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Prussien KV, Faust HL, Crosby LE, Smith-Whitley K, Barakat LP, Schwartz LA. The pervasive influence of systems of power on transition readiness for adult care in sickle cell disease: A qualitative study. Pediatr Blood Cancer 2024; 71:e31156. [PMID: 38953147 DOI: 10.1002/pbc.31156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/03/2024] [Accepted: 06/05/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Adolescence and young adulthood are vulnerable developmental periods for individuals with sickle cell disease (SCD), particularly given the impact of social inequities, challenges with transitioning to adult healthcare services, and increased risk for morbidity and mortality. Systems of power, such as institutionalized and interpersonal manifestations of bias, could impact SCD transfer and engagement in adult care through their influence on healthcare transition readiness; yet research in this area is limited. OBJECTIVE To characterize how systems of power impact transition readiness factors described in the Social-ecological Model of AYA Readiness for Transition to Promote Health Equity (SMART-E) framework at the patient, caregiver, and practitioner levels. METHODS Pediatric adolescents and young adults (AYA), transferred AYA, caregivers, and practitioners participated in semi-structured focus groups and individual interviews examining health equity and systems of power during healthcare transition. Focus groups/interviews were transcribed and coded using a deductive approach via the updated SMART-E framework. RESULTS Ten pediatric AYA with SCD, nine transferred AYA with SCD, eight caregivers, and nine practitioners participated in a focus group or interview. Qualitative findings across reporters emphasize the impact of systems of power (e.g., racial bias and disease stigma) on knowledge, skills and self-efficacy, beliefs and expectations, goals and motivation, and emotions and psychosocial functioning at the patient, caregiver, and practitioner levels. CONCLUSION Systems of power are prevalent with respect to transition barriers for AYA with SCD and their supports. Structural, institutional, and individual factors with potential to reduce the influence of systems of power should be further identified and targeted for intervention.
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Affiliation(s)
- Kemar V Prussien
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Haley L Faust
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lori E Crosby
- Division of Behavioral Medicine, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Kim Smith-Whitley
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Pfizer, New York, New York, USA
| | - Lamia P Barakat
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisa A Schwartz
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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Eades-Brown NT, Oguntoye AO, Aldossary D, Ezenwa MO, Duckworth L, Dede D, Johnson-Mallard V, Yao1 Y, Gallo A, Wilkie DJ. Adherence to a reproductive health intervention for young adults with sickle cell. J Am Assoc Nurse Pract 2024:01741002-990000000-00207. [PMID: 38408228 PMCID: PMC11339234 DOI: 10.1097/jxx.0000000000000997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/29/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND The CHOICES intervention is tailored specifically for young adults with sickle cell disease (SCD) or sickle cell trait (SCT). The face-to-face (F2F) delivery format is feasible with efficacy for improving knowledge about reproductive health for those with SCD or SCT. PURPOSE The purpose of the study was to compare the participant adherence to a remote online CHOICES intervention study (N = 107) and a F2F CHOICES intervention study (N = 234). METHODOLOGY In both studies, participants with SCD or SCT were randomized into experimental or usual care control groups. Descriptive statistics were collected for all participants by group in both studies. Adherence was measured by retention at each data collection time point. Independent t-tests were conducted to compare mean participant adherence of the F2F and online studies postbaseline (6, 12, 18, and 24 months). RESULTS There was a significant difference in mean adherence postbaseline between the studies (p = .005). The results suggest that more research is necessary for proper online participant retention. CONCLUSION Advance practice nurses that are well informed on CHOICES can transmit the availability of this evidence-based intervention to this special population. Special referral for the CHOICES intervention, which is tailored specifically for young adults with SCD or SCT, may increase adherence to the intervention if it comes from trusted health care providers. IMPLICATIONS Nurse practitioners are educators in primary and acute care settings. Encounters with reproductive age populations with SCD or SCT can occur in both settings.
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Affiliation(s)
| | | | - Dalal Aldossary
- College of Nursing, University of Florida, Gainesville, Florida
- Department of Nursing Fundamentals, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Duane Dede
- College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | | | - Yingwei Yao1
- College of Nursing, University of Florida, Gainesville, Florida
| | - Agatha Gallo
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, USA
| | - Diana J. Wilkie
- College of Nursing, University of Florida, Gainesville, Florida
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Law EF, Tham SW, Howard W, Ward TM, Palermo TM. Executive Functioning and Self-Management Processes Mediate the Relationship Between Insomnia and Pain-Related Disability. THE JOURNAL OF PAIN 2024; 25:273-283. [PMID: 37633572 PMCID: PMC10840973 DOI: 10.1016/j.jpain.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/27/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023]
Abstract
Insomnia has been identified as a predictor of reduced benefit from cognitive-behavioral treatment (CBT) for adolescent chronic pain; however, it is not well understood how insomnia leads to reduced treatment response. The purpose of this study was to evaluate executive function and self-management processes as 2 potential mediators of the relationship between insomnia symptoms and pain-related disability outcomes from internet-delivered CBT using a single-arm clinical trial design. Eighty-five adolescents with chronic pain (77% female, ages 12-17 years) and their caregiver received an 8-week internet-delivered CBT intervention. Youth completed validated measures of insomnia symptoms, executive function, self-management processes, and pain-related disability at baseline, mid-treatment, immediate post-treatment, and 3-month follow-up. Results from multilevel structural equation modeling indicated that more severe insomnia symptoms were associated with greater problems with executive function, which, in turn, led to lower engagement in self-management processes and less improvement in pain-related disability. These findings identify 2 mediators by which higher insomnia symptoms may lead to reduced benefit from CBT intervention for chronic pain. Research is needed to understand whether psychological treatments for chronic pain may be optimized by strategies targeting insomnia, executive function, and/or engagement in self-management. This trial was registered at clinicaltrials.gov (NCT04043962). PERSPECTIVE: Our study suggests that executive functioning and self-management processes mediate the relationship between insomnia and treatment outcomes for pediatric chronic pain, highlighting the impact of insomnia on youth learning and implementation of self-management strategies and the critical need for targeted sleep interventions in this population.
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Affiliation(s)
- Emily F. Law
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - See Wan Tham
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Waylon Howard
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Teresa M. Ward
- Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle, WA, USA
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Poku BA, Atkin KM, Kirk S. Self-management interventions for children and young people with sickle cell disease: A systematic review. Health Expect 2023; 26:579-612. [PMID: 36597596 PMCID: PMC10010100 DOI: 10.1111/hex.13692] [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] [Received: 09/05/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Increasing numbers of interventions are being developed to support self-management for children and young people (CYP) with sickle cell disease (SCD), but no systematic review has systematically synthesized this evidence regarding their characteristics, effectiveness, acceptability and feasibility for all published intervention types. METHODS The Joanna Briggs Institute guidelines for mixed-method reviews were followed. A systematic search of eight databases and key journals was conducted from their inception to November 2021. Primary research of self-management interventions targeting CYP with SCD aged 8-24 years and reporting any health/social outcome and acceptability data were included. Design-specific standardized critical appraisal instruments were used. Two independent reviewers screened and appraised the articles. A third reviewer resolved disagreements. RESULTS Of 1654 articles identified, 38 studies were included. Methodological quality was moderate. Most studies evaluated SCD education, psycho-behavioural, psychosocial and skills training and/or social support interventions. They appear to demonstrate short-term improvements in knowledge, social functioning and medical adherence outcomes. Interventions that were multifaceted in content, combined technological platforms and in-person group-based formats and involved peers, family and care providers were more acceptable and effective. The long-term impact of interventions was limited, including CYP's involvement in the intervention development and implementation. CONCLUSIONS There is inconclusive evidence for any self-management programme. Nonetheless, support from family, peers and care providers appears to be important for self-management interventions' effectiveness and acceptability. Future research needs to prioritize CYP involvement in both intervention design and delivery, their wider social context and include CYP with SCD from non-Black backgrounds. PATIENT AND PUBLIC CONTRIBUTION Three young people with SCD recruited acted as the review advisors. They were formally trained in the review process and involved in every aspect of the review: the design, conduct and interpretation of the findings. CYP involvement in the interventions' development and implementation was analysed as part of the review. This systematic review was conducted as part of a wider research project titled: Understanding fatigue experiences of CYP with SCD to guide the co-development of a fatigue self-management intervention. Two of the young advisors involved in the review were also involved in the development of the project funding application.
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Affiliation(s)
- Brenda A Poku
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Sue Kirk
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Hoyt CR, Hurwitz S, Varughese TE, Yaeger LH, King AA. Individual-level behavioral interventions to support optimal development of children with sickle cell disease: A systematic review. Pediatr Blood Cancer 2023; 70:e30178. [PMID: 36583467 PMCID: PMC10416609 DOI: 10.1002/pbc.30178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/15/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022]
Abstract
This review aimed to identify and describe individual-level behavioral interventions for children 0-18 years of age with sickle cell disease (SCD). PRISMA guidelines were followed at each stage of this review. Twenty-seven studies were included, representing six intervention types: disease knowledge (n = 7), self-management (n = 7), pain management (n = 4), school functioning (n = 4), cognitive health (n = 4), and mental health (n = 2). Most interventions targeted older children (5+ years), while only two examined interventions for children 0-3 years. This review suggests that offering education about disease knowledge, self-management, and pain management interventions can be beneficial for this population. Future research is needed to understand interventions to support young children and the impact of SCD on development.
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Affiliation(s)
- Catherine R Hoyt
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sadie Hurwitz
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Taniya E Varughese
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lauren H Yaeger
- Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Allison A King
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Education, Washington University School of Medicine, St. Louis, Missouri, USA
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Sterlin A, de Montalembert M, Taylor M, Mensah S, Vandaele M, Lanzeray A, Poiraud L, Allali S. Impact of COVID-19 pandemic on access to online therapeutic education programs for children with sickle cell disease. J Pediatr Nurs 2022; 66:179-183. [PMID: 35816905 PMCID: PMC9265241 DOI: 10.1016/j.pedn.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) is a lifelong disease for which outcomes may be influenced by patients' self-care knowledge. Therapeutic education (TPE) is a patient-centered teaching instrument based on patient's adaptative processes and needs. TPE was developed in the Paris area by a pediatric health network using interactive face-to-face meetings. The COVID-19 pandemic has impacted the TPE modalities by promoting online training. Our aims were to evaluate the accessibility of patients with SCD to online TPE. METHODS We compared sessions of TPE before and after the onset of the pandemic: the number of sessions, performed face-to-face or online, individual or in a group. We also recorded the number of participants in each session and their age, school level, and department in France. FINDINGS We observed an increase in the total number of trained children, but participation varied greatly according to the geographical area of residence, with a decrease from 22.4% to 4.9% in the proportion of attendees living in the most socio-economically deprived French departments. DISCUSSION Online TPE is feasible for patients with SCD but with unequal access according to socio-economic status. APPLICATION TO PRACTICE Access to TPE needs to be improved for patients living in socially disadvantaged areas.
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Affiliation(s)
- Alizee Sterlin
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France
| | - Mariane de Montalembert
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France.; Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Hôpital Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France.
| | - Melissa Taylor
- Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Hôpital Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Sandrine Mensah
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France
| | - Marie Vandaele
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France
| | - Agathe Lanzeray
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France.; Unité Transversale d'Education Thérapeutique, Hôpital Necker Enfants Malades, Paris, France
| | - Louise Poiraud
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France
| | - Slimane Allali
- Réseau Francilien de Soins des Enfants Drépanocytaires, Hôpital Necker-Enfants malades, et Agence Régionale de Santé Ile-de-France, Paris, France.; Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Hôpital Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
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Sargent B, Harbourne R, Moreau NG, Sukal-Moulton T, Tovin M, Cameron JL, Stevenson RD, Novak I, Heathcock J. Research Summit V: Optimizing Transitions From Infancy to Early Adulthood in Children With Neuromotor Conditions. Pediatr Phys Ther 2022; 34:411-417. [PMID: 35653258 PMCID: PMC9250600 DOI: 10.1097/pep.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this executive summary is to review the process and outcomes of the Academy of Pediatric Physical Therapy Research Summit V, "Optimizing transitions from infancy to young adulthood in children with neuromotor disabilities: biological and environmental factors to support functional independence." SUMMARY OF KEY POINTS An interdisciplinary group of researchers, representatives from funding agencies, and individuals with neuromotor disabilities and their parents participated in an intensive 2.5-day summit to determine research priorities to optimize life transitions for children with neuromotor disabilities. Recommended priorities for research included (1) promoting self-determination and self-efficacy of individuals with neuromotor disabilities and their families, (2) best care at the right time: evidence-based best practice care, led and navigated by families seamlessly across the lifespan, (3) strengthening connections between developmental domains to enhance function and participation, and (4) optimal dosing and timing to support adaptive bone, muscle, and brain plasticity across the lifespan.
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Affiliation(s)
- Barbara Sargent
- University of Southern California, Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles, California, USA
| | - Regina Harbourne
- Duquesne University, Rangos School of Health Sciences, Department of Physical Therapy, Pittsburgh, Pennsylvania, USA
| | - Noelle G. Moreau
- Louisiana State University Health Sciences Center – New Orleans, Department of Physical Therapy, School of Allied Health, New Orleans, Louisiana USA
| | - Theresa Sukal-Moulton
- Northwestern University, Departments of Physical Therapy and Human Movement Sciences and Pediatrics, Feinberg School of Medicine, Chicago, IL, USA
| | - Melissa Tovin
- Nova Southeastern University, Department of Physical Therapy, Fort Lauderdale, FL, USA
| | - Judy L. Cameron
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - Richard D. Stevenson
- University of Virginia School of Medicine, Department of Pediatrics, Charlottesville, VA, USA
| | - Iona Novak
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jill Heathcock
- The Ohio State University, School of Health and Rehabilitation Sciences, Division of Physical Therapy, Columbus, OH, USA
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Ouyang A, Gadiraju M, Gadiraju V, Power L, Gadiraju V, Liu G, Guilliams KP, Binkley MM, Badawy SM, Fields ME. GRAPES: Trivia game increases sickle cell disease knowledge in patients and providers and mitigates healthcare biases. Pediatr Blood Cancer 2022; 69:e29717. [PMID: 35441455 DOI: 10.1002/pbc.29717] [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: 01/07/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients with sickle cell disease (SCD) endure healthcare biases that are partially due to a lack of disease-specific education among healthcare providers. Furthermore, there is a paucity of age-appropriate health education materials for patients with SCD. To address this gap, we created the GRAPES tool (Game to Raise Awareness for Patient/Provider/Public Education of SCD; www.tinyurl.com/GRAPESgame) and hypothesized that utilization of the GRAPES tool will improve patient and provider SCD knowledge and mitigate healthcare bias. PROCEDURE The GRAPES tool is an online, single-player trivia game. A feasibility study was conducted in pediatric patients with SCD at age 10 years or older and registered nurses. All participants were assessed for change in SCD-relevant knowledge and satisfaction post-gameplay. Providers were assessed for change in attitudes toward patients with SCD post-gameplay. RESULTS Twenty-five patients and 25 providers were enrolled. All participants (P < 0.001), and specifically within the patient (P = 0.019) and provider (P < 0.001) cohorts, showed increased SCD knowledge post-gameplay. Both patients and providers reported high satisfaction with GRAPES. Provider negative attitudes were reduced (P = 0.007) post-gameplay without change in positive attitudes (P = 0.959). Providers demonstrated post-gameplay reduced (P = 0.001) belief that patients' changing behavior around providers indicates inappropriate drug-seeking behavior. CONCLUSIONS This study demonstrates the feasibility and acceptability of the GRAPES tool as a potential digital, behavioral intervention to provide educational materials for patients and their providers in different clinical settings, improve knowledge about SCD, and decrease stigma against patients with SCD in the healthcare setting.
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Affiliation(s)
- Amy Ouyang
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Manasa Gadiraju
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Veda Gadiraju
- University of Washington School of Medicine, Seattle, Washington
| | - Landon Power
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | | | - Gloria Liu
- Rutgers University, New Brunswick, New Jersey
| | - Kristin P Guilliams
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Michael M Binkley
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Melanie E Fields
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
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Wakimizu R, Sasaki K, Yoshimoto M, Miyazaki A, Saito Y. Multidisciplinary Approach for Adult Patients With Childhood-Onset Chronic Disease Focusing on Promoting Pediatric to Adult Healthcare Transition Interventions: An Updated Systematic Review. Front Pediatr 2022; 10:919865. [PMID: 35774103 PMCID: PMC9237398 DOI: 10.3389/fped.2022.919865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Owing to improved prognosis, the number of adult patients with childhood-onset chronic disease (APCCD) has increased. In this systematic review, we evaluated a multidisciplinary approach toward APCCD, focusing on promoting pediatric to adult healthcare transition interventions and their effects. METHODS We reviewed literature comparing the effects of pediatric to adult healthcare transition interventions in children and adolescents with childhood-onset chronic disease, using PubMed, MEDLINE, and CINAHL, from 2010 to 2021 (keywords: "transition," "children," "intervention," "healthcare," etc.). The inclusion criteria were as follows: (i) original studies, (ii) studies on pediatric to adult healthcare transition interventions in children with chronic disease, (iii) patients including "adolescents" aged 12 and older receiving intervention, and (iv) studies that included the four elements of the PICO model: Patient/ Problem, Intervention, Comparison and Outcome model. RESULTS After evaluating 678 studies, 16 were selected, comprising topics such as "individual education programs" (n = 6), "group meetings" (n = 6), "active learning using information and communications technology" (n = 2), and "transition clinics" (n = 2). The effects obtained varied, depending on the contents and methods of the intervention. Additionally, there was no evidence of adverse outcomes from these interventions. CONCLUSIONS Pediatric to adult healthcare transition interventions provide systematic support for the transition, patient independence, and social participation; thus, they should be adopted based on their expected effects.
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Affiliation(s)
- Rie Wakimizu
- Department of Child Health Care Nursing, Division of Health Innovation and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Keita Sasaki
- Master Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Mitsuki Yoshimoto
- Master Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Akari Miyazaki
- Master Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yumiko Saito
- Doctoral Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
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10
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Hood AM, Kölbel M, Stotesbury H, Kawadler J, Slee A, Inusa B, Pelidis M, Howard J, Chakravorty S, Height S, Awogbade M, Kirkham FJ, Liossi C. Biopsychosocial Predictors of Quality of Life in Paediatric Patients With Sickle Cell Disease. Front Psychol 2021; 12:681137. [PMID: 34594262 PMCID: PMC8476744 DOI: 10.3389/fpsyg.2021.681137] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/18/2021] [Indexed: 11/13/2022] Open
Abstract
Sickle cell disease (SCD) refers to a group of inherited blood disorders with considerable morbidity that causes severe pain, reduces life expectancy, and requires significant self-management. Acute painful episodes are the hallmark of SCD, but persistent daily pain is also highly prevalent in this population. Characterising the impact and experience of SCD-related morbidity (i.e., sleep disruption, frequent emergency department visits, cognitive dysfunction) on health-related quality of life (HRQOL) requires multiple assessment methods to best capture the underlying mechanisms. To gain a greater understanding of the effect of common symptom categories on HRQOL and to determine potential pain coping targets, the present study investigated whether demographic, socioeconomic, sleepiness, pain burden, frequency of emergency department (ED) visits, and cognition predicted HRQOL in a paediatric sample of patients with SCD. Our study was a secondary analysis of baseline assessment data of children with SCD aged 8-15 years (n = 30) in the Prevention of Morbidity in Sickle Cell Anaemia Phase 2b (POMSb2) randomised controlled clinical trial of auto-adjusting continuous positive airways pressure. Patients completed cognitive testing (IQ, Processing Speed Index, Delis-Kaplan Executive Function Scale (DKEFS) Tower, Conner's Continuous Performance Test), sleepiness (Epworth Sleepiness Scale), and HRQOL (PedsQL Sickle Cell Module) at baseline. Patients reported pain burden (Sickle Cell Pain Burden Inventory-Youth) each month over 8 visits. Caregivers provided demographic information and reported their child's executive function (Behavioural Rating Inventory of Executive Function) at baseline. Data from our analysis demonstrated that demographic factors (i.e., age, gender, level of neighbourhood deprivation) and treatment variables (i.e., hydroxyurea use) did not independently predict HRQOL, and laboratory values (i.e., haemoglobin, haematocrit, mean oxygen saturation) were not significantly correlated with HRQOL (ps > 0.05). However, sleepiness, pain burden, ED visits, and executive dysfunction independently predicted HRQOL (R 2 = 0.66) with large effects (η2 = 0.16 to 0.32). These findings identify specific, measurable symptom categories that may serve as targets to improve HRQOL that are responsive to change. This knowledge will be useful for multimodal interventions for paediatric patients with SCD that include sleep management, pain coping strategies, and executive function training.
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Affiliation(s)
- Anna M Hood
- Developmental Neurosciences Unit and Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Melanie Kölbel
- Developmental Neurosciences Unit and Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Hanne Stotesbury
- Developmental Neurosciences Unit and Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jamie Kawadler
- Developmental Neurosciences Unit and Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - April Slee
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Baba Inusa
- Department of Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - Maria Pelidis
- Department of Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - Jo Howard
- Department of Haematological Medicine, King's College London, London, United Kingdom.,Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Subarna Chakravorty
- Paediatric Haematology, King's College Hospital NHS Trust, London, United Kingdom
| | - Sue Height
- Paediatric Haematology, King's College Hospital NHS Trust, London, United Kingdom
| | - Moji Awogbade
- Department of Haematological Medicine, King's College Hospital NHS Trust, London, United Kingdom
| | - Fenella J Kirkham
- Developmental Neurosciences Unit and Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, United Kingdom.,Department of Clinical Haematology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.,Department of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom
| | - Christina Liossi
- Department of Psychology, University of Southampton, Southampton, United Kingdom.,Paediatric Psychology, Great Ormond Hospital for Children NHS Foundation Trust, London, United Kingdom
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