Young adults’ needs when seeking first-line healthcare: A grounded theory design

Elite para athletes with active coping behaviour are less likely to report a sports injury

OBJECTIVE

Elite para athletes report a high incidence of sports injuries. Research suggests that athletes' strategies to manage adversities may influence the sports injury risk, but knowledge about para athletes' coping behaviours and their association with injuries is limited. The aim was to describe the distribution of coping behaviours in Swedish elite para athletes by sex, age, impairment, sport and to examine associations between coping behaviours and the probability of reporting a prospective sports injury during a 52-week study period.

METHOD

Eighty-three para athletes participating in the 'Sports-related injuries and illnesses in Paralympic sport study' completed the Brief COPE Inventory. Over the following 52 weeks, athletes reported any sports injuries they sustained. The analysis of coping behaviours comprised descriptive statistics and linear regression, and associations between coping behaviour and the probability of being injured were examined by logistic regression analyses.

RESULTS

The most frequently used coping behaviours were acceptance, active coping and planning. The most common less-useful coping behaviour was self-blame. Athletes with more active coping behaviours were less likely to report an injury, and using humour as coping behaviour was associated with a higher probability of injury among young athletes. Also, athletes with physical impairment reported a higher use of active coping and emotional support compared with athletes with visual impairment, and athletes participating in individual sports used acceptance as a coping behaviour to a larger extent than athletes in team sports.

CONCLUSION

Use of active coping in Swedish elite para athletes was associated with a lower likelihood of reporting an injury. Young athletes using humour as a coping strategy had a higher likelihood of reporting an injury. The results suggest that support of active coping behaviours and a sport context fostering help-seeking behaviours should be considered in future prevention measures.

Using online health information for unknown symptoms common among young adults: a qualitative analysis of health-related web pages illustrating the need for numeracy skills, the ability to deal with uncertainty, and the risk of ruling out self-care

Young adults experiencing unfamiliar symptoms commonly seek health information online. This study's aim was to explore how health information websites express and communicate health information about symptoms common among young adults and guide readers in regard to health, illness, and care. Symptoms commonly searched for by young adults were used as search terms. The resulting data comprised material from 24 web pages and was analyzed using content analysis. The foremost purpose of online health information is to try to narrow down the user's symptoms and then advise the user on what actions to take. This is done by first forming a foundation of knowledge through descriptions and explanations, then specifying the symptom's time, duration, and location, and finally giving advice on whether to self-manage symptoms or seek additional information about them. However, the uncertainty of the diagnosis may rule out self-care. For readers inexperienced with health care, forming a decisive conclusion about diffuse symptoms on the sole basis of online health information could be challenging. The necessity of numeracy skills and the ability to deal with uncertainty are highlighted. There is a discrepancy between health advice given online and readers' accessibility to health care that needs to be addressed in future policy and research.

Experiences of transition from adolescence to young adulthood in the context of chronic skin conditions: an interpretative phenomenological analysis

BACKGROUND

Chronic skin conditions are common in youth. The developmental transition to young adulthood involves social, psychological and physical changes. Adolescents with chronic skin conditions may experience greater challenges than their healthy peers due to the addition of managing and coping with their condition.

OBJECTIVE

This study explored experiences of transition from adolescence to adulthood in the context of chronic skin conditions.

METHOD

Semi-structured interviews were conducted with seven young adults with chronic skin conditions (eczema, psoriasis, hidradenitis suppurativa). An interpretative phenomenological analysis methodological approach was used.

RESULTS

Six themes were generated: (1) Navigating a difficult medical journey; (2) Managing a chronic skin condition is all-consuming; (3) Living with a chronic skin condition can be physically limiting; (4) Distressed, isolated and abnormal: How my skin makes me feel; (5) What is wrong with you? Experiences of stigma because of my skin; and (6) The resilience journey when living with a chronic skin condition.

CONCLUSIONS

Findings highlight the difficulties experienced by young dermatology patients, particularly during adolescence, including challenges with healthcare providers, mobility disruptions and stigmatisation. Findings offer insight into how young people can be supported during their transition into adulthood, for example, treating skin conditions with a psychodermatological approach.

Abdominal Ultrasonography Used for Abdominal Pain in the Rural Outpatient Setting of South Texas: Impact on Patient Outcomes

Introduction Abdominal ultrasonography is a key diagnostic tool used in complaints of abdominal pain. The rationale for this study is to examine abdominal ultrasonography's impact on the conclusion of care of abdominal pain in a predominantly Hispanic/Latino patient population. Materials and methods A chart review of 350 patients with a new diagnosis of abdominal pain from a rural family practice clinic in Texas was performed. These patients' charts were reviewed for a new diagnosis of abdominal pain, medications prescribed for abdominal pain, whether abdominal ultrasonography was completed, and the number of visits regarding their complaint. The last visit for their abdominal pain was denoted as the conclusion of care of abdominal pain within the clinic. The primary analyses were logistic regressions with conclusion of pain care or number of visits as the outcome and abdominal ultrasound completion as the primary predictor. Results The sample size was 216 of the 350. Patients were excluded due to age under 18 and if the patient's pain was not coded as epigastric, generalized, or right upper quadrant pain. The patient age range was 18-88 years, and they were all of Hispanic/Latino origin. Abdominal ultrasound was completed on 59 of the patients, and 65 patients experienced conclusion of primary care for abdominal pain. Regarding the number of visits for abdominal pain, 69% had one visit, 25% had two visits, and 6% had three or more visits. Patients who had abdominal ultrasounds were more likely to have multiple visits (typically just two visits) but had markedly higher conclusions of care for abdominal pain. These relationships remained when adjusting for demographic and medical covariates such as age, abdominal pain (all types), and medical treatments used. Conclusion In the outpatient rural care of Hispanic/Latino patients residing in the Rio Grande Valley, patients who had a new complaint of abdominal pain were more likely to have conclusion of primary care for abdominal pain, with only a slight increase in primary care healthcare consumption, if abdominal ultrasonography was completed for abdominal pain.

Youth preferences for healthcare providers and healthcare interactions: a qualitative study

BACKGROUND

Patient-physician relationships in healthcare can influence healthcare provision, patient engagement, and health outcomes. Little is known about youth preferences on types and characteristics of their healthcare providers. The aim of this study was to assess youth perspectives on preferences for and interactions with their healthcare providers.

METHODS

We posed 5 open-ended questions to 1,163 MyVoice participants, a nationwide text message cohort of United States youth aged 14-24, on April 10, 2020 related to youth preferences for healthcare providers. Content analysis was used to develop a codebook. Responses were independently coded by two reviewers with discrepancies discussed to reach consensus. Descriptive statistics were calculated for demographics and frequency of codes.

RESULTS

944 (81%) participants responded to at least one question. Respondents had a mean age of 18.9 years (SD: 2.8) and were a majority female (53.6%) and White (56.3%). Youth reported "kindness" or other personality traits (31%) and education (30%) as important in choosing their doctor. Patient-physician concordance was not important to many youths (44%) and among those who reported concordance as important (55%), having the same gender was the most noted (68%). Youth suggested respect, open conversation, and addressing issues directly to help alleviate uncomfortable situations, though some would simply switch providers.

CONCLUSION

Personality and empathy are important provider characteristics valued by youth. Female respondents preferred gender concordant providers, particularly for sexual health-related issues, and non-white respondents were more likely to prefer racial concordance. Strengthening professional and interpersonal skills among youth-serving providers may improve healthcare engagement and satisfaction among youth.

Factors influencing patients' experience of communication with the medical team of the emergency department

The Emergency Department (ED) setting often presents situations where the doctor-patient relationship is fundamental and may be challenging. Thus, it is important to use effective communication to improve outcomes. This study explores patients' experience of communication with the medical team aiming to discover whether there are some objective factors which may affect their perception. A prospective, cross-sectional study in two hospitals: an urban, academic trauma center and a small city hospital. Adult patients discharged from the ED in October 2021 were consecutively included. Patients filled out a validated questionnaire, the Communication Assessment Tool for Teams (CAT-T), assessing communication perception. Additional data about the participants were collected by the physician in a dedicated tab to assess whether there were objective factors influencing the patient's perception of the medical team's communication skills. Statistical analysis was then performed. 394 questionnaires were analyzed. The average score for all items exceeded 4 (good). Younger patients and patients who were conveyed by ambulance attributed lower scores than other groups (p value < 0.05). A significant difference between the two hospitals was also observed in favour of the bigger hospital. In our study long waiting times did not generate less satisfied responses. The item which received the lowest scores was "the medical team encouraged me to ask questions". Overall, patients were satisfied with doctor-patient communication. Age, setting, way of conveyance to the hospital are objective factors that may influence patients' experience and satisfaction in the ED.

Psychometric properties and measurement invariance of the Arabic Self-Care Inventory

BACKGROUND

Self-care is a fundamental aspect of health and well-being for healthy individuals and those with chronic illnesses. However, the available self-care measurement instruments have limited support regarding their psychometric properties. Research about the validation of comprehensive, theory-based self-care tools in the Arabic language and culture is also limited. In addition, many self-care measurement tools are available only for people with chronic illnesses.

OBJECTIVE

To examine the psychometric properties of the Arabic version of the Self-care Inventory (SCI) in the general adult population in Jordan.

METHODS

This study was conducted using a cross-sectional design. Data collection was performed using a demographics questionnaire, and Arabic versions of the SCI, Self-care Self-Efficacy, and the Center for Epidemiologic Studies Depression Scale-revised. SPSS and AMOS were used to analyze the data. Data analysis was conducted by performing confirmatory factor analysis, measurement invariance, internal consistency, and bivariate correlations.

RESULTS

The results revealed that the SCI comprises three scales: self-care maintenance, self-care monitoring, and self-care management. The goodness of mode fit indices showed that the models of these scales fit the data well by meeting the following set a priori criteria: (RMSEA < .07, CFI > .95, and X2/df < 5). The factor loadings of the individual items of the SCI provided further evidence about the factor structure of the three scales. Regarding measurement invariance, the results indicated that partial invariance across participants' sex is assumed. The values of both Cronbach's α and composite reliability showed that the internal consistency of the SCI is supported. Cronbach's α of the self-care maintenance, self-care monitoring, and self-care management were .82, .86, and .83, respectively.

CONCLUSION

The psychometric properties of the Arabic version of the SCI demonstrate its validity and reliability as a robust assessment tool for measuring self-care in the general adult population.

Antecedents and Consequences of Online Healthcare Community Usage: A Grounded Theory Approach

The online healthcare community has grown rapidly in recent years. However, the antecedents and consequences of the use of online healthcare community platforms have not been systematized. Using grounded theory, this study collects first-hand data on the use of online healthcare communities through in-depth interviews and analyzes the interview data using a three-level coding approach including open coding, axial coding, and selective coding. The results showed the following. (1) Doctors, hospitals, and the online platforms themselves, along with the impact of healthcare environmental factors, affect patients using the online healthcare community. (2) The use of an online healthcare platform affects patient-related factors, such as emotional dependence and patient satisfaction, as well as factors related to doctor–patient interactions, such as the perception of healthcare quality and the doctor–patient relationship, through mediating factors, including doctor–patient communication, treatment processes, and healthcare costs. (3) Improving patients’ healthcare experience and the doctor–patient relationship may feed back into operation quality and the operating environment of the online healthcare community, thus promoting the promotion and use of an online healthcare community platform.