Objective. To explore the self-management needs of adolescents with juvenile idiopathic arthritis and the acceptability of a Web-based program of self-management aimed at improving quality of life. Methods. A descriptive qualitative design was used. A convenience sample of 36 adolescents (male and female) who varied in age, disease onset subtype, and disease severity were recruited from 4 Canadian tertiary care pediatric centers. Individual (n ؍ 25) and 3 focus-group (n ؍ 11) interviews were conducted with adolescents using semistructured interview guides. After each interview session, the audiotaped interview data were transcribed verbatim. NUD*IST 6.0 was used to assist with the sorting, organizing, and coding of the data. Data were organized into categories that reflected emerging themes. Results. Adolescents articulated how they developed effective self-management strategies through the process of "letting go" from others who had managed their illness (health care professionals, parents) and "gaining control" over managing their illness on their own. The 2 strategies that assisted in this process were gaining knowledge and skills to manage the disease and experiencing understanding through social support. Five further subthemes emerged around skills to manage the disease, including knowledge and awareness about the disease, listening to and challenging care providers, communicating with the doctor, managing pain, and managing emotions. Conclusion. Adolescents were united in their call for more information, self-management strategies, and meaningful social support to better manage their arthritis. They believed that Web-based interventions were a promising avenue to improve accessibility and availability of these interventions.
Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.
Columbia (UBC) and various partners created the Northern Medical Program (NMP), a regional distributed site of UBC's medical doctor undergraduate program. Early research on the impacts of the NMP revealed a high degree of social connectedness. The objective of the present study was to explore the role of social capital in supporting the regional training site and the benefits accrued to a broad range of stakeholders and network partners. Methods: In this qualitative study, 23 semi-structured interviews were conducted with community leaders in 2007. A descriptive content analysis based on analytic induction technique was employed. Carpiano's Bourdieu-based framework of 'neighbourhood' social capital was adapted to empirically describe how social capital was produced and mobilized within and among networks during the planning and implementation of the NMP. Results: Results from this study reveal that the operation of social capital and the related concept of social cohesion are multifaceted, and that benefits extend in many directions, resulting in somewhat unanticipated benefits for other key stakeholders and network partners of this medical education program. Participants described four aspects of social capital: (i) social cohesion;ii) social capital resources; (iii) access to social capital; and (iv) outcomes of social capital.
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