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Olival MG, Vilela TS, Hankins JS, Bendo CB, Lobo CL, Maioli MCP, Bandeira FM, Werneck GL, Soares AR. Translation, transcultural adaptation, and validation of PedsQL 3.0 Sickle Cell Disease Module into Brazilian Portuguese. Pediatr Blood Cancer 2024; 71:e30862. [PMID: 38287205 DOI: 10.1002/pbc.30862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/04/2023] [Accepted: 12/29/2023] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Despite the high prevalence of sickle cell disease (SCD) in Brazil, no studies have described the validation of an SCD-specific health-related quality-of-life (HRQoL) instrument in children. We validated PedsQL 3.0 Sickle Cell Disease Module (PedsQL-SCD) for Brazilian Portuguese, and cross-validated it with PedsQL 4.0 Generic Core Scale (PedsQL-GCS) in children with SCD. METHODS PedsQL-SCD was translated and culturally adapted using forward and reverse translations. PedsQL-SCD and PedsQL-GCS were tested in children and adolescents with SCD aged 2-18 years and their caregivers. Validity was assessed using the Pearson and intraclass correlation coefficients, and reliability measured with Cronbach's alpha. RESULTS PedsQL-SCD was validated in 206 children with SCD (median age 14 years, range: 8-18) and 201 caregivers. Among patients and caregivers, the mean total score for PedsQL-SCD was 65.7 and 64.1, respectively. The mean total score for PedsQL-GCS was 73.1 and 68.9 among patients and caregivers, respectively. The internal consistency for PedsQL-SCD and PedsQL-GCS was good; Cronbach's alpha coefficients ranged from .59-.93 to .64-.83 among patients and from .60-.95 to .65-.85 among caregivers, respectively. Most intercorrelations between PedsQL-SCD and PedsQL-GCS, for patients and caregivers, had medium to large effect sizes (range: .23-.63 and .27-.64, respectively). Pain and pain impact domains of PedsQL-SCD and physical dimension of PedsQL-GCS had the highest cross-correlation (.63 and .6 for patients; .63 and .64 for caregivers, respectively), confirming convergent construct validity. CONCLUSION PedsQL-SCD is a valid, culturally appropriate measure to assess HRQoL in children with SCD in Brazil and is well-correlated PedsQL-GCS.
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Affiliation(s)
- Maristela G Olival
- Clinical Hematology and Research Division, Instituto de Hematologia Arthur de Siqueira Cavalcanti--HEMORIO, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thiago S Vilela
- Pediatric Hematology Sector, Pediatrics Department, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Jane S Hankins
- Departments of Global Pediatric Medicine and Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Cristiane B Bendo
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Clarisse L Lobo
- Clinical Hematology and Research Division, Instituto de Hematologia Arthur de Siqueira Cavalcanti--HEMORIO, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Christina P Maioli
- Hematology Service, Pedro Ernesto University Hospital/Medical Sciences Faculty/Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia M Bandeira
- Hematology Service, Pedro Ernesto University Hospital/Medical Sciences Faculty/Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme L Werneck
- Department of Epidemiology, Social Medicine Institute/Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andréa R Soares
- Hematology Service, Pedro Ernesto University Hospital/Medical Sciences Faculty/Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
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Moody KL. Association of Sickle Cell Pain & Symptoms on Health-Related Quality of Life Among Pediatric Patients. J Pain Symptom Manage 2022; 64:304-309. [PMID: 35550166 DOI: 10.1016/j.jpainsymman.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Sickle cell disease (SCD) may cause significant complications leading to increased disease burden and poor psychosocial functioning. Yet, little is known about specific disease-related variables associated with decreased health-related quality of life (HRQOL) of this population. OBJECTIVES This study aims to discover whether pain and disease-related symptoms are associated with the HRQOL of pediatric patients diagnosed with SCD. METHODS A total of 150 patient (ages 8-17 years) and parent dyads were enrolled in this cross-sectional quantitative research study. Measures of HRQOL were gathered using the Pediatric Quality of Life (PedsQL) 3.0 SCD module, while the frequency of pain and SCD-related symptoms was reported by parent-proxy. Linear regression was deployed to analyze whether pain and SCD-related symptoms separately predict HRQOL scores in youth with SCD. RESULTS Study results revealed that the frequency of pain (P < 0.001) and SCD-related symptoms (P < 0.001) predicted lower HRQOL scores in children and adolescents with SCD. Moreover, age (P < 0.05) emerged as a significant predictor of HRQOL in this sample. CONCLUSION Pain and disease-related symptoms separately predicted lower HRQOL scores in the study sample, which shows that other SCD-related symptoms aside from pain has the potential to negatively impact youth with SCD. Implications for these findings extend the knowledge of clinicians in the healthcare setting to recognize the detriment of other SCD-related symptoms that may be overlooked, as pain is often the focus.
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Affiliation(s)
- Kendall L Moody
- School of Social Work, Howard University, Washington, District of Columbia, USA.
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Stokoe M, Zwicker HM, Forbes C, Abu-Saris NEH, Fay-McClymont TB, Désiré N, Guilcher GM, Singh G, Leaker M, Yeates KO, Russel KB, Cho S, Carrels T, Rahamatullah I, Henry B, Dunnewold N, Schulte F. Health related quality of life in children with sickle cell disease: A systematic review and meta-analysis. Blood Rev 2022; 56:100982. [DOI: 10.1016/j.blre.2022.100982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 11/02/2022]
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Kinahan JY, Graham JMI, Hébert YV, Sampson M, O'Hearn K, Klaassen RJ. Patient-reported Outcome Measures in Pediatric Non-Malignant Hematology: A Systematic Review. J Pediatr Hematol Oncol 2021; 43:121-134. [PMID: 33136776 DOI: 10.1097/mph.0000000000001984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/28/2020] [Indexed: 01/19/2023]
Abstract
Patient-reported outcome measures (PROMs) are questionnaires completed by patients or caregivers without influence by health care professionals. As such, PROMs show subjective health experiences, enhance the clinical information available to providers, and inform clinical action. The objective of this systematic review is to identify and list which validated PROMs have been used to monitor health-related quality of life in pediatric patients with nonmalignant hematology (hemophilia, immune thrombocytopenia, sickle cell disease, and thalassemia). Databases (MEDLINE, Embase, HaPI, CINAHL, and PsycTESTS) were searched to identify publications that validated or used PROMs as an outcome measure in the 4 disease groups. Overall, 209 articles met the inclusion criteria, identifying 113 PROMs. Of the 113 identified PROMs, 95 are generic and can be used in multiple disease groups. The Pediatric Quality of Life Generic Core Scales was the most frequently used generic PROM (68 studies). The 18 remaining PROMs were disease specific. The results of this review, together with the COSMIN tool for selecting outcome measures, will allow clinicians to evaluate the PROMs that are best suited to their patient population. In addition, the focus groups are currently being conducted with patients, parents, and clinicians to determine the optimal use of PROMs in the clinical environment.
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Affiliation(s)
- Julia Y Kinahan
- Children's Hospital of Eastern Ontario Research Institute
- University of Ottawa, Ottawa, ON
| | - Johann M I Graham
- Children's Hospital of Eastern Ontario Research Institute
- Regional Hospital Center of Lanaudiere, Saint-Charles-Borromée
- Laval University, Quebec City, QC, Canada
| | - Yamilée V Hébert
- Children's Hospital of Eastern Ontario Research Institute
- University of Ottawa, Ottawa, ON
| | | | - Katie O'Hearn
- Children's Hospital of Eastern Ontario Research Institute
| | - Robert J Klaassen
- Children's Hospital of Eastern Ontario Research Institute
- Division of Hematology/Oncology, Department of Pediatrics
- University of Ottawa, Ottawa, ON
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Abstract
Fetal hemoglobin (HbF) can blunt the pathophysiology, temper the clinical course, and offer prospects for curative therapy of sickle cell disease. This review focuses on (1) HbF quantitative trait loci and the geography of β-globin gene haplotypes, especially those found in the Middle East; (2) how HbF might differentially impact the pathophysiology and many subphenotypes of sickle cell disease; (3) clinical implications of person-to-person variation in the distribution of HbF among HbF-containing erythrocytes; and (4) reactivation of HbF gene expression using both pharmacologic and cell-based therapeutic approaches. A confluence of detailed understanding of the molecular basis of HbF gene expression, coupled with the ability to precisely target by genomic editing most areas of the genome, is producing important preliminary therapeutic results that could provide new options for cell-based therapeutics with curative intent.
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Pandarakutty S, Murali K, Arulappan J, Al Sabei SD. Health-Related Quality of Life of Children and Adolescents with Sickle Cell Disease in the Middle East and North Africa Region: A systematic review. Sultan Qaboos Univ Med J 2021; 20:e280-e289. [PMID: 33414931 PMCID: PMC7757932 DOI: 10.18295/squmj.2020.20.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/02/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
Sickle cell disease (SCD) can significantly impair the health-related quality of life (HRQOL) of children and adolescents. This review aimed to assess current evidence regarding the HRQOL of children and adolescents with SCD in the Middle East and North Africa region. A systematic search of various databases was conducted to identify relevant articles, including MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), Scopus® (Elsevier, Amsterdam, the Netherlands), Cumulative Index to Nursing and Allied Health Literature®, Masader (Oman Virtual Science Library, Muscat, Oman) and EBSCOhost (EBSCO Information Services, Ipswich, Massachusetts, USA). A total of 533 articles were identified; however, only 10 were eligible for inclusion in the final analysis. Results from these studies showed that children and adolescents with SCD had compromised HRQOL compared to their healthy peers, particularly in terms of physical, psychosocial, familial, financial and academic functioning. Therefore, interventions are necessary to improve overall HRQOL outcomes for this population.
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Affiliation(s)
- Suthan Pandarakutty
- Department of Nursing, College of Health Sciences, University of Buraimi, Al Buraimi, Oman
| | - Kamala Murali
- Department of Paediatric Nursing, Rani Meyyammai College of Nursing, Annamalai University, Chidambaram, Tamil Nadu, India
| | | | - Sulaiman D Al Sabei
- Fundamentals & Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Effectiveness of Nurse Led Intervention on Health Related Quality of Life among Children with Sickle Cell Disease in Oman: A Pilot Study. Adv Hematol 2020; 2019:6045214. [PMID: 32089692 PMCID: PMC7024092 DOI: 10.1155/2019/6045214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/03/2019] [Accepted: 10/16/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction. The children with Sickle Cell Disease (SCD) generally have poor Health Related Quality of Life (HRQOL). The study aimed to evaluate the effectiveness of nurse led intervention on HRQOL among children with SCD.
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Boulassel MR, Al-Zubaidi A, Al-Zadjali S, Al-Qarni Z, Al-Naamany N, Al-Yarabi A, Elshinawy M, Wali Y. Elevated levels of circulating invariant natural killer cell subsets are skewed toward Th2-like phenotype in children with sickle cell disease. Clin Immunol 2019; 210:108308. [PMID: 31726101 DOI: 10.1016/j.clim.2019.108308] [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: 08/04/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 11/24/2022]
Abstract
Invariant natural killer T (iNKT) cells are being considered as potential targets for immunotherapeutic strategies in a variety of conditions including sickle cell disease (SCD). However, relatively little is known about the fate of iNKT cell subsets in children with SCD. Herein, quantitative and qualitative analyses of circulating iNKT cell subsets were carried out in 120 children in steady state and 30 healthy controls. Children with SCD displayed significantly elevated levels of circulating iNKT cell subsets with a preferential polarization toward Th2-like cells. The known SCD modifiers did not influence levels of iNKT cell subsets, except that children carrying the Bantu haplotype exhibited elevated levels of CD4iNKT cells, and to a lesser degree CD8iNKT cells. Collectively, these findings indicate that circulating iNKT cell subsets are significantly increased in children with SCD, and highlight the existence of imbalanced production of cytokines toward Th2-like phenotype, which seems to be associated with genetic polymorphisms.
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Affiliation(s)
- Mohamed-Rachid Boulassel
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman.
| | - Abeer Al-Zubaidi
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman
| | - Shoaib Al-Zadjali
- Department of Haematology, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman
| | - Zahra Al-Qarni
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman
| | - Nidaa Al-Naamany
- Department of Allied Health Sciences, College of Medicine and Health Sciences, Sultan Qaboos University, Oman
| | - Ahmed Al-Yarabi
- Department of Medicine, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman
| | - Mohamed Elshinawy
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman; Pediatric Department, Faculty of Medicine, Alexandria University, Egypt
| | - Yasser Wali
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Oman
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Oliveira CDL, Kelly S, de Almeida-Neto C, Carneiro-Proietti AB, Camargo FC, Salomon T, Flor-Park MV, Maximo C, Rodrigues DW, Mota RA, Teixeira CM, Loureiro P, Sabino EC, Custer B. Quality of life in pre-adolescent children with sickle cell disease in Brazil. Pediatr Hematol Oncol 2019; 36:457-467. [PMID: 31490092 PMCID: PMC6872937 DOI: 10.1080/08880018.2019.1660743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/03/2019] [Accepted: 08/20/2019] [Indexed: 12/16/2022]
Abstract
Sickle cell disease (SCD) affects more than 13 million people and can have a significant impact on the quality of life (QoL) of those persons. We performed a cross-sectional study to evaluate the QoL in SCD children 8-12 years old enrolled from November 2014 to March 2016 in a large multicenter cohort study in Brazil. The PedsQL™ SCD Module was used to evaluate QoL in 412 children from six Brazilian health centers. The mean age of participants was 10.5 years and 193(46.7%) were women. The mean global score was 60.7, with a Cronbach´s alpha of 0.92. There were significant differences in socioeconomic demographics and treatments among participants at the six centers, but age, income, SCD genotype, and use of hydroxyurea did not significantly affect the QoL scores. After adjustment for all of these variables in a linear regression model, a significant difference was observed by site in global QoL score and the dimensions 'worry II'(β0 = 20.7, p < .00), 'treatment´(β0 = 66.8, p < .00) and communication II'(β0 = 45.8, p < .00). These dimensions are affected by the capacity of health professionals to provide clinical and psychological support to patients. Our results suggest that QoL of this patient population varied according the health center even adjusted by sociodemographics characteristics. Additional training of health professionals in psychological and clinical support could directly reduce patient apprehension about the disease its clinical complications.
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Affiliation(s)
| | | | | | | | | | | | - Miriam V. Flor-Park
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto da Criança, São Paulo, Brazil
| | | | | | | | | | | | | | - Brian Custer
- VitalantResearchInstitute, San Francisco, CA, USA
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