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To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self-management and transition readiness.
Cross-sectional international study, reported following STROBE guidelines.
Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020).
Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State–Trait Anxiety Inventory short form). Perceptions of health self-management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation.
Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self-management and transition readiness.
Transition readiness should be determined by an assessment of knowledge, self-management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care.
Transition readiness and self-management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care.
We have adhered to the STROBE statement, using STROBE checklist for cross-sectional studies.
No patient or public involvement.
ClinicalTrials.org NCT04631965.
Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.
This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years).
Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.
Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake.
CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities.
At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.
Existing literature suggests that transgender women (TW) may be at high risk for adverse mental health due to stress attributed to combined experiences of stigma and complex social and structural vulnerabilities. Little research has examined how these co-occurring experiences relate to mental health. We aimed to test a theoretically driven conceptual model of relationships between stigma, social and structural vulnerabilities, and mental health to inform future intervention tailoring.
Partial least square path modeling followed by response-based unit segmentation was used to identify homogenous clusters in a diverse community sample of United States (US)-based TW (N = 1418; 46.2% White non-Hispanic). This approach examined associations between latent constructs of stigma (polyvictimization and discrimination), social and structural vulnerabilities (housing and food insecurity, unemployment, sex work, social support, and substance use), and mental health (post-traumatic stress and psychological distress).
The final conceptual model defined the structural relationship between the variables of interest within stigma, vulnerability, and mental health. Six clusters were identified within this structural framework which suggests that racism, ethnicism, and geography may be related to mental health inequities among TW.
Our findings around the impact of racism, ethnicism, and geography reflect the existing literature, which unfortunately shows us that little change has occurred in the last decade for TW of color in the Southern US; however, the strength of our evidence (related to sampling structure and sample size) and type of analyses (accounting for co-occurring predictors of health, i.e., stigma and complex vulnerabilities, reflecting that of real-world patients) is a novel and necessary addition to the literature. Findings suggest that health interventions designed to offset the negative effects of stigma must include anti-racist approaches with components to reduce or eliminate barriers to resources that contribute to social and structural vulnerabilities among TW. Herein we provide detailed recommendations to guide primary, secondary, and tertiary prevention efforts.
This study demonstrated the importance of considering stigma and complex social and structural vulnerabilities during clinical care and design of mental health interventions for transgender women who are experiencing post-traumatic stress disorder and psychological distress. Specifically, interventions should take an anti-racist approach and would benefit from incorporating social support-building activities.
Relato biográfico de Mónica, una enfermera que ha vivido en primera persona el inicio de la pandemia Covid-19 en el centro de trabajo donde está desarrollando su actividad laboral, después de casi 20 años de profesión, esta ha sido la situación sanitaria más difícil que ha vivido. Para construir el relato he realizado una entrevista semiestructurada, con preguntes abiertas centradas en los temas principales que ha vivido. La informante relata su historia describiendo los diferentes momentos iníciales de la pandemia, la complejidad del momento vivido, los miedos, sufrimientos y la profesionalidad con que afronto la situación. Este tipo de relato nos puede ser de utilidad para que otros y en especial a las personas de fuera del contexto sanitario sean conocedoras de la realidad enfermera, sus experiencias y de cómo se trabajó en los momentos iníciales y posteriores de una pandemia.
Objetivo principal: el objetivo de esta investigación es describir los hábitos de consumo alimentario y determinar qué variables sociodemográficas, dentro del colectivo de los estudiantes jóvenes universitarios, están implicadas en la elección de los alimentos. Metodología: se aplicó un cuestionario ad hoc, anónimo y auto-administrado a 599 estudiantes de la Universidad de Alicante, matriculados en el curso académico 2018/2019. Resultados principales: los resultados muestran que los jóvenes universitarios concentran sus ingestas en la comida (90,2%) y la cena (82%). Se evidenció, además, que los alimentos incluidos en la dieta mediterránea se consumen dos o tres veces por semana en esta población, pero en porcentajes diferentes. Los datos confirman que los educados en un estilo democrático consumen, en un 59%, alimentos enriquecidos con vitaminas y minerales por encima de otros estilos educativos familiares. De los estudiantes que afirmaban consumir alimentos precocinados un 51,9% pertenecen a un estilo educativo democrático, un 32,3% al permisivo, un 14,6% al autoritario y un 1,2% al negligente, lo que confirma la influencia de la cultura educativa familiar en los hábitos de alimentación de este grupo etario para esta variable. Conclusión principal: se concluye que las pautas definitorias de la dieta mediterránea han perdido protagonismo en este grupo poblacional, al comparar sus resultados con los de otros momentos históricos. Además, los resultados obtenidos muestran que los estilos de crianza no influyen de forma determinante en la elección de la alimentación en la etapa universitaria, a excepción del consumo alimentos precocinados.
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