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Assessing and Enhancing Psychosocial Functioning

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Care of Adults with Chronic Childhood Conditions
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Abstract

Positive social experiences are essential to patient health and wellbeing. The primary care provider’s office is an important social environment for an adolescent with special healthcare needs as physicians serve as both social agents as well as medical providers for these young people. Attaining the age of majority accelerates the transition to adult healthcare, and occurs at a time when social interactions are of paramount importance and among these patients’ most salient preoccupations. In light of evidence suggesting that young people with chronic conditions are at-risk for problems in social competence and performance related to their illness, the adult Primary Care Provider (PCP) has a unique opportunity to detect and address problems in social functioning. Through strategic communication and appropriate use of external resources, the PCP can promote healthy social engagement and positive social behaviors. The following chapter will (1) review the most relevant aspects of social development during the young adult period; (2) discuss ways to identify barriers to optimal social functioning; and (3) provide strategies for the PCP to facilitate this aspect of patient care.

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References

  1. Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, Fatusi A, et al. Adolescence and the social determinants of health. Lancet. 2012;379(9826):1641–52.

    Article  PubMed  Google Scholar 

  2. Rosendal M, Vedsted P, Christensen KS, Moth G. Psychological and social problems in primary care patients: general practitioners’ assessment and classification. Scand J Prim Health Care. 2013;31(1):43–9.

    Google Scholar 

  3. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Pinquart M, Teubert D. Academic, physical, and social functioning of children and adolescents with chronic physical illness: a meta-analysis. J Pediatr Psychol. 2012;37(4):376–89.

    Article  PubMed  Google Scholar 

  5. Martinez W, Carter JS, Legato LJ. Social competence in children with chronic illness: a meta-analytic review. J Pediatr Psychol. 2011;36(8):878–90.

    Article  PubMed  Google Scholar 

  6. Geist R, Grdisa V, Otley A. Psychosocial issues in the child with chronic conditions. Best Pract Res Clin Gastroenterol. 2003;17(2):141–52.

    Article  PubMed  Google Scholar 

  7. Evan EE, Zeltzer LK. Psychosocial dimensions of cancer in adolescents and young adults. Cancer. 2006;107(7 Suppl):1663–71.

    Article  PubMed  Google Scholar 

  8. Zbikowski SM, Klesges RC, Robinson LA, Alfano CM. Risk factors for smoking among adolescents with asthma. J Adolesc Health. 2002;30(4):279–87.

    Article  PubMed  Google Scholar 

  9. Compas BE, Jaser SS, Dunn MJ, Rodriguez EM. Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol. 2012;8:455.

    Article  PubMed  Google Scholar 

  10. Kyngäs H. Support network of adolescents with chronic disease: adolescents’ perspective. Nurs Health Sci. 2004;6(4):287–93.

    Article  PubMed  Google Scholar 

  11. Oris L, Seiffge-Krenke I, Moons P, Goubert L, Rassart J, Goossens E, et al. Parental and peer support in adolescents with a chronic condition: a typological approach and developmental implications. J Behav Med. 2016;39(1):107–19.

    Article  PubMed  Google Scholar 

  12. Jose PE, Ryan N, Pryor J. Does social connectedness promote a greater sense of well-being in adolescence over time? J Res Adolesc. 2012;22(2):235–51.

    Article  Google Scholar 

  13. Kearns A, Whitley E, Tannahill C, Ellaway A. Loneliness, social relations and health and well-being in deprived communities. Psychol Health Med. 2015;20(3):332–44.

    Article  PubMed  Google Scholar 

  14. Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci. 2013;110(15):5797–801.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of alameda county residents. Am J Epidemiol. 1979;109(2):186–204.

    CAS  PubMed  Google Scholar 

  16. Morris J. Social exclusion and young disabled people with high levels of support needs. Crit Soc Policy. 2001;21(2):161–83.

    Article  Google Scholar 

  17. Reiter-Purtill J, Waller J, Noll R. Empirical and theoretical perspectives on the peer relationships of children with chronic conditions. In: Roberts M, Steele R, editors. Handbook of pediatric psychology. 4th ed. New York: The Guilford Press; 2009. p. 672–88.

    Google Scholar 

  18. Twyman KA, Saylor CF, Saia D, Macias MM, Taylor LA, Spratt E. Bullying and ostracism experiences in children with special health care needs. J Dev Behav Pediatr. 2010;31(1):1–8.

    Article  PubMed  Google Scholar 

  19. Vanhalst J, Rassart J, Luyckx K, Goossens E, Apers S, Goossens L, et al. Trajectories of loneliness in adolescents with congenital heart disease: associations with depressive symptoms and perceived health. J Adolesc Health. 2013;53(3):342–9.

    Article  PubMed  Google Scholar 

  20. Perrin JM, MacLean WE, Perrin EC. Parental perceptions of health status and psychologic adjustment of children with asthma. Pediatrics. 1989;83(1):26–30.

    CAS  PubMed  Google Scholar 

  21. Van Cleave J, Davis MM. Bullying and peer victimization among children with special health care needs. Pediatrics. 2006;118(4):e1212–9.

    Article  PubMed  Google Scholar 

  22. Nassau JH, Drotar D. Social competence among children with central nervous system-related chronic health conditions: a review. J Pediatr Psychol. 1997;22(6):771–93.

    Article  CAS  PubMed  Google Scholar 

  23. Rantanen K, Eriksson K, Nieminen P. Social competence in children with epilepsy: a review. Epilepsy Behav. 2012;24(3):295–303.

    Article  CAS  PubMed  Google Scholar 

  24. Gebauer-Bukurov K, Markovic J, Sekulic S, Bozic K. Social competence among well-functioning adolescents with epilepsy. Epilepsy Behav. 2015;42:54–60.

    Article  PubMed  Google Scholar 

  25. Yeates KO, Bigler ED, Gerhardt CA, Rubin KH, Stancin T, Taylor HG, et al. Theoretical approaches to understanding social function in childhood brain insults: toward the integration of social neuroscience and developmental psychology. In: Anderson V, Beauchamp M, editors. Developmental social neuroscience and childhood brain insult: theory and practice. New York: Guilford Press; 2012. p. 207–30.

    Google Scholar 

  26. Livingston MH, Rosenbaum PL, Russell DJ, Palisano RJ. Quality of life among adolescents with cerebral palsy: what does the literature tell us? Dev Med Child Neurol. 2007;49(3):225–31.

    Article  PubMed  Google Scholar 

  27. Albrecht GL, Devlieger PJ. The disability paradox: high quality of life against all odds. Soc Sci Med. 1999;48(8):977–88.

    Article  CAS  PubMed  Google Scholar 

  28. Suris J-C, Michaud P-A, Akre C, Sawyer SM. Health risk behaviors in adolescents with chronic conditions. Pediatrics. 2008;122(5):e1113–8.

    Article  PubMed  Google Scholar 

  29. Reid GJ, Irvine MJ, McCrindle BW, Sananes R, Ritvo PG, Siu SC, et al. Prevalence and correlates of successful transfer from pediatric to adult health care among a cohort of young adults with complex congenital heart defects. Pediatrics. 2004;113(3):e197–205.

    Article  PubMed  Google Scholar 

  30. Suris J-C, Parera N. Sex, drugs and chronic illness: health behaviours among chronically ill youth. Eur J Public Health. 2005;15(5):484–8.

    Article  PubMed  Google Scholar 

  31. Britto MT, Garrett JM, Dugliss MA, Daeschner C, Johnson CA, Leigh MW, et al. Risky behavior in teens with cystic fibrosis or sickle cell disease: a multicenter study. Pediatrics. 1998;101(2):250–6.

    Article  CAS  PubMed  Google Scholar 

  32. Sawyer SM, Drew S, Yeo MS, Britto MT. Adolescents with a chronic condition: challenges living, challenges treating. The Lancet. 2007;369(9571):1481–9.

    Article  PubMed  Google Scholar 

  33. Aanerud M, Carsin A-E, Sunyer J, Dratva J, Gislason T, Jarvis D, et al. Interaction between asthma and smoking increases the risk of adult airway obstruction. Eur Respir J. 2015;45(3):635–43.

    Article  PubMed  Google Scholar 

  34. Hargrove A, Penny D, Sawyer S. Sexual and reproductive health in young people with congenital heart disease: a systematic review of the literature. Pediatr Cardiol. 2005;26(6):805–11.

    Article  CAS  PubMed  Google Scholar 

  35. Cardenas DD, Topolski TD, White CJ, McLaughlin JF, Walker WO. Sexual functioning in adolescents and young adults with spina bifida. Arch Phys Med Rehabil. 2008;89(1):31–5.

    Article  PubMed  Google Scholar 

  36. Kakleas K, Kandyla B, Karayianni C, Karavanaki K. Psychosocial problems in adolescents with type 1 diabetes mellitus. Diabetes Metab. 2009;35(5):339–50.

    Article  CAS  PubMed  Google Scholar 

  37. Orlicka K, Barnes E, Culver EL. Prevention of infection caused by immunosuppressive drugs in gastroenterology. Ther Adv Chronic Dis. 2013;2040622313485275.

    Google Scholar 

  38. Henry-Reid LM, O’Connor KG, Klein JD, Cooper E, Flynn P, Futterman DC. Current pediatrician practices in identifying high-risk behaviors of adolescents. Pediatrics. 2010;125(4):e741–7.

    Article  PubMed  Google Scholar 

  39. Eneriz-Wiemer M, Sanders LM, Barr DA, Mendoza FS. Parental limited english proficiency and health outcomes for children with special health care needs: a systematic review. Acad Pediatr. 2014;14(2):128–36.

    Article  PubMed  Google Scholar 

  40. Vart P, Gansevoort RT, Joosten MM, Bultmann U, Reijneveld SA. Socioeconomic disparities in chronic kidney disease: a systematic review and meta-analysis. Am J Prev Med. 2015;48(5):580–92.

    Article  PubMed  Google Scholar 

  41. Knapp C, Huang IC, Hinojosa M, Baker K, Sloyer P. Assessing the congruence of transition preparedness as reported by parents and their adolescents with special health care needs. Matern Child Health J. 2013;17(2):352–8.

    Article  PubMed  Google Scholar 

  42. Ng S, Dinesh S, Tay S, Lee E. Decreased access to health care and social isolation among young adults with cerebral palsy after leaving school. J Orthop Surg. 2003;11(1):80.

    Article  CAS  Google Scholar 

  43. Bonnie RJ, Stroud C, Breiner H. Investing in the health and well-being of young adults. Washington DC: 2015 by The National Academy of Sciences; 2015.

    Google Scholar 

  44. Fegran L, Hall EO, Uhrenfeldt L, Aagaard H, Ludvigsen MS. Adolescents’ and young adults’ transition experiences when transferring from paediatric to adult care: a qualitative metasynthesis. Int J Nurs Stud. 2014;51(1):123–35.

    Article  PubMed  Google Scholar 

  45. Reiss JG, Gibson RW, Walker LR. Health care transition: youth, family, and provider perspectives. Pediatrics. 2005;115(1):112–20.

    PubMed  Google Scholar 

  46. Sawin KJ, Rauen K, Bartelt T, Wilson A, O’Connor RC, Waring WP III, et al. Transitioning adolescents and young adults with spina bifida to adult healthcare: initial findings from a model program. Rehabil Nurs. 2015;40(1):3–11.

    Article  PubMed  Google Scholar 

  47. Goldenring JM, Rosen DS. Getting into adolescent heads: an essential update. Contemp Pediatr. 2004;21(1):64–92.

    Google Scholar 

  48. Duggan M, Brenner J. The demographics of social media users, 2012: Pew Research Center’s Internet & American Life Project Washington, DC; 2013.

    Google Scholar 

  49. Best P, Manktelow R, Taylor B. Online communication, social media and adolescent wellbeing: a systematic narrative review. Child Youth Serv Rev. 2014;41:27–36.

    Article  Google Scholar 

  50. Greene JA, Choudhry NK, Kilabuk E, Shrank WH. Online social networking by patients with diabetes: a qualitative evaluation of communication with facebook. J Gen Intern Med. 2011;26(3):287–92.

    Article  PubMed  Google Scholar 

  51. Hayutin LG, Reed-Knight B, Blount RL, Lewis J, McCormick ML. Increasing parent-pediatrician communication about children’s psychosocial problems. J Pediatr Psychol. 2009;34(10):1155–64.

    Article  PubMed  Google Scholar 

  52. Rosendal M, Vedsted P, Christensen KS, Moth G. Psychological and social problems in primary care patients—general practitioners’ assessment and classification. Scand J Prim Health Care. 2013;31(1): 43–9.

    Google Scholar 

  53. Linton JC. Psychological assessment in primary care. In: Hass LJ, editor. Handbook of primary care psychology. New York: Oxford University Press; 2004. p. 35–45.

    Google Scholar 

  54. Moyer VA. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: US preventive services task force recommendation statement. Ann Intern Med. 2013;159(3):210–8.

    PubMed  Google Scholar 

  55. Siu AL, Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, Ebell M, et al. Screening for depression in adults: us preventive services task force recommendation statement. JAMA. 2016;315(4):380–7.

    Article  CAS  PubMed  Google Scholar 

  56. Saitz R, Palfai TP, Cheng DM, Alford DP, Bernstein JA, Lloyd-Travaglini CA, et al. Screening and brief intervention for drug use in primary care: the aspire randomized clinical trial. JAMA. 2014;312(5):502–13.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Moyer VA. Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children and adolescents: US preventive services task force recommendation statementinterventions to reduce drug use in children and adolescents. Ann Intern Med. 2014;160(9):634–9.

    Article  PubMed  Google Scholar 

  58. Ewing JA. Detecting alcoholism: the cage questionnaire. JAMA. 1984;252(14):1905–7.

    Article  CAS  PubMed  Google Scholar 

  59. Saunders JB, Aasland OG, Babor TF, De la Fuente JR, Grant M. Development of the alcohol use disorders identification test (audit): who collaborative project on early detection of persons with harmful alcohol consumption-ii. Addiction. 1993;88(6):791–804.

    Article  CAS  PubMed  Google Scholar 

  60. Gomez A, Conde A, Santana J, Jorrin A. Diagnostic usefulness of brief versions of alcohol use disorders identification test (audit) for detecting hazardous drinkers in primary care settings. J Stud Alcohol. 2005;66(2):305–8.

    Article  CAS  PubMed  Google Scholar 

  61. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The audit alcohol consumption questions (audit-c): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (acquip). Alcohol use disorders identification test. Arch Intern Med. 1998;158(16):1789–95.

    Article  CAS  PubMed  Google Scholar 

  62. Yudko E, Lozhkina O, Fouts A. A comprehensive review of the psychometric properties of the drug abuse screening test. J Subst Abuse Treat. 2007;32(2):189–98.

    Article  PubMed  Google Scholar 

  63. Bohn M, Babor T, Kranzler H. Validity of the drug abuse screening test (dast-10) in inpatient substance abusers. Probl Drug Depend. 1991;119:233–5.

    Google Scholar 

  64. Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med. 2010;170(13):1155–60.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Ware JE Jr, Sherbourne CD. The mos 36-item short-form health survey (sf-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.

    Article  PubMed  Google Scholar 

  66. Weissman MM, Bothwell S. Assessment of social adjustment by patient self-report. Arch Gen Psychiatry. 1976;33(9):1111.

    Article  CAS  PubMed  Google Scholar 

  67. Bosc M. Assessment of social functioning in depression. Compr Psychiatry. 2000;41(1):63–9.

    Google Scholar 

  68. Weissman MM, Olfson M, Gameroff MJ, Feder A, Fuentes M. A comparison of three scales for assessing social functioning in primary care. Am J Psychiatry. 2001;158(3):460–6.

    Google Scholar 

  69. Kroenke K, Spitzer RL, Williams JB. The phq-9. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Achenbach T, Rescorla LA. Manual for the aseba adult forms and profiles. Burlington: Research Center for Children and Families, University of Vermont; 2003.

    Google Scholar 

  71. Reynolds CR, Kamphaus RW. Basc-2 behavioral assessment system for children manual. Circle Pines: AGS Publishing; 2004.

    Google Scholar 

  72. Aman MG, Singh NN, Stewart AW, Field CJ. The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. Am J Ment Defic. 1985;89(5):485–91.

    CAS  PubMed  Google Scholar 

  73. Reiss S, Levitan GW, Szyszko J. Emotional disturbance and mental retardation: Diagnostic overshadowing. Am J Ment Defic. 1982;86(6):567–74.

    CAS  PubMed  Google Scholar 

  74. Hayes SC, Nelson RO, Jarrett RB. The treatment utility of assessment: a functional approach to evaluating assessment quality. Am Psychol. 1987;42(11):963.

    Article  CAS  PubMed  Google Scholar 

  75. Muench J, Jarvis K, Gray M, Hayes M, Vandersloot D, Hardman J, et al. Implementing a team-based sbirt model in primary care clinics. J Subst Use. 2015;20(2):106–12.

    Article  Google Scholar 

  76. Kaner E, Beyer F, Dickinson H, Pienaar E, Campbell F, Schlesinger C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007;2.

    Google Scholar 

  77. Gryczynski J, Mitchell SG, Peterson TR, Gonzales A, Moseley A, Schwartz RP. The relationship between services delivered and substance use outcomes in new mexico’s screening, brief intervention, referral and treatment (sbirt) initiative. Drug Alcohol Depend. 2011;118(2):152–7.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Ozechowski TJ, Becker SJ, Hogue A. Sbirt-a: adapting sbirt to maximize developmental fit for adolescents in primary care. J Subst Abuse Treat. 2016;62:28–37.

    Article  PubMed  Google Scholar 

  79. Miller WR, Rollnick S. Motivational interviewing: helping people change. New York: Guilford Press. 2012.

    Google Scholar 

  80. Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler C, et al. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns. 2013;93(2):157–68.

    Article  PubMed  Google Scholar 

  81. Sansom-Daly UM, Peate M, Wakefield CE, Bryant RA, Cohn RJ. A systematic review of psychological interventions for adolescents and young adults living with chronic illness. Health Psychol. 2012;31(3):380–93.

    Article  PubMed  Google Scholar 

  82. Roberts CS, Piper L, Denny J, Cuddeback G. A support group intervention to facilitate young adults’ adjustment to cancer. Health Soc Work. 1997;22(2):133–41.

    Article  CAS  PubMed  Google Scholar 

  83. Scholten L, Willemen AM, Last BF, Maurice-Stam H, van Dijk EM, Ensink E, et al. Efficacy of psychosocial group intervention for children with chronic illness and their parents. Pediatrics. 2013;131(4):e1196–203.

    Article  PubMed  Google Scholar 

  84. Stewart M, Letourneau N, Masuda JR, Anderson S, McGhan S. Impacts of online peer support for children with asthma and allergies: “It just helps you every time you can’t breathe well”. J Pediatr Nurs. 2013;28(5):439–52.

    Article  PubMed  Google Scholar 

  85. Maurice-Stam H, Scholten L, de Gee EA, van der Zanden RA, Conijn B, Last BF, et al. Feasibility of an online cognitive behavioral-based group intervention for adolescents treated for cancer: a pilot study. J Psychosoc Oncol. 2014;32(3):310–21.

    Article  PubMed  Google Scholar 

  86. Suris J-C, Michaud P-A, Viner R. The adolescent with a chronic condition. Part I: developmental issues. Arch Dis Child. 2004;89(10):938–42.

    Article  PubMed  PubMed Central  Google Scholar 

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Coletti, D.J., Kane, N.S. (2016). Assessing and Enhancing Psychosocial Functioning. In: Pilapil, M., DeLaet, D., Kuo, A., Peacock, C., Sharma, N. (eds) Care of Adults with Chronic Childhood Conditions. Springer, Cham. https://doi.org/10.1007/978-3-319-43827-6_25

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