Research

170 KiB

Open AccessArticle

The Role of Medication in Supporting Emotional Wellbeing in Young People with Long-Term Needs

by Nicola J. Gray and Damian M. Wood

Healthcare 2017, 5(4), 84; https://doi.org/10.3390/healthcare5040084 - 03 Nov 2017

Cited by 3 | Viewed by 5253

Young people frequently use and access prescribed medications for a range of health problems. Medications aimed at treating both common health problems and long-term physical and mental health needs in adolescence can have a significant effect on a young person’s emotional well-being. We [...] Read more.

Young people frequently use and access prescribed medications for a range of health problems. Medications aimed at treating both common health problems and long-term physical and mental health needs in adolescence can have a significant effect on a young person’s emotional well-being. We use a series of case studies to illustrate the challenges for healthcare professionals supporting young people with medication use. The studies illustrate the efficacy and limitations of medication on improving emotional well-being by alleviating illness and distress, and how this efficacy must be balanced against both the adverse effects and the burden of treatment. There are specific challenges for medication management during adolescence including issues of adherence/concordance, facilitating autonomy and participation in decision making, and promoting independence. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

Review

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179 KiB

Open AccessReview

Measuring Outcomes of Psychological Well-Being within Paediatric Health Settings

by Halina Flannery, Sarah Glew, Aylana Brewster and Deborah Christie

Healthcare 2018, 6(1), 1; https://doi.org/10.3390/healthcare6010001 - 29 Dec 2017

Cited by 10 | Viewed by 5589

Abstract

There are many widely used, validated patient reported outcome measures for physical and mental health. However, capturing outcomes from young people living with chronic health conditions presents a challenge, needing to take the complex interplay of physical and mental health into consideration. The [...] Read more.

There are many widely used, validated patient reported outcome measures for physical and mental health. However, capturing outcomes from young people living with chronic health conditions presents a challenge, needing to take the complex interplay of physical and mental health into consideration. The authors found that regularly used outcome measures for child and adolescent emotional well-being in paediatric settings largely fall into two groups: paediatric quality of life and child and adolescent mental health measures. The applicability and potential for use of these measures within this context is discussed. Whilst offering some utility, neither approach leaves sufficient space for young people’s individual experiences of illness and treatment. The scope of using alternative qualitative approaches that capture the rich stories and experiences of young people living with chronic illnesses is considered. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

561 KiB

Open AccessFeature PaperReview

Connecting the Mind–Body Split: Understanding the Relationship between Symptoms and Emotional Well-Being in Chronic Pain and Functional Gastrointestinal Disorders

by Line Caes, Alex Orchard and Deborah Christie

Healthcare 2017, 5(4), 93; https://doi.org/10.3390/healthcare5040093 - 05 Dec 2017

Cited by 9 | Viewed by 9110

Abstract

Paediatric chronic conditions, e.g., chronic pain and functional gastrointestinal disorders, are commonly diagnosed, with fatigue, pain and abdominal discomfort the most frequently reported symptoms across conditions. Regardless of whether symptoms are connected to an underlying medical diagnosis or not, they are often associated [...] Read more.

Paediatric chronic conditions, e.g., chronic pain and functional gastrointestinal disorders, are commonly diagnosed, with fatigue, pain and abdominal discomfort the most frequently reported symptoms across conditions. Regardless of whether symptoms are connected to an underlying medical diagnosis or not, they are often associated with an increased experience of psychological distress by both the ill child and their parents. While pain and embarrassing symptoms can induce increased distress, evidence is also accumulating in support of a reciprocal relationship between pain and distress. This reciprocal relationship is nicely illustrated in the fear avoidance model of pain, which has recently been found to be applicable to childhood pain experiences. The purpose of this article is to illustrate how mind (i.e., emotions) and body (i.e., physical symptoms) interact using chronic pain and gastrointestinal disorders as key examples. Despite the evidence for the connection between mind and body, the mind–body split is still a dominant position for families and health care systems, as evidenced by the artificial split between physical and mental health care. In a mission to overcome this gap, this article will conclude by providing tools on how the highlighted evidence can help to close this gap between mind and body. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

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662 KiB

Open AccessReview

The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness

by Albert Farre and Tim Rapley

Healthcare 2017, 5(4), 88; https://doi.org/10.3390/healthcare5040088 - 18 Nov 2017

Cited by 142 | Viewed by 42838

Abstract

The importance of how disease and illness are conceptualised lies in the fact that such definition is paramount to understand the boundaries and scope of responsibility associated with medical work. In this paper, we aim to provide an overview of the interplay of [...] Read more.

The importance of how disease and illness are conceptualised lies in the fact that such definition is paramount to understand the boundaries and scope of responsibility associated with medical work. In this paper, we aim to provide an overview of the interplay of these understandings in shaping the nature of medical work, philosophically, and in practice. We first discuss the emergence of the biopsychosocial model as an attempt to both challenge and broaden the traditional biomedical model. Then, we outline the main criticisms associated with the biopsychosocial model and note a range of contributions addressing the shortcomings of the model as initially formulated. Despite recurrent criticisms and uneven uptake, the biopsychosocial model has gone on to influence core aspects of medical practice, education, and research across many areas of medicine. One of these areas is adolescent medicine, which provides a particularly good exemplar to examine the contemporary challenges associated with the practical application of the biopsychosocial model. We conclude that a more optimal use of existing bodies of evidence, bringing together evidence-based methodological advances of the biopsychosocial model and existing evidence on the psychosocial needs associated with specific conditions/populations, can help to bridge the gap between philosophy and practice. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

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675 KiB

Open AccessReview

Helping Health Services to Meet the Needs of Young People with Chronic Conditions: Towards a Developmental Model for Transition

by Albert Farre and Janet E. McDonagh

Healthcare 2017, 5(4), 77; https://doi.org/10.3390/healthcare5040077 - 19 Oct 2017

Cited by 26 | Viewed by 7133

Abstract

The transition to adult healthcare has been the subject of increased research and policy attention over many years. However, unmet needs of adolescent and young adults (AYAs) and their families continue to be documented, and universal implementation has yet to be realised. Therefore, [...] Read more.

The transition to adult healthcare has been the subject of increased research and policy attention over many years. However, unmet needs of adolescent and young adults (AYAs) and their families continue to be documented, and universal implementation has yet to be realised. Therefore, it is pertinent to re-examine health transition in light of the principles of adolescent medicine from which it emerged, and consider this particular life transition in terms of a developmental milestone rather than a negotiation of structural boundaries between child and adult services. Health transitions are an integral part of AYA development and as such, occur alongside, and in connection with, a range of other important transitions that affect many other areas of life. In this paper, we discuss the interrelated nature of health transitions and AYA development; outline the underpinnings of a developmentally appropriate approach to transitional care; and consider the outcome measurement of such care based on existing evidence. A developmental approach has the potential to refocus transition on the fundamental principles of adolescent medicine, enabling health transition to be integrated along with other life transitions into routine AYA developmental assessments rather than being limited to the geographies of different healthcare settings and a potential health crisis. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

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504 KiB

Open AccessReview

Adolescent Neurological Development and Implications for Health and Well-Being

by Angela Griffin

Healthcare 2017, 5(4), 62; https://doi.org/10.3390/healthcare5040062 - 29 Sep 2017

Cited by 43 | Viewed by 10373

Abstract

Adolescence is evolution’s solution to bringing the capacity of our large, complex brains to fruition. It is a critical period for brain development and the experiences of each adolescent during this time helps to shape their adult brain. Brain developments lead to both [...] Read more.

Adolescence is evolution’s solution to bringing the capacity of our large, complex brains to fruition. It is a critical period for brain development and the experiences of each adolescent during this time helps to shape their adult brain. Brain developments lead to both the hormonal changes and the emotional, cognitive, and behavioral characteristics of the teenage years. They drive a growth towards independence via more complex reasoning skills, increased importance of social affiliations outside the family, and an urge to experiment and explore boundaries. In the context of still incomplete inhibitory systems, a heightened sensitivity to rewards, including the need for social acceptance, can mean risk-taking or impulsive behaviour in some. The continued plasticity of the brain can also mean a creativity and openness to novel solutions. These normative steps of adolescence are especially relevant to young people with chronic health conditions. An understanding of brain development at this time can help us appreciate the perspective and priorities of adolescents with health conditions. It can also guide us towards better ways of collaborating with them. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

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222 KiB

Open AccessReview

Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics

by Roz Shafran, Sophie D. Bennett and Mhairi McKenzie Smith

Healthcare 2017, 5(3), 44; https://doi.org/10.3390/healthcare5030044 - 16 Aug 2017

Cited by 6 | Viewed by 9255

Abstract

There are strong calls from many national and international bodies for there to be a ‘holistic’ and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking [...] Read more.

There are strong calls from many national and international bodies for there to be a ‘holistic’ and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have demonstrated efficacy in improving holistic health outcomes, for example Cognitive Behaviour Therapy, Behavioural Therapies and Problem Solving Therapies. They have shown to impact upon a wide range of outcomes, including psychological distress, pain, physical health, medication adherence, and family outcomes. There is increasing recognition that the holistic goals of the child and family should be prioritised, and that interventions and outcomes should reflect these goals. A focus on holistic goals in therapy can be achieved through a combination of personalised goal-based outcomes in addition to symptom-based measures. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

Other

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173 KiB

Open AccessViewpoint

What Else? The Basics and Beyond for Effective Consultations with Youth with Special Healthcare Needs

by April S. Elliott and Monique C. Jericho

Healthcare 2017, 5(4), 69; https://doi.org/10.3390/healthcare5040069 - 01 Oct 2017

Cited by 1 | Viewed by 4566

Abstract

Youth with special healthcare needs (YSHCN) require medical support for disease management and equally require that providers be responsive to their ever-changing and sometimes unique psychosocial and developmental needs. This paper reviews the fundamentals of adolescent consultation reminding the reader that YSHCN are, [...] Read more.

Youth with special healthcare needs (YSHCN) require medical support for disease management and equally require that providers be responsive to their ever-changing and sometimes unique psychosocial and developmental needs. This paper reviews the fundamentals of adolescent consultation reminding the reader that YSHCN are, after all, still youth with the same basic needs as their healthy peers. Beyond the basics, consultations with this population are characterized by complexities which are best managed by providers who can nimbly adjust their clinical stance. In non-urgent clinical scenarios, clinicians can adopt a coaching stance which we introduce and expand upon in this paper. Characterized by the five elements of non-judgment, curiosity, empathy, openness, and flexibility, the coaching stance can be adopted without specific training. We demonstrate its application using TGROW (Topic, Goal, Reality, Options and Wrap Up), a coaching framework that holds promise for use in clinical settings. Consultants may consider incorporating the coaching stance and TGROW into their practice repertoire, as both may be particularly helpful when consulting with adolescents with chronic illness. Full article

(This article belongs to the Special Issue Supporting Emotional Well-Being and Psychological Health Outcomes in Young People with Long-Term Health Needs)

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