scholarly journals ‘What does that mean?’: a qualitative exploration of the primary and secondary clinical care experiences of young people with continence problems in the UK

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015544 ◽  
Author(s):  
Katie Whale ◽  
Helen Cramer ◽  
Anne Wright ◽  
Caroline Sanders ◽  
Carol Joinson
Keyword(s):  
Young People ◽  
Coping Strategies ◽  
Clinical Care ◽  
Qualitative Interviews ◽  
Clinical Experiences ◽  
Increased Risk ◽  
Wide Range ◽  
Age Appropriate ◽  
The Uk ◽  
Qualitative Exploration

ObjectivesTo explore the clinical care experiences of young people with continence problems.DesignIn-depth semistructured qualitative interviews were conducted by Skype and telephone, with the addition of art-based participatory research techniques. Transcripts were analysed using inductive thematic analysis.SettingPrimary and secondary care in the UK.ParticipantsWe interviewed 20 participants (9 females, 11 males) aged 11–20 years. There were six participants with bedwetting alone, five with daytime wetting alone, five with combined (day and night) wetting and four with soiling.ResultsWe identified four themes: appointment experiences, treatment experiences, engagement with treatment and internalisation and externalisation of the continence problem. Patient-focused appointments using age-appropriate language were highly desirable. Continuity of care was highlighted as an important aspect of positive clinical experiences; however, this was found to be rare with many participants seeing a different person on each visit. Participants had tried a wide range of treatments for their continence problems with varying degrees of success. Relapse and treatment failure were common. Experiencing relapse was distressing and diminished participants’ belief in the success of future treatments and undermined adherence. Participants would be seen to adopt two opposing coping strategies for dealing with their continence problem— internalisation and externalisation.ConclusionIncontinence in young people is challenging to manage. Young people may need to try a range of treatments before their symptoms improve. Due to challenges in treatment, there is an increased risk of poor adherence. During patient-focused appointments, clinicians should work to build rapport with patients and use age-appropriate language. Involving young people in their own care decisions is important. The way in which young people understand their continence problem can influence their coping strategies and adherence to treatment regimes.

scholarly journals ‘Not just a piece of skin in front of you’—a qualitative exploration of the experiences of adolescents with eczema and psoriasis with healthcare professionals

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041108
Author(s):  
Isabella Joy de Vere Hunt ◽  
Abigail McNiven ◽  
Amanda Roberts ◽  
Himesh Parmar ◽  
Tess McPherson
Keyword(s):  
Young People ◽  
Skin Disease ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Secondary Analysis ◽  
Emotional Impact ◽  
Skin Conditions ◽  
The Uk ◽  
Qualitative Exploration

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.

scholarly journals How to increase chlamydia testing in primary care: a qualitative exploration with young people and application of a meta-theoretical model

2020 ◽  
Vol 96 (8) ◽  
pp. 571-581
Author(s):  
Lorraine K McDonagh ◽  
Hannah Harwood ◽  
John M Saunders ◽  
Jackie A Cassell ◽  
Greta Rait
Keyword(s):  
Primary Care ◽  
Young People ◽  
Sampling Methods ◽  
Healthcare Providers ◽  
Implementation Strategies ◽  
Potential Intervention ◽  
Individual Interviews ◽  
Chlamydia Testing ◽  
Wide Range ◽  
The Uk

ObjectiveThe objective of this study was to explore young people’s perspectives barriers to chlamydia testing in general practice and potential intervention functions and implementation strategies to overcome identified barriers, using a meta-theoretical framework (the Behaviour Change Wheel (BCW)).MethodsTwenty-eight semistructured individual interviews were conducted with 16–24 year olds from across the UK. Purposive and convenience sampling methods were used (eg, youth organisations, charities, online platforms and chain-referrals). An inductive thematic analysis was first conducted, followed by thematic categorisation using the BCW.ResultsParticipants identified several barriers to testing: conducting self-sampling inaccurately (physical capability); lack of information and awareness (psychological capability); testing not seen as a priority and perceived low risk (reflective motivation); embarrassment, fear and guilt (automatic motivation); the UK primary care context and location of toilets (physical opportunity) and stigma (social opportunity). Potential intervention functions raised by participants included education (eg, increase awareness of chlamydia); persuasion (eg, use of imagery/data to alter beliefs); environmental restructuring (eg, alternative sampling methods) and modelling (eg, credible sources such as celebrities). Potential implementation strategies and policy categories discussed were communication and marketing (eg, social media); service provision (eg, introduction of a young person’s health-check) and guidelines (eg, standard questions for healthcare providers).ConclusionsThe BCW provided a useful framework for conceptually exploring the wide range of barriers to testing identified and possible intervention functions and policy categories to overcome said barriers. While greater education and awareness and expanded opportunities for testing were considered important, this alone will not bring about dramatic increases in testing. A societal and structural shift towards the normalisation of chlamydia testing is needed, alongside approaches which recognise the heterogeneity of this population. To ensure optimal and inclusive healthcare, researchers, clinicians and policy makers alike must consider patient diversity and the wider health issues affecting all young people.

scholarly journals “You’re just there, alone in your room with your thoughts” A qualitative study about the impact of lockdown among young people during the COVID-19 pandemic

2021 ◽  
Author(s):  
Alison R. McKinlay ◽  
Tom May ◽  
Joanna Dawes ◽  
Daisy Fancourt ◽  
Alexandra Burton
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Young People ◽  
Social Life ◽  
Qualitative Interviews ◽  
Social Contact ◽  
Adolescents And Young Adults ◽  
Quantitative Evidence ◽  
The Uk ◽  
The Impact

AbstractBackgroundAdolescents and young adults have been greatly affected by quarantine measures during the coronavirus-19 pandemic. Quantitative evidence suggests that many young people have struggled with their mental health throughout “lockdown”, but little is understood about the qualitative impact of social distancing restrictions on mental health, wellbeing and social life. We therefore sought to elicit the views and experiences of adolescents and young adults living in the UK during the pandemic.MethodsSemi-structured qualitative interviews were undertaken with 37 participants aged 13-24.ResultsWe identified 4 superordinate themes most commonly described by participants about their experiences during the pandemic, including: a) missing social contact during lockdown, b) disruption to education, c) changes to social relationships, and d) improved wellbeing during lockdown. Although we identified some positive experiences during the pandemic, including an increased awareness of mental health and stronger relationship ties, many said they struggled with loneliness, a decline in mental health, and anxiety about socialising after the pandemic.ConclusionsFindings suggest that some young people may have felt less stigma talking about their mental health now compared to before the COVID-19 pandemic. However, many are worried about how the pandemic has affected their education and social connections and may require additional psychological, practical and social support. Our findings highlight the important role that education providers play in providing a source of information and support to adolescents and young adults during times of uncertainty.

scholarly journals Pilot mixed-methods evaluation of interpersonal counselling for young people with depressive symptoms in non-specialist services

2018 ◽  
Vol 21 (4) ◽  
pp. 134-138 ◽  
Author(s):  
Paul Oliver Wilkinson ◽  
Viktoria Cestaro ◽  
Ian Pinchen
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Young People ◽  
Qualitative Interviews ◽  
Current Treatment ◽  
Reduced Form ◽  
Youth Workers ◽  
Treatment As Usual ◽  
Receive Treatment ◽  
The Uk

BackgroundThe majority of young people receive treatment for depressive symptoms in the UK from staff with minimal specialist mental health/therapeutic training. There is no evidence to guide them as to what treatments are likely to be effective. Interpersonal counselling (IPC) is a reduced form of interpersonal psychotherapy and may be an appropriate treatment to use in this population.ObjectivesTo test the effectiveness and acceptability of IPC delivered by youth workers to young people with primarily depressive symptoms.MethodsYouth workers received a 2-day training course in IPC, followed by regular supervision. They delivered IPC to 23 young people who they would normally see in their service, with depressive symptoms as their main problem. Symptoms were assessed by the Revised Child Depression and Anxiety Scale (RCADS). Qualitative interviews of youth workers and young people assessed acceptability.FindingsMean (SD) RCADS depression-T scores fell from 78.2 (11.1) to 52.9 (16.8). All young people and youth workers interviewed were positive about it. Participants detailed specific advantages of IPC above standard counselling, including practical help, the use of goals, psychoeducation and integrating a self-rated questionnaire into treatment.Conclusions and clinical implicationsIPC is likely to be an effective and acceptable treatment for young people with primarily depressive symptoms seen in local authority non-specialist mental health services. Further research is needed to determine if it is more effective than current treatment as usual.

scholarly journals Symposium 6: Young people, artificial nutrition and transitional care Transition in young people on home parenteral nutrition

2009 ◽  
Vol 68 (4) ◽  
pp. 441-445 ◽  
Author(s):  
Susan Protheroe
Keyword(s):  
Young People ◽  
Health Services ◽  
Parenteral Nutrition ◽  
Transitional Care ◽  
Clinical Care ◽  
Young Person ◽  
Home Parenteral Nutrition ◽  
Artificial Nutrition ◽  
Adult Services ◽  
Increased Risk

Pharmacological, surgical and technological advances have resulted in children now surviving through adolescence into adulthood with conditions that were previously unseen by adult services. Arranging transition for young people on home parenteral nutrition (HPN) to the adult sector is one of greatest challenges for health services that care for young people. Transition is not only a key quality issue for health services, but is a multidimensional process covering psychosocial, educational and vocational aspects. Poorly-planned transition may result in difficulties when young people access adult specialist services. As a consequence, there may be increased risk of non-adherence or lack of follow-up, which carries dangers of morbidity and mortality as well as poor social and educational outcomes. Transition does not end at the exit from the paediatric clinic, but continues into the adult sector, which needs to provide developmentally-appropriate clinical care. Recent Department of Health initiatives are aimed at ensuring that young people do not miss out on healthcare during the transfer between paediatric and adult services. Transfer can be a major, often daunting, event for young people. Parents may also fear transfer and need to learn to ‘let go’ of some control, which may be particularly difficult with a young person on HPN.

Clinical, Research, and Public Health Implications of Poor Measurement of Vitamin D Status

2017 ◽  
Vol 100 (5) ◽  
pp. 1225-1229 ◽  
Author(s):  
Robyn M Lucas ◽  
Shelley Gorman ◽  
Lucinda Black ◽  
Rachel E Neale
Keyword(s):  
Vitamin D ◽  
Health Outcomes ◽  
Vitamin D Deficiency ◽  
Clinical Care ◽  
Large Population ◽  
Reference Method ◽  
Vitamin D Status ◽  
Absolute Level ◽  
Increased Risk ◽  
Wide Range

Abstract There is widespread concern about the high prevalence of vitamin D deficiency amid evidence to support that such a state may increase the risk of a wide range of adverse health outcomes. Estimating the prevalence of deficiency, as well as establishing linksto health outcomes, requires the accurate and precise measurement of 25-hydroxyvitamin D [25(OH)D] in serum or plasma. Accurate measurement of 25(OH)D underlies the definitions of vitamin D deficiency, insufficiency, and sufficiency and, thus, prevalence estimates. Imprecise measurement of 25(OH)D in epidemiological research can result in incorrect null findingsof associations with disease. When associations withdisease are found, the inaccuracy of measurement forestalls defining the absolute level of 25(OH)D thatis associated with increased risk. For the clinician,both inaccuracy and imprecision are problematic, because clinical care is most often based on a single measurement to define vitamin D status. New initiatives to develop a standard reference method and the assignment of “true” values to samples provide a solution to these problems. The use of standardized assays in large population studies will allow comparisons to be made between populations and over time that have not previously been possible and will improve our understanding of the role of vitaminD in health and disease.

scholarly journals Mathematics delivering the advantage: the role of mathematicians in manufacturing and beyond

2017 ◽  
Vol 473 (2201) ◽  
pp. 20170094 ◽  
Author(s):  
Vicki Saward
Keyword(s):  
Young People ◽  
Manufacturing Sector ◽  
Industrial Base ◽  
Wide Range ◽  
Manufacturing Sectors ◽  
The Uk

Much has been written about the benefits that mathematics can bring to the UK economy and the manufacturing sector in particular, but less on the value of mathematicians and a mathematical training. This article, written from an industry perspective, considers the value of mathematicians to the UK's industrial base and the importance to the UK economy of encouraging young people in the UK to choose to study mathematics at school as a gateway to a wide range of careers. The points are illustrated using examples from the author's 20 years' experience in the security and intelligence and manufacturing sectors.

Victimization and Resilience: Experiences of Rural LGBTQ+ Youth Across Multiple Contexts

2021 ◽  
pp. 088626052110435
Author(s):  
Traci L. Wike ◽  
Leah M. Bouchard ◽  
Aaron Kemmerer ◽  
Mauricio P. Yabar
Keyword(s):  
Rural Communities ◽  
Young People ◽  
Rural Areas ◽  
Interpersonal Violence ◽  
Qualitative Interviews ◽  
Rural Youth ◽  
Social Contexts ◽  
Lgbtq Youth ◽  
Increased Risk ◽  
Identity Based

LGBTQ+ youth experience higher rates of interpersonal violence, such as peer-based bullying and identity-based harassment, than their counterparts. Experiences of victimization can occur across different social contexts including family, school, peers, and community. LGBTQ+ youth in rural communities may be at increased risk for identity-based victimization due in part to geographic isolation and an often conservative value system that may create a hostile environment to LGBTQ+ individuals. However, few studies have examined the experiences of rural LGBTQ+ youth from their perspectives, and how the rural context may affect their experiences with victimization and social support. This qualitative study explores the victimization experiences of rural LGBTQ+ youth, the supports available to them, and ways they show resilience. We conducted qualitative interviews with a sample of 11 young people ages 12-21, recruited in partnership with a local LGBTQ+ agency across a rural five county region in the Southeastern United States. Four themes emerged related to how rural youth navigate bullying, harassment, and victimization across different social contexts and the support that is available to them: (1) conflicting family messages, (2) navigating personal safety at school, (3) connecting through technology, and (4) confronting negative religious sentiment. A fifth theme captures the strengths of young people in the mid of victimization: (5) demonstrating individual and collective resilience. Although rural LGBTQ+ youth experience victimization in similar ways to urban and suburban youth, rural youth may have less access to social supports that buffer effects of victimization. This study highlights the strengths in rural LGBTQ+ young people as well as their commitment to supporting one another and seeing change in their communities. Findings illustrate a need for greater support for LGBTQ+ youth in rural areas while leveraging existing strength of the youth and their community for sustainable support and resources.

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