The qualitative study contributes to a better understanding of the challenges of transition to achieve self-management and social development for young adults with spina bifida. Findings in the life stories highlighted issues that necessitate increased advocacy and interventions from professionals within the health and social system.
The purpose of this study was to explore factors associated with inner strength in women following coronary stent placement. A grounded theory design using the "middle range theory of inner strength in women" guided the study. The research question was "How do women experience inner strength during their recovery from coronary stent placement following an acute coronary event?" A sample of 12 women with history of post-myocardial infarction cardiac stent placement completed semistructured interviews. Categories of data emerged to include "changing patterns of fear" and stages of "living a new normal." Data analysis resulted in themes consistent with previous research of inner strength in women. The results provide a theory-based foundation for critical care practice interventions to promote the health of women experiencing a life-threatening infarction and a stent placement. Nursing interventions extending into rehabilitation can enhance the quality of life in women living with coronary artery disease as a chronic condition.
Purpose
This article focuses on the transition to adult health care in youth with spina bifida (SB) from the perspective of theory, measurement, and interventions.
Methods
The purpose of this article is to discuss (a) a theory of linkages between the transfer of medical responsibility from parent to child and the transition from pediatric to adult health care, as mediated by transition readiness; (b) measurement issues in the study of self‐management and the transition to adult health care; and (c) U.S.‐based and international interventions focused on the transition to adult health care in young adults with SB.
Findings
Individuals with SB must adhere to a complex multicomponent treatment regimen while at the same time managing a unique array of cognitive and psychosocial challenges and comorbidities that hinder self‐management, medical adherence, and the transition to adult health care. Moreover, such youth endure multiple transitions to adult health care (e.g., in the areas of urology, orthopedics, neurosurgery, and primary care) that may unfold across different time frames. Finally, three transition‐related constructs need to be assessed, namely, transition readiness, transition completion, and transition success.
Conclusions
SB provides an important exemplar that highlights the complexities of conducting research on the transition to adult health care in youth with chronic health conditions. Many transition trajectories are possible, depending on the functioning level of the child and a host of other factors. Also, no single transition pathway is optimal for all patients with SB.
Clinical Relevance
The success of the process by which a child with SB transitions from pediatric to adult health care can have life‐sustaining implications for the patient.
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