Transition

过渡
  • 文章类型: Journal Article
    军队是一种男性主导的环境和文化,在这种环境和文化中,退伍军人可能会遇到重大的制度偏见。对于退伍军人来说,过渡可能会令人困惑和孤立。团体计划是过渡支持的重要来源。然而,我们对女性退伍军人的具体团体计划需求知之甚少。
    为了检查向退伍军人女性提供的心理健康和福祉支持小组计划,了解他们的价值,并找到最有帮助的。
    女性退伍军人(所有类型);使用任何设计的实证研究;在1990年至2022年之间发布;专注于过渡问题的小组计划(例如住房,employment,教育,身体健康,心理健康)。
    同行评议的期刊和论文。
    搜索了六个数据库:Medline(通过OvidSP),PsycINFO(通过OvidSP),EmCare(通过OvidSP),CINAHL,Scopus,和ProQuest。
    在35项纳入研究的群体类型中存在显著的异质性,节目内容和结构,会议长度,影响的测量,后续行动,等等。大多数程序是面对面交付的。身体健康和预防性保健是女性退伍军人的重要话题,特别是生殖健康,心理健康,和慢性疼痛。包括身体活动的团体,创意艺术,和替代疗法都有益于女性的身心健康。以优势为基础的女性团体,在妇女的帮助下,为退伍军人提供了安全的空间来分享她们的经历,增强自我表达,agency,和自我授权。这对于经历过军事性创伤的女性尤为重要。
    这项审查发现了针对女性退伍军人的少量但多样化的团体计划。许多计划评估的质量中等或低质量,并且缺乏足够的信息来确定收益是否会随着时间的推移而持续。没有涉及澳大利亚女性退伍军人的研究。尽管有这些担忧,这篇综述强调了几个有用的经验教训,可以帮助改善设计,delivery,以及对女性退伍军人团体项目的评估。
    回顾女性退伍军人过渡心理健康和福祉支持小组计划女性退伍军人学习成为士兵,水手和飞行员在男性主导的环境和文化中,他们的存在是高度可见的,受到挑战,并经常受到制度偏见的影响。对于退伍军人来说,过渡可能会令人困惑和孤立。我们对退伍军人支持她们成功过渡到平民生活的具体需求知之甚少。团体计划是退伍军人过渡和过渡后支持的重要来源。这篇评论的目的是审查现有的文献,心理健康和福祉支持小组计划提供给女退伍军人,以了解什么是女退伍军人的价值,并发现在这些计划的设计和交付最有帮助。该综述包括35项研究;其中33项是在美国进行的。它们具有混合质量和多样化的设计。只有女性群体受到青睐。基于优势的计划,有助于建立情感优势,机构和授权的妇女被他们重视。身体健康和预防保健是退伍军人团体计划的重要主题,促进自我表达和自我授权的创造性艺术和替代疗法也是如此。
    UNASSIGNED: The military is a male-dominated environment and culture in which women veterans can experience significant institutional prejudice. Transition can be confusing and isolating for women veterans. Group programs are an important source of transition support. However, we know little about the specific group program needs of women veterans.
    UNASSIGNED: To examine mental health and well-being support group programs delivered to women veterans, to understand what they value and find most helpful.
    UNASSIGNED: Women military veterans (all types); empirical studies using any design; published between 1990 and 2022; group programs focused on transition issues (such as housing, employment, education, physical health, mental health).
    UNASSIGNED: Peer-reviewed journals and theses.
    UNASSIGNED: Six databases searched: Medline (via Ovid SP), PsycINFO (via Ovid SP), EmCare (via Ovid SP), CINAHL, Scopus, and ProQuest.
    UNASSIGNED: There was significant heterogeneity across 35 included studies in type of groups, program content and structure, length of sessions, measurement of impact, follow-up, and so forth. Most programs were delivered face to face. Physical health and preventative healthcare were important topics for women veterans, particularly reproductive health, mental health, and chronic pain. Groups that included physical activity, creative arts, and alternative therapies were beneficial to women\'s physical and mental health. Strengths-based women-only groups, facilitated by women, that created safe spaces for women veterans to share their experiences, enhanced self-expression, agency, and self-empowerment. This was particularly important for women who had experience military sexual trauma.
    UNASSIGNED: This review found a small but diverse range of group programs available for women veterans. Many program evaluations were of moderate or low quality and lacked sufficient information to determine whether benefits were sustained over time. No studies involved Australian women veterans. Despite these concerns, this review highlighted several useful lessons that could help inform improved design, delivery, and evaluation of group programs for women veterans.
    Review of women veteran transition mental health and well-being support group programsWomen veterans learn to become soldiers, sailors and aviators in a male-dominated environment and culture in which their presence is highly visible, challenged and often subject to institutional prejudice. Transition can be confusing and isolating for women veterans. We know little about the specific needs of women veterans to support them to transition successfully to civilian life. Group programs are an important source of transition and post-transition support for veterans. The aim of this review was to examine the existing literature on mental health and well-being support group programs delivered to women veterans to understand what women veterans value and find most helpful in the design and delivery of such programs. Thirty-five studies were included in this review; 33 of these were conducted in the United States. They were of mixed quality and diverse design. Women only groups were favored. Strengths-based Programs that help to build emotional strengths, agency and empowered women were valued by them. Physical health and preventative healthcare are important topics for group programs for women veterans, as are creative arts and alternative therapies that facilitate self-expression and self-empowerment.
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  • 文章类型: Journal Article
    这项研究旨在研究与家庭机械通气生活的年轻人如何经历从童年到成年的过渡,与日常生活有关。感知健康并过渡到成人专业医疗保健。
    采访了9名年轻人(3名女性和6名男性,年龄在18-31岁之间),并使用现象学解释学对数据进行了初步分析。在实际研究中,数据使用Beck描述的二次分析进行了重新设计.两名受访者进行了侵入性通风,六名进行了非侵入性通风,其中1例接受持续气道正压通气(CPAP)治疗。
    结果分为两个主要类别。第一;走向成年;第二,处理健康和医疗保健联系人的变化。该研究强调了持续的社会关系以及成为社交和身体活跃社区的一部分的重要性。从儿科到成人医疗保健的转变是稳固的,效果很好,但这是一个参与者努力寻找自己声音的过程。
    对于患有HMV的年轻人来说,向成年过渡是一个敏感而具有挑战性的时期,但稳定,亲密关系和组织良好的转移可以使这个群体感到安全,能够找到和使用自己的声音。
    UNASSIGNED: This study aimed to examine how young people living with Home Mechanical Ventilation experience the transition from childhood to young adulthood in relation to everyday life, perceived health and transition into adult professional healthcare.
    UNASSIGNED: Nine young adults (three females and six males aged 18-31) were interviewed, and data was primary analysed using phenomenological hermeneutics. In the actual study, data was reworked using secondary analysis as described by Beck. Two interviewees were ventilated invasively and six non-invasively, and one was treated with continuous positive airway pressure (CPAP).
    UNASSIGNED: The results are presented in two main categories. First; moving towards adulthood; and second, To handle changes in health and healthcare contacts. The study highlights the importance of ongoing social relations and being part of a socializing and physically active community. The transfer from paediatric to adult healthcare was solid and worked out well but was a process in which the participants struggled to find their own voice.
    UNASSIGNED: The transition into adulthood is a sensitive and challenging time for young people with HMV, but stable, close relationships and a well-organized transfer can enable this group to feel safe and able to find and use their own voice.
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  • 文章类型: Journal Article
    背景:医学生认为向职员教育的过渡是压力和挑战性的,并且在职员教育轮换期间将自己视为新手。因此,发展的观点很重要,因为向职员的过渡支持而不是阻碍了增长。因此,这项研究考察了医学生向职员的过渡及其发展特征。
    方法:对18名医学生或完成了医学生职务的毕业生进行了深入访谈。基于Straussian扎根理论,对收集到的数据进行了分析,分析了实习前和实习后教育的差异.
    结果:我们的数据分析揭示了过渡过程的五个阶段:“预期和焦虑,\"\"现实检查,\"\"寻求解决方案,“\”实际应用,\"和\"过渡和稳定。“核心类别,也就是说,“从学生成长为学生医生,“是由患者驱动的,他们认为参与者是学生医生。同时,与会者认识到,有一个同事同意的解决方案比知道正确的答案更重要。正在过渡到职员职位的参与者显示出发展特征,分为三类:个人,社会,和专业。具体来说,他们试图通过个人发展来平衡职员和生活,学会了在医院四处导航,并通过社会发展减少了紧张,并通过专业发展发展注重效率的临床能力。
    结论:本研究探讨了学生过渡到职务教育的过程以及在此期间出现的发展特征。学生的动机是患者认为他们是学生医生。通过过渡,他们保持了工作与生活的平衡,适应了医院,但通过注重效率的临床能力培养,形成了过度以医生为中心的态度。把他们发展成医疗专业人士,协助他们过渡并培养以病人为中心的态度至关重要。
    BACKGROUND: Medical students perceive the transition to clerkship education as stressful and challenging and view themselves as novices during their rotation in clerkship education. The developmental perspective is thus important because the transition to clerkship supports rather than hinders growth. Accordingly, this study examines medical students\' transition to clerkship and their developmental features.
    METHODS: In-depth interviews were conducted with 18 medical students or graduates who had completed clerkships as medical students. Based on Straussian grounded theory, the collected data were analyzed in terms of the differences between pre- and post-clerkship education.
    RESULTS: Our data analysis revealed five stages of the transition process: \"anticipation and anxiety,\" \"reality check,\" \"seeking solutions,\" \"practical application,\" and \"transition and stability.\" The core category, that is, \"growing up from being students to being student doctors,\" was driven by patients who perceived the participants as student doctors. Meanwhile, the participants recognized that having a solution that is agreed upon by colleagues was more important than knowing the correct answer. The participants undergoing the transition to clerkship showed developmental features divided into three categories: personal, social, and professional. Specifically, they attempted to balance clerkship and life through personal development, learned to navigate around the hospital and reduced tension through social development, and developed clinical competencies focused on efficiency through professional development.
    CONCLUSIONS: This study explores the process of students\' transition to clerkship education and the developmental features that emerge during this period. The students were motivated by patients who perceived them as student doctors. Through the transition, they maintained a work-life balance and adapted to hospitals but developed an overly doctor-centered attitude by cultivating clinical competencies with a focus on efficiency. To develop them into medical professionals, it is essential to assist their transition and cultivate a patient-centered attitude.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    代表性民意调查显示,美国公众可能对退伍军人持二分法的看法。虽然大多数美国公众赞赏和尊重他们的退伍军人,他们也被认为遭受战争造成的创伤和身体残疾。对退伍军人的受害态度可能会导致污名化,并更难过渡到平民社会。对于部署到伊拉克和阿富汗的美国退伍军人来说,这可能尤其成问题,因为这些年轻的退伍军人不仅需要重新融入平民社会,还需要重新融入平民工作场所。本研究旨在揭示和解开与伊拉克和阿富汗退伍军人有关的英雄化和受害情绪的根本原因。为了超越社会理想的报道和文化规范,我们对29名个人(20名非退伍军人和9名退伍军人)进行了深入的半结构化访谈.通过主题分析确定了三个主题:主题1“对伊拉克和阿富汗部署的个人理解”代表了一个基本框架,该框架污染了对主题2“战争概念化”的看法,部署,和暴力“和主题3”对退伍军人人格的评价。“如果部署被认为是合理的,然后退伍军人被英雄化,与平民相比,具有至高无上的利他主义特征。与部署经验任意相关的对健康的负面影响被归类为短暂的。如果部署经过仔细检查,然后退伍军人被认为是欺骗政府的幼稚受害者,长期的健康问题。重要的是,由于围绕部署合法性的讨论取决于上下文,参与者能够将退伍军人视为受害者和英雄并肩。总之,退伍军人的英雄化和受害化可能是考虑不同观点的结果,在日益复杂的社会世界中阐明多样性和获取模棱两可的信息。尽管目前的发现可能需要进一步验证,他们建议改变消极,对退伍军人的刻板印象可能需要部署和统一任务目标的连贯理由。
    Representative opinion polls indicate that members of the U.S. public may hold dichotomous perceptions of their veterans. While the majority of the U.S. public appreciates and honors their veterans, they are also considered to suffer from war-induced trauma and physical disabilities. Victimizing attitudes toward the veteran population may result in stigmatization and a more difficult transition into civilian society. This may be particularly problematic for U.S. veterans who were deployed to Iraq and Afghanistan as this younger veteran population needs to reintegrate not only into civilian society but also into civilian workplace settings. The present study aims to uncover and unravel underlying rationalities that justify heroizing and victimizing sentiments in relation to Iraq and Afghanistan veterans. In order to delve beyond socially desirable reporting and cultural norms, in-depth semi-structured interviews with 29 individuals (20 non-veterans and 9 veterans) were conducted. Three themes were identified by thematic analysis: Theme 1 \"Individual Understandings of the Deployments to Iraq and Afghanistan\" represents an underlying framework that tainted perceptions of Theme 2 \"Conceptualizations of war, deployment, and violence\" and Theme 3 \"Evaluations of the veteran\'s personality.\" If the deployments were considered justified, then veterans were heroized, characterized with supreme altruistic traits when compared with civilians. Negative effects on health that were arbitrarily related to deployment experience were classified as short-lived. If the deployments were scrutinized, then veterans were considered as naïve victims of a deceitful government, suffering from long-term health problems. Importantly, as discussions surrounding the legitimacy of the deployments were context-dependent, the participants were able to hold perceptions of veterans as victims and as heroes side by side. In conclusion, the heroization and victimization of veterans may be the result of considering different viewpoints, elucidating diversity and access to equivocal information in an increasingly complex social world. Although the present findings may require further validation, they suggest that changing negative, stereotyping perceptions of veterans may require a coherent rationale for deployments and uniform mission objectives.
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  • 文章类型: Journal Article
    背景:有问题的愤怒,以频率过高为特征,强度,和愤怒的持续时间,导致严重的情绪困扰和功能干扰,对军事人口构成了明显的挑战。尽管它很重要,关于这一主题的研究是有限的。这项研究通过探索在北约阿富汗执行任务的大量挪威军事人员样本中的愤怒问题,为文献做出了贡献。
    方法:向在2001年至2020年期间部署到阿富汗的所有挪威军事人员发送了与挪威武装部队联合医疗服务部门在2020年进行的基于网络的横断面调查的链接。共有6205人(反应率:67.7%)参加。横断面调查评估了有问题的愤怒,身心健康,战区压力源暴露,和生活质量。
    结果:总体而言,8.4%的参与者报告有问题的愤怒。精神健康障碍,与部署有关的羞耻和内疚,慢性疼痛,军事到平民过渡的挑战与有问题的愤怒独立相关。无论是留任,还是作为预备役人员与军方保持兼职联系,都减轻了部署后出题愤怒的风险,与完全脱离兵役相比。
    结论:研究结果表明,在战斗部署的退伍军人中,有问题的愤怒相当普遍。鉴于有问题的愤怒和心理健康障碍之间的关联,慢性疼痛,和转型挑战,旨在缓解有问题的愤怒的干预措施需要是多方面的,包括维持与兵役持续联系的可能性。通过减少有问题的愤怒的风险,职业,服务人员的人际关系和健康结果可能会得到改善。未来的研究应该检查有问题的愤怒对随着时间的推移调整的影响,预防策略,和其他高风险职业的愤怒问题。
    BACKGROUND: Problematic anger, characterized by excessive frequency, intensity, and duration of anger which causes substantial emotional distress and functional interference, poses a marked challenge in military populations. Despite its importance, research on this topic is limited. This study contributes to the literature by exploring problematic anger in a large sample of Norwegian military personnel who served in NATO missions in Afghanistan.
    METHODS: All Norwegian military personnel who deployed to Afghanistan between 2001 and 2020 were sent a link to a cross-sectional web-based survey by the Joint Medical Services of the Norwegian Armed Forces in 2020. A total of 6205 individuals (response rate: 67.7%) participated. The cross-sectional survey assessed problematic anger, mental and physical health, war zone stressor exposure, and quality of life.
    RESULTS: Overall, 8.4% of participants reported problematic anger. Mental health disorders, deployment-related shame and guilt, chronic pain, and challenges with the military-to-civilian transition were independently associated with problematic anger. Both staying in service and maintaining a part-time connection with the military as a reservist mitigated the risk of problematic anger after deployment, compared to complete separation from military service.
    CONCLUSIONS: Findings demonstrate a sizeable prevalence of problematic anger among veterans of combat deployments. Given the associations between problematic anger and mental health disorders, chronic pain, and transition challenges, interventions designed to mitigate problematic anger need to be multi-faceted, including the possibility of maintaining an ongoing connection to military service. By reducing the risk of problematic anger, occupational, interpersonal and health outcomes may be improved for service members. Future research should examine the impact of problematic anger on adjustment over time, prevention strategies, and problematic anger in other high-risk occupations.
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  • 文章类型: Journal Article
    尽管小儿炎症性肠病(PIBD)的发病率持续上升,没有共识的过渡准则或标准化做法。
    我们旨在研究:(1)成功转移的决定因素,(2)转移与过渡对病程和患者依从性的影响,(3)PIBD患者独有的特点,在成人护理中需要特别注意。
    纵向,后续行动,2001年至2022年进行的对照研究,回顾性数据收集至2018年,因此具有前瞻性。
    三百五十一名PIBD患者参加了这项研究,其中152人被转移到成人护理,平均转移后随访时间为3年。73名患者参与了结构性转变,而79人自行转移到成人护理。主要结局指标是疾病活动(由PCDAI定义,PUCAI,CDAI,和梅奥分数)和课程,住院治疗,手术,IBD相关并发症,包括人体测量和骨密度,患者依从性,药物依从性,继续医疗。
    经历结构性转变的患者在缓解中花费的时间明显更多(83.6%±28.5%对77.5%±29.7%,p=0.0339),并且对药物的依从性更好(31.9%对16.4%的不依从率,p=0.0455)在成人护理中,自我转移的患者停止医疗护理的风险增加了1.59倍,复发的风险增加了1.88倍。转移后患者的依从性恶化(38.5%对29%,p=0.0002),在医疗保健系统之间的变化期间,失访率最高(12.7%),其中女性是危险因素(p=0.010)。PIBD患者在到达成人护理时经历过IBD相关并发症(23.4%)和以前的手术(15%),营养不良率高,增长减值,骨骼健康状况不佳。
    结构转变在确保PIBD患者的最佳病程和降低失访率方面起着关键作用。
    结构转变在确保PIBD患者的最佳疾病结局中起着关键作用,在我们的研究中,它与较低的疾病活动性有关,更少的复发,更好的药物依从性,与自我转移相比,失访率较低。
    UNASSIGNED: Despite the continuously rising rate of pediatric-onset inflammatory bowel diseases (PIBD), there are no consensus transitional guidelines or standardized practices.
    UNASSIGNED: We aimed to examine: (1) the determinants of a successful transfer, (2) the effects of the transfer versus transition on the disease course and patient compliance, (3) the unique characteristics of PIBD patients, that need special attention in adult care.
    UNASSIGNED: Longitudinal, follow-up, controlled study conducted between 2001 and 2022, with retrospective data collection until 2018, thence prospective.
    UNASSIGNED: Three hundred fifty-one PIBD patients enrolled in the study, of whom 152 were moved to adult care, with a mean post-transfer follow-up time of 3 years. Seventy-three patients took part in structured transition, whereas 79 self-transferred to adult care. The main outcome measures were disease activity (defined by PCDAI, PUCAI, CDAI, and Mayo-scores) and course, hospitalizations, surgeries, IBD-related complications, including anthropometry and bone density, patient compliance, medication adherence, and continuation of medical care.
    UNASSIGNED: Patients who underwent structured transition spent significantly more time in remission (83.6% ± 28.5% versus 77.5% ± 29.7%, p = 0.0339) and had better adherence to their medications (31.9% versus 16.4% non-adherence rate, p = 0.0455) in adult care, with self-transferred patients having a 1.59-fold increased risk of discontinuing their medical care and a 1.88-fold increased risk of experiencing a relapse. Post-transfer the compliance of patients deteriorated (38.5% versus 29%, p = 0.0002), with the highest lost-to-follow-up rate during the changing period between the healthcare systems (12.7%), in which female gender was a risk factor (p = 0.010). PIBD patients had experienced IBD-related complications (23.4%) and former surgeries (15%) upon arriving at adult care, with high rates of malnutrition, growth impairment, and poor bone health.
    UNASSIGNED: Structured transition plays a key role in ensuring the best disease course and lowering the lost-to-follow-up rate among PIBD patients.
    UNASSIGNED: Structured transition plays a key role in ensuring the best disease outcome among PIBD patients, as in our study it was associated with lower disease activity, fewer relapses, better medication adherence, and lower lost-to-follow-up rate as opposed to self-transfer.
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  • 文章类型: Journal Article
    \“超高风险\”的精神病年轻人被认为是患精神病谱系障碍的高风险。主要是,高危人群年龄在18-35岁,但也可能包括年幼的儿童和青少年。该人群中的个体以减弱或短暂的精神病症状(特别是知觉异常)的形式经历精神病前驱。尽管诊断是通过结构化访谈进行的,这些措施未能充分评估感知异常的精确形式和内容,尤其是在儿童和青少年身上。
    本研究涉及对超高危儿童和青少年的知觉异常(尤其是幻觉)文献的系统回顾。
    分析回顾了五项研究,并得出了有关知觉异常的结论(即,幻觉)由研究样本经历,注重形式,内容,以及与其他症状的关联。值得注意的是,2所调查的研究表明幻觉与童年创伤的经历之间存在关系。
    向精神病的转变和童年创伤的经历可能对应于超高危儿童和青少年的不同类型的幻觉。这些知识可以改善年轻人对前驱状态的识别,高危人群。
    UNASSIGNED: \"Ultra-high risk\" for psychosis young adults are assumed to be at higher risk of developing a psychotic spectrum disorder. Predominantly, the ultrahigh-risk population is aged 18-35 years, but it may also include younger children and adolescents. Individuals in this population experience psychosis prodromes in the form of attenuated or brief psychotic symptoms (particularly perceptual abnormalities). Albeit diagnosis is made via structured interviews, such measures fail to sufficiently assess the precise form and content of perceptual abnormalities, especially as they manifest in children and adolescents.
    UNASSIGNED: The present study involved a systematic review of the literature on perceptual abnormalities (particularly hallucinations) in ultrahigh-risk children and adolescents.
    UNASSIGNED: The analysis reviewed five studies and drew conclusions about the perceptual abnormalities (ie, hallucinations) experienced by the study samples, focusing on form, content, and associations with other symptoms. Of note, 2 of the investigated studies suggested a relationship between hallucinations and experiences of childhood trauma.
    UNASSIGNED: The transition to psychosis and experiences of childhood trauma could correspond to different types of hallucinations in ultrahigh-risk children and adolescents. This knowledge could improve the identification of prodromal states in the young, ultrahigh-risk population.
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  • 文章类型: Journal Article
    几乎没有证据可以为了解来自历史上边缘化群体的父母和青年在成年后的经历提供背景,特别是关于黑人自闭症过渡年龄青年及其家庭成员的过渡经历。这篇评论建立在最近的出版物上,这些出版物为美国对黑人自闭症经历的交叉理解提供了信息,并概述了研究建议,以更好地满足黑人自闭症过渡年龄青年的具体需求。鉴于黑人自闭症青年在转型研究和转型过程中的不足,我们为改善自闭症转型研究提供建议.我们提出了实现公平研究过程所必需的变革,这可以为设计有针对性的干预措施提供信息,以改善黑人自闭症青年的过渡体验。
    为什么这个话题很重要?关于黑人自闭症青年和年轻人在向成年过渡期间的经历的研究很少。研究这群人很重要,因为在过渡期间,他们可能对服务和支持有更多未满足的需求。由于种族主义在社区中的长期影响,他们可能更难获得就业或继续接受教育。本文的目的是什么?我们报道了最近关于黑人自闭症青年向成年过渡的研究。我们提供研究和实践建议。作者为这一主题带来了什么个人或专业观点?这项研究的作者是alistic研究人员和研究助理,他们是研究团队的成员,或建议,自闭症转型研究。A.M.R.是白人研究员,和自闭症患者的家庭成员,研究自闭症青年的转型经历。S.V.是黑色的,非二进制,具有黑人LGBTQIA+心理健康经验的公共卫生社会工作者。E.-D.W.是一名黑人研究员,研究黑人自闭症青年的心理健康。H.S.是一位白人定性社会学家,具有从严重残疾镜头向年轻成年过渡的经验。K.A.A.是一位混血研究人员,他是白人,研究自闭症的交叉性,种族,和贫困。T.M.H.是一位黑人研究员,他的工作重点是交叉身份,特别关注种族和自闭症,以及这些交叉点影响个人生活体验的方式。L.L.S.是一位白人研究人员,在研究卫生服务差异方面具有丰富的经验。该团队的定位是,我们确定为非自闭症研究人员,他们寻求支持自闭症研究中对黑人自闭症青年和成年人的关注。关于这个话题已经知道了什么?我们知道,很少有人关注研究黑人自闭症青年及其家庭如何经历成年的过渡。我们还知道,他们不太可能及时收到有关过渡的信息。这些差距是不可接受的。作者有什么建议?我们需要找到更好的方法来了解黑人自闭症青年成年后面临的障碍。我们还需要了解他们用来克服这些障碍的优势。这些信息将帮助我们设计改进过渡的方法。这项工作应该与黑人自闭症青年及其家人作为伙伴一起完成。研究人员应该使用不同的方法邀请黑人青年参加他们的研究。当研究人员设计研究时,他们应该考虑人的身份之间的联系,比如自闭症患者,黑色,或贫穷,因为这些身份结合在一起使歧视变得更糟。如果学术部门的领导重视雇用黑人和自闭症学者,并鼓励研究领域的更多多样性,那将是有帮助的。这些建议将如何帮助现在或将来的自闭症成年人?有可能改变黑人自闭症过渡年龄的年轻人如何过渡。然而,同样的解决方案并不适用于所有社区。这是因为在过渡期间,不同的社区在获得信息和服务方面遇到了不同的障碍。我们希望这些建议将有助于研究人员思考如何提高黑人自闭症青年及其家庭成员的参与度。
    Little evidence is available to provide context for understanding the experiences of parents and youth from historically marginalized groups as they age into adulthood, especially in regard to the transition experiences of Black autistic transition-age youth and their family members. This commentary builds upon recent publications that inform intersectional understandings of Black autistic experiences in America, and outlines research recommendations to better address the specific needs of Black autistic transition-age youth. Given the noted deficits in transition research and the transition process in regard to the experiences of Black autistic youth, we provide recommendations for improving autism transition research. We propose changes that are necessary to achieve equitable research processes, which could inform the design of targeted interventions to improve transition experiences for Black autistic youth.
    Why is this topic important? There is little research on the experiences of Black autistic youth and young adults during the transition to adulthood. It is important to study this group of people, because they may have more unmet needs for services and supports during the transition years. They may have a harder time achieving employment or continuing their education because of the long-term effects of racism in communities. What is the purpose of this article? To add to what is known on this topic, we report on recent studies about Black autistic youth during the transition to adulthood. We provide research and practice recommendations. What personal or professional perspectives do the authors bring to this topic? The authors of this study are allistic researchers and research assistants who are members of a research team working on, or advising, autism transition research. A.M.R. is a White researcher, and a family member of autistic individuals, who studies the transition experiences of autistic youth. S.V. is a Black, nonbinary, public health social worker with experience in Black LGBTQIA+ mental health. E.-D.W. is a Black researcher who studies the mental health of Black autistic youth. H.S. is a White qualitative sociologist with experience studying the transition to young adulthood from the critical disability lens. K.A.A. is a mixed-race researcher who is White-presenting and who studies the intersectionality of autism, race, and poverty. T.M.H. is a Black researcher whose work focuses on intersecting identities, with a special focus on race and autism, and the way those intersections impact the lived experiences of individuals. L.L.S. is a White researcher with experience in studying health services disparities. The positionality of this team is that we identify as nonautistic researchers who seek to support increased focus on Black autistic youth and adults within autism research. What is already known about this topic? We know that there has been little attention given to studying how Black autistic youth and their families experience the transition to adulthood. We also know they are less likely to receive information about the transition in a timely manner. These disparities are unacceptable. What do the authors recommend? We need to find better ways to learn about the barriers that Black autistic youth face as they become adults. We also need to learn about the strengths they use to overcome these barriers. That information will help us to design ways to improve transitions. This work should be done with Black autistic youth and their families as partners. Researchers should use different approaches to invite Black youth into their studies. When researchers are designing studies they should think about the connections between people\'s identities such as being autistic, Black, or poor, because these identities combine to make discrimination worse. It would be helpful if the leaders of academic departments placed value on hiring Black and autistic scholars and encouraged more diversity within research. How will these recommendations help autistic adults now or in the future? It is possible to make changes in how Black autistic transition-age youth move through transition. However, the same solutions will not work for all communities. This is because different communities experience different barriers to receiving information and services during the transition years. We hope these recommendations will help researchers to think about how they can improve the participation of Black autistic youth and their family members.
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  • 文章类型: Journal Article
    目的:调查相同的健康状况是否导致EQ-5D青年和成人描述系统的反应分布相同。
    方法:在南非(ZA)和埃塞俄比亚(ET)招募了13-18岁的青少年,这些青少年有一系列的健康状况,来自普通的上学人口。在ZA参与者完成了英语EQ-5D-3L,EQ-5D-Y-3L和EQ-5D-5L平行。而在ET中,参与者并行完成了AmharicEQ-5D-5L和EQ-5D-Y-5L。分析旨在描述青年和成人工具之间的过渡,而不是国家之间的差异。
    结果:来自592名完成EQ-5D-3L的青少年的数据,分析EQ-5D-Y-3L和EQ-5D-5L(ZA)和完成EQ-5D-5L和EQ-5D-Y-5L(ET)的693。与成人版本相比,青少年在心理健康方面报告了更多问题。在EQ-5D-3L和EQ-5D-5L上没有问题的青少年中,分别有13%和4%在EQ-5D-Y-3L上报告了一些问题。在五个级别版本之间的过渡中,这一点不太明显,有4%的青少年在EQ-5D-Y-5L上报告的问题比EQ-5D-5L更多。很少有青少年报告了严重的问题(EQ-5D-3L或EQ-5D-Y-3L的3级和EQ-5D-5L或EQ-5D-5L的4级和5级),因此版本之间的反应几乎没有变化。在ZA,歧视性权力,根据香农指数衡量,Y-3L的疼痛/不适(ΔH'=0.11)和焦虑/抑郁(ΔH'=0.04)高于3L,Y-3L的所有维度均高于5L。同样,Y-5L的ET判别能力高于5L(ΔH范围0.05-0.09)。Gwet的AC在所有配对的(ZA)3L和(ET)5L尺寸上显示出良好到非常好的一致性。所有EQ-5D版本的汇总评分能够区分已知疾病组。
    结论:尽管针对青年和成人的EQ-5D仪器之间的总体一致性很高,它们在健康状况方面没有提供相同的结果,来自同一个受访者。焦虑/抑郁的差异最为显著。在描述性分析中,需要考虑个人对各种描述性系统的反应方式的这些差异,当在仪器之间转换时,以及比较偏好加权分数时。
    OBJECTIVE: To investigate whether the same health state results in the same distribution of responses on the EQ-5D youth and adult descriptive systems.
    METHODS: Adolescents aged 13-18 years with a range of health conditions and from the general school going population were recruited in South Africa (ZA) and Ethiopia (ET). In ZA participants completed the English EQ-5D-3L, EQ-5D-Y-3L and EQ-5D-5L in parallel. Whereas in ET participants completed the Amharic EQ-5D-5L and EQ-5D-Y-5L in parallel. Analysis aimed to describe the transition between youth and adult instruments and not differences between countries.
    RESULTS: Data from 592 adolescents completing the EQ-5D-3L, EQ-5D-Y-3L and EQ-5D-5L (ZA) and 693 completing the EQ-5D-5L and EQ-5D-Y-5L (ET) were analysed. Adolescents reported more problems on the youth versions compared to the adult version for the dimension of mental health. 13% and 4% of adolescents who reported no problems on the EQ-5D-3L and EQ-5D-5L reported some problems on the EQ-5D-Y-3L respectively. This was less notable with transition between the five level versions with 4% of adolescents reporting more problems on the EQ-5D-Y-5L than the EQ-5D-5L. Very few adolescents reported severe problems (level 3 on the EQ-5D-3L or EQ-5D-Y-3L and level 4 and level 5 on the EQ-5D-5L or EQ-5D-5L) thus there was little variation between responses between the versions. In ZA, discriminatory power, measured on the Shannon\'s Index, was higher for Y-3L compared to 3L for pain/discomfort (ΔH\'=0.11) and anxiety/depression (ΔH\'=0.04) and across all dimensions for Y-3L compared to 5L. Similarly, in ET discriminatory power was higher for Y-5L than 5L (ΔH\' range 0.05-0.09). Gwet\'s AC showed good to very good agreement across all paired (ZA) 3L and (ET) 5L dimensions. The summary score of all EQ-5D versions were able to differentiate between known disease groups.
    CONCLUSIONS: Despite the overall high levels of agreement between EQ-5D instruments for youth and for adults, they do not provide identical results in terms of health state, from the same respondent. The differences were most notable for anxiety/depression. These differences in the way individuals respond to the various descriptive systems need to be taken into consideration for descriptive analysis, when transitioning between instruments, and when comparing preference-weighted scores.
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