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3In 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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Misleading graphs can give readers a distorted view of the underlying data. We want to know how to most effectively correct misleading graphs and if it matters whether a correction uses the full-design of the original or a clean design with all embellishment and colors removed. We focus on vocationally educated young adults, a group that is vulnerable to misinformation and has so far been underrepresented in research. We use a mixed-method approach with a qualitative think-aloud task (n=10, data collected in April 2023) and a quantitative survey (n=130, data collected between July and October 2023). The think-aloud task showed that vocational students use a combination of calculating and estimating to process graphs, which contradicts existing literature, and that their perception is heavily influenced by context. The survey showed that graph corrections work in reducing misleading effects and also have a learning effect such that students are less misled by new misleading graphs of the same type. There was no difference between full-design and clean design corrections. These results imply that vocationally educated young adults can benefit from seeing corrections of misleading graphs.
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Communicative participation is the primary outcome of speech and language therapy for people with communication disorders. However, there are no instruments that measure communicative participation from the perspective of adolescents and young adults. Moreover, little research has been conducted in which adolescents and young adults with various communication problems were asked about relevant participation situations in which they need to communicate. Before a new measurement instrument can be developed, it is necessary to explore adolescents’ and young adults’ views on their communicative participation.
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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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OBJECTIVE: To document the development of work participation in young adults with cerebral palsy who are transitioning into adulthood, examine associated characteristics, and investigate work limitations and barriers among employed persons.
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Communicative participation is the most important outcome of speech and language therapy, but there are no measurement instruments for children, adolescents, and young adults. This paper describes the development of MyCommunication-Youth: an item bank to measure self-reported communicative participation in children, adolescents and young adults with various communication disorders.
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Introduction: Diabetes distress (DD) is a serious problem in many people with diabetes and is associated with unfavorable clinical and psychosocial outcomes in children and adults. Little is known about DD in young adults (YAs) with type 1 diabetes mellitus (T1DM) who transferred to adult care. This study aimed to explore the differences between YAs with/without DD regarding transfer experiences, self-management and health-related quality of life (HRQoL). Research design and methods: Cross-sectional online questionnaire completed by YAs with T1DM after transfer. DD was measured with the short form Problem Areas in Diabetes scale. Descriptive analyses were followed by t-tests and χ2 tests to explore differences between the groups with/without DD. Effect sizes were calculated. Results: Of 164 respondents with mean age 22.7 (±1.56) years, 60.7% was female. The total sample scored low on DD (6.52±4.67; range: 0–17), but 57 (34.8%) had a score ≥8, indicating DD. YAs with DD felt less ready to transfer to adult care than those without DD and scored lower on alliance between pediatric and adult care and reception in adult care. They also reported poorer selfmanagement skills and lower HRQoL in all domains of functioning. Conclusions: More than one-third YAs experienced DD after transfer; this was associated with less favorable transition, self-management and psychosocial outcomes. Transfer in care seems to be a source of DD. Systematic screening on DD and attention for YAs’ worries is recommended in both pediatric and adult care.
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Purpose: Employment of young adults with chronic physical conditions entering the labor market after finishing post-secondary education remains behind compared to typically developing peers. The aim of this study is to evaluate changes in their paid employment levels after following a vocational rehabilitation intervention (‘At Work’). Materials and methods: Participants aged between 16 and 27 years (n = 90) were recruited via rehabilitation physicians and a jobcoach agency and participated in a vocational rehabilitation program. Cochran’s Q and McNemar tests served to test the development of intervention participants’ paid employment over time. Chi-square tests were used to compare intervention participants’ paid employment level with national reference data selected on age and having a self-reported chronic physical condition. Results: Paid employment level of the intervention cohort significantly increased from 10.0% at baseline to 42.4% at 2-years follow-up (p < 0.001). At 2-years follow-up, their employment rates approached the employment rates of national reference data (42.4% versus 52.9%, p = 0.17). Conclusion: Starting from a disadvantaged position, the paid employment rate of the intervention cohort substantially increased over time, approaching the employment rate of reference data. ‘At Work’ seems to be appropriate for supporting this specific group who face obstacles to enter the labor market, to find competitive employment. IMPLICATIONS FOR REHABILITATION - ‘At Work’ is a vocational rehabilitation intervention for young adults with chronic physical conditions who experience problems with finding and maintaining competitive employment after finishing post-secondary education. - The ‘At Work’ intervention entails a combination of group sessions and individual coaching sessions based on the supported employment methodology. - Paid employment rates of the intervention cohort substantially increased on the short- and long term, and approached employment rates of reference data of persons with chronic physical conditions. - The ‘At Work’ intervention seems appropriate to support young adults with chronic physical conditions who experience barriers for work participation, to enter the labor market and find competitive and sustainable employment.
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High consumption of animal-source foods, specifically meat, adversely affects human health and the environment. Dietary habits are shaped at younger ages and a reduction in meat consumption may be facilitated by the life course transitions in early adulthood, but studies are limited. This study among young Dutch adults aimed to describe their perceptions on the influence of life course transitions on meat consumption, barriers and enablers to reduce meat consumption, and strategies for reducing meat consumption. Barriers and enablers were grouped applying the COM-B model that includes capability, opportunity, and motivation. This quantitative cross-sectional study included a representative sample of 1806 young adults from two Dutch consumer panels who completed an online survey. Young adults frequently reported life course transitions, especially those related to moving house, to have decreased their meat consumption. Barriers and enablers to reduce meat consumption were identified for all three factors of the COM-B model. Important barriers included taste, perceived high prices of meat alternatives, and habits. In contrast, important enablers included care for the environment and animal welfare, enjoyment of smaller portions of meat and saving money. However, barriers and enablers largely differed by groups of meat consumption frequency. Self-perceived effective strategies for reducing meat consumption were price reduction of meat alternatives, recipes for vegetarian meals, and more attractive meat alternatives. The findings of this study are relevant for the development of targeted behaviour-change programmes including interventions in the physical and the social environment (like lowering prices and improving the offer of meat alternatives).
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