Background
About half of adult Irritable Bowel Syndrome (IBS) patients report symptoms with eating and disordered eating habits. However little is known about eating in adolescent IBS patients, a common age at which eating disorders develop. The aim of the study was to investigate if adolescents with IBS are more likely than healthy controls to experience eating associated symptoms, report disordered eating patterns, and show differences in diet composition.
Methods
A total of 99 adolescents between 15–21 years-of-age participated (n=48 IBS; n=51 healthy controls (HC)). All subjects completed three 24-hour dietary recalls and questionnaires on eating associated symptoms (EAS) and disordered eating.
Key Results
IBS patients were more likely to report eating associated symptoms than HC (91.7% vs 28%, p<0.001). Eating associated symptoms were controlled by avoiding the offending food (97.7%), not eating any food even when hungry (43.2%), or vomiting after eating (13.6%). Compared to HC, IBS patients reported reduced daily intake of overall calories (1828 vs 2139; p<.05), fat (65.4gr vs 81.4 gr, p<.05) and lactose (8.2gr vs 12.8gr, p<.01). No differences were found between IBS and HC in screening for disordered eating patterns or BMI, though IBS patients endorsed using potentially unhealthy eating behaviors in an attempt to control symptoms.
Conclusions & Inferences
Eating associated symptoms are very common in adolescents with IBS and associated with changes in eating behaviors and dietary composition. They do not appear to change BMI and risk for eating disorders. More research is needed to guide adolescents with IBS in making appropriate dietary changes to control eating associated symptoms.
Interventions for improving adherence in adolescents with IBD should address disease, individual, and family factors with special attention given to adolescents who have been diagnosed longer.
With improved health care, increasing numbers of children and adolescents with chronic illness and disability now live into adulthood. With this change, the health care community needs to address problems related to the transition from parents caring for their young children's needs to increasing health care responsibility being required of adolescents and young adults (AYA). The current article presents a conceptualization of relevant research related to the transition of health care responsibility from parent to AYA. Using a developmental systems perspective, representative literature on adolescent and dyad-level factors related to the transition of health care responsibility is reviewed to inform clinical practice and future intervention research. To identify the health care tasks that researchers have thus far considered as most important for successful transition, we review assessment measures in this area. The varying levels of agreement on transition of health care behaviors provide an index of current thought by experts in this field. Those behaviors consistently identified as key for successful transition of responsibility from parent to adolescent are outlined to inform future research and clinical practice.
Overall, preliminary support suggests that programmatic psychosocial interventions for reducing physical symptoms and improving coping may be beneficial for adolescents with IBD and their families.
This study aimed to identify prospective predictors of health-related quality of life (HRQOL) for adolescent solid organ (kidney, liver, heart, lung) transplant recipients. Methods Data regarding demographics, individual/transplant characteristics, and environmental characteristics were gathered from 66 adolescent transplant recipients and their families at baseline and used to predict the physical functioning, mental health, and general health perceptions domains of HRQOL 18 months later. Results Baseline levels of HRQOL explained the greatest amount of variance in levels of HRQOL at follow-up; however, specific demographic (i.e., income), individual/transplant (i.e., adherence, frequency of rescheduled clinic appointments, and presence of a rejection episode), and environmental factors (i.e., family conflict) contributed to the variance in HRQOL domains beyond baseline levels. Conclusions This study identified certain modifiable individual and environmental factors and non-modifiable risk factors associated with lower future HRQOL. Transplant centers should begin screening and addressing these factors to potentially improve HRQOL.
Sixty young adult survivors of a serious childhood illness completed quantitative and qualitative measures assessing the relationship between specific disease and distress factors and posttraumatic growth (PTG). Individuals who had recovered from their illness reported greater growth than those who were currently experiencing their illness. The regression model accounted for 47% of the variance in PTG, with perceived severity, illness status, and posttraumatic stress symptoms emerging as significant predictors. Qualitative analyses identified salient positive and negative factors associated with having had an illness, such as a positive shift in perspective and frequent medical requirements. Being past the daily demands of illness management may allow for greater PTG. Realization of positive aspects of having had an illness may require prompting.
Data indicate that the overall proportions of families experiencing "universal", "targeted", and "clinical" levels of familial distress may be constant from the time of diagnosis into survivorship care. Overall, the PAT2.0 demonstrated strong psychometric properties among survivors of pediatric cancer and shows promise as a psychosocial screening measure to facilitate more effective family support in survivorship care.
OBJECTIVE : To evaluate levels of executive functioning in a sample of adolescent and young adult (AYA) transplant recipients, and to examine executive functioning in association with barriers to adherence and medication nonadherence. METHOD : In all, 41 caregivers and 39 AYAs were administered self- and proxy-report measures. RESULTS : AYA transplant recipients have significant impairments in executive functioning abilities. Greater dysfunction in specific domains of executive functioning was significantly associated with more barriers to adherence and greater medication nonadherence. CONCLUSION : AYA transplant recipients are at increased risk for executive dysfunction. The assessment of executive functioning abilities may guide intervention efforts designed to decrease barriers to adherence and promote developmentally appropriate levels of treatment responsibility.
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