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Reinman L, Schatz J, Johnston J, Bills S. Fatigue, Stress Appraisal, and Emotional Functioning Among Youth With Sickle Cell Disease: A Daily Diary Study. J Pediatr Psychol 2023; 48:562-571. [PMID: 37167536 PMCID: PMC10321392 DOI: 10.1093/jpepsy/jsad019] [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: 10/01/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess how fatigue is related to mood among youth with sickle cell disease (SCD) by evaluating if the cognitive appraisal of stress moderates the impact of fatigue on emotional functioning consistent with the Risk-and-Resistance Model of Chronic Illness. METHODS Daily diaries assessing fatigue (Numerical Rating Scale), pain intensity (Numerical Rating Scale), mood (Positive and Negative Affect Schedule for Children), and cognitive appraisal of stress (Stress Appraisal Measure for Adolescents) were collected from 25 youth with SCD (ages 11-18 years) for 8 consecutive weeks resulting in 644 daily diaries for analyses. RESULTS When measured concurrently, higher fatigue was associated with higher negative mood controlling for pain and prior-night sleep quality. Fatigue predicted next-day negative mood through its interaction with primary and secondary appraisal of stress, consistent with stress appraisal as a protective factor. A similar pattern was observed for pain, which, like fatigue, is a common SCD-related stressor. CONCLUSION Fatigue and negative mood are inter-related when concurrently assessed, but their temporal association in SCD suggests that mood changes are not an inevitable sequalae of increased fatigue; fatigue influenced subsequent levels of negative mood, but only in the presence of less adaptive cognitions about stress; specifically, a higher perceived threat from stress and a lower belief in the ability to manage stress. The results suggest specific cognitive targets for reducing the negative impact of fatigue on mood in SCD.
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Affiliation(s)
- Laura Reinman
- Department of Psychiatry, University of Colorado School of Medicine, USA
| | - Jeffrey Schatz
- Department of Psychology, University of South Carolina, USA
| | - Julia Johnston
- Department of Psychology, University of South Carolina, USA
| | - Sarah Bills
- Department of Psychology, University of South Carolina, USA
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2
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Constantinou C, Payne N, van den Akker O, Inusa B. A qualitative exploration of health-related quality of life and health behaviours in children with sickle cell disease and healthy siblings. Psychol Health 2023; 38:125-146. [PMID: 34339316 DOI: 10.1080/08870446.2021.1955119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study explored the health-related quality of life (HRQL) and health behaviours of children with sickle cell disease (SCD) and healthy siblings, drawing on Gap theory, which suggests HRQL is the discrepancy between current and ideal selves. DESIGN Thirty-two interviews, facilitated by children's drawings of their current and ideal selves were thematically analysed. RESULTS Two themes were identified. First, limitations of SCD and adjusted expectations. Children with SCD report some discrepancy in HRQL as they would like to participate in more physical activity, but overall, they appear to have normalised their condition and adjusted their expectations in the context of the limits of their condition. Healthy siblings worry about their sibling and have greater expectations about engaging in adventurous activities and for their future. Second, coping with SCD. Children have limited social support, although children with SCD seek support from their mothers. They also modify health behaviours, like reducing exercise to help prevent and cope with sickle-related pain. CONCLUSION Children have some discrepancies in their HRQL but adjusted expectations among children with SCD may reduce discrepancy. Adapting health behaviours may help to cope with SCD but it is important that reductions in physical activity do not impair HRQL.
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Affiliation(s)
| | - Nicola Payne
- Psychology Department, Middlesex University, London, UK
| | | | - Baba Inusa
- Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK
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3
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Raiza Fontes Barros Bomfim J, Orge Anunciação Bacelar C, Marques da Silva Neto M, Salles C, Marice Teixeira Ladeia A, Renata Rissatto-Lago M. Association between hearing impairment, school performance and cognitive function in children and adolescents with sickle cell disease. Trop Med Int Health 2022; 27:244-250. [PMID: 35048475 DOI: 10.1111/tmi.13722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the association among hearing impairment, school performance, and cognitive function in children and adolescents with sickle cell disease. METHODS Thirty-one participants with sickle cell disease (SCD) and 31 healthy participants in the control-comparison group (CG), both aged 8-17 years underwent auditory system evaluation (pure tone audiometry and acoustic reflex), were screened for the risks of (central) auditory processing disorder and dysfunction of cognitive function using the Scale of Auditory Behaviors (SAB) and the Mini-Mental State Examination (MMSE), respectively, and were interviewed to obtain clinical data and data on school performance. RESULTS In the SCD group, eight (25.8%) participants presented with sensorineural hearing loss (SNHL). The group with SCD and SNHL presented a higher occurrence of poor school performance than the group of participants with SCD without SNHL (p= 0.016). The MMSE score for aspects related to attention and calculation in the SCD group with SNHL was lower than in the SCD group without SNHL (p= 0.016). In the SAB, the SCD group with SNHL presented a lower score than the SCD group without SNHL in aspects related to academic performance and attention. CONCLUSION Hearing impairment in children and adolescents with SCD, specifically SNHL, is associated with poor school performance and enhances the risk of cognitive impairment in terms of attention and calculation.
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Affiliation(s)
| | | | | | - Cristina Salles
- Postgraduate Course in Medicine and Human Health, Bahiana School of Medicine and Public Health, Salvador, Brazil.,Department of Otolaryngology, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador, Brazil
| | - Ana Marice Teixeira Ladeia
- Postgraduate Course in Medicine and Human Health, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Mara Renata Rissatto-Lago
- College of Speech Therapy, Department of the Life Science, State University of Bahia, Salvador, Brazil
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4
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Tezol O, Karahan F, Unal S. Sickle Cell Disease and Psychosocial Well-Being: Comparison of Patients With Preclinical and Clinical Avascular Necrosis of the Femoral Head. Turk Arch Pediatr 2022; 56:308-315. [PMID: 35005723 PMCID: PMC8655956 DOI: 10.5152/turkarchpediatr.2021.20270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
Aim: Sickle cell disease (SCD) has significant adverse psychosocial impacts in childhood. Patients with SCD may be affected by avascular necrosis (AVN) and the most commonly involved site is the femoral head. We aimed to conduct a comparative investigation of the psychosocial well-being of pediatric SCD patients with preclinical and clinical femoral head AVN. Materials and Methods: Patients with homozygous SCD and healthy peers aged 7-17 years were included in this cross-sectional study. Psychosocial well-being was assessed by the Strengths and Difficulties Questionnaire (SDQ), parent version. SDQ scores were compared between the groups. Results: A total of 74 mother–child couples were enrolled in this study. The SCD with clinical AVN (stages I-IV) group consisted of 17 patients, SCD with preclinical AVN (stage 0) group consisted of 20 patients, and the control group consisted of 37 individuals. The sociodemographic characteristics and medians of total difficulties, emotional problems, conduct problems, hyperactivity, and peer problems scores were not different between the 3 groups (P > .05). There was a significant difference between the 3 groups in the prosocial score that indicates more positive social behaviors. Both groups, SCD with clinical AVN and with preclinical AVN, had lower prosocial scores than the control group (P < .001). The 2 patient groups did not differ in any SDQ scores or disease-related characteristics of vaso-occlusive crises and blood/exchange transfusions in the recent year (P > .05). Conclusions: Pediatric patients with SCD, whether or not complicated with clinical AVN, had lower prosocial scores than healthy peers. This study has presented the first comparison of the psychosocial well-being of pediatric SCD patients with preclinical and clinical femoral head AVN.
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Affiliation(s)
- Ozlem Tezol
- Department of Pediatrics Mersin University School of Medicine, Mersin, Turkey
| | - Feryal Karahan
- Department of Pediatric Hematology, Mersin University School of Medicine, Mersin, Turkey
| | - Selma Unal
- Department of Pediatric Hematology, Mersin University School of Medicine, Mersin, Turkey
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5
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Ojinnaka U, Ahmed Z, Kannan A, Quadir H, Hakobyan K, Gaddam M, Mostafa JA. A Traditional Review of Sickle Cell Disease and the Associated Onset of Dementia: Hematological and Neurocognitive Crossroads. Cureus 2021; 13:e18906. [PMID: 34703679 PMCID: PMC8530004 DOI: 10.7759/cureus.18906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
Sickle cell trait and disease are potential risk factors for dementia and cognitive dysfunction in African Americans, as are genetic variants. This illness affects around 300 million people globally. Due to its ability to defend against severe malaria, it represents an evolutionary survival advantage. It has been shown that sickle cell disease and trait are independent risk factors for the prevalence and incidence of albuminuria and chronic renal disease. Sickle cell anemia impairs cognitive performance in people with minimal or mild manifestations of the genetic blood disorder, owing mostly to its cerebrovascular implications. Similarly, various cerebral minor vascular disorders, such as silent cerebral infarcts, have been linked to the sickle cell trait, which is associated with impaired cognitive ability. It has been found that patients with sickle cell disease have a significantly decreased subcortical and cortical brain volume. Adults and children with sickle cell disease have been documented to have attention-related issues, particularly reduced sustained attention.
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Affiliation(s)
- Ugochi Ojinnaka
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zubayer Ahmed
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Amudhan Kannan
- Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
- General Surgery, Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Huma Quadir
- Internal Medicine, Family Medicine, Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Knkush Hakobyan
- Diagnostic Radiology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mrunanjali Gaddam
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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6
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Desmond HE, Lindner C, Troost JP, Held Z, Callaway A, Oh GJ, Lafayette R, O'Shaughnessy M, Elliott M, Adler SG, Kamil ES, Pesenson A, Selewski DT, Gipson PE, Carlozzi NE, Gipson DS, Massengill SF. Association between Psychiatric Disorders and Glomerular Disease. GLOMERULAR DISEASES 2021; 1:118-128. [PMID: 36751494 PMCID: PMC9677713 DOI: 10.1159/000516359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/06/2021] [Indexed: 01/20/2023]
Abstract
Introduction Patients with chronic health conditions, particularly chronic kidney disease, are at heightened risk for psychiatric disorders; yet, there are limited data on those with primary glomerular disease. Methods This study included patients with glomerular disease enrolled in the kidney research network multisite patient registry. Registry data include encounter, diagnoses, medication, laboratory, and vital signs data extracted from participants' electronic health records. ICD-9/10 diagnosis codes were used to identify a subset of psychiatric disorders focused on anxiety, mood, and behavioral disorders. Time-varying Cox proportional hazard models were used to analyze time from the onset of kidney disease to diagnosis of psychiatric disorder. Adjusted models retained significant covariates from the full list of potential confounders, including age, sex, race, ethnicity, time-varying treatment, the estimated glomerular filtration rate, and proteinuria (urine protein-to-creatinine ratio [UPCR]). Analogous models examined diagnosis of psychiatric disorder as a predictor of time to end-stage kidney disease (ESKD). Results Data were available for 950 participants, with a median of 58 months of follow-up. 110 (12%) participants were diagnosed with psychiatric disorder during the follow-up. The estimated rate of psychiatric diagnosis after kidney disease was 14.7 cases per 1,000 person-years and was highest among those of adolescent age at the time of kidney disease diagnosis. Adjusted analyses found adolescent age (vs. adult, hazard ratio [HR] = 3.11, 95% confidence interval [CI] 1.87-5.17) and Asian race (vs. white, HR = 0.34, 95% CI 0.16-0.71) were associated with psychiatric diagnosis. A higher UPCR per 1 log unit (HR 1.13, 95% CI 1.01-1.27) and a higher total number of oral medications were associated with psychiatric disorder (p < 0.001). Psychiatric diagnosis was also associated with progression to ESKD (HR = 2.45, 95% CI 1.53-3.92) in adjusted models. Discussion/Conclusion Psychiatric disorders were documented in approximately one-eighth of patients with glomerular disease and correlated with clinical disease characteristics such as age, race, proteinuria, and oral medication burden. These findings suggest mental health screening is warranted in patients of all ages with glomerular disease.
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Affiliation(s)
- Hailey E. Desmond
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA,*Hailey E. Desmond,
| | - Clare Lindner
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan P. Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Zack Held
- Division of Pediatric Nephrology, Department of Pediatrics, Levine Children's Hospital, Atrium Health, Charlotte, North Carolina, USA
| | | | - Gia J. Oh
- Department of Pediatric Nephrology, Randall Children's Hospital at Legacy Emanuel Medical Center, Legacy Health, Portland, Oregon, USA
| | - Richard Lafayette
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - Matthew Elliott
- Metrolina Nephrology Associates, Charlotte, North Carolina, USA
| | - Sharon G. Adler
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-University of California, Torrance, California, USA
| | - Elaine S. Kamil
- Division of Pediatric Nephrology, Department of Pediatrics, Cedars-Sinai Medical Center, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | | | - David T. Selewski
- Division of Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Patrick E. Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA,Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Noelle E. Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Debbie S. Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan F. Massengill
- Division of Pediatric Nephrology, Department of Pediatrics, Levine Children's Hospital, Atrium Health, Charlotte, North Carolina, USA
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7
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Tumenta T, Thanju A, Perera P, Kallikkadan J, Fouron P, Olupona T. Opioid-Induced Psychosis in a Patient With Sickle Cell Disease. Cureus 2021; 13:e15557. [PMID: 34277180 PMCID: PMC8270061 DOI: 10.7759/cureus.15557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/29/2022] Open
Abstract
Sickle cell disease (SCD) is a common inherited hemoglobin disorder in which people have atypical hemoglobin, known as hemoglobin S. It is highly prevalent in non-Hispanic Blacks and people of Arab descent. It causes a distortion of the shape of red blood cells, leading to occlusion of blood vessels and thus tissue hypoxia and injury. The resultant infarction/reperfusion, in turn, causes fatigue and pain. Patients with SCD require constant analgesic medications for pain management. In the general population, opioids are amongst the most prescribed medications for pain management and the trend has been gradually growing during the past two decades. Side effects commonly associated with opioids are gastrointestinal and central nervous system-related, with up to 80% of patients experiencing at least one adverse effect. We report the case of a 36-year-old male patient who has a history of cannabis use and no prior psychiatric history, who developed acute psychosis while receiving a high dose of hydromorphone for sickle cell pain crisis. This case contributes to the growing literature about opioid-induced psychosis and also explores psychosis in sickle cell disease. Understanding the pharmacology and potential side effects of opioids is critical given the increasing number of patients using prescribed and illicit opioids.
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Affiliation(s)
| | - Amod Thanju
- Psychiatry, Interfaith Medical Center, Brooklyn, USA
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8
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McNeill AM, Hudock RL, Foy AMH, Shanley R, Semrud-Clikeman M, Pierpont ME, Berry SA, Sommer K, Moertel CL, Pierpont EI. Emotional functioning among children with neurofibromatosis type 1 or Noonan syndrome. Am J Med Genet A 2019; 179:2433-2446. [PMID: 31566897 DOI: 10.1002/ajmg.a.61361] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/13/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022]
Abstract
While neurofibromatosis type 1 (NF1) and Noonan syndrome (NS) are clinically distinct genetic syndromes, they have overlapping features because they are caused by pathogenic variants in genes encoding molecules within the Ras-mitogen-activated protein kinase signaling pathway. Increased risk for emotional and behavioral challenges has been reported in both children and adults with these syndromes. The current study examined parent-report and self-report measures of emotional functioning among children with NF1 and NS as compared to their unaffected siblings. Parents and children with NS (n = 39), NF1 (n = 39), and their siblings without a genetic condition (n = 32) completed well-validated clinical symptom rating scales. Results from parent questionnaires indicated greater symptomatology on scales measuring internalizing behaviors and symptoms of attention deficit hyperactivity disorder (ADHD) in both syndrome groups as compared with unaffected children. Frequency and severity of emotional and behavioral symptoms were remarkably similar across the two clinical groups. Symptoms of depression and anxiety were higher in children who were also rated as meeting symptom criteria for ADHD. While self-report ratings by children generally correlated with parent ratings, symptom severity was less pronounced. Among unaffected siblings, parent ratings indicated higher than expected levels of anxiety. Study findings may assist with guiding family-based interventions to address emotional challenges.
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Affiliation(s)
- Alana M McNeill
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Rebekah L Hudock
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Allison M H Foy
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.,Department of Educational Psychology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ryan Shanley
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Margaret Semrud-Clikeman
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mary Ella Pierpont
- Division of Genetics and Metabolism, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Susan A Berry
- Division of Genetics and Metabolism, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Katherine Sommer
- Division of Hematology and Oncology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Christopher L Moertel
- Division of Hematology and Oncology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Elizabeth I Pierpont
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
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9
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Connolly ME, Bills SE, Hardy SJ. Neurocognitive and psychological effects of persistent pain in pediatric sickle cell disease. Pediatr Blood Cancer 2019; 66:e27823. [PMID: 31131984 DOI: 10.1002/pbc.27823] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/15/2019] [Accepted: 05/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pain is a major complication of sickle cell disease (SCD), spanning vaso-occlusive crises and persistent pain. Although it is known that persistent pain is associated with considerable impairment in youth without SCD, little is known about the functional effects of persistent pain in SCD. The current study aimed to (a) characterize persistent pain in youth with SCD and (b) determine the extent to which youth with SCD and persistent pain differ in disease morbidity, functional impairment, and neurocognitive and psychological functioning. PROCEDURE Eighty-nine participants (ages 7-16) and caregivers completed questionnaires (BRIEF [Behavior Rating Inventory of Executive Function], Conners-3 [Conners-third edition], and PedsQL™-SCD Module, where PedsQL is Pediatric Quality of Life Inventory). Participants completed neurocognitive tests WISC-V [Wechsler Intelligence Scale for Children-fifth edition], WJ-III [Woodcock Johnson Tests of Achievement-third edition], and WIAT-III [Wechsler Individual Achievement Test-third edition]). Youth were classified as having persistent pain if they reported daily pain for 7 days. Chi-square and independent sample t-test analyses were used to assess group differences (those with vs without persistent pain). RESULTS Patients with persistent pain (n = 18) reported lower health-related quality of life (P = .000). Caregivers were more likely to rate youth with persistent pain as having lower planning/organization abilities (P = .011) and clinically elevated symptoms of defiance/aggression and oppositional defiance (Ps = .00; .01). Patients with persistent pain demonstrated poorer working memory (P = .023) and processing speed (P = .027), and fewer demonstrating reading fluency abilities in the average or above range (P = .026). CONCLUSIONS Youth with SCD and persistent pain are at risk for psychosocial and neurocognitive impairments, suggesting that persistent pain may be an important indicator of disease burden. Furthermore, disease management may be enhanced by assessing cognitive and psychosocial functioning and incorporating interdisciplinary treatments addressing impairment associated with persistent pain.
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Affiliation(s)
- Megan E Connolly
- Departments of Pediatrics and Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC.,Divisions of Hematology and Oncology, Children's National Health System, Washington, DC
| | - Sarah E Bills
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Steven J Hardy
- Departments of Pediatrics and Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC.,Divisions of Hematology and Oncology, Children's National Health System, Washington, DC
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Condorelli M, Demeestere I. Challenges of fertility preservation in non-oncological diseases. Acta Obstet Gynecol Scand 2019; 98:638-646. [PMID: 30771251 DOI: 10.1111/aogs.13577] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/11/2019] [Indexed: 12/15/2022]
Abstract
Clinicians should provide fertility counseling to all patients receiving gonadotoxic treatment. International scientific societies have mainly focused on oncological patients, and fewer efforts have been made to apply these recommendations to women diagnosed with benign disease (eg benign hematological diseases, autoimmune diseases, and gynecological or genetic disorders). However, these indications account for 8%-13% of the demand for fertility preservation. The risk of premature ovarian failure due to treatment, or to the disease itself, can be considered fairly high for many young women. Counseling and adequate management of these women require particular attention due to the severe health conditions that are associated with some of these diseases. In this review, we address specific issues related to providing adequate fertility counseling and management for women who have been diagnosed with the major non-oncological indications, based on the literature and on our clinical experience.
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Affiliation(s)
- Margherita Condorelli
- Research Laboratory on Human Reproduction and Fertility Clinic, CUB-Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Demeestere
- Research Laboratory on Human Reproduction and Fertility Clinic, CUB-Erasme, Université Libre de Bruxelles, Brussels, Belgium
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11
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Bills SE, Schatz J, Hardy SJ, Reinman L. Social-environmental factors and cognitive and behavioral functioning in pediatric sickle cell disease. Child Neuropsychol 2019; 26:83-99. [PMID: 30789071 DOI: 10.1080/09297049.2019.1577371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Sickle cell disease (SCD), an inherited blood disorder that primarily affects individuals of African descent, is associated with serious medical complications as well as numerous social-environmental risk factors. These social-environmental factors are linked to long-standing social inequities, such as financial hardship and racial discrimination, both of which impact cognitive and behavioral functioning in youth. Previous research on the relationship between social-environmental risk and psychological functioning has primarily relied on non-modifiable, unidimensional measures of socioeconomic status (SES), such as income and parental education, as a proxy for social-environmental risk. The current study aimed to address the limitations associated with typical SES-type measures by comparing the unique and shared association of SES and more targeted and modifiable social-environmental factors (e.g., parent and family functioning) with specific areas of cognitive and behavioral adjustment in pediatric SCD. Seventy children ages 4-8 years old and their parents completed measures of social-environmental risk and psychological adjustment. Exploratory factor analysis indicated parent and family functioning measures were largely independent of SES. Parent and family functioning predicted phonological processing and ADHD symptoms above and beyond SES alone. In addition, the predictive ability of social-environmental risk factors appears to vary by genotype severity for measures of social functioning and math problem-solving ability. Future studies are needed to explore more specific and well-supported models of modifiable social-environmental risk and the relative impact of social-environmental risk on cognitive and behavioral functioning.
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Affiliation(s)
- Sarah E Bills
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Jeffrey Schatz
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Steven J Hardy
- Divisions of Hematology and Oncology, Children's National Health System, Washington, DC, USA.,Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Laura Reinman
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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12
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Dinleyici M, Dağlı FŞ. Evaluation of quality of life of healthy siblings of children with chronic disease. Turk Arch Pediatr 2018; 53:205-213. [PMID: 30872922 DOI: 10.5152/turkpediatriars.2018.6778] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/29/2018] [Indexed: 11/22/2022]
Abstract
The quality of life determination of children with chronic disease is closely related to treatment success. Quality of life assessment studies revealed that it was not limited to the individual, the quality of life of the family members also had to be assessed. Along with the child being diagnosed with chronic illness, some changes occur in the family structure, and in family roles. Quality of life assessment studies in healthy siblings generally indicate a global influence. These children live in different senses such as closure, aggression, depression, anxiety, guilt, and isolation. Psychosocial impact (short or long-term) of healthy siblings have been associated with disease type, severity, disease duration, age, sex, and ability to cope. Further comprehensive studies among healthy siblings of children with chronic disease about quality of life are needed. Building support groups (especially family support groups) to express feelings and thoughts freely for healthy siblings can positively affect the well-being and self-esteem of the child.
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Affiliation(s)
- Meltem Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir Turkey
| | - Figen Şahin Dağlı
- Department of Pediatrics, Division of Social Pediatrics, Gazi University School of Medicine, Ankara, Turkey
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13
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Niinomi K, Fukui M. Related Variables of Behavioral and Emotional Problems and Personal Growth of Hospitalized Children's Siblings: Mothers' and Other Main Caregivers' Perspectives. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2018; 55:46958018787054. [PMID: 30015529 PMCID: PMC6050797 DOI: 10.1177/0046958018787054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The psychological well-being of the siblings of hospitalized children is at risk.
This study examined the variables related to siblings’ internalizing problems
and personal growth during hospitalization from the perspectives of mothers and
other main caregivers who temporarily assumed the main caregiver role to the
siblings of hospitalized children in place of mothers in the period of
children’s hospitalization. A cross-sectional, exploratory survey conducted in
Japan examined 113 mothers’ and 90 other main caregivers’ perspectives regarding
the psychological state of 2- to 18-year-old siblings of hospitalized children.
Mothers and/or other main caregivers of siblings during their brothers’ or
sisters’ hospitalization completed the Child Behavior Checklist and the
Siblings’ Personal Growth Scale. Multiple linear regression analysis was
performed with Child Behavior Checklist internalizing problems and total
Siblings’ Personal Growth Scale scores as dependent variables for mothers’ and
caregivers’ perspectives. From mothers’ perspectives, environmental factors that
change with hospitalization affected siblings. From the perspectives of the
other main caregivers, children’s and families’ demographic factors affected
siblings’ psychological state. Frequency of e-mail contact between mothers and
siblings, explanation of the hospitalized child’s condition, and hospital
visitation rules (F = 5.88, P = .001)
explained 12.3% of variance in mothers’ Siblings’ Personal Growth Scale scores.
Among other main caregivers, 11.6% of variance in the Child Behavior Checklist
scores was explained by hospitalized children’s birth order and main caregiver’s
prehospitalization residence (F = 5.51, P =
.006). Results suggest that the perceived variables related to siblings’
psychological changes differ between mothers and other main caregivers.
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Cecilio SG, Pereira SADS, Pinto VDS, Torres HDC. Barriers experienced in self-care practice by young people with sickle cell disease. Hematol Transfus Cell Ther 2018; 40:207-212. [PMID: 30128428 PMCID: PMC6098173 DOI: 10.1016/j.htct.2017.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/23/2017] [Indexed: 12/02/2022] Open
Abstract
Objective To identify barriers to the self-care practice of young people with sickle cell disease. Method This qualitative study was conducted with 17 individuals with sickle cell disease aged between 13 and 24 years in Belo Horizonte, MG, Brazil in March and April 2017. An interview investigated the barriers to self-care practice and the feelings associated with sickle cell disease. Data were transcribed and analyzed according to Bardin's perspective using the following steps: (1) pre-analysis, (2) exploration of the material, and (3) treatment of the results (inference and interpretation). Results Five thematic categories emerged: (1) feelings: anger, sadness, and fear; (2) bullying and stigmatization: challenges regarding walking, speaking, or behaving, as well as patient labels; (3) cognitive factors: doubts related to medication, hydration, heredity and maternity; (4) medication compliance: fear of the side effects suffered and anger triggered by the obligation to use the medication; (5) family issues: complaints of not earning the mothers’ trust to live independently. Conclusion The barriers to self-care in young people with sickle cell disease indicate difficulties related to emotional, behavioral, and environmental aspects. Understanding these factors will favor a better adaptation of youths to the context of sickle cell disease.
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Lavery SA, Islam R, Hunt J, Carby A, Anderson RA. The medical and ethical challenges of fertility preservation in teenage girls: a case series of sickle cell anaemia patients prior to bone marrow transplant. Hum Reprod 2016; 31:1501-7. [DOI: 10.1093/humrep/dew084] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/23/2016] [Indexed: 11/13/2022] Open
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Lance EI, Comi AM, Johnston MV, Casella JF, Shapiro BK. Risk Factors for Attention and Behavioral Issues in Pediatric Sickle Cell Disease. Clin Pediatr (Phila) 2015; 54:1087-93. [PMID: 26149844 PMCID: PMC4970427 DOI: 10.1177/0009922815594356] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Children with sickle cell disease have an increased risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder, intellectual disability, and specific learning disabilities. Little research has been done to characterize the sickle cell disease-related characteristics associated with neurodevelopmental disorders in the sickle cell disease population. METHODS This study was a retrospective chart review involving the outpatient records of 2 medical centers, Kennedy Krieger Institute and Johns Hopkins Hospital. Participants in the study included 59 children with sickle cell disease with a documented neurodevelopmental diagnosis, specifically attention deficit hyperactivity disorder, attention issues, behavioral issues, executive dysfunction, specific learning disabilities in math, reading, and reading comprehension, intellectual disabilities, developmental delay, fine motor disorders, language disorders, or autism spectrum disorders. RESULTS Children with sickle cell disease type hemoglobin S-β thalassemia plus had significantly higher odds of attention issues than children with sickle cell disease type hemoglobin SS (OR = 17.0, 95% CI = 1.99-145.00, P < .02). Children with sickle cell disease and a reported history of asthma had significantly higher odds of behavioral issues than children with sickle cell disease without a history of asthma, after adjustment for gender and sickle cell disease type (exact OR = 19.53, 95% CI = 1.16-1369.72, P < .04). CONCLUSION Children with sickle cell disease may have increased risk for certain neurodevelopmental diagnoses based on their disease characteristics and associated comorbidities. These preliminary study results should be explored in a larger database.
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Affiliation(s)
- Eboni I. Lance
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anne M. Comi
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael V. Johnston
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Bruce K. Shapiro
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Bakri MH, Ismail EA, Elsedfy GO, Amr MA, Ibrahim A. Behavioral impact of sickle cell disease in young children with repeated hospitalization. Saudi J Anaesth 2014; 8:504-9. [PMID: 25422609 PMCID: PMC4236938 DOI: 10.4103/1658-354x.140867] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) in children with a history of repeated hospitalization is distressing for children as well as their parents leading to anxiety and has negative effects on the psychological state of children and their families. OBJECTIVE The aim of the study was to determine the overall effect of SCD on the behavior of young children age 1½ to 5 years old who had repeated history of hospitalization, compared to a control group of healthy children attended a vaccination clinic. PATIENTS AND METHODS Thirty-five children of age 1½ to 5 years who have SCD and repeated history of hospitalization were recruited from pediatric clinic as the study group and matched with same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist (CBCL) 1½ to 5 years and diagnostic and statistical (DSM)-oriented scale. Behavior data were collected through a semi-structured questionnaire. RESULTS CHILDREN WHO HAVE SCD HAD STATISTICALLY SIGNIFICANT BEHAVIORAL CHANGES ON CBCL COMPARED TO THE CONTROL GROUP: Anxiety/depression (65.2 vs. 55.1; P < 0.001), somatic complaint (66.7 vs. 54.4; P < 0.001) withdrawn (63.4 vs. 53.2; P < 0.001), aggressive behavior (60.4 vs. 56; P=0.04), and internalizing symptoms (64.7 vs. 51.5; P < 0.001), respectively. The DSM scale showed that children with SCD scored significantly higher in pervasive developmental disorder compared to the control group (60.9 vs. 53.9; P < 0.001) respectively. CONCLUSION Children with SCD who had history of repeated hospitalization are at an increased risk of developing behavioral problems. Psychological counseling, social support, and proper pain management could minimize these behavioral consequences.
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Affiliation(s)
- Mohamed H. Bakri
- Department of Anesthesia, Children's Hospital, Faculty of Medicine, Assiut University, Egypt
| | - Eman A. Ismail
- Department of Anesthesia, Children's Hospital, Faculty of Medicine, Assiut University, Egypt
| | - Ghada O Elsedfy
- Department of Pediatric, Children's Hospital, Faculty of Medicine, Assiut University, Egypt
| | - Mostafa A. Amr
- Department of Psychiatry, Faculty of Medicine, Mansoura University, Egypt
| | - Ahmed Ibrahim
- Department of Community Medicine, Faculty of Medicine, University of Western Kordofan, Sudan
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Hensler M, Wolfe K, Lebensburger J, Nieman J, Barnes M, Nolan W, King A, Madan-Swain A. Social skills and executive function among youth with sickle cell disease: a preliminary investigation. J Pediatr Psychol 2014; 39:493-500. [PMID: 24431467 DOI: 10.1093/jpepsy/jst138] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore the relationship between executive function (EF) and social skills in youth with sickle cell disease (SCD). METHODS 20 youth with SCD completed objective tests of EF (Tasks of Executive Control; Animal Sorting subtest from the Developmental Neuropsychological Assessment-Second Edition), an IQ screener, and paper-and-pencil measures of social skills (Social Skills Improvement System [SSIS]). Primary caregivers completed paper-and-pencil measures of EF (Behavior Rating Inventory of Executive Function) and social skills (SSIS). RESULTS EF scores from the Behavior Rating Inventory of Executive Function related to parent- and child-reported social skills such that EF deficits correlated with poorer overall and domain-specific social skills. Similarly, EF scores from the Animal Sorting test related to child-reported social skills. Worse parent-reported EF predicted worse parent-reported social skills above the variance accounted for by IQ. CONCLUSIONS EF is related to social skills and may be necessary for successful social interaction among youth with SCD. These results provide rationale and guidance for future larger-scale investigations of EF and social skills among children with SCD.
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Affiliation(s)
- Molly Hensler
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - Kelly Wolfe
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - Jeffrey Lebensburger
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - Jilian Nieman
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - Margaux Barnes
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - William Nolan
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - Allison King
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
| | - Avi Madan-Swain
- Department of Psychology, University of Alabama at Birmingham, Department of Psychology, Nationwide Children's Hospital, Department of Pediatrics, Division of Hematology and Oncology, University of Alabama at Birmingham, Department of Psychiatry, University of Minnesota, and Program in Occupational Therapy and Department of Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine
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Tanabe P, Dias N, Gorman L. Care of children with sickle cell disease in the emergency department: parent and provider perspectives inform quality improvement efforts. J Pediatr Oncol Nurs 2013; 30:205-17. [PMID: 23836847 DOI: 10.1177/1043454213493509] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Children with sickle cell disease (SCD) present to the emergency department (ED) with complex medical and behavioral health needs. Little research has been conducted to understand elements necessary to provide a comprehensive approach. We conducted 9 focus groups and 2 individual interviews with ED nurses, ED physicians, parents, 1 SCD nurse practitioner, and 1 SCD hematologist in 6 states. The primary aim of the study was to assess the appropriateness of the Emergency Department Sickle Cell Assessment of Needs and Strengths for pediatric patients. Participants were asked to discuss important aspects of ED management. Transcripts were analyzed according to 5 key decision points, and common themes were identified for each decision. Decisions included triage, analgesic management, diagnostic evaluation, disposition, and high risk evaluation and referrals needed at discharge. Participants identified critical areas that can be used to organize and improve the assessment, management, and disposition/referral decisions in order to provide better care to children with SCD in the ED. Parent input was critical for each decision.
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Pica in children with sickle cell disease: two case reports. J Pediatr Nurs 2012; 27:e65-70. [PMID: 22917881 DOI: 10.1016/j.pedn.2012.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 07/10/2012] [Accepted: 07/18/2012] [Indexed: 11/20/2022]
Abstract
Children with sickle cell disease (SCD) are at greater risk for developing pica compared to other children. This comorbidity can result in harmful medical and nutritional, and neurodevelopmental consequences. This article will describe the medical, nutritional, and psychosocial functioning in two children with SCD and pica in order to illustrate the potential complications and correlates of this co-morbidity. In addition, the clinical implications of pica in children with SCD will be discussed.
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Ekinci Ö, Çelik T, Ünal Ş, Özer C. Psychiatric problems in children and adolescents with sickle cell disease, based on parent and teacher reports. Turk J Haematol 2012; 29:259-64. [PMID: 24744670 PMCID: PMC3986751 DOI: 10.5505/tjh.2012.15986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 02/06/2012] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the occurrence of psychiatric problems in children and adolescents withsickle cell disease (SCD). MATERIAL AND METHODS The Child Behavior Checklist for ages 4-18 years (CBCL/4-18), Conners' Parent RatingScale (CPRS), Conners' Teacher Rating Scale (CTRS-R), and The Turgay DSM-IV Based Child and Adolescent BehaviorDisorders Screening and Rating Scale, clinician and parent forms (T-DSM-IV-S) were given to the caregivers and teachersof 31 children with SCD aged between 7-18 years and the caregivers and teachers of 34 age matched controls with irondeficiencyanemia. RESULTS The SCD patients had higher scores on all 4 of scales. Among the subscales, internalizing problems, andattention problems were more prominent in the SCD patients. CONCLUSION Children and adolescents with SCD appear to have an increased risk for psychiatric problems. Regularpsychological evaluation and referral to child and adolescent psychiatry clinics may facilitate timely diagnosis andeffective treatment of at-risk children and adolescents.
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Affiliation(s)
- Özalp Ekinci
- Ozalp Ekinci Child and Adolescent Psychiatry Clinic, Hatay, Turkey
| | - Tanju Çelik
- Mustafa Kemal University, School of Medicine, Department of Pediatrics, Hatay, Turkey
| | - Şule Ünal
- Antakya State Hospital, Pediatric Hematology Clinic, Hatay, Turkey
| | - Cahit Özer
- Mustafa Kemal University, School of Medicine, Department of Family Medicine, Hatay, Turkey
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Jacob E, Duran J, Stinson J, Lewis MA, Zeltzer L. Remote monitoring of pain and symptoms using wireless technology in children and adolescents with sickle cell disease. J Am Assoc Nurse Pract 2012; 25:42-54. [PMID: 23279278 DOI: 10.1111/j.1745-7599.2012.00754.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of this study was to examine (a) symptoms, (b) pain characteristics (intensity, location, quality), (c) pain medications and nonpharmacological strategies used for pain, (d) thoughts and feelings, and (e) healthcare visits. We also examined the relationship between pain and sleep. DATA SOURCES Pain and symptoms were entered on an electronic e-Diary using a smartphone and were remotely monitored by an advanced practice registered nurse (APRN). Sixty-seven children and adolescents (10-17 years) reported mild to severe pain at home that did not require healthcare visits. Symptoms reported were (a) general symptoms such as tiredness/fatigue (34.7%), headache (20.8%), yellowing of the eyes (28.4%); (b) respiratory symptoms such as sniffling (32.9%), coughing (19.1%), changes in breathing (10.0%); and (c) musculoskeletal symptoms such as stiffness in joints (15.8%). A significant negative correlation was found between pain and sleep (r = -.387, p = .024). Factors that predict pain included previous history of sickle cell disease (SCD) related events, symptoms, and negative thoughts. CONCLUSION Pain and multiple symptoms entered on a web-based e-Diary were remotely monitored by an APRN and prompted communications, further evaluation, and recommendations. IMPLICATIONS FOR PRACTICE Remote monitoring using wireless technology may facilitate timely management of pain and symptoms and minimize negative consequences in SCD.
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Affiliation(s)
- Eufemia Jacob
- University of California Los Angeles School of Nursing, Los Angeles, California 90095, USA.
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Guzeldemir E, Toygar HU, Boga C, Cilasun U. Dental and periodontal health status of subjects with sickle cell disease. J Dent Sci 2011. [DOI: 10.1016/j.jds.2011.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Hijmans CT, Fijnvandraat K, Grootenhuis MA, van Geloven N, Heijboer H, Peters M, Oosterlaan J. Neurocognitive deficits in children with sickle cell disease: a comprehensive profile. Pediatr Blood Cancer 2011; 56:783-8. [PMID: 21370411 DOI: 10.1002/pbc.22879] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 09/21/2010] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) can lead to profound cerebral damage, associated with neurocognitive deficits. The aim of the current study was to evaluate a broad range of neurocognitive functions in children with SCD compared to a SES-matched control group, in order to gain more insight into the specific deficits of these patients. METHODS Forty-one children with homozygous SCD (HbSS or HbS-β0-thalassemia) and 38 controls were assessed on a comprehensive set of well-defined and validated measures of neurocognitive functioning. Besides general intelligence, we evaluated executive functioning extensively (including response inhibition, sustained attention, planning, visuo-spatial working memory, and verbal working memory) as well as visuo-motor functioning. RESULTS SCD was clearly associated with lower IQ scores. More than one in three children with SCD had a Full-scale IQ below 75. Furthermore, children with SCD showed deficits in visuo-motor functioning. Some evidence was found for executive dysfunction: Children with SCD displayed poor visuo-spatial working memory, as well as subtle deficits in sustained attention and planning. No significant differences were found between children with SCD and controls in terms of response inhibition and verbal working memory. CONCLUSIONS Children with SCD are at increased risk of lower intelligence, visuo-motor impairments, and executive dysfunction. These neurocognitive deficits may underlie high rates of scholastic impairments in these children. The present findings further illuminate the importance of regular neurocognitive evaluations and future neurocognitive rehabilitation programs for children with SCD.
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Affiliation(s)
- Channa T Hijmans
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
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Barreto FJN, Cipolotti R. Sintomas depressivos em crianças e adolescentes com anemia falciforme. JORNAL BRASILEIRO DE PSIQUIATRIA 2011. [DOI: 10.1590/s0047-20852011000400008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo: Determinar a frequência de sintomas depressivos em crianças e adolescentes com anemia falciforme, bem como caracterizar e associar tal sintomatologia aos dados individuais. Métodos: Realizou-se um estudo transversal com portadores de anemia falciforme dos 7 aos 17 anos, atendidos em um ambulatório de Hematologia Pediátrica, os quais preencheram o Inventário de Depressão Infantil (CDI). Resultados: Foram avaliados 76 pacientes, estabelecendo-se em 13 o ponto de corte. Vinte e seis pacientes (34,2%) apresentavam sintomas sugestivos de depressão. "Não ser tão bom quanto os outros colegas" foi o item mais pontuado, além de ter predominado significativamente naqueles com escore de CDI maior ou igual a 13, assim como as variáveis: ter pais separados ou viúvos e renda familiar mensal menor ou igual a R$ 510,00. O item "preocupação com dores" foi bem pontuado, independentemente da presença de sintomas depressivos (p = 0,1). Conclusão: A depressão em crianças e adolescentes com anemia falciforme ainda é pouco estudada. Os dados obtidos indicam frequência elevada de sintomas depressivos nessa população. Possivelmente, conviver precocemente com a separação dos pais e pertencer a uma família com baixa renda esteja relacionado ao desenvolvimento desses sintomas.
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Hijmans CT, Fijnvandraat K, Oosterlaan J, Heijboer H, Peters M, Grootenhuis MA. Double disadvantage: a case control study on health-related quality of life in children with sickle cell disease. Health Qual Life Outcomes 2010; 8:121. [PMID: 20977722 PMCID: PMC2988059 DOI: 10.1186/1477-7525-8-121] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Accepted: 10/26/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low health-related quality of life (HRQoL) of children with sickle cell disease (SCD) may be associated with consequences of the disease, or with the low socio-economic status (SES) of this patient population. The aim of this study was to investigate the HRQoL of children with SCD, controlling for SES by comparing them to healthy siblings (matched for age and gender), and to a Dutch norm population. METHODS The HRQoL of 40 children with homozygous SCD and 36 healthy siblings was evaluated by the KIDSCREEN-52. This self-report questionnaire assesses ten domains of HRQoL. Differences between children with SCD and healthy siblings were analyzed using linear mixed models. One-sample t-tests were used to analyze differences with the Dutch norm population. Furthermore, the proportion of children with SCD with impaired HRQoL was evaluated. RESULTS In general, the HRQoL of children with SCD appeared comparable to the HRQoL of healthy siblings, while children with SCD had worse HRQoL than the Dutch norm population on five domains (Physical Well-being, Moods & Emotions, Autonomy, Parent Relation, and Financial Resources). Healthy siblings had worse HRQoL than the Dutch norm population on three domains (Moods & Emotions, Parent Relation, and Financial Resources). More than one in three children with SCD and healthy siblings had impaired HRQoL on several domains. CONCLUSION These findings imply that reduced HRQoL in children with SCD is mainly related to the low SES of this patient population, with the exception of disease specific effects on the physical and autonomy domain. We conclude that children with SCD are especially vulnerable compared to other patient populations, and have special health care needs.
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Affiliation(s)
- Channa T Hijmans
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, P.O. Box 304, 1100 VC Amsterdam, The Netherlands
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, P.O. Box 304, 1100 VC Amsterdam, The Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, P.O. Box 304, 1100 VC Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| | - Harriët Heijboer
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, P.O. Box 304, 1100 VC Amsterdam, The Netherlands
| | - Marjolein Peters
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, P.O. Box 304, 1100 VC Amsterdam, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, P.O. Box 304, 1100 VC Amsterdam, The Netherlands
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Depressive behaviour in children diagnosed with a mitochondrial disorder. Mitochondrion 2010; 10:528-33. [DOI: 10.1016/j.mito.2010.05.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 03/16/2010] [Accepted: 05/25/2010] [Indexed: 12/20/2022]
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