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Niranjan SJ, Brown G, Bailey J, Geurs R, Robinson KJ, Schechter MS, Powers KE, Clemm C, Reno K, Oates GR. "I eat chocolate milk for dinner because we just have nothing in our fridge": The invisible burden and dire consequences of food insecurity for people with cystic fibrosis in the United States. Pediatr Pulmonol 2024. [PMID: 39041893 DOI: 10.1002/ppul.27179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND One-third of people with cystic fibrosis (pwCF) are food insecure, with profound negative implications for their health. This qualitative study explored lived experiences with food insecurity among pwCF or their caregivers and summarized their perspectives on food insecurity screening in the cystic fibrosis (CF) programs where they receive care. METHODS Semi-structured qualitative interviews were conducted with two groups: (1) adults with CF and (2) parents or caregivers of children with CF. PwCF or their caregivers with previously documented food insecurity were referred for participation by pediatric and adult CF programs across the United States. Interviews were recorded and transcribed, and data were coded and analyzed by two independent coders using a content-analysis approach with a constant comparative method to generate themes. RESULTS A total of 26 participants from 22 CF programs were interviewed. The sample included 17 adults with CF and nine parents of children with CF. Participants were predominantly White (88%) and female (92%). Five overarching themes emerged: (1) food insecurity among CF patients and their families is onerous, (2) financial constraints imposed by the CF disease contribute to food insecurity, (3) federal and state programs provide limited food assistance, and other support is minimal, (4) shame and stigma engulf conversations around food insecurity with CF care teams, and (5) food insecurity screening in clinical settings is critical. CONCLUSIONS Food insecurity among pwCF is invisible, but its consequences are dire. Assistance is limited, screening is inconsistent, and stigma is widespread. There is an urgent need to normalize food insecurity screening, standardize the screening process, and expand food assistance programs for pwCF.
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Affiliation(s)
| | - Georgia Brown
- Community Advisor to the Cystic Fibrosis Foundation, Bethesda, Maryland, USA
| | - Julianna Bailey
- The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robin Geurs
- The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Keith J Robinson
- University of Vermont Children's Hospital, Burlington, Vermont, USA
| | - Michael S Schechter
- Virginia Commonwealth University and Children's Hospital of Richmond at VCU, Richmond, Virginia, USA
| | | | | | - Kim Reno
- Cystic Fibrosis Foundation, Bethesda, Maryland, USA
| | - Gabriela R Oates
- The University of Alabama at Birmingham, Birmingham, Alabama, USA
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2
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Harrigan M, Mulrennan S, Jessup M, Waters P, Bennett K. Who Am I? Self-concept in Adults with Cystic Fibrosis: Association with Anxiety and Depression. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10023-7. [PMID: 38980550 DOI: 10.1007/s10880-024-10023-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 07/10/2024]
Abstract
Cystic Fibrosis (CF) is a progressive condition resulting in reduced lung function and strongly associated with elevated anxiety and depression symptoms. Self-concept refers to an individual's overarching sense of identity, a positive level of which is widely associated with reduced anxiety and depression. There is a significant lack of self-concept research within CF. This study explores the association between self-concept and anxiety and depression in adults with CF. 64 adults living with CF in Western Australia completed validated online questionnaires (Generalised Anxiety Disorder-7, Patient Health Questionnaire-9, Tennessee Self-Concept Questionnaire 2: Short-Form) and consented to the collection of medical data. Descriptive, t-test, correlation and multiple regression analysis were undertaken. Higher levels of self-concept were associated with lower levels of anxiety and depression symptoms. Lower self-concept levels were a significant predictor of increased anxiety and depression symptoms after accounting for physical health status. Mean self-concept scores for those who required mental health intervention were significantly lower compared to those that did not. This study identifies a significant relationship between self-concept and anxiety and depression in adults with CF. Further research is required to establish causation and test the feasibility of self-concept interventions in reducing anxiety and depression symptoms.
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Affiliation(s)
- Maggie Harrigan
- Medical School, The University of Western Australia (UWA), Perth, WA, Australia.
- Institute for Respiratory Health (IRH), Perth, WA, Australia.
- Cystic Fibrosis Western Australia (CFWA), Perth, WA, Australia.
| | - Siobhain Mulrennan
- Medical School, The University of Western Australia (UWA), Perth, WA, Australia
- Institute for Respiratory Health (IRH), Perth, WA, Australia
- Sir Chares Gairdner Hospital (SCGH) Adult Cystic Fibrosis Clinic, Perth, WA, Australia
| | - Melanie Jessup
- School of Nursing, Midwifery and Social Work, The University of Queensland (UQ), Brisbane, QLD, Australia
| | - Phoebe Waters
- Sir Chares Gairdner Hospital (SCGH) Adult Cystic Fibrosis Clinic, Perth, WA, Australia
| | - Kellie Bennett
- Medical School, The University of Western Australia (UWA), Perth, WA, Australia
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Sufian S, Mueller R, Langfelder-Schwind E, Caldwell K, Brown G, Ruben M, Mody S, Walker P, Godfrey E. When chronicity meets cyclicity: The cultivation of embodied knowledge and selfhood by cis-gender women with cystic fibrosis. SSM. QUALITATIVE RESEARCH IN HEALTH 2024; 5:100412. [PMID: 38993933 PMCID: PMC11238905 DOI: 10.1016/j.ssmqr.2024.100412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
This article offers the case of cystic fibrosis (CF), a multi-system disease, to illustrate how individuals with chronic illness cultivate and apply embodied knowledge to optimize their well-being. We identified three interrelated processes that occur when disease chronicity and menstrual cyclicity meet: 1) knowledge production with a period-tracking app; 2) application of embodied knowledge to manage life with menstrual-related CF symptoms; 3) cultivation of the body-self as a menstruating woman with CF. These dynamic processes capture how cis-gender women with CF attune to their bodies, navigate their illness, and situate themselves within their lifeworlds. Genetic conditions like CF are apt for studying these processes because adults have managed their disease for decades, with longitudinal experience that often exceeds that of their clinicians. Our evidence elucidates the co-constitutive nature of chronic disease, gendered subjectivity, and biological processes in flux. We explored the menstrual cyclicity of chronic disease symptoms by having 72 participants track their CF symptoms across 4 menstrual cycles on a customized period-tracking app. We performed semi-structured interviews with 20 participants to understand how they interpreted these cyclical CF symptoms. We learned that digital tracking attuned participants to monthly fluctuations in CF symptoms. They applied this knowledge to manage their lives and shape their sense of self. We argue that women with CF produce distinct embodied knowledge during their reproductive years, shaping their illness experience, disease management, overall health, quality of life, and selfhood. The dynamics we describe may reflect broader patterns by which women with other chronic illnesses experience their bodies and understand themselves in the world.
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Affiliation(s)
- Sandy Sufian
- University of Illinois at Chicago, United States
| | | | | | | | - Georgia Brown
- CFReSHC: Cystic Fibrosis Reproductive and Sexual Health Collaborative, United States
| | | | - Sheila Mody
- University of California San Diego, United States
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4
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Pitts LN, Woods B, Polen M, Nichols LS, Ladores S. Transcending Limitations: A Phenomenological Exploration of How Hygge Practices Enrich the Lived Experiences of Adults with Cystic Fibrosis. Creat Nurs 2024; 30:74-86. [PMID: 38291619 DOI: 10.1177/10784535241228522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Hygge practices embody joy, peace, mindfulness, coziness, and conviviality. Cystic fibrosis (CF) is a progressive condition with complex therapies and physical limitations. Little is known about how hygge practice may impact individuals living with CF. A qualitative study explored how adults with CF use hygge practices to promote wellness and cope with their disease. A purposive network sample of 15 adults with CF who utilized hygge practices completed semistructured audio-recorded telephone interviews. Recordings were transcribed and analyzed using Colaizzi's thematic analysis approach. Results reveal that hygge practices influenced individuals' aesthetics, attitudes, and activities, deeply impacting the physical and emotional experience of living with CF. Incorporating hygge into CF care may improve psychological well-being and quality of life for members of this community.
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Affiliation(s)
- Leslie N Pitts
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittany Woods
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Lynn S Nichols
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
- School of Nursing, Boise State University, Boise, ID, USA
| | - Sigrid Ladores
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
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Glasscoe C, Hope HF, Lancaster GA, McCray G, West K, Patel L, Patel T, Hill J, Quittner AL, Southern KW. Development and preliminary validation of the challenges of living with cystic fibrosis (CLCF) questionnaire: a 46-item measure of treatment burden for parent/carers of children with CF. Psychol Health 2023; 38:1309-1344. [PMID: 35259034 DOI: 10.1080/08870446.2021.2013483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/29/2021] [Accepted: 11/28/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Treatments for cystic fibrosis (CF) are complex, labour-intensive, and perceived as highly burdensome by caregivers of children with CF. An instrument assessing burden of care is needed. DESIGN A stepwise, qualitative design was used to create the CLCF with caregiver focus groups, participant researchers, a multidisciplinary professional panel, and cognitive interviews. MAIN OUTCOME MEASURES Preliminary psychometric analyses evaluated the reliability and convergent validity of the CLCF scores. Cronbach's alpha assessed internal consistency and t-tests examined test-retest reliability. Correlations measured convergence between the Treatment Burden scale of the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and the CLCF. Discriminant validity was assessed by comparing CLCF scores in one vs two-parent families, across ages, and in children with vs without Pseudomonas aeruginosa (PA). RESULTS Six Challenge subscales emerged from the qualitative data and the professional panel constructed a scoresheet estimating the Time and Effort required for treatments. Internal consistency and test-retest reliability were adequate. Good convergence was found between the Total Challenge score and Treatment Burden on the CFQ-R (r=-0.49, p = 0.02, n = 31). A recent PA infection signalled higher Total Challenge for caregivers (F(23)11.72, p = 0.002). CONCLUSIONS The CLCF, developed in partnership with parents/caregivers and CF professionals, is a timely, disease-specific burden measure for clinical research.
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Affiliation(s)
- Claire Glasscoe
- Institute of Translational Medicine, Department of Women's & Children's Health, University of Liverpool, Liverpool, UK
| | - Holly F Hope
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | | | | | - Kiri West
- DMOPS (Movement Disorders), Liverpool University Hospitals NHS Foundation Trust (Aintree site), Liverpool, UK
| | - Latifa Patel
- Respiratory Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Tulsi Patel
- Evelina London Children's Hospital, London, UK
| | - Jonathan Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Kevin W Southern
- Institute of Translational Medicine, Department of Women's & Children's Health, University of Liverpool, Liverpool, UK
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6
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Harrigan M, Bennett K, Mulrennan S, Jessup M. Living with cystic fibrosis during the COVID-19 pandemic: a social connectedness perspective. Int J Qual Stud Health Well-being 2022; 17:2062820. [PMID: 35438049 PMCID: PMC9037166 DOI: 10.1080/17482631.2022.2062820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose This study explores the concept of social connectedness for adults with Cystic Fibrosis (CF), generally and during the onset of the COVID-19 pandemic, to help inform contemporary CF healthcare. Social connectedness is an essential component of belonging and refers to an individual’s sense of closeness with the social world. Unique disease factors make exploration of social connectedness pertinent, added to by COVID-19, with the CF population potentially facing increased risk for severe illness. Methods Seventeen adults with CF in Western Australia undertook interviews, with findings categorized as overarching themes. Results In a general sense, participants described social connectedness challenges caused by CF, despite which they reported meaningful connections that benefits their mental and physical health. Within a COVID-19 specific context, participants demonstrated resilience in the face of adversity, highlighted the importance of empathy in relation to the pandemic, and described how social support is both an outcome and enhancer of social connectedness. Conclusions This study contributes to limited social connectedness literature within CF and chronic illness in general, highlighting the importance of social connectedness awareness raising, assessments and interventions in CF healthcare inside and outside the COVID-19 pandemic.
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Affiliation(s)
- Maggie Harrigan
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Cystic Fibrosis Research Unit, Institute for Respiratory Health (IRH), Nedlands, Western Australia, Australia
| | - Kellie Bennett
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Siobhain Mulrennan
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Cystic Fibrosis Research Unit, Institute for Respiratory Health (IRH), Nedlands, Western Australia, Australia
- Cystic Fibrosis Clinic, Department of Respiratory Health, Nedlands, Western Australia, Australia
| | - Melanie Jessup
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
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Bathgate CJ, Hjelm M, Filigno SS, Smith BA, Georgiopoulos AM. Management of Mental Health in Cystic Fibrosis. Clin Chest Med 2022; 43:791-810. [PMID: 36344081 DOI: 10.1016/j.ccm.2022.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article is intended for use among all cystic fibrosis care team members. It covers common mental health concerns and their unique presentations in persons with cystic fibrosis (pwCF) in areas such as depression, anxiety, trauma, behavioral disorders emerging in childhood, sleep, problematic eating patterns, and the impact of substance use. Furthermore, the authors address ways to manage these mental health symptoms through risk assessment, psychological interventions, and/or psychotropic medications. Quick reference tables are provided for evidence-based psychological interventions and medications often used for mental health conditions in pwCF.
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Affiliation(s)
| | - Michelle Hjelm
- University of Cincinnati College of Medicine; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Stephanie S Filigno
- University of Cincinnati College of Medicine; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Beth A Smith
- Jacobs School of Medicine and Biomedical Sciences, Children's Psychiatry Clinic, 1028 Main Street, Buffalo, NY 14202, USA
| | - Anna M Georgiopoulos
- Part-Time, Harvard Medical School; Department of Psychiatry, Massachusetts General Hospital, Yawkey 6900, 55 Fruit Street, Boston, MA 02114, USA
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8
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Ischander M, Lozowski-Sullivan S. Psychologist's Unique Role in Improving Quality of Life of Children with Chronic Lung Diseases and Their Families. Pediatr Clin North Am 2022; 69:951-963. [PMID: 36207105 DOI: 10.1016/j.pcl.2022.05.008] [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] [Indexed: 11/05/2022]
Abstract
Pediatric chronic lung diseases burden their patients and families with heavy treatment loads, frequent extensive clinic visits to multiple providers, frequent emergency department visits and hospitalizations, and contribute to significant psychosocial issues with caregiver's burnout. The purpose of this chapter is to outline the psychosocial impact of the major pediatric chronic lung diseases and the unique role of the psychologist in relieving this burden. These include severe asthma, cystic fibrosis, bronchopulmonary dysplasia, and dependence on home mechanical ventilation.
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Affiliation(s)
- Mariam Ischander
- Department of Pediatric and Adolescent Medicine, Division of Pulmonology and Sleep Medicine, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
| | - Sheryl Lozowski-Sullivan
- Department of Pediatric and Adolescent Medicine, Division of Psychology, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
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9
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Taheri L, Mirlashari J, Modaresi M, Pederson A. Cough in adolescent with cystic fibrosis, from nightmare to COVID-19 stigma: A qualitative thematic analysis. J Pediatr Nurs 2022; 64:119-125. [PMID: 35279332 PMCID: PMC8906655 DOI: 10.1016/j.pedn.2022.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Cough is part of the daily life of patients with Cystic fibrosis (CF) and its most common symptom. This study explored the experiences of adolescents with CF in Iran during the COVID-19 pandemic in relation to their cough. DESIGN AND METHODS In this qualitative study, we conducted 32 semi-structured interviews with 21 adolescents with CF. We analyzed the data thematically. RESULTS We identified three main themes among adolescents with CF in relation to coughing: 1. Cough is a permanent companion; 2. Coughing raises fear of double stigma; 3. Patients' individualized coping strategies to deal with coughing. Participants complained that cough interrupted daily tasks and sleep, drew unwanted attention in public places, and elicited questions about whether they were COVID-19 patients or substance users-both highly stigmatized identities. CONCLUSION Although coughing is a protective mechanism for CF patients, frequent coughing often causes major challenges, particularly during the COVID pandemic, when people were acutely sensitive and aware about coughing. During the COVID-19 pandemic, in addition to taking care of themselves and managing the disease, CF patients therefore had to also overcome issues related to social stigma and isolation. PRACTICE IMPLICATIONS Healthcare workers play an important role in increasing public awareness about CF and its symptoms, including cough. During the pandemic, healthcare workers can help reduce the stigma of coughing through public education. Healthcare workers can actively communicate with patients to identify severe and ineffective cases of cough due to exacerbation of the disease and refer them to a specialist.
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Affiliation(s)
- Leila Taheri
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Jila Mirlashari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Department of OBGYN, Women's Health Research Institute, University of British Columbia, Vancouver, Canada.
| | - Mohammadreza Modaresi
- Pediatric Pulmonary Disease and Sleep Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Science, Tehran, Iran; Cystic Fibrosis research center, Iran CF Foundation (ICFF), Tehran, Iran.
| | - Ann Pederson
- Population Health School of Population and Public health, University of British Columbia, British Columbia, Canada.
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Kauser S, Keyte R, Mantzios M, Egan H. A Qualitative Exploration into Experiences and Attitudes Regarding Psychosocial Challenges, Self-compassion, and Mindfulness in a Population of Adults with Cystic Fibrosis. J Clin Psychol Med Settings 2022; 29:898-910. [PMID: 35147829 DOI: 10.1007/s10880-022-09859-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
To investigate the current psychosocial challenges faced by adults with Cystic Fibrosis (CF), while exploring attitudes and experiences of mindfulness and self-compassion. Mindfulness and self-compassion are important resources for supporting psychological and physical well-being, yet there is limited research exploring these positive psychology concepts in CF literature. Twenty UK domiciled adults with a diagnosis of CF, took part in a semi-structured interview. Using a thematic analysis approach, four themes were developed: (a) "I didn't expect to be here": Surpassing the CF life expectancy, (b) "Am I psychologically bringing this upon myself?": Psychological complexities of CF, (c) "I've had to really learn to be kind to myself": The importance of compassion and being self-compassionate, (d) "I think it's a great tool": The benefits of practising mindfulness. This research demonstrates a robust need for increased integration of accessible psychological practices into routine CF-care and self-care for adults with CF. Particularly, practises and interventions that draw on the concepts of mindfulness and self-compassion, which may benefit patient's health and wellbeing profoundly.
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Affiliation(s)
- S Kauser
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK.
| | - R Keyte
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - M Mantzios
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - H Egan
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
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11
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Comment améliorer la transition au sein des CRCM : analyse des besoins des patients et de leurs parents lors de l’arrivée en service adulte. Rev Mal Respir 2022; 39:132-139. [DOI: 10.1016/j.rmr.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 12/22/2021] [Indexed: 11/20/2022]
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Blamires J, Dickinson A, Tautolo ES, Byrnes CA. A "pretty normal" life: a qualitative study exploring young people's experience of life with bronchiectasis. Int J Qual Stud Health Well-being 2021; 16:2003520. [PMID: 34793292 PMCID: PMC8604450 DOI: 10.1080/17482631.2021.2003520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
PURPOSE Bronchiectasis is a chronic respiratory disease that impacts significantly on quality of life for those who have it. There is a paucity of literature exploring the perspectives of children and young people. The aim of this study was to examine the day-to-day life experience of a group of young people with bronchiectasis. METHOD A qualitative study using semi-structured interviews explored fifteen young people's perspectives of life with bronchiectasis. Key themes were identified using an inductive iterative approach through constant comparative analysis guided by Thorne's interpretive description. RESULTS Life with bronchiectasis was conceptualized by participants as "Pretty Normal". This consisted of two co-existing life views which represented how young people balanced the ups and downs of adolescence while learning to accommodate the demands of living with bronchiectasis. Three key thematic elements "sore and tired", 'life interrupted and "looking after self", influenced and challenged these two views of life. CONCLUSIONS Young people with bronchiectasis portray life as being the same as their peers. Despite this, they recognized that the symptoms, interruptions, and self-management responsibilities led them to find ways of coping and integrating their experience into a new and modified view of normal.
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Affiliation(s)
- Julie Blamires
- School of Clinical Sciences Auckland University of Technology, Northcote, Auckland
| | - Annette Dickinson
- School of Clinical Sciences Auckland University of Technology, Northcote, Auckland
| | - El Shadan Tautolo
- School of Public Health & Interdisciplinary Studies Director-AUT Pacific Health Research Centre, Auckland University of Technology, NZ
| | - Catherine A Byrnes
- Department of Paediatrics; Child and Youth Health, Faculty of Health & Medical Sciences, University of Auckland, Auckland, NZ
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13
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Pattie P, Ranganathan S, Harrison J, Vidmar S, Hall GL, Foong RE, Harper A, Ramsey K, Wurzel D. Quality of life is poorly correlated to lung disease severity in school-aged children with cystic fibrosis. J Cyst Fibros 2021; 21:e188-e203. [PMID: 34801433 DOI: 10.1016/j.jcf.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/07/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no data exclusively on the relationship between health-related quality-of-life (HRQOL) and lung disease severity in early school-aged children with cystic fibrosis (CF). Using data from the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) we assessed the relationships between HRQOL, lung function and structure. METHODS 125 children aged 6.5-10 years enrolled in the AREST CF program were included from CF clinics at Royal Children's Hospital (RCH), Melbourne (n = 66) and Perth Children's Hospital (PCH), Perth (n = 59), Australia. Demographics, HRQOL measured by Cystic Fibrosis Questionnaire-Revised (CFQ-R), spirometry, multiple-breath washout (MBW) and chest CT were collected across two years. Correlation between CFQ-R scores and lung structure/function parameters and agreement between parent-proxy and child-reported HRQOL were evaluated. RESULTS No correlation was observed between most CFQ-R domain scores and FEV1 z-scores, excepting weak-positive correlation with parent CFQ-R Physical (rho = 0.21, CI 0.02-0.37), and Weight (rho = 0.21, CI 0.03-0.38) domain and child Body domain (rho = 0.26, CI 0.00-0.48). No correlation between most CFQ-R domain scores and LCI values was noted excepting weak-negative correlation with parent Respiratory (rho = -0.23, CI -0.41--0.05), Emotional (rho = -0.24, CI -0.43--0.04), and Physical (-0.21, CI -0.39--0.02) domains. Furthermore, structural lung disease on CT data demonstrated little to no association with CFQ-R parent and child domain scores. Additionally, no agreement between child self-report and parent-proxy CFQ-R scores was observed across the majority of domains and visits. CONCLUSION HRQOL correlated poorly with lung function and structure in early school-aged children with CF, hence clinical trials should consider these outcomes independently when determining study end-points.
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Affiliation(s)
- Phillip Pattie
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
| | - Sarath Ranganathan
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Joanne Harrison
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Suzanna Vidmar
- Department of Paediatrics, The University of Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Graham L Hall
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Rachel E Foong
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Alana Harper
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Kathryn Ramsey
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Danielle Wurzel
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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14
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Lynn C, Lyons E, Muther E. Delivery of cystic fibrosis psychosocial care across developmental stages. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1993228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Courtney Lynn
- Department of Psychiatry, University of Colorado School of Medicine
- Children’s Hospital Colorado, Pediatric Mental Health Institute
| | - Emma Lyons
- Children’s Hospital Colorado, Pediatric Mental Health Institute
| | - Emily Muther
- Department of Psychiatry, University of Colorado School of Medicine
- Children’s Hospital Colorado, Pediatric Mental Health Institute
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15
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Anxiety in Children with Cystic Fibrosis and Their Parents: A Systematic Review. Clin Child Fam Psychol Rev 2021; 24:370-390. [DOI: 10.1007/s10567-021-00345-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 12/21/2022]
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16
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Torun T, Çavuşoğlu H, Doğru D, Özçelik U, Ademhan Tural D. The Effect of Self-Efficacy, Social Support and Quality of Life on Readiness for Transition to Adult Care Among Adolescents with Cystic Fibrosis in Turkey. J Pediatr Nurs 2021; 57:e79-e84. [PMID: 33279319 DOI: 10.1016/j.pedn.2020.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/22/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study is to examine the effects of self-efficacy, social support and quality of life on readiness for transition to adult care in adolescents with cystic fibrosis. DESIGN AND METHODS A descriptive and cross-sectional study design was used. Data were collected from 50 adolescent between 14 and 17 years old with cystic fibrosis, by using The Transition Readiness Assessment Questionnaire, Social Support Appraisals Scale for Children, Self-Efficacy Questionnaire for Children and health-related quality-of-life instrument, the KIDSCREEN-10. RESULTS A positive correlation was found between the readiness levels of adolescents for transition to adult care and self-efficacy levels. In path analysis, self-efficacy was found to have a significant effect on the level of readiness for transition to adult care. There was not statistically significant relationship between the level of readiness for transition to adult care and health-related quality of life and perceived social support. Path analysis revealed that health-related quality of life and perceived social support had significant effects on the self-efficacy levels of adolescents. CONCLUSIONS Self-efficacy were associated with readiness for the transition to adult care. Although perceived social support and quality of life were not related with transition readiness these variables had significant effects on perceived self-efficacy, which was determined as a factor affecting the readiness for the transition to adult care. PRACTICE IMPLICATIONS In adolescents with cystic fibrosis, self-efficacy, social support and quality of life levels should be taken into account when planning preparation programs for transition to adult care.
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Affiliation(s)
- Tuğçe Torun
- Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Turkey.
| | - Hicran Çavuşoğlu
- Head of Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Turkey
| | - Deniz Doğru
- Pediatric Pulmonology Department, Faculty of Medicine, Hacettepe University, Turkey
| | - Uğur Özçelik
- Pediatric Pulmonology Department, Faculty of Medicine, Hacettepe University, Turkey
| | - Dilber Ademhan Tural
- Pediatric Pulmonology Department, Faculty of Medicine, Hacettepe University, Turkey
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17
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Schneider M, Simpson J, Zlomke K. A comparison study: caregiver functioning and family resilience among families of children with cystic fibrosis, asthma, and healthy controls. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1842207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Mallory Schneider
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | - Jessica Simpson
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | - Kimberly Zlomke
- Department of Psychology, University of South Alabama, Mobile, AL, USA
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18
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Bell SC, Mall MA, Gutierrez H, Macek M, Madge S, Davies JC, Burgel PR, Tullis E, Castaños C, Castellani C, Byrnes CA, Cathcart F, Chotirmall SH, Cosgriff R, Eichler I, Fajac I, Goss CH, Drevinek P, Farrell PM, Gravelle AM, Havermans T, Mayer-Hamblett N, Kashirskaya N, Kerem E, Mathew JL, McKone EF, Naehrlich L, Nasr SZ, Oates GR, O'Neill C, Pypops U, Raraigh KS, Rowe SM, Southern KW, Sivam S, Stephenson AL, Zampoli M, Ratjen F. The future of cystic fibrosis care: a global perspective. THE LANCET RESPIRATORY MEDICINE 2020; 8:65-124. [DOI: 10.1016/s2213-2600(19)30337-6] [Citation(s) in RCA: 351] [Impact Index Per Article: 87.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/19/2019] [Accepted: 08/14/2019] [Indexed: 02/06/2023]
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