Client-centered Research Articles

Everyone is searching for it and those who acquired it enjoy better mental health: a latent profile analysis of Chinese adolescents’ meaning in life

ObjectiveOne factor associated with rising rates of depression and anxiety among youth is a lack of meaning in life (MIL). The importance of living a meaningful and purposeful life cannot be overstressed, especially for adolescents who are in a critical life stage and have recently experienced a 3-year-long global health crisis, namely the COVID-19 pandemic. Although previous studies have examined adolescents’ MIL, the majority of them adopted a variable-centered approach. The present study adopts a person-centered approach to investigate the updated MIL among Chinese adolescents in the aftermath of the COVID-19 pandemic, the demographic factors related to profile classification, and the differences in mental health among adolescents in different MIL classes.MethodsA questionnaire assessing MIL, depression, anxiety, stress, and demographic information was administered to 1,196 Chinese adolescents (mean age = 13.07 ± 0.58; 44.73% were female individuals). A three-step latent profile analysis was conducted.Results and discussionThis study revealed that (1) adolescents can be categorized into three classes: high MIL, medium MIL, and low and searching MIL. (2) Adolescents from intact families with higher educated mothers were more likely to be classified as high MIL class rather than low MIL class. Furthermore, (3) adolescents with high MIL experienced the best mental health outcomes, those with medium MIL experienced moderate mental health, and those with low MIL, who were still searching for MIL, exhibited the poorest mental health. External support may be necessary in the search process for Chinese adolescents. Future research could explore the process of searching for MIL and identify the challenges adolescents encounter when developing their sense of MIL.

Diabetes prevention after gestational diabetes: challenges and opportunities

Abstract Gestational diabetes (GDM) poses significant health concerns for women and their offspring, with implications that extend beyond pregnancy. While GDM often resolves postpartum, a diagnosis of GDM confers a greater risk of future type 2 diabetes (T2D) and other chronic illnesses. Furthermore, the intergenerational impact of GDM predisposes offspring to increased chronic disease risk. Despite the awareness of the short- and long-term consequences of GDM, translating this knowledge into prevention strategies remains challenging. Challenges arise from a lack of clarity among health professionals regarding roles and responsibilities in chronic disease prevention and women’s lack of awareness of the magnitude of associated health risks. These challenges are compounded by changes in the circumstances of new mothers as they adjust to balance the demands of infant and family care with their own needs. Insights into behaviour change strategies, coupled with advances in technology and digital healthcare delivery options, have presented new opportunities for diabetes prevention among women with a history of GDM. Additionally, there is growing recognition of the benefits of adopting an implementation science approach to intervention delivery, which seeks to enhance the effectiveness and scalability of interventions. Effective prevention of T2D following GDM requires a comprehensive person-centred approach that leverages technology, targeted interventions, and implementation science methodologies to address the complex needs of this population. Through a multifaceted approach, it is possible to improve the long-term health outcomes of women with prior GDM.

Evaluating a Kid’s Dementia Awareness Game with Pre-Licensure Children and Young People’s Nursing (CYP) Students in Northern Ireland – A Pre/Posttest Study

ABSTRACT Dementia not only affects the person living with the condition but also their family and wider social circle. For that reason, it is important to educate family members, the wider public and health professionals. How a child and young people’s (CYP) nurse supports and responds to a CYP whose family member has dementia or acts as a carer is of interest to pre-licensure (pre-registration) CYP nursing programs. With serious games becoming more common as a method to educate a diverse population regardless of age and gender, this study aims to learn if playing a kid’s dementia awareness game improves CYP nursing student’s attitude to dementia using a validated pre-/posttest questionnaire. This study adopted a pretest, posttest design to assess the attitudes of pre-licensure CYP nursing students toward dementia. The Approaches to Dementia Questionnaire (ADQ) was administered before and after playing a serious CYP kid’s dementia game developed by children and people living with dementia for 10- to 11-year-old children. The ADQ measured the total score, Hope subscale, and person-centered approaches. Matched paired t-test was used for analysis conducted with SPSS statistics 29. Seventy-two participants, from one university in Northern Ireland, completed pretest measures, of these, 55 also completed the posttest questionnaire. The participating CYP pre-licensure undergraduate and postgraduate nursing students demonstrated a significant increase in overall dementia attitudes post-gameplay, with an increase from 78.31 to 83.27. Subscales for Hope (27.75 to 30.44) and person-centered approaches also exhibited significant improvement (50.56 to 52.84). Demographic data revealed all participants as female, with 50% knowing a person living with dementia, and limited training experiences. In conclusion, this study has shown a positive response to playing a dementia game relevant to the child population. This adds to the literature building on the use of serious games for health education. Attitudes and hope scales increased with the use of the game.

Assessing palliative care needs in patients with dementia: A cross-sectional analysis of an predominantly oldest-old population from a geriatric memory clinic.

In this cross-sectional study, we assessed palliative care (PC) needs in older adults with dementia. Using the NECPAL CCOMS-ICO© 3.1 tool and comprehensive geriatric assessment, 16.25% of the 554 evaluated patients required PC, which had clinical frailty and a moderate stage of dementia. Advanced frailty was associated with the poorest prognosis, according to the PC-based stratification. Our findings support the use of PC assessment in dementia care, which focuses on a person-centered approach while minimizing unnecessary or ineffective treatments and meeting the real-world patient's needs. PC care may fulfill the multidimensional nature of dementia, shifting towards personalized palliative approaches.

Examining the Empathy Profiles and Work Outcomes of Trauma Workers

Trauma work involves intervening with others enduring acute pain and suffering, often with heavy psychological and physical health impacts. An important question is whether dispositional empathy helps or hurts trauma workers in their occupational functioning. The current study addresses this gap in the research literature by using a person-centered approach to examine the empathy profiles and professional outcomes of a broad sample of trauma workers ( n = 315). We measured their trait empathy and organizational outcomes (occupational burnout, person-job fit, turnover intentions, job performance), and found three distinct empathy profiles which differed significantly in their occupational functioning. A ‘self-focused’ empathy profile (dominated by high personal distress responding) reported the worst functioning; an ‘other-oriented’ profile (high on perspective taking and empathic concern) had more positive functioning, and an unexpected ‘low reactivity’ profile (a full SD below the general population on empathy facets) showed the lowest exhaustion. Exploratory analyses revealed that first responders (e.g., police, firefighters, EMTs, paramedics) were overrepresented in the ‘low reactivity’ profile, while psychology-related professions (e.g., psychologists, counsellors, social workers) were underrepresented in that profile. The significance of these results, as well as their implications for empathy research and vocational counselling in the field of trauma work, are discussed.

On the nature, predictors, and outcomes of work passion profiles: A generalisability study across distinct types of employees.

Thus far, little research has adopted a person-centred approach to investigate the nature of work passion profiles. As a result, our understanding of the most commonly occurring combinations of harmonious passion (HP) and obsessive passion (OP) in the workplace remains limited. To achieve a more refined understanding of the nature of these work passion profiles, our first aim was thus to identify the configurations of HP and OP for work observed among five samples, including 11 subsamples, of employees (N=7258). Then, we also considered the extent to which these profiles and their associations with theoretically-relevant predictors (work-home segmentation and organisational support) and outcomes (work engagement, work-family conflict, turnover intentions, presenteeism, and counterproductive work behaviours) generalised across all subsamples. We identified a total of five profiles with a structure that differed slightly across samples: High OP Dominant, High HP Dominant, Average HP Dominant, Low HP Dominant (i.e., low levels of passion dominated by higher levels of HP relative to OP), and Moderately Low Passion. The High OP Dominant profile was systematically the most prevalent (37.5%-54.1% of the sample), whereas the High HP Dominant was the least prevalent (2.1%-7.7%). Across all samples, work-home segmentation was related to a higher likelihood of membership into the profiles characterised by higher, relative to lower or moderate, levels of passion (HP and OP), whereas organisational support also helped employees to stay away from the High OP Dominant profile. Lastly, the least desirable outcomes were observed in the High OP Dominant profile, whereas the most desirable outcomes were observed in the High HP Dominant profile. Interestingly, work engagement levels where comparable in these two profiles. Beyond their theoretical implications for research on work passion, these results highlight how work passion has highly similar implications across contexts.

Engaging with Culturally and Linguistically Diverse Communities to Promote Palliative Care That Exceeds Expectation.

Given longstanding barriers that obstruct integrated palliative care, particularly for culturally and linguistically diverse communities, this article demonstrates a way to engage with Syrian, Bhutanese and African communities to learn about brilliant palliative care with and from members of these communities. This study involved the methodology of POSH-VRE, which combines positive organisational scholarship in healthcare (POSH) with video-reflexive ethnography (VRE). Members of the Syrian, Bhutanese, and African communities (n = 14) participated in a focus group or an interview to consider understandings of palliative care; conceptualisations of a good death; how and why palliative care was typically enacted in their communities; the associated effects; as well as the relationship between culturally and linguistically diverse communities and public palliative care services. Discussions were aided by video recordings captured during the previous study on brilliant palliative care, which participants were invited to review. Video recordings and transcripts of the focus groups and interview were analysed using reflexive thematic analysis. The participants demonstrated considerable variability in the ways that palliative care was understood and enacted. For some, death was a taboo topic, while for others, it was a reality that was required to face, particularly in war-torn regions. Similarly, while doctors were held in high regard, participants held different views about how they should enact palliative care and the anticipation of death, particularly because family members were deemed to be a pivotal part of palliative care. To improve the care of people of culturally and linguistically diverse communities who experience a life-limiting illness, participants highlighted three opportunities. These included the avoidance of generalisations, prioritising the needs and preferences of cultural groups, and leveraging the community network. This study demonstrated how reciprocal understandings of palliative care were potentiated using POSH-VRE. Specifically, the members of the Bhutanese, African and Syrian communities demonstrated diversity in the needs, preferences, and customs of culturally and linguistically diverse communities. As such, integrated palliative care is likely to be bolstered by relinquishing assumptions about how cultural groups wish to be referred to and cared for and adopting a public health approach to palliative care that embraces both a population-based and person-centred approach to care. Members of the Bhutanese, African and Syrian communities contributed to this study as participants and co-researchers, contributing to the analysis and interpretation of the data and in the preparation of the article.

Exploring Personality Profiles as a Source of Phenotypic Diversity in Autistic Children and Adolescents.

This study adopts a person-centered approach to evaluate personality diversity as a source of interpersonal variability in autistic children and adolescents, and how personality subgroup membership relates to variability in autistic characteristics, social-emotional presentations, and parenting outcomes. Latent Profile Analysis was used to analyze 569 parent reports on a child-based Five-Factor-Model personality measure (aged 6-18 years; Mage = 11.8 years, SD = 3.1; 70% boys). Four distinct personality profile groups were identified, showing varying levels in the low to average range of all five personality domains. All groups scored lowest on Extraversion and Emotional Stability. They differed the most in Imagination and the least in Emotional Stability. Group 1 (n = 72) exhibited the lowest mean-level scores on all five domains, whereas Group 4 (n = 90) had the highest domain scores. Group 2 (n = 307) and Group 3 (n = 100) showed more diverse patterns. Group membership was meaningfully associated with variation in characteristics of social interaction and communication, internalizing, externalizing, and attentional problems, psychosocial strengths, and positive parenting strategies. Only modest group differences were found in parenting stress. All groups had similar scores on repetitive and restrictive behaviors. These findings help to better understand and support natural subgroups within the autism phenotype by exploring shared personality attributes.

Commercial forensic interviewing in the South African context: the Ponaletso CFI framework

Purpose The continued prevalence of financial crime and the lack of effective commercial forensic interviewing strategies prompted the development, presented here, of a conceptual framework to explain the relational dynamics conducive to interactions during a commercial forensic interview (CFI). The purpose of this study is to present such a framework which may facilitate the process of obtaining admissible evidence in different forums. Design/methodology/approach A grounded theory approach was adopted to develop a conceptual framework, drawing on the findings of a scoping review, direct observations of interactions involving commercial forensic practitioners (FPs) and interviewees, and data obtained from semi-structured interviews, making use of critical realism as a meta-theoretical framework. Findings Data obtained from the review informed the integrated approach of the conceptual framework, thus combining the structure of the PEACE model and creating an optimal interpersonal context informed by the person-centred approach (PCA). Observational data were used to identify the relational qualities associated with the interpersonal styles (clusters of relational qualities) of FPs in the CFI context, thereby contributing to complex relational dynamics. Interview data were used both to describe effective and ineffective interpersonal styles and how they played out in the CFI with interviewees, yielding information that unfortunately proved not to be admissible in a legal context. The findings of the different phases indicated the need for an integrated conceptual approach, the Ponaletso CFI framework, which draws on the structure of the PEACE model and the PCA, as expressed in the relational qualities of interactional pattern analysis (IPA). The framework consists of the interview stage (before, during and after), the structure (phases) of the PEACE model, the type of questions (open- or closed-ended) according to the PCA, FPs’ interpersonal styles (clusters of relational qualities as explained by IPA) and the observable relational dynamics between FPs and interviewees. When FPs use the Ponaletso CFI framework, there is a greater likelihood of extracting admissible evidence because the interview is guided by a clear structure with a step-by-step questioning approach by FPs, while taking into consideration the relational dynamics to which they contribute. Originality/value The proposed conceptual framework considers relational dynamics and how FPs can navigate towards optimal relational dynamics in CFI contexts. FPs can apply the structure, ask appropriate questions at the relevant phases and observe the relational dynamics playing out in the interpersonal context of the CFI. To the best of the authors’ knowledge, this is the first attempt at creating an integrated interviewing framework for conducting CFIs aligned with the legal context in South Africa. Using the Ponaletso CFI framework may aid FPs in obtaining admissible evidence and facilitate an optimal interpersonal context during commercial forensic investigations while respecting interviewees’ constitutional rights.

Parental control and bullying: Variable-centered and person-centered approaches.

Previous research has established a connection between parental control and bullying. However, the nuanced relationships involving different combinations of psychological control (PPC) and behavioral control (PBC), along with traditional and cyberbullying, remain ambiguous. Thus, this study investigated the associations of specific parental control dimensions and profiles with traditional and cyberbullying, focusing on the potential mediating mechanism of moral disengagement. A sample of 831 students (48.4% were female; Mage = 18.98 years; SDage = 1.08) was analyzed. Through latent profile analysis, three control profiles emerged: low PPC and PBC (40.31%), low PPC and high PBC (29.00%), and high PPC and PBC (30.69%). The findings indicated a positive correlation between PPC and traditional/cyberbullying. Moral disengagement mediated the relationship between PPC/PBC and traditional/cyberbullying. Particularly, high PPC and PBC were linked to cyberbullying. Moral disengagement mediated the relationship between high PPC and PBC and traditional/cyberbullying. These insights provide valuable empirical data for developing bullying interventions that consider parental control and moral disengagement.

The Complexity of Health Self-Management Behavior. Beliefs and Attitudes of Individuals Living With Spinal Cord Injury in Switzerland.

Within the objective of defining targets for interventions to support self-management behaviors among people living with spinal cord injury, this study aims to describe self-management attitudes and beliefs in community-dwelling people living with spinal cord injury in Switzerland and to identify their correlates in terms of personal characteristics and outcomes, such as secondary health conditions and quality of life. This is a cross-sectional, observational study using data from the third community survey of the Swiss Spinal Cord Injury Cohort Study. Out of 1158 individuals, the data revealed high endorsement in areas of prevention importance, perceived knowledge, adherence to recommendations, and proactive problem-solving. Personal and lesion characteristics were significantly associated with differing self-management beliefs and attitudes. Overall, a more positive and proactive stance toward self-management correlated with enhanced outcomes. However, readiness to renounce activities to adhere to self-management recommendations was associated with lower quality of life. The findings confirm the complex nature of self-management among individuals with spinal cord injury, advocating for a tailored, person-centered approach in designing interventions. Highlighting a potential trade-off between strict self-management adherence and quality of life outcomes posits an avenue for balanced, individualized self-management strategies to ameliorate health outcomes and life quality for individuals with spinal cord injury.

The Use of Snoezelen to Support People With Profound Intellectual and Multiple Disabilities: An International Survey Describing the Perspectives of Support Persons.

Snoezelen is often used for people with profound intellectual and multiple disabilities, but scarcely evaluated. This study aimed to provide insight into the application and perceived effects of snoezelen from the perspective of support persons. We conducted an international survey with professionals (n = 130) and relatives (n = 8) supporting people with profound intellectual and multiple disabilities. Information regarding the application and perceived effects was gathered. Content and descriptive analysis were used. Despite variation, common characteristics were identified regarding purpose, approach and context. Perceived positive effects mostly concerned improved mental health of the person receiving snoezelen (n = 88). A person-centred approach was reported as important element for positive effects. This study describes the use of snoezelen for people with profound intellectual and multiple disabilities. These insights can be used for future research into working elements and effects of snoezelen and facilitate evidence-based support.

The roles of task-specific self-efficacy and enjoyment in EFL learners’ development of speaking CALF: A longitudinal study

This longitudinal study adopts a person-centred approach to examine EFL learners’ development of speaking CALF; the fluctuating correlations of affective ID variables (self-efficacy and enjoyment), as well as their impacts on oral task performance over time. Thirty-one Chinese EFL learners completed eight oral tasks bi-weekly over six months, followed by post-task scales to measure task-specific self-efficacy and enjoyment. Data were subjected to group-based multi-trajectory modelling (GBMM) to discern the development of speaking CALF, moving correlation analysis to explore the interactions between task-specific self-efficacy and enjoyment, and panel data regression to examine the longitudinal impact of task-specific self-efficacy and enjoyment on oral task performance. GBMM results revealed variability at both the group and individual levels, despite similar educational backgrounds and learning contexts, as evidenced by differing speaking CALF patterns. Moving correlation analyses revealed dynamic, non-linear trends between self-efficacy and enjoyment. Panel data regression analyses suggested that higher levels of affective ID variables would generate better oral performance, as evidenced by speaking CALF patterns. This study successfully integrated ID variables into TBLT research within a CDST framework for enhancing our understanding of the complex nature of EFL learners’ speaking competence and underscoring the interconnectivity between task-specific self-efficacy and enjoyment.

Exploring Unique Patterns of Self-Injury Recovery: A Latent Profile Analysis.

As nonsuicidal self-injury (NSSI) has become an increasing public health concern, the last few years have seen the emergence of efforts to address NSSI recovery. Although many recovery efforts adopt a medical view of self-injury and focus on cessation of the behaviour, recovery can mean many different things to different people. In this study, we provide initial empirical validation of the self-injury recovery framework, by assessing whether different recovery profiles exist. Our sample comprised 733 participants with lived experience of NSSI (M age = 24.54, sd = 6.39). Participants completed self-report measures of constructs related to NSSI recovery and NSSI characteristics. Using latent profile analysis, we identified six unique profiles reflecting differences in thoughts/urges to self-injure, self-efficacy, social support, optimism, coping, underlying adversities, perceptions of scarring, disclosure, resilience and self-compassion. Multivariate analyses of variance confirmed these profiles differed according to NSSI characteristics such as frequency of NSSI, a self-assessment of recovery, the desire to self-injure or avoid self-injury and the number of people disclosed to. A homogenous sample and cross-sectional design limit generalisability of our findings across populations and across time. Our findings reinforce that recovery can take many different forms, with different factors being relevant to different individuals. Adopting a person-centred approach that centres an individual's lived experience and emphasises what is important to them in the recovery process offers opportunities for more empathic responses to self-injury and better outcomes for individuals who self-injure.

Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective.

Multidimensional Individualized Stuttering Therapy (MIST) is based on proactive collaborative work and shared decision making between client and clinician with the goal of identifying individual case-appropriate procedures and therapy elements in a manner that is meaningful and context-sensitive for each person. MIST combines value- and awareness-based elements from acceptance and commitment therapy (ACT) with stuttering and speech modification interventions. In keeping with the principles of ACT, we locate mindfulness as part of an embodied practice facilitated through a collaboration between the person who stutters and the speech-language therapist. The aim of this study was to see whether the positive results of MIST recorded at 12 months post-therapy remained stable at 24 months post-therapy and to consider the role of embodiment and awareness within MIST. Fifteen of 18 adults already enrolled in a treatment study (2015/FO12451) took part in a single-group repeated-measures design. They completed measures of stuttering severity, impact of stuttering, unhelpful thoughts and beliefs about stuttering, general anxiety symptoms, and fear of negative evaluation. There was a significant reduction of stuttering severity and negative impact of stuttering from pre-therapy to 24 months post-therapy. Unhelpful thoughts and beliefs about stuttering, symptoms of general anxiety, and fear of negative evaluation were reduced at 12 months post-therapy, and these values remained stable at 24 months post-therapy. MIST was associated with positive outcomes at 24 months post-therapy, suggesting a possible connection between the person-centered approach and longer-term benefit. Findings are discussed within the context of mindfulness and embodied adjustment, and shared client-clinician decision making. The absence of a control group is a limiting factor regarding certainty of interpretation. Future research is therefore needed on collaborative and individualized approaches to stuttering therapy that include embodiment and awareness perspectives.

Codesigning training for health providers to improve detection and response to elder abuse.

Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was co-designed as part of a trial aimed at improving elder abuse detection and response. Between March and April 2023, 7 health providers and 10 older people and family carers participated in two national Australian online codesign workshops. Using the World Café method, discussions focused on what knowledge and skills health providers needed for screening; clinical and social issues affecting screening and referral; and support older people needed throughout the process. Data were thematically analyzed. Participants said health providers should take a trauma-informed, person-centered approach to screening, and explain the limits of confidentiality to older people. Clinical, social, and systemic issues such as dementia, ethnic diversity, and housing availability complicated screening and referrals. To facilitate disclosure, participants said health providers needed to reflect on whether they held ageist views. There were differing opinions on the length of the training and if all health providers or only social workers should screen for abuse. Participants' feedback on trauma-informed care, consent, and cognitive impairment concorded with evidence on best practice responses to elder abuse and were integrated in the training. Given operational constraints in health services, feedback from health providers about the training length and the inclusion of all health providers in screening were prioritized. The training is being evaluated in a national trial.

Client characteristics and early working alliance development: A person-centered research approach

Objective Certain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g., intersectional identities, prior treatment experiences) are related to alliance development. The present study leveraged a person-centered research approach to examine profiles of early alliance development and differences in the latent class structure of client characteristics among alliance development profiles. Method Individual psychotherapy clients (N = 2,579) rated the working alliance for their first four sessions and self-reported demographics, treatment history, and psychological distress. Therapists provided their assessment of clients’ primary presenting concerns at baseline. Results Latent profile analysis revealed three profiles of working alliance development: high and stable, moderate and increasing, and low and stable. Follow-up person-centered analyses (multigroup confirmatory latent class analysis) indicated that clients in the alliance profiles differed in their combinations of clinical and demographic characteristics. For example, women of color with high baseline distress and a history of prior psychotherapy were over-represented in the low and stable alliance profile. Conclusion These results are consistent with recommendations to holistically consider how clients’ characteristics and experiences shape psychotherapy processes. Results also highlight the utility of person-centered quantitative methods in psychotherapy research.

A Lifeline to Fill the Silence of Homelessness: Person-Centered Analysis of Digital Coping and Links to Mental and Physical Health.

Individuals experiencing homelessness are among the most vulnerable population for mental and physical health disparities. Despite navigating numerous stressors on a day-to-day basis, they are vastly underrepresented within coping research. Using a person-centered approach, this study addresses ways in which technology is leveraged to manage ongoing stressors associated with the experience of homelessness. We employed a two-step and k-means cluster analysis within a sample of unhoused individuals (n = 66). Two distinct clusters emerged, revealing unique patterning of digital coping, stress, self-efficacy, and technology use. Resulting clusters were validated across numerous health outcomes, including mental and physical health problems, as well as digital service use and experience of homelessness. High digital engagement/low self-efficacy individuals (65% of sample) reported high levels of digital self-efficacy, yet lower levels of general self-efficacy. In contrast, low digital engagement/high self-efficacy individuals (35% of sample) engaged in relatively lower digital coping and technology use, with lower stress and higher general self-efficacy. High digital engagement/low self-efficacy individuals, in turn, reported more mental and physical health problems; whereas low digital engagement/high self-efficacy reported somewhat decreased digital access. Relatively few differences emerged between the clusters on experiences of homelessness. Due to the transient nature of unhoused people, reaching such vulnerable populations via technology to support their digital coping and subsequently enhance well-being outcomes represents a critical next step for digital equity. This population is poised to benefit from digital equity efforts, with critical implications for reduced health disparities.

Motivational profiles in instrumental music learning: Perspectives on self-determination theory

This study examined the motivation of child and adolescent music students to learn instruments in five Austrian music schools using a person-centered approach. Drawing on self-determination theory, two autonomous and controlled forms of motivational regulation were surveyed. The results of a cluster analysis ( N = 616) were used to construct four motivational profiles: one autonomously motivated type (high quality), one overall highly motivated type (high quantity), one moderately autonomously motivated type (low quality), and one type with poor quantity motivation. The clusters showed differences in the support required to meet music students’ basic psychological needs in music lessons, which are essential determinants in the development of autonomous motivation, in the individual activity preferences associated with playing an instrument, and in the tendency to stop playing an instrument. No differences were found between the instrument groups and gender. This study provides theoretical and practical implications of a person-centered approach to music-related motivation research.

Development of the iManage SCD mobile health application for transition

ObjectiveThis paper outlines the design and implementation of iManage SCD, a self-management mobile health application for adolescents and young adults (AYA) with sickle cell disease (SCD) during transition from pediatric to adult health care. MethodsThe Integrate, Design, Assess, Share (IDEAS) framework, emphasizing user insights, iterative design, rigorous assessment, and knowledge sharing, guided the development process. The design team consisted of researchers, psychologists, physicians, social workers, AYA with SCD, and parents of AYA with SCD (n = 16) across three states. Qualitative focus groups and interviews were conducted and analyzed using thematic analysis across the integrate and design phases. Point of use feedback from AYA with SCD was used to assess feasibility and acceptability. ResultsThe development process was centered around tenants of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition. Development integrated multidisciplinary perspectives, fostering a person-centered approach. The iterative design process involved collaboration with a digital health firm, Agency39A. Health equity and implementation considerations were addressed at individual, community, and healthcare system levels. Themes that emerged from focus groups with AYA, clinicians, and researchers in the integrate and design phases of development included recommendations for content and user experience features. ConclusionsiManage SCD emerges as a comprehensive, user-friendly mobile health application, incorporating theoretical principles and direct user input. The development process demonstrated feasibility and acceptability, and the paper discusses dissemination strategies for the Community Health Workers and Mobile Health Programs to Help Young Adults with SCD Transition to Using Adult Healthcare Services (COMETS) study.