scholarly journals Patient, caregiver, and provider perceptions of pain and pain management in adolescents and young adults with bleeding disorders

Haemophilia ◽  
2017 ◽  
Vol 23 (6) ◽  
pp. 852-860 ◽  
Author(s):  
Angela Lambing ◽  
Cynthia D. Nichols ◽  
James E. Munn ◽  
Terry L. Anderson ◽  
Bartholomew J. Tortella ◽  
...  
Keyword(s):  
Young Adults ◽  
Pain Management ◽  
Adolescents And Young Adults ◽  
Bleeding Disorders ◽  
Provider Perceptions

scholarly journals Adolescents and Young Adults with Cancer Using a Symptom Heuristics App: Provider Perceptions and Actions

2020 ◽  
Vol 9 (5) ◽  
pp. 579-585
Author(s):  
Catherine Fiona Macpherson ◽  
Kristin Stegenga ◽  
Jeanne M. Erickson ◽  
Lauri A. Linder ◽  
Amy R. Newman ◽  
...  
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Provider Perceptions

Outcome of Transitioning Pediatric Patients with Sickle Cell Disease to Adult Programs.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3743-3743 ◽  
Author(s):  
Samir K. Ballas ◽  
Carlton Dampier
Keyword(s):  
Chronic Pain ◽  
Young Adults ◽  
Pain Management ◽  
Sickle Cell Disease ◽  
Medical Care ◽  
Sickle Cell ◽  
Adolescents And Young Adults ◽  
Cell Disease ◽  
Adult Care ◽  
Female Ratio

The transition of medical care of patients with sickle cell disease (SCD) from pediatric to adult providers represents a milestone in their lives. Major concerns among adolescents and young adults about transition include taking responsibility for self, making own decisions, cost of medical care, fear of suboptimal pain management, and reluctance to leave known providers. In this study we present our experience in the process of transition to adult care and its outcome over the last ten years. Adolescents and young adults were given information about the nature of medical care provided by adult internists and hematologists. The sickle cell programs available in the city were described. Moreover, site visits to the hospitals where adult care was to be provided were arranged. During these visits, adolescents and young adults had the chance to meet the hematologist and other potential providers and ask questions, visit the emergency room, the clinic, and the sickle day unit if applicable. Patients were empowered to choose the program to which they wished to be transitioned. During the last 10 years, 90 adolescents and young adults (See Table) with SCD (Sickle Cell Anemia [SS], Hemoglobin SC Disease, and Sickle Thalassemia [ST]) were transitioned to the adult sickle cell program of Thomas Jefferson University. Age of transition varied between 18 and 25 years. Eighteen patients (20%) died. Age at death was 24.9 ± 2.95 years and the male/female ratio was 10:8. Complications of sickle cell disease after transition included leg ulcers, stroke, avascular necrosis, anxiety, depression, and priapism. Nineteen patients (10 males, 9 females) were employed. Twenty-nine (32%) patients developed chronic pain syndrome and its sequelae. Many patients failed to achieve their childhood goals. The data show that a significant number of patients die within 10 years after transition. The quality of life of survivors is suboptimal and drifts into issues of chronic pain management in the adult environment. Identifying these issues may provide predictors that identify children at risk to have undesirable outcomes after transition. Aggressive management and refining the process of transition should improve the outcome after transition. Distribution of the Transitioned Patients SS SC ST Total Male 31 8 4 43 Female 34 8 5 47 Total 65 16 9 90

scholarly journals Opioid Use in Children

2019 ◽  
Vol 24 (1) ◽  
pp. 72-75
Author(s):  
Kelly L. Matson ◽  
Peter N. Johnson ◽  
Van Tran ◽  
Evan R. Horton ◽  
Jennifer Sterner-Allison ◽  
...  
Keyword(s):  
Young Adults ◽  
Pain Management ◽  
Pediatric Population ◽  
The United States ◽  
Opioid Use Disorder ◽  
Adolescents And Young Adults ◽  
Evidence Based ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Electronic Prescription

Limited guidance on opioid use exists in the pediatric population, causing medication safety concerns for pain management in children and adolescents. Opioid misuse and use disorder continue to greatly affect adolescents and young adults in the United States, furthering the apprehension of their use. Pediatric Pharmacy Advocacy Group (PPAG) recommends pharmacists contribute their knowledge to pain management in children, including the discussion of appropriate use of non-opioid alternatives for pain and when to recommend coprescribing of naloxone. PPAG also supports the review of electronic prescription drug–monitoring programs prior to opioid prescribing and dispensing by both prescribers and pharmacists. Education by pharmacists of children and their families regarding proper administration, storage, and disposal, as well as the awareness of opioid misuse and use disorder among adolescents and young adults, is key to prevention. If opioid use disorder is diagnosed, PPAG encourages improved access among adolescents to evidence-based medications including methadone, buprenorphine, and naltrexone. Furthermore, pharmacists should assist in screening and referral to evidence-based treatment.

Suffering Before The Cure: Evaluation Of Psychological Morbidities In Adolescents and Young Adults With Hematologic Malignancies In Early Survivorship

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 771-771
Author(s):  
Lori S. Muffly ◽  
Fay J Hlubocky ◽  
Joseline Gomez ◽  
Kate Breitenbach ◽  
Mary Lappe ◽  
...  
Keyword(s):  
Young Adults ◽  
Hodgkin Lymphoma ◽  
Median Time ◽  
Traumatic Stress ◽  
Hematologic Malignancies ◽  
Adolescents And Young Adults ◽  
Psychological Burden ◽  
Provider Perceptions ◽  
Psychological Domain ◽  
Anxiety Depression

Abstract Background Adolescents and young adults (AYAs) with cancer face unique psychosocial challenges. Hematologic malignancies account for the greatest frequency of AYA cancers and a growing number of AYA cancer survivors; however, there remains a paucity of studies describing the early and late psychological impact of experiencing a life-threatening blood cancer as an AYA. How oncologists perceive the psychological burden of cancer in AYAs is also unknown; provider under-appreciation may in part contribute to the documented unmet desire for mental health support amongst AYA cancer patients. The aims of this study were therefore to describe the prevalence and severity of psychological morbidities in AYAs with hematologic malignancies, and to examine provider perceptions of psychological morbidity in their AYA patients. Methods Patients ages 15-40 years at diagnosis of acute leukemia, aggressive non-Hodgkin lymphoma, and Hodgkin lymphoma who were undergoing curative intent therapy (on-treatment cohort) or had completed therapy within 2 years and were in remission (early survivor cohort) underwent a one-time semi-structured interview that incorporated validated measures of anxiety (State Anxiety Inventory [SAI]), depression (Center for Epidemiological Studies Depression Scale [CES-D]), and post-traumatic stress (PTSD Checklist [PCL-C]). Frequencies of patient anxiety, depression, traumatic stress, and composite distress (impairment in ≥1 psychological domain) were determined using published instrument cut-points, and stratified by cohort (on-treatment versus early survivor). Following patient enrollment, providers completed a survey evaluating their perception of the subject’s anxiety, depression, and traumatic stress. Spearman correlation coefficients evaluated correlations between provider perceptions and AYA scores on the survey measures. Results Between October 2012 and May 2013, 61 (26 on-treatment, 35 early survivors) of 77 eligible AYAs completed the study and are evaluable. Median age at diagnosis was 26 years. 64% were male; 59% non-Hispanic white, 15% Hispanic, and 20% African American. 52% and 48% had lymphoma or leukemia, respectively. Median time from diagnosis to study interview was 13 months (range, 1-102). On-treatment versus early survivor cohort demographics differed only in median time from diagnosis to interview (5.4 months versus 13.6 months, p= .009). Of the 61 evaluable patients, 23% met criteria for anxiety, 28% for depression, and 13% for traumatic stress; 46% demonstrated PTSD symptomatology. 36% met criteria for impairment in at least one psychological domain. Psychological impairments were as frequent in the early survivors as the on-treatment cohort. Provider surveys were distributed for the first 30 patients enrolled; 48 surveys were returned for 27 of the 30 patients. Providers were 50% attending physicians, 44% nurses, and 6% fellows; 71% were female. Providers had, on average, 10-20 interactions with the patient. Provider perceptions of their AYA patient’s psychological morbidities varied substantially between providers, and did not significantly correlate with results obtained via patient surveys (anxiety: r=.11, p= .57; depression: r=.13, p= .53; traumatic stress: r=.004, p= .98). Conclusions Many AYAs with hematologic malignancies experience substantial psychological morbidities both while undergoing therapy as well as during the first two years following treatment completion, with over one-third of patients meeting criteria for anxiety, depression, or traumatic stress. This psychological burden does not appear to be accurately appreciated by their oncology providers, indicating a need for increased awareness among the hematology/oncology community. Additional studies will explore the long-term implications of these findings, as well as novel interventions aimed at reducing the psychological burden for AYAs with hematologic malignancies. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Supporting Adolescents and Young Adults with Cancer: Oncology Provider Perceptions of Adolescent and Young Adult Unmet Needs

2017 ◽  
Vol 6 (4) ◽  
pp. 519-523 ◽  
Author(s):  
Anne C. Kirchhoff ◽  
Brynn Fowler ◽  
Echo L. Warner ◽  
Samantha T. Pannier ◽  
Douglas Fair ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Unmet Needs ◽  
Adolescents And Young Adults ◽  
Adolescent And Young Adult ◽  
Provider Perceptions

scholarly journals Prevalence of Bleeding Symptoms among Adolescents and Young Adults in the Capital City of Saudi Arabia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tarek Owaidah ◽  
Mahasen Saleh ◽  
Hazzah Alzahrani ◽  
Mahmood Abu-Riash ◽  
Ali Al Zahrani ◽  
...  
Keyword(s):  
Young Adults ◽  
Hemophilia A ◽  
Capital City ◽  
Adolescents And Young Adults ◽  
Sample Population ◽  
Bleeding Disorders ◽  
Severe Morbidity ◽  
Riyadh City ◽  
Bleeding Symptom ◽  
First Time

Background.Bleeding disorders vary in prevalence. While some are rare, some can be common in both sexes. Most bleeding disorders manifest as chronic bleeding tendencies or as an increase in bleeding during surgical procedures or trauma. The consequences of bleeding can be as simple as iron deficiency or catastrophic, resulting in severe morbidity and mortality. Bleeding disorders typically affect both sexes except hemophilia A and B, which mainly affects males.Method.We conducted a questionnaire-based survey among adolescents and young adults (1901[49%]boys, 1980[51%]girls) in Riyadh city regarding bleeding symptoms. Of these, 1849 (47.6%) responded “Yes/Positive” for at least one question about the bleeding symptoms.Results.The most common bleeding symptom was epistaxis (19.7% of the sample population) detected in Phase I of the study. A tandem survey was conducted among 525 adolescents who had responded “Yes/Positive” to any one of the questions inquiring about bleeding symptoms.Conclusion.In this study, we report for the first time the prevalence of bleeding symptoms in a representative sample of Saudi adolescents and young adults.

scholarly journals Provider perceptions’ of a patient navigator for adolescents and young adults with cancer

2019 ◽  
Vol 27 (11) ◽  
pp. 4091-4098
Author(s):  
Kayla N. LaRosa ◽  
Marilyn Stern ◽  
Courtney Lynn ◽  
Janella Hudson ◽  
Damon R. Reed ◽  
...  
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Patient Navigator ◽  
Provider Perceptions

scholarly journals Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

2017 ◽  
Vol Volume 10 ◽  
pp. 787-795 ◽  
Author(s):  
Kathy A Sheehy ◽  
Caroline Lippold ◽  
Amy L Rice ◽  
Raissa Nobrega ◽  
Julia C Finkel ◽  
...  
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Pain Management ◽  
Adolescents And Young Adults ◽  
Hospitalized Children ◽  
Single Center
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