Video Intervention/Prevention Assessment: A patient-centered methodology for understanding the adolescent illness experience

View:

Full Record

Author:

Rich, Michael; Lamola, Steven; Gordon, Jason; Chalfen, Richard

» Save Citation
» Email Citation
» View CMCH Synopsis

Year:

2000

Article Title:

Video Intervention/Prevention Assessment: A patient-centered methodology for understanding the adolescent illness experience

Journal:

Journal of Adolescent Health

Volume:

Edition:

Issue:

Pages:

155-165

ISBN/ISSN:

1054-139X

Source of Funding:

John W. Alden Trust; ; Arthur Vining Davis Foundations; ; Gerondelis Foundation; ; Agnes M. Lindsay Trust; ; Mary A. and John M. McCarthy Foundation; ; Deborah Munroe Noonan Memorial Fund

Study Design:

Correlational Study

Publication Type:

Journal Article

Age Group:

Adolescence (13-17 yrs), Adulthood (18 yrs & older), Childhood (birth-12 yrs), School Age (6-12 yrs), Young Adulthood (18-29 yrs)

URL:

Abstract:

Objective: To obtain a patient-centered perspective on illness and health care through video technology and qualitative methods.

Design: Pilot study of Video Intervention/Prevention Assessment (VIA). Condition-Specific Verbal Report (CSVR) administered as in-person interview assessed comprehensive medical history and psychosocial state. Pediatric Asthma Quality of Life Questionnaire (PAQL) measured health-related quality of life as the impact of asthma on symptoms, activity level, and emotions. General health status assessed by the Child Health Questionnaire-Child Form 87 (CHQ-CF87). Participants created visual narratives of their everyday lives for 4 - 8 weeks including a house tour, daily activities, self-care/medical management, contacts with the health care system, and interviews with close family/friends about asthma. Participants given the opportunity to edit the video post-taping. Video logs noted portion of assignment completed, objective scene descriptions, material source, time codes of each scene, and subjective comments in relation to the scene and participant's health status.

Subjects and Setting: 21 young people, ages 8 - 25, diagnosed with moderate or sever asthma and recruited from a tertiary care pediatric hospital and an inner-city health center. 10 female; 10 black, 9 white; 6 Hispanic.

Intervention(s): N/A

Outcome Measure(s): Post-test HRQL scores assessed changes in disease-specific quality of life. Physician evaluated visual narratives for health affecting features of physical/psychological environment, medical self-management, and nature/quality of relationship with health care providers. Mental health professional evaluated psychological responses to illness, coping mechanisms, and health-related behaviors. Obstacles to medical care and social attitudes toward disease also assessed. Anthropologist analyzed how participants saw and synthesized their worlds.

Results: Most of the home and neighborhood tours revealed asthma triggers specifically asked about, but not reported in the CSVR. Self-administration of medication was varied with some participants exceeding recommended doses, while others discontinued medications without physician consultation. Complex power relationships between patients and physicians observed and instances of gaps in communication/ understanding. The impact of chronic disease on the individual and family's lives were illustrated.

Conclusions: VIA can expand knowledge of disease beyond the clinical setting and has implications as a research tool, as a therapeutic intervention, and as patient-centered communication. � Center on Media and Child Health

Keywords:

Adolescent Attitudes
Adolescents
Anthropology
Asthma
Beliefs
Chronic Illness
Chronic Illness (Media Content)
Communications
Coping Behavior
Emotional Response
Empathy
Families and Family Life
Health Behavior
Health Education
Interventions
Media Production
Medical Treatment
Patients
Perception
Physician's Role
Psychology
Public Health
Technology
Verbal Behavior
Video Cameras
Videotapes