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患有儿童期和成年期系统性红斑狼疮的年轻人的生活教育经历:一项加拿大多中心定性研究。

Lived Education Experience of Young Adults With Childhood- and Adult-Onset Systemic Lupus Erythematosus: A Multicenter Canadian Qualitative Study.

作者信息

Nishat Fareha, Golding Michael A, Merrill Kaitlyn A, Protudjer Jennifer L P, Woodgate Roberta L, Kaur Ramandeep, Lacaille Diane, Oguzoglu Umut, Touma Zahi, Peschken Christine, Stinson Jennifer N, Lim Lily S H

机构信息

F. Nishat, MPH, Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.

M.A. Golding, MA, K.A. Merill, BSc, L.S.H. Lim, MBBS, PhD, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

J Rheumatol. 2025 Apr 1;52(4):368-374. doi: 10.3899/jrheum.2024-0695.

Abstract

OBJECTIVE

Young adults with systemic lupus erythematosus (SLE) have physical, cognitive, and psychosocial health issues and other comorbidities that may affect educational attainment and, ultimately, lifetime socioeconomic achievement. We aimed to understand the lived educational experiences of young adults with SLE and to assess their perceived barriers from SLE.

METHODS

Individual semistructured interviews were conducted remotely with participants from 2 SLE clinics in Canada. All interviews were transcribed verbatim, double-coded, and analyzed using a reflexive thematic approach.

RESULTS

Thirteen participants (85% female) with a median age of 20.5 years-8 with childhood-onset SLE and 5 with adult-onset SLE-were interviewed. Four themes were identified: (1) challenges due to SLE (difficulties adjusting to the diagnosis, physical and cognitive symptoms of SLE); (2) changes in aspirations (education or career goals modified by reducing course load or shifting to a more sedentary or less demanding career); (3) facilitators of student success (social support from family and friends, parental financial support, individualized accommodations from institutions, and asynchronous learning opportunities as a response to the coronavirus disease 2019 pandemic); and (4) coping and moving forward (using more adaptive than maladaptive coping strategies to self-manage, including self-acceptance, pacing, and planning).

CONCLUSION

Whereas most participants were successfully engaging in higher education, their performance was often negatively affected by the physical and cognitive toll of SLE. Social support and academic accommodations helped to alleviate the challenges experienced by this group. Going forward, clinicians should initiate conversations about the educational experiences of young adults with SLE to proactively address the challenges they may face.

摘要

目的

患有系统性红斑狼疮(SLE)的年轻人存在身体、认知和心理社会健康问题以及其他合并症,这些可能会影响教育程度,并最终影响一生的社会经济成就。我们旨在了解患有SLE的年轻人的教育经历,并评估他们认为的来自SLE的障碍。

方法

对来自加拿大两家SLE诊所的参与者进行了远程个人半结构式访谈。所有访谈均逐字转录、双重编码,并采用反思性主题方法进行分析。

结果

对13名参与者(85%为女性)进行了访谈,他们的中位年龄为20.5岁,其中8名患有儿童期发病的SLE,5名患有成人期发病的SLE。确定了四个主题:(1)SLE带来的挑战(难以适应诊断、SLE的身体和认知症状);(2)抱负的变化(通过减少课程负担或转向更久坐或要求更低的职业来修改教育或职业目标);(3)学生成功的促进因素(家人和朋友的社会支持、父母的经济支持、机构提供的个性化便利条件以及作为对2019年冠状病毒病大流行的应对措施的异步学习机会);(4)应对与前进(使用比适应不良的应对策略更具适应性的策略进行自我管理,包括自我接受、调整节奏和制定计划)。

结论

尽管大多数参与者成功地接受了高等教育,但他们的表现往往受到SLE的身体和认知影响的负面影响。社会支持和学术便利条件有助于减轻该群体所经历的挑战。展望未来,临床医生应就患有SLE的年轻人的教育经历展开对话,以积极应对他们可能面临的挑战。

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