Peer Contact Research Articles

Self-determination theory in acute child and adolescent mental health inpatient care. A qualitative exploratory study.

There is a dearth of research to guide acute adolescent mental health inpatient care. Self-determination Theory provides evidence that meeting needs for relatedness, autonomy and competence is likely to increase wellbeing and intrinsic motivation. These needs may be able to be met in the inpatient environment. This qualitative study aimed to explore young people's experience of acute mental health inpatient care with particular attention to meeting of these three needs. Fifteen young people were interviewed. The importance of relatedness with staff, other young people and families was identified. Relatedness with staff and peers were valued parts of admission. Some young people describe enhanced relatedness with family. They described loss of autonomy as a negative experience but appreciated opportunities to be involved in choices around their care and having more freedom. Coming into hospital was associated with loss of competence but they described building competence during the admission. Engaging in activities was experienced positively and appeared to enhance meeting of all three needs. Meeting of the three needs was associated with an experience of increased safety. Engaging young people in activities with a focus on relatedness, autonomy and competence may have specific therapeutic potential. Autonomy, experience of competence and connection with staff may enhance safety more effectively than physical containment. Peer contact may have untapped therapeutic value we understand little of. This study supports the value of Self-determination Theory as a guide day to day inpatient care to meet the needs of adolescents for relatedness, autonomy and competence.

Adolescents' peer contacts promote life satisfaction in young adulthood — A connection mediated by the subjective experience of not being lonely

Life satisfaction is known to be associated with several social and mental adversities. We examined whether social activities and relationships in adolescence are related to life satisfaction in young adulthood. The psychosocial background characteristics of the study subjects (n = 787, aged 13–18 years) were recorded by using self-rated questionnaires. Five years later, the Life Satisfaction (LS) scale was used to measure the participants' life satisfaction. Of the baseline variables, a low frequency of meeting with friends and subjective loneliness among males and a low number of recreational sporting hobbies among females associated with lower life satisfaction in young adulthood. The association between the frequency of meeting friends in adolescence and life satisfaction in young adulthood was mediated by the level of loneliness and Beck Depression Inventory (BDI) score in adolescence. We conclude that loneliness in adolescence may associate with low life satisfaction and related problems in young adulthood. Investing in support and social gatherings in the adolescent community may prevent youth loneliness.

The school community contributes to how children cope effectively with a disaster

ABSTRACT The Canterbury, New Zealand, earthquake disaster of 2010–2011 had a major impact on children. The present study aims to increase understanding of schools’ contributions to children’s recovery by examining how this core context fosters children’s effective coping in a disaster. The study uses a phenomenological approach to investigate the disaster experience from the children’s (n = 32) own viewpoint and from that of their parents (31), teachers (6), and school principals (5). The schools in the study proved a stable, supportive environment for children providing routine, consistency, and a sense of safety and security. Teachers were a trusted source of support for children, and they coached children to cope. Teachers and schools also continually kept channels open between children and their families, including maintaining contact with parents during aftershocks to reassure them their children were safe. Peer contact was also important for children to share their experiences and gain support from one another. Principals considered welfare and put in place support mechanisms for staff and the children. Understanding how a school context and the relationships within that context promote effective coping in children facing a disaster is critical for developing more effective psychosocial support, and intervention strategies for children. In view of the school’s key role, support to schools and teachers, including further training for education professionals, is needed throughout a disaster cycle if children’s positive adaptation and coping is to be fostered.

Is Reflective Learning Visible in Online Discussion Forums for Medical Students on General Practice Placements? A Qualitative Study

Problem: Reflection is important for lifelong learning and professional development, and discussion forums have been highlighted as a potential platform for enhancing reflection further through peer interaction and teacher feedback. Forums provide students on general practice (GP) placement the opportunity to engage in collaborative reflective learning despite their geographical isolation and disparate schedules. This case report seeks to explore whether online discussion forums demonstrate community presence and reflective learning among medical students on GP placement. Intervention: Online discussion forums were introduced into the curriculum for University of Auckland Year 5 and 6 medical students on their respective 4- and 6-week GP placement. Via asynchronous posts and comments, groups of eight students on average presented cases and experiences for discussion with peers and an overseeing GP faculty member. Context: Students were dispersed across a large geographical area and were unlikely to have peer contact in their assigned practices. Online discussion forums were implemented for a number of reasons, including facilitating reflective learning. An adapted community of inquiry framework was used to investigate the cognitive, social, and teacher presence elements visible in the discussion forum transcripts of unanimously consenting groups. Content analysis of the transcripts was performed to evaluate the presence and quality of reflective learning. Impact: The forums were predominately student-led with relatively scarce comments by GP faculty facilitators. The majority of cases and experiences presented related to clinical management of patients and dissonance triggered by the on-site supervisor’s actions. Ideas, knowledge, and understanding of presented encounters were shared and built on by positive and supportive interaction, broadening students’ perspectives and, at times, leading to the formation of solutions. However, students’ reflection was mostly superficial. Deep reflection was rarely present, and affective dimensions of reflection were disclosed relatively less than clinical cognitive aspects of reflection. Direct instruction, based on prior experience and pedagogical expertise, was the main form of comment made by faculty facilitators, who prompted with questions to a far lesser extent. Lessons Learned: Online discussion forums appeared to enable medical students on GP placement to interact positively with peers and faculty facilitators. However, deep reflection was not reached. Modifying the discussion forums to facilitate more peer interaction and addressing the barriers that limit faculty facilitation may encourage deeper and more affective reflections.

Web-Supported Social Network Testing for HIV Among Men Who Have Sex With Men With a Migration Background: Protocol for a Mixed Methods Pilot Study

BackgroundOf newly diagnosed HIV positive men who have sex with men (MSM) in the Netherlands, 29% have a non-Western migration background (MSM-NW). Among MSM-NW, HIV positivity rates are high (0.8%-2.0%), as is the proportion of late stage infections (39%). Factors such as HIV and sexual orientation–related stigma may form barriers for timely testing. Innovative approaches for HIV testing are needed to better reach MSM-NW. Social network testing (SNT) for HIV is an evidence-supported approach where peer recruiters identify persons (network associates) who could benefit from testing in their social or sexual networks. Web-supported SNT might be particularly promising for reaching people who may not be reached by regular care.ObjectiveThe purpose of this paper is to describe the design of our pilot PREVENT (Peer-Empowered Voluntary Extended Network Testing). In this pilot, we will explore whether SNT using HIV self-tests is feasible and acceptable among MSM-NW in the Netherlands and whether it reaches those who were never or not recently tested for HIV (>1 year ago).MethodsThe project aims to include 50 to 60 MSM and MSM-NW peers who will distribute 4 to 5 oral HIV self-tests each aiming to reach 200 network associates (NAs). Enrollment of peers includes 4 steps: (1) fostering interest in becoming a peer by health care professionals at sexual health clinics, HIV treatment clinics, and community settings; (2) sending peer contact information to the peer coordinator; (3) registering peers and giving program instructions by the peer coordinator and referring to the Web-based training at time2test; and (4) receiving precoded HIV self-tests for distribution in the peers’ networks. NAs who receive the self-test will log in with their test package code in the time2test application for step-by-step test instructions. After testing is complete, NAs receive tailored follow-up information depending on their test result.ResultsBetween January and May 2019, 10 STI clinics and 7 HIV treatment clinics started recruiting peers. Results of the PREVENT pilot are expected in December 2020.ConclusionsThis is the first Web-supported peer-driven SNT pilot using HIV self-tests in the Netherlands and one of the first in Europe. Implementation is considered successful if it reaches MSM-NW who were never or not recently tested for HIV. Additionally, it may encourage conversations within the networks about risk behavior and barriers to HIV testing, potentially contributing to the Joint United Nations Programme on HIV/AIDS goal of zero HIV infections.Trial RegistrationNetherlands Trial Registry NL7424; https://www.trialregister.nl/trial/7424International Registered Report Identifier (IRRID)DERR1-10.2196/14743

Solitude and Loneliness Profiles in Early Adolescents: A Person-Centred Approach

In early adolescence, developmental tasks lead boys and girls to oscillate between the search for and the fear of solitude, between feelings of loneliness and the need for peer contact. Adopting a multidimensional and person-centred approach, the aim of the present study was to distinguish different clusters related to profiles of solitude attitudes and loneliness and to evaluate the role of relational and socio-demographic variables as predictors of cluster belonging. Measures of loneliness, attitudes towards aloneness, friendship quality, self-esteem and rejection sensitivity were collected in a population of 656 Italian native and immigrant early adolescents. Three clusters emerged, differently predicted by relational and socio-demographic variables. An adaptive and normative profile was found for the Aversion to aloneness and the constructive solitude clusters, while a more maladaptive profile emerged for the non-constructive solitude cluster. The results are discussed in the light of the developmental challenges that early adolescents face.

Leisure-time socializing with peers as a mediator of recent decline in alcohol use in Czech adolescents

ABSTRACTBackground: Significant declines in adolescent alcohol use have recently been observed in Europe. Growing research has focused on explaining the ongoing changes. The aim of the paper was to analyze to what extent the changes in unorganized leisure-time activities, especially a decline in socializing with peers, have affected recent changes in adolescent alcohol use in the Czech Republic.Methods: Samples of 15–16-year-old adolescents, surveyed in 2011 (N1 = 3,699) and 2015 (N2 = 2,738) ESPAD studies, were analyzed. A structural equation model was constructed for boys and girls separately to test the mediating effect of changes in the frequency of going out with friends on decline in adolescent binge drinking and alcohol intoxication.Results: The decline in the frequency of going out with friends explained a major part of the decline in alcohol use. The mediating effect was confirmed in both binge drinking and alcohol intoxication, and more pronounced among the girls (65.4–99.6%) compared to boys (51.1–62.7%).Conclusion: Recent changes in unorganized socializing with peers have had a significant effect on alcohol consumption among adolescents. Future research should focus on more in-depth analysis of the complexity of the relationship between face-to-face peer contacts, intensive electronic media communication, and adolescent alcohol use.

HIV prevention programme cascades: insights from HIV programme monitoring for female sex workers in Kenya.

IntroductionHIV prevention cascades have emerged as a programme management and monitoring tool that outlines the sequential steps of an HIV prevention programme. We describe the application of an HIV combination prevention programme cascade framework to monitor and improve HIV prevention interventions for female sex workers (FSWs) in Kenya.MethodsTwo data sources were analysed: (1) annual programme outcome surveys conducted using a polling booth survey methodology in 2017 among 4393 FSWs, and (2) routine programme monitoring data collected by (a) 92 implementing partners between July 2017 and June 2018, and (b) Learning Site in Mombasa (2014 to 2015) and Nairobi (2013). We present national, sub‐national and implementing partner level cascades.ResultsAt the national level, the population size estimates for FSW were 133,675 while the programme coverage targets were 174,073. Programme targets as denominator, during the period 2017 to 2018, 156,220 (90%) FSWs received peer education and contact, 148,713 (85%) received condoms and 83,053 (48%) received condoms as per their estimated need. At the outcome level, 92% of FSWs used condoms at the last sex with their client but 73% reported consistent condom use. Although 96% of FSWs had ever tested for HIV, 85% had tested in the last three months. Seventy‐nine per cent of the HIV‐positive FSWs were enrolled in HIV care, 73% were currently enrolled on antiretroviral therapy (ART) and 52% had attended an ART clinic in the last month. In the last six months, 48% of the FSWs had experienced police violence but 24% received violence support. National and sub‐national level cascades showed proportions of FSWs lost at each step of programme implementation and variability in programme achievement. Hotspot and sub‐population level cascades, presented as examples, demonstrate development and use of these cascades at the implementation level.ConclusionsHIV prevention programme cascades, drawing on multiple data sources to provide an understanding of gaps in programme outputs and outcomes, can provide powerful information for monitoring and improving HIV prevention programmes for FSWs at all levels of implementation and decision‐making. Complexity of prevention programmes and the paucity of consistent data can pose a challenge to development of these cascades.

User perspectives on a psychosocial blended support program for partners of patients with amyotrophic lateral sclerosis and progressive muscular atrophy: a qualitative study

BackgroundPartners are often the main caregivers in the care for patients with amyotrophic lateral sclerosis (ALS) and progressive muscular atrophy (PMA). Providing care during the progressive and fatal disease course of these patients is challenging and many caregivers experience feelings of distress. A blended psychosocial support program based on Acceptance and Commitment Therapy was developed to support partners of patients with ALS and PMA. The aim of this qualitative study is to gather insight into experiences with different components of the support program (program evaluation) and to discover what caregivers gained from following the program (mechanisms of impact).MethodsIndividual in-depth interviews, about caregivers’ experiences with the support program were conducted with 23 caregivers of ALS/PMA patients enrolled in a randomized controlled trial designed to measure the effectiveness of the blended psychosocial support program. The program, performed under the guidance of a psychologist, consists of psychoeducation, psychological and mindfulness exercises, practical tips and information, and options for peer contact. Interviews were audio-recorded, transcribed verbatim and analyzed thematically.ResultsThe program evaluation showed that caregivers perceived each component of the program as beneficial but ambivalent reactions were expressed about the mindfulness exercises and peer contact functions. Caregivers expressed the need for a more personalized program with respect to the order and timing of the modules and wanted to continue the support program for a longer time. The main mechanism of impact of the program that caregivers reported was that they became more aware of their own situation. They further indicated that the program helped them to perceive control over the caregiving situation, to accept negative emotions and thoughts, to be there for their partner and feel acknowledged.ConclusionsThe blended psychosocial support program for caregivers of patients with ALS/PMA is valued by caregivers for enhancing self-reflection on their challenging situation which stimulated them to make choices in line with their own needs and increased their feeling of control over caregiving. The different components of the program were overall appreciated by caregivers, but the mindfulness and peer support components should be further adapted to the needs of the caregivers.Trial registrationDutch Trialregister NTR5734, registered 28 March 2016.

Social media and e-learning use among European exercise science students.

With the rise of digital technologies, electronic learning and communication tools are becoming a firm part of academia to promote knowledge of health sciences. This study sought to analyse the attitude of students regarding social media and digital learning for study purposes in sport and exercise science. A survey was carried out with a questionnaire (20 main items) in six sport science faculties, equally spread across Germany (G), Italy (I) and the United Kingdom (UK) between February and October 2017. The focus areas were students' usage of social media (Facebook, Google+, Instagram, LinkedIn, Skype, Twitter, WhatsApp, YouTube) for academic purposes and their use of e-learning. Data were analysed by quantitative and qualitative methods. 229 students participated in the study (G: 68, I: 121, UK: 40). While YouTube was mostly used for receiving knowledge, WhatsApp and Facebook showed additional preferences for peer contacts for learning purposes and knowledge discussions. Preferred online data sources were PubMed (77%), free access journals (67%), YouTube (66%) and Wikipedia (63%). Often used digital learning materials were own universities' PowerPoints (77%), scripts (59%) and scientific articles (53%). However, some preferences showed national differences. The evaluated participants showed an overall high use of social media and e-learning tools for their studies. Students would like more digital learning sources made available to them by their institutions. However, some differences in preferences of digital learning or communication tools may exist and this should be considered for international approaches to promote health knowledge among students.

Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study.

BackgroundSelf-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms.ObjectiveThe aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre.MethodsThe project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points—preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention.ResultsA total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos.ConclusionsThis study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.

Hearing siblings\u2019 voices: exploring the (online) support needs of siblings of children with a chronic condition

BackgroundSiblings of children and adolescents with a chronic condition are at risk for developing psychosocial problems. It is important, that they receive appropriate support according to their needs. A sibling-specific module of an existing online intervention (Op Koers Online) for adolescents with a chronic condition might be an appropriate way to offer psychosocial support to siblings. The aim of the current study is to identify siblings’ online support needs in order to develop a sibling-specific module of the existing Op Koers Online intervention.ResultsA total of 91 siblings (mean age 15.2 years, Standard Deviation 2.7) of children with a chronic condition completed an online questionnaire; nine semi-structured interviews were held additionally. Of all participants, 55% would like to initiate or increase contact with other siblings of children with a chronic condition and 46% of those were interested in an online chat course. The themes for online support considered most important were impact on daily life, worrying about brother’s/sister’s future, handling other people’s reactions, and how attention is divided within the family.ConclusionsSiblings are interested in peer contact and online support. Op Koers Online for siblings seems to be a suitable intervention to offer online psychosocial support. The next step is to develop a sibling specific module of the Op Koers Online course, taking into account the identified themes.

The decline in adolescent substance use across Europe and North America in the early twenty-first century: A result of the digital revolution?

ObjectivesIncreases in electronic media communication (EMC) and decreases in face-to-face peer contact in the evening (FTF) have been thought to explain the recent decline in adolescent substance use (alcohol, tobacco, cannabis). This study addresses this hypothesis, by examining associations between (time trends in) EMC, FTF, and substance use in more than 25 mainly European countries.MethodsUsing 2002–2014 data from the international Health Behaviour in School-aged Children (HBSC) study, we ran multilevel logistic regression analyses to investigate the above associations.ResultsNational declines in substance use were associated with declines in FTF, but not with increases in EMC. At the individual level, both EMC and FTF related positively to substance use. For alcohol and cannabis use, the positive association with EMC was stronger in more recent years. Associations between EMC and substance use varied across countries, but this variation could not be explained by the proportion of young people using EMC within countries.ConclusionsOur research suggests that the decrease in FTF, but not the increase in EMC, plays a role in the recent decrease in adolescent substance use.

Using intercultural videos of direct contact to implement vicarious contact: A school-based intervention that improves intergroup attitudes

We aimed to create an engaging and dynamic intervention for schools that uses videos of direct school peer contact to implement a vicarious contact intervention. Participants were ethnic majority (Italian) and minority (immigrant) high school students ( N = 485; age ranging from 14 to 22 years old, Mage = 17.24 years), who were asked to watch and evaluate videos created by peers from their school for a competition for the best video on intercultural friendships. Results revealed that vicarious contact, relative to a control condition where participants were not shown any videos, improved outgroup attitudes, reduced negative outgroup stereotypes, and increased willingness to engage in contact with the outgroup. These effects only emerged when intercultural friendships in the videos were salient. Inclusion of the other in the self, but neither intergroup anxiety nor fear of rejection by the outgroup, significantly mediated the effect of the videos on outcomes. We discuss theoretical and practical implications of the findings.

De behoeften aan openheid, lotgenotencontact en gespecialiseerde counseling voor donorkinderen1

Abstract Being a donor-child: wishes for parental support, peer support and counseling Most studies on donor-conceived offspring have shown that secrets in families about the genetic origin of the child can harm the parent-child relationship and as a consequence early disclosure of donor conception is recommended. Data on whether donor-conceived offspring appreciate guidance to cope with their questions and feelings related to being a donor-child are not available. We held semi-structured in-depth interviews with male and female donor-conceived offspring (Mage = 26.9, range 17-41) born within father-mother (n = 11), two-mother (n = 7), or single mother families (n = 6). The majority of donor offspring (n = 20) were descendants of anonymous donors. The interviews were fully transcribed and analyzed using the constant comparative method. Donor-conceived offspring would have appreciated openness from their parents about being a donor-child and wished that their parents would have received specialist guidance before donor sperm treatment. They valued the availability of peer contact to exchange stories and would have liked assistance in getting access to trustful information about characteristics and identifying information of their donor. Donor-conceived offspring wished to know where to find counsellors for guidance when needed. Donor-conceived offspring missed guidance by their parents, appreciated peer-support and the availability of guidance by counsellors for themselves. Our findings demonstrate that peer support and guidance by counsellors for donor-conceived offspring should be available for those who need it. The findings also support counselling to intended parents before donor sperm treatment.

Buffering against academic loneliness: The benefits of social media-based peer support during postgraduate study

Although the support provided by social relationships may be essential to a successful student transition, the transition to postgraduate study has had little consideration from a social support perspective. The study described in this article investigated the role played by social support in postgraduate taught students’ adjustment to university, and how social media contributes to this support. Thematic analysis indicated that participants benefitted most from specialised support from peers dealing with similar academic challenges. Facebook groups showed potential as a platform for building supportive peer networks. However, the heightened visibility of communications on this platform led some participants towards Facebook Messenger as a medium for peer contact. The study suggested that, in order to meet postgraduates’ needs, institutions could ensure postgraduate students have sufficient opportunity for collaboration within their cohorts. In addition, while social media may aid this process, students’ individual communication preferences may inevitably influence their engagement with particular platforms.

Social relationships in adolescence and heavy episodic drinking from youth to midlife in Finland and Sweden\xa0\u2014\xa0examining the role of individual, contextual and temporal factors

BackgroundApplying the Process-Person-Context-Time (PPCT) model of the bioecological theory, this study considers whether proximal processes between the individual and the microsystem (social relationships within family, peer group and school) during adolescence are associated with heavy episodic drinking (HED), from youth to midlife, and whether the macro level context (country) plays a role in these associations.MethodsParticipants of two prospective cohort studies from Finland and Sweden, recruited in 1983/1981 at age 16 (n = 2194/1080), were followed-up until their forties using postal questionnaires. Logistic regression analysis was used to examine associations between social relationships at age 16 and HED (at least monthly intoxication or having six or more units of alcohol in one occasion) at ages 22/21, 32/30 and 42/43. Additive interactions between microsystem settings, as well as between settings and country, were also considered.ResultsConsistent with the PPCT model, we found individual, contextual and temporal aspects to be associated with drinking habits. Higher levels of poor family relationships were associated with an increased likelihood of HED (ages 22/21 and 32/30) in both Finnish women and men and Swedish men. Higher levels of peer contact were associated with an increased likelihood of HED in both Finnish women (ages 32 and 42) and men (ages 22 and 32), and Swedish men (age 21). In contrast with the other groups, poorer relationships with classmates were associated with an increased likelihood of HED (age 30) for Swedish women only. For women, the combined effect of having both daily peer contact and living in Finland for HED at age 42/43 was statistically distinguishable from a pure additive effect.ConclusionsMicro and to a lesser extent macro level contexts are associated with heavy episodic drinking well into adulthood. The most relevant processes in the adolescent microsystem occur in family and peer settings. However, long-lasting protective or risk-raising effects between different settings and later HED were not found. Promoting good relationships across different contexts during adolescence may reduce the incidence of HED in adulthood.

Support needs of caregivers of patients with amyotrophic lateral sclerosis: A qualitative study

The aim of this study was to explore the support needs of Dutch informal caregivers of patients with amyotrophic lateral sclerosis (ALS). Individual semi-structured interviews were conducted with 21 caregivers of ALS patients. Audio-taped interviews were transcribed and data were analyzed thematically. A total of four global support needs emerged: "more personal time", "assistance in applying for resources", "counseling", and "peer contact". Despite their needs, caregivers are reluctant to apply for and accept support. They saw their own needs as secondary to the needs of the patients. ALS seems to lead to an intensive caregiving situation with multiple needs emerging in a short period. This study offers targets for the development of supportive interventions. A proactive approach seems essential, acknowledging the importance of the role of the caregivers in the care process at an early stage, informing them about the risk of burden, monitoring their wellbeing, and repeatedly offering support opportunities. Using e-health may help tailor interventions to the caregivers' support needs.

The quality of experience of students with and without special educational needs in everyday life and when relating to peers

The aim of this paper is to investigate the quality of experience of students with and without SEN in everyday life in general and when relating to peers in particular: (1) How do they experience everyday school life vs. leisure time? (2) How much time per week do they spend with peers outside school? and (3) How do they experience those peer contacts? The data comprised 120 grade 8 (20%) and grade 9 (80%) students from the German-speaking part of Switzerland, with a mean age of 15.8 years (SD = 0.8 years). Of these students, 42 were diagnosed with SEN, of which 32 were taught in regular classes and 10 in special classes. Students were asked to report their current affective states on about 31 randomly selected occasions during one week, with a total of 3758 ‘snapshots’ of their activities and their emotional experience in everyday life. Data were collected using the experience sampling method. Momentary affective states were measured by the PANA short-scales. The findings show, first, that students with and without SEN from regular classes interact as often with peers during leisure time, while students with SEN from special classes are presumably more likely to interact with family. Second, adolescents experience leisure activities more positively than instruction. Third, social interactions generally have a positive effect on the quality of experience. The quality of experience is especially good for teenagers when they are with peers – best with peers during leisure time. There are no differences between the student groups.

Being a donor-child: wishes for parental support, peer support and counseling

Objectives: We aimed at exploring the wishes of Dutch donor-conceived offspring for parental support, peer support and counseling and sought to contribute to the improvement of health care for all parties involved with assisted reproductive technologies.Methods: We held semi-structured in-depth interviews with 24 donor-conceived offspring (Mage = 26.9, range 17–41) born within father–mother, two-mother and single mother families. The majority of the donor offspring was conceived with semen of anonymous donors. All offspring were recruited by network organizations and snowball sampling. The interviews were fully transcribed and analyzed using the constant comparative method.Results: Donor-conceived offspring wished that their parents had talked openly about donor conception and had missed parental support. They wished that their parents would have received counseling before donor sperm treatment on how to talk with their children about donor conception in several stages of life. They valued the availability of peer contact to exchange stories with other donor-conceived offspring and would have liked assistance in getting access to trustworthy information about characteristics and identifying information of their donor. Donor-conceived offspring wished to know where to find specialist counseling when needed.Conclusions: Peer support and counseling by professionals for donor-conceived offspring should be available for those who need it. The findings also support professional counseling for intended parents before treatment to improve parental support for donor-children.