Maureen Lyon - Academia.edu (original) (raw)

Papers by Maureen Lyon

Handbook of Supportive Oncology and Palliative Care, 2018

Pediatric Blood & Cancer, Jul 19, 2020

Background: Cancer diagnoses pose challenges to adolescents' and young adults' (AYA) physical, me... more Background: Cancer diagnoses pose challenges to adolescents' and young adults' (AYA) physical, mental, and emotional health, and developmental tasks. In order for AYAs, caregivers, clinicians, and other collaborators to optimize health outcomes (coproduction of health), understanding what living well means for AYAs who have experienced cancer is necessary. The objective was to develop an empirical definition of "living well" for AYAs who have experienced cancer to broadly understand AYA values and priorities. This definition may ultimately guide future conversations between caregivers and AYAs, eliciting thorough, personal definitions of living well from individual AYAs. Such conversations may enhance AYA participation in coproducing their health. Procedure: Qualitative analysis using a phenomenological approach of N = 30 structured Respecting Choices interviews conducted with AYAs (14-21 years; mean 84.2 [SD 69] months postcancer diagnosis with 21% on active treatment) from four tertiary pediatric hospitals in the context of a primary study of a pediatric advance care planning intervention trial.

Journal of Adolescent Health, Sep 1, 2017

Abstinence from sexual intercourse can be a healthy choice for adolescents, particularly if an ad... more Abstinence from sexual intercourse can be a healthy choice for adolescents, particularly if an adolescent is not ready to engage in sex. However, government programs exclusively promoting abstinence-only-until-marriage (AOUM) are problematic from scientific and ethical viewpoints. Most young people initiate sexual intercourse as adolescents or young adults, and given a rising age at first marriage around the globe, increasingly fewer adolescents wait until marriage to initiate sex. While theoretically fully protective, abstinence intentions often fail, as abstinence is not maintained. AOUM programs are not effective in delaying initiation of sexual intercourse or changing other behaviors. Conversely, many comprehensive sexuality education programs successfully delay initiation of sexual intercourse and reduce sexual risk behaviors. AOUM programs inherently provide incomplete information and are often neglectful to sexually active adolescents; lesbian, gay, bisexual, transgender, and questioning adolescents; pregnant and parenting adolescents; and survivors of sexual assault. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs to prevent HIV infection. In many U.S. communities, AOUM programs have replaced more comprehensive approaches to sexuality education.

Journal of Adolescent Health, Feb 1, 2017

There were two patient cohorts: prior to and after the introduction of the formal program. Data f... more There were two patient cohorts: prior to and after the introduction of the formal program. Data from one year prior to last appointment at HSC and one year after the first appointment at TGH were collected. The effects of covariates on imaging/clinic/transfusion/subspecialist appointment attendance, medication adherence and hospitalizations were analyzed by multivariable regression. Results: 112 patients met the criteria for transfer/transition, 51 transferred prior to August 1, 2014 and 61 through the CSTP. No significant differences were observed in baseline demographics. The CSTP significantly reduced the proportion of patients lost to follow-up from 29% (11/38) to 7% (4/57) (P¼0.0335). The presence of the CSTP was independently associated with a significant increase in the proportion of patients on hydroxyurea or iron chelation who maintained or improved their medication adherence to 4 days a week (P¼0.047, LR 4.668). A trend towards improvement or maintenance of 90% attendance to appointments was observed (P¼0.096, OR 2.254). Variations in appointment attendance can be explained by patient's age, distance from the hemoglobinopathy center, and English as patient's first language. No independent predictor was found in frequency of hospitalization. No new overt strokes or deaths occurred in the year after moving to the adult center. Conclusions: CSTP with dedicated TN was significantly associated with reduction in the number of AYA lost to follow-up, and improvement and maintenance of fair to good medication adherence. Further analysis of economic benefit and patient satisfaction will be conducted. A clustered randomized-controlled trial will be forthcoming to determine the effectiveness of this transition model of care on AYA patients with sickle cell disease. Sources of Support: Funding for the transition program provided by the

BMJ supportive & palliative care, Sep 1, 2015

Journal of Adolescent Health, Feb 1, 2016

Clinical practice in pediatric psychology, Sep 1, 2021

Children (Basel), May 12, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Frontiers in Psychology

Background and AimsEnd-of-life (EoL) discussions can be difficult for seriously ill adolescents a... more Background and AimsEnd-of-life (EoL) discussions can be difficult for seriously ill adolescents and young adults (AYAs). Researchers aimed to determine whether completing Voicing My CHOiCES (VMC)—a research-informed advance care planning (ACP) guide—increased communication with family, friends, or health care providers (HCPs), and to evaluate the experience of those with whom VMC was shared.MethodsFamily, friends, or HCPs who the AYAs had shared their completed VMC with were administered structured interviews to assess their perception of the ACP discussion, changes in their relationship, conversation quality, and whether the discussion prompted changes in care. Open-ended responses underwent thematic analysis.ResultsOne-month post-completion, 65.1% of AYA had shared VMC completion with a family member, 22.6% with a friend, and 8.9% with an HCP. Among a sample of respondents, family (47%) and friends (33%) reported a positive change in their relationship with the AYA. Participant de...

Cancer Epidemiology, Biomarkers & Prevention, 2020

Background: Providers are uniquely positioned to encourage health-promoting behaviors, particular... more Background: Providers are uniquely positioned to encourage health-promoting behaviors, particularly among cancer survivors where patients develop trust in providers. Methods: We utilized the National Health Interview Survey to identify adults who reported a visit to a provider in the prior year (44,385 individuals with no cancer history and 4,792 cancer survivors), and reported prevalence of provider discussions on weight loss, physical activity, diet, and smoking. We used generalized linear mixed models to examine predicted prevalence of provider lifestyle discussions by cancer history overall, and among those who do not meet body mass index (BMI), activity, or smoking guidelines. Results: Among those with a BMI of 25–<60 kg/m2, 9.2% of those with a cancer history and 11.6% of those without a cancer history reported being told to participate in a weight loss program (P < 0.001). Overall, 31.7% of cancer survivors and 35.3% of those with no cancer history were told to increase...

Palliative Care and Social Practice, 2020

Background: Parents of children with life-limiting illnesses experience considerable burden and d... more Background: Parents of children with life-limiting illnesses experience considerable burden and distress, yet few interventions have targeted their well-being. Objectives: Evaluate the use and feasibility of the Paediatric Carer Support Needs Assessment Tool (pCSNAT) in assessing and addressing parents’ needs caring for cancer and non-cancer conditions. Carer well-being outcomes were also tested. Methods: A non-randomised prospective intervention pilot study. Twenty-eight parents (out of 42 approached) and 5 health professionals working in paediatric palliative care services in Western Australia (2018–2019) completed the pilot study. Results: Two-thirds of eligible parents completed the study. The highest support needs included having time for yourself; practical help in the home; knowing what to expect in the future; financial, legal or work issues; and knowing who to contact if you are concerned. Almost all needs were considerably more pronounced for the non-cancer group. The pCSN...

Journal of Palliative Medicine, 2021

Journal of Adolescent Health, 2012

JAMA Network Open, 2020

IMPORTANCE The associations of spiritual and religious factors with patient-reported outcomes amo... more IMPORTANCE The associations of spiritual and religious factors with patient-reported outcomes among adolescents with cancer are unknown. OBJECTIVE To model the association of spiritual and religious constructs with patient-reported outcomes of anxiety, depressive symptoms, fatigue, and pain interference. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used baseline data, collected from 2016 to 2019, from an ongoing 5-year randomized clinical trial being conducted at 4 tertiaryreferral pediatric medical centers in the US. A total of 366 adolescents were eligible for the clinical trial, and 126 were randomized; participants had to be aged 14 to 21 years at enrollment and be diagnosed with any form of cancer. Exclusion criteria included developmental delay, scoring greater than 26 on the Beck Depression Inventory II, non-English speaking, or unaware of cancer diagnosis. EXPOSURES Spiritual experiences, values, and beliefs; religious practices; and overall self-ranking of spirituality's importance. MAIN OUTCOMES AND MEASURES Variables were taken from the Brief Multidimensional Measurement of Religiousness/Spirituality (ie, feeling God's presence, daily prayer, religious service attendance, being very religious, and being very spiritual) and the spiritual well-being subscales of the Functional Assessment of Chronic Illness Therapy (meaning/peace and faith). Predefined outcome variables were anxiety, depressive symptoms, fatigue, and pain interference from Patient-Reported Outcomes Measurement Information System pediatric measures. RESULTS A total of 126 individuals participated (72 [57.1%] female participants; 100 [79.4%] white participants; mean [SD] age, 16.9 [1.9] years). Structural equation modeling showed that meaning and peace were inversely associated with anxiety (β =-7.94; 95% CI,-12.88 to-4.12), depressive symptoms (β =-10.49; 95% CI,-15.92 to-6.50), and fatigue (β =-8.90; 95% CI,-15.34 to-3.61). Feeling God's presence daily was indirectly associated with anxiety (β =-3.37; 95% CI,-6.82 to-0.95), depressive symptoms (β =-4.50; 95% CI,-8.51 to-1.40), and fatigue (β =-3.73; 95% CI,-8.03 to-0.90) through meaning and peace. Considering oneself very religious was indirectly associated with anxiety (β =-2.81; 95% CI,-6.06 to-0.45), depressive symptoms (β = −3.787; 95% CI,-7.68 to-0.61), and fatigue (β =-3.11, 95% CI,-7.31 to-0.40) through meaning and peace. Considering oneself very spiritual was indirectly associated with anxiety (β = 2.11; 95% CI, 0.05 to 4.95) and depression (β = 2.8, 95% CI, 0.07 to 6.29) through meaning and peace. No associations were found between spiritual scales and pain interference.

Journal of Pain and Symptom Management, 2019

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Journal of Pain and Symptom Management, 2018

Journal of Adolescent Health, 2016