people with disabilities often lag behind their typically developing peers in the achievement of adult roles, which has been attributed to a lack of opportunities to develop critical life skills. Residential Immersive Life Skills (RILS) programs provide situated learning opportunities to develop life skills alongside peers and away from home in real-world settings. Retrospective research suggests that attending RILS programs is a transformative experience that empowers youth, provides parental hope, and increases service provider expertise. However, prospective, comparative research is needed to determine longer term benefits of these programs on youth life trajectories, in addition to exploring the program features and participant experiences that optimize program success. This protocol describes a 5-year, multi-site prospective study examining the effects of RILS programs for youth with disabilities. Methods The study involves RILS programs at three sites in Ontario, Canada. Cohorts of treatment and control groups will receive the study protocol over 3 successive years. Thirty English-speaking participants aged 14–21 years with a child-onset disability and the cognitive capacity to engage in goal setting will be recruited every year for 3 years in the following groups: youth attending a RILS program (Group A); a deferred RILS control group of youth (Group B); a control group of youth attending a non-residential life skills program (Group C); and a control group matched on age, diagnoses, and cognitive capacity not receiving any life skills intervention (Group D). All participants will complete measures of self-determination and self-efficacy at four time points. Program opportunities and experiences will also be assessed in-the-moment at the RILS programs. Qualitative interviews pre-program and at 3- and 12-months post-program will be undertaken with a sub-sample of youth and parents to explore their expectations and experiences. Discussion This study will address key gaps in the literature pertaining to the long-term impact of RILS programs and the role of immersive environments in shaping youth outcomes and experiences. Our research program aims to uncover transferable processes and essential features by which RILS programs have their effects on attitudes, cognitions, and behaviour. Trial registration The trial registration number on clinicaltrials.gov is NCT02753452 (retrospectively registered 26 April 2016). Trial sponsor: Holland Bloorview Kids Rehabilitation Hospital.
Collapse
Affiliation(s)
- Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada. .,Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Alanna Rudzik
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Shauna Kingsnorth
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | | |
Collapse
|
6
|
Granek L, Nathan PC, Rosenberg-Yunger ZRS, D'Agostino N, Amin L, Barr RD, Greenberg ML, Hodgson D, Boydell K, Klassen AF. Psychological factors impacting transition from paediatric to adult care by childhood cancer survivors. J Cancer Surviv 2012; 6:260-9. [PMID: 22547096 DOI: 10.1007/s11764-012-0223-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 03/28/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Childhood cancer survivors require life-long care focused on the specific late effects that may arise from their cancer and its treatment. In many centers, survivors are required to transition from follow-up care in a paediatric cancer center, to care provided in an adult care setting. The purpose of this study was to identify the psychological factors involved in this transition to adult care long-term follow-up clinics. METHODS Qualitative interviews were conducted with ten paediatric survivors still in paediatric care, as well as 28 adult survivors of whom 11 had transitioned successfully to adult care (attended three long-term follow-up (LTFU) appointments consecutively); ten who failed to transition (attended at least one LTFU appointment as an adult, but were inconsistent with subsequent attendance); and seven who had never transitioned (did not attend any LTFU care as an adult). Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. RESULTS Two overall categories and four subthemes were identified: (1) Identification with being a cancer survivor included the subthemes of 'cancer identity' and 'cancer a thing of the past' and; (2) Emotional components included the subthemes of 'fear and anxiety' and 'gratitude and gaining perspective'. The analysis revealed that the same factor could act as either a motivator or a hindrance to successful transition in different survivors (e.g., fear of recurrence of cancer might be a barrier or a facilitator depending on the survivor's life experience). CONCLUSIONS Psychological factors are an important consideration when preparing cancer survivors for transition to adult long-term follow-up care. Identifying and addressing the individual psychological needs of childhood cancer survivors may improve the likelihood of their successful transition to adult care.
Collapse
Affiliation(s)
- Leeat Granek
- Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Wang G, McGrath BB, Watts C. Health care transitions among youth with disabilities or special health care needs: an ecological approach. J Pediatr Nurs 2010; 25:505-50. [PMID: 21035018 PMCID: PMC2994364 DOI: 10.1016/j.pedn.2009.07.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 06/02/2009] [Accepted: 07/14/2009] [Indexed: 11/29/2022]
Abstract
This literature review of 46 articles uses the ecological model as a framework for organizing concepts and themes related to health care transition among youth with disabilities or special health care needs (SHCN). Transition involves interactions in immediate and distal environmental systems. Important interactions in immediate environments include those with family members, health care providers, and peers. Activities in distal systems include policies at the governmental and health system levels. The ecological model can help researchers and practitioners to design experimental interventions in multiple settings that ensure smooth transitions and support the well-being of youth with disabilities or SHCN.
Collapse
Affiliation(s)
- Grace Wang
- Institute for Public Health Genetics, School of Public Health, University of Washington, Seattle, WA, USA.
| | | | | |
Collapse
|
8
|
Adebiyi AO, Uchendu OC, Ikotun OT, Oluleye OW, Olukotun OP. Falls and outcomes amongst old people in rural dwellings. Ann Ib Postgrad Med 2009; 7:6-11. [PMID: 25161462 PMCID: PMC4111007 DOI: 10.4314/aipm.v7i2.64082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Falls are the leading cause of injury deaths among
people 65 years and older. This study gives an insight into the
prevalence of falls among older people and how they occur in a
rural setting in Nigeria. Methods: A community based survey of 210 consenting old people
aged 65 years and above selected using a multi-stage sampling
technique was done. Study instrument was a semi-structured
interviewer administered questionnaire and visual acuity was tested
using Snellens chart. Results: Incidence of falls was 21.4%. Of those who had falls,
86.7% were walking while 11.1% were either sitting or running
when it occurred. The nature of the fall was tripping in 44.4%,
slipping in 35.6% and hitting an object in 17.8% of cases.
Consequences of falls included pain 48.9%, bruises 22.2%,
lacerations 13.3% and fractures 11.1%. Females had more falls than
males; 23.8% vs 19.0%, p = 0.40. Major injuries resulting from
falls also occurred more frequently amongst females than males;
30.7% vs. 15.0%, p = 0.3. History of diabetes and alcohol use
increased the odds of falling (OR 4.1, 95% CI 1.0 – 16.0; OR 2.2,
95% CI 1.0 – 4.6 respectively). Being in a monogamous marriage
and having normal sight were protective of having falls (OR 0.4,
95% CI 0.2 – 0.9; OR 0.4, 95% CI 0.2 – 0.9 respectively). Conclusion: Falls often occur from tripping and slipping while
females are more likely to have major injuries. Risk factors for
falls were alcohol use and diabetes while having normal sight and
being monogamous were protective. Prevention should aim at a
life course approach to addressing these intrinsic and extrinsic
factors.
Collapse
Affiliation(s)
- A O Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan
| | - O C Uchendu
- Department of Community Medicine, College of Medicine, University of Ibadan
| | - O T Ikotun
- Department of Community Medicine, College of Medicine, University of Ibadan
| | - O W Oluleye
- Department of Community Medicine, College of Medicine, University of Ibadan
| | - O P Olukotun
- Department of Community Medicine, College of Medicine, University of Ibadan
| |
Collapse
|
9
|
Johnson KL, Dudgeon B, Kuehn C, Walker W. Assistive technology use among adolescents and young adults with spina bifida. Am J Public Health 2006; 97:330-6. [PMID: 17194874 PMCID: PMC1781409 DOI: 10.2105/ajph.2004.050955] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to determine the use of assistive technology among a population of individuals with spina bifida. METHODS We performed a descriptive analysis of individuals aged 13 to 27 years diagnosed with myelomeningocele (n=348) using data obtained from an existing database at Children's Hospital and Regional Medical Center, Seattle, Washington. We summarized disease characteristics, utilization of assistive technology, community and self-care independence, and other variables. RESULTS Eighty-four percent of the respondents lived with at least 1 of their natural parents. Fifty-seven percent used wheelchairs, 35% used braces, and 23% used walking aids. Independent self-care was a common skill, but 72% reported limited participation in structured activities. Half were aged 18 years or older; of those, only 50% had completed high school and 71% were unemployed. Those aged younger than 18 years were all still in school (100%). CONCLUSIONS Adolescents and young adults with spina bifida rely on assistive technology and specialized care routines to maintain their health. Assistive technology use for mobility is common; little is known about secondary complications associated with use of these technologies or the use of assistive technology to address learning disabilities and other societal barriers. Underutilization of assistive technology could delay successful transitions to independent living and community participation.
Collapse
Affiliation(s)
- Kurt L Johnson
- School of Medicine, University of Washington, Seattle, WA 98195, USA.
| | | | | | | |
Collapse
|
10
|
King GA, Baldwin PJ, Currie M, Evans J. The Effectiveness of Transition Strategies for Youth With Disabilities. CHILDRENS HEALTH CARE 2006. [DOI: 10.1207/s15326888chc3502_4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|