Online Focus Groups with Parents And Adolescents with Heart Transplants: Challenges and Opportunities.

Pediatric heart transplant recipients are scarce and widely dispersed. Previous studies of adolescents in this population were limited to small homogenous samples. Although online focus groups are an emerging data collection method, its use in pediatric populations has not been fully realized. The purpose of this study was to explore the feasibility of using online focus groups with pediatric populations. Adolescents (aged 13 to 21 years) at least 6 months post-heart transplant and their parents were recruited from two children's hospitals. An online discussion forum (iTracks) was used to conduct asynchronous focus groups with separate parent and adolescent groups. Six parents and four adolescents participated in the discussions. iTracks provided a framework for conducting focus groups in dispersed populations. Access to the discussion transcripts enhanced data analysis and eliminated transcription costs. Overall, online discussion forums were a feasible and cost-effective option to conduct online focus groups in this pediatric population.

Transition to self-management after pediatric heart transplant.

CONTEXT: Little is known about adolescent transition to self-management after heart transplant. This gap in knowledge is critically important because the consequences of poor self-management are costly and life-threatening, often resulting in nonadherence, rejection, repeated hospitalizations, and poor quality of life. OBJECTIVE: To explore how adolescents and parents perceive their roles in self-management, and how adolescents integrate self-management into their daily lives and navigate the transition from parent-dominated to self-management. DESIGN: Qualitative descriptive design, using online focus groups. SETTING: Online focus groups using itracks, an online qualitative software program. PARTICIPANTS: A purposive sample of 4 adolescents, 13 to 21 years old, who were at least 6 months posttransplant, and of 6 parents of adolescent heart transplant recipients. RESULTS: Several parallel themes emerged from the parent and adolescent online focus groups. Managing medications was the predominant theme for both parents and adolescents. For the remaining themes, parents and adolescents expressed similar ideas that were categorized into parallel themes, which included staying on top of things/becoming independent, letting them be normal/being normal, and worries and stressors. CONCLUSIONS: The transition to self-management after heart transplant was a clear goal for both parents and adolescents. The transition is a shared responsibility between parents and adolescents with a gradual shift from parent-directed to self-management. The process of transition was not linear or smooth, and in several instances, parents described efforts to transfer responsibility to the adolescent only to take it back when complications arose. Additional research with a larger sample is needed in order to fully understand adolescent heart transplant recipients' transition to self-management.

Effects of study abroad on cultural and interprofessional competencies.

BACKGROUND: Healthcare professionals require personal and professional skills that include the ability to provide care to diverse populations and to collaborate across disciplines to deliver culturally sensitive quality care. International learning experiences can provide opportunities for students in health professions to work and learn collaboratively across disciplines. PURPOSE: The purpose of this research was to measure the effect of a short-term Costa Rican study abroad experience on interprofessional and cultural competencies of occupational therapy (OT) and nursing students. METHODS: This mixed methods study was approved by the university Institutional Review Board and consisted of four training sessions and a 10-day study abroad experience. Ten OT doctoral students and three undergraduate nursing students participated in the research. While abroad, students engaged in fieldwork activities, tours, observations, and dialogue with local residents, healthcare professionals, and researchers. Students completed a demographic questionnaire and pre- and post-surveys - the Cultural Competency Questionnaire (CCQ) and the Entry Level Interprofessional Questionnaire (ELIQ) - and reflection journals. RESULTS: Results of the CCQ subscales showed statistically significant improvement in knowledge (p < .001) and skills (p < .001). The ELIQ Likert scale results suggest statistically significant improvement in Communication and Teamwork (p < .05). The qualitative data further support the value of study abroad experiences for level one fieldwork in an occupational therapy clinical doctorate program for developing cultural competencies in OT and nursing students. CONCLUSION: Results confirm that a short-term study abroad experience can increase acquisition of cultural competencies. Improved interprofessional communication and teamwork was also supported by student comments.

Stimulant medications: a trade-off? The lived experience of adolescents with ADHD.

PURPOSE: The purpose of this study was to gain information and insight about prescription stimulant medication use among children and adolescents with attention deficit-hyperactivity disorder (ADHD) across developmental stages. DESIGN AND METHODS: Investigators conducted semistructured qualitative interviews with 15 college students with ADHD. Follow-up interviews confirmed and validated information obtained during initial interviews. RESULTS: Qualitative data analysis resulted in three global categories related to the use of prescription stimulant medication from childhood to late adolescence: (a) the early years, (b) "the trade-off," and (c) stimulant medications in college. PRACTICE IMPLICATIONS: Increased education about prescription stimulant medications and closer management is needed to reduce side effects and minimize the risks of misuse.

The relationship between behavioral inhibition and time perception in children.

PURPOSE: To test one component of Barkley's (1997) model of executive functions by examining the relationship between behavioral inhibition and time perception in children. METHOD: Correlation analysis was used to determine the relationships between measures of behavioral inhibition and time perception for the entire sample, and for boys (n = 34) and girls (n = 26) separately. FINDINGS: For both parent and child measures, behavioral inhibition and time perception scores were correlated for the total group and for girls. Child measure of behavioral inhibition and time perception were not correlated for boys. CONCLUSIONS: The findings of this study support Barkley's theory and indicate a relationship between poor behavioral inhibition and poor time perception in children.

Effect of methylphenidate on time perception in children with attention-deficit/hyperactivity disorder.

The effects of methylphenidate (MPH) on performance of a time-production task were studied in 17 children with attention-deficit/hyperactivity disorder who participated in 1 test session on and 1 off MPH. Participants held a response lever down for at least 10 but no longer than 14 s. Administration of MPH had no effect on the number of correct responses or on the mean duration of lever holds. MPH administration significantly decreased timing response variability, increased holds of 10- to 11-s duration, and decreased lever holds of extremely short durations. These results indicate that administration of MPH resulted in more precise timing performance without changing the mean duration of lever holds, suggesting an enhancement in working memory.

Time perception differences in children with and without ADHD.

INTRODUCTION: The purpose of this study was to compare time perception in children with and without attention deficit hyperactivity disorder (ADHD) with use of a time reproduction task. METHODS: The sample consisted of 60 children (30 with ADHD and 30 without ADHD) ranging in age from 9 to 12 years. Children were asked to watch a light, verbally estimate how long the light was illuminated, and hold a lever in a depressed position for the same amount of time they thought the light was on. Each child participated in 16 trials of 3, 6, 12, or 24 seconds for a total of 64 trials. RESULTS: Children with ADHD had significantly greater absolute discrepancy scores on the time reproduction task (F(1,58) = 10.878; P <.01) than did children in the control group. In addition, children with ADHD had greater increases in absolute discrepancy scores across time intervals (F(3,174) = 82.08; P <.01). DISCUSSION: Poor time perception affects the performance of social skills and other adaptive behaviors such as health consciousness and concerns for safety. The findings of this study indicate that children with ADHD have impaired time perception compared with children who do not have ADHD.