Thomas Westergren

Pushing myself is easier when Physical activity is fun : Children and adolescents with asthma and their perceptions of participation in physical activity

Children with asthma may be less physically active than their healthy peers. We aimed to investigate whether perceived exercise limitation (EL) was associated with lung function or bronchial hyper‐responsiveness (BHR), socioeconomic factors, prenatal smoking, overweight, allergic disease, asthma severity, or physical activity (PA).

A nested case-control study: personal, social and environmental correlates of vigorous physical activity in adolescents with asthma

Abstract Objective: Physical activity (PA) is associated with health benefits. Children and adolescents with asthma may be limited in their PA, particularly at vigorous intensity due to asthma symptoms or poor psychological adjustment to asthma. We aimed to investigate if self-perceived competence, enjoyment, support from others and social-physical environment were associated with vigorous physical activity (VPA) and secondarily to assess if such associations were modified by asthma and asthma severity. Methods: Data from a nested case–control study at 13 years of age within the birth-cohort Environment and Childhood Asthma Study were compiled from 95 participants with and 79 without asthma. The participants completed a questionnaire designed to capture self-perceived competence, enjoyment, support from others and social-physical environment. VPA, defined as ≥ 6 Metabolic Equivalents, was recorded objectively by SenseWear™ Pro2 Armband. Asthma severity was assessed pragmatically by lung function and use of inhaled glucocorticosteroids and β2-agonists and incidence of exacerbations in the last 14 days. Data were analysed using linear regression analysis. Results: No significant differences between adolescents with and without asthma were identified in terms of VPA, competence-enjoyment, support from others and social-physical environment. Peer support (b = 0.29 (0.05–0.52)) and competence-enjoyment (b = 0.23 (0.01–0.44)) were significantly and positively associated with VPA, and teacher support (b = –0.26 (−0.50 to −0.02)) were inversely associated. The model explained 25% of the variance in VPA. Conclusions: Peer support and competence-enjoyment were positively associated with increased VPN in adolescents irrespectively of asthma and asthma severity.

Active play exercise intervention in children with asthma: a PILOT STUDY

Objective Increased physical activity (PA) may be beneficial for children with asthma. Knowledge about how to intervene and encourage children with asthma to be physically active is required. In the present study, we aimed to pilot a 6-week exercise intervention designed as active play and examine attendance rate, exercise intensity and childrens perceptions of participating. Methods 6 children with asthma (4 boys, 2 girls) aged 10–12 years, participated in 60 min of active play exercise twice weekly. A mixed-methods design was applied. The data analysed included attendance rate, exercise intensity assessed by heart rate (HR) monitoring during exercise sessions, registration and description of the active play exercise programme, 3 semistructured focus groups, field observations of 5 exercise sessions, and preintervention and postintervention testing. Findings The average attendance rate was 90%. Intensity ≥80% of maximal HR (HRmax) was recorded for a median (IQR) time of 22 (8) out of 60 min per session. Median (IQR) HR during the sessions was 146 (9; 74% of HRmax) bpm. Children reported increased health-related quality of life (HRQoL) post-test compared with baseline. Children enjoyed participating and reported no limitations by asthma or serious asthma attacks. Instead, they perceived that their asthma and fitness had improved after the programme. The instructors created an inclusive atmosphere that was characterised by easy-to-master games, fair competition, humour and mutual participation. Conclusions The exercise intervention pilot focusing on active play had a high attendance rate, relatively high exercise intensity, and satisfaction; the children perceived that their fitness and asthma had improved, and reported increased HRQoL. A randomised controlled trial of active play exercise including children with asthma should be conducted to evaluate effect on PA level, physical fitness, asthma control and HRQoL.

Adolescent boys with asthma – a pilot study on embodied gendered habits

Purpose Asthma is a common chronic disease with gender differences in terms of severity and quality of life. This study aimed to understand the gendered practices of male asthmatic adolescents in terms of living with and managing their chronic disease. The study applied a sociological perspective to identify the gender-related practices of participants and their possible consequences for health and disease. Patients and methods The study used a combined ethnomethodology and grounded theory design, which was interpreted using Bourdieu’s theory of practice. We aimed to discover how participants interpreted their social worlds to create a sense of meaning in their everyday lives. The study was based on multistage focus group interviews with five adolescent participants at a specialist center for asthmatic children and youths. We took necessary precautions to protect the participants, according to the principles of the Declaration of Helsinki. The study protocol was approved by the Regional Committee for Medical Research Ethics and the hospital’s research department. Results The core concept for asthmatic male adolescents was being men. They were focused on being nonasthmatic, and exhibited ambivalence towards the principles of the health services. Physical activity supported their aim of being men and being nonasthmatic, as well as supported their treatment goals. Being fearless, unconcerned, “cool,” and dependent also supported the aim of being men and being nonasthmatic, but not the health service principle of regular medication. Occasionally, the participants were asthmatic when they were not able to or gained no advantages from being nonasthmatic. Their practice of being men independently of being asthmatic emphasized their deeply gendered habits. Conclusion Understanding gender differences in living with and managing asthma is important for health workers. Knowledge of embodied gendered habits and their reproduction in social interactions and clinical work should be exploited as a resource during the supervision of asthmatic adolescent boys.

Perceived exercise limitation in asthma: The role of disease severity, overweight, and physical activity in children†

Children with asthma may be less physically active than their healthy peers. We aimed to investigate whether perceived exercise limitation (EL) was associated with lung function or bronchial hyper‐responsiveness (BHR), socioeconomic factors, prenatal smoking, overweight, allergic disease, asthma severity, or physical activity (PA).

Experiences of health care providers in the transfer of adolescent or young adults with a chronic condition from pediatric to adult hospital care: a systematic review protocol

REVIEW QUESTION What are the experiences of physicians and nurses (in this paper defined as health care providers in the transfer of adolescents or young adults with a chronic condition from pediatric to adult hospital care? Specifically, the review will explore the experiences of health care providers in: Preparing adolescents and young adults for their transfer from pediatric to adult care Continuity of care between pediatric and adult care Using standardized procedures to facilitate the adolescents and young adults transfer. OBJECTIVE The objective of this systematic review is to identify and synthesize the best available evidence from qualitative primary studies on the experiences of physicians and nurses in the transfer of adolescents and young adults with a chronic condition from pediatric to adult hospital care. INCLUSION CRITERIA Types of participants This review will consider data from physicians and nurses (defined as health care providers in this study) who have experience(s) in transferring adolescents and young adults with a chronic condition from pediatric to adult care. Health care provider experiences should focus on adolescents and young adults aged 13-24 years, regardless of gender, ethnicity or country of origin. Exclusion criteria are studies focusing on experiences of health care providers responsible for adolescents and young adults in residential accommodation or institutionalized care, adolescents and young adults with mental illnesses or diagnosis, or adolescents and young adults with intellectual disabilities. Phenomena of interest Experiences of physicians or nurses responsible for adolescents (13-18 years) or young TRUNCATED AT 250 WORDS

Teachers' experiences of adolescents' pain in everyday life: a qualitative study

Objectives More adolescents report pain now than previously. In Norway, episodic pain problems have been reported by 60% of children and adolescents aged 8–18 years, with 21% reporting duration of pain of more than 3 months. Since adolescents spend much time at school, the attitude and behaviour of teachers play important roles regarding the experience of pain felt by adolescents in everyday life. Yet research on how teachers perceive the pain experienced by adolescents in a school setting is limited. We therefore seek to gain insight to teachers’ classroom experiences with (1) adolescents self-reported pain symptoms; (2) adolescents management of their pain and (3) how to help adolescents manage their pain. Setting Teachers in 5 junior high schools in Norway representing municipalities in 3 rural areas and 2 cities. Research design A qualitative study with an explorative design comprising 5 focus group interviews. Each group consisted of 3–8 junior high school teachers. A semistructured interview guide was used to cover the issues. The transcribed text was analysed with qualitative content analysis. Participants 22 teachers participated (5 men, 17 women; age range 29–62 years) with teaching experience ranging from 3 to nearly 40 years. Results The main theme describing the experience of teachers with adolescents’ pain in everyday life is that pain and management of pain is a social, physical and psychological interwoven phenomenon. Through empirical analyses, 3 subcategories emerged: (1) everyday pain—expressing strenuous life; (2) managing pain—escaping struggle and (3) strategies of teachers—support and normalisation. Conclusions Teachers have a biopsychosocial understanding and approach to pain experienced by adolescents. This understanding influences the role of teachers as significant others in the lives of adolescents with regard to pain and management of their pain in a school setting.

Relationship between physical activity level and psychosocial and socioeconomic factors and issues in children and adolescents with asthma: a scoping review

Background Asthma is a heterogeneous chronic airway disease which may reduce capability for physical activity. In healthy peers, physical activity is influenced by psychosocial and socioeconomic factors. Knowledge about the role of these factors has not been mapped in children and adolescents with asthma. Objective The main objective of this scoping review was to identify psychosocial and socioeconomic factors associated with physical activity level in children and adolescents with asthma in the literature. The specific objectives were to map the instruments used to measure these factors, report on the construction and validation of these instruments, map psychosocial and socioeconomic issues related to physical activity level reported in qualitative studies, and identify gaps in knowledge about the relationship between psychosocial and socioeconomic factors and physical activity level in children and adolescents with asthma. Inclusion criteria Types of participants Children and adolescents with asthma aged six to 18 years. Concept Psychosocial and socioeconomic factors related to physical activity level and participation. Context All physical activity contexts. Types of sources Quantitative and qualitative primary studies in English, with no date limit. Search strategy The databases searched included nine major databases for health and sports science, and five databases for unpublished studies. After screening and identification of studies, the reference lists of all identified reports were searched, and forward citation searches were conducted using four databases. Extraction of the results The following data were extracted: (a) relevant study characteristics and assessment of physical activity level, (b) instruments used to assess psychosocial and socioeconomic factors, (c) association between physical activity level and these factors, (d) construction and validation of instruments, and (e) psychosocial and socioeconomic issues related to physical activity participation. Presentation of the results Twenty-one quantitative and 13 qualitative studies were included. In cross-sectional studies, enjoyment, physical self-concept, self-efficacy, attitudes and beliefs about physical activity and health, psychological distress, health-related quality of life, and social support were more often reported as being correlated with physical activity level. In three studies, the construct validity was assessed by factor analysis and construct reliability tests for the study population. Qualitative studies reported 10 issues related to physical activity participation, and capability and being like peers were most commonly reported. There was no direct evidence that qualitative research informed the development or adjustment of instruments in quantitative studies. Conclusions Seven psychosocial factors correlated with physical activity level; capability and being like peers were the most commonly reported issues. Reports of the construction and validation of instruments were sparse.