101
|
Abstract
OBJECTIVES The aim of the study was to determine quality of life (QoL), stress, and anxiety levels in parents of children with biliary atresia (BA), and to assess factors associated with parental QoL. METHODS Parents of children (6-16 years) with BA were included in this cross-sectional study. We used validated questionnaires to assess parental QoL, stress, and anxiety levels. We compared the results with reference data from the general population and determined associated factors using generalized linear mixed model analysis. Results are given as mean ± SD or median [min-max]. RESULTS We included 61 parents of 39 children (aged 11 ± 3 years). Thirty-one children (79%) had undergone a liver transplantation (LTx). Parents reported reduced family activities (88 [8-100] vs 95 [30-100], P = 0.002) and more emotional worry (83 [17-100] vs 92 [95-100], P < 0.001) compared with reference data, but a stronger family cohesion (85 [30-100] vs 60 [30-100], P = 0.05). Scores on parental QoL, anxiety and stress were similar to reference data. Fathers (16.0 [11-19]) and mothers (15.4 ± 1.4) scored higher on the psychological domain compared with reference data (vs 14.7 ± 2.2, P < 0.01). There was no significant difference in QoL of parents with children with native liver or those who had undergone LTx. Older age and high anxiety trait in parents were adversely associated with physical QoL. Household income below &OV0556;35 000/year and high anxiety trait were adversely associated with environmental QoL. CONCLUSIONS QoL in parents of school-aged children with BA appears to be unaffected. Parents with high-anxiety personality trait, older age, and low household income are at increased risk of impaired QoL.
Collapse
|
102
|
A.L. van Tilburg M, Edlynn E, Maddaloni M, van Kempen K, Díaz-González de Ferris M, Thomas J. High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA. CHILDREN-BASEL 2020; 7:children7100193. [PMID: 33096787 PMCID: PMC7589303 DOI: 10.3390/children7100193] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The 2020 SARS-CoV-2 pandemic led to community-wide measures affecting parents and children such as school/daycare closures, job losses, and interruptions in medical care for children with chronic diseases. This is the first study to describe the level of stress and mental health of parents of either healthy children or children with chronic conditions, during the 2020 pandemic. METHODS A representative sample of US parents was recruited from 10-17 April 2020. Parents completed online questionnaires about the past 7 days, including the Perceived Stress Scale, Resilient Coping Scale, Self-Efficacy Scale, Kansas Marital Satisfaction Scale, Parental Stress Scale, PROMIS Anxiety and Depression scales and various other pandemic-related stress questions Results: Levels of stressors (e.g., job loss, school closures, etc.) were high during this time (e.g., 79% of children attended home/online school) and parents reported being moderately to highly stressed. Rates of clinical anxiety (44.6%) and depression (42.2%) were high. Parents of children with chronic conditions reported higher levels of stress and worse mental health, but did not differ from other parents in dealing with stress or interruptions in work, child schooling, and marital satisfaction. DISCUSSION The COVID-19 pandemic has introduced unprecedented levels of stress for parents, especially those of children with chronic conditions. Mental health effects are expected to continue for months/years and preparation is needed to meet an increasing demand for mental health care.
Collapse
Affiliation(s)
- Miranda A.L. van Tilburg
- Department of Clinical Research, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 27506, USA;
- Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC 27514, USA
- School of Social Work, University of Washington, Seattle, WA 98105, USA
- Correspondence:
| | - Emily Edlynn
- Oak Park Behavioral Medicine, Oak Park, IL 60301, USA;
| | - Marina Maddaloni
- Department of Clinical Research, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 27506, USA;
| | - Klaas van Kempen
- Department of Economics, University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC 27599, USA;
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics University of North Carolina, Chapel Hill, NC 27514, USA;
| | - Maria Díaz-González de Ferris
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics University of North Carolina, Chapel Hill, NC 27514, USA;
| | - Jody Thomas
- Department of Psychiatry and Biobehavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5101, USA;
| |
Collapse
|
103
|
Effects of acceptance and commitment therapy on process measures of family caregivers: A systematic review and meta-analysis. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
104
|
Phillips NL, Widjaja E, Smith ML. Changes in caregiver depression, anxiety, and satisfaction with family relationships in families of children who did and did not undergo resective epilepsy surgery. Epilepsia 2020; 61:2265-2276. [PMID: 32944931 DOI: 10.1111/epi.16672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate longitudinal changes in caregiver depression, anxiety, and family relationships following resective surgery for pediatric drug-resistant epilepsy (DRE). METHODS This multicenter cohort study involved 177 caregivers of children with DRE aged 4-18 years (63 surgical and 114 nonsurgical). Caregivers completed measures of depression (Quick Inventory of Depressive Symptomatology), anxiety (Generalized Anxiety Disorder 7-item scale), and satisfaction with family relationships (Family Adaptability, Partnership, Growth, Affective, and Resolve scale) at baseline, 6 months, and 1 year. Additional data collected at baseline included child, caregiver, and family sociodemographic and clinical factors as well as family environment (demands and resources). RESULTS At 1 year, 64% and 27% of surgical and nonsurgical patients were seizure-free, respectively. Linear mixed-effects models found a reduction in caregiver depression (b = -0.85, P = .004) and anxiety (b = -1.09, P = .003), but not family satisfaction (b = 0.18, P = .31) over time. There was no effect of treatment. When seizure outcome was added to the model, seizure freedom was associated with fewer depressive symptoms (b = -1.15, P = .005) and greater family satisfaction (b = 0.65, P = .006), but not anxiety (b = -0.41, P = .42). A greater proportion of caregivers of patients who achieved seizure freedom (32%) versus continued seizures (18%) reported clinically meaningful improvement in depression at 1 year (P = .03). Lower baseline depression (β = 0.42, P < .001), greater family resources (β = -0.18, P = .04), and male caregiver (β = 0.15, P = .02) predicted lower caregiver depression, and lower baseline anxiety (β = 0.47, P < .001), greater family resources (β = -0.24, P = .01), and higher education (β = -0.13, P = .04) predicted lower caregiver anxiety at 1 year. Baseline functioning was the only predictor of family relationships at 1 year (β = 0.49, P < .001). SIGNIFICANCE Caregivers of children who achieved seizure freedom, irrespective of surgical treatment, report fewer depressive symptoms and greater satisfaction with family relationships. Baseline functioning is the strongest predictor of outcome; however, caregivers of families with fewer resources and supports are also at risk of poor psychosocial outcomes.
Collapse
Affiliation(s)
- Natalie L Phillips
- Neurosciences and Mental Health Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elysa Widjaja
- Neurosciences and Mental Health Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mary Lou Smith
- Neurosciences and Mental Health Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto Mississauga, Toronto, Ontario, Canada
| |
Collapse
|
105
|
Han A, Yuen HK, Jenkins J. Acceptance and commitment therapy for family caregivers: A systematic review and meta-analysis. J Health Psychol 2020; 26:82-102. [PMID: 32659142 DOI: 10.1177/1359105320941217] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acceptance and commitment therapy is an emerging evidenced-based practice, but no systematic review regarding the effects of ACT on family caregivers has been conducted. This article examined the effects of ACT on family caregivers by conducting meta-analysis with a random effects model. Twenty-four articles were identified from four electronic databases searched up to 30 March 2020. Meta-analyses found moderate effects of ACT on depressive symptoms and quality of life, small effects on anxiety, and small to moderate effects on stress. Further ACT studies should be conducted to measure effects on different outcomes for various family caregiver populations.
Collapse
Affiliation(s)
- Areum Han
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hon K Yuen
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy Jenkins
- Telehealth Private Practice: jeremyjenkins.icouch.me, Montana, USA
| |
Collapse
|
106
|
Dijkstra-de Neijs L, Leenen PJM, Hays JP, van der Valk ES, Kraaij R, van Rossum EFC, Ester WA. Biological Consequences of Psychological Distress in Caregivers of Children with Autism Spectrum Disorder and its Potential Relevance to Other Chronic Diseases Including Cancer. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00237-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Abstract
Purpose of Review
Caregivers of children with a chronic illness are a neglected group in medical research and patient care, and are frequently confronted with chronic psychological distress. The biological consequences of this chronic distress are unclear but highly relevant, as these caregivers have a lifelong task in caring for their child. In this review, the authors specifically describe caregiver distress related to autism spectrum disorder (ASD), but the review may be relevant to other chronic diseases, including cancer.
Recent Findings
Epidemiological evidence illustrates the increased mortality risk in caregivers of children with ASD although some individual factors appear to diminish these risks. Biological studies demonstrate that caregiver distress can lead to dysregulation of the hypothalamic-pituitary-adrenal-axis, a pro-inflammatory state of the immune and central nervous system, and gut microbiome imbalance.
Summary
Caregivers of children with a chronic illness like ASD deserve more health-related attention with respect to their psychological and physical well-being. Such attention would benefit individual caregivers, as well as their children, as both are highly interconnected. Structural psychological and physical screening of caregivers can be considered.
Collapse
|
107
|
Arabiat D, Al Jabery M, Whitehead L. A concept analysis of psychological distress in parents related to diabetes management in children and adolescents. J SPEC PEDIATR NURS 2020; 25:e12287. [PMID: 31971657 DOI: 10.1111/jspn.12287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To report a concept analysis of parents' psychological distress in the context of diabetes management among children and adolescents. A clear understanding of the possible impact of diabetes management on parents will help to inform how nurses can work with parents to support glycaemic control in children and adolescents. DESIGN AND METHOD Concept analysis using Walker and Avant's eight-stage approach was used as a guiding framework. PubMed, OVID (CINAHL, Medline, PsychInfo), the Cochrane library and the Joanna Briggs library were searched for the past 50 years. RESULTS Thirty-three studies provided data for the concept analysis. Attributes included difficulty coping, changes in emotional status and manifestations of mental health problems. PRACTICE IMPLICATION Based on the literature synthesis, we suggest all facets of distress related to diabetes can in principle be inferred through the proposed relationship between distress and other interactions of individual coping, caring burden and family relational functioning. The proposed conceptual model linking antecedents' factors and individual characteristics of parents to the concepts of psychological distress may assist researchers to design interventions for supporting diabetes management in children and adolescents.
Collapse
Affiliation(s)
- Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, western Australia, Australia.,Faculty of Nursing, Maternal and Child Nursing Department, The University of Jordan, Amman, Jordan
| | - Mohammad Al Jabery
- Faculty of Education, Department of Special Education, The University of Jordan, Amman, Jordan
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, western Australia, Australia.,Postgraduate Centre for Nursing Studies, University of Otago, Christchursch, New Zealand
| |
Collapse
|
108
|
Pinquart M. Meta-Analysis of Anxiety in Parents of Young People with Chronic Health Conditions. J Pediatr Psychol 2020; 44:959-969. [PMID: 31220871 DOI: 10.1093/jpepsy/jsz024] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Chronic health conditions are often associated with uncertainty and threats which may cause anxiety in the family members. The present meta-analysis analyzed whether parents of children with chronic physical diseases and/or sensory/physical disabilities show higher anxiety levels than parents of healthy/nondisabled children or test norms. METHODS The databases PSYCINFO, MEDLINE, Google Scholar, CINAHL, and PSYNDEX were searched for relevant studies. In total, 486 studies were identified that fulfilled the inclusion criteria. RESULTS We found moderate elevations of anxiety symptoms in parents of young people with chronic conditions (g = .54 standard deviation units). About 16% of the parents fulfilled the criteria for an anxiety disorder. Parents of young people with neuromuscular disorders, HIV-infection/AIDS, and cancer during active treatment showed large elevations of anxiety symptoms. Elevations of anxiety symptoms were smaller in the cases of longer lasting chronic conditions, longer time since the end of active treatment, in families of older children, in samples with lower percentages of mothers, and in studies from economically developed countries compared to less developed countries. CONCLUSION Measures for preventing and reducing anxiety symptoms in parents of young people with neuromuscular disorders, HIV-infection/AIDS, and those undergoing cancer treatments are particularly needed.
Collapse
|
109
|
Im Y, Jung S. Family functioning according to clusters of family management styles in Korean families of children with chronic atopic disease: A cross-sectional study. Int J Nurs Stud 2020; 109:103674. [PMID: 32590247 DOI: 10.1016/j.ijnurstu.2020.103674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic allergic diseases in children are often linked with behavioral problems, poor daily living, negative perceptions of health, and low life satisfaction. OBJECTIVES This study aimed to propose clusters of family management styles in the Korean families of children with chronic atopic disease, including allergic asthma, atopic dermatitis, and/or allergic rhinitis and examine the level of family functioning according to these clusters. DESIGN Cross-sectional study. SETTINGS A university-level hospital in metropolitan Seoul, South Korea. PARTICIPANTS Parents of children with chronic atopic disease. METHODS This study included 146 participants. The Korean version of the Family Management Measure and the Korean Family Functioning Scale were used to assess family management styles and family functioning, respectively. Data were analyzed using SPSS 24.0 using descriptive statistics, agglomerative hierarchical clustering with Ward's method prior to k-means clustering, k-means clustering analysis, analysis of variance, and chi-squared test. RESULTS Four clusters of family management styles were identified as follows: stable-resilient, less committed, parents' mission, and challenging. Among all participants, 19.9%, 30%, 20.6%, and 29.5% belonged to each of these clusters, respectively. The level of family functioning significantly differed between the four clusters, with the stable-resilient cluster having the highest mean level and the challenging cluster having the lowest mean level. Parents' perceived the complexity of self-managing their child's condition as one of the factors differentiating the level of family functioning of each cluster. CONCLUSIONS This study identified four clusters of family management styles and showed that each cluster was associated with a different level of family functioning. The unique characteristics of the four clusters may be helpful in providing individualized care and promoting positive family functioning in families with children having chronic atopic disease.
Collapse
Affiliation(s)
- YeoJin Im
- College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea.
| | - Sunyoung Jung
- College of Nursing, Korea University, 145 Anam-ro, Seongbuk-Gu, Seoul 02841, South Korea.
| |
Collapse
|
110
|
Daily parenting of children with cerebral palsy: The role of daily child behavior, parents' daily psychological needs, and mindful parenting. Dev Psychopathol 2020; 33:184-200. [PMID: 32381132 DOI: 10.1017/s0954579419001688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to advance the current understanding of the daily dynamics that are involved in raising a child with Cerebral Palsy (CP). Specifically, we examined the role of mindful parenting and of day-to-day variation in parents' psychological needs and child behavior in explaining day-to-day variation in parents' autonomy-supportive, psychologically controlling, and responsive parenting behavior. Parents (N = 58) of children with CP (Mage = 12.68 years) participated in a 7-day diary study. Multilevel analyses indicated that parents' autonomy-supportive, psychologically controlling, and responsive behaviors fluctuate considerably between days. Further, daily fluctuations in both child behavior and parents' own psychological needs were found to be associated with this daily variability in parenting. In addition, interindividual differences in mindful parenting were associated positively with parents' responsiveness and negatively with psychologically controlling parenting across the week. These findings point towards the changeability of parenting behavior among parents of a child with CP and suggest that interventions targeting parenting behavior in the context of CP will be most effective when taking into account both the parents' and the child's functioning.
Collapse
|
111
|
Boldyreva U, Streiner DL, Rosenbaum PL, Ronen GM. Quality of life in adolescents with epilepsy, cerebral palsy, and population norms. Dev Med Child Neurol 2020; 62:609-614. [PMID: 31898321 DOI: 10.1111/dmcn.14450] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2019] [Indexed: 12/18/2022]
Abstract
AIM To compare: (1) self- and proxy-reported quality of life (QoL) in adolescents with epilepsy, cerebral palsy (CP), both epilepsy and CP, and a representative general population sample; and (2) parental stress between parents of adolescents with epilepsy, CP, or both epilepsy and CP. METHOD This was a cross-sectional observational study with 496 adolescents with epilepsy, 699 with CP, 192 with both CP and epilepsy, and 15 396 from the general population, assessed with the KIDSCREEN-52 and Parenting Stress Index (PSI). RESULTS All KIDSCREEN-52 domains showed statistically significant differences across groups. The epilepsy population showed clinically better scores for 'school environment' than the general population (Cohen's d=0.62). Parents scored adolescents with CP lower than adolescents with epilepsy or general populations on 'physical health' (d=0.57, d=0.55) and 'social-support and peers' (d=0.82, d=0.91). Parents of adolescents with CP scored them lower than parents of the epilepsy group on 'autonomy' (d=0.62). Parents of adolescents with epilepsy scored them lower on 'mood and emotions' (d=0.52) and 'social acceptance' (d=0.66) than the general population. PSI scores were better for parents of adolescents with CP than for parents of adolescents with epilepsy (d=2.12, d=2.70, d=3.35, d=1.67). INTERPRETATION Adolescents with epilepsy or CP self-report equal or better QoL than the general adolescent population, which should comfort families and allow clinicians to address parental concerns. WHAT THIS PAPER ADDS Adolescents with epilepsy, with or without cerebral palsy (CP), self-reported better school environment than adolescents in the general population. Proxy quality of life (QoL) results showed clinically important differences across groups in 6 out of 10 domains of the KIDSCREEN-52. Proxy-reported results showed poorer QoL scores for adolescents with epilepsy or CP than the general population. Parental stress level was lower in parents of children with CP or both CP and epilepsy, than in those with only epilepsy.
Collapse
Affiliation(s)
- Uliana Boldyreva
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Gabriel M Ronen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
112
|
Sharkey CM, Schepers SA, Drake S, Pai ALH, Mullins LL, Grootenhuis MA. Psychosocial Risk Profiles Among American and Dutch Families Affected by Pediatric Cancer. J Pediatr Psychol 2020; 45:463-473. [PMID: 32196095 DOI: 10.1093/jpepsy/jsaa012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/09/2020] [Accepted: 02/17/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Little is known about relations between domains of psychosocial risk among pediatric cancer populations. The Psychosocial Assessment Tool 2.0 (PAT2.0) is one internationally validated screening measure that can examine these relations. This study aimed to examine risk profiles and predictors of these patterns exhibited by American and Dutch families. METHODS Caregivers of children newly diagnosed with cancer (N = 262; nUSA=145, nNL=117) completed the PAT2.0 as part of larger studies conducted in the United States and the Netherlands. Latent profile analysis and multinomial logistic regression examined differences in demographic and medical variables across risk profiles. Domains assessed included Family Structure/Resources, Child Problems, Sibling Problems, Family Problems, Caregiver Stress Reactions, and Family Beliefs. RESULTS Four groups were identified: "Low-Risk" (n = 162) defined by generally low risk across domains; "Moderate-Caregiver" (n = 55) defined by elevated Caregiver Stress Reactions domain; "Moderate-Children" (n = 25) defined by elevated Child Problems and/or Sibling Problems, and "Elevated-Risk" (n = 20) marked by generally high overall risk. Dutch families had higher odds of being in the Elevated-Risk group, compared to the Low-Risk group. Caregiver age, gender, and educational attainment predicted group membership. Families classified as Targeted or Clinical had higher odds of being in the Moderate or Elevated risk groups. CONCLUSION The PAT2.0 appears to identify largely similar patterns of risk, suggesting that families experience common psychosocial difficulties in both American and Dutch societies. The two Moderate groups demonstrated specific risk sources, suggesting that evaluation of domain patterns, rather than reliance on PAT2.0 risk level, could be of clinical benefit.
Collapse
|
113
|
Pinquart M. Featured Article: Depressive Symptoms in Parents of Children With Chronic Health Conditions: A Meta-Analysis. J Pediatr Psychol 2020; 44:139-149. [PMID: 30346613 DOI: 10.1093/jpepsy/jsy075] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/25/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Caring for children with chronic health conditions is associated with stressors that may impair mental health. The goal of our meta-analysis was to analyze depressive symptoms among parents who care for a child or adolescent with chronic physical disease and/or sensory disability and/or physical disability compared with parents of healthy children or test norms. Methods A systematic search through electronic databases identified 460 relevant studies that were included in a random-effects meta-analysis. Results Parents of children with chronic conditions showed small to moderate elevations of depressive symptoms compared with parents of healthy/nondisabled children and test norms (g = .46 SD units). Twelve studies using structured clinical interviews provided a weighted mean depression rate of 20.9%. The highest elevations were found among parents of young people with neuromuscular disorders, cancer, and cerebral palsy. Elevations of depressive symptoms were greater in cases with shorter durations of the chronic condition, in mothers compared with fathers, and in parents from economically less developed countries rather than developed countries. Conclusions Parents of children with chronic conditions, particularly parents of children with neuromuscular disorders, cancer, and cerebral palsy, should be screened for depression and receive psychosocial services aimed at reducing these symptoms, if needed.
Collapse
|
114
|
Continisio GI, Serra N, Guillari A, Civitella MT, Sepe A, Simeone S, Gargiulo G, Toscano S, Esposito MR, Raia V, Rea T. An investigation on parenting stress of children with cystic fibrosis. Ital J Pediatr 2020; 46:33. [PMID: 32183848 PMCID: PMC7079368 DOI: 10.1186/s13052-020-0795-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 02/25/2020] [Indexed: 12/13/2022] Open
Abstract
Background The management of chronic diseases, particularly in children, requires an integrated physical and psychological approach to both sick children and their family. This is the case of Cystic Fibrosis (CF), a complex genetic chronic disease, where, a comprehensive evaluation of the emotional impact and an effective multidimensional approach are indicated. Aim This study investigates on parenting stress in children and adolescents with CF and its determinants related to parents, children and the disease severity. Methods The study involved 34.04% adult males and 65.96% adult females (range 21-55 years) and 47 children with CF, 54.35% males and 45.65% females (range 1-17 years). The data were obtained through a Parenting Stress Index – Short Form (PSI-SF) questionnaire. According to the PSI-SF scoring system, three types of stress were detected: a typical stress pattern (normal), a high stress pattern (increased) and a defensive response, which may be considered as a high stress feature in children which requires monitoring and clinical evaluation. Results This study shows a significant presence of stress in females (60.23%), of subject married (84.62%), unemployed (69.23%) and with education level such as “middle School” (61.54%). Concerning children of parents with high stress, it resulted most frequent children with one sibling (53.85%). Finally, by univariate analysis, it resulted a significant positive correlation between parenting stress and disease degree of children. Instead by multivariate analysis, we found that the variables: Number of siblings and Birth order were a significant positive and negative predictor of parenting stress respectively. Conclusion An increased stress level was detected in less than one third of parents of subjects with CF. These data may be related to the psychological support which is part of the routine management of CF care team. However, as children’s features seem to act as a determinant of stress more than parental ones, the parental-child dysfunction should be the target for further integrated interventions.
Collapse
Affiliation(s)
| | - Nicola Serra
- Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, Naples, Italy.
| | - Assunta Guillari
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Maria Teresa Civitella
- Department of Translational Medical Sciences, University Federico II of Naples, Naples, Italy
| | - Angela Sepe
- Department of Translational Medical Sciences, University Federico II of Naples, Naples, Italy
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianpaolo Gargiulo
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Silvia Toscano
- Department of Translational Medical Sciences, University Federico II of Naples, Naples, Italy
| | | | - Valeria Raia
- Department of Translational Medical Sciences, University Federico II of Naples, Naples, Italy
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, Naples, Italy
| |
Collapse
|
115
|
Carrion-Plaza A, Jaen J, Montoya-Castilla I. HabitApp: New Play Technologies in Pediatric Cancer to Improve the Psychosocial State of Patients and Caregivers. Front Psychol 2020; 11:157. [PMID: 32116953 PMCID: PMC7020696 DOI: 10.3389/fpsyg.2020.00157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 01/21/2020] [Indexed: 11/13/2022] Open
Abstract
Childhood cancer involves long periods of hospitalization that trigger emotions such as fear or sadness. Previous research has studied the positive effects of technology games on improving the hospitalization experience, but most do not focus on caregivers and none allow interaction with the real time observation of a zoo. The present study evaluates the impact of HabitApp and assesses the short-term impact on the psychosocial state of patients and caregivers in order to improve the hospitalization experience. The participants in this study were 39 patients plus 39 caregivers. A quantitative analysis revealed a significant improvement in patient’s and caregiver’s psychosocial factors from the pre-play period to 10 min play time, and a significant interaction effect between the psychological state and the impact of HabitApp. The children with highest levels of depression obtained most benefit from the positive effects. A qualitative analysis brought out four themes: physical state, emotional state, social interaction, and hospital routines. Using a user experience questionnaire the patients and caregiver reported high satisfaction rates with the app use. These results confirm that it is important to continue studying this type of technology in order to develop better interventions to be included in an integral approach to this pathology considering caregivers into pediatric oncology patients’ play therapy.
Collapse
Affiliation(s)
- Alicia Carrion-Plaza
- EMINA Group, Departamento de Personalidad, Evaluación y Tratamientos Psicológico, Facultad de Psicología, University of Valencia, Valencia, Spain
| | - Javier Jaen
- ISSI-Futurelab Group, Departamento de Sistemas Informáticos y Computación, Universitat Politècnica de València, Valencia, Spain
| | - Inmaculada Montoya-Castilla
- EMINA Group, Departamento de Personalidad, Evaluación y Tratamientos Psicológico, Facultad de Psicología, University of Valencia, Valencia, Spain
| |
Collapse
|
116
|
Romero-Martínez Á, Hidalgo-Moreno G, Moya-Albiol L. Neuropsychological consequences of chronic stress: the case of informal caregivers. Aging Ment Health 2020; 24:259-271. [PMID: 30450952 DOI: 10.1080/13607863.2018.1537360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Caring for a family member with a long-term illness is a significant source of chronic stress that might significantly accelerate the cognitive ageing of informal caregivers. Nevertheless, the absence of a defined theoretical body of literature on the neuropsychology of this population makes it difficult to understand what the characteristic neuropsychological deficits of these caregivers are.Aims: The main aim of this study is to carry out a systematic review of studies of cognitive deficits present in informal caregivers of people with several chronic pathologies, and analyse the effects of cognitive-behavioural interventions on caregivers' cognition.Methods: The scientific literature was reviewed following the PRISMA quality criteria for reviews using the following digital databases: PubMEd, PsycINFO, and Dialnet.Results: Identification of 2046 abstracts and retrieval of 211 full texts led to the inclusion of 38 papers. The studies showed heterogeneous results, but most of the cross-sectional studies reviewed that employed neuropsychological assessments concluded that informal caregivers reported a generalized cognitive deterioration, especially memory dysfunctions (i.e. learning verbal, visuospatial, and digit information). Moreover, they also presented low selective attention and capacity for inhibition, along with slow processing speed. Longitudinal studies confirmed that caregivers whose care situation was more prolonged showed a marked deterioration in their overall cognitive state, memory, processing speed, and vocabulary richness. However, although the patient's death does not seem to reverse the neuropsychological alterations in caregivers, cognitive-behavioural interventions that employ techniques to reduce stress levels, cognitive biases, and inadequate adaptation schemas seem to improve some of the aforementioned cognitive abilities.Conclusions: Results from this synthesis and critical analysis of neuropsychological deficits in informal caregivers offer guidelines for diagnosing caregivers' cognitive status by including a test battery covering all the domains considered relevant. Finally, given the ability of cognitive behavioural interventions to improve cognition in caregivers, further studies on their long-term effects on caregivers are warranted.Chronic stress entails an acceleration of the cognitive ageingCross-sectional studies concluded that informal caregivers reported a generalized cognitive deteriorationCognitive-behavioural interventions seem to improve cognitive abilities of caregivers.
Collapse
|
117
|
Zelihić D, Hjardemaal FR, Lippe CVD. Caring for a child with Bardet-Biedl syndrome: A qualitative study of the parental experiences of daily coping and support. Eur J Med Genet 2020; 63:103856. [PMID: 31972368 DOI: 10.1016/j.ejmg.2020.103856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/12/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
This study aimed to explore the parental experiences of having a child with Bardet-Biedl syndrome (BBS) and how parents managed to cope with this situation. Five parents of children with BBS (0-18 years old) participated in semistructured in-depth interviews. Inductive thematic analysis was used to identify themes. The parents experienced distress due to a lack of knowledge on BBS in their support system (e.g., school staff, clinicians, and family members), and they found it stressful to coordinate with multiple support services. Socialization at work, support from family members, and communicating with other parents who are in a similar situation promoted better coping and adaptations to daily life. Results highlight the importance of parents receiving adequate support while they face daily challenges. An increased knowledge on how rare disorders impact family life is needed in the support system.
Collapse
Affiliation(s)
- Deniz Zelihić
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital HF, Norway
| | | | | |
Collapse
|
118
|
Torres-Made MD, Peláez-Ballestas I, García-Rodríguez F, Villarreal-Treviño AV, Fortuna-Reyna BDJ, de la O-Cavazos ME, Rubio-Pérez NE. Development and validation of the CAREGIVERS questionnaire: multi-assessing the impact of juvenile idiopathic arthritis on caregivers. Pediatr Rheumatol Online J 2020; 18:3. [PMID: 31937332 PMCID: PMC6961380 DOI: 10.1186/s12969-020-0400-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/06/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The primary caregiver is an important person in the life of patients with JIA. Their reactions depend on social, emotional and economic factors that affect the therapeutic alliance. Some generic instruments have been used to evaluate burden, anxiety, or quality of life of caregivers. This study aims to develop a specific instrument to measure the psychosocial and economic impacts on primary caregivers of patients with JIA. METHODOLOGY This is a mixed methods research, that includes qualitative and quantitative data, and was carried out in two phases. First phase: a pragmatic qualitative study (questionnaire construction) was conducted in two parts, a non-systematic literature review followed by interviews with primary caregivers. Second phase: a cross-sectional study (questionnaire validation) to complete validation and estimate Cronbach's alphas based on tetrachoric correlation coefficients, correlation matrix and Cohen's kappa coefficient test. RESULTS There were 38 articles found related to the experience of caregivers. 15 primary caregivers were interviewed (female 93%, median age 45 years). Thematic analysis identified 9 important topics from the perspective of participants (economic impact, coping, family roles, impact of diagnosis, mental health, couple/mate relationships, impact at work, religion, and knowledge of the disease). These topics were combined to create the interview questionnaire (56 items). Later, it was modified to 62 items that were divided into five dimensions: impact of the disease (psychosocial, economic, family, and relationships), knowledge of the disease, alternative medicine, future, and religion. The interview questionnaire was applied to 32 primary caregivers (female 93%, median age 37 years), results identify depression on 29 (90%), 18 (56%) feel sadness at diagnosis, 20 (63%) mentioned that JIA has influenced in their financial situation, 23 (72%) feel anxiety about the future, and 11 (37%) considered that their family relationships have changed. Statistical analysis identified inconsistencies during convergent and divergent validity of the construct. Consequently, 11 items were eliminated, 3 relocated, 6 modified, and 39 compacted obtaining the "Impact of Pediatric Rheumatic Diseases on Caregivers Multi-assessment Questionnaire" (CAREGIVERS questionnaire). This final version resulted on an eight-dimension (28 items) instrument. CONCLUSIONS The CAREGIVERS questionnaire captures perspectives of both the participants and clinicians. It will be helpful to measure the impact of the disease and thus, to improve the quality of care of children with JIA and their families.
Collapse
Affiliation(s)
- Marcia Daniela Torres-Made
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Ingris Peláez-Ballestas
- 0000 0001 2221 3638grid.414716.1Rheumatology Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Fernando García-Rodríguez
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Ana Victoria Villarreal-Treviño
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Brenda de Jesús Fortuna-Reyna
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Manuel Enrique de la O-Cavazos
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Nadina Eugenia Rubio-Pérez
- Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Monterrey, Mexico.
| |
Collapse
|
119
|
Morawska A, Mitchell AE, Etel E, Kirby G, McGill J, Coman D, Inwood A. Psychosocial functioning in children with phenylketonuria: Relationships between quality of life and parenting indicators. Child Care Health Dev 2020; 46:56-65. [PMID: 31782540 DOI: 10.1111/cch.12727] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/26/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study aimed to assess the impact of phenylketonuria (PKU) and its treatment on parent and child health-related quality of life (HRQoL) and to identify the parenting-related correlates of parent and child HRQoL, as well as metabolic control. METHODS Eighteen mothers of 2- to 12-year-old children with PKU participated and completed a series of self-report questionnaires including the PKU Impact and Treatment Quality of Life Questionnaire (PKU-QOL). RESULTS Mothers reported that the most significant impact of PKU on HRQoL was in relation to the impact of their child's anxiety during blood tests on their own HRQoL and guilt related to poor adherence to dietary restrictions and supplementation regimens. Higher reported intensity of child emotional and behavioural difficulties and parenting stress were associated with higher scores for PKU symptoms on the PKU-QOL, higher scores for emotional, social, and overall impact of PKU, and higher scores for the impact of dietary restriction. Where mothers reported greater use of overreactivity as a parenting strategy, children tended to have better lifetime phenylalanine levels; however, the overall impact of PKU and the impact of supplement administration on mothers' HRQoL were worse for these families. CONCLUSIONS These findings have implications for a holistic family-centred approach to the care of children with PKU and their families.
Collapse
Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Evren Etel
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Grace Kirby
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - James McGill
- Queensland Lifespan Metabolic Medicine Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - David Coman
- Queensland Lifespan Metabolic Medicine Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Anita Inwood
- Queensland Lifespan Metabolic Medicine Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Nursing and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
120
|
Jaser SS, Hamburger ER, Pagoto S, Williams R, Meyn A, Jones AC, Simmons JH. Communication and coping intervention for mothers of adolescents with type 1 diabetes: Rationale and trial design. Contemp Clin Trials 2019; 85:105844. [PMID: 31499228 PMCID: PMC6815728 DOI: 10.1016/j.cct.2019.105844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 12/21/2022]
Abstract
Mothers of adolescents with type 1 diabetes (T1D) experience high rates of depressive symptoms and diabetes distress, which are established risk factors for deteriorating glycemic control, problems with adherence, increased depressive symptoms, and poor quality of life in adolescents. Given that adolescents are a high-risk population for suboptimal glycemic control, novel interventions to improve outcomes in adolescents with T1D are needed. Building on effective interventions to treat depression in adults, and our own pilot work in this population, we developed a cognitive behavioral intervention, Communication & Coping, to target maternal depressive symptoms and parenting behaviors. The randomized controlled trial compares the telephone and Facebook-delivered Communication & Coping intervention, which promotes the use of adaptive coping strategies and positive parenting practices, to a diabetes education control condition on diabetes outcomes and psychosocial outcomes in adolescents with T1D. This paper describes the study rationale, trial design, and methodology.
Collapse
|
121
|
Panzeri A, Rossi Ferrario S, Vidotto G. Interventions for Psychological Health of Stroke Caregivers: A Systematic Review. Front Psychol 2019; 10:2045. [PMID: 31551881 PMCID: PMC6743500 DOI: 10.3389/fpsyg.2019.02045] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/21/2019] [Indexed: 02/03/2023] Open
Abstract
Background: The increasing number of stroke patients (SPs) requires informal caregivers to bear a high burden of responsibilities and heavy (di)stress. Moreover, these issues could lead to the development of serious psychological problems (e.g., depressive and/or anxious) that in turn could give rise to poor health-related quality of life outcomes. However, although the value of psychological interventions has been widely recognized for SPs, the scientific literature lacks an updated synthesis of interventions addressing the psychological health of their caregivers. Aim: The aim of this review is to summarize the interventions for the psychological health of stroke caregivers and provide a resume of literature-based evidence of their efficacy. Method: A literature review from 2005 to date was conducted in three online databases: PubMed, Scopus, and Google Scholar. Eligibility criteria for studies were (A) English language, (B) caregivers and patients aged 18 years or above, (C) SP's caregiver beneficiating of a specific intervention, and (D) outcome measures addressing depressive and/or anxiety symptomology, quality of life, well-being, or burden. Results: Across the selected 45 studies, substantial differences are observable in three main categories: (a) type of intervention (b) techniques, and (c) operators. Interventions' advantages and results are discussed. Overall, studies using psychological techniques, such as cognitive-behavioral therapy, coping skill-training, and problem-solving therapy, showed their usefulness and efficacy in reducing the caregivers' depressive and anxious symptoms, and burden. Interventions led by psychologists and tailored to meet caregivers' specific needs showed more positive outcomes. Conclusion: This review underlines the usefulness of psychological interventions aimed at reducing the psychological burden, such as anxious and depressive symptomatology, of SPs' informal caregivers. Hence, psychological interventions for caregivers should be integrated as part of the stroke rehabilitation process to improve informal caregivers' and patients' quality of life and well-being.
Collapse
Affiliation(s)
- Anna Panzeri
- Psychology and Neuropsychology Unit, Istituti Clinici Scientifici Maugeri, Veruno, Italy
- General Psychology Department, Università degli Studi di Padova, Padova, Italy
| | - Silvia Rossi Ferrario
- Psychology and Neuropsychology Unit, Istituti Clinici Scientifici Maugeri, Veruno, Italy
| | - Giulio Vidotto
- General Psychology Department, Università degli Studi di Padova, Padova, Italy
| |
Collapse
|
122
|
Kuper H, Lopes Moreira ME, Barreto de Araújo TV, Valongueiro S, Fernandes S, Pinto M, Lyra TM. The association of depression, anxiety, and stress with caring for a child with Congenital Zika Syndrome in Brazil; Results of a cross-sectional study. PLoS Negl Trop Dis 2019; 13:e0007768. [PMID: 31568478 PMCID: PMC6786834 DOI: 10.1371/journal.pntd.0007768] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 10/10/2019] [Accepted: 09/10/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) infection in pregnancy can cause microcephaly and a wide spectrum of severe adverse outcomes, collectively called "Congenital Zika Syndrome" (CZS). Parenting a child with disabilities can have adverse mental health impacts, but these associations have not been fully explored in the context of CZS in Brazil. METHODOLOGY/PRINCIPAL FINDINGS A cross-sectional study was undertaken in Recife and Rio de Janeiro, including 163 caregivers of a child with CZS (cases) and 324 caregivers with an unaffected child (comparison subjects), identified from existing studies. The primary caregiver, almost always the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-DASS-21), social support (Medical Outcomes Study Social Support Scale-MOS-SSS), and socio-demographic data. Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. A high proportion of mothers reported experiencing severe or extremely severe levels of depression (18%), anxiety (27%) and stress (36%). Mothers of children with CZS were more likely to experience symptoms of depression, anxiety andstress, compared to mothers of comparison children. These associations were more apparent among mothers living in Rio de Janeiro. These differences were reduced after adjustment for socio-economic status and social support. Among mothers of children with CZS, low social support was linked to higher levels of depression, anxiety and stress, but there was no association with socio-economic status. CONCLUSIONS/SIGNIFICANCE Depression, anxiety and stress were very common among mothers of young children in Brazil, regardless of whether they were parenting a child with disabilities. Mothers of children with CZS may be particularly vulnerable to poor mental health, and this association may be buffered through better social support.
Collapse
Affiliation(s)
- Hannah Kuper
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maria Elisabeth Lopes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | - Sandra Valongueiro
- Postgraduate Programme in Public Health, Federal University of Pernambuco, Recife, Brazil
| | - Silke Fernandes
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Marcia Pinto
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Tereza Maciel Lyra
- Aggeu Magalhães Institute, FIOCRUZ/PE, Recife, Brazil
- Faculty of Medicine, University of Pernambuco, Recife, Brazil
| |
Collapse
|
123
|
Feragen KB, Stock NM, Myhre A, Due-Tønnessen BJ. Medical Stress Reactions and Personal Growth in Parents of Children With a Rare Craniofacial Condition. Cleft Palate Craniofac J 2019; 57:228-237. [PMID: 31426676 DOI: 10.1177/1055665619869146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The birth of a child with a congenital craniofacial anomaly (CFA) can have a profound psychological impact on the family. Despite the complexity and variability in treatment for these rare conditions, few studies have been conducted into parents' emotional responses to health-care experiences. The aim of the present study was to investigate parents' subjective experiences of their child's condition and treatment using an in-depth qualitative approach. METHODS Individual semistructured interviews were conducted in person or over the telephone with 48 parents of children with a range of rare CFAs. Interviews were transcribed verbatim, translated into English, and analyzed using inductive thematic analysis. RESULTS Participants reported physical and psychological symptoms that could be indicative of medical traumatic stress in relation to their child's diagnosis and treatment. Participants described feelings of powerlessness and the weight of being responsible for their child's care. Yet, participants also reported that as a result of their experiences, their perspective on life had changed and they had grown in self-confidence. CONCLUSIONS The findings provide insight into the complex physical and psychological effects experienced by parents in response to their child's diagnosis and medical treatment, as well as an understanding of how these experiences may also result in personal growth over time. Implementation of trauma-informed evidence-based resources should be considered in craniofacial care and future research, particularly in regard to prevention and treatment of psychological distress.
Collapse
Affiliation(s)
| | - Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, England
| | - Anita Myhre
- Centre for Rare Disorders, Oslo University Hospital (Rikshospitalet), Oslo, Norway
| | | |
Collapse
|
124
|
Beckers LWME, Smeets RJEM, van der Burg JJW. Therapy-related stress in parents of children with a physical disability: a specific concept within the construct of parental stress. Disabil Rehabil 2019; 43:1185-1192. [PMID: 31424960 DOI: 10.1080/09638288.2019.1646815] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this article is to conceptualise the phenomenon of therapy-related parental stress in parents of children with a physical disability. METHODS Three models related to parental stress were reviewed, i.e., general parental stress, burden of caregiving in parents of children with physical disabilities, and experiences of these parents with their child's therapy. RESULTS The proposed definition of therapy-related parental stress is "the subjective stress and subsequent changes of functioning and health experienced by a parent of a child with a physical disability in response to paramedical therapies (i.e., physical, occupational, and/or speech and language therapy)". A theoretical model is proposed to describe the process of therapy-related parental stress. Available questionnaires will most likely not be valid and responsive to capture the (changes in) stress parents experience related to therapy their child receives. CONCLUSIONS This article provides a first definition of therapy-related parental stress and a theoretical model to visualise the processes with regard to this topic. Empirical testing of the presented components and their coherence is needed to confirm or improve the model. A questionnaire that specifically measures the concept of therapy-related parental stress is needed, along with evaluating therapy-related parental stress in clinical practice and research.Indications for rehabilitationIt is imperative to recognise paramedical therapies (i.e., physical, occupational, and speech and language therapy) as a potential stressor for parents of children with a physical disability, both in paediatric rehabilitation practice and research.A definition and theoretical model of therapy-related parental stress is proposed and the need for measures to evaluate this phenomenon is argued.The authors provide a starting point for the evidence base of the concept of therapy-related parental stress.
Collapse
Affiliation(s)
- Laura W M E Beckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,CIR Revalidatie, Eindhoven, the Netherlands
| | - Jan J W van der Burg
- Department of Paediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.,School of Pedagogical and Educational Sciences, Radboud University, Nijmegen, the Netherlands
| |
Collapse
|
125
|
Bailhache M, Doyle O, Salmi LR, McDonnell T. Does maternal attachment to her infant mediate the link between perceptions of infant crying at 6 months and parenting stress at 24 months? A structural equation modelling approach. Child Care Health Dev 2019; 45:540-550. [PMID: 31021419 DOI: 10.1111/cch.12676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/15/2019] [Accepted: 04/22/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Parenting stress is influenced by many factors including maternal attachment and excessive infant crying, yet the nature of these relationships is not well understood. For example, excessive infant crying despite maternal soothing may impact maternal attachment to the child, leading to higher stress. This paper explored whether maternal perception of excessive infant crying at 6 months was associated with higher maternal parenting stress at 24 months, and whether maternal attachment mediated this relationship. METHODS All families, present at 24 months in a randomized controlled trial of a 5-year early intervention programme targeting school readiness skills in disadvantaged area of Ireland, were included. At 6 months, infant crying was assessed using a maternal reported measure of duration of infant crying, and maternal attachment to the infant was assessed using the Condon Maternal Attachment Scale. Parenting stress was assessed at 24 months using the childrearing stress subscale from the Parenting Stress Index. Structural equation modelling was used to explore the direct and indirect effects of maternal perceptions of excessive infant crying on parenting stress, controlling for infant, maternal, and environmental characteristics, and focusing on the mediating role of maternal attachment. RESULTS Reporting excessive infant crying at 6 months was associated with lower maternal attachment at 6 months, which led to higher parenting stress at 24 months. In addition, vulnerable adult attachment style, previous maternal mental health difficulties, low paternal education, paternal involvement with the child, and not being married were associated with higher parenting stress. CONCLUSION Findings suggest that the association between maternal perceptions of excessive crying at 6 months and later parenting stress may be mediated through maternal attachment to the infant. Interventions based on improving maternal attachment could be investigated to determine the effectiveness of supporting mothers with low attachment.
Collapse
Affiliation(s)
- Marion Bailhache
- Pole de pediatrie, CHU de Bordeaux, Bordeaux, France.,ISPED, Centre INSERM U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
| | - Orla Doyle
- UCD Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.,UCD School of Economics, University College Dublin, Dublin, Ireland
| | - Louis-Rachid Salmi
- ISPED, Centre INSERM U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France.,Pole de Santé Publique, CHU de Bordeaux, Bordeaux, France
| | | |
Collapse
|
126
|
Beckers LWME, Rameckers EAA, Smeets RJEM, van der Burg JJW, Aarts PBM, Schnackers MLAP, Janssen-Potten YJM. Barriers to recruitment of children with cerebral palsy in a trial of home-based training. Contemp Clin Trials Commun 2019; 15:100371. [PMID: 31198879 PMCID: PMC6556814 DOI: 10.1016/j.conctc.2019.100371] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/27/2019] [Accepted: 04/25/2019] [Indexed: 01/28/2023] Open
Abstract
Many trials fail to include the targeted number of participants, causing scientific and ethical problems. The COAD trial of home-based training programs (HBTPs) for children with unilateral cerebral palsy (CP) encountered recruitment problems, even though the parent-delivered home-based approach complies with recent health-care developments in the Netherlands. The current project aimed to identify the barriers to recruitment in the COAD trial. This summative, multidimensional evaluation comprised informal conversational interviews in which stakeholders who had been involved reflected on the factors that impeded successful recruitment of participants into the COAD trial. Barriers to implementation and recruitment were clustered according to the constructs of the Consolidated Framework for Implementation Research (CFIR). Member checking validated the findings. A total of 41 stakeholders contributed to the evaluation. Barriers to the implementation of the HBTPs were identified within every domain of the CFIR (intervention characteristics, outer setting, inner setting, characteristics of individuals, and process). Parent-delivered home-based training was perceived as highly complex and in conflict with the pressures on and the needs of parents. Many parents preferred the alternative center-based group interventions. The involvement of a resonance group was highly valued, and opportunities for further enhancements emerged. Additionally, the importance of research consortia was emphasized. The appropriateness of the RCT as the study design was criticized. The findings of this study are summarized in a tool which provides a dozen directions for the successful recruitment of participants in pediatric rehabilitation research.
Collapse
Affiliation(s)
- L W M E Beckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands
| | - E A A Rameckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands.,Rehabilitation and Physical Therapy, University of Hasselt, Hasselt, Belgium
| | - R J E M Smeets
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,CIR Revalidatie, Location Eindhoven, the Netherlands
| | - J J W van der Burg
- Department of Pediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.,School of Pedagogical and Educational Sciences, Radboud University, Nijmegen, the Netherlands
| | - P B M Aarts
- Department of Pediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - M L A P Schnackers
- Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands
| | - Y J M Janssen-Potten
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands
| |
Collapse
|
127
|
van Aswegen T, Myezwa H, Potterton J, Stewart A. The effect of the Hambisela programme on stress levels and quality of life of primary caregivers of children with cerebral palsy: A pilot study. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2019; 75:461. [PMID: 30863797 PMCID: PMC6407451 DOI: 10.4102/sajp.v75i1.461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/25/2018] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Caregivers of children with cerebral palsy (CP) are at risk of having high stress levels and poor quality of life (QOL) which could have a detrimental effect on themselves and their children. Taking caregivers' well-being into consideration is therefore important when providing rehabilitation to children with CP. Interventions to mediate primary caregiver stress and QOL using an educational tool have not been tested in this population in South Africa. OBJECTIVES The aim of this study was to determine the effect of a group-based educational intervention, Hambisela, on stress levels and QOL of primary caregivers of children with CP in Mamelodi, a township in Gauteng, South Africa. METHOD Eighteen primary caregivers of children with CP participated in a quasi-experimental pretest-post-test pilot study. Hambisela, a group-based educational intervention, was carried out once a week over 8 consecutive weeks. Caregiver stress and QOL were assessed before and after the intervention using the Parenting Stress Index-Short Form (PSI-SF) and the Paediatric Quality of Life-Family Impact Module (PedsQLTM-FIM). Sociodemographic information was assessed using a demographic questionnaire. The Gross Motor Function Classification System (GMFCS) was used to assess the gross motor level of severity of CP in the children. RESULTS Data were collected for 18 participants at baseline and 16 participants at follow-up. At baseline, 14 (87.5%) participants had clinically significant stress which reduced to 11 (68.8%) at follow-up. There was no significant change in primary caregiver's stress levels (p = 0.72) and QOL (p = 0.85) after the Hambisela programme. Higher levels of education were moderately associated with lower levels of primary caregiver stress (r = -0.50; p = 0.03). CONCLUSION Most primary caregivers in this pilot study suffered from clinically significant stress levels. Hambisela, as an educational intervention, was not effective in reducing the stress or improving the QOL in these primary caregivers of children with CP. Future studies with a larger sample size are needed to investigate the high stress levels of primary caregivers of children with CP. CLINICAL IMPLICATIONS Rehabilitation services for children with disabilities should include assessments to identify caregivers with high stress levels. Holistic management programmes should also include care for the carers.
Collapse
Affiliation(s)
- Tamryn van Aswegen
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Hellen Myezwa
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Joanne Potterton
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Aimee Stewart
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| |
Collapse
|
128
|
Caregiver stress in children with craniosynostosis: a systematic literature review. Childs Nerv Syst 2019; 35:217-225. [PMID: 30155782 DOI: 10.1007/s00381-018-3959-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 08/19/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES We present an overview of the literature on caregiver stress in children with craniosynostosis and report common trends in the literature. INTRODUCTION Craniosynostosis occurs approximately 1 in 2500 births. As this is a diagnosis most common in infants and often requires surgical treatment, this is a significant and stressful ordeal for caregivers. Caregiver stress impacts various outcomes for the child, and little is understood and known about caregiver stress in the pediatric craniosynostosis population. METHODS A literature search for all articles pertaining to craniosynostosis and parental/caregiver stress was conducted using PubMed, Embase, PsychINFO, and CINAHL databases. RESULTS Seven articles on caregiver stress in craniofacial abnormalities patients and three articles on caregiver stress in pediatric craniosynostosis patients specifically were identified. Three articles on parental satisfaction after craniosynostosis repair were also identified and included in the review. Few published studies exist in the literature on caregiver stress in children with craniosynostosis and no clear trends were identified. It is evident that caregiver stress significantly affects the psychosocial outcomes of children with craniosynostosis. However, there are an equal number of studies reporting significant differences in caregiver stress in children with craniosynostosis as those reporting no significant differences. CONCLUSIONS There is evidence that caregiver stress affects psychosocial outcomes of children with craniosynostosis, but no clear trends of either increased or decreased levels of stress were identified in caregivers of children with craniosynostosis. Additional research is needed to identify risk factors related to caregiver stress.
Collapse
|
129
|
van den Heuvel LL, Levin J, Mpango RS, Gadow KD, Patel V, Nachega JB, Seedat S, Kinyanda E. Agreement and Discrepancy on Emotional and Behavioral Problems Between Caregivers and HIV-Infected Children and Adolescents From Uganda. Front Psychiatry 2019; 10:460. [PMID: 31354539 PMCID: PMC6637279 DOI: 10.3389/fpsyt.2019.00460] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/11/2019] [Indexed: 01/14/2023] Open
Abstract
Background: HIV-infected children and adolescents (CA-HIV) face significant mental health challenges related to a broad range of biological and psychosocial factors. Data are scarce on the agreement and discrepancy between caregivers and CA-HIV regarding emotional and behavioral problems (EBPs) in CA-HIV. Objectives: We determined agreement between self- versus caregiver- reported EBPs and describe factors associated with informant discrepancy among caregiver-youth dyads who participated in the "Mental health among HIV-infected CHildren and Adolescents in KAmpala and Masaka, Uganda" (CHAKA) study. Methods: In a cross-sectional sample, caregiver-reported EBPs were assessed with the Child and Adolescent Symptom Inventory-5 (CASI-5), and self-reported problems were evaluated with the Youth Inventory-4 (YI-4) in 469 adolescents aged 12-17 years and the Child Inventory-4 (CI-4) in 493 children aged 8-11 years. Adolescents were questioned about experiences of HIV stigma. Caregiver psychological distress was assessed with the Self-Reporting Questionnaire (SRQ-20). Linear regression models were applied to identify variables associated with discrepancy scores. Results: Self-reported emotional problems (EPs) were present in 28.8% of adolescents and 36.9% of children, and 14.5% of adolescents self-reported behavioral problems (BPs). There was only a modest correlation (r ≤ 0.29) between caregiver- and CA-HIV-reported EBPs, with caregivers reporting more EPs whereas adolescents reported more BPs. Informant discrepancy between adolescents and caregivers for BPs was associated with adolescent age and caregiver's employment and HIV status. Among adolescents, EP discrepancy scores were associated with adolescent's WHO HIV clinical stage, caregiver level of education, and caregivers caring for other children. Among children, EP discrepancy scores were associated with child and caregiver age, caregiver level of education, and caregiver self-rated health status. HIV stigma and caregiver psychological distress were also associated with discrepancy, such that adolescents who experienced HIV stigma rated their EPs as more severe than their caregivers did and caregivers with increased psychological distress rated EBPs as more severe than CA-HIV self-rated. Conclusions: EBPs are frequently endorsed by CA-HIV, and agreement between informants is modest. Informant discrepancy is related to unique psychosocial and HIV-related factors. Multi-informant reports enhance the evaluation of CA-HIV and informant discrepancies can provide additional insights into the mental health of CA-HIV.
Collapse
Affiliation(s)
- Leigh L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Jonathan Levin
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard S Mpango
- Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS/Senior Wellcome Trust Fellowship, Entebbe, Uganda
| | - Kenneth D Gadow
- Department of Psychiatry, Stony Brook University, New York, NY, United States
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Massachusetts, MA, United States
| | - Jean B Nachega
- Departments of Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States.,Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Eugene Kinyanda
- Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS/Senior Wellcome Trust Fellowship, Entebbe, Uganda.,Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda.,Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
130
|
Butler A, Van Lieshout RJ, Lipman EL, MacMillan HL, Gonzalez A, Gorter JW, Georgiades K, Speechley KN, Boyle MH, Ferro MA. Mental disorder in children with physical conditions: a pilot study. BMJ Open 2018; 8:e019011. [PMID: 29301763 PMCID: PMC5781020 DOI: 10.1136/bmjopen-2017-019011] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Methodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up. DESIGN Prospective pilot study. SETTING Two children's tertiary-care hospitals. PARTICIPANTS Children aged 6-16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents. OUTCOME MEASURES Response, participation and retention rates. Child mental disorder using the Mini International Neuropsychiatric Interview at baseline and 6 months. Child quality of life, parental symptoms of stress, anxiety and depression, and family functioning. All outcomes were parent reported. RESULTS Response, participation and retention rates were 90%, 83% and 88%, respectively. Of the 50 children enrolled in the study, the prevalence of multimorbidity was 58% at baseline and 42% at 6 months. No sociodemographic characteristics were associated with multimorbidity. Multimorbidity at baseline was associated with declines over 6 months in the following quality of life domains: physical well-being, β=-4.82 (-8.47, -1.17); psychological well-being, β=-4.10 (-7.62, -0.58) and school environment, β=-4.17 (-8.18, -0.16). There was no association with parental psychosocial outcomes over time. CONCLUSIONS Preliminary evidence suggests that mental disorder in children with a physical condition is very common and has a negative impact on quality of life over time. Based on the strong response rate and minimal attrition, our approach to study child multimorbidity appears feasible and suggests that multimorbidity is an important concern for families. Methodological and substantive findings from this pilot study have been used to implement a larger, more definitive study of child multimorbidity, which should lead to important clinical implications.
Collapse
Affiliation(s)
- Alexandra Butler
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Louise Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Kathy Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kathy N Speechley
- Department of Paediatrics, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|