51
|
Shared Surgical Decision Making and Youth Resilience Correlates of Satisfaction With Clinical Outcomes. J Craniofac Surg 2016; 26:1574-80. [PMID: 26114527 DOI: 10.1097/scs.0000000000001892] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to identify factors associated with youth satisfaction with surgical procedures performed to address oral cleft or craniofacial conditions (CFCs). It was hypothesized that youth mental health, participation in decision making, perceived consequences of living with a CFC, and coping strategies would be associated with satisfaction with past surgeries. A total of 203 youth between the ages of 11 and 18 years (mean age = 14.5, standard deviation = 2.0, 61% male participants, 78% oral cleft) completed a series of questionnaires measuring depression, self-esteem, participation in decision making, condition severity, negative and positive consequences of having a CFC, coping, and satisfaction with past surgeries. Multiple regression analysis using boot-strapping techniques found that youth participation in decision making, youth perception of positive consequences of having a CFC, and coping accounted for 32% of the variance in satisfaction with past surgeries (P < 0.001). Youth age, sex, and assessment of condition severity were not significantly associated with satisfaction with surgical outcome. Depression, self-esteem, and negative consequences of having a CFC were not associated with satisfaction with past surgeries. Youth should be actively involved in the decision for craniofacial surgery. Youth who were more satisfied with their surgical outcomes also viewed themselves as having gained from the experience of living with a CFC. They felt that having a CFC made them stronger people and they believed that they were more accepting of others and more in touch with others' feelings because of what they had been through.
Collapse
|
52
|
Resch B, Mühlanger A, Maurer-Fellbaum U, Pichler-Stachl E, Resch E, Urlesberger B. Quality of Life of Children with Cystic Periventricular Leukomalacia - A Prospective Analysis with the Child Health Questionnaire-Parent Form 50. Front Pediatr 2016; 4:50. [PMID: 27242979 PMCID: PMC4869559 DOI: 10.3389/fped.2016.00050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/02/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cystic periventricular leukomalacia (PVL) is associated with moderate to severe physical and mental handicaps in preterm infants. We hypothesized whether or not those handicaps were associated with a poorer quality of life (QOL) of affected children and their families compared to matched controls. PATIENTS AND METHODS All children with the diagnosis PVL collected from a local database of the Division of Neonatology of the Medical University of Graz, Austria, and born between 1997 and 2008 were included in the study group. Preterm infants matched for gestational age, birth weight, year of birth, and gender without PVL served as controls. Selected perinatal data and neurological outcome were documented. The interview of the parents was conducted using the Child Health Questionnaire-Parent Form 50 (CHQ-PF50), German version. The CHQ-PF50 consists of 50 items divided over 11 multi-item scales and 2 single-item questions. RESULTS The CHQ-PF50 was answered by 21 parents of the study (26%) and 44 of the control (39%) group. Cases were diagnosed as having developmental delay, dystonia, strabismus, central visual impairment, seizures, and cerebral palsy (81 vs. 7%, p < 0.001) more common than controls. Analysis of the CHQ-PF 50 revealed significantly poorer results for cases regarding physical health (physical functioning: p < 0.001, physical social limitations: p < 0.001, and physical summary score: p < 0.001). Several psychosocial categories (behavior, mental health, and self-esteem) and the psychosocial summary score did not differ between groups. Only two categories (parental impact concerning time p = 0.004 and family activities: p = 0.026) revealed significantly poorer results in the cases as it was for the global category for health (p = 0.009). CONCLUSION Children with PVL had an overall poorer QOL regarding physical aspects. However, PVL was not generally associated with a poorer QOL regarding psychosocial aspects.
Collapse
Affiliation(s)
- Bernhard Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria
| | - Anja Mühlanger
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz , Graz , Austria
| | - Ute Maurer-Fellbaum
- Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria; Outpatient Department of Developmental Follow-Up, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Pichler-Stachl
- Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria; Outpatient Department of Developmental Follow-Up, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz , Graz , Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department of Pediatrics, Medical University of Graz , Graz , Austria
| |
Collapse
|
53
|
Abstract
OBJECTIVE To assess long-term health status and health-related quality of life in survivors of cardiac arrest in childhood and their parents. In addition, to identify predictors of health status and health-related quality of life. DESIGN This medical follow-up study involved consecutive children surviving cardiac arrest between January 2002 and December 2011, who had been admitted to the ICU. Health status was assessed with a medical interview, physical examination, and the Health Utilities Index. Health-related quality of life was assessed with the Child Health Questionnaires and Short-Form 36. SETTING A tertiary care university children's hospital. PATIENTS Of the eligible 107 children, 57 (53%) filled out online questionnaires and 47 visited the outpatient clinic (median age, 8.7 yr; median follow-up interval, 5.6 yr). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of the participants, 60% had an in-hospital cardiac arrest, 90% a nonshockable rhythm, and 50% a respiratory etiology of arrest. Mortality rate after hospital discharge was 10%. On health status, we found that 13% had long-term neurologic deficits, 34% chronic symptoms (e.g., fatigue, headache), 19% at least one sign suggestive of chronic kidney injury, and 15% needed special education. Health Utilities Index scores were significantly decreased on most utility scores and the overall Health Utilities Index mark 3 score. Compared with Dutch normative data, parent-reported health-related quality of life of cardiac arrest survivors was significantly worse on general health perception, physical role functioning, parental impact, and overall physical summary. On patient reports, no significant differences with normative data were found. Parents reported better family cohesion and better health-related quality of life for themselves on most scales. Patients' health status, general health perceptions, and physical summary scores were significantly associated with cardiac arrest-related preexisting condition. CONCLUSIONS Considering the impact of cardiac arrest, the overall outcome after cardiac arrest in childhood is reasonably good. Prospective long-term outcome research in large homogeneous groups is needed.
Collapse
|
54
|
Jiang F, Torgerson TR, Ayars AG. Health-related quality of life in patients with primary immunodeficiency disease. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2015; 11:27. [PMID: 26421019 PMCID: PMC4587876 DOI: 10.1186/s13223-015-0092-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/01/2015] [Indexed: 12/31/2022]
Abstract
Primary immunodeficiency disease (PIDD) with hypogammaglobulinemia is characterized by recurrent and severe bacterial infections and IgG replacement is the standard of care in many of these patients. Health-related quality of life (HRQOL) is becoming increasingly recognized as a factor that affects patient well-being and treatment preferences. In an effort to better understand what factors affect HRQOL in patients with PIDD, we reviewed the published literature that used standardized instruments for the measurement of HRQOL. We investigated HRQOL in PIDD patients compared with normal controls and patients with other chronic diseases; we also investigated the impact of treatment administration on patient satisfaction. The most commonly encountered health-related quality of life instruments were the child heath questionnaire parental form 50, short form 36, PedsQL 4.0, Lansky's play performance scale, and Life Quality Index. Patients with PIDD scored significantly lower on many of the instruments compared with normal controls. Also, while it appears that many patients appreciate home-based and subcutaneous IgG replacement therapy, patient satisfaction ultimately involves various clinical factors and individual patient preferences. By further analyzing what factors impact HRQOL, therapy adjustments can be made to maximize patient well-being and minimize disease impact on daily functioning.
Collapse
Affiliation(s)
- Fonda Jiang
- />University of Washington, Seattle, WA USA
- />Center for Allergy and Inflammation UW Medicine at South Lake Union, 850 Republican Street, Seattle, WA 98109-4725 USA
| | - Troy R. Torgerson
- />University of Washington, Seattle, WA USA
- />Seattle Children’s Hospital, Seattle, WA USA
| | - Andrew G. Ayars
- />University of Washington, Seattle, WA USA
- />Seattle Children’s Hospital, Seattle, WA USA
| |
Collapse
|
55
|
Pullens B, Pijnenburg MW, Hoeve HJ, Baatenburg de Jong RJ, Buysse CMP, Timmerman MK, van der Schroeff MP, Joosten KFM. Long-term functional airway assessment after open airway surgery for laryngotracheal stenosis. Laryngoscope 2015; 126:472-7. [DOI: 10.1002/lary.25419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Bas Pullens
- Department of Otorhinolaryngology and Head and Neck Surgery; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Marielle W. Pijnenburg
- Department of Pediatrics, Pediatric Pulmonology; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Hans J. Hoeve
- Department of Otorhinolaryngology and Head and Neck Surgery; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Rob J. Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Corinne M. P. Buysse
- Department of Pediatrics, Intensive Care Unit; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Marieke K. Timmerman
- Department of Otorhinolaryngology and Head and Neck Surgery; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Marc P. van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| | - Koen F. M. Joosten
- Department of Pediatrics, Intensive Care Unit; Erasmus Medical Center, Sophia Children's Hospital; Rotterdam the Netherlands
| |
Collapse
|
56
|
Dellenmark-Blom M, Chaplin JE, Gatzinsky V, Jönsson L, Abrahamson K. Health-related quality of life among children, young people and adults with esophageal atresia: a review of the literature and recommendations for future research. Qual Life Res 2015; 24:2433-45. [PMID: 25829227 DOI: 10.1007/s11136-015-0975-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2015] [Indexed: 01/16/2023]
Abstract
PURPOSE Esophageal atresia (EA) is a rare congenital malformation requisite of surgical treatment. Survival rates have significantly increased in recent decades, but treated children are at risk of chronic morbidity. This study aims to review the literature on health-related quality of life (HRQOL) in patients with EA and describe the questionnaires used. METHODS A literature search was conducted in Pubmed, Cinahl and PsycINFO, from inception to January 2015. A meta-analysis of studies investigating HRQOL in patients with EA compared to healthy references was performed. The effect size was calculated as Cohen's d. RESULTS Twelve articles (published 1995-2014) describing HRQOL among children, young people and adults were identified. Only European studies were found, and these had variable sample sizes (8-128). Overall HRQOL was reported to be reduced in five of the seven studies that compared overall HRQOL with a healthy reference population. Impaired physical or general health was described in eight articles. In the meta-analysis, eight eligible studies provided 16 estimates of the effect of EA, six of which reached statistical significance for worse HRQOL (p < 0.05). Using Cohen's criteria, the pooled estimate of the effect of EA was small for overall and physical HRQOL, and <0.2 for the mental and social HRQOL components. Altogether, 15 different questionnaires were used, and none were condition specific for EA. CONCLUSIONS Different findings are reported; however, this study suggests that patients with EA may have a reduced HRQOL. Moreover, HRQOL is not adequately measured in this group. Additional research is required.
Collapse
Affiliation(s)
- Michaela Dellenmark-Blom
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden.
| | - John Eric Chaplin
- Gothenburg Pediatric Growth Research Center (GPGRC), Department of Pediatrics, Institute of Clinical Sciences, Gothenburg University, 416 85, Gothenburg, Sweden
| | - Vladimir Gatzinsky
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden
| | - Linus Jönsson
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden
| | - Kate Abrahamson
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden
| |
Collapse
|
57
|
Costello JM, Mussatto K, Cassedy A, Wray J, Mahony L, Teele SA, Brown KL, Franklin RC, Wernovsky G, Marino BS. Prediction by clinicians of quality of life for children and adolescents with cardiac disease. J Pediatr 2015; 166:679-83.e2. [PMID: 25722271 PMCID: PMC4347874 DOI: 10.1016/j.jpeds.2014.11.061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 10/16/2014] [Accepted: 11/26/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine whether clinicians could reliably predict health-related quality of life (HRQOL) for children with cardiac disease, the level of agreement in predicted HRQOL scores between clinician sub-types, and agreement between clinician-predicted HRQOL scores and patient and parent-proxy reported HRQOL scores. STUDY DESIGN In this multicenter, cross-sectional study, a random sample of clinical summaries of children with cardiac disease and related patient and parent-proxy reported HRQOL scores were extracted from the Pediatric Cardiac Quality of Life Inventory data registry. We asked clinicians to review each clinical summary and predict HRQOL. RESULTS Experienced pediatric cardiac clinicians (n = 140), including intensive care physicians, outpatient cardiologists, and intensive care, outpatient, and advanced practice nurses, each predicted HRQOL for the same 21 pediatric cardiac patients. Reliability within clinician subspecialty groups for predicting HRQOL was poor (intraclass correlation coefficients, 0.34-0.38). Agreement between clinician groups was low (Pearson correlation coefficients, 0.10-0.29). When comparing the average clinician predicted HRQOL scores to those reported by patients and parent-proxies by Bland Altman plots, little systematic bias was present, but substantial variability existed. Proportional bias was found, in that clinicians tended to overestimate HRQOL for those patients and parent-proxies who reported lower HRQOL, and underestimate HRQOL for those reporting higher HRQOL. CONCLUSIONS Clinicians perform poorly when asked to predict HRQOL for children with cardiac disease. Clinicians should be cognizant of these data when providing counseling. Incorporating reported HRQOL into clinical assessment may help guide individualized treatment decision-making.
Collapse
Affiliation(s)
- John M. Costello
- Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University Feinberg School of Medicine
| | | | - Amy Cassedy
- Cincinnati Children's Hospital Medical Center
| | - Jo Wray
- Great Ormond Street Hospital for Children NHS Trust
| | - Lynn Mahony
- University of Texas Southwestern Medical Center
| | | | | | | | | | | |
Collapse
|
58
|
Bompori E, Niakas D, Nakou I, Siamopoulou-Mavridou A, Tzoufi MS. Comparative study of the health-related quality of life of children with epilepsy and their parents. Epilepsy Behav 2014; 41:11-7. [PMID: 25269688 DOI: 10.1016/j.yebeh.2014.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE We aimed to evaluate the health-related quality of life (HRQoL) of schoolchildren with epilepsy and its determinants and the HRQoL of their parents in comparison with those of healthy children and their parents. MATERIALS AND METHODS The study sample comprised 100 children with epilepsy (58 males), 8-16 years of age, diagnosed at least 6 months earlier. The children with epilepsy were divided into two subgroups: A, with well controlled idiopathic epilepsy, and B, with drug-resistant or symptomatic epilepsy and with concomitant neurodevelopmental problems. A control group consisted of 100 healthy age- and gender-matched children. One parent in each family completed two questionnaires standardized for use in Greece: KIDSCREEN-27 (version for parents) to assess the HRQoL of the children and SF-12 to assess the parental HRQoL. For each of the five dimensions of KIDSCREEN-27 and for the physical and mental component scales of the SF-12 tool, the standardized mean difference (SMD) was used for comparison between the various groups and subgroups. Linear regression analysis was used to explore the effect of specific illness-related factors on the five dimensions of KIDSCREEN-27 in the children with epilepsy. RESULTS The parent-reported scores on KIDSCREEN-27 of the children with epilepsy were worse overall than those of healthy children, but the difference reached statistical significance only for the dimensions of "physical well-being" (p = 0.001) and "school environment" (p < 0.001). The differences were greater in adolescents (age group: 13.5-16years). The worst scores were recorded in subgroup B, the children with severe epilepsy, in the dimensions "physical well-being" (p < 0.001), "school environment" (p < 0.0001), and "peers and social support" (p = 0.044). The factors found to have a significant effect on all dimensions were mental retardation, physical disability, abnormal brain imaging findings, learning problems, and, to a lesser degree, administration of a large number of antiepileptic drugs and prolonged treatment. The parents of children with resistant epilepsy and accompanying neurodevelopmental problems scored significantly worse on the SF-12 mental health scale than those of healthy children (p < 0.001). CONCLUSIONS Epilepsy, particularly severe epilepsy with concomitant neurodevelopmental problems, adversely affects the HRQoL of both schoolchildren and their parents.
Collapse
Affiliation(s)
- Eleni Bompori
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece; Faculty of Social Sciences, Hellenic Open University, Patras, Greece.
| | - Dimitrios Niakas
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
| | - Iliada Nakou
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece
| | | | - Meropi S Tzoufi
- Department of Child Health, Ioannina University School of Medicine, Ioannina, Greece
| |
Collapse
|
59
|
Wenhold F, MacIntyre U, Rheeder P. Screening for dietary fat intake of grade six children: self-assessment vs. maternal assessment. MATERNAL & CHILD NUTRITION 2014; 10:630-641. [PMID: 23006413 PMCID: PMC6860331 DOI: 10.1111/j.1740-8709.2012.00444.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
As part of justifiable nutrition promotion, this study aimed to determine internal consistency of a dietary fat screener and to compare self-assessment to maternal assessment of fat intake of grade six (about 12 years old) learners in a South African public primary school. The children completed in school a pictorial, quantitative food frequency-type screener consisting of 10 high-fat food categories; mothers individually completed a text version. Internal consistency was measured with item-total correlations, Cronbach's alpha and the split-half method. Child-mother comparison was based on kappa (κ) statistics, McNemar's tests, Wilcoxon signed-rank test and the Bland-Altman method. In total, 101 (93.5%) children and 78 (72.2%) mothers responded. The screener was internally consistent, regardless of data source and statistical technique. For portion sizes and frequency of intake, children consistently reported higher intake than mothers. This resulted in systematic error, also evidenced by a significant difference from zero for the difference between child's and mother's final test scores for the whole group, and for boys and girls separately (always P < 0.001). In 76% of the pairs, classification into high fat or prudent intake was identical, yet the chance-corrected agreement was poor (κ = 0.16) and non-agreement was non-symmetrical (P = 0.001). Children and mothers reported high fat intakes (93% and 75%, respectively). It was concluded that the dietary fat screener was internally consistent, yet children and mothers did not agree in their assessment. The high fat intakes reported by children and mothers warrant measurement refinement and implementation of primary prevention programmes.
Collapse
Affiliation(s)
- Friede Wenhold
- Department of Human NutritionFaculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
| | - Una MacIntyre
- Department of Human NutritionFaculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
| | - Paul Rheeder
- Division Clinical EpidemiologySchool of Health Systems and Public HealthUniversity of PretoriaPretoriaSouth Africa
| |
Collapse
|
60
|
Bocca G, Kuitert MWB, Sauer PJJ, Stolk RP, Flapper BC, Corpeleijn E. A multidisciplinary intervention programme has positive effects on quality of life in overweight and obese preschool children. Acta Paediatr 2014; 103:962-7. [PMID: 24862085 DOI: 10.1111/apa.12701] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/27/2014] [Accepted: 05/20/2014] [Indexed: 01/09/2023]
Abstract
AIM Up to 18.1% of Dutch children aged 3-5 are overweight and up to 3.3% are obese, with higher levels in girls. This study assessed the effect of a multidisciplinary intervention programme on health-related quality of life (HRQoL) in this patient group. METHODS We randomised 75 children to a multidisciplinary intervention, comprising dietary advice, exercise sessions and psychological counselling for parents or the standard care programme, providing healthy lifestyle advice. The parents completed quality of life and child health questionnaires at baseline and after 16 weeks and 12 months. RESULTS At 16 weeks, children in the intervention group experienced more bodily pain and less mental health than the standard care group, but at 12 months, this difference disappeared and they showed a more positive change in HRQoL than the standard care group, especially for the physical domain. When we combined both groups, a decreased BMIz-score over 12 months was associated with increased global health and reduced visceral fat correlated with increased general health. CONCLUSION At 12 months, a multidisciplinary intervention programme for overweight and obese children aged 3-5 years had beneficial effects on HRQoL, especially for the physical domain. Reduced obesity parameters correlated with several increased HRQoL parameters.
Collapse
Affiliation(s)
- G Bocca
- Department of Paediatrics; Beatrix Children's Hospital; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - MWB Kuitert
- Department of Paediatrics; Beatrix Children's Hospital; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - PJJ Sauer
- Department of Paediatrics; Beatrix Children's Hospital; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - RP Stolk
- Department of Epidemiology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - BC Flapper
- Department of Paediatrics; Beatrix Children's Hospital; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - E Corpeleijn
- Department of Epidemiology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| |
Collapse
|
61
|
van Litsenburg RRL, Huisman J, Pieters R, Verhaak C, Kaspers GJL, Gemke RJBJ. Determinants of quality of life during induction therapy in pediatric acute lymphoblastic leukemia. Support Care Cancer 2014; 22:3235-42. [PMID: 25011520 DOI: 10.1007/s00520-014-2349-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 06/29/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Improvement in survival of pediatric acute lymphoblastic leukemia (ALL) has increased the attention to quality of life (QoL) . QoL is impaired during maintenance treatment, but little is known about QoL during induction therapy. Identification of patients with poor QoL during induction will provide opportunities for early interventions, and may subsequently improve future QoL. This national multi-center study aimed to assess QoL and its determinants during ALL induction treatment. METHODS Proxy reports of the Child Health Questionnaire (CHQ) and the PedsQL cancer version were collected. Child, treatment, and parental characteristics were analyzed as potential determinants in a multiple regression model. RESULTS One hundred thirty parents of children participated (response rate 82 %), median child age was 5.7 years and 48 % were female. QoL, as measured with the CHQ, was significantly lower than the norm, the effect sizes were large, and the differences were clinically relevant. Physical QoL was more often affected than psychosocial QoL. Regression models could be constructed for 4/ 10 CHQ scales and 6/ 8 PedsQL cancer scales, accounting for 7 to 36 % of the variance in scores. Impaired QoL was most often associated with older children, girls, and time since diagnosis. Also, father respondents seem to have a lower QoL perception compared to mother respondents although this needs to be confirmed in future research. CONCLUSIONS Specific counseling for subsets of patients with a higher risk of low QoL during the early phases of therapy is warranted.
Collapse
Affiliation(s)
- Raphaële R L van Litsenburg
- Department of Pediatrics, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands,
| | | | | | | | | | | |
Collapse
|
62
|
Functional health status in children and adolescents after Fontan: comparison of generic and disease-specific assessments. Cardiol Young 2014; 24:469-77. [PMID: 23746330 PMCID: PMC4068336 DOI: 10.1017/s1047951113000632] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE The aim of this study was to compare associations between generic versus disease-specific functional health status assessments and patient and clinical characteristics for patients with severe congenital heart disease. METHODS This was a cross-sectional observational study involving 325 single ventricle patients, aged 10-18 years, after Fontan procedure. Enrolled patients underwent a medical history review, laboratory testing, and assessment of the functional health status by completion of the generic Child Report Child Health Questionnaire and the disease-specific Congenital Heart Adolescent and Teenage questionnaire. Correlated conceptually equivalent domains from both questionnaires were identified and their associations with patient and clinical variables were compared. RESULTS From the generic assessment, patients perceived marginally lower physical functioning (p = 0.05) but greater freedom from bodily pain compared with a normal population (p < 0.001). The equivalent physical functioning/limitations domain of the generic instrument, compared with the disease-specific instrument, had similar associations (higher multi-variable model R²) with medical history variables (R² = 0.14 versus R² = 0.12, respectively) and stronger associations with exercise testing variables (R² = 0.22 versus R² = 0.06). Similarly, the corresponding freedom from bodily pain/symptoms domains from both questionnaires showed a greater association for the generic instrument with medical history variables (R² = 0.15 versus R² = 0.09, respectively) and non-cardiac conditions (R² = 0.13 versus R² = 0.06). The associations of each questionnaire with echocardiographic results, cardiac magnetic resonance imaging results, and serum brain natriuretic peptide levels were uniformly weak (R² range <0.01 to 0.04). CONCLUSIONS Assessment of the physical functional health status using generic and disease-specific instruments yields few differences with regard to associations between conceptually similar domains and patient and clinical characteristics for adolescents after Fontan procedure.
Collapse
|
63
|
Heidemann CH, Godballe C, Kjeldsen AD, Johansen ECJ, Faber CE, Lauridsen HH. Otitis Media and Caregiver Quality of Life: Psychometric Properties of the Modified Danish Version of the Caregiver Impact Questionnaire. Otolaryngol Head Neck Surg 2014; 151:142-9. [PMID: 24687943 DOI: 10.1177/0194599814528245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/26/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Otitis media in children may have a considerable impact on caregiver quality of life. The disease-specific Caregiver Impact Questionnaire is designed to assess caregiver quality of life in relation to child otitis media. Assessment of the psychometric properties of this instrument is limited. This study assesses the psychometric properties of this instrument including validity, reproducibility, responsiveness, and interpretability. STUDY DESIGN Longitudinal validation study. SETTING Secondary care units. METHODS Analyses were based on data from 435 families. Validity was assessed using confirmatory factor analysis, internal consistency, and hypothesis testing. Test-retest reliability and measures of smallest detectable change were investigated in the assessment of reproducibility. Responsiveness was investigated by means of hypothesis testing and receiver operating characteristic analysis. An anchor-based distribution method was applied for determining minimal important change as perceived by the respondent. RESULTS Factor analysis confirmed the hypothesized 1-factor structure with an acceptable fit. Cronbach's alpha was .90. In the analysis of construct validity, 88.9% of the hypothesized correlations were correctly predicted. Intraclass correlation coefficient was 0.87 and smallest detectable change corresponded to approximately one-fourth of the scale. Responsiveness was found to be good and a change score of 13.8 represented minimal important change. CONCLUSION The modified Danish version of the Caregiver Impact Questionnaire is a valid and reproducible measurement tool that is also sensitive to measuring change in the current setting. A change score representing minimal important change as perceived by the respondent is proposed. Results of this study support the use of this instrument.
Collapse
Affiliation(s)
- Christian Hamilton Heidemann
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Christian Godballe
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Anette Drøhse Kjeldsen
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | | | - Christian Emil Faber
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Henrik Hein Lauridsen
- Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| |
Collapse
|
64
|
Wrotniak BH, Schall J, Brault ME, Balmer D, Stallings VA. Health-related quality of life in children with sickle cell disease using the child health questionnaire. J Pediatr Health Care 2014; 28:14-22. [PMID: 23140759 PMCID: PMC4479286 DOI: 10.1016/j.pedhc.2012.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 09/12/2012] [Accepted: 09/16/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study sought to determine if changes in parent-reported health-related quality of life (HRQOL) in children with sickle cell disease (SCD-SS) occurred after participation in a nutritional supplementation study and to compare HRQOL responses with normative scores from non-White children. METHOD Parents of children with SCD-SS between the ages of 5 and 13 years completed the Child Health Questionnaire (CHQ-PF50) at baseline and at 12 months. RESULTS For the 47 children (8.6 ± 2.4 yrs, 43% female), baseline Child Health Questionnaire scale scores were significantly lower than normative scale scores for parental emotional impact, general health, and overall physical health, but they were higher for mental health. After the nutritional supplementation study, overall physical health and parental emotional impact improved to normative levels. Furthermore, physical role functioning significantly improved. DISCUSSION Participation in a nutritional study had a positive impact on parent-reported HRQOL physical scores in children with SCD-SS. More research is necessary to develop care providers' awareness and adequate HRQOL interventions for this population.
Collapse
Affiliation(s)
- Brian H. Wrotniak
- The Children’s Hospital of Philadelphia, Philadelphia, PA and Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
- D’Youville College, Buffalo, NY
| | - Joan Schall
- The Children’s Hospital of Philadelphia, Philadelphia, PA and Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | | | | | - Virginia A. Stallings
- The Children’s Hospital of Philadelphia, Philadelphia, PA and Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
65
|
Felix JF, Voortman T, van den Hooven EH, Sajjad A, Leermakers ET, Tharner A, Jong JCKD, Duijts L, Verhulst FC, de Jongste JC, Tiemeier H, Hofman A, Rivadeneira F, Moll HA, Raat H, Jaddoe VW, Franco OH. Health in children: A conceptual framework for use in healthy ageing research. Maturitas 2014; 77:47-51. [DOI: 10.1016/j.maturitas.2013.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 09/19/2013] [Indexed: 12/22/2022]
|
66
|
Park HJ, Yang HK, Shin DW, Kim YY, Kim YA, Yun YH, Nam BH, Bhatia S, Park BK, Ghim TT, Kang HJ, Park KD, Shin HY, Ahn HS. Cross-cultural adaptation of the korean version of the minneapolis-manchester quality of life instrument-adolescent form. J Korean Med Sci 2013; 28:1788-95. [PMID: 24339710 PMCID: PMC3857376 DOI: 10.3346/jkms.2013.28.12.1788] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/08/2013] [Indexed: 11/25/2022] Open
Abstract
We verified the reliability and validity of the Korean version of the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form (KMMQL-AF) among Korean childhood cancer survivors. A total of 107 childhood cancer patients undergoing cancer treatment and 98 childhood cancer survivors who completed cancer treatment were recruited. To assess the internal structure of the KMMQL-AF, we performed multi-trait scaling analyses and exploratory factor analysis. Additionally, we compared each domains of the KMMQL-AF with those of the Karnofsky Performance Status Scale and the Revised Children's Manifest Anxiety Scale (RCMAS). Internal consistency of the KMMQL-AF was sufficient (Cronbach's alpha: 0.78-0.92). In multi-trait scaling analyses, the KMMQL-AF showed sufficient construct validity. The "physical functioning" domain showed moderate correlation with Karnofsky scores and the "psychological functioning" domain showed moderate-to-high correlation with the RCMAS. The KMMQL-AF discriminated between subgroups of different adolescent cancer survivors depending on treatment completion. The KMMQL-AF is a sufficiently reliable and valid instrument for measuring quality of life among Korean childhood cancer survivors.
Collapse
Affiliation(s)
- Hyeon Jin Park
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
| | - Hyung Kook Yang
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Dong Wook Shin
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea
- Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul, Korea
| | - Yoon Yi Kim
- Korea Childhood Leukemia Foundation, Seoul, Korea
| | - Young Ae Kim
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Young Ho Yun
- Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Byung Ho Nam
- Cancer Biostatistics Branch, National Cancer Research Institute, National Cancer Center, Goyang, Korea
| | - Smita Bhatia
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Byung Kiu Park
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
| | - Thad T. Ghim
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Duk Park
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Young Shin
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Seop Ahn
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
67
|
Heidemann CH, Godballe C, Kjeldsen AD, Johansen ECJ, Faber CE, Lauridsen HH. The Otitis Media-6 questionnaire: psychometric properties with emphasis on factor structure and interpretability. Health Qual Life Outcomes 2013; 11:201. [PMID: 24257471 PMCID: PMC4222717 DOI: 10.1186/1477-7525-11-201] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 11/18/2013] [Indexed: 11/29/2022] Open
Abstract
Background The Otitis Media-6 questionnaire (OM-6) is the most frequently used instrument to measure health related quality of life in children with otitis media. The main objectives of this study are 1) to translate and cross-culturally adapt the OM-6 into Danish, and 2) to assess important psychometric properties including structural validity and interpretability of the OM-6 in a Danish population of children suffering from otitis media. Methods The OM-6 was translated and cross-culturally adapted according to international guidelines. A longitudinal validation study enrolled 491 children and their families, and the measurement properties of the OM-6 were evaluated using the Cosmin taxonomy. The properties assessed were construct and structural validity (confirmatory factor analysis) including internal consistency, reproducibility (test-retest reliability and smallest detectable change), responsiveness and interpretability. Results A total of 435 children were eligible to participate in the study. Analyses of structural validity and internal consistency indicated that parent appraisal of hearing and speech problems may be problematic. Both scales showed similarly good test-retest reliability and construct validity, were able to discriminate between diagnostic subgroups and responsive to change. Cut-off values of 16.7 and 30.0 were found to represent minimal important change for the patients. Conclusions The Danish version of the OM-6 is a reliable, valid, responsive and interpretable questionnaire to measure quality of life in children with otitis media. This study sheds light on possible weaknesses of the instrument that needs to be acknowledged in the utilization of the instrument. However, despite these issues our results support the continuing use of OM-6 as a 1-factor functional health scale with a separate global health rating. Furthermore, indications of values representing minimal important change as perceived by the respondent are presented.
Collapse
|
68
|
Westendorp T, Verbunt JA, Remerie SC, Smeets RJEM. Responsiveness of the Child Health Questionnaire-Parent Form in adolescents with non-specific chronic pain or fatigue. Eur J Pain 2013; 18:540-7. [PMID: 24019235 DOI: 10.1002/j.1532-2149.2013.00393.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND The Child Health Questionnaire (CHQ) is a widely used instrument for measuring health-related quality of life covering both the physical and psychosocial domain. This study examined the responsiveness of the Dutch CHQ 50-item Parent Form (PF50) in a sample of adolescents with chronic non-specific pain and/or fatigue. METHOD Five different methods were used to calculate the responsiveness for the physical (PhS) and psychosocial (PsS) subscale of the CHQ-50: standardized response mean (SRM), pooled effect sizes (ESs), standard error of measurement of agreement (SEMagreement ), minimal detectable change (MDC) and the area under the receiver operating characteristics (ROC) curve. For data analysis, the population was divided into two groups based on the parent's global perceived effect of treatment: a changed group (A) and an unchanged group (B). RESULTS The responsiveness analyses were performed including 92 adolescents (88.0% girls; mean age 16.4 years). The SRMs are 2.89 and 1.01 for the PhS and PsS, respectively. Large ESs are found for group A (PhS = 3.30; PsS = 1.16). The method used for calculating SEMagreement results in a score of PhS = 18.92 and PsS = 11.39. The MDCs of PhS and PsS are 52.45 and 31.57, respectively. The area under the ROC curve (AUC) for PhS = 0.79 and for PsS = 0.64, and the corresponding optimal cut-off points are 21.1 and 7.0. CONCLUSION Using the methods SRM, ES and AUC, the responsiveness of the CHQ-PF50 in adolescents with non-specific chronic pain or fatigue treated in a rehabilitation clinic is adequate for the physical scale and moderate for the psychosocial scale.
Collapse
Affiliation(s)
- T Westendorp
- Rijndam Rehabilitation Center, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, CAPHRI, Maastricht University, The Netherlands
| | | | | | | |
Collapse
|
69
|
Sanders MS, de Jonge RCJ, Terwee CB, Heymans MW, Koomen I, Ouburg S, Spanjaard L, Morré SA, van Furth AM. Addition of host genetic variants in a prediction rule for post meningitis hearing loss in childhood: a model updating study. BMC Infect Dis 2013; 13:340. [PMID: 23879305 PMCID: PMC3726293 DOI: 10.1186/1471-2334-13-340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 07/16/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Sensorineural hearing loss is the most common sequela in survivors of bacterial meningitis (BM). In the past we developed a validated prediction model to identify children at risk for post-meningitis hearing loss. It is known that host genetic variations, besides clinical factors, contribute to severity and outcome of BM. In this study it was determined whether host genetic risk factors improve the predictive abilities of an existing model regarding hearing loss after childhood BM. METHODS Four hundred and seventy-one Dutch Caucasian childhood BM were genotyped for 11 single nucleotide polymorphisms (SNPs) in seven different genes involved in pathogen recognition. Genetic data were added to the original clinical prediction model and performance of new models was compared to the original model by likelihood ratio tests and the area under the curve (AUC) of the receiver operating characteristic curves. RESULTS Addition of TLR9-1237 SNPs and the combination of TLR2 + 2477 and TLR4 + 896 SNPs improved the clinical prediction model, but not significantly (increase of AUC's from 0.856 to 0.861 and from 0.856 to 0.875 (p = 0.570 and 0.335, respectively). Other SNPs analysed were not linked to hearing loss. CONCLUSIONS Although addition of genetic risk factors did not significantly improve the clinical prediction model for post-meningitis hearing loss, AUC's of the pre-existing model remain high after addition of genetic factors. Future studies should evaluate whether more combinations of SNPs in larger cohorts has an additional value to the existing prediction model for post meningitis hearing loss.
Collapse
Affiliation(s)
- Marieke S Sanders
- Department of Pediatric Infectious Diseases - Immunology, and Rheumatology, VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
70
|
April KT, Cavallo S, Feldman DE. Children with juvenile idiopathic arthritis: are health outcomes better for those diagnosed younger? Child Care Health Dev 2013; 39:442-8. [PMID: 22676178 DOI: 10.1111/j.1365-2214.2012.01386.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children living with juvenile idiopathic arthritis (JIA) have swollen, painful and stiff joints, which may have an impact on all spheres of their life, as well as their family. While children diagnosed in their preschool years may be at risk for worse physical outcomes than children diagnosed later in life, it is not clear whether they have worse psychological outcomes and whether these outcomes have an impact on their everyday life. The aim of this study was to examine the association between age at diagnosis and health outcomes in families of children with JIA. METHODS Parents of children with JIA (n = 182) who attended rheumatology clinics at the Montreal Children's Hospital and British Columbia Children's Hospital completed measures assessing socio-demographic attributes, their child's health status, health-related quality of life and pain level, as well as their own level of psychological distress and coping behaviours. Regression models explored the association between age at diagnosis and health outcomes while adjusting for sex, age, severity and duration of the disease. RESULTS Parents of children diagnosed with JIA before 5 years of age found their child to have a better health-related quality of life in terms of psychosocial functioning than parents of children diagnosed later [β = -0.91 (-1.63, -0.19)]. Children diagnosed younger were also found to be less limited in schoolwork or activities with friends because of emotional or behavioural problems than children diagnosed later [odds ratio = 0.07 (0.01, 0.42)]. CONCLUSIONS Children diagnosed younger seem to show good psychosocial adjustment, which may also be true for their caregivers. Perhaps more attention to psychosocial adjustment should be given to families of children who are diagnosed with the disease at an older age.
Collapse
Affiliation(s)
- K Toupin April
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ottawa, ON, Canada
| | | | | |
Collapse
|
71
|
de Jonge RCJ, Sanders MS, Terwee CB, Heymans MW, Gemke RJBJ, Koomen I, Spanjaard L, van Furth AM. Independent validation of an existing model enables prediction of hearing loss after childhood bacterial meningitis. PLoS One 2013; 8:e58707. [PMID: 23536814 PMCID: PMC3594173 DOI: 10.1371/journal.pone.0058707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Accepted: 02/05/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study aimed external validation of a formerly developed prediction model identifying children at risk for hearing loss after bacterial meningitis (BM). Independent risk factors included in the model are: duration of symptoms prior to admission, petechiae, cerebral spinal fluid (CSF) glucose level, Streptococcus pneumoniae and ataxia. Validation helps to evaluate whether the model has potential in clinical practice. STUDY DESIGN 116 Dutch school-age BM survivors were included in the validation cohort and screened for sensorineural hearing loss (>25 dB). Risk factors were obtained from medical records. The model was applied to the validation cohort and its performance was compared with the development cohort. Validation was performed by application of the model on the validation cohort and by assessment of discrimination and goodness of fit. Calibration was evaluated by testing deviations in intercept and slope. Multiple imputation techniques were used to deal with missing values. RESULTS Risk factors were distributed equally between both cohorts. Discriminative ability (Area Under the Curve, AUC) of the model was 0.84 in the development and 0.78 in the validation cohort. Hosmer-Lemeshow test for goodness of fit was not significant in the validation cohort, implying good fit concerning the similarity of expected and observed cases. There were no significant differences in calibration slope and intercept. Sensitivity and negative predicted value were high, while specificity and positive predicted value were low which is comparable with findings in the development cohort. CONCLUSIONS Performance of the model remained good in the validation cohort. This prediction model might be used as a screening tool and can help to identify those children that need special attention and a long follow-up period or more frequent auditory testing.
Collapse
Affiliation(s)
- Rogier C J de Jonge
- Department of Pediatric Infectious Diseases - Immunology, and Rheumatology, VU University Medical Center, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
72
|
Correlation between the Child Health Questionnaire and the International Knee Documentation Committee score in pediatric and adolescent patients with an anterior cruciate ligament tear. J Pediatr Orthop 2013; 33:216-20. [PMID: 23389579 DOI: 10.1097/bpo.0b013e3182745439] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The modified International Knee Documentation Committee (Pedi-IKDC) Subjective Knee Evaluation Form has recently been shown to be valid, reliable, and responsive in a pediatric and adolescent population. The correlations between the Pedi-IKDC and quality-of-life-related health measures have not been studied in depth to determine how a knee injury affects patients in this age group. The purpose of this study was to examine the association between the Pedi-IKDC score and the Child Health Questionnaire (CHQ) in a group of pediatric patients with an anterior cruciate ligament (ACL) injury. METHODS A prospectively collected registry of patients with ACL injuries was searched to indentify all patients who had completed both the Pedi-IKDC and CHQ (CHQ-CF87) questionnaires. These were analyzed to determine significant correlations between domains of the CHQ and the Pedi-IKDC. RESULTS A total of 135 patients were included (80 male, 55 female) with a median age of 15.3 years (range, 13.1 to 17.2 y). The cohort included patients treated both operatively (120) and nonoperatively (15). The total Pedi-IKDC score was found to correlate with the majority of the CHQ including expected domains such as physical function (correlation coefficient = 0.64), bodily pain (0.7), and family activities (0.41), in addition to emotional role (0.45), mental health (0.46), self-esteem (0.45), and social limitations--physical (0.38) (P < 0.001 for all correlations). CONCLUSIONS Seven of the 12 domains on the CHQ are significantly correlated with the IKDC in adolescent patients with an ACL tear. Self-esteem, mental health, emotional role, and social limitations categories are significantly correlated with knee function suggesting that quality-of-life in this population is affected in domains outside of physical function and pain. A greater understanding of the psychosocial impact of injury may be of utility in these patients. STUDY DESIGN Level III cross-sectional study.
Collapse
|
73
|
Gordijn MS, van Litsenburg RR, Gemke RJ, Huisman J, Bierings MB, Hoogerbrugge PM, Kaspers GJL. Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2013; 60:479-85. [PMID: 22887764 DOI: 10.1002/pbc.24261] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 06/26/2012] [Indexed: 11/12/2022]
Abstract
BACKGROUND With the improved survival of childhood acute lymphoblastic leukemia (ALL), the effect of treatment on psychosocial well-being becomes increasingly relevant. Literature on sleep and fatigue during treatment is emerging. However, information on these subjects after treatment is sparse. This cross-sectional study examined sleep and fatigue in relation to depression and quality of life (QoL) after treatment for childhood ALL. PROCEDURE Sleep, fatigue, depression, and QoL were evaluated by parent proxy and/or child self-reports of the Children's Sleep Habits Questionnaire, the PedsQL™ multidimensional fatigue scale, the Children's Depression Inventory and the Child Health Questionnaire. All total scores were compared to Dutch norm references. RESULTS Sixty-two children were included, being 36 (interquartile range 22-62) months after finishing treatment. Parents rated the ALL survivors as having more disturbed sleep, more fatigue and poorer physical QoL compared to the Dutch norm. ALL survivors themselves reported less sleep problems, less depressive symptoms, and better psychosocial QoL than the Dutch norm. More sleep disturbances and fatigue correlated with more symptoms of depression and a worse QoL. CONCLUSIONS Differences in parental and self-reports, including worse parental ratings, might be explained by worried parents and/or the adaptive style of the children. Impaired sleep and fatigue correlated with more depressive symptoms and a worse QoL.
Collapse
Affiliation(s)
- Maartje S Gordijn
- Department of Pediatrics, Division Oncology/Hematology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
74
|
Price KJ, Wales J, Eiser C, Knowles J, Heller S, Freeman J, Brennan A, McPherson A, Wellington J. Does an intensive self-management structured education course improve outcomes for children and young people with type 1 diabetes? The Kids In Control OF Food (KICk-OFF) cluster-randomised controlled trial protocol. BMJ Open 2013; 3:e002429. [PMID: 23355675 PMCID: PMC3563116 DOI: 10.1136/bmjopen-2012-002429] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The Kids In Control OF Food (KICk-OFF) is a cluster-randomised controlled trial, which aims to determine the efficacy of a 5 day structured education course for 11-year-olds to 16-year-olds with type 1 diabetes (T1DM) when compared with standard care, and its cost effectiveness. Less than 15% of children and young people with T1DM in the UK meet the recommended glycaemic target. Self-management education programmes for adults with T1DM improve clinical and psychological outcomes, but none have been evaluated in the paediatric population. KICk-OFF is a 5-day structured education course for 11-year-olds to 16- year-olds with T1DM. It was developed with input from young people, parents, teachers and educationalists. METHODS AND ANALYSIS 36 paediatric diabetes centres across the UK randomised into intervention and control arms. Up to 560 participants were recruited prior to centre randomisation. KICk-OFF courses are delivered in the intervention centres, with standard care continued in the control arm. Primary outcomes are change in glycaemic control (HbA1c) and quality of life between baseline and 6 months postintervention, and the incidence of severe hypoglycaemia. Sustained change in self-management behaviour is assessed by follow-up at 12 and 24 months. Health economic analysis will be undertaken. Data will be reported according to the CONSORT statement for cluster-randomised clinical trials. All analyses will be by intention-to-treat with a two-sided p value of <0.05 being regarded as statistically significant. The study commenced in 2008. Data collection from participants is ongoing and the study will be completed in 2013. ETHICS The study has been approved by the Sheffield Research Ethics Committee. DISSEMINATION Results will be reported in peer reviewed journals and conferences. TRIAL REGISTRATION Current Controlled Trials ISRCTN37042683.
Collapse
Affiliation(s)
| | - Jerry Wales
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Christine Eiser
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Julie Knowles
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Simon Heller
- School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK
| | - Jenny Freeman
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Amy McPherson
- Department of Health Psychology, University of Nottingham, Nottingham, UK
| | | |
Collapse
|
75
|
Banks L, Lin YT, Chahal N, Manlhiot C, Yeung RSM, McCrindle BW. Factors associated with low moderate-to-vigorous physical activity levels in pediatric patients with Kawasaki disease. Clin Pediatr (Phila) 2012; 51:828-34. [PMID: 22523278 DOI: 10.1177/0009922812441664] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND/METHODS We sought to determine functional health status and physical activity determinants in 27 patients with Kawasaki disease (KD; 20 males, 11 ± 3 years old). Patient physical activity data were compared with a population-based study of healthy children (Canadian Health Measures Survey). RESULTS KD patients performed less moderate-to-vigorous physical activity (MVPA) than healthy children (males, 27 vs 61 min/d, P < .001; females, 10 vs 47 min/d, P < .001). Male KD patients performed more MVPA than female KD patients (median = 27; quartiles [Q1 15, Q3 26] min/d vs 10 [Q1 7, Q3 11] min/day, P = .009). Lower MVPA in KD patients was significantly associated with female gender; lower child self-efficacy score; lower Child Health Questionnaire (CHQ-PF50) scores for role functioning behavioral issues, physical functioning, and family cohesion; and higher CHQ-PF50 scores for self-esteem and family activity limitations. CONCLUSION Physical activity counseling should be a focus of management for children with a history of KD.
Collapse
Affiliation(s)
- Laura Banks
- 1Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | | | | |
Collapse
|
76
|
Gordijn MS, van Litsenburg RR, Gemke RJBJ, Bierings MB, Hoogerbrugge PM, van de Ven PM, Heijnen CJ, Kaspers GJL. Hypothalamic-pituitary-adrenal axis function in survivors of childhood acute lymphoblastic leukemia and healthy controls. Psychoneuroendocrinology 2012; 37:1448-56. [PMID: 22385687 DOI: 10.1016/j.psyneuen.2012.01.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Revised: 12/20/2011] [Accepted: 01/31/2012] [Indexed: 12/30/2022]
Abstract
Of all malignancies in children, acute lymphoblastic leukemia (ALL) is the most common type. Since survival significantly improves over time, treatment-related side effects become increasingly important. Glucocorticoids play an important role in the treatment of ALL, but they may suppress the hypothalamic-pituitary-adrenal (HPA) axis. The duration of HPA axis suppression is not yet well defined. The present study aimed at assessing the function of the HPA axis by determining the cortisol awakening response (CAR) and the dexamethasone (DEX) suppression test in children that were treated for childhood ALL, compared to a healthy age and sex matched reference group. In addition, questionnaires regarding sleep, fatigue, depression and quality of life were completed by the children and their parents. Fourty-three survivors who finished their treatment for childhood ALL 37 (interquartile range 22-75) months before and 57 healthy controls were included. No differences in CAR were observed between ALL survivors and the reference group, but survivors of ALL had higher morning cortisol levels and an increased cortisol suppression in response to oral dexamethasone. Higher cortisol levels in childhood ALL survivors were associated with more fatigue and poorer quality of life. We conclude that the experience of a stressful life event in the past may have caused a long-term dysregulation of the HPA axis in childhood ALL survivors, as reflected in an increased cortisol production and an enhanced negative feedback mechanism.
Collapse
Affiliation(s)
- Maartje S Gordijn
- Department of Pediatrics, Division Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
77
|
Hullmann SE, Ryan JL, Ramsey RR, Chaney JM, Mullins LL. Measures of general pediatric quality of life: Child Health Questionnaire (CHQ), DISABKIDS Chronic Generic Measure (DCGM), KINDL-R, Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales, and Quality of My Life Questionnaire (QoML). Arthritis Care Res (Hoboken) 2012; 63 Suppl 11:S420-30. [PMID: 22588762 DOI: 10.1002/acr.20637] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
78
|
de Niet J, Timman R, Bauer S, van den Akker E, Buijks H, de Klerk C, Kordy H, Passchier J. The effect of a short message service maintenance treatment on body mass index and psychological well-being in overweight and obese children: a randomized controlled trial. Pediatr Obes 2012; 7:205-19. [PMID: 22492669 DOI: 10.1111/j.2047-6310.2012.00048.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 12/19/2011] [Accepted: 01/03/2012] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Maintaining weight loss results in childhood obesity treatment is difficult to achieve. Self-management techniques such as self-monitoring are associated with increased weight loss and maintenance. This study analyzes whether self-monitoring of lifestyle behaviours through a short message service maintenance treatment (SMSMT) via mobile phones with personalized feedback positively effects weight, lifestyle behaviours and psychological well-being in obese children. METHODS After 3 months of behavioural lifestyle treatment, 141 overweight and obese children (7-12 years) were randomly assigned to an intervention group receiving SMSMT for 9 months (n = 73) or to the control group (n = 68). The intervention group sent weekly self-monitoring data on exercise and eating behaviour and their mood via mobile phones. In return, they received tailored feedback messages. Primary treatment outcomes were weight, eating behaviour and psychological well-being, i.e. competence, self-esteem and quality of life. Secondary outcome was adherence to the SMSMT. Data were analyzed with mixed modelling. RESULTS SMSMT did not improve treatment outcomes. Controls gained temporarily in physical health scores (P = 0.01). SMSMT completers sent on average every 2 weeks an SMS. Children who had greater weight loss during the first 3 months of lifestyle treatment sent more SMSs (P = 0.04). CONCLUSIONS We did not find a positive effect of SMSMT on weight, eating behaviour or psychological well-being in obese children. SMSMT seems to be a feasible method of treatment delivery. Future research should study variations of SMSMT to investigate how SMSMT can be more effective.
Collapse
Affiliation(s)
- J de Niet
- Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
79
|
Engelen V, Detmar S, Koopman H, Maurice-Stam H, Caron H, Hoogerbrugge P, Egeler RM, Kaspers G, Grootenhuis M. Reporting health-related quality of life scores to physicians during routine follow-up visits of pediatric oncology patients: is it effective? Pediatr Blood Cancer 2012; 58:766-74. [PMID: 21584933 DOI: 10.1002/pbc.23158] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 03/22/2011] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of the current study is to investigate the effectiveness of an intervention that provides health-related quality of life (HRQOL) scores of the patient (the QLIC-ON PROfile) to the pediatric oncologist. PROCEDURE Children with cancer participated in a sequential cohort intervention study: intervention N = 94, control N = 99. Primary outcomes of effectiveness were communication about HRQOL domains (t-test, Mann-Whitney U-test) and identification of HRQOL problems (chi-squared test). Secondary outcomes were satisfaction (multilevel analysis), referrals (chi-squared test), and HRQOL (multilevel analysis). RESULTS The QLIC-ON PROfile increased discussion of emotional functioning (control M = 32.9 vs. intervention M = 47.4, P < 0.05) and psychosocial functioning (M = 56.9 vs. M = 63.8, P < 0.05). Additionally more emotional problems remained unidentified in the control compared to the intervention group, for example, anger (control 26% vs. intervention 3%, P < 0.01), fear (14% vs. 0%, P < 0.01), and sadness (26% vs. 0%, P < 0.001). The intervention had no effect on satisfaction and referrals, but did improve HRQOL of patients 5-7 years of age with respect to self-esteem (P < 0.05), family activities (P < 0.05), and psychosocial functioning (P < 0.01). CONCLUSIONS We conclude that a PRO is a helpful tool for systematic monitoring HRQOL of children with cancer, without lengthening the duration of the consultation. It is recommended to be implemented in clinical practice.
Collapse
Affiliation(s)
- Vivian Engelen
- Psychosocial Department, Academic Medical Centre/Emma Children's Hospital, Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
80
|
Assessment tools and classification systems used for the upper extremity in children with cerebral palsy. Clin Orthop Relat Res 2012; 470:1257-71. [PMID: 21932104 PMCID: PMC3314769 DOI: 10.1007/s11999-011-2065-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Clinicians interested in assessment and outcome measurement of upper extremity (UE) function and performance in children with cerebral palsy (CP) must choose from a wide range of tools. QUESTIONS/PURPOSES We systematically reviewed the literature for UE assessment and classification tools for children with CP to compare instrument content, methodology, and clinical use. METHODS We searched Health and Psychosocial Instruments (HaPI), US National Library of Medicine (PubMed), and Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus) databases (1937 to the present) to identify UE assessment and outcomes tools. We identified 21 tools for further analysis and searched HaPI, PubMed, CINAHL Plus, and Google Scholar ( http://scholar.google.com/schhp?tab=ws ) databases to identify all validity and reliability studies, systematic reviews, and original references for each of the 21 tools. RESULTS The tools identified covered ages birth to adulthood. International Classification of Functioning, Disability and Health domains addressed by these tools included body function, body structure, activities and participation, and environmental factors. Eleven of the tools were patient or family report, seven were clinician-based observations, and three tools could be used in either fashion. All of the tools had published evidence of validity. Nine of the tools were specifically designed for use in subjects with CP. Two of the tools required formal certification before use. Ten of the tools were provided free of charge by the investigators or institution who developed them. CONCLUSIONS Familiarity with the psychometric and clinometric properties of assessment and classification tools for the UE in children with CP greatly enhances a clinician's ability to select and use these tools in daily clinical practice for both clinical decision-making and assessment of outcome.
Collapse
|
81
|
Kang HY, Kim KH, Kim JH, Kim HM, Kim J, Kim MS, El Khoury AC, Kim DS. Economic evaluation of the national immunization program of rotavirus vaccination for children in Korea. Asia Pac J Public Health 2012; 25:145-58. [PMID: 22234827 DOI: 10.1177/1010539511416806] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The authors assessed the cost-effectiveness of rotavirus vaccination to develop an evidence-based national immunization program in Korea. A Markov model was constructed to compare the costs and clinical outcomes of vaccination versus no vaccination. The birth cohort of 493189 infants in 2007 was followed until the age of 5 years. Korea-specific data for epidemiological characteristics and economic burden of rotavirus diarrhea were used for the modeled estimation. Efficacy of RotaTeq® was based on a recent clinical trial. Rotavirus vaccination would prevent 181238 symptomatic cases (reduction rate = 63.2%) over 5 years after birth. From the societal perspective, at a vaccination cost of 100000 Korean won (KW; 1 US$ ≈ 1200 KW) per dose, universal vaccination would cost 375 620 KW per case averted. The breakeven price of vaccine was 56061 KW. Rotavirus vaccination would reduce the burden of the disease substantially and be a cost-effective strategy to prevent rotavirus diarrhea in Korea.
Collapse
Affiliation(s)
- Hye-Young Kang
- Yonsei University, College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Incheon, Korea
| | | | | | | | | | | | | | | |
Collapse
|
82
|
Health-related problems and quality of life in patients with syndromic and complex craniosynostosis. Childs Nerv Syst 2012; 28:879-82. [PMID: 22234545 PMCID: PMC3360850 DOI: 10.1007/s00381-012-1681-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 01/02/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE We conducted this study to gauge the health-related problems, quality of life and the performance of the Health Utility Index Mark 3 (HUI-3) in patients with syndromic and complex craniosynostosis. Patients with syndromic and complex craniosynostosis have various physical and mental problems. More insight on these problems, per syndrome, could provide guidance to improve patient treatment and follow-up. METHODS A cross-sectional, comparative study on 131 patients and their parents was performed. Health-related quality of life was measured with the HUI-3 and the Visual Analogue Scale (VAS). All data were compared to a normative Dutch population. Vision, hearing and intelligence were objectively measured. RESULTS The HUI-3 and the VAS were significant lower compared to the normative Dutch population. All syndromes have a high prevalence of vision and speech problems. Cognitive problems were mainly reported in patients with Apert, Crouzon and Muenke syndrome. Ambulation and dexterity problems were seen in Apert, Crouzon, Saethre-Chotzen and complex craniosynostosis. Only patients with Apert syndrome scored significantly worse on pain. The HUI-3 had a medium to strong correlation with the objectively measured outcomes. CONCLUSIONS The overall quality of life is lower in patients with syndromic and complex craniosynostosis. To improve quality of life, more attention is needed for problems with vision and speech.
Collapse
|
83
|
Kobayashi K, Kamibeppu K. Quality of life reporting by parent-child dyads in Japan, as grouped by depressive status. Nurs Health Sci 2011; 13:170-7. [DOI: 10.1111/j.1442-2018.2011.00595.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
84
|
van Litsenburg RRL, Huisman J, Hoogerbrugge PM, Egeler RM, Kaspers GJL, Gemke RJBJ. Impaired sleep affects quality of life in children during maintenance treatment for acute lymphoblastic leukemia: an exploratory study. Health Qual Life Outcomes 2011; 9:25. [PMID: 21496357 PMCID: PMC3095992 DOI: 10.1186/1477-7525-9-25] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 04/18/2011] [Indexed: 11/28/2022] Open
Abstract
Background With the increase of pediatric cancer survival rates, late effects and quality of life (QoL) have received more attention. Disturbed sleep in pediatric cancer is a common clinical observation, but research on this subject is sparse. In general, sleep problems can lead to significant morbidity and are associated with impaired QoL. Information on sleep is essential to develop interventions to improve QoL. Methods Children (2-18 years) with acute lymphoblastic leukemia (ALL) were eligible for this multi-center study. The Children's Sleep Habits Questionnaire (CSHQ), Child Health Questionnaire (CHQ) and Pediatric Quality of Life Inventory 3.0™ Acute Cancer Version (PedsQL) were used to assess sleep and QoL halfway through maintenance therapy. Sleep and QoL were measured during and after dexamethasone treatment (on-dex and off-dex). Results Seventeen children participated (age 6.7 ± 3.3 years, 44% boys). Children with ALL had more sleep problems and a lower QoL compared to the norm. There were no differences on-dex and off-dex. Pain (r = -0.6; p = 0.029) and worry (r = -0.5; p = 0.034) showed a moderate negative association with sleep. Reduced overall QoL was moderately associated with impaired overall sleep (r = -0.6; p = 0.014) and more problems with sleep anxiety (r = -0.8; p = 0.003), sleep onset delay (r = -0.5; p = 0.037), daytime sleepiness (r = -0.5; p = 0.044) and night wakenings (r = -0.6; p = 0.017). Conclusion QoL is impaired in children during cancer treatment. The results of this study suggest that impaired sleep may be a contributing determinant. Consequently, enhanced counseling and treatment of sleep problems might improve QoL. It is important to conduct more extensive studies to confirm these findings and provide more detailed information on the relationship between sleep and QoL, and on factors affecting sleep in pediatric ALL and in children with cancer in general.
Collapse
|
85
|
Engelen V, Koopman HM, Detmar SB, Raat H, van de Wetering MD, Brons P, Anninga JK, Abbink F, Grootenhuis MA. Health-related quality of life after completion of successful treatment for childhood cancer. Pediatr Blood Cancer 2011; 56:646-53. [PMID: 21298753 DOI: 10.1002/pbc.22795] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 07/20/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND Previous studies have assessed health-related quality of life (HRQOL) during several treatment stages in children with cancer, but there is limited knowledge about HRQOL shortly after completing therapy. This study determined HRQOL of children with cancer shortly after the end of successful treatment compared with normative values. PROCEDURE Several age-specific HRQOL questionnaires were administered: the ITQOL (generic, proxy-report, 0-4 years), CHQ PF 50 (generic, proxy-report, 5-7 years), Kidscreen (generic, self-report, 8-18 years) and Disabkids (chronic generic, self-report, 8-18 years). RESULTS Children with cancer (N = 191, mean age 9.25, SD 5.06, 47.1% female) participated. Physical well-being was affected for all ages. Compared to normative values 0- to 7-year-olds were rated significantly lower on the majority of the scales. In addition, 12- to 18-year-olds had significantly better HRQOL than the norm on social scales. Compared to chronically ill norms, 8- to 18-year-olds demonstrated no differences, except for 12- to 18-year-olds who experienced significantly more physical limitations. Additionally, we found that HRQOL of parents of 0- to 7-year-olds was poorer than the norm. CONCLUSION HRQOL in children with cancer and their parents can be impaired compared with the norm. Therefore, HRQOL should be monitored in clinical practice to make paediatric oncologists aware of these problems. For young children, we recommend checking whether certain HRQOL problems can be explained by parental worries. For older children and adolescents, paediatric oncologists need to consider social desirability and the child's adaptive style.
Collapse
Affiliation(s)
- V Engelen
- Psychosocial Department, Academic Medical Centre/Emma Children's Hospital, Amsterdam, the Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
86
|
de Wee EM, Fijnvandraat K, de Goede-Bolder A, Mauser-Bunschoten EP, Eikenboom JCJ, Brons PP, Smiers FJ, Tamminga R, Oostenbrink R, Raat H, van der Bom JG, Leebeek FWG. Impact of von Willebrand disease on health-related quality of life in a pediatric population. J Thromb Haemost 2011; 9:502-9. [PMID: 21166992 DOI: 10.1111/j.1538-7836.2010.04175.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Von Willebrand disease (VWD) is the most frequent inherited bleeding disorder. Whether VWD is associated with health-related quality of life (HR-QoL) in children is unknown. OBJECTIVES This nationwide cross-sectional study measured HR-QoL in children with moderate or severe VWD. Our primary aim was to compare HR-QoL of VWD patients with that of reference populations. Additionally, we studied the impact of bleeding phenotype and VWD type on HR-QoL. METHODS HR-QoL was assessed with the Infant/Toddler QoL Questionnaire (0-5 years) and Child Health Questionnaire (6-15 years), and compared with reference population scores. Multivariate analysis was used to evaluate the influence of type of VWD and bleeding phenotype on HR-QoL scores. RESULTS Preschool children (0-5 years, n = 46) with VWD had lower HR-QoL scores for general health perceptions and parental time than reference populations. School children (6-15 years, n = 87) with VWD had lower scores for physical functioning, role functioning - emotional/behavioral, general health perceptions, and physical summary. Type of VWD was associated with HR-QoL in school children for bodily pain, general health perceptions, parental emotion, family activities, and physical summary. Scores of children with type 3 VWD were, on average, 15 points lower than those of the reference population on the above-mentioned scales. A more severe bleeding phenotype was associated with a lower score on 11/15 physical, emotional and social scales. CONCLUSION HR-QoL is lower in VWD children than in reference populations, in particular in school children. The negative impact of VWD is sensitive to type of VWD and bleeding phenotype; as well as physical scales, emotional and social scales are affected.
Collapse
Affiliation(s)
- E M de Wee
- Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
87
|
Baildam EM, Ennis H, Foster HE, Shaw L, Chieng ASE, Kelly J, Herrick AL, Richards HL. Influence of childhood scleroderma on physical function and quality of life. J Rheumatol 2010; 38:167-73. [PMID: 21041272 DOI: 10.3899/jrheum.100447] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE there have been few studies of quality of life in childhood scleroderma and these focused predominantly on self-perception and the influence of skin lesions. Our cross-sectional study aimed to describe the influence of childhood scleroderma on physical function and quality of life in relation to clinical and demographic measures. METHODS children with either localized scleroderma or systemic sclerosis (SSc) attending pediatric rheumatology clinics, together with their parents or guardians, were asked to complete a set of 4 validated measures. Clinical and demographic data were provided by consultant pediatric rheumatologists. RESULTS in total, 28 children and their parents/guardians participated in the study (68% female, median age 13 yrs; 86% localized scleroderma, 14% SSc). The median Child Health Assessment Questionnaire (CHAQ) score was 0.1 (range 0-3, 0 indicating no impairment), the median Child Dermatology Life Quality Index (CDLQI) score was 5 (range 0-30, 0 indicating no impairment), and the median Child Quality of Life Questionnaire (CQOL) function score was 26 (range 0-105, 0 indicating no impairment). Family activity, measured by the Child Health Questionnaire (CHQ-PF50), was also moderately impaired by scleroderma, with a median score of 83 (0-100, 100 indicating no impairment). CONCLUSION scleroderma had only a moderate effect on quality of life and physical function as measured by the 4 validated instruments. Although a small number of children reported greater impairment, this is an encouraging finding, given its potential disfiguring and debilitating effects.
Collapse
|
88
|
Abstract
PURPOSE Although restorative proctocolectomy has become the standard surgical treatment for ulcerative colitis and familial adenomatous polyposis, there are no prospective studies in children of the impact of this intervention on health-related quality of life. METHODS A prospective study of health-related quality of life in children with ulcerative colitis or familial adenomatous polyposis undergoing restorative proctocolectomy was performed. Patients and their parents who agreed to participate completed standardized health-related quality-of-life surveys (Medical Outcomes Study Short Form-36 and Child Health Questionnaire Parent Form) within one month before colectomy and approximately one year after completion of their surgery. RESULTS Of the 60 patients who agreed to participate, 44 completed surveys at the appropriate time periods allowing comparison. The parents of 28 of these subjects also completed paired surveys. Before colectomy, patients with ulcerative colitis had substantially lower health-related quality-of-life scores, which were also mirrored in parental surveys. Following surgery patients with ulcerative colitis had significant improvement in 7 of 8 Medical Outcomes Study Short Form-36 patient subscales and all 6 corresponding Child Health Questionnaire Parent Form parental subscales of health-related quality of life. Patients with familial adenomatous polyposis showed improvement in the bodily pain subscale alone, whereas their corresponding parental surveys only showed improvement in the mental health subscale. CONCLUSION There are clearly significant adverse affects on health-related quality of life in children with ulcerative colitis that dramatically improved following restorative proctocolectomy.
Collapse
|
89
|
Buysse CMP, Vermunt LCAC, Raat H, Hazelzet JA, Hop WCJ, Utens EMWJ, Joosten KFM. Surviving meningococcal septic shock in childhood: long-term overall outcome and the effect on health-related quality of life. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2010; 14:R124. [PMID: 20587048 PMCID: PMC2911772 DOI: 10.1186/cc9087] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 04/01/2010] [Accepted: 06/29/2010] [Indexed: 11/29/2022]
Abstract
Introduction The purpose of this study was to evaluate associations between long-term physical and psychological outcome variables in patients who survived meningococcal septic shock (MSS) in childhood. Methods The study population was made up of all MSS patients requiring intensive care treatment between 1988 and 2001. Results A total of 120 patients visited the follow-up clinic (age at paediatric intensive care unit (PICU) admission 3.1 years; follow-up interval 9.8 years; age at follow-up 14.5 years (all medians)). Four major outcomes were considered: 1) major physical sequelae (defined as major scars and/or orthopaedic sequelae) (29/120), 2) mild neurological impairments (39/120), 3) problem behaviour (defined as a total score above the 90th percentile of the reference groups on questionnaires to screen for psychopathology) (16/114) and 4) total intelligence quotient < 85 (18/115). No differences were found between patients with major physical sequelae and patients without major physical sequelae as to the presence of problem behaviour or total IQ < 85. Also, no differences were found between patients with mild neurological impairments and patients without as to the presence of problem behaviour or total IQ < 85. Finally, no differences were found between patients with major physical sequelae and patients without as to the presence of mild neurological sequelae. Less favourable scores on behavioural and emotional problems were significantly associated with poorer health-related quality of life (HR-QoL). HR-QoL scores were to a lesser amount predicted by severity of illness at time of PICU admission or by adverse physical outcome. Conclusions Long-term adverse physical and psychological outcomes in survivors of MSS did not seem to be associated. Poorer HR-QoL was mainly predicted by problem behaviour.
Collapse
Affiliation(s)
- Corinne M P Buysse
- Department of Paediatrics, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Dr Molewaterplein 60, Rotterdam 3015 GJ, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
90
|
Wille N, Badia X, Bonsel G, Burström K, Cavrini G, Devlin N, Egmar AC, Greiner W, Gusi N, Herdman M, Jelsma J, Kind P, Scalone L, Ravens-Sieberer U. Development of the EQ-5D-Y: a child-friendly version of the EQ-5D. Qual Life Res 2010; 19:875-86. [PMID: 20405245 PMCID: PMC2892611 DOI: 10.1007/s11136-010-9648-y] [Citation(s) in RCA: 531] [Impact Index Per Article: 37.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2010] [Indexed: 11/24/2022]
Abstract
Purpose To develop a self-report version of the EQ-5D for younger respondents, named the EQ-5D-Y (Youth); to test its comprehensibility for children and adolescents and to compare results obtained using the standard adult EQ-5D and the EQ-5D-Y. Methods An international task force revised the content of EQ-5D and wording to ensure relevance and clarity for young respondents. Children’s and adolescents’ understanding of the EQ-5D-Y was tested in cognitive interviews after the instrument was translated into German, Italian, Spanish and Swedish. Differences between the EQ-5D and the EQ-5D-Y regarding frequencies of reported problems were investigated in Germany, Spain and South Africa. Results The content of the EQ-5D dimensions proved to be appropriate for the measurement of HRQOL in young respondents. The wording of the questionnaire had to be adapted which led to small changes in the meaning of some items and answer options. The adapted EQ-5D-Y was satisfactorily understood by children and adolescents in different countries. It was better accepted and proved more feasible than the EQ-5D. The administration of the EQ-5D and of the EQ-5D-Y causes differences in frequencies of reported problems. Conclusions The newly developed EQ-5D-Y is a useful tool to measure HRQOL in young people in an age-appropriate manner.
Collapse
Affiliation(s)
- Nora Wille
- Department of Psychosomatics in Children and Adolescents, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246 Hamburg, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
91
|
Klaassen RJ, Barr RD, Hughes J, Rogers P, Anderson R, Grundy P, Ali SK, Yanofsky R, Abla O, Silva M, Carret AS, Cappelli M. Nurses provide valuable proxy assessment of the health-related quality of life of children with Hodgkin disease. Cancer 2010; 116:1602-7. [DOI: 10.1002/cncr.24888] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
92
|
Peetsold MG, Heij HA, Deurloo JA, Gemke RJBJ. Health-related quality of life and its determinants in children and adolescents born with oesophageal atresia. Acta Paediatr 2010; 99:411-7. [PMID: 19912137 DOI: 10.1111/j.1651-2227.2009.01579.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM Following surgical correction in the neonatal period, patients born with oesophageal atresia have significant co-morbidity, particularly in childhood. This study evaluates health-related quality of life and its determinants such as concomitant anomalies and the presence of respiratory and/or gastro-intestinal symptoms 6-18 years after repair of oesophageal atresia. METHODS Parents of 24 patients with oesophageal atresia completed the child health questionnaire for parents and 37 patients completed the child form. Gastro-intestinal symptoms were assessed by a validated standardized reflux questionnaire. Results were compared with a healthy reference population. RESULTS Parents as well as patients themselves scored significantly lower on the domain general health perception. According to parents, general health perception was negatively affected by age at follow-up and concomitant anomalies. Patients reported that reflux symptoms reduced general health perception. CONCLUSION In this first study describing health-related quality of life in children and adolescents born with oesophageal atresia, we demonstrated that general health remains impaired because of a high incidence of concomitant anomalies and gastrointestinal symptoms in patients with oesophageal atresia when compared with the healthy reference population.
Collapse
Affiliation(s)
- M G Peetsold
- Department of Pediatrics, VU University Medical Centre, Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
93
|
McAuley KA, Taylor RW, Farmer VL, Hansen P, Williams SM, Booker CS, Mann JI. Economic evaluation of a community-based obesity prevention program in children: the APPLE project. Obesity (Silver Spring) 2010; 18:131-6. [PMID: 19444231 DOI: 10.1038/oby.2009.148] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Effective strategies are urgently required to reduce the prevalence of obesity during growth. Determining which strategies are most successful should also include analysis of their relative costs. To date, few obesity prevention studies in children have reported data concerning cost-effectiveness. The aim of this study was to assess the costs and health benefits of implementing the APPLE (A Pilot Program for Lifestyle and Exercise) project, a 2-year controlled community-based obesity prevention initiative utilizing activity coordinators (ACs) in schools and nutrition promotion in New Zealand children (5-12 years). The marginal costs of the project in 2006 prices were estimated and compared with the kilograms (kg) of weight-gain prevented for children in the intervention relative to the control arm. The children's health-related quality of life (HRQoL) was also measured using the Health Utilities Index (HUI). The total project cost was NZ$357,490, or NZ$1,281 per intervention child for 2 years (NZ$1 = US$0.67 = UK pound 0.35 = EUR euro 0.52). Weight z-score was reduced by 0.18 (0.13, 0.22) units at 2 years and 0.17 (0.11, 0.23) units at 4 years in intervention relative to control children. Mean HUI values did not differ between intervention and control participants. The reduction in weight z-score observed is equivalent to 2.0 kg of weight-gain prevented at 15 years of age. The relatively simple intervention approach employed by the APPLE project was successful in significantly reducing the rate of excessive weight gain in children, with implementation costs of NZ$664-1,708 per kg of weight-gain prevented over 4 years.
Collapse
Affiliation(s)
- Kirsten A McAuley
- Edgar National Centre for Diabetes Research, Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand
| | | | | | | | | | | | | |
Collapse
|
94
|
Manlhiot C, Knezevich S, Radojewski E, Cullen-Dean G, Williams WG, McCrindle BW. Functional health status of adolescents after the Fontan procedure -- comparison with their siblings. Can J Cardiol 2009; 25:e294-300. [PMID: 19746247 DOI: 10.1016/s0828-282x(09)70139-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies have suggested that patients who have undergone the Fontan procedure experience lower functional health status and diminished exercise capacity compared with other children. OBJECTIVES To compare the functional health status of Fontan patients with and without siblings, assess whether there are any differences between Fontan patients and their siblings, and determine associated factors. METHODS A cross-sectional, single-centre, observational study was performed on Fontan patients 10 to 20 years of age, and their sibling closest in age, followed in a tertiary pediatric hospital. Functional health status was measured by the Child Health Questionnaire Child Form and the Pediatric Quality of Life Inventory. RESULTS A total of 68 patients and 38 siblings were enrolled. Patients with siblings scored significantly lower on numerous domains of physical functional status than those without siblings. Compared with their matched siblings, Fontan patients reported significantly lower scores in all domains of the Pediatric Quality of Life Inventory and on physical (but not psychosocial) domains of the Child Health Questionnaire Child Form. Factors associated with increased patient-sibling differences included younger patient age, female sex, intracardiac lateral tunnel Fontan connection and lower ejection fraction at the time of study enrollment. CONCLUSIONS Adolescents with Fontan physiology reported a lower functional health status in physical domains than their siblings, but had similar status in psychosocial domains. Having a sibling was associated with lower reported functional health status, suggesting an important effect of self-perceived physical limitations over true limitations.
Collapse
Affiliation(s)
- Cedric Manlhiot
- Division of Cardiology, Labatt Family Heart Centre, Toronto, Canada
| | | | | | | | | | | |
Collapse
|
95
|
McNeil DA, Wilson BN, Siever JE, Ronca M, Mah JK. Connecting Children to Recreational Activities: Results of a Cluster Randomized Trial. Am J Health Promot 2009; 23:376-87. [DOI: 10.4278/ajhp.071010107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Identify if outreach support increases school-aged children's participation in recreational activities. Design. Cluster randomized trial. Setting. Sixteen schools in economically vulnerable neighborhoods were randomized to either an intervention or control group. Subjects. Children in grades 3 to 5 and their families were invited to participate. Intervention. Children in intervention schools were assigned a “connector” (outreach worker) to facilitate participation in recreation activities. Measures. The Children's Assessment of Participation and Enjoyment (CAPE) was the primary measure at baseline, middle, and end of 1 year. Demographics, body mass index, child physical and psychosocial health, coordination, and self-esteem were measured. Analysis. A generalized linear model was used to test differences between intervention and control groups. Results. Three hundred and sixty children enrolled, and 306 (85 %) completed the study. A greater proportion of children in the intervention group compared with the control group increased participation in physical activity (21 % vs. 10%, p = .02). Children who increased their activity were more likely to have higher levels of contact with the connectors (31 % vs. 8%, p = .001). Study limitations included (I) 29% of eligible families participated, (2) first use of the CAPE instrument as a longitudinal measure, and (3) connectors were not blinded to group assignment. Conclusion. Children living in vulnerable neighborhoods benefit from outreach workers to connect them with physical activity programs.
Collapse
Affiliation(s)
- Deborah A. McNeil
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Brenda N. Wilson
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Jodi E. Siever
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Margie Ronca
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Jean K. Mah
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| |
Collapse
|
96
|
Prediction and treatment of asthma in preschool children at risk: study design and baseline data of a prospective cohort study in general practice (ARCADE). BMC Pulm Med 2009; 9:13. [PMID: 19368704 PMCID: PMC2678979 DOI: 10.1186/1471-2466-9-13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 04/15/2009] [Indexed: 11/24/2022] Open
Abstract
Background Asthma is a difficult diagnosis to establish in preschool children. A few years ago, our group presented a prediction rule for young children at risk for asthma in general practice. Before this prediction rule can safely be used in practice, cross-validation is required. In addition, general practitioners face many therapeutic management decisions in children at risk for asthma. The objectives of the study are: (1) identification of predictors for asthma in preschool children at risk for asthma with the aim of cross-validating an earlier derived prediction rule; (2) compare the effects of different treatment strategies in preschool children. Design In this prospective cohort study one to five year old children at risk of developing asthma were selected from general practices. At risk was defined as 'visited the general practitioner with recurrent coughing (≥ 2 visits), wheezing (≥ 1) or shortness of breath (≥ 1) in the previous 12 months'. All children in this prospective cohort study will be followed until the age of six. For our prediction rule, demographic data, data with respect to clinical history and additional tests (specific immunoglobulin E (IgE), fractional exhaled nitric oxide (FENO), peak expiratory flow (PEF)) are collected. History of airway specific medication use, symptom severity and health-related quality of life (QoL) are collected to estimate the effect of different treatment intensities (as expressed in GINA levels) using recently developed statistical techniques. In total, 1,938 children at risk of asthma were selected from general practice and 771 children (40%) were enrolled. At the time of writing, follow-up for all 5-year olds and the majority of the 4-year olds is complete. The total and specific IgE measurements at baseline were carried out by 87% of the children. Response rates to the repeated questionnaires varied from 93% at baseline to 73% after 18 months follow-up; 89% and 87% performed PEF and FENO measurements, respectively. Discussion In this study a prediction rule for asthma in young children, to be used in (general) practice, will be cross-validated. Our study will also provide more insight in the effect of treatment of asthma in preschool children.
Collapse
|
97
|
Revisiting predictors of parental health care-seeking behaviors for nonurgent conditions at one inner-city hospital. Pediatr Emerg Care 2009; 25:238-243. [PMID: 19382324 DOI: 10.1097/pec.0b013e31819e350e] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION To determine important predictors of why parents seek care for their children at a pediatric emergency department (ED) compared to their child's primary care provider's (PCP's) walk-in clinic. DESIGN Cross-sectional study. SETTING An inner-city hospital located in New York City, from April 2003 to January 2004. PARTICIPANTS A convenience sample of 170 parents with children younger than 18 years, Medicaid beneficiaries, had a PCP, and presented with a nonurgent medical problem either at the pediatric ED or walk-in clinic. MAIN OUTCOME MEASURE The main outcome measure was the setting in which parents sought care for their child; odds ratios (ORs) were calculated for parents seeking care in the pediatric ED compared to those seeking care at the walk-in clinic, adjusting for predisposing, enabling, and need-related factors. RESULTS Of the 170 parent-child visits, 87 (51%) were seeking care at the ED and 83 (49%) at their child's walk-in clinic. In logistic regression, single parenting was the strongest predictor for seeking care in the ED (OR, 5.54; 95% confidence interval [CI], 1.4-26.9), followed by Hispanic ethnicity (OR, 4.96; 95% CI, 1.43-17.2), low parental perceptions of their child's physical health (OR, 0.90; 95% CI, 0.82-0.99), controlling for number of chronic conditions, parental working status, and satisfaction with their PCP. CONCLUSIONS Single parenting, Hispanic ethnicity, and perceptions of health are associated with health care-seeking behaviors in high cost settings among Medicaid beneficiaries. Targeted education programs could be used to influence future site of care.
Collapse
|
98
|
Fosse NE, Haas SA. Validity and stability of self-reported health among adolescents in a longitudinal, nationally representative survey. Pediatrics 2009; 123:e496-501. [PMID: 19254984 DOI: 10.1542/peds.2008-1552] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The goals of this study to assess (1) the stability of self-reported health among a nationally representative sample of youth in adolescence over a period of 6 years, (2) the concordance of self-reported health between parents and children, and (3) the validity of self-reported health across a range of physical and emotional indicators of adolescent well-being. METHODS This study uses data from rounds 1 to 7 (1997-2003) of the National Longitudinal Survey of Youth, 1997 Cohort (NLSY97). The sample consists of 6748 youth born between January 1, 1980, and December 31, 1984. Data on one of the youths' parents were also included in the baseline of the survey. Analyses were conducted using polychoric correlations and ordinal logistic regression. RESULTS Self-reported health of adolescents over a 7-year period indicated moderate stability (40% agreement after 7 years for girls and 41% for boys). Concordance was also present between parents and their children, although the association was higher among same-gender pairings (mother-daughter and father-son concordances). Adolescents' self-reported health was also linked with the presence or absence of chronic health conditions, emotional problems, and with being overweight or obese but not with sensory conditions or physical deformity. CONCLUSIONS Self-reported health is stable from early and middle adolescence to young adulthood. Self-reported health is also a valid measure of a variety of physical and emotional dimensions of adolescent well-being. The stability and validity of self-reported health do not differ by the gender of the child, although there is slightly greater concordance when the reporting parent is the same gender as the child.
Collapse
Affiliation(s)
- Nathan E Fosse
- AM, Harvard University, Department of Sociology, 33 Kirkland St, Cambridge, MA 02474, USA.
| | | |
Collapse
|
99
|
Krab LC, Oostenbrink R, de Goede-Bolder A, Aarsen FK, Elgersma Y, Moll HA. Health-related quality of life in children with neurofibromatosis type 1: contribution of demographic factors, disease-related factors, and behavior. J Pediatr 2009; 154:420-5, 425.e1. [PMID: 18950800 DOI: 10.1016/j.jpeds.2008.08.045] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 07/02/2008] [Accepted: 08/26/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate health-related quality of life (HR-QOL) in children with neurofibromatosis type 1 (NF1) with parental reports and children's self-reports, and to investigate the potential contribution of demographic factors, disease-specific factors, and problems in school performance or behavior. STUDY DESIGN In a prospective observational study, parents of 58 children with NF1 (32 boys, 26 girls, age 12.2 +/- 2.5 years) visiting a university clinic, and their 43 children 10 years or older were assessed with the Child Health Questionnaire (CHQ). Potential determinants of domain scores were assessed in 3 explorative regression models. RESULTS Parents reported a significant impact of NF1 on 9/13 CHQ scales, with moderate effect sizes on 8 (general health perceptions, physical functioning, general behavior, mental health, self esteem, family activities, role functioning emotional/behavioral, and parent emotional impact). Children report an impact on bodily pain, and an above average general behavior. Multiple CHQ scales were sensitive to demographic factors and behavioral problems, and 1 to NF1 severity. NF1 visibility and school problems did not influence HR-QOL. CONCLUSIONS Parents, but not the children with NF1, report a profound impact of NF1 on physical, social, behavioral, and emotional aspects of HR-QOL. Multiple HR-QOL domains were most sensitive to behavioral problems, which points to an exciting potential opportunity to improve HR-QOL in children with NF1 by addressing these behavioral problems.
Collapse
Affiliation(s)
- Lianne C Krab
- NF1 CoRe Team (Cognitive Research Team), Department of General Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
100
|
Bruijn J, Arts WF, Duivenvoorden H, Dijkstra N, Raat H, Passchier J. Quality of life in children with primary headache in a general hospital. Cephalalgia 2009; 29:624-30. [PMID: 19175611 DOI: 10.1111/j.1468-2982.2008.01774.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Knowledge on the quality of life of children with headache is lacking. Until now only a few studies in this field have provided information on a limited number of life domains. The aim of this study was to assess the quality of life in a comprehensive number of life domains in children with primary headache presenting at an out-patient paediatric department in a general hospital. From October 2003 to October 2005 all children referred to the out-patient paediatric department of the Vlietland Hospital because of primary headache were investigated by protocol. A thorough history was taken and a general physical and neurological examination was performed. The International Headache Society criteria were used for classification. Quality of life (QoL) was measured using the Dutch version of the Child Health Questionnaire (CHQ-PF50 Dutch edition) and compared with data from a previously investigated cohort of healthy children from the same region, and with data from a cohort of children from the USA with asthma or with attention deficit hyperactivity disorder (ADHD), investigated with the CHQ-PF50. A total of 70 primary headache patients were included in the study (25 with tension-type headache, 36 with migraine, seven with chronic tension-type headache, two with both tension-type headache and migraine). Their mean age was 10.6 years (range 4-17 years); 37 children were male. On all but one subscale (self-esteem) the QoL of the children with primary headache was decreased compared with the cohort of healthy children, especially on the domains of mental health, parental impact time and family cohesion. Compared with the cohort of children with asthma the QoL was significantly worse for our headache group on seven subscales and significantly better on one subscale (general health perception). Compared with the cohort of children with ADHD, the QoL was significantly worse on six subscales but significantly better on three subscales. There were no significant differences on any QoL subscale between children with tension-type headache and children with migraine. We conclude that the QoL in children with primary headache presenting at the out-patient paediatric department of a general hospital seems to be considerably diminished. Furthermore, we conclude that, in this population there is no difference in QoL between children with tension-type headache and those with migraine.
Collapse
Affiliation(s)
- J Bruijn
- Department of Paediatrics, Vlietland Hospital, Vlaardingen, Schiedam, the Netherlands.
| | | | | | | | | | | |
Collapse
|