The Quality of Life and the Impact of Interventions on the Health Outcomes of Looked After and Accommodated Young People

Author(s):  
D. Carroll ◽  
C. R. Martin
BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine Arnaud ◽  
Carine Duffaut ◽  
Jérôme Fauconnier ◽  
Silke Schmidt ◽  
Kate Himmelmann ◽  
...  

Abstract Background Effective inclusion in society for young people with disabilities is increasingly seen as generating opportunities for self-development, and improving well-being. However, significant barriers remain in the vast majority of activities meaningful for young adults. Research argues that various personal (disabilities, health) and environmental (access to the resources needed, accessible environment, discrimination, lack of personal economic independence) factors contribute to limited participation. However, previous studies conducted in young people with cerebral palsy (CP) mainly investigated the transition period to adulthood, and did not fully consider the whole range of impairment severity profiles or environmental barriers. In this study, we will use the follow-up of the SPARCLE cohort and a comparison group from the general population (1) to investigate the impact of the environment on participation and quality of life of young adults with CP, (2) to determine predictors of a successful young adulthood in educational, professional, health and social fields, (3) to compare quality of life and frequency of participation in social, work and recreational activities with the general population, (4) to document on participation and quality of life in those with severe disabilities. Methods The SPARCLE3 study has a combined longitudinal and cross-sectional design. Young adults with CP aged 22 to 27 years in 6 European regions previously enrolled in the SPARCLE cohort or newly recruited will be invited to self-complete a comprehensive set of questionnaires exploring participation (daily life and discretionary activities), health-related quality of life, body function, personal factors (health, personal resources), and contextual factors (availability of needed environmental items, family environment, services provision) during home visits supervised by trained researchers. Proxy-reports or adapted questionnaires will be used for those with the most severe impairments. The recruitment of a large group from the general population (online survey) will enable to identify life areas where the discrepancies between young people with CP and their able-bodied peers are the most significant. Discussion This study will help identify to what extent disabilities and barriers in environment negatively affect participation and quality of life, and how previous valued experiences during childhood or adolescence might modulate these effects.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andre M. N. Renzaho ◽  
Daniel Doh ◽  
Rashidul A. Mahumud ◽  
Moses Galukande ◽  
Joseph K. Kamara

Abstract Background Various interventions to improve the quality of life (QoL) among slum dwellers across sub Saharan Africa have been implemented. However, the interventions impacts remain less understood. We assessed the impact of the Urban Program on Livelihoods and Income Fortification and Socio-civic Transformation (UPLIFT) project on QoL, psychological wellbeing, self-esteem, and the quality of neighbourhood social environment of young people aged 13–25 years in slum areas of Makindye and Nakawa Divisions in Kampala, Uganda. Methods The study was designed as a mixed method evaluation using repeated cross-sectional survey and grounded theory in both the intervention and comparison communities. The intervention effect was estimated using the difference-in-differences Kernel propensity-score matching technique, with bootstrapping. The “rcs” option was used given that data were from repeated cross-sectional surveys. A thematic analysis was adopted for the qualitative data to triangulate and complement the quantitative data. Results The UPLIFT project led to an improvement in QoL, psychological wellbeing, and self-esteem of young people. In terms of QoL, the project led to a six-percentage point increase in quality of living conditions scores (where higher scores reflect better living conditions; lower ones, worse living conditions). However, a negative effect was observed for personal independence whilst the project did not have any impact on social relations. In terms of self-esteem and psychological wellbeing, the project led to a 4.6-point increase in self-esteem scores, a 5.4-point increase in self-acceptance scores, a 5.3- point increase in purpose in life scores, a 5.7 - point increase in personal growth, and a 10.7-point increase in autonomy scores. However, the project had a negative effect on personal independence; and had no impact on environmental mastery and the quality of neighbourhood social environment. Conclusion Functional community-owned assets accumulation and capacity building initiatives for young people in slum areas improved their psychological wellbeing and quality of life. However, such initiatives do not appear to address social relationships and personal independence of young people in slum areas.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
Amelia Austen ◽  
Carina Hou ◽  
Khushbu Patel ◽  
Keri Brady ◽  
Gabrielle G Grant ◽  
...  

Abstract Introduction Burn injuries can have major long-term effects on the health and quality of life for children and adolescents. This study narratively reviewed the health outcomes literature focusing on the impact of burn injury for children aged 5–18. Methods Literature targeting pediatric outcomes was reviewed to identify the effects of burns on children aged 5–18 (n=16). Inclusion criteria included studies that focused on the impact of burns on health and quality of life and were age-appropriate for this population. Articles were identified via PubMed, Web of Science, and manual reference checks. Data collected included the outcomes and health domains assessed in each article and the findings of the effects of the burn injury on those specific outcomes. The Preschool LIBRE Conceptual Model served as a ‘domains framework’ to guide the identification of outcomes and health domains. Results Long-term burn-specific outcomes and broad health domains identified were physical functioning (n=9), psychological functioning (n=12), social functioning (n=4), symptoms (n=8), and family (n=7). Some studies exclusively focused on one domain whereas others assessed two domains or more. Subdomains such as upper extremity functioning and functional independence were addressed in the physical functioning domain. Psychological functioning outcomes included subdomains such as emotional health and behavioral problems. Social functioning outcomes evaluated subdomains such as problems with peers and social participation. The symptoms domain addressed post-burn pain and itch. Family outcomes subdomains such as parental satisfaction with appearance and general family functioning were identified. Conclusions Burn-specific outcomes and health domains assessing the effects of burns on children aged 5–18 were identified among 16 studies. There is a need for a comprehensive assessment tool that more precisely measures the impact of burn injury across these domains. This work will inform the development of the School-Aged Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile – a new outcome metric for children and adolescents with burns. Applicability of Research to Practice This review is relevant to researchers and clinicians assessing health outcomes and measuring burn recovery in children aged 5–18.


BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0052
Author(s):  
Yemi Oluboyede ◽  
Sarah Hill ◽  
Suzanne McDonald ◽  
Emily Henderson

BackgroundObesity is thought to be one of the most serious global public health challenges of the 21st century. The primary care setting is important in terms of the diagnosis, education and management of obesity in children and young people. This study explored the views of primary care clinicians on the implementation of a quality of life (QoL) tool to help young people and their families identify the impact of weight on QoL.AimTo assess the acceptability and feasibility of implementing the Weight-specific Adolescent Instrument for Economic-evaluation (WAItE) QoL tool for young people aged 11–18 years in primary care.MethodOne-to-one, semi-structured interviews were conducted with a purposive sample of primary healthcare clinicians working in practices located in areas of varying deprivation in Northern England, UK. Interview transcripts were coded and analysed using Framework Analysis in NVivo 10.ResultsParticipants (n=16 General Practitioners; n=4 practice nurses) found the WAItE tool acceptable for them and their patients and believed it was feasible for use in routine clinical practice. It was important to primary care clinicians that the tool would provide an overall QoL score that would be easy for General Practitioners and nurses to interpret, to help them identify patients most in need of specialist help.ConclusionsThis study has developed a platform for further research around QoL in overweight and obese young people. A future feasibility study will focus on implementing the tool in a small number of primary healthcare practices.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Marshall A Taunton ◽  
Sheldon Levy ◽  
Adrienne H Kovacs ◽  
Abigail M Khan

Introduction: Adverse childhood experiences (ACEs), such as witnessing domestic abuse or experiencing physical/sexual abuse, are associated with poorer long-term health outcomes, including acquired cardiovascular disease. This study offers the first investigation of ACEs in adults with congenital heart disease (CHD). Methods: In this cross-sectional study, adult CHD outpatients completed the ACE Questionnaire, the Relationship Scales Questionnaire, the Perceived Stress Scale, and a 0 - 100 linear analogue scale of quality of life. Total scores on the ACE Questionnaire range from 0 - 10 (a point for each ACE reported) and scores ≥ 4 are associated with poorest health outcomes. We performed correlations, t-tests, and analyses of variance to explore relationships between ACE Questionnaire scores and demographics, medical variables, and other survey scores. Results: A total of 100 patients were enrolled in the study (40 ± 13 years; 60% female). Ninety percent had defects of moderate or great complexity and 79% were categorized as American Heart Association anatomy + physiology stage B, C or D (i.e., some degree of symptoms and/or functional impairment). Total scores on the ACE Questionnaire ranged from 0 - 9, with a mean of 2.6 ± 2.5; 30% reported ≥ 4 ACEs. The most frequently reported ACEs were parental divorce (46%), emotional abuse (42%), and parental substance abuse problem (32%). ACE Questionnaire scores did not differ as a function of age, sex, defect complexity, or anatomy + physiology stage. However, total ACE score was significantly correlated with all 4 relationship styles (secure, preoccupied, dismissive and fearful; p-values < 0.05). Quality of life scores were lower among those with elevated ACEs, although this did not reach statistical significance (69 vs. 76, p = 0.07). Conclusion: It is well accepted that adults with CHD face many health-related challenges throughout their lives. This study serves as an important reminder to providers that many patients will also experience other significant (and potentially traumatic) stressors in childhood. Further research is needed to determine whether the impact of ACEs on adults with CHD extends beyond relationship and stress outcomes and also includes cardiac morbidity and mortality.


2020 ◽  
pp. 68-89
Author(s):  
T.G. Bokhan ◽  
◽  
E.D. Galazhinsky ◽  
O.V. Terekhina ◽  
A.L. Ul'yanich ◽  
...  

At present, to solve the problem of the life quality of the population has become an integral criterion for evaluating the effectiveness and success of the state's socio-economic policy. The appeal to the study of the quality of life among young people in its objective, subjective and person’s aspects is determined by the fact that youth as a social group differs from other groups of the population. It is more active, has relevant knowledge and skills, an accelerated adaptation process, greater migration mobility and material needs. It faces the task of self-determination in socio-economic and political changes and the choice of life orientations. The aim is to determine the contribution of personal resources to the subjective assessment of the quality of life among representatives of socio-demographic youth groups with different perceptions of self-realization opportunities in living conditions. The research is based on the newly developed conceptual working model of the quality of life by D.A. Leontiev (2020), which integrates objective, subjective and person’s factors of environmental assessment. The methods used are: the questionnaire «Quality of life and satisfaction», «Life satisfaction» scale, «Self-realization satisfaction index in living conditions», questionnaire «Self-organization activity», questionnaire «Differential diagnosis of reflexivity», «Self-determination of personality and basic beliefs» scale. Sample is 280 people aged 18 to 40 years, including 140 people living in the rural municipality of the North of the Tomsk region (Siberian region), and 140 residents of the city of Tomsk. As a result, we have found out that there is some general dissatisfaction with the quality of life, but the representatives of rural youth are less satisfied with the quality of their lives than the representatives of urban working youth. Personal resources are significantly more pronounced in the urban working youth group; many representatives of rural youth have deficits in personal resources. It is revealed that such a personal resource as self-identity can me-diate the impact of assessing the opportunities for self-realization in environmental conditions on the quality of life among urban and rural youth. At the same time, we have identified specific personal resources that can serve as mediators in assessing opportunities for self-realization in living conditions and the quality of life among urban and rural youth. However, a small percentage of variance indicates the need to refine the results and include new personal resources in the search for mediators of this relationship. The data revealed in both groups on the mediation nature of assessing the possibility of self-realization in living conditions indicate the importance of creating conditions for self-realization for young people, both in urban and rural living environments.


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