Purther Halle, Nitert-Brown Cora, Vahidi Ferdosi Diba, Ho Emily S
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Hand Ther. 2023 Sep;28(3):103-110. doi: 10.1177/17589983231168034. Epub 2023 Apr 4.
Youth with brachial plexus birth injuries (BPBI) have an increased risk of mental health issues such as depression, anxiety, and diminished self-confidence. Despite this evidence, current standards of care focus on physical interventions. Evaluation of psychological and emotional concerns is rarely prioritized in clinical settings. Therefore, mental health needs are unmet and poorly understood.
An interpretivist qualitative approach was used to understand the perspectives of youth with BPBI and their caregivers on the barriers and facilitators of addressing mental health concerns, to inform practice guidelines, and promote meaningful participation within this population.
A purposeful sample of nine youth with BPBI between 10 to 20 years and eight caregivers participated in in-depth interviews. The interviews were semi-structured and an average of 60 min (35-85 min) long. Three themes emerged from these data: (i) physical disability identity and mental health; (ii) pursuit of "normal" body image; and (iii) paradox of advocacy. Findings illuminated the intersection of physical and mental health in these youth and provides actionable practice recommendations. Areas of need were identified including mental health support around the challenges of advocacy, body image, surgery, and preparation for the 'aging out' process for youth and their families.
The well-being of youth with BPBI is a result of the intersection between their physical and mental health. Further research on optimizing mental health resources within physical health settings is needed to better support the holistic needs of these youth and their families.
患有臂丛神经产伤（BPBI）的青少年出现心理健康问题的风险增加，如抑郁、焦虑和自信心下降。尽管有这些证据，但目前的护理标准侧重于物理干预。在临床环境中，心理和情感问题的评估很少被优先考虑。因此，心理健康需求未得到满足且了解不足。
采用解释主义定性方法，以了解患有BPBI的青少年及其照顾者对解决心理健康问题的障碍和促进因素的看法，为实践指南提供信息，并促进该人群的有意义参与。
有目的地抽取了9名年龄在10至20岁之间患有BPBI的青少年和8名照顾者参与深入访谈。访谈采用半结构化，平均时长60分钟（35 - 85分钟）。从这些数据中出现了三个主题：（i）身体残疾身份与心理健康；（ii）追求“正常”身体形象；（iii）倡导的悖论。研究结果揭示了这些青少年身心健康的交叉点，并提供了可操作的实践建议。确定了需求领域，包括围绕倡导、身体形象、手术以及青少年及其家庭“成年过渡”过程准备等挑战的心理健康支持。
患有BPBI的青少年的幸福感是其身心健康交叉的结果。需要进一步研究如何在身体健康环境中优化心理健康资源，以更好地支持这些青少年及其家庭的整体需求。
