title: Experiences among children and adolescents of living with spina bifida and their visions of the future.
abstract: Purpose Transitioning to independence may be problematic for persons with spina bifida (SB). Experiences of young persons with SB may provide insights into this group's needs for support. Therefore, the aim of this study was to investigate children's and adolescents' experiences of living with SB, their social and emotional adjustment, and their thoughts about becoming independent adults. Method Semi-structured interviews were conducted with young persons with SB (N = 8, age range 10-17 years). Social and emotional problems were assessed using Beck Youth Inventories. The interview transcripts were analyzed using qualitative content analysis. Results Three main themes were found: being a person with SB; everyday living as a person with SB; and preparing for life as an adult with SB. Indications of emotional and social problems were most prominent among participants with milder physical disability. Conclusions The findings indicate that young persons with SB may overestimate their independence. Other potentially problematic areas were lack of motivation, planning and preparedness for becoming independent. Research on transition to independence in this group should consider assistance at an early age in planning and executing strategies for independence. In addition, the potentially difficult situation for young persons with mild SB should be investigated further. Implications for rehabilitation Children and adolescents with spina bifida might lack the motivation and skills for planning their future and health care programmes should therefore include preparations for life as an adult. Clinical assessment of the level of independence should specifically distinguish between the activities they know how to do and what tasks they actually execute independently. Routine follow-ups should include screening for problems with social and emotional adjustment. Be aware of a potential condition-severity paradox whereby those with less severe impairment might have an increased risk of developing symptoms of social and emotional problems.
authors.affiliation: a Department of Habilitation , Linköping University , Linköping , Sweden.|b Department of Medical and Health Sciences , Linköping University , Linköping , Sweden.
authors.forename: Lina
authors.initials: L
authors.lastname: Strömfors
authors.affiliation: b Department of Medical and Health Sciences , Linköping University , Linköping , Sweden.|c Research & Development Unit of Local Health Care , Linköping University , Linköping , Sweden.
authors.forename: Susan
authors.initials: S
authors.lastname: Wilhelmsson
authors.affiliation: c Research & Development Unit of Local Health Care , Linköping University , Linköping , Sweden.|d Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden.|e Department of Dermatology and Venereology , Linköping University , Linköping , Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Falk
authors.affiliation: f Department of Science and Technology , Linköping University , Linköping , Sweden.
authors.forename: Gunnar E
authors.initials: GE
authors.lastname: Höst
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002648:Child; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D011569:Psychiatric Status Rating Scales; D016135:Spinal Dysraphism / Q000523:psychology*
keywords: Adjustment; adolescents; children; independence; qualitative content analysis; spina bifida