Perspectives Of Adults Research Articles

Transition from Paediatric to Adult Diabetes Care in People with Type1 Diabetes: An Online Survey from France.

The transition from paediatric to adult diabetes care (TPA) of children/adolescents with type1 diabetes (T1D) represents a unique challenge and remains a critical phase in the T1D care pathway. This study aims to describe and understand the experience of the transition process from a participant's perspective in young adults who are living in France with T1D and to measure their satisfaction. An online questionnaire was presented to people with T1D in France on a global online participant community platform. The questionnaire was developed by a scientific committee including paediatric and adult diabetologists and refined by a group of participants. Thematic qualitative analysis was performed on the responses. A total of 104 respondents were included in the survey (mean age 24.4years [95%CI 23.8-25.0]; 61.5% female). The mean age at the time of transition was 18.4years (95%CI 17.8-18.9), and 56% of respondents had their first adult diabetology follow-up in the same institution. During TPA, of the 76 participants who experienced personal issues, 74% experienced at least one issue with their diabetes management in the months following the transition. In the following months, 61% experienced new or unexpected problems in monitoring their diabetes after transition and 44% reported unusual glycaemic imbalances, including hypoglycaemia (8%) and hyperglycaemia (9%) requiring hospitalisation. Presence of personal issues during TPA was significantly associated with occurrence of problems with diabetes management or glycaemic imbalance. Three factors identified for a successful transition were (i) early meeting with the 'adult' diabetes care team, (ii) letting the participants choose the right age to leave paediatric clinic and (iii) having good diabetes control at the beginning of the TPA process. Most young adults with T1D report experiencing issues around TPA with significant consequences on their disease management. Hence, it is necessary to identify these issues to better support them and improve diabetes management during this phase.

The impact of perceived walking environment on social support for older adults

The idea of new urbanism advocates for promoting social support, defined as the network of care or help a person receives from non-family members, by improving the walking environment and other components of new urbanism. However, the impact of the walking environment on social support, especially from the perspective of older adults’ perceptions, remains unclear. In a rapidly aging urban environment, the demand for walkable living spaces has increased among older adults. One typical measure of the walking environment, walking accessibility, often focuses on travel time and/or distance to different urban opportunities but ignores travelers’ subjective feelings and experiences about the walking environment. These subjective factors are important for policymakers to design, implement, and regulate appropriate plans and strategies to enhance social interaction among older adults at the community level. This study examines how, in the Chinese context, the perceived walking environment is associated with social support, mediated by walking time and perceived level of safety, using generalized structural equation models with data from the 2021 Chinese General Social Survey (CGSS). The results show that, as compared to walking time, perceived safety is more likely to be influenced by the perceived walking environment, which positively correlates with social support. This suggests that older adults feel more socially supported by their neighbors when they perceive their living environment as safe and walkable. These findings provide new evidence for decision-makers to develop and implement targeted policies on walking accessibility for older adults with better understanding of the relationship between the perceived walking environment and social support.

Navigating Social Services from the Perspective of Finnish Older Adults with Complex Needs: An Examination of Different Dimensions of Access

This study aims to increase understanding of accessing social services for older adults with complex needs. Individual interviews (18) with older clients of gerontological social work and diaconal social work in Finland were analyzed using abductive content analysis. The conceptual framework of access to services, consisting of five interrelated dimensions by Penchansky and Thomas (1981) and the sixth dimension, awareness, by Saurman (2016), was used as a basis for analysis and reporting of results. The findings showed that accessing services was affected by all six dimensions and factors related to both the service system and the clients. The main results showed that available services did not always meet the needs of older adults (Availability), or they did not have enough information about the services (Awareness). Attitudes toward both the service system and older adults affected their experiences (Acceptability), as well as the perceived approachability of the services (Accommodation). In addition, mobility of services and physical abilities of clients (Accessibility), together with the perceived worth of services in relation to their cost (Affordability), influenced older adults’ access to services. Overall, this study emphasizes the significance of considering different aspects of access in service design and policies for services for older adults.

Assessing older adult educational needs: A mixed-methods study for identification and prioritization

ABSTRACT To improve the quality of life of older adults, adequate education and training is necessary. To provide effective training, it is crucial to assess and prioritize the educational needs of older adults. This study aims to identify and prioritize the educational needs of older adults with a mixed-methods approach and was conducted in two phases. In the first phase, we used the inductive content analysis method to explain the educational needs of older adults. In the second phase, a cross-sectional study was conducted to determine the level of need and prioritize these needs. During the first phase, the study identified 10 key areas of educational needs for older adults. Almost all educational titles had a statistically significant relationship with age and education, indicating that these factors play a crucial role in determining the educational needs of older adults (p < .05). According to the results, it is essential to emphasize and invest more in the topics that are of priority from the perspective of the older adults in planning programs aimed at empowering and educating the older adults. Additionally, awareness-raising and information dissemination strategies should be used for other basic needs of the older adults that have not yet been recognized as perceived needs.

Novel Framework of Financial Hardship in Childhood Cancer: Incorporating Stakeholder Perspectives.

Although financial hardship in childhood cancer contributes to poor outcomes, no standardized tool to assess its impact exists. Existing methods are heterogeneous and designed using high-income country (HIC), adult perspectives. This project aimed to construct a stakeholder-informed conceptual framework of financial hardship in childhood cancer with global relevancy. Group concept mapping, a participatory mixed-methods approach, was used. Participants were parents or caregivers of a child with cancer, childhood cancer survivors, and clinical or nonclinical support personnel, fluent in English, Spanish, or Portuguese. A representative panel established a comprehensive list of relevant items. Participants individually sorted these items into concepts and then rated each item for impact using a four-point Likert scale. Multidimensional scaling and hierarchical cluster analysis identified concepts. Descriptive statistics were calculated for impact ratings. One fourth (21/80) of participants were parents/caregivers or childhood cancer survivors. Participants worked in clinical (44/80), charity/volunteer (27/80), and other nonclinical (13/80) roles. Of the 41 represented countries, 78.0% (32) were low- and middle-income countries (LMICs). Conceptual themes spanned six distinct clusters: medical, nonmedical, assistance and support, treatment impact, family impact, and caregiver impact. These were distinct in composition compared with an existing framework for adult oncology. Caregiver impact (mean, 3.39) and treatment impact (mean, 3.29) were the highest rated clusters, and impact ratings were higher in LMICs compared with HICs. We developed a framework for financial hardship in childhood cancer that reflects the voices of stakeholders, including parents and caregivers, from diverse global contexts. The findings lay a foundation for the development and validation of tools to systematically assess financial hardship in families of children with cancer and inform effective policies and interventions.

Comparative Analysis Between Children's Perspective and Adult Perspective in Old Stories in the South of the City

With the development of fast-paced life and increasing pressure in modern society, children's literature-related works are becoming increasingly abundant. Returning to the world of children and exploring the beauty of childhood is one of the important topics of current research. The research topic of this article is the connection between children's perspectives and adults' perspectives. The research method of this article is as follows: First, read the text of the novel, looking for chapters that fit the theme as well as the direction of the research. Three aspects were selected: the conflict between "madness and civilization", the dialectic of "right and wrong", and the helplessness of "separation and growth". Then, through direct comparison and analysis, it is discovered that the child's perspective is to think deeply about this rational adult world with a critical eye. Finally, it is concluded that children's eyes can not only discover the beauty of the adult world but also present the true nature of children's resistance to and criticism of the real world. It also provides insight into the contradictions and hopelessness behind them and explores the expression of rationalization.

Perspectives of older adults and their caregivers on the development of a robotic exercise coach

Perspectives of older adults and their caregivers on the development of a robotic exercise coach

Perspectives of Adults with Pain Regarding Online Pain Self-Management Resources

Perspectives of Adults with Pain Regarding Online Pain Self-Management Resources

Ageism from the perspective of older adults: A phenomenological study

ABSTRACT This study aims to determine what meaning older adults attribute to ageism and then to reach findings thereof in curriculum studies on the same topic. The study was conducted with phenomenological design. The researcher held face-to-face interviews with a total of 13 participants over the age of 65 using a semi-structured interview form and maximum variation sampling method. Inductive content analysis was used to analyze the data. The themes, sub-themes, and codes obtained as a result of the analysis were examined under four headings. These headings are discrimination as a concept, experiences of ageism, reactions expressed against ageism, and pattern of ageism. The results of the study showed that discriminatory attitudes and behaviors of other adults and social and biological/physiological conditions were among the factors that lead to ageism and behavioral, cognitive and emotional effects emerged when older adults were exposed to ageism. It was revealed that the older adults took measures against the effects of ageism by withdrawing from the social environment, ignoring, and being active. The results of the study were discussed in the context of disadvantaged groups, discrimination, ageism and culture literature, and inferences were made about the curriculum studies that can be carried out to raise awareness, knowledge, and skills by accepting that schools have an important role in combating ageism.

Digital transformation for the prevention of delirium in older adults with dementia: Development of simulation intervention using virtual reality and augmented reality programs and its subjective effects

We aimed to develop a simulation program for physicians and nurses involved in virtual reality (VR) and augmented reality (AR) treatment and care from the perspective of these professionals and older adults with dementia who developed delirium, and to test the effectiveness of the program. effectiveness of the program was analyzed through free-response statements from 67 nurses (84.8%) and 12 doctors (15.2%) who participated in the program between February 16 and April 18, 2023. Regarding the experience of delirium from the perspective of older adults with dementia (personal experience), the following statements were extracted "1. I do not understand where I am, the situation, and the treatment/care that is about to be given"; "2. I want the situation to be explained to me so that I can understand the reasons for my hospitalization and the treatment/care I am receiving"; "3. The eerie environment of the hospital and the high pressure of the staff made me feel anxious and fearful"; "4. Please respect my existence as I endure pain, anxiety, and loneliness"; "5. I feel relieved when doctors and nurses deal with me from my point of view"; and "6. I feel relieved when there is a familiar presence, such as a family member or the name I am calling on a daily basis". Specific categories of self-oriented empathy were extracted from the experience of physical restraint at night using VR and the experience of delirium using AR. This suggests the possibility of objective effects on treatment and care in future practice.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

To explore the experiences of health services among adults with cerebral palsy (CP) in Ireland, from the perspectives of adults with CP, their support people, and service providers. A qualitative descriptive study design was used. In-depth semi-structured interviews were conducted between March and August 2021 with adults with CP, people who supported them, and health professionals. Thematic analysis was used to evaluate the data. Twenty-one adults with CP, seven support people (family carer[s], spouse or partner, or friend), and 15 service providers participated in the study. Adults had a mean age of 38 years 5 months (range 22-58 years) and were classified in Gross Motor Function Classification System levels I to V. Five themes were identified from the data: (1) access challenges in adult services; (2) knowledge and understanding of CP; (3) support people's role and care burden; (4) communication and interaction in adult services; and (5) health system challenges. Adults with CP in Ireland face multiple challenges accessing the health services they need. Services were reported to be inadequate, with limited resources and understanding of CP. Participants highlighted a need for system-level interventions, including enhanced training for health professionals to effectively meet the needs of adults with CP.

What supports do autistic adolescents and adults need? Perspectives of self-reporting adults and caregivers.

Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important. This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis. There was no consumer or community involvement in the completion of this project. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs. Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of supports that are important to them. Understanding what supports are valued by autistic adolescents and adults will support occupational therapists deliver effective and individualised services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important to them. This study involved two anonymous online surveys. Survey one was completed by caregivers of autistic adolescents and/or adults. Survey two was completed by self-reporting autistic adults. Surveys included both open-ended and closed-answer responses to better understand the support needs of autistic individuals living in Australia. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Closed-answer response questions from both the caregivers and self-reporting autistic adolescents and adults showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Open-ended response questions revealed six main priorities including, employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. This study found that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy. Further, participant responses highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs.

Adult endocrinologists' perspectives on transitioning adolescent patients with congenital adrenal hyperplasia.

The study aimed to evaluate adult endocrinologists' perspectives on caring for patients with congenital adrenal hyperplasia (CAH) and views on their transition from pediatric to adult care. An online survey was conducted among adult clinical endocrinologists at Harvard Medical School-affiliated hospitals from March to October 2022. Most participants (25/34, 73.5 %) treat patients with CAH and expressed moderate to high confidence (23/32, 71.9 %) in their care. Those that did not treat or accept referrals cited insufficient expertise, knowledge, and resources as reasons. Only half of respondents correctly answered at least 50 % ofstandard of care questions. The main transition of care barrieridentified was the absence of standardized policies (12/34, 35.3 %). Participants, though involved in care of patients with CAH, had varied responses to standard of care questions and transition of care barriers, emphasizing the need for standardized transition protocols and additional training to ensure up-to-date clinical knowledge.

Identification and prioritization of patient-centred strategies to enhance IBD-related care for older adults: a modified Delphi approach

Abstract Background The older adult age group makes up one of the fastest-growing groups of individuals with inflammatory bowel disease (IBD). It is important to hear the perspectives of older adults living with IBD about care experiences and managing their illness. The purpose of this patient-oriented study was to identify and prioritize patient-centred strategies that have the potential to enhance IBD-related care for older adults in Saskatchewan. Methods The interprofessional research team, consisting of older adult individuals living with IBD, gastroenterology providers, and researchers specializing in IBD or older adult education used a modified Delphi approach to identify and prioritize strategies that may enhance IBD-related care for older adults. Thirty-one older adults with IBD participated in ranking, revising, and prioritizing statements related to their chronic illness care. Nine statements were developed that highlighted strategies for older adult IBD care. Results Through the consensus process, 6 statements were retained. Co-creating a treatment plan with the IBD provider was ranked as the top priority statement for older adults with IBD. Conclusion Facilitating collaborative relationships and understanding individual priorities for IBD-related care for older adults has the potential to enhance positive health outcomes and quality of life for these individuals.

PH Roundtable: Recommending Exercise in Pulmonary Hypertension: Adult and Pediatric Perspectives

PH Roundtable: Recommending Exercise in Pulmonary Hypertension: Adult and Pediatric Perspectives

Young Adult Patient and Caregiver Perspectives on Transition Readiness in an Inflammatory Bowel Disease Clinic.

When it comes to readiness to transition to an adult subspecialty clinic, perspectives between patients with inflammatory bowel disease (IBD) and their caregivers may differ and influence the ability to successfully transition. Patients with IBD have been shown to suffer from poor transfers of care. There is a need to more efficiently and accurately assess transition readiness to improve the transfer process. Patients transferring to an adult subspecialty clinic and their caregivers were each administered the Transition Readiness Assessment Questionnaire and IBD Self-Efficacy Scale-Adolescent. Differences between patient and caregiver responses and agreement among each dyad were tested. There were 29 dyads of patients and caregivers who enrolled. There was no difference between patient and caregiver total scores. The average level of agreement between patients and caregivers was 78%. There was no association between patient response and their age, gender, ethnicity, age at time of transfer, age at diagnosis, or number of emergency room visits in the prior year. Patient-reported readiness to transition to adult care was confirmed by their caregivers using validated readiness assessment tools. As transition clinics must focus on high-yield interventions, a readiness survey of young adult patients without a survey of their caregivers may be adequate. However, as experts in each patient's journey, caregivers may be utilized when setting goals and priorities for a transition readiness program. The surveys used in this study can be used broadly to aid subspecialty clinics that are trying to improve the transition process.

Perspectives of Young Adults in the Pursuit of a Political Career

Perspectives of Young Adults in the Pursuit of a Political Career

All is well in moderation: Perspectives of young adults on positive and negative factors influencing the quality of romantic relationships

All is well in moderation: Perspectives of young adults on positive and negative factors influencing the quality of romantic relationships

Emotional Changes during Imagery Rescripting of Aversive Social Memories in Social Anxiety Disorder: A Randomized Controlled Trial

Introduction: Imagery rescripting (ImRs) is a psychotherapeutic intervention targeting aversive memories. During the three-phase intervention, patients reexperience their aversive memory (phase 1), observe the scene from their adult perspective, and intervene to help their former selves (phase 2), and reexperience it again with the positive changes (phase 3). Previous studies have rarely investigated emotional and regulatory processes taking place during the intervention. Objective: This randomized controlled trial investigated self-reported affective and physiological responses during ImRs. Methods: Seventy-seven patients with social anxiety disorder (SAD) were randomly assigned to a single session of ImRs or a control intervention (recall and discussion of the memory) targeting an aversive social memory. Heart rate (HR) and heart rate variability (HRV) were assessed during and post hoc ratings of positive and negative feelings after baseline and the intervention phases. Results: Relative to the control intervention, ImRs resulted in an initial increase in negative feelings from baseline to phase 1 and a following larger (phase 1 to phase 2) and more stable (phase 2 to phase 3) decrease in negative feelings/increase in positive feelings. On the physiological level, during ImRs compared to the control intervention, mean HR was significantly higher during phase 1 and HRV during phase 3, each compared to baseline. Conclusions: These results provide further information about the specific sequence of emotional responses on different response levels during ImRs, being consistent with known theories of emotional processing and supposed mechanisms of ImRs.

“Thanks to my activists Friends”: a qualitative study of perspectives of young adults and professionals on the factors related to seeking support among victims of sexual violence in Spain

BackgroundSexual violence (SV) is a public health problem with high prevalence among the young population. The use of formal resources for SV care (e.g. institutional services) is low in this age group. This study applies a framework of health assets to identify the factors that positively influence the search for support for SV among young people, the functions of that support and the level of proximity as articulated by both young people and professionals.MethodsA qualitative study was conducted through 38 semi-structured interviews with young people and professionals from SV resource centers and/or care services for the young population in Spain. A thematic theoretical analysis was conducted, embedded in inductive insights emerging from the data, following a particular adaptation of the constant comparative method, under the grounded theory approach. This analysis was carried out by coding the interview transcripts with the support of Atlas.ti.ResultsYoung women identified assets, categorized as feminist, that they believe they are essential in the search for formal support services for SV. However, unlike young men, they considered the police and judicial system to be barriers and not assets. There were also differences between the young people and professionals in identifying assets. Young people also considered their partner and traditional media as health assets, in contrast to professionals who did not identify these as such valuable resources in the help-seeking process. Informal assets, such as family, friends and the internet are considered close resources. In contrast, specialized care services for gender-based violence/SV and the judicial and police systems were perceived as more distant resources among the young interviewees.ConclusionsThis study shows similarities and discrepancies among young women and men and SV response professionals in identifying assets for seeking SV support among youth. The study shows an inverse relationship between perceptions of proximity and the level of formality of the asset. This study also contributes to map the relationships and information exchanges between assets. It is advisable to inform professionals about the assets that professionals do not acknowledge, and about actions that allow young people to access formal resources.