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3Introduction: Depression can be a serious problem in young adult students. There is a need to implement and monitor prevention interventions for these students. Emotion-regulating improvisational music therapy (EIMT) was developed to prevent depression. The purpose of this study was to evaluate the feasibility of EIMT for use in practice for young adult students with depressive symptoms in a university context. Method: A process evaluation was conducted embedded in a larger research project. Eleven students, three music therapists and five referrers were interviewed. The music therapists also completed evaluation forms. Data were collected concerning client attendance, treatment integrity, musical components used to synchronise, and experiences with EIMT and referral. Results: Client attendance (90%) and treatment integrity were evaluated to be sufficient (therapist adherence 83%; competence 84%). The music therapists used mostly rhythm to synchronise (38 of 99 times). The students and music therapists reported that EIMT and its elements evoked changes in all emotion regulation components. The students reported that synchronisation elicited meaningful experiences of expressing joy, feeling heard, feeling joy and bodily responses of relaxation. The music therapists found the manual useful for applying EIMT. The student counsellors experienced EIMT as an appropriate way to support students due to its preventive character. Discussion: EIMT appears to be a feasible means of evoking changes in emotion regulation components in young adult students with depressive symptoms in a university context. More studies are needed to create a more nuanced and evidence-based understanding of the feasibility of EIMT, processes of change and treatment integrity.
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The transition from adolescence to adulthood is a critical phase for young people living with perinatal HIV, who must navigate typical developmental milestones while managing a chronic illness and facing (fear of) societal stigma. This qualitative study explored the lived experiences of Dutch young adults (aged 20–30) with perinatal HIV, focusing on their transition to adulthood and from pediatric to adult care. Semi-structured interviews were conducted with 11 participants. While the findings are based on a small, self-selected sample and are not intended to be statistically representative, they offer in-depth insight into key challenges during transition. The findings highlight the profound impact of stigma and selective disclosure of HIV-status. Parental support was important but complex, especially when views on disclosure differed. Peer contact could provide a sense of connection, though many did not feel the need for ongoing involvement. Participants described challenges in social and professional contexts. Experiences with the transition to adult care varied, with more recent transfers being more positive. Valued key elements of transitional care included support from nurse specialists, meeting the adult provider beforehand, and a warm welcome in adult care. Despite stable medical management, the psychological burden of stigma and fear of disclosure remained significant. These findings underscore the need for tailored transition programs addressing medical, psychosocial and emotional needs, including psychological support, structured attention to family dynamics, pre-transfer meetings with adult providers, and peer support.
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There is a lack of service provision for young adult caregivers (18-25 years of age). This study aims to describe the expectations and prospects of young adult caregivers regarding support from health and education professionals. A qualitative focus group design was used. Twenty-five young Dutch adults (aged 18-25 years) who were growing up with a chronically ill family member participated in one of seven focus groups. Qualitative inductive analysis was used to identify codes and main themes. Two overarching themes with five sub-themes emerged from the focus group discussions. The overarching themes are: the 'process of approaching young adults' and the 'types of support these young adults require'. The process of approaching young adults contains the sub-themes: 'recognition, attention, and listening', 'open-minded attitude', 'reliability', and 'respecting autonomy'. The types of support this group requires contains the sub-themes: 'information and emotional support'. Health and education professionals should first and foremost be aware and listen to young adult caregivers, pay attention to them, have an open-minded attitude, respect their autonomy, and have the knowledge to provide them with information and emotional support. Further research could yield comprehensive insights into how professionals can meet these requirements and whether these results apply to male young adult caregivers and young adult caregivers not enrolled in a healthcare-related study program.
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In our center we encounter serious problems with a number young adult (18- 25yrs) renal transplant recipients that are non-compliant to the medication regime. This could well be one of the reasons for the significantly worse unadjusted 10 years kidney graft survival in this patient group compared to that in recipients > 25 years: 47.2% versus 64.0%. This paper focuses on the attitudes and behavior of young adults towards compliance with the immunosuppressive drugs.
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Introduction The process of transition from paediatric to adult care is a crucial step towards self-management of healthcare for young adults with chronic health conditions. In the Netherlands, the On Your Own Feet program offers an extensive framework for supporting optimal transition. In this national study, we aimed to evaluate the transition experiences of young adults with perinatal HIV who transferred from a paediatric to an adult HIV treatment centre. Methods Participants who transferred to adult care less than six years ago received questionnaires on transition experiences, the validated On Your Own Feet – Transition Experiences Scale (OYOF-TES), and demographics. Demographic and healthcare-related variables were collected from patients’ medical files. We explored correlations between OYOF-TES scores and other variables. Results Of 44 participants, 29 responded (65.1 %). Their median age was 20 (IQR 19–23). Overall, high scores were found on the subscales ‘Reception in adult care’ (median 4.8, IQR 4.0–5.0), ‘Alliance paediatric and adult care’ (median 4.0, IQR 3.4–4.4), and ‘Transfer readiness’ (median 4.2, IQR 3.8–4.8). The lowest scores were found in the subscales ‘Preparation for transfer’ (median 3.3, IQR 2.7–4.0) and ‘Youth involvement’ (median 3.5, IQR 2.5–4.5). Higher scores on transition experiences were correlated with younger age and female sex, while lower scores were correlated with those of whom one or both biological parents died during childhood. Conclusion Transition experiences in our population were positive. Younger participants felt better prepared for the transfer, which indicates that transition is increasingly becoming a joint effort between young adults and healthcare professionals and that pathways accustomed to individual needs improve the transition experience for young adults with perinatal HIV.
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Background Young adulthood is a challenging period for people with diabetes mellitus type 1 (T1DM) as they are facing multiple life transitions while managing a demanding disease. This poses a risk for impaired health-related quality of life (HRQOL). We assessed HRQOL in a cohort of young adults with T1DM in the Netherlands, and compared outcomes with those of Dutch norm groups of healthy young adults and young adults with a chronic disease. Methods We analyzed data collected in a larger evaluation study on transitional care for young adults with T1DM in a nationwide sample in the Netherlands, including twelve participating hospitals. These data had been obtained from online questionnaires completed by young adults with T1DM after they had transferred to adult care. HRQOL was self-reported with the Pediatric Quality of Life Inventory for young adults (PedsQL-YA). Results One hundred and sixty-five young adults with T1DM participated (44.2% response); and they scored significantly worse than did healthy peers on all domains of HRQOL, except social functioning. Particularly, functioning at school or work was worse than that of the norm group. The study group’s HRQOL-scores were comparable to norm scores of young adults with chronic diseases, although the physical and social functioning of young people with T1DM was better. One quarter (26.1%) of all young adults with T1DM reported fatigue. Conclusions During transition to adulthood, young adults with T1DM struggle to maintain a balance between the demands of managing a disease and their life. Many of them encounter problems at work or school, and suffer from fatigue. These findings underscore the need to regularly assess HRQOL, and to discuss work- and education-related issues in clinical practice.
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Many children with profound intellectual and multiple disabilities (PIMD) now reach adulthood. The aim of this study was to elicit parents’ experiences with the transfer from pediatric to adult medical care. A convenience sample of 131 Dutch parents of young people with PIMD (16–26 years) completed a web-based questionnaire. Twenty-two percent of the young persons were still in pediatric care; 22% of the others had no care coordinator, although their health needs were the same. Parents valued the care provided by the pediatrician, and wished to see it continued. They were critical about how they had been prepared for transfer to adult care. Parents provided suggestions to improve transitional care, such as early start, information provision, and a joint consultation between pediatric and adult care. DOI: 10.1352/1934-9556-51.3.176
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This scoping review provides an overview of the impact of growing up with a chronically ill family member on young adults (18-25 years old), and their specific needs. Young adults represent an important life stage involving a transition to adulthood, during which individuals' family situations can affect their future. We searched relevant studies following the guideline of Arskey and O'Mailley's methodological framework and the PRISMA statement guidelines for scoping reviews in PubMed, PsychInfo and reference lists to identify articles for inclusion. Studies from 2005 to 2020 were included in this review. Of the 12 studies, six qualitative studies, five quantitative studies and one mixed method study were included. Eight studies discussed the impact, including consequences at a physical and mental level, at their personal development and future perspectives, but also positive effects, such as being capable of organizing their lives. Four studies discussed the needs of young adult carers, including emotional needs, support needs with regard to stimulating autonomy (arising from internal conflicts) and developing their own identity, and the concerned attitude of involved professionals. An unambiguous definition of the target group and further well-designed research are needed to improve clarity about the role of support, so that future professionals can adequately address the needs and wishes of young adults who grow up with an ill family member.
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Introduction: Health-related quality of life (HRQoL) in adult people with HIV is lower than that of the general population. Previously, no differences were detected in HRQoL of Dutch children with perinatal HIV (PHIV) compared with norm groups. In this study, we compared HRQoL of PHIV young adults (PHIV-YA, aged 18–30 years) with 2 norm groups, the healthy Dutch YA population and YA with various chronic conditions. Methods: Participants received questionnaires on HRQoL, adherence, and demographics. Additional social and health care-related variables were collected from patients' medical files. We explored correlations between HRQoL and demographic characteristics. Effect sizes (ES, Hedges 'g with confidence intervals) were calculated to quantify the difference between PHIV-YA and norm groups. Results: Of 81 participants, 53 filled out the questionnaires. Compared with the healthy Dutch YA population, PHIV-YA aged 18–30 years had significantly lower HRQoL scores in the school/work subscale. PHIV-YA aged 26–30 years had significantly lower total, physical and psychosocial HRQoL scores as well. Participants in the older age category had lower HRQoL scores throughout all subcategories as compared with the younger age group. For PHIV-YA aged 18–25 years, lower scores on the school/work subscale were correlated with substance use and being born outside the Netherlands. Conclusions: PHIV-YA had low HRQoL scores in school/work functioning compared with the healthy Dutch YA population. The circumstances driving these outcomes are likely to be multidimensional, including HIV infection, social background, and challenges in growing up with a chronic condition.
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Background and purpose A generic, structured transitional care pathway dedicated to patients in the academic setting is currently lacking. This study aimed to identify the key factors influencing a successful transition from pediatric to adult care for adolescents and young adults and to develop a generic, hospital-wide Blueprint for transitional care in such settings, using intervention mapping as the guiding method Method A combination of literature review, focus groups, and semi-structured interviews was carried out, leading to a logical model of the problem in a situation where transition is poorly managed or when transitional care is absent in the academic setting. This model helped outline the behavioral objectives, determinants, and change goals, which were then transformed into practical applications. Key interventions were identified and integrated into a coherent Blueprint for transitioning from pediatric to adult healthcare. A Transition Programme Development Working Group and a Transition Patient Council have been involved in every step of the Blueprint's development. Results The Blueprint for structured transitional care promotes pediatric and adult collaboration through eight key interventions, including two joint consultations, one double-time consultation, and appointing a transition coordinator who annually prepares and updates individual transition plans. Conclusion Intervention mapping helped designing a structured, personalized Blueprint as an evidence based example for transitioning patients with rare and chronic conditions in an academic hospital. The Blueprint described in this article is currently being implemented and evaluated across six pilot departments. If proven effective, it can be disseminated more widely.
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