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Calderon-Noy G, Gilboa A. Music Therapy with Neonatal Intensive Care Unit-Discharged Mother-Infant Dyads: Developing a Method for Nurturing Communicative Parental Efficacy (CoPE with Music). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168553. [PMID: 34444308 PMCID: PMC8391218 DOI: 10.3390/ijerph18168553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022]
Abstract
While much advancement has been documented in the practice of music therapy in the neonatal intensive care unit (NICU) environment, there is currently a shortage of music therapy-based methods for NICU-discharged dyads. Back in their homes, mothers might feel alone, lacking guidance, and possibly losing their parental efficacy and their ability to communicate with their baby. In this article, we present a method for nurturing the communicative parental efficacy (CoPE) that was successfully practiced with several NICU-discharged dyads. In eight weekly sessions, the music therapist improvises with the dyad and focuses on (1) containing the mother's emotions; (2) modeling musical interactions with the baby; and (3) practicing these musical interactions with the mother, enabling her to gain communicative parental efficacy. The basic ideas of CoPE are outlined, and a short case study is then described, to demonstrate how it is used. Finally, suggestions for future directions for the development of CoPE are provided.
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A shared vision of quality of life: Partnering in decision-making to understand families' realities. Paediatr Respir Rev 2019; 29:14-18. [PMID: 30366651 DOI: 10.1016/j.prrv.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/11/2018] [Indexed: 11/22/2022]
Abstract
Quality of life (QOL) measures are increasingly used when important prognostication and treatment decisions need to be made in the care of a critically ill child. Unfortunately, health-care professionals and families experience difficulties when attempting to accurately predict and estimate QOL for a patient. Aspects such as subjectivity, complexity and adaptation to illness play an important role in how QOL is ultimately experienced. This often leads to inaccurate estimates of QOL, when performed by individuals other than the patient, such as clinicians or family members. In order to make decisions in the best interest of the patient, a partnership between families and clinicians must be fostered, based on communication, trust and mutual understanding of values. This article will attempt to describe some of the challenges that come into play when assessing QOL for a patient and will provide tools for building a clinician-family partnership in the decision-making process.
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Lakshmanan A, Agni M, Lieu T, Fleegler E, Kipke M, Friedlich PS, McCormick MC, Belfort MB. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health Qual Life Outcomes 2017; 15:38. [PMID: 28209168 PMCID: PMC5312577 DOI: 10.1186/s12955-017-0602-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 01/24/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. METHODS We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores. Potentially modifiable factors were use of community-based services, financial burdens, and health-related social problems. We estimated associations of potentially modifiable factors with outcomes, adjusting for socio-demographic and infant characteristics using linear regression. RESULTS Median (inter-quartile range) infant gestational age was 28 (26-31) weeks. Higher Impact on Family scores (indicating worse effects on family functioning) were associated with taking ≥3 unpaid hours/week off from work, increased debt, financial worry, unsafe home environment and social isolation. Lower parent emotion scores (indicating greater impact on the parent) were also associated with social isolation and unpaid time off from work. Lower parent time limitations scores were associated with social isolation, unpaid time off from work, financial worry, and an unsafe home environment. In contrast, higher parent time limitations scores (indicating less impact) were associated with enrollment in early intervention and Medicaid. CONCLUSIONS Interventions to reduce social isolation, lessen financial burden, improve home safety, and increase enrollment in early intervention and Medicaid all have the potential to lessen the impact of preterm birth on parents and families.
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Affiliation(s)
- Ashwini Lakshmanan
- Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
- Newborn and Infant Critical Care Unit, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
| | - Meghana Agni
- Drexel School of Medicine, Philadelphia, PA, USA
| | - Tracy Lieu
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Eric Fleegler
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Michele Kipke
- Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Philippe S Friedlich
- Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA
| | - Marie C McCormick
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Social and Behavioral Sciences, The Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Chow MYK, Morrow AM, Cooper Robbins SC, Leask J. Condition-specific quality of life questionnaires for caregivers of children with pediatric conditions: a systematic review. Qual Life Res 2013; 22:2183-200. [PMID: 23292299 DOI: 10.1007/s11136-012-0343-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Childhood illness or disability can affect the quality of life (QoL) of the child's primary caregiver. Our aim was to identify, describe the content and systematically review the psychometric properties of condition-specific QoL questionnaires for caregivers of children. METHODS Medline, PsycInfo, Embase, CINAHL, and the Cochrane library databases were searched from 1 January 1990 to 30 June 2011. Articles related to the development and measurement of caregiver QoL were screened to identify condition-specific questionnaires. The characteristics of the questionnaires were extracted, and their psychometric properties were evaluated using the consensus-based standards for the selection of health measurement instruments checklist with 4-point scale. RESULTS We identified 25 condition-specific caregiver QoL questionnaires covering 16 conditions. Conditions included atopic dermatitis, asthma, diabetes, oro-facial disorders, and two acute illnesses. Questionnaires were developed predominantly in high-income countries. Questionnaires had the highest quality rating for content validity, followed by hypothesis testing. Methodological quality was satisfactory for criterion validity; fair in reliability and responsiveness; and poor in internal consistency and structural validity. CONCLUSIONS The increasing number of questionnaires developed over time shows improved recognition of the importance of caregiver QoL. There is a paucity of QoL questionnaires for caregivers of otherwise healthy children suffering from physical injuries and acute conditions associated with significant caregiver burden. Cultural validation of existing and new questionnaires in lower-income countries is necessary. Data collected by condition-specific questionnaires can assist clinicians and health economists in estimating caregiver burden and the types of healthcare services caregivers require and may be useful for healthcare administrators to evaluate interventions.
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Affiliation(s)
- Maria Yui Kwan Chow
- National Centre for Immunisation Research and Surveillance, The Research Building, Kids Research Institute, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia,
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Hamilton MJ, Sarcornrattana O, Illiopoulou M, Xie Y, Kitchell B. Questionnaire-based assessment of owner concerns and doctor responsiveness: 107 canine chemotherapy patients. J Small Anim Pract 2012; 53:627-33. [PMID: 22957892 DOI: 10.1111/j.1748-5827.2012.01269.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To quantify owner concerns regarding clinical signs in canine patients receiving chemotherapy and to assess degree of concordance between client and veterinarian concerns regarding patient quality of life. METHODS Retrospective analysis of owner-reported concerns during chemotherapy treatment. Owner-reported adverse events were recorded sequentially for each patient through a partially open design questionnaire and correlated with veterinary patient summaries for each visit. Canine patients treated for transitional cell carcinoma, haemangiosarcoma, malignant melanoma or osteosarcoma were eligible for inclusion. Minimum treatment eligibility was two chemotherapy treatments given in 21-day protocol cycles, with a maximum of six treatment cycles recorded. RESULTS A total of 553 evaluable visits, seen by 18 oncology clinicians, were assessed. Owners expressed concern before chemotherapy in 48% of visits. Owner concerns at the first visit did not differ significantly from those expressed at the sixth visit. Remission status was a significant factor in owners' rate of reporting concerns. Diarrhoea grade was associated with owners' concerns. Clinician gender was not associated with responsiveness to owners' concerns. CLINICAL SIGNIFICANCE Questionnaire-based surveys appear to be an effective tool for communicating dog owners' concerns regarding chemotherapy and potentially for monitoring a clinician's attentiveness. Owners expressed concerns at approximately half of chemotherapy appointments.
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Affiliation(s)
- M J Hamilton
- Fifth Avenue Veterinary Specialists, 1 West 15th St, New York, NY 10011, USA
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Berbis J, Einaudi MA, Simeoni MC, Brévaut-Malaty V, Auquier P, d'Ercole C, Gire C. Quality of life of early school-age French children born preterm: a cohort study. Eur J Obstet Gynecol Reprod Biol 2012; 162:38-44. [PMID: 22424585 DOI: 10.1016/j.ejogrb.2012.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 10/11/2011] [Accepted: 02/10/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To describe the health-related quality of life (HRQL) of a cohort of children aged 6-10 years who were born preterm; and to determine whether sociodemographic factors, neonatal features and neurocognitive status were affecting their HRQL. STUDY DESIGN All singleton infants born between 24 and 32 weeks of gestation between January 1997 and December 2001 at the study hospital, who were still alive in 2007 (age 6-10 years), and who had undergone complete clinical paediatric follow-up were included in the study. Maternal and perinatal data were obtained by chart review and regular clinical examination. The 'Battery for Rapid Evaluation of Cognitive Functions' (BREV) was used for cognitive evaluation when children were aged 4-8 years. HRQL data were collected in 2007 using the 'Vécu et Santé Perçue de l'Adolescent et de l'Enfant' (VSP-A) questionnaire (parent version). The HRQL of the preterm children was compared with that of a French reference population. RESULTS Of 202 children who fulfilled the inclusion criteria, 82 children participated in the study. Their mean age was 7.9 years [standard deviation (SD) 1.4], mean birth weight was 1130.0 g (SD 361.4), 23 children were born before 28 weeks of gestation, 46 were female and 11 had major neurocognitive disorders. These data were not significantly different for the non-respondents (n=120). Parents of preterm children reported a significantly lower perception of HRQL of their child compared with parents of children in the reference population, as reflected by VSP-A global index scores and scores for the 'body image', 'vitality', 'psychological well-being' and 'school performance' dimensions. In multivariate analyses, three factors were found to be significantly associated with at least one dimension in the VSP-A scale in the preterm children: presence of major neurocognitive disorders, negatively correlated with 'vitality', 'relationships with friends', 'physical well-being' and 'school performance' dimensions; maternal parity, positively correlated with the 'psychological well-being' dimension; and socio-economic status of family, positively correlated with the 'relationships with friends' dimension. The maximum R(2) was 15%. CONCLUSION In addition to neurocognitive disorders, other variables such as socio-economic status of the family have a significant impact on the HRQL of preterm children at 6-10 years of age. Given the low proportion of variability in HRQL explained by the models, there is a need to explore other factors (e.g. environmental).
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Affiliation(s)
- J Berbis
- Research Unit, Aix-Marseille University, Marseille, France.
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Dahan-Oliel N, Majnemer A, Mazer B. Quality of life of adolescents and young adults born at high risk. Phys Occup Ther Pediatr 2011; 31:362-89. [PMID: 21599571 DOI: 10.3109/01942638.2011.572151] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Research on quality of life (QoL) of adolescents and young adults born preterm and those with congenital heart disease (CHD) was systematically reviewed, and factors associated with QoL were identified. Forty-five studies met the inclusion criteria for review. Although the majority of studies found that self-reported QoL of adolescents and young adults born preterm did not differ from term controls, several studies reported lower QoL among individuals born preterm, especially those who had additional impairments. Most studies on adolescents and young adults with CHD reported lower QoL compared with healthy peers, which may be in part due to real or perceived physical activity limitations of individuals with CHD. Overall, parents reported that their adolescents born at high risk had a less favorable QoL compared with those who served as controls. Encouraging age-appropriate, safe, and enjoyable physical activity and avoiding unnecessary restrictions and overprotection are considerations for optimizing QoL.
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Affiliation(s)
- Noémi Dahan-Oliel
- School of Physical and Occupational Therapy, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.
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Hodek JM, von der Schulenburg JM, Mittendorf T. Measuring economic consequences of preterm birth - Methodological recommendations for the evaluation of personal burden on children and their caregivers. HEALTH ECONOMICS REVIEW 2011; 1:6. [PMID: 22828392 PMCID: PMC3395039 DOI: 10.1186/2191-1991-1-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 07/20/2011] [Indexed: 05/20/2023]
Abstract
This study aims to identify the impact of a preterm birth on financial and emotional burden from the families' perspective. Additionally, a comprehensive schedule of recommendations for a sufficient evaluation of all aspects of burden is developed. Based on the results of a literature search relevant categories and sub-domains for a questionnaire covering multiple aspects of associated financial and emotional burden are identified and converted into a recommendation scheme. Results of the literature search illustrate the large extend of burden of prematurity on parents. This results in substantial out-of-pocket expenditures (OOPE) and emotional distress to the parents besides the medical problems and further financial costs to the health insurance system. According to the results on infants' state of health, OOPE and emotional distress are significantly increased with decreasing gestational age. OOPE for transportation often amounts to the main parental cost dimension. Moreover there is some evidence for a high magnitude of reduced income and missed work days. The family perspective has to be taken into account when calculating the overall costs of preterm births from a societal point of view. However, in recent years economic evaluations were performed rather inhomogeneously in this field. For future studies a) direct medical costs, b) direct non-medical costs, c) indirect costs as well as d) intangible costs (in terms of emotional distress and reduced quality of life for caregivers and children) are the main categories that should be evaluated measuring personal burden of preterm birth on families adequately. A detailed list of specific sub-domains is given. Additionally, the recommendations are not restricted to application in infants born preterm and/or at low birth weight.
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Affiliation(s)
- Jan-Marc Hodek
- University of Bielefeld, Department of Health Economics and Health Care Management, Bielefeld, Germany
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Ko J, Lee BH, Kim M. Relationship between Function and Health-Related Quality of Life of School-Aged Children with Cerebral Palsy. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.189] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jooyeon Ko
- Department of Physical Therapy, Bundang CHA Medical Center
| | | | - Minyoung Kim
- Department of Rehabilitation Medicine, Bundang CHA Medical Center
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Harel H, Gordon I, Geva R, Feldman R. Gaze Behaviors of Preterm and Full-Term Infants in Nonsocial and Social Contexts of Increasing Dynamics: Visual Recognition, Attention Regulation, and Gaze Synchrony. INFANCY 2010; 16:69-90. [DOI: 10.1111/j.1532-7078.2010.00037.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hallin AL, Stjernqvist K. Adolescents born extremely preterm: behavioral outcomes and quality of life. Scand J Psychol 2010; 52:251-6. [PMID: 21121924 DOI: 10.1111/j.1467-9450.2010.00850.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Fifty-two extremely premature born and 54 full-term controls were assessed regarding behavioral outcomes, risk-taking and self-perceived quality of life. Behavioral outcomes were assessed with the Achenbach Youth Self Report; risk-taking was estimated regarding alcohol and nicotine use; self-perceived quality of life and future expectations were rated; and attention and hyperactivity problems were surveyed retrospectively with the Wender Utah Rating Scale. The prematurely born reported fewer problems than full-term born on the externalizing scale (delinquent behavior and aggressive behaviour); and they reported less alcohol consumption. No difference was observed between the two groups concerning nicotine use, views about quality of life and expectations for the future or in the retrospective assessment of attention and hyper-activity problems. Conclusively, the prematurely born adolescents described a quality of life and future expectations comparable to full-term born controls. They also reported fewer behavioral problems and less risk-taking behavior.
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Affiliation(s)
- Anne-Li Hallin
- Department of Psychology, Lund University, Lund, Sweden.
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Assessment of Health-Related Quality of Life Among Primary Caregivers of Children with Autism Spectrum Disorders. J Autism Dev Disord 2010; 41:1214-27. [DOI: 10.1007/s10803-010-1140-6] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Méndez Rubio I, Lázaro de Mercado P, Carbonell Estrany X, Figueras Aloy J. Calidad de vida en lactantes nacidos prematuros según ingresos por infección respiratoria. An Pediatr (Barc) 2010; 73:121-31. [DOI: 10.1016/j.anpedi.2009.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 10/06/2009] [Accepted: 10/12/2009] [Indexed: 10/20/2022] Open
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Vederhus BJ, Markestad T, Eide GE, Graue M, Halvorsen T. Health related quality of life after extremely preterm birth: a matched controlled cohort study. Health Qual Life Outcomes 2010; 8:53. [PMID: 20492724 PMCID: PMC2894784 DOI: 10.1186/1477-7525-8-53] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 05/23/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of infants born before the last trimester now grow up. However, knowledge on subsequent health related quality of life (HRQoL) is scarce. We therefore aimed to compare HRQoL in children born extremely preterm with control children born at term. Furthermore, we assessed HRQoL in relation to perinatal and neonatal morbidity and to current clinical and sociodemographic characteristics. METHOD The Child Health Questionnaire (CHQ-PF50) and a general questionnaire were applied in a population based cohort of 10 year old children born at gestational age < or = 28 weeks or with birth weight < or = 1000 grams in Western Norway in 1991-92 and in term-born controls, individually matched for gender and time of birth. The McNemar test and paired t-tests were used to explore group differences between preterms and matched controls. Paired regression models and analyses of interaction (SPSS mixed linear model) were used to explore potential effects of sociodemographic and clinical characteristics on HRQoL in the two groups. RESULTS All 35 eligible preterm children participated. None had major impairments. Learning and/or attention problems were present in 71% of preterms and 20% of controls (odds ratio (OR): 7.0; 95% confidence interval (CI): 2.2 to 27.6). Insufficient professional support was described by 36% of preterm vs. 3% of control parents (OR: infinite; CI: 2.7 to infinite). Preterms scored lower on eight CHQ-PF50 sub-scales and the two summary scores, boys accounting for most of the deficits in areas of behavior, psychosocial functioning and parental burden. HRQoL was associated with learning and/or attention problems in both preterm and control children, significantly more so in preterms in areas related to health and parental burden. Within the preterm group, HRQoL was mostly unrelated to perinatal and neonatal morbidity. CONCLUSIONS HRQoL for children born extremely preterm, and particularly for boys, was described by parents to be inferior to that of children born at term, and sufficiently poor to affect the daily life of the children and their families. Learning and/or attention problems were reported for a majority of preterms, strongly influencing their HRQoL.
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Affiliation(s)
- Bente J Vederhus
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.
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Mottram R, Holt J. “Is gestational age a factor in determining the health-related quality of life of children and young people born preterm?” A critical review of the literature. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.jnn.2009.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
The mother's voice, along with other developmentally appropriate sensory events (ie, touch, light, smells), stimulates maturation of the sensory systems and helps shape normal fetal development. While vast changes in the neonatal intensive care unit have occurred over the last 2 decades, little research has addressed the loss of exposure to maternal voice for the preterm infant. To address this gap, we compared studies that directly investigated effects of exposure to maternal voice on preterm infants. Studies reviewed were conducted between 1972 and 2007. All presented recordings of maternal voice at sound levels above current recommendations, and few of the findings reached statistical significance. Some potentially positive developmental effects were indicated. Future study of the effects of exposure to maternal voice on preterm infants using recommended sound levels is needed.
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Lin JD, Hu J, Yen CF, Hsu SW, Lin LP, Loh CH, Chen MH, Wu SR, Chu CM, Wu JL. Quality of life in caregivers of children and adolescents with intellectual disabilities: use of WHOQOL-BREF survey. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:1448-1458. [PMID: 19660901 DOI: 10.1016/j.ridd.2009.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Accepted: 07/09/2009] [Indexed: 05/28/2023]
Abstract
The present study based on World Health Organization quality of life (WHOQOL-BREF) scale to examine quality of life of the caregivers caring for their children/adolescents with intellectual disabilities in Taiwan, and the factors contributing to their quality of life. Structured interviews were conducted with 597 caregivers of children/adolescents with intellectual disabilities. The results found that the mean scores in each domain of WHOQOL-BREF of the caregivers as the followings: physical capacity (PC) was 13.71+/-2.35, psychological well-being (PW) was 12.21+/-2.55, social relationship (SR) was 12.99+/-2.43 and environment (EN) was 12.32+/-2.38. These mean scores were lower than the general population and slight higher than the caregivers of adults with intellectual disabilities in Taiwan. Finally, multiple stepwise regressions were conducted to examine the characteristics of caregiver and children/adolescents with intellectual disabilities will more likely explained the WHOQOL-BREF mean scores. The study found the following three factors: self-perceived health status, household income and stress from insufficient family support were significantly correlated to all four domains in multiple stepwise regression analyses. The results highlights that caregivers of children and adolescents with intellectual disabilities seem to display a lower WHOQOL-BREF mean score than the general population, probably for a combination of stress, health and household income factors. These finding must be taken into account in policy making to provide better and more specific supports and interventions for the caregivers of people with intellectual disabilities.
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Affiliation(s)
- Jin-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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18
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Questions never asked. Positive family outcomes of extremely premature childbirth. Qual Life Res 2009; 18:567-73. [DOI: 10.1007/s11136-009-9480-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 04/10/2009] [Indexed: 10/20/2022]
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van der Pal SM, Maguire CM, Bruil J, Le Cessie S, Wit JM, Walther FJ, Veen S. Health-related quality of life of very preterm infants at 1 year of age after two developmental care-based interventions. Child Care Health Dev 2008; 34:619-25. [PMID: 18549436 DOI: 10.1111/j.1365-2214.2008.00840.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In the context of a growing interest in developmental care (DC) this study explores the effect of the basic elements of DC and the additional effect of the individual approach of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on the health-related quality of life (HRQoL) of very preterm infants at 1 year of age. The basic elements of DC in this study were defined as the use of standardized nests and incubator covers whose protective characteristics were hypothesized to have a positive effect on the infant's HRQoL. The individualized approach of the NIDCAP was thought to further increase HRQoL. METHODS Very preterm (<or=32 weeks) born infants in a Dutch Neonatal Intensive Care Unit at two locations were included in two consecutive randomized controlled trials (RCT) comparing controls (standard care) with basic DC (standardized nests and covers) in the first RCT and basic DC with NIDCAP in the second RCT. Parents completed a questionnaire (RCT 1, n=136; RCT 2, n=128) regarding their infant's HRQoL (TNO-AZL Preschool Quality of Life Questionnaire) at 1 year of age, corrected for prematurity. Because of multiple testing a P-value of below 0.01 was chosen to indicate significance. RESULTS HRQoL scores ranged from good to optimal for most infants. No significant differences were found between basic DC vs. controls and NIDCAP vs. basic DC on the child's HRQoL as reported by parents at 1 year of age. CONCLUSIONS These two RCT show that the basic elements of DC and the more individualized NIDCAP do not improve HRQoL of very preterm infants at 1 year of age.
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Affiliation(s)
- S M van der Pal
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
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Palta M, Sadek-Badawi M. PedsQL relates to function and behavior in very low and normal birth weight 2- and 3-year-olds from a regional cohort. Qual Life Res 2008; 17:691-700. [PMID: 18459069 DOI: 10.1007/s11136-008-9346-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 04/04/2008] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVE To compare PedsQL scores in young children who were very low (< or =1,500 g) or normal birth weight (>2,500 g) and to examine the relationship of the PedsQL score to behavioral and functional scores. METHODS The PedsQL, Achenbach Child Behavior Checklist and the PEDI functional scales were telephone administered to parents of a regional cohort of 672 very low birth weight and 455 normal birth weight children, 2- and 3-years old. PedsQL scales were regressed on behavior, function and health conditions. RESULTS Mean (SD) overall PedsQL score was 91 (8.4) for normal birth weight and 87 (12) for very low birth weight children, and changed little when standardized to the race/ethnicity and maternal education of corresponding Wisconsin births. Mobility function and the CBCL explained 58% of the variance in PedsQL, but the relationship was curvilinear. CONCLUSION The PedsQL is sensitive to health problems of very low birth weight in young children. The PedsQL is quite strongly related to mobility and behavior problems, but scales these differently than do standard instruments. Parents either do not think of subtle issues with child function and behavior without specific prompting or do not perceive them as problems affecting quality of life.
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Affiliation(s)
- Mari Palta
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA.
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Cui Y, Stapleton F, Suttle C. Developing an instrument to assess vision-related and subjective quality of life in children with intellectual disability: data collection and preliminary analysis in a Chinese population. Ophthalmic Physiol Opt 2008; 28:238-46. [DOI: 10.1111/j.1475-1313.2008.00564.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gray R, Petrou S, Hockley C, Gardner F. Self-reported health status and health-related quality of life of teenagers who were born before 29 weeks' gestational age. Pediatrics 2007; 120:e86-93. [PMID: 17606553 DOI: 10.1542/peds.2006-2034] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of this study was to describe the self-reported health status and health-related quality of life of British teenagers who are in mainstream schooling and were born before 29 weeks' gestational age compared with British teenagers who were born at term. METHODS All surviving children who were born at <29 weeks' gestation in the former Northern Region of England in 1983 and in the former Oxford Region of England and in Scotland in 1984 were eligible. A comparison group of teenagers who were born at term were also recruited. Children's responses to the Health Utilities Index Mark III were compared. RESULTS A total of 218 of the original 535 children who were born in the 3 regions during the study period were alive at 15 to 16 years of age. A complete Health Utilities Index Mark III record was available for 140 children in mainstream schools and for 108 control subjects. In 7 of the 8 attributes (vision, hearing, speech, emotion, pain, ambulation, and dexterity), there were no statistically significant differences in any functional impairment between the comparator groups. However, the preterm group did report a higher level of functional impairment in the cognition attribute (40.7% vs 25.0%). Although there was no difference in the median Health Utilities Index Mark III utility score between the 2 groups (0.93), there was a broader range of utility scores for the preterm group (0.07-1.0 vs 0.45-1.0 for the control group). CONCLUSIONS Despite objective evidence that children and teenagers who were born preterm have poorer health on average than term-born control subjects, this is not reflected in their own ratings of their health status and health-related quality of life at 15 to 16 years of age. The reasons for these differences need to be further explored.
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Affiliation(s)
- Ron Gray
- National Perinatal Epidemiology Unit, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, United Kingdom.
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Grilli L, Feldman DE, Majnemer A, Couture M, Azoulay L, Swaine B. Associations between a functional independence measure (WeeFIM) and the pediatric quality of life inventory (PedsQL4.0) in young children with physical disabilities. Qual Life Res 2006; 15:1023-31. [PMID: 16900282 DOI: 10.1007/s11136-006-0041-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine the association between functional status, measured by the WeeFIM and health-related quality of life (HRQL), measured by the PedsQL4.0 for children with physical disabilities. To explore child, parent and service-related factors associated with each of these measures. PATIENTS Parents of 115 children (2-5 years) with physical disabilities who were referred to occupational (OT) or physical therapy (PT). Mean age of the children was 3 years 7 months (+/-10 months), 79 were boys and 67 were diagnosed with global developmental delay. RESULTS Children had more difficulties with self-care tasks and cognitive abilities, as compared to mobility activities on the WeeFIM. The correlation between total WeeFIM and total PedsQL4.0 was r=0.39. WeeFIM mobility and self-care quotients were each fairly correlated with PedsQL-Physical Health Summary Score (rs=0.29 and rs=0.28 respectively). There was no significant association between WeeFIM cognition quotient and each of PedsQL scores (rs=0.03-0.05). The receipt of PT services was highly associated (p<0.001) with lower scores on the PedsQL-Physical Health Summary score, PedsQL-Total score, and WeeFIM mobility quotient. CONCLUSION The WeeFIM and the PedsQL4.0 appear to assess related but different constructs, supporting the need to incorporate complementary measures when measuring general health of children with disabilities.
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Affiliation(s)
- Lisa Grilli
- Université de Montréal, Ecole de réadaptation, and McGill University Health Centre, Montreal Children's Hospital, QC, Canada.
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Dahl LB, Kaaresen PI, Tunby J, Handegård BH, Kvernmo S, Rønning JA. Emotional, behavioral, social, and academic outcomes in adolescents born with very low birth weight. Pediatrics 2006; 118:e449-59. [PMID: 16882786 DOI: 10.1542/peds.2005-3024] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Very low birth weight survivors are at increased risk of developing emotional and behavioral problems and low social and academic competencies. Information on such problems in very low birth weight adolescents is still sparse. OBJECTIVES Our purpose for this work was to study gender-specific emotional and behavioral problems and social and academic competencies in a cohort of very low birth weight adolescents in north Norway. METHODS Families with very low birth weight adolescents aged 13 to 18 years, born between 1978 and 1989 (n = 162) were addressed by mail and asked to complete the Child Behavior Check List and the Youth Self-Report. Data were compared with 2 normative adolescent populations (Child Behavior Check List, n = 540; Youth Self-Report, n = 2522). Scores given by very low birth weight adolescents and their parents on identical items in Child Behavior Check List and Youth Self-Report (cross-informant syndrome constructs) were compared in pairs. To explore predictive effects, demographic and early medical characteristics were entered into a hierarchical multiple regression analysis. RESULTS There were 156 eligible families, and 99 (63.5%) responded. All completed the Child Behavior Check List, and 82 (52.6%) completed the Youth Self-Report. Very low birth weight boys reported less externalizing and internalizing behaviors and thought and attention problems and higher activity score, whereas very low birth weight girls reported less externalizing behavior and less social, thought, and attention problems and higher activity score compared with normative adolescents. Very low birth weight parents, however, reported more social and attention problems and less social and school competence in boys and more internalizing behavior and social and attention problems and less school competence in girls compared with normative parents. They scored high proportions of both genders within the borderline/clinical range on all of the scales, except for externalizing behavior and social problems in girls. Female very low birth weight adolescents, in contrast to males, reported more problems than parents when compared in pairs, and externalizing problems in particular were not recognized by parents. CONCLUSIONS From parents' point of view, significant proportions of very low birth weight adolescents experience more emotional and behavioral problems and less competence than normative adolescents. In contrast, very low birth weight adolescents state less problems and similar or higher competence than normative adolescents. Very low birth weight adolescent girls report more emotional and behavioral problems compared with their parents than very low birth weight adolescent boys do. Externalizing problems in very low birth weight adolescent girls are often not recognized by parents. To better understand these seemingly paradoxical findings and to develop adequate intervention programs, there is a need for prospective longitudinal studies.
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Affiliation(s)
- Lauritz Bredrup Dahl
- Child and Adolescent Clinic, University Hospital of North-Norway, N-9038 Tromsø, Norway.
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Houtzager BA, Hogendoorn SM, Papatsonis DNM, Samsom JF, van Geijn HP, Bleker OP, van Wassenaer AG. Long-term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labour. BJOG 2006; 113:324-31. [PMID: 16487205 DOI: 10.1111/j.1471-0528.2006.00851.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the long-term psychosocial and motor effects on children exposed in utero to nifedipine or ritodrine for the management of preterm labour. DESIGN Randomised controlled trial. SETTING Multicentre study in two university and one primary hospital in the Netherlands. POPULATION In the original trial, 185 women were randomised to either nifedipine (n = 95) or ritodrine (n = 90). Of the 185 liveborn children, 171 survived (92%), and of these 102 (61%) were followed up at age 9-12 years. METHODS Age-specific questionnaires were administered to the parent and teacher. Additional data were obtained from medical records. MAIN OUTCOME MEASURES Questionnaires were used to assess the child's behavioural-emotional problems, quality of life (QoL), motor functioning, parenting distress and the child's education. RESULTS Of the 171 eligible families, 102 (61%) agreed to participate and completed the questionnaires. Response was equal in the ritodrine group (n = 54 of 83 surviving children, 65%) compared with the nifedipine group (n= 48 of 88 surviving children, 55%). After controlling for differing perinatal characteristics at birth, no significant differences between the groups were detected with respect to long-term behaviour-emotional outcome, QoL, education, motor functioning or parenting distress. Psychosocial outcome was slightly better in the nifedipine group. CONCLUSIONS The results do not support any differential postnatal effect of the tocolytic agents ritodrine or nifedipine on the child's long-term psychosocial and motor functioning. The slightly better outcome of children randomised in the nifedipine group is most likely due to more favourable perinatal outcomes in this group. These results merit further investigation in a larger group of survivors.
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Affiliation(s)
- B A Houtzager
- Pediatric Psychosocial Department, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Allen MC. Preterm outcomes research: a critical component of neonatal intensive care. MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES RESEARCH REVIEWS 2003; 8:221-33. [PMID: 12454898 DOI: 10.1002/mrdd.10044] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
While early preterm outcome studies described the lives of preterm survivors to justify the efforts required to save them, subsequent studies demonstrated their increased incidence of cerebral palsy, mental retardation, sensory impairments, minor neuromotor dysfunction, language delays, visual-perceptual disorders, learning disability and behavior problems compared to fullterm controls. Because infants born at the lower limit of viability require the most resources and have the highest incidence of neurodevelopmental disability, there is concern that resources have gone primarily to neonatal intensive care and are not available for meeting the followup, health, educational and emotional needs of these fragile infants and their families. Despite many methodological concerns, preterm outcome studies have provided insight into risk factors for and causes of CNS injury in preterm infants. Nevertheless, it remains difficult to predict neurodevelopmental outcome for individual preterm infants. Perinatal and neonatal risk factors are inadequate proxies for neurodevelopmental disability. Recent randomized controlled trials with one to five year neurodevelopmental followup have provided valuable information about perinatal and neonatal treatments. Recognizing adverse longterm neurodevelopmental effects of pharmacological doses of postnatal steroids is a sobering reminder of the need for longterm neurodevelopmental followup in all neonatal randomized controlled trials. Ongoing longterm preterm neurodevelopmental studies, analysis of changes in outcomes over time and among centers, and evaluation of the longterm safety, efficacy and effectiveness of many perinatal and neonatal management strategies and proposed neuroprotective agents are all necessary for further medical and technological advances in neonatal intensive care.
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MESH Headings
- Hospitalization
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/etiology
- Infant, Newborn, Diseases/mortality
- Infant, Newborn, Diseases/rehabilitation
- Infant, Premature
- Infant, Very Low Birth Weight
- Intensive Care, Neonatal
- Survival Rate
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Affiliation(s)
- Marilee C Allen
- The Johns Hopkins Hospital, Baltimore, Maryland 21287-3200, USA.
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