Understanding identity construction among deaf adolescents and young adults: implications for the delivery of person and family-centered care in audiological rehabilitation
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PROVIDER: S-EPMC10646389 | biostudies-literature | 2023 Jan
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Project description:IntroductionGlobally adolescents and young adults (AYA) with tuberculosis (TB) face unique challenges. Until recently they have received little attention and few tailored interventions exist. To improve TB outcomes in this population, there is a need to implement tailored interventions. However, limited research has been conducted about how to meet the needs of AYA with tuberculosis. In this paper we present the findings of a qualitative study to explore the needs of AYA with TB in Zimbabwe and to identify interventions to optimize their engagement in TB care.MethodsWe conducted two participatory workshops with 16 AYA, aged 10-24 years diagnosed with TB to explore their experiences of TB disease and treatment. Through subsequent interviews with 15 of the same AYA and with two other key stakeholder groups (health care providers n = 11 and policy makers n = 9), we sought to identify areas of convergence and divergence about what youth-orientated services and policies would be effective in Zimbabwe. Qualitative data were analyzed iteratively and thematically.ResultsThe findings are presented to align with four levels of a socio-ecological framework: individual, community, health system and policy. All three stakeholder groups highlighted the unmet mental health and TB literacy needs of AYA, which are particularly acute early in their TB care journey, as well as the imperative of engendering family support and securing the continuity of educational or employment opportunities during and after receiving TB care. There was a consensus that clinical services needed to become more youth-centered by extending training for health care providers and investing in peer-delivered psychosocial support. More broadly, there was also a strong consensus that adolescent-specific TB policies require further development and implementation, accompanied by community-based TB education and awareness campaigns to emphasize the curability of TB and to reduce TB related stigma.ConclusionsThere is much to be done to improve TB care for AYA. We found that there is need for alignment on where investment is needed to support the development of context-appropriate and effective interventions. There is an opportunity to benefit from translational learning from other successful approaches, such as HIV, within the region. Implementation of evidence-based interventions and youth-friendly policies and programs are much needed to improve outcomes for AYA with TB.
| S-EPMC11567634 | biostudies-literature
Project description:Background and objectives: More and more children with severe-to-profound hearing loss are receiving cochlear implants (CIs) at an early age to improve their hearing and listening abilities, speech recognition, speech intelligibility, and other aspects of spoken language development. Despite this, the rehabilitation outcomes can be very heterogeneous in this population, not only because of issues related to surgery and fitting or the specific characteristics of the child with his/her additional disabilities but also because of huge differences in the quality of the support and rehabilitation offered by the therapist and the family. These quality standards for the rehabilitation of young deaf children receiving CIs are developed within the European KA202 Erasmus+ project "VOICE"-vocational education and training for speech and language therapists and parents for the rehabilitation of children with CIs, Ref. No.: 2020-1-RO01-KA202-080059. Material and methods: To develop these quality standards, we used the input from the face-to-face interviews of 11 local rehabilitation experts in CIs from the four partner countries of the project and the outcomes of the bibliographic analysis of 848 publications retrieved from six databases: Pub Med, Psych Info, CINAHL, Scopus, Eric, and Cochrane. Based on all this information, we created a first set of 32 quality standards over four domains: general, fitting, rehabilitation, and for professionals. Further on, the Delphi method was used by 18 international rehabilitation experts to discuss and agree on these standards. Results: The results from the literature analysis and the interviews show us that more than 90% of the consulted international experts agreed on 29 quality standards. They focus on different aspects of rehabilitation: the multidisciplinary team, their expertise and knowledge, important rehabilitation topics to focus on, and programming issues related to rehabilitation. Conclusions: These quality standards aim to optimize the activity of speech rehabilitation specialists so that they reach the optimal level of expertise. Also presented is the necessary equipment for the IC team to carry out the rehabilitation sessions in good conditions. This set of quality standards can be useful to ensure the appropriate postoperative care of these children. As a result, the rehabilitation process will be more relaxed, and therapists will have the opportunity to focus more on the specific needs of each child, with the provision of quality services, which will result in better results. This theme is particularly complex and dependent on multifactorial aspects of medicine, education, speech therapy, social work, and psychology that are very intricate and interdependent.
| S-EPMC10386159 | biostudies-literature
Project description:Background: The International Classification of Functioning, Disability and Health (ICF) classification is a biopsychosocial frame of reference that contributes to a holistic understanding of the functioning of a client and the factors involved. Personal factors (PFs) are not currently classified in the ICF due to large societal and cultural diversity and lack of clarity in the scope of such factors. Aims: To ascertain which factors in the ICF classification have been defined as PFs in different studies and what conclusions have been drawn on their role in the ICF classification. Methods: The study was a scoping review. A systematic search for articles published in 2010-2020 was performed on the Cinahl, Pubmed, ScienceDirect, and Sport Discus databases. The PFs specified in the articles were classified according to the seven categories proposed by Geyh et al. socio-demographic factors; position in the immediate social and physical context; personal history and biography; feelings; thoughts and beliefs; motives; and general patterns of experience and behavior. Results: The search yielded 1,988 studies, of which 226 met the inclusion criteria. The studies had addressed a wide variety of PFs that were linked to all seven categories defined by Geyh et al. Some studies had also defined PFs that were linkable to other components of the ICF or that did not describe functioning. Approximately 22% (51) of the studies discussed the role of PFs in rehabilitation. Conclusions: The range of PFs in the ICF classification addressed in the reviewed studies is wide. PFs play an important role in rehabilitation. However, according to the reviewed studies, a more precise coding of PFs is not yet warranted.
| S-EPMC9397796 | biostudies-literature
Project description:Although prior research has shown potential academic difficulties for Tibetan adolescents when coping with the mainstream Han culture, little is known about their psychosocial adjustment. Adopting a person-centered approach, the current study explores psychosocial adjustment profiles based on internalizing indicators (i.e., depression, loneliness, life satisfaction, positive affect, and negative affect) and externalizing indicators (i.e., prosocial behavior and antisocial behavior). Moreover, guided by the empathy theory, this study also examines the direct and interactive effects of empathy (affective and cognitive empathy) and ethnicity (Tibetan vs. Han adolescents) on psychosocial adjustment profiles. A total of 306 Tibetan adolescents (66.3% girls) and 321 Han adolescents (55.1% girls) were involved in this study, and participants were asked to fill in a set of self-report questionnaires. A latent profile analysis revealed five psychosocial adjustment profiles: adaptive, maladaptive, externalizing, internalizing, and moderate. Furthermore, a multiple multinomial analysis showed Han adolescents were more likely than Tibetan adolescents to be a member of adaptive and moderate profiles than of the externalizing profile. Individuals with low affective empathy and high cognitive empathy were prone to be adequate in terms of psychosocial functioning, and the effects of low affective empathy and high cognitive empathy on psychosocial functioning were highlighted in Han adolescents only.
| S-EPMC6700380 | biostudies-literature
Project description:Decreasing the number of adolescents who have never had sexual intercourse is one way to address sexual health disparities. We used intersectionality to explore the joint effects of religiosity and racial identity on Black adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1,170), a nationally representative study of Black adolescents. Latent profile analysis and survival analysis were used to evaluate study hypotheses. Results showed four distinct profiles of religiosity and racial identity. These profiles explained 19% of the variability in sexual initiation. Additional analyses revealed sociodemographic differences in profile membership. Findings contribute to understanding ethnic heterogeneity among Black adolescents and racial identity and religiosity as sociocultural factors that influence sexual initiation; and support reconceptualizing Black adolescent religiosity.
| S-EPMC6580859 | biostudies-literature
Project description:Background and purpose"Take Charge" is a novel, community-based self-directed rehabilitation intervention which helps a person with stroke take charge of their own recovery. In a previous randomized controlled trial, a single Take Charge session improved independence and health-related quality of life 12 months following stroke in Māori and Pacific New Zealanders. We tested the same intervention in three doses (zero, one, or two sessions) in a larger study and in a broader non-Māori and non-Pacific population with stroke. We aimed to confirm whether the Take Charge intervention improved quality of life at 12 months after stroke in a different population and whether two sessions were more effective than one.MethodsWe randomized 400 people within 16 weeks of acute stroke who had been discharged to institution-free community living at seven centers in New Zealand to a single Take Charge session (TC1, n = 132), two Take Charge sessions six weeks apart (TC2, n = 138), or a control intervention (n = 130). Take Charge is a "talking therapy" that encourages a sense of purpose, autonomy, mastery, and connectedness with others. The primary outcome was the Physical Component Summary score of the Short Form 36 at 12 months following stroke comparing any Take Charge intervention to control.ResultsOf the 400 people randomized (mean age 72.2 years, 58.5% male), 10 died and two withdrew from the study. The remaining 388 (97%) people were followed up at 12 months after stroke. Twelve months following stroke, participants in either of the TC groups (i.e. TC1 + TC2) scored 2.9 (95% confidence intervals (CI) 0.95 to 4.9, p = 0.004) points higher (better) than control on the Short Form 36 Physical Component Summary. This difference remained significant when adjusted for pre-specified baseline variables. There was a dose effect with Short Form 36 Physical Component Summary scores increasing by 1.9 points (95% CI 0.8 to 3.1, p < 0.001) for each extra Take Charge session received. Exposure to the Take Charge intervention was associated with reduced odds of being dependent (modified Rankin Scale 3 to 5) at 12 months (TC1 + TC2 12% versus control 19.5%, odds ratio 0.55, 95% CI 0.31 to 0.99, p = 0.045).ConclusionsConfirming the previous randomized controlled trial outcome, Take Charge-a low-cost, person-centered, self-directed rehabilitation intervention after stroke-improved health-related quality of life and independence.Clinical trial registration-urlhttp://www.anzctr.org.au. Unique identifier: ACTRN12615001163594.
| S-EPMC7739137 | biostudies-literature
Project description:ObjectivesLittle is understood about how Multiracial individuals are socialized around race and ethnicity, and how these socialization messages are related to ethnic-racial identity development.MethodThis study utilizes a person-centered framework with a diverse sample of 286 Multiracial college students to examine the patterns of ethnic-racial socialization messages individuals received from their primary caregiver.ResultsA latent profile analysis of caregivers' socialization messages produced a four-profile solution: Typical Messages (socialization messages with average frequency), Minority Messages (frequent cultural socialization and preparation for bias geared toward minority group membership), High Mistrust (frequent promotion of mistrust messages), and Low Frequency (all socialization messages at low frequency). Overall, profile differences were evident with respect to ethnic-racial identity endorsement, where participants in the Minority Messages profile endorsed the greatest levels of ethnic/racial exploration. In addition, individuals in the Minority Messages profile also endorsed higher levels of ethnic/racial identity resolution and affirmation than the High Mistrust and Low Frequency Messages profile. Individuals in the High Mistrust profile endorsed greater levels of identity conflict than the Minority Messages profile.ConclusionsThe current study provides evidence that the pattern of socialization messages Multiracial participants received growing up impact their ethnic-racial identity endorsement. Results highlight the need for continued quantitative and person-centered work when studying socialization and identity in Multiracials. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
| S-EPMC8298278 | biostudies-literature
Project description:PurposeIn order to develop a theoretical framework for person-centered care models for children with epilepsy and their parents, we conducted a qualitative study to explore and understand parents' needs, values, and preferences to ultimately reduce barriers that may be impeding parents from accessing and obtaining help for their children's co-occurring problems.MethodsA qualitative grounded theory study design was utilized to understand parents' perspectives. The participants were 22 parents of children with epilepsy whose age ranged from 31 to 53 years. Interviews were conducted using open-ended semistructured questions to facilitate conversation. Transcripts were analyzed using grounded theory guidelines.ResultsIn order to understand the different perspectives parents had about their child, we devised a theory composed of three zones (Zones 1, 2, and 3) that can be used to conceptualize parents' viewpoints. Zone location was based on a parent's perspectives on their child's comorbidities in the context of epilepsy. These zones were developed to help identify distinctions between parents' perspectives and to provide a framework within which to understand parents' readiness to access and implement interventions to address the child's struggles. These zones of understanding describe a parent's perspectives on their children's struggles at a particular point in time. This is the perspective from which parents address their child's needs. This theoretical perspective provides a structure in which to discuss a parent's perspectives on conceptualizing or comprehending the child's struggles in the context of epilepsy. The zones are based on how the parents describe (a) their concerns about the child's struggles and (b) their understanding of the struggles and (c) the parent's view of the child's future.ConclusionsClinicians working with individuals and families with epilepsy are aware that epilepsy is a complex and unpredictable disorder. The zones help clinicians conceptualize and build a framework within which to understand how parents view their child's struggles, which influences the parents' ability to understand and act on clinician feedback and recommendations. Zones allow for increased understanding of the parent at a particular time and provide a structure within which a clinician can provide guidance and feedback to meet parents' needs, values, and preferences. This theory allows clinicians to meet the parents where they are and address their needs in a way that benefits the parents, family, and child.
| S-EPMC4180211 | biostudies-literature
Project description:OBJECTIVES:This study sought to develop a tool for evaluating person-centered therapeutic relationships within physiotherapy services, and to examine the content validity of the same. METHODS:A mixed qualitative and quantitative study was performed in three distinct phases: 1) the items were generated based on a literature review and a content analysis of focus groups of patients and physiotherapists; 2) an e-Delphi survey process was performed based on three rounds to select and refine the proposed questionnaire; 3) two rounds of cognitive interviews were conducted to evaluate the comprehension of items, the clarity of language and the appropriateness and relevance of content. RESULTS:Thirty-one items were generated based on the seven domains identified after the analysis of four focus groups of physiotherapists and four patient focus groups. Nine experts participated in the e-Delphi survey. Fifty-five patients participated in the two rounds of the cognitive pre-tests. Participating patients were from public and private physical therapy services. Based on the participants' suggestions, four items were removed, and four were added, whereas 16 were reworded. CONCLUSIONS:The final tool comprised 31 items divided into seven domains. The response format was based on a 5-point Likert frequency scale. The response options ranged from "strongly agree" to "strongly disagree".
| S-EPMC7051061 | biostudies-literature
Project description:BackgroundPerson-centered care (PCC) is an important concept in many countries' national guidelines and dementia plans. Key intervention categories, i.e., a taxonomy of person-centered (PC)-interventions, to provide person-centered dementia care, are difficult to identify from literature.ObjectiveThis systematic review aimed to identify and categorize published PC-interventions into key intervention categories to guide the provision of person-centered dementia care.MethodsConduct of this systematic review followed Cochrane guidelines. A search of the dimensions 'Dementia', 'Person-Centered Care', and 'Intervention' combined was performed in PubMed, EMBASE, and Web of Science. Study selection was based on 2-stage screening against eligibility criteria, limited to controlled study designs. Information about interventions and outcomes was extracted into an "Effects Table". The identified PC-interventions were categorized in intervention categories to provide person-centered dementia care.ResultsSearches identified 1,806 records. 19 studies were included. These covered a range of psychosocial interventions, oftentimes multi-component interventions, which followed heterogeneous approaches. Studies were conducted in long-term care/hospital settings. Nine key intervention categories were identified: social contact, physical activities, cognitive training, sensory enhancement, daily living assistance, life history oriented emotional support, training and support for professional caregivers, environmental adjustments, and care organization.ConclusionOur findings provide a current overview of published PC-interventions in dementia, which followed heterogeneous approaches under the PCC-concept. The heterogeneity made it challenging to identify a well-defined concept of PCC and common key intervention categories. An effectiveness-evaluation of "PC" - including "relationship-centered"-interventions may be valuable, to assess whether an explicit focus on relationships around PCC-interventions yields an added benefit.Prospero-idCRD42021225084.
| S-EPMC8609709 | biostudies-literature