Patient-provider communication in nephrology care for adolescents and young adults

Coburn, Shayna S.; Eakin, Michelle N.; Roter, Debra; Pruette, Cozumel S.; Brady, Tammy M.; Mendley, Susan R.; Tuchman, Shamir; Fivush, Barbara A.; Riekert, Kristin A.

doi:10.1016/j.pec.2017.03.026

Cited by 13 publications

(11 citation statements)

References 33 publications

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“…64,66 Furthermore, collaborations with providers and the healthcare system can significantly decrease barriers that patients and caregivers experience in transition readiness. Increased participation of youth in clinic visits as they get older indicates an appropriate shift in health-information sharing responsibilities 67 and can lead to higher success with transition readiness. 68 In fact, ability to foster connections with healthcare providers and elicit support around transition needs, rather than complete autonomy, is critical in building resilience in transition-age patients.…”

Section: Risk and Resilience Factorsmentioning

confidence: 99%

Psychological functioning and psychosocial issues in pediatric kidney transplant recipients

Amatya

Monnin

Christofferson

2020

Pediatric Transplantation

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Research demonstrates that psychological factors are important for positive transplant outcomes, though there is little literature that synthesizes these factors in a comprehensive model among pediatric kidney transplant patients. This review analyzes psychological and psychosocial factors related to medical outcomes and overall well‐being post‐transplant by utilizing the PPPHM and referencing the existing literature on risk and resilience. Pediatric kidney transplant recipients are more susceptible to mental health concerns such as depression, anxiety, and ADHD, as well as developmental and neurocognitive delays, compared to healthy peers. Complex medical care and psychosocial needs for patients have implications for family functioning, parental and sibling mental health, and youth readiness to transition to adult care. It is important to carefully monitor patient functioning with empirically validated tools and to intervene in a multidisciplinary setting as early as possible to identify patients at risk and reduce potential negative impact. Psychologists are uniquely trained to assess and address these issues and are a valuable component of multidisciplinary, culturally competent care. While research in this expansive field is improving, more data are needed to establish gold standard approaches to mental health and psychosocial care in this population.

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Section: Risk and Resilience Factorsmentioning

confidence: 99%

Psychological functioning and psychosocial issues in pediatric kidney transplant recipients

Amatya

Monnin

Christofferson

2020

Pediatric Transplantation

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“…The CHAT study examined shifts in communication between patients, family members, and providers during routine clinic visits, and found that caregivers spoke more than adolescents and young adults and shifts in communication occurred at different time points, with caregiver communication decreasing in middle adolescence while adolescent/young adult communication did not increase until young adulthood. This mismatch raises concern for a potential lapse in communication during middle adolescence, which may negatively impact adherence in this vulnerable population 29 …”

Section: Family‐level Factors That Contribute To and Impact Non‐adhermentioning

confidence: 99%

Empowering patients to adhere to their treatment regimens: A multifaceted approach

Pruette

Amaral

2020

Pediatric Transplantation

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It is well‐recognized that adolescence and early adulthood are a high‐risk period for non‐adherence with treatment regimens in solid organ transplant recipients, leading to high rates of rejection and graft loss (Transplantation, 92, 2011, 1237; Pediatr Transplant, 9, 2005, 381; Transplantation, 77, 2004, 769). Preventing medication non‐adherence is the holy grail of transplant adolescent care. If we can determine how best to support our patients in taking their daily medications as prescribed, we can improve long‐term health, reduce need for re‐transplantation, and reduce healthcare costs. In the last few years, several studies have provided us with additional insights into potentially effective interventions and have highlighted existing gaps in knowledge. This article reviews recent literature published over the last 5 years on the topic of adherence in transplant recipients, highlighting insights and opportunities to promote adherence at the individual patient level, family level, healthcare system level, and community level. Above all, the recent work that is highlighted suggests that adherence interventions for prevention and treatment must be multifaceted, individualized, and longitudinal to be effective.

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“… 29 , 32 Also, the ages of patients varied from 8 to 17 years, encompassing a range of developmental stages, during which child participation has been shown to evolve. 44 Selection bias might have limited inclusion of less social physicians or families or those with more strained physician-family relationships. Participants were aware that they were being videotaped, thus leading to the possibility of a Hawthorne effect – that participants did not display their typical behavior due to awareness of observation.…”

Section: Limitationsmentioning

confidence: 99%

A pilot study of observed physician–parent–child communication and child satisfaction in a gastroenterology clinic

Becker¹,

Lin²,

Miller³

2018

PPA

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BackgroundChild participation in pediatric medical visits is low. In this pilot study, we sought to better understand relationships between observed communication and child-reported perceptions of communication in a clinical setting.Materials and methodsFor this cross-sectional observational study, pediatric gastroenterology appointments (n=39) were videotaped and coded to quantify various adult affective (eg, chit-chat, empathy) and facilitative (eg, asking questions, encouraging responses) behaviors toward the child, interference with child participation (eg, interrupting or ignoring child), and child verbal participation. Post-visit surveys assessed child perceptions of having voice in the clinical encounter, ease of understanding, and satisfaction with communication.ResultsParent and provider chit-chat was associated with child-reported ease of understanding. Provider facilitation was positively associated with child participation, but affective communication strategies were not. Physician interference was negatively associated with ease of understanding but positively associated with perception of voice.ConclusionFacilitative communication may improve outcomes by enhancing child participation and thus exchange of medical information, whereas chit-chat appears to positively impact children’s perceptions of communication.

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Patient-provider communication in nephrology care for adolescents and young adults

Abstract: During transition-oriented treatment planning, providers should engage both AYAs and caregivers to avoid potential gaps in communication.

Cited by 13 publications

References 33 publications

Psychological functioning and psychosocial issues in pediatric kidney transplant recipients

Psychological functioning and psychosocial issues in pediatric kidney transplant recipients

Empowering patients to adhere to their treatment regimens: A multifaceted approach

A pilot study of observed physician–parent–child communication and child satisfaction in a gastroenterology clinic

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Patient-provider communication in nephrology care for adolescents and young adults

Abstract: During transition-oriented treatment planning, providers should engage both AYAs and caregivers to avoid potential gaps in communication.

Cited by 13 publications

References 33 publications

Psychological functioning and psychosocial issues in pediatric kidney transplant recipients

Psychological functioning and psychosocial issues in pediatric kidney transplant recipients

Empowering patients to adhere to their treatment regimens: A multifaceted approach

A pilot study of observed physician&ndash;parent&ndash;child communication and child satisfaction in a gastroenterology clinic

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A pilot study of observed physician–parent–child communication and child satisfaction in a gastroenterology clinic