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Lykke C, Ekholm O, Olsen M, Sjøgren P. Paediatric end-of-life care - symptoms and problems: parent assessment. BMJ Support Palliat Care 2023; 13:e327-e333. [PMID: 33707300 DOI: 10.1136/bmjspcare-2021-002891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Symptoms and problems (S&P) are under-reported in children in end-of-life care.To target future interventions, the primary aim was to examine S&P in children in end-of-life care. METHODS All parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012-2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents' assessments of S&P during the last month of life were restricted to children aged 3-18 years. Data were analyses by means of descriptive statistics. RESULTS Children ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced 'mess-ups' or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death. CONCLUSION According to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.
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Affiliation(s)
- Camilla Lykke
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
- Department of Oncology and Palliative Care, Nordsjællands Hospital, Hillerod, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
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2
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Ochoa-Dominguez CY, Hamilton AS, Zhuang X, Mack WJ, Milam JE. Factors Associated With Agreement Between Parent and Childhood Cancer Survivor Reports on Child's Health Related Quality of Life. Eval Health Prof 2023:1632787231185856. [PMID: 37376980 DOI: 10.1177/01632787231185856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Pediatric Health Related Quality of Life (HRQoL) among childhood cancer survivors (CCS) measures the impact of illness and treatment from the patient's perspective. However, parents often serve as proxies when the child cannot provide information directly. Studies of agreement between parents' proxy assessment and child's self-report have shown discrepancies. Understanding the reasons for discrepancies is under studied. Thus, this study examined the agreement of 160 parent-CCS dyads on the child's domains of HRQoL by mean difference, intra-class correlation coefficients, and Bland-Altman plots. Differences in agreement were assessed by patients' age, ethnicity, and whether or not they lived with their parents. Overall, the Physical Function Score showed good agreement between parents and CCS (ICC = 0.62), while the Social Function Score had fair agreement (ICC = 0.39). CCS were more likely to rate their Social Function Score higher than their parent. The lowest agreement for the Social Function Score was found for 18-20 years old's (ICC = .254) versus younger or older CCS, and among non-Hispanic whites (ICC = 0.301) versus Hispanics. Differences in agreement varied by patient age and ethnicity, suggesting that other factors, including emotional, familial, and cultural factors, may influence parental awareness of CCS HRQoL.
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Affiliation(s)
- Carol Y Ochoa-Dominguez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, CA, USA
| | - Ann S Hamilton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Xueyan Zhuang
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Wendy J Mack
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Joel E Milam
- Department of Epidemiology and Biostatistics, University of California, Irvine
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3
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Schroeder KM, Rizzieri T, Lion RR, Mtenga N, Gisiri M, McFatrich M, Reeve BB. Swahili translation and cultural adaptation of the pediatric patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Patient Rep Outcomes 2023; 7:56. [PMID: 37306774 PMCID: PMC10260717 DOI: 10.1186/s41687-023-00598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The pediatric patient-reported outcomes version of the common terminology criteria for adverse event measure was developed and validated for use in pediatric cancer clinical trials to better capture the symptom experiences through direct self-report. The study aim was to develop and validate a Swahili language version of the patient-reported outcomes version of the common terminology criteria for adverse event measure. METHODS The pediatric version of 15 core symptom adverse events, and the corresponding questions, were selected from the patient-reported outcomes version of the common terminology criteria for adverse event library, then forward and back translated into Swahili by bilingual translators. The translated items were further refined using concurrent cognitive interviewing. Each round of interviews included five children, ages 8-17 years-old, receiving cancer therapy at Bugando Medical Centre, the cancer referral hospital for Northwest Tanzania, and continued until at least 80% of participants understood the question. RESULTS Three rounds of cognitive interviews were completed involving 13 patients and 5 caregivers. Among patients, 50% of questions (19/38) were fully comprehended after the first interview round. Two Adverse Events (anxiety and peripheral neuropathy) were the most difficult for participants to understand, associated with education level and experience. Goal comprehension was achieved after three rounds of interviews with no further revisions required. All parents in the first cognitive interview group comprehended the survey, with no additional revisions. CONCLUSION A Swahili patient-reported outcomes version of the common terminology criteria for adverse event was effective in eliciting patient-reported Adverse Events related to cancer treatment, with good comprehension for children aged 8-17 years. This survey is important to incorporate patient self-reporting of symptomatic toxicities and is an effective tool to increase capacity for pediatric cancer clinical trials throughout East Africa, further reducing global disparities in cancer care.
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Affiliation(s)
| | | | | | | | | | | | - Bryce B Reeve
- Duke Department of Population Health Sciences, Durham, USA
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4
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Singh I, Asnani MR, Harrison A. Health-Related Quality of Life in Adolescents With Chronic Illness in Jamaica: Adolescent and Parent Reports. J Adolesc Health 2023; 72:12-20. [PMID: 36202679 DOI: 10.1016/j.jadohealth.2022.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study is to assess the level of agreement between adolescents' self-assessment and parent-proxy reports on health-related quality of life (HRQOL) in Jamaican adolescents with chronic illness. METHODS A cross-sectional study was conducted, recruiting adolescents living with a chronic illness (ALCIs)-asthma, human immunodeficiency virus, insulin-dependent diabetes mellitus, or sickle cell disease and age/sex-matched healthy adolescents. Data were collected on HRQOL from adolescents and parents using the Pediatric Quality of Life Scale. Parent-adolescent agreement was determined at group level (Wilcoxon signed-rank test) and individual level (intraclass correlation coefficient). RESULTS Two hundred twenty-six (226) parent/adolescent pairs participated: 130 ALCIs and 96 healthy peers; mean age 14.9 ± 2.8 years; 58% females. Adolescents with and without chronic illness reported similar HRQOL; parent-proxies reported better HRQOL for healthy adolescents compared to ALCIs. Intraclass correlation demonstrated higher levels of parent-adolescent correlation for ALCIs than healthy adolescents (ALCIs: 0.11-0.34; healthy adolescents: 0.01-0.10). At group level, analyses demonstrated better parent-proxy rating of QOL in all of the scores with the exception of the general health score. Parent-proxies overestimated QOL for asthma and insulin-dependent diabetes mellitus but not for sickle cell disease and human immunodeficiency virus. Linear regression modeling revealed that female sex and living with chronic illness were significant predictors of agreement. DISCUSSION Parent-proxies overestimated adolescents' QOL compared to adolescents' report regardless of whether the adolescent was living with a chronic illness or not. As such, health care providers should elicit feedback from the adolescent wherever possible and proxy reports should be used as complementary information rather than primary source.
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Affiliation(s)
- Indira Singh
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Kingston, Jamaica
| | - Monika Rani Asnani
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Mona, Kingston, Jamaica
| | - Abigail Harrison
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Kingston, Jamaica.
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Gurlek Gokcebay D, Küpeli S, Gürsel O, Arman Bilir O, Akyay A, Pekpak E, Akbayram S, Öncül Y, Meral Güneş A, Kirkiz S, Çakı Kılıç S, Ok Bozkaya İ, Ozbek NY. Hematopoietic stem cell transplantation activities and HRQOL of refugee or asylum seeker children in Turkey: A multicenter study. Pediatr Transplant 2022; 26:e14397. [PMID: 36207767 DOI: 10.1111/petr.14397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 10/10/2022]
Abstract
BACKGROUND Refugee or asylum seekers (RAS) children are at increased risk of physical, developmental, and behavioral health issues. The aim of this study was to evaluate clinical and psychosocial outcomes of hematopoietic stem cell transplantation (HSCT) in RAS children and compare health-related quality of life (HRQOL) to those of Turkish peers. METHODS This retrospective study included patients who underwent HSCT aged 0-18 years and completed 100-day post-transplant. The PedsQL 4.0 Generic Core Scale was used in children over 5 years old to compare HRQOL. RESULTS A total of 166 RAS patients (M/F: 106 /60) underwent 174 HSCTs (six patients had two, and one had three HSCT) compared to 66 Turkish patients. The mean age of the patients in the RAS group was 7.8 ± 4.9 years and similar to controls. A total of 124 patients (75%) were from Syria, and 49 (25%) were from other countries in the Middle East and Africa. The cause of migration was war in 121 (74%) RAS patients. Complications of HSCT were no different between the groups. However, the rate of neutropenic sepsis was significantly higher in the RAS group (p = 0.004). The total scores of HRQOL were not different between RAS and controls. In the RAS group, ratings of social functioning were lower in patients with consanguinity or non-malignant disease or who had match-related donors. DISCUSSION Identifying areas of difficulty in subscales of HRQOL may help physicians to classify patients who need additional supportive care. Regular monitoring and supporting physical needs may result in better functional outcomes after HSCT.
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Affiliation(s)
- Dilek Gurlek Gokcebay
- Pediatric Bone Marrow Transplantation Unit, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Serhan Küpeli
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, Çukurova University, Adana, Turkey
| | - Orhan Gürsel
- Pediatric Bone Marrow Transplantation Unit, University of Health Sciences Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ozlem Arman Bilir
- Pediatric Bone Marrow Transplantation Unit, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Arzu Akyay
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, İnönü University, Malatya, Turkey
| | - Esra Pekpak
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, Gaziantep University, Gaziantep, Turkey
| | - Sinan Akbayram
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, Gaziantep University, Gaziantep, Turkey
| | - Yurday Öncül
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, İnönü University, Malatya, Turkey
| | - Adalet Meral Güneş
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, Uludağ University, Bursa, Turkey
| | - Serap Kirkiz
- Faculty of Medicine Pediatric Bone Marrow Transplantation Unit, Gazi University, Ankara, Turkey
| | - Suar Çakı Kılıç
- Pediatric Bone Marrow Transplantation Unit, University of Health Sciences Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - İkbal Ok Bozkaya
- Pediatric Bone Marrow Transplantation Unit, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Namık Yasar Ozbek
- Pediatric Bone Marrow Transplantation Unit, University of Health Sciences Ankara City Hospital, Ankara, Turkey
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The role of parental health and distress in assessing children’s health status. Qual Life Res 2022; 31:3403-3412. [PMID: 35876948 PMCID: PMC9587925 DOI: 10.1007/s11136-022-03186-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/24/2022]
Abstract
Purpose The purpose of the study was to examine the contributions of parents’ health and distress to parent’s and children’s assessments of children’s health. Methods We used baseline data from a longitudinal study of 364 children (ages 4–12) about to undergo surgery and their parents in a Southern California pediatric hospital. We used the 20-item child self-reported CHRIS 2.0 general health and the parallel parent-reported measure of the child’s health, along with a measure of parental distress about the child’s health were administered in the perioperative period. Other measures included parents’ physical and mental health, quality of life, distress over their child’s health, and number and extent of other health problems of the child and siblings. Results On average, parents’ reports about the child were consistently and statistically significantly higher than children’s self-reports across all sub-dimensions of the CHRIS 2.0 measure. Parents’ personal health was positively associated with their reports of the child’s health. More distressed parents were closer to the child’s self-reports, but reported poorer personal health. Conclusion Parent–child differences in this study of young children’s health were related to parental distress. Exploring the nature of the gap between parents and children in assessments of children’s health could improve effective clinical management for the child and enhance family-centered pediatric care. Future studies are needed to assess the generalizability of CHRIS 2.0 to other health settings and conditions and to other racial/ethnic groups. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03186-z.
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Freyer DR, Lin L, Mack JW, Maurer SH, McFatrich M, Baker JN, Jacobs SS, Lucas N, Withycombe JS, Tomlinson D, Villabroza KR, Waldron MK, Hinds PS, Reeve BB. Lack of Concordance in Symptomatic Adverse Event Reporting by Children, Clinicians, and Caregivers: Implications for Cancer Clinical Trials. J Clin Oncol 2022; 40:1623-1634. [PMID: 35294262 PMCID: PMC9113216 DOI: 10.1200/jco.21.02669] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/15/2021] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To examine concordance in symptomatic adverse event (AE) grading using the Common Terminology Criteria for Adverse Events (CTCAE 4.0) for clinicians and its patient-reported outcome (PRO) versions for children (Ped-PRO-CTCAE) and caregivers (Ped-PRO-CTCAE [Caregiver]). METHODS Children age 7-18 years with a first cancer diagnosis, their clinicians, and caregivers completed CTCAE-based measures before starting a treatment course (T1) and after the treatment (T2). Grades (0-3) were assigned by each reporter for 15 core AEs spanning physical and mental health. Mean grades were compared between reporters using two-sample t-tests; agreement was estimated using weighted kappa (κ) statistics. Multivariable mixed regression models were used to evaluate associations of clinical factors with AE reporting concordance. Significance was set at α = .05 (two-sided). RESULTS There were 438 child-clinician-caregiver triads with complete data at either T1 or T2. For children, the mean age was 13 years (standard deviation = 3.4), 53.7% were male, 32.6% non-White, and 56.4% had leukemia/lymphoma. At T1, clinician mean AE grades were significantly lower (ie, better) than children for all AEs and remained significantly lower at T2 except for constipation, nausea, anorexia, neuropathy, and anxiety. Caregiver mean AE grades were similar to children at T1 and significantly higher (ie, worse) at T2 for nausea, vomiting, anorexia, pain, fatigue, anxiety, and depression. Agreement for child-clinician grading was poor-to-fair at T1 (κ range, 0.08-0.34) and T2 (0.11-0.35), and for child-caregiver, was fair-to-good at T1 (0.34-0.65) and T2 (0.24-0.60). No factors were consistently associated with reporter concordance across AEs. CONCLUSION Compared with children, symptomatic AEs were consistently under-reported by clinicians with low agreement and over-reported by caregivers with low-moderate agreement. Direct reporting by children using Ped-PRO-CTCAE or similar measures should be routinely incorporated for toxicity assessment in clinical trials.
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Affiliation(s)
- David R. Freyer
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Li Lin
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Jennifer W. Mack
- Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA
| | - Scott H. Maurer
- UPMC Children's Hospital and University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Justin N. Baker
- Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
| | - Shana S. Jacobs
- Division of Oncology, Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC
| | | | | | - Deborah Tomlinson
- The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada
| | | | - Mia K. Waldron
- Department of Nursing Science, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Pamela S. Hinds
- Department of Nursing Science, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Bryce B. Reeve
- Departments of Population Health Sciences and Pediatrics, Duke University School of Medicine, Durham, NC
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Hayase T, Mieno MN, Kobayashi K, Mori N, Lebowitz AJ, Kato Y, Saito Y, Yuza Y, Sano H, Osone S, Hori T, Shinkoda Y, Yamamoto N, Hasegawa D, Yano M, Ashiarai M, Hasegawa D, Sawada A, Yamaguchi T, Morimoto A, Fukushima K. Reliability and Validity of the Japanese Pediatric Version of Memorial Symptom Assessment Scale. J Pain Symptom Manage 2022; 63:e495-e504. [PMID: 35031501 DOI: 10.1016/j.jpainsymman.2021.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/23/2022]
Abstract
CONTEXT Few instruments in Japanese assess health-related quality of life in pediatric cancer patients. OBJECTIVES To translate the Memorial Symptom Assessment Scale (MSAS) into Japanese pediatric and proxy versions (MSAS-J 7-12, MSAS-J 13-18, and MSAS-J-Proxy) and assess validity and reliability. METHODS Phase I comprised forward-backward translation and pilot testing in 13 children and 16 guardians. Phase II consisted of psychometric testing of the three MSAS-J versions in 162 children and 238 guardians. Internal consistency, test-retest reliability, and construct and known-group validity of the MSAS-J were assessed. RESULTS Cronbach's alpha coefficients for the total and subscale scores were over 0.70, excluding the psychological symptom (PSYCH) subscale score of the MSAS-J 7-12. Most MSAS-J scores significantly inversely correlated with two versions of the Pediatric Quality of Life Inventory. A strong child-guardian correlation was shown in the total and subscale scores (ICC range 0.66-0.83). Kappa estimates showed acceptable child-guardian symptom agreement. MSAS-J 7-12 and proxy differentiated patients according to clinical status. CONCLUSION MSAS-J is a reliable and valid instrument to assess symptoms among Japanese children with cancer.
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Affiliation(s)
- Tomomi Hayase
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan.
| | - Makiko N Mieno
- Department of Medical Informatics, Center for Information, Jichi Medical University, Shimotsuke, Japan
| | - Kyoko Kobayashi
- Department of Child Health Nursing, St. Luke's International University Graduate School of Nursing Science, Tokyo, Japan
| | - Naoko Mori
- Department of Pediatrics, Akabane Zaitaku Clinic, Tokyo, Japan; Departments of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Adam Jon Lebowitz
- Department of General Education, Jichi Medical University, Shimotsuke, Japan
| | - Yoko Kato
- Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuya Saito
- Departments of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Yuki Yuza
- Departments of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Hirozumi Sano
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Shinya Osone
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsukasa Hori
- Department of Pediatrics, Sapporo Medical University, Sapporo, Japan
| | - Yuichi Shinkoda
- Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Michihiro Yano
- Department of Pediatrics, Akita University School of Medicine, Akita, Japan
| | - Miho Ashiarai
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Akihisa Sawada
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan
| | - Keitaro Fukushima
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Japan
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9
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The impact of CNS-directed treatment on quality of life in childhood cancer survivors. Qual Life Res 2022; 31:817-829. [PMID: 34455525 PMCID: PMC8882709 DOI: 10.1007/s11136-021-02984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Pediatric cancer survivors may have lower quality of life (QoL), but most research has assessed outcomes either in treatment or long-term survivorship. We focused on early survivorship (i.e., 3 and 5 years post-diagnosis), examining the impact of CNS-directed treatment on child QoL, as well as sex and age at diagnosis as potential moderators. METHODS Families of children with cancer (ages 5-17) were recruited at diagnosis or relapse (N = 336). Survivors completed the PedsQL at 3 (n = 96) and 5 years (n = 108), along with mothers (101 and 105, respectively) and fathers (45 and 53, respectively). The impact of CNS treatment, sex, and age at diagnosis on child QoL was examined over both time since diagnosis and time since last treatment using mixed model analyses. RESULTS Parent-report of the child's total QoL was in the normative range and stable between 3 and 5 years when examining time since diagnosis, while child reported QoL improved over time (p = 0.04). In terms of time since last treatment, mother and child both reported the child's QoL improved over time (p = 0.0002 and p = 0.0006, respectively). Based on parent-report, males with CNS-directed treatment had lower total QoL than females and males who did not receive CNS-directed treatment. Age at diagnosis did not moderate the impact of treatment type on total QoL. CONCLUSIONS Quality of life (QoL) in early survivorship may be low among males who received CNS-directed treatment. However, this was only evident on parent-report. Interventions to improve child QoL should focus on male survivors who received CNS-directed treatment, as well as females regardless of treatment type.
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10
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Murugappan MN, King-Kallimanis BL, Reaman GH, Bhatnagar V, Horodniceanu EG, Bouchkouj N, Kluetz PG. Patient-Reported Outcomes in Pediatric Cancer Registration Trials: A US Food and Drug Administration Perspective. J Natl Cancer Inst 2022; 114:12-19. [PMID: 33930159 PMCID: PMC8755487 DOI: 10.1093/jnci/djab087] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 09/21/2023] Open
Abstract
Pediatric patient-reported outcome (PRO) data can help inform the US Food and Drug Administration's (FDA's) benefit-risk assessment of cancer therapeutics by quantifying symptom and functional outcomes from the patient's perspective. This study assessed use of PROs in commercial pediatric oncology trials submitted to the FDA for regulatory review. FDA databases were searched to identify pediatric oncology product applications approved between 1997 and 2020. Sponsor-submitted documents were reviewed to determine whether PRO data were collected, which instruments were used, and the quality of collected data (ie, sample size, completion rates, and use of fit-for-purpose instruments). The role of PROs in each trial (endpoint hierarchy) was also recorded in addition to whether any PRO endpoints were included in product labeling. We reviewed 17 pediatric oncology applications, 4 of which included PRO data: denosumab, tisagenlecleucel, larotrectinib, and selumetinib. In these 4 instances, PROs served as exploratory endpoints and were not incorporated in product labeling. Trials that collected PRO data were phase II or phase I/II single-arm studies with sample sizes of 28 to 88 patients. Symptomatic adverse events (AEs) were characterized using clinician-reported Common Terminology Criteria for Adverse Events (CTCAE) without additional patient self-report. PROs were infrequently used in pediatric cancer registration trials. When PROs were used, PRO data were limited by lack of a clear research objective and corresponding prospective statistical analysis plan. Contemporary PRO symptom libraries, such as the National Cancer Institute's Pediatric PRO-CTCAE, may provide an opportunity to better evaluate the occurrence and impact of symptomatic AEs, from the patient's perspective, in pediatric oncology trials.
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Affiliation(s)
- Meena N Murugappan
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Gregory H Reaman
- Oncology Center for Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | - Vishal Bhatnagar
- Oncology Center for Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | - Erica G Horodniceanu
- Oncology Center for Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | - Najat Bouchkouj
- Oncology Center for Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | - Paul G Kluetz
- Oncology Center for Excellence, US Food and Drug Administration, Silver Spring, MD, USA
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11
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Crossan E, O'Connell AC. Parental perception on oral health-related quality of life and dental features of ectodermal dysplasia and isolated hypodontia in children. BMC Oral Health 2021; 21:510. [PMID: 34627220 PMCID: PMC8502392 DOI: 10.1186/s12903-021-01878-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/21/2021] [Indexed: 11/11/2022] Open
Abstract
Background Children missing 6 or more permanent teeth often present with complex dental care needs and significant impacts on their oral health related quality of life (OHRQoL). The most important facet in the overall care for these children is the child’s own experience, but parents primarily make the decisions regarding their child’s dental management. Understanding the parental perspective could have a positive impact on planning and provision of care for these patient groups in the future. The study compared the parental perspectives on OHRQoL impact and dental experience for children with ectodermal dysplasia (ED), severe isolated hypodontia (IH), and matched controls following assessment of their dental features.
Design A cross-sectional study of 172 children (mean age: 12.4 years old) was conducted; 86 with severe hypodontia (≥ 6 missing teeth; ED: 29; IH: 57) and 86 age and gender matched controls. The Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS) and a supplemental questionnaire were used to gather information on parental perceptions of OHRQoL and dental experiences, respectively. Clinical examinations were used to assess and compare the dental features between children with ED, IH and their respective controls. Results Higher scores (p < 0.05) were found in P-CPQ and FIS scores between the children with ED, IH and their respective controls. P-CPQ scores for males with ED had a moderate correlation with functional limitations (Rs = 0.576; p = 0.001*), oral symptoms (Rs = 0.444; p = 0.016*) and overall QoL (Rs = 0.499; p = 0.006*). The ED group reported earlier awareness of issues, the youngest attendance (3.24 years) and highest perceived number of appointments (“20 or more”; 58.6%). The mean number of missing teeth in the ED group was almost twice that of the IH group (ED: 20.17; IH: 10.68) and the median number of missing teeth (Radiographically: ED = 21; IH = 9; Clinically: ED = 11; IH = 6), was significantly greater in the ED group when compared to the IH group (p < 0.001*). Conclusion Parents of children with ED and IH perceive a greater impact on QoL, for both the child and their family. Children with ED need earlier intervention and more extensive treatment than children with IH and their controls.
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Affiliation(s)
- Emily Crossan
- Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Anne C O'Connell
- Dublin Dental University Hospital, Trinity College, Dublin, Ireland.
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12
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Yawary R, Hegde S. Silver Diamine Fluoride Protocol for Reducing Preventable Dental Hospitalisations in Victorian Children. Int Dent J 2021; 72:322-330. [PMID: 34272061 PMCID: PMC9275345 DOI: 10.1016/j.identj.2021.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/05/2021] [Accepted: 05/20/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction This study was designed to assess whether a dental caries management protocol combining a single application of 38% silver diamine fluoride (SDF) with comprehensive oral health education will successfully divert high-risk children from dental treatment under dental general anaesthesia (DGA), arrest active caries in primary teeth, and improve parent-reported child oral health–related quality of life (OHRQoL). Methods Children aged 2 to 10 years, who attended two public dental agencies in Victoria, Australia, and were unable to tolerate restorative treatments in the clinic setting, elected to participate in either a 38% SDF intervention protocol or, alternatively, referral for DGA. Follow-up examinations were completed at 6 months to assess caries progression, decayed missing filled tooth index, PUFA index (pulpal involvement, ulceration, fistula, abscess), DGA referral rates, and OHRQoL (Early Childhood Oral Health Impact Scale [ECOHIS]). Results Of the total sample, 89.5% of children (n = 102) [mean (SD) age, 4.1 (1.0) years] with 401 active carious lesions elected to participate in the 38% SDF protocol; 10.5% (n = 12) of parents opted for referral for treatment under DGA. The proportion of active caries subsequently arrested at follow-up (number of arrested lesions/number of lesions treated) was 0.78 (95% CI, 0.69 to 0.87). There was an 88% reduction in referrals for DGA in eligible children over the 6-month period. The 38% SDF intervention group showed a significant improvement in ECOHIS scores at follow-up (P < .001). Discussion Adoption of the 38% SDF intervention protocol resulted in a significant reduction in the rate of preventable dental hospitalisations. Most parents opted against referral for DGA. Parent-reported OHRQoL for children improved significantly.
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Affiliation(s)
- Rana Yawary
- Dental Health Services Victoria, Carlton, Victoria, Australia.
| | - Shalika Hegde
- Dental Health Services Victoria, Carlton, Victoria, Australia
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13
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Eaton BR, Goldberg S, Tarbell NJ, Lawell MP, Gallotto SL, Weyman EA, Kuhlthau KA, Ebb DH, MacDonald SM, Yock TI. Long-term health-related quality of life in pediatric brain tumor survivors receiving proton radiotherapy at <4 years of age. Neuro Oncol 2021; 22:1379-1387. [PMID: 32064512 DOI: 10.1093/neuonc/noaa042] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this analysis is to report long-term health-related quality of life (HRQoL) among brain tumor survivors treated with proton therapy (PRT) at a very young age. METHODS Fifty-nine children <4 years old received PRT between 2000 and 2011. Forty families participated. HRQoL was assessed by child self-report (CSR; age ≥5) and parent proxy report (PPR; age 2+) using the PedsQL Core. RESULTS The median age was 2.5 years (range, 0.3-3.8) at PRT and 9.1 years (5.5-18) at last follow-up. The most common diagnoses were ependymoma (n = 22) and medulloblastoma (n = 7). Median follow-up is 6.7 years (3-15.4). Follow-up mean CSR and PPR scores were: total core (78.4 and 72.9), physical (82.9 and 75.2), psychosocial (76.0 and 71.6), emotional (74.4 and 70.7), social (81.2 and 75.1), and school (72.4 and 69.9). Parent-reported HRQoL fell within a previously defined range for healthy children in 37.5% of patients, and for children with severe health conditions in 45% of patients. PPR HRQoL was stable from baseline to last follow-up among all domains except for social functioning. History of gastrostomy tube was significantly associated with poorer CSR and PPR HRQoL on multivariable analysis. Ninety percent of children functioned in a regular classroom, 14 (36%) used a classroom aid, 9 (23%) used an outside tutor, and 18 (46%) had an individualized education plan. CONCLUSION Long-term HRQoL among brain tumor survivors treated with PRT at a very young age is variable, with over a third achieving HRQoL levels commensurate with healthy children. KEY POINTS 1. One third of survivors reported long-term HRQoL scores comparable to those of healthy children.2. Treatment for hydrocephalus or a feeding tube was associated with significantly lower HRQoL.3. Total core HRQoL scores remained stable from baseline to last follow-up.
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Affiliation(s)
- Bree R Eaton
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Saveli Goldberg
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nancy J Tarbell
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Miranda P Lawell
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Sara L Gallotto
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Elizabeth A Weyman
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Karen A Kuhlthau
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - David H Ebb
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Shannon M MacDonald
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Torunn I Yock
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
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Morino T, Shinohara Y, Niu Q, Shimoura K, Tabata A, Hanai A, Ogawa M, Kato T, Tanimukai H, Tsuboyama T, Matsuoka M, Adachi S, Aoyama T. Perception Gap in Health-Related Quality of Life Between Young Adult Survivors of Childhood Cancer and Their Family. J Adolesc Young Adult Oncol 2021; 10:735-739. [PMID: 33691481 DOI: 10.1089/jayao.2020.0232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Young adult survivors of childhood cancer may have a perception gap with their families. Patients aged 18-39 years after treatment of cancer and their families (28 pairs) completed a survey that contained questions on health-related quality of life using the 36-item short form survey. There was a significant difference in the role-social component score (mean difference -2.23; p = 0.04) with family reporting higher scores than patients. Families may overestimate the social function of cancer survivors, emphasizing the importance of the long-term follow-up by taking into account the risk of a gap (IRB approval No.: R2257-1).
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Affiliation(s)
- Tappei Morino
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuki Shinohara
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Qian Niu
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kanako Shimoura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ami Tabata
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Hanai
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Medical Sciences Innovation Hub Program, Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - Masahiro Ogawa
- Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan
| | - Toshihiro Kato
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hitoshi Tanimukai
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Palliative Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Tadao Tsuboyama
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,School of Health Sciences, Bukkyo University, Kyoto, Japan
| | - Mari Matsuoka
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Soichi Adachi
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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15
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Toulia E, Kaklamanos EG, Chatzigianni A, Papadopoulos MA. Child perceptions questionnaire: translation, cultural adaptation and initial validation in a Greek adolescent population with malocclusion. Eur Arch Paediatr Dent 2020; 22:175-180. [PMID: 32372134 DOI: 10.1007/s40368-020-00531-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/15/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Several studies have shown that orthodontic anomalies may affect young people's Oral Health-Related Quality of Life (OHRQoL). The purpose the present study was to translate in the Greek language, culturally adapt and initially validate the CPQ11-14 ISF-16 for a Greek adolescent population with malocclusion. METHODS Following relevant methodological recommendations, after translation, the comprehensiveness of the Greek version of CPQ11-14 ISF-16 (CPQ11-14 ISF-16-GR) was verified in a pilot study of 20 Greek adolescents. The main study was undertaken in a sample of 200 adolescents that presented for an initial consultation at the Postgraduate Orthodontic Clinic. Cronbach's alpha was used to test internal consistency/reliability and Spearman's rho for criterion validity with the Oral Health Impact Profile (OHIP-14). Forty individuals completed the same questionnaires again after 3 weeks. Test-retest reliability was assessed using Intraclass Correlation Coefficient. Statistical tests were undertaken using SPSS (v. 24, IBM Corp., NY, USA). RESULTS The CPQ11-14 ISF-16-GR presented high internal consistency (Cronbach's alpha = 0.848 > 0.70) and very satisfactory Discrimination Index (DI = 0.47 > 0.30). Moreover, the CPQ11-14ISF-16 showed excellent criterion validity with OHIP-14 (rho = 0.719, p < 0.001). Test-retest reliability was at high levels as well (ICC = 0.719, p < 0.001). CONCLUSION The CPQ11-14 ISF-16-GR exhibits satisfactory psychometric properties to continue the investigation of OHRQoL in Greek adolescents with malocclusion. Further testing of is required in a variety of environments to increase generalizability and investigate the particular characteristics of CPQ application in malocclusion cases.
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Affiliation(s)
- E Toulia
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - E G Kaklamanos
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Building 34, Dubai Healthcare City, Dubai, United Arab Emirates.
| | - A Chatzigianni
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - M A Papadopoulos
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloníki, Greece
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16
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Singh N, Dubey N, Rathore M, Pandey P. Impact of early childhood caries on quality of life: Child and parent perspectives. J Oral Biol Craniofac Res 2020; 10:83-86. [PMID: 32181125 PMCID: PMC7062923 DOI: 10.1016/j.jobcr.2020.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/28/2019] [Accepted: 02/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of present study was to examine early childhood caries' impact on oral health-related quality of life from children's self report and parental perception. METHODS 200 healthy children in the age group of 3-5 years and their parents/guardians were enrolled in the study. 100 children diagnosed with early childhood caries (interventional group) and 100 children without caries (control group) along with their parents/guardians participated in face to face interview and responded to Michigan oral health related quality of life scale - child and parent version. Four weeks after full mouth rehabilitation children with ECC and their parents responded to a survey for a follow-up assessment. Data was analyzed and evaluated using Statistical Package for Social Sciences Version 21.0 statistical software and Chi square test. RESULTS In our study we have found that ECC subjects had poorer oral health-related quality of life compared to caries free subjects. Further one month follow up after complete treatment, the oral health-related QoL improved significantly in ECC children. CONCLUSIONS Early childhood caries has a definite negative impact on the OHRQoL of children. At one month follow up after complete oral rehabilitation, the quality of life improved significanty as assessed by children's self reports as well as parental perceptions of their child's OHRQoL.
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Affiliation(s)
- Neerja Singh
- Department of Pediatric and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, India
| | | | - Monika Rathore
- Department of Pediatric and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, India
| | - Pallavi Pandey
- Department of Pediatric and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, India
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17
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Di Giuseppe G, Thacker N, Schechter T, Pole JD. Anxiety, depression, and mental health-related quality of life in survivors of pediatric allogeneic hematopoietic stem cell transplantation: a systematic review. Bone Marrow Transplant 2020; 55:1240-1254. [DOI: 10.1038/s41409-020-0782-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/24/2019] [Accepted: 01/03/2020] [Indexed: 12/20/2022]
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18
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McFatrich M, Brondon J, Lucas NR, Hinds PS, Maurer SH, Mack JW, Freyer DR, Jacobs SS, Baker JN, Mowbray C, Wang M, Castellino SM, Barz Leahy A, Reeve BB. Mapping child and adolescent self-reported symptom data to clinician-reported adverse event grading to improve pediatric oncology care and research. Cancer 2019; 126:140-147. [PMID: 31553494 DOI: 10.1002/cncr.32525] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/07/2019] [Accepted: 08/26/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Clinicians are the standard source for adverse event (AE) reporting in oncology trials, despite the subjective nature of symptomatic AEs. The authors designed a pediatric patient-reported outcome (PRO) instrument for symptomatic AEs to support the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) (the Pediatric PRO-CTCAE). The current study developed a standardized algorithm that maps all possible Pediatric PRO-CTCAE response patterns to recommended CTCAE grades to improve the accuracy of AE reporting in pediatric oncology trials. METHODS Two rounds of surveys were administered to experienced cancer clinicians across 9 pediatric hospitals. In round 1, pediatric oncologists assigned CTCAE grades to all 101 possible Pediatric PRO-CTCAE response patterns. The authors evaluated clinician agreement of CTCAE grades across response patterns and categorized each response pattern as having high or low agreement. In round 2, a survey was sent to a larger clinician group to examine clinician agreement among a select set of Pediatric PRO-CTCAE response patterns, and the authors examined how clinical context influenced grade assignment. RESULTS A total of 10 pediatric oncologists participated in round 1. Of the 101 possible patterns, 89 (88%) had high agreement. The Light weighted kappa was averaged across the 10 oncologists (Light kappa = 0.73; 95% CI, 0.66-0.81). A total of 139 clinicians participated in round 2. High clinician agreement remained for the majority of generic response patterns and the clinical context did not typically change grades but rather improved agreement. CONCLUSIONS The current study provides a framework for integrating child self-reported symptom data directly into mandated AE reporting in oncology trials. Translating Pediatric PRO-CTCAE responses into clinically meaningful metrics will guide future cancer care and toxicity grading.
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Affiliation(s)
- Molly McFatrich
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Jennifer Brondon
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nicole R Lucas
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Pamela S Hinds
- Department of Nursing Science, Professional Practice, and Quality Outcomes, Children's National Health System, Washington, DC
| | - Scott H Maurer
- Division of Pediatric Hematology/Oncology and Blood and Marrow Transplantation, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer W Mack
- Division of Population Sciences for Pediatric Hematology/Oncology, Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, Massachusetts
| | - David R Freyer
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California
| | - Shana S Jacobs
- Center for Cancer and Blood Disorders, Children's National Health System, Washington, DC
| | - Justin N Baker
- Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Catriona Mowbray
- Center for Cancer and Blood Disorders, Children's National Health System, Washington, DC
| | - Mian Wang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sharon M Castellino
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Allison Barz Leahy
- Division of Oncology, Cellular Therapy and Transplant Section, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
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19
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Jaeken K, Cadenas de Llano-Pérula M, Lemiere J, Verdonck A, Fieuws S, Willems G. Difference and relation between adolescents' and their parents or caregivers' reported oral health-related quality of life related to orthodontic treatment: a prospective cohort study. Health Qual Life Outcomes 2019; 17:40. [PMID: 30808364 PMCID: PMC6390370 DOI: 10.1186/s12955-019-1094-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/15/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Parents/caregivers play an important role in deciding whether their children will undergo orthodontic treatment or not. Their perceptions also have an influence on other choices involving orthodontic treatment. The purpose of this study was to investigate the difference and correlation between the ratings given by children and their parents or caregivers on their oral health-related quality of life (OHRQoL) before, during and after orthodontic treatment. METHODS In this ongoing observational prospective cohort study, 498 children aged 11 to 16 years-old and one of their parents/caregivers completed questionnaires before (T0), 1 year after start (T1) and 1 month after the end of orthodontic treatment (T2). OHRQoL was scored by using the Child Perception Questionnaire (CPQ11-14) and the Parental-Caregiver Perception questionnaire (P-CPQ). The self-perception of oral aesthetics was evaluated with the Oral Aesthetic Subjective Impact Scale (OASIS) in addition to the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Spearman correlations, Mann-Whitney U-tests and linear models were used to analyze the longitudinal data. RESULTS At T0, the ratings of parents/caregivers were significantly lower for the total CPQ as well as for the subdomains of oral symptoms, functional limitations and emotional well-being. Parents/caregivers also scored significantly lower at T2 for the total CPQ and the subdomain of oral symptoms. The relations between the scores of children and their parents/caregivers were significant at all three time points, as were the changes in scores, but all of them were at most moderate in size. Parents/caregivers scored significantly lower for OASIS than their children at all time points and only at baseline a significant, weak correlation was found. CONCLUSION The reports of parents/caregivers should be seen as important complementary information in OHRQoL research. TRIAL REGISTRATION This study was approved by the Medical Ethical Commitee of the University Hospitals Leuven and the Katholieke Universiteit Leuven (ML5739), Leuven, Belgium, on the 12th of May of 2009, with the registration number S51642. All procedures performed are in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Affiliation(s)
- Katrien Jaeken
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Jurgen Lemiere
- Child and Adolescent Psychiatry/Pediatric Haemato-oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven and University Hasselt, Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
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20
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Gothwal VK, Seelam B, Mandal AK. Quality of life following surgery for congenital glaucoma: findings of the LVPEI congenital glaucoma registry. Eye (Lond) 2018; 33:659-667. [PMID: 30518976 DOI: 10.1038/s41433-018-0293-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 09/10/2018] [Accepted: 10/15/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To evaluate the health-related quality of life (HRQoL) of children operated for primary congenital glaucoma (PCG) using the Kidscreen-27 questionnaire. METHODS A total of 121 children (mean age, 11.8 years; SD, 2.8 years; 51% males) with unilateral or bilateral PCG who underwent glaucoma surgery in infancy (mean duration since surgery, 10.2 years; [SD] 4.2 years) by a single surgeon at a tertiary eye care centre were administered the Kidscreen-27 questionnaire (self-or interviewer administered in a face-to-face interview) during their routine follow-up visit. We investigated the measurement properties of Kidscreen-27 questionnaire using Rasch analysis and generated interval-level estimates of HRQoL. The main outcome measure was HRQoL (i.e., Rasch-derived Kidscreen score). Multivariable linear regression analyses assessed the influence of socio-demographic and clinical variables on the HRQoL of children with PCG. RESULTS Majority (83%) of the children had bilateral PCG and congenital type of the disease (79%). Mean presenting acuity (logMAR) in the better eye was 0.32 (SD, 0.36; median, 0.18). Rasch analysis of Kidscreen-27 questionnaire indicated need for minor modifications following which a psychometrically robust unidimensional 23-item Kidscreen questionnaire emerged. In multivariable model, age of the child was independently associated with a 32% (β = -0.24 [95% CI, -0.11, -0.36]) increase in the HRQoL score. CONCLUSIONS Despite undergoing successful glaucoma surgery, children with PCG reported reduced HRQoL. Younger children with PCG are more likely to experience this lowered HRQoL and ophthalmologists will need to be alert to this. Efforts must be made to improve the HRQoL of children with PCG.
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Affiliation(s)
- Vijaya K Gothwal
- Brien Holden Eye Research Centre-Patient-Reported Outcomes Unit, Hyderabad, India
| | - Bharani Seelam
- Brien Holden Eye Research Centre-Patient-Reported Outcomes Unit, Hyderabad, India
| | - Anil K Mandal
- Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India.
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21
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Mueller EL, Cochrane AR, Bennett WE, Carroll AE. A survey of mobile technology usage and desires by caregivers of children with cancer. Pediatr Blood Cancer 2018; 65:e27359. [PMID: 30015371 DOI: 10.1002/pbc.27359] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/30/2018] [Accepted: 06/17/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND The use of mobile health (mHealth) has grown exponentially, even by caregivers of vulnerable populations. The study objective was to understand mobile technology usage, barriers, and desires by caregivers of children with cancer. PROCEDURE Paper surveys were mailed to caregivers of children diagnosed with cancer at Riley Hospital for Children between June 2015 and June 2017. The survey contained 13 questions, both fixed and open-ended, and was sent in both English and Spanish up to three times. RESULTS Respondents (n = 121) were primarily parents (93.2%), median age was 40.7 years (range 23-63), and most were white, non-Hispanic (74.4%). The majority made under $100,000 annual household income (72.9%) and had an education of at least some college or greater (74.5%). Nearly all owned a smart phone (99.2%) and most (61.2%) owned a tablet. Among operating systems, the majority used iOS (62.8%), while 49.6% used Android. About a third (37.1%) reported no barriers to mobile technology use, but 22.4% experienced "data limitations." Overall, 86.2% wanted at least one medical management website/app: medical knowledge (61.2%), symptom tracking/management (49.1%), and medication reminders (44.8%). Further, 62.1% wanted access to child's medical record and 58.6% wanted communication with medical providers. Lower education was significantly associated with experiencing phone/plan barriers (P = 0.008). CONCLUSION The majority of caregivers of children with cancer use mobile technology with minimal barriers; future research should focus on designing an mHealth tool to address the medical management needs by caregivers of children with cancer.
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Affiliation(s)
- Emily L Mueller
- Center for Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.,Division of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Anneli R Cochrane
- Center for Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.,Division of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - William E Bennett
- Center for Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.,Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Aaron E Carroll
- Center for Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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22
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Verstraete J, Ramma L, Jelsma J. Influence of the child's perceived general health on the primary caregiver's health status. Health Qual Life Outcomes 2018; 16:8. [PMID: 29321017 PMCID: PMC5763523 DOI: 10.1186/s12955-018-0840-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In estimating the impact of an intervention, ignoring the effect of improving the health of one member of the caregiver/child dyad on the Health Related Quality of Life (HRQoL) of the other member may lead to an underestimation of the utility gained. This may be particularly true for infants/young children and their caregivers. The aim of this study was to quantify the interaction between the child's perceived general health as assessed by the newly developed Toddler and Infant Questionnaire (TANDI) on the reporting of the caregiver's own HRQoL as assessed by the EQ-5D-3 L. METHODS A sample of 187 caregivers participated. A total of 60 caregivers of acutely-ill (AI) and 60 caregivers of chronically-ill (CI) children were recruited from a children's hospital. The 67 caregivers of general population (GP) children were recruited at a pre-school. Each caregiver completed the proxy rating of their child's HRQoL on the TANDI (The TANDI is an experimental HRQoL instrument, modelled on the EQ-5D-Y proxy, for children aged 1-36 months), which comprises of six dimensions of health and a rating of general health on a Visual Analogue Scale (VAS). The caregiver completed the EQ-5D-3 L, a self-report measure of their own HRQoL. Forward stepwise regression models were developed with 1) the VAS score of the caregiver and 2) the VAS score of the child as dependent variables. The independent variables for the caregiver included dummy variables for the presence or absence of problems on the EQ-5D-3 L and the VAS score of the child. The independent variables for the child included dummy variables for each TANDI dimension and the VAS of the caregiver. RESULTS The TANDI results indicated that in five of the six dimensions AI children had more problems than the other two groups and the GP children were reported to have a significantly higher VAS than the other two groups. The child's VAS was significantly correlated with the caregiver's VAS in all groups, but most strongly in the AI group. The preference based scores (using the UK TTO tariff) were only correlated in the AI group. The inclusion of the child's VAS increased the variance accounted for 11% of the VAS score of the caregiver. Anxiety and depression was the only dimension which accounted for more variance (18%). Similarly the perceived health state, VAS of the caregiver accounted for 14% of the variance in the child's VAS, second only to problems with play (25%). CONCLUSION There does indeed appear to be a strong relationship between the VAS scores of the children and their caregivers. The perceived general health of the child influences the caregivers reporting of their general health, more than their own report of experiencing pain or discomfort or problems with mobility. Thus, improving the HRQoL of the very young child may improve the caregiver's HRQoL as well. Conversely, if the caregiver has a lower perceived HRQoL this may result in a decrement in the reported VAS of the child, independent of the presence or absence of problems in the different dimensions. This improvement is not currently captured by Cost Utility Analysis (CUA). It is recommended that future research investigates this effect with regards to CUA calculations.
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Affiliation(s)
- Janine Verstraete
- Department of Physiotherapy, Red Cross War Memorial Children’s Hospital, Klipfontein Road, Rondebosch, Cape Town, 7700 South Africa
- Faculty of Health and Rehabilitation Sciences, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Lebogang Ramma
- Faculty of Health and Rehabilitation Sciences, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Jennifer Jelsma
- Faculty of Health and Rehabilitation Sciences, Anzio Road, Observatory, Cape Town, 7925 South Africa
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23
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Longo E, Badia M, Begoña Orgaz M, Gómez-Vela M. Comparing parent and child reports of health-related quality of life and their relationship with leisure participation in children and adolescents with Cerebral Palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:214-222. [PMID: 29055241 DOI: 10.1016/j.ridd.2017.09.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 08/10/2017] [Accepted: 09/28/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to examine the level of agreement between reports of health-related quality of life (HR-QoL) obtained from children and adolescents with cerebral palsy (CP) and their parents. We also examined the relationships between child and parent perception of the different domains of HR-QoL and participation dimensions. Sixty-nine children and adolescents with CP and their parents separately completed parallel forms of the KIDSCREEN questionnaire. The Spanish version of the Children's Assessment of Participation and Enjoyment (CAPE) was completed by the child/adolescent. Concordance between the children's and the parents' HR-QoL scores was analyzed via Pearson and intraclass correlations. Differences in means were tested using paired Student's t-tests. Chi-square tests were using to assess the incidence of personal variables in the agreement and disagreement of children-parents' responses. The relationships between HR-QoL and leisure participation was confirmed with Pearson's correlation coefficients. Correlations between child and parent HR-QoL scores were small in 7 domains, medium in 2 and large in the Social Support & Peers domain. Children reported significantly better HR-QoL than their parents did. Participation was positively associated with specific domains of HR-QoL, but only weakly, and there were discrepancies between parent and child reports of HR-QoL. These findings provide interesting information about the importance of hearing the voices of children and adolescents with CP to promote HR-QoL and leisure participation.
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Affiliation(s)
- Egmar Longo
- Federal University of Rio Grande do Norte/FACISA, Brazil.
| | - Marta Badia
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - M Begoña Orgaz
- Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - María Gómez-Vela
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
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24
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Pinheiro LC, McFatrich M, Lucas N, Walker JS, Withycombe JS, Hinds PS, Sung L, Tomlinson D, Freyer DR, Mack JW, Baker JN, Reeve BB. Child and adolescent self-report symptom measurement in pediatric oncology research: a systematic literature review. Qual Life Res 2017; 27:291-319. [PMID: 28879501 DOI: 10.1007/s11136-017-1692-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Previous work in pediatric oncology has found that clinicians and parents tend to under-report the frequency and severity of treatment-related symptoms compared to child self-report. As such, there is a need to identify high-quality self-report instruments to be used in pediatric oncology research studies. This study's objective was to conduct a systematic literature review of existing English language instruments used to measure self-reported symptoms in children and adolescents undergoing cancer treatment. METHODS A comprehensive literature search was conducted in MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO to identify relevant articles published through November 10, 2016. Using pre-specified inclusion/exclusion criteria, six trained reviewers carefully screened abstracts and full-text articles for eligibility. RESULTS There were 7738 non-duplicate articles identified in the literature search. Forty articles met our eligibility criteria, and within these articles, there were 38 self-report English symptom instruments. Most studies evaluated only cross-sectional psychometric properties, such as reliability or validity. Ten studies assessed an instrument's responsiveness or ability to detect changes in symptoms over time. Eight instruments met our criteria for use in future longitudinal pediatric oncology studies. CONCLUSIONS This systematic review aids pediatric oncology researchers in identifying and selecting appropriate symptom measures with strong psychometric evidence for their studies. Enhancing the child's voice in pediatric oncology research studies allows us to better understand the impact of cancer and its treatment on the lives of children.
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Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, 10064, USA.
| | - Molly McFatrich
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nicole Lucas
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Walker
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Pamela S Hinds
- Department of Nursing Research and Quality Outcomes, Children's National Health System, Department of Pediatrics, George Washington University, Washington, DC, USA
| | - Lillian Sung
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.,Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Deborah Tomlinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - David R Freyer
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Justin N Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Bryce B Reeve
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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25
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Carpenter D, Gonzalez D, Retsch-Bogart G, Sleath B, Wilfond B. Methodological and Ethical Issues in Pediatric Medication Safety Research. Pediatrics 2017; 140:e20170195. [PMID: 28778857 PMCID: PMC5574727 DOI: 10.1542/peds.2017-0195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 12/26/2022] Open
Abstract
In May 2016, the Eshelman School of Pharmacy at The University of North Carolina at Chapel Hill convened the PharmSci conference to address the topic of "methodological and ethical issues in pediatric medication safety research." A multidisciplinary group of experts representing a diverse array of perspectives, including those of the US Food and Drug Administration, children's hospitals, and academia, identified important considerations for pediatric medication safety research and opportunities to advance the field. This executive summary describes current challenges that clinicians and researchers encounter related to pediatric medication safety research and identifies innovative and ethically sound methodologies to address these challenges to improve children's health. This article addresses 5 areas: (1) pediatric drug development and drug trials; (2) conducting comparative effectiveness research in pediatric populations; (3) child and parent engagement on study teams; (4) improving communication with children and parents; and (5) assessing child-reported outcomes and adverse drug events.
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Affiliation(s)
| | | | - George Retsch-Bogart
- Department of Pediatrics, School of Medicine
- Clinical and Translational Research Center of the North Carolina Translational and Clinical Sciences Institute, and
- Cystic Fibrosis Therapeutics Development Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | | | - Benjamin Wilfond
- Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, University of Washington, Seattle, Washington
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26
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Rosenberg AR, Wolfe J. Approaching the third decade of paediatric palliative oncology investigation: historical progress and future directions. THE LANCET CHILD & ADOLESCENT HEALTH 2017; 1:56-67. [PMID: 29333484 DOI: 10.1016/s2352-4642(17)30014-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Paediatric palliative care (PPC) endeavours to alleviate the suffering and improve the quality of life of children with serious illnesses and their families. In the past two decades since WHO defined PPC and called for its inclusion in paediatric oncology care, rigorous investigation has provided important insights. For example, the first decade of research focused on end-of-life experiences of the child and the family, underscoring the high prevalence of symptom burden, the barriers to parent-provider concordance with regards to prognosis, as well as the need for bereavement supports. The second decade expanded PPC oncology investigation to include the entire cancer continuum and the voices of patients. Other studies identified the need for support of parents, siblings, and racial and ethnic minority groups. Promising interventions designed to improve outcomes were tested in randomised clinical trials. Future research will build on these findings and pose novel questions about how to continue to reduce the burdens of paediatric cancer.
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Affiliation(s)
- Abby R Rosenberg
- Seattle Children's Hospital Cancer and Blood Disorders Center, Seattle, WA, USA (A R Rosenberg MD); Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA (A R Rosenberg); Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA (A R Rosenberg); Department of Psychosocial Oncology and Palliative Care, and Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, MA, USA (J Wolfe MD); Department of Medicine, Boston Children's Hospital, Boston, MA, USA (J Wolfe); and Harvard Medical School, Boston, MA, USA (J Wolfe)
| | - Joanne Wolfe
- Seattle Children's Hospital Cancer and Blood Disorders Center, Seattle, WA, USA (A R Rosenberg MD); Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA (A R Rosenberg); Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA (A R Rosenberg); Department of Psychosocial Oncology and Palliative Care, and Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, MA, USA (J Wolfe MD); Department of Medicine, Boston Children's Hospital, Boston, MA, USA (J Wolfe); and Harvard Medical School, Boston, MA, USA (J Wolfe)
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27
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Ullrich CK, Rodday AM, Bingen KM, Kupst MJ, Patel SK, Syrjala KL, Harris LL, Recklitis CJ, Chang G, Guinan EC, Terrin N, Tighiouart H, Phipps S, Parsons SK. Three sides to a story: Child, parent, and nurse perspectives on the child's experience during hematopoietic stem cell transplantation. Cancer 2017; 123:3159-3166. [PMID: 28387946 DOI: 10.1002/cncr.30723] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/13/2017] [Accepted: 03/15/2017] [Indexed: 11/12/2022]
Abstract
BACKGROUND The experience of children undergoing hematopoietic stem cell transplantation (HSCT), including the ways in which different participants (ie, children, parents, and nurses) contribute to the overall picture of a child's experience, is poorly characterized. This study evaluated parent, child, and nurse perspectives on the experience of children during HSCT and factors contributing to interrater differences. METHODS Participants were enrolled in a multicenter, prospective study evaluating child and parent health-related quality of life over the year after HSCT. Children (n = 165) and their parents and nurses completed the Behavioral, Affective, and Somatic Experiences Scale (BASES) at baseline (before/during conditioning), 7 days after the stem cell infusion (day+7), and 21 days after the stem cell infusion (day+21). The BASES domains included Somatic Distress, Mood Disturbance, Cooperation, and Getting Along. Higher scores indicated more distress/impairment. Repeated measures models by domain assessed differences by raters and changes over time and identified other factors associated with raters' scores. RESULTS Completion rates were high (≥73% across times and raters). Multivariate models revealed significant time-rater interactions, which varied by domain. For example, parent-rated Somatic Distress scores increased from baseline to day+7 and remained elevated at day+21 (P < .001); children's scores were lower than parents' scores across time points. Nurses' baseline scores were lower than parents' baseline scores, although by day+21 they were similar. Older child age was associated with higher Somatic Distress and Mood Disturbance scores. Worse parent emotional functioning was associated with lower scores across raters and domains except for Cooperation. CONCLUSIONS Multirater assessments are highly feasible during HSCT. Ratings differ by several factors; considering ratings in light of such factors may deepen our understanding of the child's experience. Cancer 2017;123:3159-66. © 2017 American Cancer Society.
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Affiliation(s)
- Christina K Ullrich
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Angie Mae Rodday
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Kristin M Bingen
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mary Jo Kupst
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sunita K Patel
- Department of Population Sciences, City of Hope Medical Center, Duarte, California.,Department of Supportive Care Medicine, City of Hope Medical Center, Duarte, California
| | - Karen L Syrjala
- Department of Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Lynnette L Harris
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Christopher J Recklitis
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Grace Chang
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Eva C Guinan
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts
| | - Norma Terrin
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Hocine Tighiouart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.,Department of Pediatrics, Tufts University School of Medicine, Boston, Massachusetts
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28
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Reeve BB, McFatrich M, Pinheiro LC, Weaver MS, Sung L, Withycombe JS, Baker JN, Mack JW, Waldron MK, Gibson D, Tomlinson D, Freyer DR, Mowbray C, Jacobs S, Palma D, Martens CE, Gold SH, Jackson KD, Hinds PS. Eliciting the child's voice in adverse event reporting in oncology trials: Cognitive interview findings from the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events initiative. Pediatr Blood Cancer 2017; 64:10.1002/pbc.26261. [PMID: 27650708 PMCID: PMC5301979 DOI: 10.1002/pbc.26261] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/25/2016] [Accepted: 08/19/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Adverse event (AE) reporting in oncology trials is required, but current practice does not directly integrate the child's voice. The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) is being developed to assess symptomatic AEs via child/adolescent self-report or proxy-report. This qualitative study evaluates the child's/adolescent's understanding and ability to provide valid responses to the PRO-CTCAE to inform questionnaire refinements and confirm content validity. PROCEDURE From seven pediatric research hospitals, children/adolescents ages 7-15 years who were diagnosed with cancer and receiving treatment were eligible, along with their parent-proxies. The Pediatric PRO-CTCAE includes 130 questions that assess 62 symptomatic AEs capturing symptom frequency, severity, interference, or presence. Cognitive interviews with retrospective probing were completed with children in the age groups of 7-8, 9-12, and 13-15 years. The children/adolescents and proxies were interviewed independently. RESULTS Two rounds of interviews involved 81 children and adolescents and 74 parent-proxies. Fifteen of the 62 AE terms were revised after Round 1, including refinements to the questions assessing symptom severity. Most participants rated the PRO-CTCAE AE items as "very easy" or "somewhat easy" and were able to read, understand, and provide valid responses to questions. A few AE items assessing rare events were challenging to understand. CONCLUSIONS The Pediatric and Proxy PRO-CTCAE performed well among children and adolescents and their proxies, supporting its content validity. Data from PRO-CTCAE may improve symptomatic AE reporting in clinical trials and enhance the quality of care that children receive.
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Affiliation(s)
- Bryce B. Reeve
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina,Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Molly McFatrich
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Laura C. Pinheiro
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina,Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Meaghann S. Weaver
- Division of Quality of Life and Palliative Care, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Lillian Sung
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada,Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | | | - Justin N. Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | | | - Mia K. Waldron
- Department of Nursing Research and Quality Outcomes, Children’s National Health System, Washington, District of Columbia
| | - Deborah Gibson
- Division of Quality of Life and Palliative Care, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Deborah Tomlinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - David R. Freyer
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, California
| | - Catriona Mowbray
- Department of Oncology, Children’s National Health System, Washington, District of Columbia
| | - Shana Jacobs
- Department of Oncology, Children’s National Health System, Washington, District of Columbia
| | - Diana Palma
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, California
| | - Christa E. Martens
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Stuart H. Gold
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Kathryn D. Jackson
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Pamela S. Hinds
- Department of Nursing Research and Quality Outcomes, Children’s National Health System, Washington, District of Columbia,Department of Pediatrics, George Washington University, Washington, District of Columbia
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29
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Gernsbacher MA, Stevenson JL, Dern S. Specificity, contexts, and reference groups matter when assessing autistic traits. PLoS One 2017; 12:e0171931. [PMID: 28192464 PMCID: PMC5305234 DOI: 10.1371/journal.pone.0171931] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/29/2017] [Indexed: 12/18/2022] Open
Abstract
Many of the personality and behavioral traits (e.g., social imperviousness, directness in conversation, lack of imagination, affinity for solitude, difficulty displaying emotions) that are known to be sensitive to context (with whom?) and reference group (according to whom?) also appear in questionnaire-based assessments of autistic traits. Therefore, two experiments investigated the effects of specifying contexts and reference groups when assessing autistic traits in autistic and non-autistic participants. Experiment 1 (124 autistic and 124 non-autistic participants) demonstrated that context matters when assessing autistic traits (F(1,244) = 267.5, p < .001, η2p = .523). When the context of the Broad Autism Phenotype Questionnaire was specified as the participants’ out-group (e.g., “I like being around non-autistic people” or “I like being around autistic people”), both autistic and non-autistic participants self-reported having more autistic traits; when the context was specified as the participants’ in-group, participants reported having fewer autistic traits. Experiment 2 (82 autistic and 82 non-autistic participants) demonstrated that reference group matters when assessing autistic traits (F(2,160) = 94.38, p < .001, η2p = .541). When the reference group on the Social Responsiveness Scale was specified as the participants’ out-group (e.g., “According to non-autistic people, I have unusual eye contact”), autistic participants reported having more autistic traits; when the reference group was their in-group, autistic participants reported having fewer autistic traits. Non-autistic participants appeared insensitive to reference group on the Social Responsiveness Scale. Exploratory analyses suggested that when neither the context nor the reference group is specified (for assessing autistic traits on the Autism-Spectrum Quotient), both autistic and non-autistic participants use the majority (“non-autistic people”) as the implied context and reference group.
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Affiliation(s)
- Morton Ann Gernsbacher
- Department of Psychology, University of Wisconsin–Madison, Madison, Wisconsin, United States of America
- * E-mail:
| | - Jennifer L. Stevenson
- Department of Psychology, Ursinus College, Collegeville, Pennsylvania, United States of America
| | - Sebastian Dern
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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30
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Hasle H, Kaspers GJL. Strategies for reducing the treatment-related physical burden of childhood acute myeloid leukaemia - a review. Br J Haematol 2016; 176:168-178. [PMID: 27766626 DOI: 10.1111/bjh.14419] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/22/2016] [Indexed: 12/24/2022]
Abstract
Over the last four decades the survival of paediatric patients with acute myeloid leukaemia has gradually increased to 70% in high-income countries. The therapy is very intensive and associated with many acute and long-term side effects. The early death rate has been reduced to 1-4%. The acute toxicity is a limiting factor for improving survival in low-income countries. Transplant is associated with more endocrinological late effects while cardiotoxicity is more common after relapse. Reducing the physical costs of therapy without jeopardizing survival may be accomplished by optimal supportive care, less cardiotoxic anthracyclines, less consolidation courses and strict indications for stem cell transplantation. Analysing scenarios with different frequency of transplantation in first complete remission show similar overall survival rates, indicating that almost all patients can be spared the procedure in first remission. Reducing relapse risk is an effective way of reducing toxicity and more targeted therapy and improved risk group stratifications are needed.
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Affiliation(s)
- Henrik Hasle
- Department of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Gertjan J L Kaspers
- Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.,Academy of Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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31
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Nuss SL, Wilson ME. Health-Related Quality of Life Following Hematopoietic Stem Cell Transplant During Childhood. J Pediatr Oncol Nurs 2016; 24:106-15. [PMID: 17332424 DOI: 10.1177/1043454206296033] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study is to examine the self-reported and parent-reported health-related quality of life (HRQoL) of children (age < 19 years) who received a hematopoietic (bone marrow, cord blood, or peripheral blood) stem cell transplant (SCT) at the University of Nebraska Medical Center (UNMC). A total of 35 families participated: 31 SCT recipients, 35 mothers, and 28 fathers. Mean scores were 73.6 child, 71.2 mothers, and 76.2 fathers (range of 0-100, with high scores indicating better HRQoL). No significant overall HRQoL difference between parent and child were reported. Mothers reported significantly lower physical functioning (F 2,23 = 3.509, P = .041) compared to child (P = .041) and fathers (P = .025). Older age at time of transplant was associated with higher procedural anxiety according to child (r = .498, P = .005) and mothers (r = .466, P = .008). Older age at time of transplant was associated with less worry according to fathers (r = -.589, P = .002). Overall, SCT recipients and their parents report moderately high HRQoL.
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32
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Yawary R, Anthonappa RP, Ekambaram M, McGrath C, King NM. Changes in the oral health-related quality of life in children following comprehensive oral rehabilitation under general anaesthesia. Int J Paediatr Dent 2016; 26:322-9. [PMID: 26370769 DOI: 10.1111/ipd.12200] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess changes in the oral health-related quality of life (OHRQoL), after comprehensive oral rehabilitation under general anaesthesia (CORGA), among children (i) <6 years using the Early Childhood Oral Health Impact Scale (ECOHIS) and (ii) aged 6-14 years using the child oral health-related quality of life (COHRQoL) instrument. METHODS A total of 136 healthy children who had CORGA were recruited over a period of 12 months. The parent or caregiver of the study participants completed the age-appropriate questionnaire prior to the dental treatment and at the subsequent follow-up appointments (2 weeks and 3 months). Data were analysed using repeated-measures anova and Bonferroni tests. RESULTS The overall ECOHIS scores decreased significantly (P < 0.001) demonstrating large effect sizes. The greatest decreases were for the domains of child oral symptoms (57.5%) and psychology (38.7%) in the child impact section (CIS) and for the domain of parental distress (38.9%) and family function (40%) in the family impact section (FIS). For COHRQoL, the overall P-CPQ and FIS scores decreased significantly for all items (P < 0.001), demonstrating large effect sizes. The greatest decreases were for the domains of oral symptoms (77.7%), functional limitations (74.3%), and the FIS (80.1%). CONCLUSIONS The OHRQoL of children in both age groups (<6 and 6-14 years) was significantly improved after CORGA.
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Affiliation(s)
- Rana Yawary
- Paediatric Dentistry, School of Dentistry, University of Western Australia, Perth, WA, Australia
| | - Robert P Anthonappa
- Paediatric Dentistry, School of Dentistry, University of Western Australia, Perth, WA, Australia
| | - Manikandan Ekambaram
- Department of Paediatric Dentistry, Faculty of Dentistry, The Univeristy of Hong Kong, Hong Kong (SAR), China
| | - Colman McGrath
- Department of Public Health Dentistry, Faculty of Dentistry, The Univeristy of Hong Kong, Hong Kong (SAR), China
| | - Nigel M King
- Paediatric Dentistry, School of Dentistry, University of Western Australia, Perth, WA, Australia
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Bradlyn AS. Health-Related Quality of Life in Pediatric Oncology: Current Status and Future Challenges. J Pediatr Oncol Nurs 2016; 21:137-40. [PMID: 15296041 DOI: 10.1177/1043454204264376] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article presents information regarding the current status of health-related quality of life (HRQL) assessment in pediatric oncology, including the substantial advances in our knowledge that have occurred during the past 10 years. Additionally, issues that continue to challenge researchers who are attempting to measure health-related quality of life in children from point of diagnosis to cure or to death are identified. It is posited that researchers must conduct investigations of the impact of health-related quality-of-life data on clinical care and outcomes for the field to continue to advance, and for these data to be valued by patients, families, and health care providers.
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Affiliation(s)
- Andrew S Bradlyn
- Health Behavior Research Center, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26506-9136, USA.
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Parent Outlook: How Parents View the Road Ahead as They Embark on Hematopoietic Stem Cell Transplantation for Their Child. Biol Blood Marrow Transplant 2015; 22:104-11. [PMID: 26348891 DOI: 10.1016/j.bbmt.2015.08.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 08/23/2015] [Indexed: 11/22/2022]
Abstract
Pediatric hematopoietic stem cell transplantation (HSCT) offers cure for high-risk malignancies and other conditions, but carries a risk of complications. Parental outlook regarding their child's transplantation course and future health has been largely unexplored. This report presents the Parent Outlook Scale, describes its properties, and examines the outlook of parents embarking on their child's transplantation course and the associated variables. Parents of children scheduled to undergo HSCT (n = 363) at 8 US transplantation centers completed the Parent Outlook Scale, comprising 4 items assessing frequency of the parent's thoughts about the potential difficulty of the child's transplantation (Transplant Difficult subscale) and worsened health (Health Worse subscale). Item responses were rated on a 5-point Likert scale (ranging from "none" to "all of the time") and, along with scale/subscale scores, transformed to 100-point scales, with higher scores connoting greater thought frequency. Psychometrics were explored. Multivariable models identified personal and clinical characteristics associated with scale and subscale scores. The Parent Outlook Scale (α = 0.75) and subscales were found to have sound psychometric properties. Factor loading supported the single scale with 2 subscales representing distinct aspects of overall outlook. Mean scores (Parent Outlook, 52.5 ± 21.7; Transplant Difficult, 64.4 ± 25.6; Health Worse, 40.7 ± 25.7) revealed variability within and across scale/subscales. Significantly different mean subscale scores (P < .001) indicated more frequent Transplant Difficult thoughts than Health Worse thoughts. Clinical factors (solid tumor diagnosis and unrelated donor transplant) and a parent factor (worse emotional functioning) were associated with higher scale and subscale scores. Our findings show that the outlook of parents embarking on their child's HSCT course is varied and not solely a product of clinical factors readily apparent to clinicians. Referring and transplantation clinicians should create opportunities to explore with parents their perspectives and concerns before and during the course of HSCT.
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Lee SJ, Wolff D, Kitko C, Koreth J, Inamoto Y, Jagasia M, Pidala J, Olivieri A, Martin PJ, Przepiorka D, Pusic I, Dignan F, Mitchell SA, Lawitschka A, Jacobsohn D, Hall AM, Flowers MED, Schultz KR, Vogelsang G, Pavletic S. Measuring therapeutic response in chronic graft-versus-host disease. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: IV. The 2014 Response Criteria Working Group report. Biol Blood Marrow Transplant 2015; 21:984-99. [PMID: 25796139 PMCID: PMC4744804 DOI: 10.1016/j.bbmt.2015.02.025] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 12/17/2022]
Abstract
In 2005, the National Institutes of Health (NIH) Chronic Graft-versus-Host Disease (GVHD) Consensus Response Criteria Working Group recommended several measures to document serial evaluations of chronic GVHD organ involvement. Provisional definitions of complete response, partial response, and progression were proposed for each organ and for overall outcome. Based on publications over the last 9 years, the 2014 Working Group has updated its recommendations for measures and interpretation of organ and overall responses. Major changes include elimination of several clinical parameters from the determination of response, updates to or addition of new organ scales to assess response, and the recognition that progression excludes minimal, clinically insignificant worsening that does not usually warrant a change in therapy. The response definitions have been revised to reflect these changes and are expected to enhance reliability and practical utility of these measures in clinical trials. Clarification is provided about response assessment after the addition of topical or organ-targeted treatment. Ancillary measures are strongly encouraged in clinical trials. Areas suggested for additional research include criteria to identify irreversible organ damage and validation of the modified response criteria, including in the pediatric population.
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Affiliation(s)
- Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Daniel Wolff
- Department of Internal Medicine III, University of Regensburg, Regensburg, Germany
| | - Carrie Kitko
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - John Koreth
- Division of Hematologic Malignancies, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Madan Jagasia
- Division of Hematology-Oncology, Vanderbilt University, Nashville, Tennessee
| | - Joseph Pidala
- Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Attilio Olivieri
- Department of Clinical and Molecular Sciences, University of Ancona, Ancona, Italy
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Donna Przepiorka
- US Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, Maryland
| | - Iskra Pusic
- Department of Medicine, Washington University, St. Louis, Missouri
| | - Fiona Dignan
- Department of Clinical Haematology, University of Manchester, Manchester, United Kingdom
| | - Sandra A Mitchell
- Outcomes Research Branch, National Cancer Institute, Bethesda, Maryland
| | - Anita Lawitschka
- Stem Cell Transplant Unit, St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria
| | - David Jacobsohn
- Division of Blood and Marrow Transplantation, Children's National Health System, Washington, District of Columbia
| | - Anne M Hall
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Kirk R Schultz
- BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | | | - Steven Pavletic
- Outcomes Research Branch, National Cancer Institute, Bethesda, Maryland.
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Wang C, Hipp JR, Butts CT, Jose R, Lakon CM. Alcohol use among adolescent youth: the role of friendship networks and family factors in multiple school studies. PLoS One 2015; 10:e0119965. [PMID: 25756364 PMCID: PMC4355410 DOI: 10.1371/journal.pone.0119965] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 01/18/2015] [Indexed: 11/19/2022] Open
Abstract
To explore the co-evolution of friendship tie choice and alcohol use behavior among 1,284 adolescents from 12 small schools and 976 adolescents from one big school sampled in the National Longitudinal Study of Adolescent to Adult Health (AddHealth), we apply a Stochastic Actor-Based (SAB) approach implemented in the R-based Simulation Investigation for Empirical Network Analysis (RSiena) package. Our results indicate the salience of both peer selection and peer influence effects for friendship tie choice and adolescent drinking behavior. Concurrently, the main effect models indicate that parental monitoring and the parental home drinking environment affected adolescent alcohol use in the small school sample, and that parental home drinking environment affected adolescent drinking in the large school sample. In the small school sample, we detect an interaction between the parental home drinking environment and choosing friends that drink as they multiplicatively affect friendship tie choice. Our findings suggest that future research should investigate the synergistic effects of both peer and parental influences for adolescent friendship tie choices and drinking behavior. And given the tendency of adolescents to form ties with their friends' friends, and the evidence of local hierarchy in these networks, popular youth who do not drink may be uniquely positioned and uniquely salient as the highest rank of the hierarchy to cause anti-drinking peer influences to diffuse down the social hierarchy to less popular youth. As such, future interventions should harness prosocial peer influences simultaneously with strategies to increase parental support and monitoring among parents to promote affiliation with prosocial peers.
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Affiliation(s)
- Cheng Wang
- Department of Sociology, Cornell University, Ithaca, New York, United States of America
- * E-mail:
| | - John R. Hipp
- Departments of Criminology, Law and Society and Sociology, University of California Irvine, Irvine, California, United States of America
| | - Carter T. Butts
- Departments of Sociology and Statistics, University of California Irvine, Irvine, California, United States of America
| | - Rupa Jose
- Department of Psychology and Social Behavior, University of California Irvine, Irvine, California, United States of America
| | - Cynthia M. Lakon
- Program in Public Health, University of California Irvine, Irvine, California, United States of America
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Brinksma A, Tissing WJE, Sulkers E, Kamps WA, Roodbol PF, Sanderman R. Exploring the response shift phenomenon in childhood patients with cancer and its effect on health-related quality of life. Oncol Nurs Forum 2014; 41:48-56. [PMID: 24195842 DOI: 10.1188/14.onf.41-01ap] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the response shift phenomenon in pediatric patients with cancer and to determine its effects on ratings of health-related quality of life (HRQOL). DESIGN Retrospective pre- and post-test design. SETTING Pediatric oncology department in the northern part of the Netherlands. SAMPLE 37 children newly diagnosed with cancer and 80 parents. METHODS The then-test method was used to determine response shift. HRQOL was assessed within two weeks postdiagnosis (pretest) and three months later (post-test) using both child and parent reports of PedsQL and Cantril's ladder. The post-test and then-test were administered concurrently. MAIN RESEARCH VARIABLES Overall and multidimensional HRQOL. FINDINGS Scores on Cantril's then-test were lower than the pretest in both child and parent reports, indicating response shift in the assessment of overall HRQOL. Children experienced a greater response shift than parents. No differences were found between the PedsQL then- and pretests. CONCLUSIONS Both child- and parent-report ratings of overall HRQOL were affected by response shift, resulting in an underestimation of the improvement in overall HRQOL between diagnosis and three months postdiagnosis. No response shift was demonstrated in the more specific domains of HRQOL (PedsQL). IMPLICATIONS FOR NURSING Knowledge of the response shift phenomenon helps nurses to better interpret the outcomes of HRQOL. The use of the PedsQL instrument is recommended in future studies that aim to demonstrate changes in HRQOL.
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Affiliation(s)
- Aeltsje Brinksma
- School of Nursing and Health, Department of Pediatric Oncology and Hematology, Beatrix Children's Hospital in Groningen
| | - Wim J E Tissing
- School of Nursing and Health, Department of Pediatric Oncology and Hematology, Beatrix Children's Hospital in Groningen
| | - Esther Sulkers
- School of Nursing and Health, Department of Pediatric Oncology and Hematology, Beatrix Children's Hospital in Groningen
| | - Willem A Kamps
- School of Nursing and Health, Department of Pediatric Oncology and Hematology, Beatrix Children's Hospital in Groningen
| | - Petrie F Roodbol
- School of Nursing and Health, University of Groningen, the Netherlands
| | - Robbert Sanderman
- School of Nursing and Health, University Medical Center Groningen, the Netherlands
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Breitwieser CL, Vaughn LM. "A day in my life" photography project: the silent voice of pediatric bone marrow transplant patients. J Pediatr Oncol Nurs 2014; 31:284-92. [PMID: 25013004 DOI: 10.1177/1043454214531334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A photovoice project was conducted with pediatric bone marrow transplant (BMT) patients to examine their coping skills and interpretation of their experience during a BMT, especially when hospitalized. We also wanted to determine how photovoice could be used within a pediatric BMT unit. Sixteen children (ages 4-14) and 2 young adults (ages 22 and 25) from a pediatric BMT unit participated in the project. Six BMT outpatients participated in the data analysis and evaluation phase. Fourteen clinical staff evaluated the impact of the project on their practice. Three primary themes emerged from the pre- and post-BMT photos, accompanying detailed notes, and BMT outpatient analysis of the photos: (a) BMT is "torture," (b) BMT is "time slipping away," and (c) BMT requires normalization, comfort, distraction, and support. BMT patients and staff concluded that photovoice helped express and release emotions regarding the challenges of BMT. BMT staff noted that the results of this project reminded them of the importance of being patient-centered and mindful of patient experience and the therapeutic relationship.
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Affiliation(s)
| | - Lisa M Vaughn
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Graham RJ, Rodday AM, Parsons SK. Family-centered assessment and function for children with chronic mechanical respiratory support. J Pediatr Health Care 2014; 28:295-304. [PMID: 23942254 DOI: 10.1016/j.pedhc.2013.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 06/18/2013] [Accepted: 06/29/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The purpose of this study was to assess health-related quality of life (HRQL) when managing severe, chronic respiratory insufficiency (CRI) at home. METHODS Families enrolled in a comprehensive program for CRI completed the Child Health Ratings Inventories with (a) parent-proxy ratings of the child's HRQL and (b) the parent's own HRQL. Psychometrics and known groups comparisons were reported. Linear regressions models assessed the effect of the parent's HRQL on proxy ratings. RESULTS Eighty-six parents (67%) completed the measures. The child global HRQL score was low (63.1, SD = 24.9), although ratings of "family life" were higher (73.8, SD = 26.5). The parent global HRQL and emotional functioning (EF) scores were low, despite preserved physical and role function. Having a child with a congenital versus an acquired disability was associated with higher parental EF (p = .004). Higher parental EF correlated with a higher global child HRQL (p < .001). DISCUSSION Families of children with CRI experience reduced HRQL. The Child Health Ratings Inventories is a valid tool for this assessment, identifying emotional distress and potential gaps in support.
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Abreu LG, Melgaço CA, Lages EMB, Abreu MHNG, Paiva SM. Parents' and caregivers' perceptions of the quality of life of adolescents in the first 4 months of orthodontic treatment with a fixed appliance. J Orthod 2014; 41:181-7. [PMID: 24596161 DOI: 10.1179/1465313314y.0000000095] [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] [Indexed: 10/31/2022]
Abstract
OBJECTIVES To evaluate adolescents oral health-related quality of life (OHRQoL) in the first 4 months of fixed orthodontic appliance treatment using parents and caregivers as proxies. DESIGN Descriptive study. SETTING Department of Pediatric Dentistry and Orthodontics at Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. PARTICIPANTS A sample of parents and caregivers of 95 adolescents undergoing orthodontic treatment with a fixed appliance. METHODS Participants were required to answer the Brazilian version of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) before adolescent's treatment (T1) and 4 months after bonding of the fixed appliance (T2). Statistical analysis was carried out using the Wilcoxon signed rank test and the Bonferroni correction for the domains of P-CPQ. RESULTS Among the 95 participants, there were 73 mothers, 18 fathers and 4 were other relations. There was a statistically significant improvement in the overall score as well as in both emotional and social wellbeing subscales (P<0·001). CONCLUSION Parents and caregivers report an improvement on their adolescent's OHRQoL in the first 4 months of orthodontic treatment with a fixed appliance.
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Affiliation(s)
- Lucas G Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camilo A Melgaço
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Elizabeth M B Lages
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mauro H N G Abreu
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Saul M Paiva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Parsons SK, Pennarola BW. The plurality of payers’ perspectives on hematopoietic stem cell transplantation. Hematology 2013; 17 Suppl 1:S202-7. [DOI: 10.1179/102453312x13336169157211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Susan K Parsons
- Health InstituteInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Departments of Medicine and PediatricsTufts University School of Medicine, Boston, MA, USA
| | - Brian W Pennarola
- Health InstituteInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
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Parsons SK, Tighiouart H, Terrin N. Assessment of health-related quality of life in pediatric hematopoietic stem cell transplant recipients: progress, challenges and future directions. Expert Rev Pharmacoecon Outcomes Res 2013; 13:217-25. [PMID: 23570432 DOI: 10.1586/erp.13.11] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This article provides an overview of health-related quality of life (HRQoL) assessments in pediatric hematopoietic stem cell transplants, focusing on the relationship between child and parent proxy ratings of the child's HRQoL and how measurement of HRQoL may be incorporated into clinical decision-making. Parent and child ratings of the child's health may be affected differently by unequal access to and incongruent understanding of available information, as well as the effect of age difference on interpretation. In particular, parents and children may experience the impact of clinical events on HRQoL very differently. The recent US Federal emphasis on 'patient-centeredness' has helped fuel the development and application of more clinically functional and low-burden HRQoL measures. Future work in pediatric hematopoietic stem cell transplants must seek to capture the experiences and perceptions of all those involved.
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Affiliation(s)
- Susan K Parsons
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
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Sundaram SS, Alonso EM, Haber B, Magee JC, Fredericks E, Kamath B, Kerkar N, Rosenthal P, Shepherd R, Limbers C, Varni JW, Robuck P, Sokol RJ, Liver C. Health related quality of life in patients with biliary atresia surviving with their native liver. J Pediatr 2013; 163:1052-7.e2. [PMID: 23746866 PMCID: PMC4014354 DOI: 10.1016/j.jpeds.2013.04.037] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/14/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To quantify health related quality of life (HRQOL) of patients with biliary atresia with their native livers and compare them with healthy children and patients with biliary atresia post-liver transplant (LT) and to examine the relationship between HRQOL and medical variables. STUDY DESIGN A cross-sectional HRQOL study of patients with biliary atresia with their native livers (ages 2-25 years) was conducted and compared with healthy and post-LT biliary atresia samples using Pediatric Quality of Life Inventory 4.0 child self and parent proxy reports, a validated measure of physical/psychosocial functioning. RESULTS 221 patients with biliary atresia with native livers (54% female, 67% white) were studied. Patient self and parent proxy reports showed significantly poorer HRQOL than healthy children across all domains (P < .001), particularly in emotional and psychosocial functioning. Child self and parent proxy HRQOL scores from patients with biliary atresia with their native livers and post-LT biliary atresia were similar across all domains (P = not significant). Child self and parent proxy reports showed moderate agreement across all scales, except social functioning (poor to fair agreement). On multivariate regression analysis, black race and elevated total bilirubin were associated with lower Total and Psychosocial HRQOL summary scores. CONCLUSIONS HRQOL in patients with biliary atresia with their native livers is significantly poorer than healthy children and similar to children with post-LT biliary atresia. These findings identify significant opportunities to optimize the overall health of patients with biliary atresia.
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Reeve BB, Withycombe JS, Baker JN, Hooke MC, Lyons JC, Mowbray C, Wang J, Freyer DR, Joffe S, Sung L, Tomlinson D, Gold SH, Hinds PS. The first step to integrating the child's voice in adverse event reporting in oncology trials: a content validation study among pediatric oncology clinicians. Pediatr Blood Cancer 2013; 60:1231-6. [PMID: 23335328 DOI: 10.1002/pbc.24463] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 12/10/2012] [Indexed: 11/06/2022]
Abstract
PURPOSE Children with cancer experience significant toxicities while undergoing treatment. Documentation of adverse events (AEs) in clinical trials is mandated by federal agencies. Although many AEs are subjective, the current standard is clinician reporting. Our long-term goal is to create and validate a self-report measure of subjective AEs for children aged 7 years and older that will inform AE reporting for the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE). This content validation study aimed to identify which of the AEs in the current CTCAE should be included in a pediatric self-report measure. METHODS We sought expert panel review and consensus among 187 pediatric clinicians from seven Children's Oncology Group institutions to determine which of the 790 AEs are amenable to child self-report. Two survey iterations were used to identify suitable AEs, and clinician agreement estimated by the content-validity ratio (CVR) was assessed. RESULTS Response rates for surveys 1 and 2 were 72% and 67%, respectively. After the surveys, 64 CTCAE terms met the criteria of being subjective, relevant for use in pediatric cancer trials, and amenable to self-report by a child. The most frequent reasons for removal of CTCAE terms were that they relied on laboratory or clinical measures or were not applicable to children. CONCLUSION The 64 CTCAE terms will be translated into child-friendly terms as the basis of the child-report toxicity measure. Ultimately, systematic collection of these data will improve care by enhancing the accuracy and completeness of treatment toxicity reports for childhood cancer.
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Affiliation(s)
- Bryce B Reeve
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7411, USA.
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Martin-Herz SP, Zatzick DF, McMahon RJ. Health-related quality of life in children and adolescents following traumatic injury: a review. Clin Child Fam Psychol Rev 2012; 15:192-214. [PMID: 22527775 DOI: 10.1007/s10567-012-0115-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This paper comprehensively reviews the published literature investigating health-related quality of life (HRQOL) following general traumatic injury in individuals between birth and 18 years. Studies were not considered if they primarily compared medical treatment options, evaluated physical function but not other aspects of HRQOL, or focused on non-traumatic wounds. Specific injury types (e.g., burn injury) were also not included. A total of 16 studies met criteria. Participants were age 1-18 years, with 12 studies considering children 5 years of age or older. Males were overrepresented. Injury severity averaged mostly in the moderate range. HRQOL deficits were noted in injured samples in all studies except the two with the longest time to follow-up (6-11 years). Some improvement was seen 6 months to 2 years after injury. Factors associated with HRQOL deficits were investigated, with acute and posttraumatic stress disorder symptoms showing the strongest relationship. Research to date in this area is impressive, particularly the number of studies using prospective longitudinal investigations and validated measures. Challenges remain regarding methodologic differences, assessment of preinjury status, retention of participants, and management of missing data. Suggested future directions include extension of follow-up duration, utilization of pediatric self-report when possible, inclusion of younger children, and development of intervention programs.
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Oberg JA, Bender JG, Morris E, Harrison L, Basch CE, Garvin JH, Sands SA, Cairo MS. Pediatric allo-SCT for malignant and non-malignant diseases: impact on health-related quality of life outcomes. Bone Marrow Transplant 2012; 48:787-93. [DOI: 10.1038/bmt.2012.217] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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McDougall J, Wright V, Nichols M, Miller L. Assessing the Psychometric Properties of Both a Global and a Domain-Specific Perceived Quality of Life Measure When Used with Youth Who Have Chronic Conditions. SOCIAL INDICATORS RESEARCH 2012; 114:1243-1257. [PMID: 25484486 PMCID: PMC4254371 DOI: 10.1007/s11205-012-0200-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 06/04/2023]
Abstract
The purpose of this paper was to assess the psychometric properties of the Students' Life Satisfaction Scale (SLSS) and the Brief Multidimensional Students' Life Satisfaction Scale (BMSLSS) when used with youth who have chronic conditions. Baseline data from a longitudinal study examining predictors of changes in perceived quality of life (PQOL) for youth with chronic conditions were used. SLSS and BMSLSS data were collected on over 400 youth aged 11-17 using youth self-report and parent proxy-report versions. Internal consistency, convergent validity, and factor structure were examined for both versions. Extent of agreement and magnitude of differences between youth and parent report were evaluated. Finally, gender, age, and condition group differences in youth report scores were examined for the SLSS and BMSLSS. Strong internal consistency was demonstrated for the youth and parent reports of both measures. As with normative samples, a single factor structure was found for youth and parent reports of the BMSLSS. However, both youth and parent reports of the SLSS had a two-factor structure: one consisting of five positively worded items, and the other, two negatively worded items. Youth reported their PQOL to be significantly higher than did their parents. Significant differences in PQOL scores for the youth report were not found by age, gender, or conditions. Findings show that, from a psychometric standpoint, the BMSLSS (both youth and parent report) is a promising measure of PQOL for use in population-based research with youth who have chronic conditions. The SLSS may need to be revised to exclude negative items when used with this population of youth.
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Affiliation(s)
- Janette McDougall
- />Thames Valley Children’s Centre, 779 Base Line Road East, London, ON N6C 5Y6 Canada
| | - Virginia Wright
- />Bloorview Research Institute, 150 Kilgour Road, Toronto, ON M4G 1R8 Canada
| | - Megan Nichols
- />Thames Valley Children’s Centre, 779 Base Line Road East, London, ON N6C 5Y6 Canada
| | - Linda Miller
- />School of Graduate and Postdoctoral Studies, Western University, London, ON N6A 5B7 Canada
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Barbosa TDS, Gavião MBD. Validation of the Parental-Caregiver Perceptions Questionnaire: agreement between parental and child reports. J Public Health Dent 2012; 75:255-64. [PMID: 22994794 DOI: 10.1111/j.1752-7325.2012.00371.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 04/03/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To test the validity and reliability of Brazilian Portuguese version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) (Aim 1) and to assess the agreement between parents and children concerning the child's oral health-related quality of life (OHRQoL) (Aim 2). METHODS The P-CPQ and the Brazilian Portuguese versions of the Child Perceptions Questionnaires (CPQ8-10 and CPQ11-14 ) were used. Objective 1 addressed in the study that involved 210 (validity and internal reliability) and 20 (test-retest reliability) parents and Objective 2 in the study that involved 210 pairs of parents and children. Construct validity was calculated using the Spearman's correlation and the Mann-Whitney/Kruskal-Wallis tests. Reliability was determined using Cronbach's alpha and intraclass correlation coefficient (ICC). Agreement between overall and subscale scores derived from the P-CPQ and CPQ was assessed in comparison and correlation analyses. RESULTS The P-CPQ discriminated among the categories of malocclusion and dmft. The P-CPQ showed good construct validity, good internal consistency reliability, and excellent test-retest reliability. There was systematic under- and overreporting in parents' assessments for younger and older children, respectively. However, the magnitude of the directional differences was just small. At individual level, agreement between parents and children was excellent. However, it ranged from excellent to moderate or substantial in subscales for CPQ8-10 and CPQ11-14 groups, respectively. CONCLUSIONS The Portuguese version of P-CPQ is valid and reliable. Some parents have limited knowledge about child OHRQoL. Given that parental and child reports measure different realities concerning the child's OHRQoL, information provided by parents can complement the child's evaluation.
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Affiliation(s)
- Taís de Souza Barbosa
- Department of Pediatric Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba/SP, Brazil
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Furtado GEDS, Sousa MDLRD, Barbosa TDS, Wada RS, Martínez-Mier EDLA, Almeida MELD. Percepção da fluorose dentária e avaliação da concordância entre pais e filhos: validação de um instrumento. CAD SAUDE PUBLICA 2012; 28:1493-505. [DOI: 10.1590/s0102-311x2012000800008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 05/09/2012] [Indexed: 11/22/2022] Open
Abstract
Objetivou-se validar o Child's and Parent's Questionnaire about Teeth Appearance, avaliando as preocupações relacionadas à fluorose em 213 pares de pais/crianças (12 anos) de duas regiões brasileiras. A confiabilidade foi avaliada pelo alfa de Cronbach e pelo coeficiente de correlação intraclasse; e a validade de constructo e de critério, pela correlação de Spearman. Para comparar as duas regiões e avaliar a concordância pais/filhos, foi utilizado o teste t de Student. A consistência interna foi aceitável, e a confiabilidade teste-reteste, moderada a excelente. Houve correlação significativa entre percepção da fluorose moderada e severa e os dados clínicos e entre percepção da fluorose e preocupações dos indivíduos. Embora os pais de Rafael Arruda, Ceará, Brasil, tenham tido maior percepção da fluorose, o incômodo e a preocupação com a aparência foram maiores em Piracicaba, São Paulo. Os pais se mostraram mais incomodados, preocupados e insatisfeitos com a aparência dentária das crianças do que elas mesmas. Essa versão é válida e confiável para avaliar a percepção da estética dentária em crianças e em seus pais.
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Abstract
Few studies have examined the effect of parental BMT on the family and less is known regarding the impact on children. The purpose of this prospective study was to increase understanding of children's adaptation to the stress of parental BMT across a 12-month trajectory. Data were obtained from 61 children ages 10-18 before parental transplant, during parental hospitalization, 1, 4 , 8 and 12 months post BMT. Mixed linear modeling was used to analyze longitudinal data from children nested within families. Analyses examined change in child emotional adaptation, points of greatest vulnerability throughout the BMT trajectory and the impact of theoretically relevant variables on their adaptation. Children's emotional adaptation became significantly more positive over time, although their level of distress remained above the norm. Pre-transplant was the period of greatest emotional distress. Negative self-esteem, disruption within the family structure, use of disengagement coping and the mother as transplant recipient were associated with more negative adaptation. Further research is needed to fully understand the effects of parental BMT on children. However, these findings point to the importance of considering the adaptation of children and its implications for the development of preventive family interventions for this vulnerable population.
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