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Worries and needs of adults and parents of adults with neurofibromatosis type 1
Authors:Pauline H. Both  Walter Taal  Jeroen S. Legerstee  AnneLoes van Staa  Henriette A. Moll  Rianne Oostenbrink  Agnies M. van Eeghen
Affiliation:1. ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Rotterdam, The Netherlands;2. Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands;3. Department of Neuro‐Oncology/Neurology, Erasmus Medical Center‐Cancer Institute, Rotterdam, The Netherlands;4. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center‐Sophia Children's Hospital, Rotterdam, The Netherlands;5. Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands;6. Department of General Pediatrics, Erasmus Medical Center‐Sophia Children's Hospital, Rotterdam, The Netherlands;7. De Hartekamp Groep, Care and Service Center for People with Intellectual Disabilities, Haarlem, The Netherlands
Abstract:Neurofibromatosis type 1 (NF1) is a neurocutaneous disorder associated with lifelong tumor growth propensity and neurocognitive impairments. Although follow‐up of adults with NF1 often focuses on tumor growth, follow‐up of cognitive or social problems and other NF1‐related comorbidity is often not a part of standardized care. In order to provide optimal care services for these patients, we explored the care needs of adults with NF1. A qualitative study was performed using semi‐structured group interviews, exploring worries and care needs in medical, psychological, and socioeconomic domains, also focusing on the transition from pediatric to adult care. Four focus groups were conducted, including young adult patients, patients over age 30, and parents of young adult patients. In total, 30 patients and 12 parents participated. Data were transcribed verbatim and analyzed by computerized thematic analysis. Themes were organized using the World Health Organization International classification of functioning, disability, and health (ICF). Results indicated many and diverse worries and care needs both during the transitional period and in adulthood in medical, mental health, and socioeconomic domains. Worries could be categorized into 13 themes. Parents reported high stress levels and difficulties with their parental role. Participants expressed the need for more information, access to NF1 experts, daily living support, care for mental health and socioeconomic participation, and closer communication between health‐care providers. In conclusion, worries and needs of patients and parents underline the importance of multidisciplinary follow‐up and continuity of care during and after the transitional period. Additionally, parental stress requires more attention from care providers.
Keywords:adults  ICF classification  neurofibromatosis 1  qualitative research  transition
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