1
|
Arslan Şahbaz EE, Cankurtaran Ö. Evaluation of coping strategies of parents of children with cystic fibrosis. SOCIAL WORK IN HEALTH CARE 2024; 63:349-369. [PMID: 38477619 DOI: 10.1080/00981389.2024.2324858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Abstract
This cross-sectional quantitative study was conducted to evaluate the coping strategies of parents of children with cystic fibrosis. The research sample is the parents (n: 112) who presented to Thoracic Medicine Department at Hacettepe University Pediatric Hospital between 3 April 2021 - 28 May 2021 and volunteered to participate in the study. Sociodemographic Data Form and Coping Orientation to Problems Experienced Inventory (COPE Inventory) were used in the collection of data. The study examined coping strategies according to children's characteristics such as age, sex, education, and parents' independent variables such as employment status, income status, number of individuals and children in the family, communication with other families, social and financial support. Data were analyzed using Mann-Whitney and Kruskal-Wallis tests. Research findings show that religious coping was the most frequently preferred coping strategy, and behavioral disengagement was the least commonly used coping strategy. Emotion-Focused Coping Strategies were also commonly used. Social work interventions and strategies play an important role in helping parents to adopt positive coping strategies and improve their skills.
Collapse
Affiliation(s)
- Elif Ezgi Arslan Şahbaz
- Department of Social Work, Institute of Health Sciences, Faculty of Health, Ankara University, Ankara, Turkey
| | - Özlem Cankurtaran
- Department of Social Work, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Turkey
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Li S, Douglas T, Fitzgerald DA. Psychosocial needs and interventions for young children with cystic fibrosis and their families. Paediatr Respir Rev 2023:S1526-0542(23)00017-9. [PMID: 37268508 DOI: 10.1016/j.prrv.2023.04.002] [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: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 06/04/2023]
Abstract
This review summarises the experiences of young children and their families living with CF during the first five years of life following NBS diagnosis, as well as the options of psychosocial support available to them. We present strategies embedded within routine CF care that focus on prevention, screening, and intervention for psychosocial health and wellbeing that constitute essential components of multidisciplinary care in infancy and early childhood.
Collapse
Affiliation(s)
- Stella Li
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, New South Wales 2145, Australia
| | - Tonia Douglas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland 4001, Australia; Children's Health Queensland Clinical Unit, Medical School, Faculty Medicine, University of Queensland, Australia
| | - Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Child and Adolescent Health, Faculty of Medicine, Discipline of Health Sciences, University of Sydney, New South Wales, Australia.
| |
Collapse
|
4
|
Onwuakagba IU, Okoye EC, Simon LA, Okonkwo UP, Nwankwo MJ. Burden, needs, and attitudes of parents of children with cerebral palsy in a middle-income country. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01896-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
5
|
Andrews K, Smith M, Cox NS. Physiotherapy: At what cost? Parents experience of performing chest physiotherapy for infants with cystic fibrosis. J Child Health Care 2021; 25:616-627. [PMID: 33249885 DOI: 10.1177/1367493520976481] [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] [Indexed: 11/15/2022]
Abstract
Physiotherapy is one of the most burdensome aspects of cystic fibrosis (CF) care. Healthcare requirements for older children with CF are reported to impact parental quality of life and physiotherapy adherence. How parents of infants experience performing chest physiotherapy as a part of CF care is unknown. This study aimed to explore the experience of performing chest physiotherapy for parents of infants with CF. In this study, 13 parents of infants (aged 1-2 years) with CF participated in one in-depth semi-structured interview and completed a daily diary for five days. Principles of hermeneutic phenomenology guided interpretation of interview transcripts, diary entries, and field notes. For these parents, being responsible for performing chest physiotherapy was an ever-present experience of pressure, doubt, and guilt. Managing chest physiotherapy resulted in sacrifices that were perceived by parents as an expected and necessary part of meeting the healthcare needs of their child. Despite perceived sacrifices, performing chest physiotherapy was also experienced by parents as an opportunity to positively impact the health of their child. Awareness of parental perceptions and experiences of chest physiotherapy in CF may enhance the personalization of physiotherapy and minimize burden.
Collapse
Affiliation(s)
- Kristen Andrews
- School of Community Health, 1109Charles Sturt University, Albury, NSW, Australia
| | - Megan Smith
- Faculty of Science, 1109Charles Sturt University, Albury, NSW, Australia
| | - Narelle S Cox
- Monash University & Institute for Breathing and Sleep, 2541Monash University, Australia
| |
Collapse
|
6
|
Haselhurst J, Moss K, Rust S, Oliver J, Hughes R, McGrath C, Reed D, Ferguson L, Murray J. A narrative-informed evaluation of tree of life for parents of children with physical health conditions. Clin Child Psychol Psychiatry 2021; 26:51-63. [PMID: 33233929 DOI: 10.1177/1359104520972457] [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: 11/15/2022]
Abstract
BACKGROUND Parents of children with chronic health conditions can face many challenges. The Tree of Life narrative therapy group intervention aims to connect parents with their skills and resources before collectively exploring the 'storms' (challenges) they face. A narrative-informed evaluation aimed to story the parents' experiences of attending the group. METHODS Seven parents attended a Tree of Life group intervention and then participated in a narrative-informed group interview to generate stories regarding their experience of the group. The interview was recorded with consent and later transcribed. RESULTS A thematic analysis was undertaken and highlighted that the group offered parents a 'safe place to stand' to talk about difficulties; a different perspective on their situation; connection with the skills of other parents; new ideas to introduce more independence to their child; and togetherness within the 'storms' (challenges). CONCLUSIONS The narrative-informed evaluation offered opportunities to further thicken parents' preferred identity stories whilst also contributing to the evidence base of narrative-informed group interventions for parents.
Collapse
Affiliation(s)
| | - Kate Moss
- Royal Manchester Children's Hospital, Manchester, UK
| | - Stewart Rust
- Royal Manchester Children's Hospital, Manchester, UK
| | - James Oliver
- Royal Manchester Children's Hospital, Manchester, UK
| | - Rhian Hughes
- Royal Manchester Children's Hospital, Manchester, UK
| | | | - Daniel Reed
- Royal Manchester Children's Hospital, Manchester, UK
| | - Lucy Ferguson
- Royal Manchester Children's Hospital, Manchester, UK
| | - Joanne Murray
- Royal Manchester Children's Hospital, Manchester, UK
| |
Collapse
|
7
|
Bryon M. Breaking the diagnosis of cystic fibrosis to parents: A process not a one-off event. Paediatr Respir Rev 2020; 35:103-105. [PMID: 32409170 DOI: 10.1016/j.prrv.2020.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/30/2022]
Abstract
Breaking the news to parents that their child has cystic fibrosis [CF] is most frequently given in the first few weeks of the baby's life as a result of newborn screening. This is optimal to reduce morbidity but can have a significant impact on the parents' mental wellbeing and the parent-child relationship. Parent feedback indicates that assimilating the diagnosis is not a one-off event but a process that takes time. CF professionals therefore need to be aware not only of how they communicate the diagnosis initially but also the ways in which families make sense of this throughout at least the following year. The parent-patient-team relationship is essential to good health outcomes. Key objectives of this paper are to enable: (1) understanding parental responses to the diagnosis which can indicate how well they are managing CF for their child, (2) improving the way in which the diagnosis is communicated and, (3) changing team management of CF in the early years to include parental collaboration to support better mental and physical outcomes.
Collapse
Affiliation(s)
- Mandy Bryon
- Great Ormond Street Hospital for Children, London, UK.
| |
Collapse
|
8
|
Prevalence of Depression among Caregivers of Indian Children with Cystic Fibrosis. Indian J Pediatr 2018; 85:974-977. [PMID: 29777470 DOI: 10.1007/s12098-018-2695-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/26/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To study the prevalence of depression among caregivers of children with cystic fibrosis and its impact on the health and well being of these children. METHODS This cross-sectional study was conducted in a tertiary care hospital from September 2015 through August 2016. Forty one parents of children receiving treatment at the Cystic fibrosis (CF) clinic were approached to be part of the study. Six families declined the request resulting in 85% recruitment rate. The Centre for Epidemiological Studies Depression Scale (CES-D) was used to assess depression score among caregivers. The CES-D provides clinical cut-off scores of ≥16 that help in identifying persons at risk for depression. CES-D was completed by the parent closely associated with care of the affected child. Main outcome measure was to find the number of caregivers of patients who has score of ≥16 on CES-D scale, and its effect on growth and respiratory exacerbations of the affected child. RESULTS A total of 23 fathers and 12 mothers participated in the study. The mean age of male and female caregivers was 30.9 ± 5.4 and 27.8 ± 4.7 y respectively. Eighteen (51.4%) caregivers scored above the clinical cut-off on the CES-D in the index study with mean score of 22.0 ± 4.0. The mean CES-D score among non-depressive caregivers was 7.76 ± 4.2. Significant negative association was found between parental depression and child's health. Children with high parental CES-D score suffered significantly more respiratory exacerbations (3.83 ± 1.2 episodes) in last six months than parents with low CES-D score (2.18 ± 1.28 episodes) (p value = 0.00). Similarly, stunting was more commonly seen in patients with high caregiver CES-D score (15 vs. 7; P value = 0.01). CONCLUSIONS A very high prevalence of caregiver depression was found in cystic fibrosis, which negatively impacted care and well being of the affected patients. Depression was more common in families with poor economic and education level.
Collapse
|
9
|
Kopp AT, Chini BA, Dimitriou SM, Grossoehme DH. Body Sanctification and Sleep in Adolescents with Cystic Fibrosis: A Pilot Study. JOURNAL OF RELIGION AND HEALTH 2017; 56:1837-1845. [PMID: 28516396 DOI: 10.1007/s10943-017-0415-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Imbuing one's body with divine significance is associated with health-protective behaviors. The purpose of this study was to determine whether adolescents with a life-shortening, chronic disease (cystic fibrosis) who sanctified their bodies also received adequate sleep. Data from Daily Phone Diaries and questionnaire replies from 45 adolescents with cystic fibrosis (ages 11-19 years) were analyzed. A significant relationship between body sanctification and sleep was found, with between-gender differences. Body sanctification is an understudied construct which is associated with healthy behaviors.
Collapse
Affiliation(s)
- Antonia T Kopp
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, MLC 2021, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Barbara A Chini
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, MLC 2021, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Sophia M Dimitriou
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, MLC 2021, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Daniel H Grossoehme
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, MLC 2021, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
| |
Collapse
|
10
|
Raraigh KS, Pastore MT, Greene L, Karczeski BA, Fisher LK, Ramsey BW, Langfelder-Schwind E. Diagnosis and Treatment of Cystic Fibrosis: A (Not-so) Simple Recessive Condition. CURRENT GENETIC MEDICINE REPORTS 2017. [DOI: 10.1007/s40142-017-0122-9] [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]
|
11
|
Singogo C, Mweshi M, Rhoda A. Challenges experienced by mothers caring for children with cerebral palsy in Zambia. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2015; 71:274. [PMID: 30135879 PMCID: PMC6093109 DOI: 10.4102/sajp.v71i1.274] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/15/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Mothers caring for children with disability experience a number of challenges. AIM The aim of the study was to explore the challenges that mothers who cared for children with cerebral palsy (CP) living in Zambia experienced. METHODS During a qualitative study the experiences of 16 conveniently sampled mothers of children with CP, from the Ndola district in Zambia, were explored by means of interviews. The responses were thematically analysed. All the necessary ethical considerations were upheld. RESULTS Mothers experienced social isolation and marital problems, as well as negative attitudes from family, friends, community members and health care professionals. The physical environment created access challenges because of a lack of sidewalks, ramps, functioning lifts and small indoor spaces. CONCLUSION Mothers of children with CP feel socially isolated owing to a lack of support from family, community members, and health care providers. This social isolation was exacerbated by attitudes of others towards the mothers; it was felt that mothers were responsible for their children's condition. Mothers also experienced marital problems as a result of having a child with CP.
Collapse
Affiliation(s)
- Carol Singogo
- Department of Physiotherapy, University of the Western Cape, South Africa
| | | | - Anthea Rhoda
- Department of Physiotherapy, University of the Western Cape, South Africa
| |
Collapse
|
12
|
Tluczek A, Clark R, McKechnie AC, Brown RL. Factors affecting parent-child relationships one year after positive newborn screening for cystic fibrosis or congenital hypothyroidism. J Dev Behav Pediatr 2015; 36:24-34. [PMID: 25493463 PMCID: PMC4276429 DOI: 10.1097/dbp.0000000000000112] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Examine factors that mediate parent-infant relationships 12 months after positive newborn screening (NBS). METHODS We examined effects of infant diagnosis, parents' perceptions of child vulnerability and child attachment, parental depression and anxiety on parent-infant feeding interactions for 131 mothers and 118 fathers of 131 infants whose NBS and diagnostics confirmed cystic fibrosis (CF, n = 23), congenital hypothyroidism (CH, n = 35), CF carrier status (CF-C, n = 38), or healthy normal NBS (H, n = 35). RESULTS Separate composite indicator structural equation models for mothers and fathers showed that neonatal diagnosis was not associated with increased anxiety or depression. In comparison with the healthy group, CF group parents reported higher perceptions of child vulnerability (p < .001, p = .002), and CF-C group fathers viewed their children as more attached (p = .021). High maternal perception of child vulnerability was associated with low perceptions of child attachment (p = .001), which was associated with task-oriented feeding behavior (p = .016, p = .029). Parental task-oriented feeding behavior was associated with less positive (p < .001, p < .001) and more negative interactions (p < .001, p = .001) with their infants. High paternal perception of child vulnerability was associated with negative parent interactions (p < .001). High parental affective involvement and verbalization was associated with high infant affective expressiveness, communicative skills, and social responsiveness (mothers' p < .001, fathers' p < .001). High parental negative effect and/or inconsistent and intrusive behavior were associated with infant dysregulation and irritability (mothers, p < .001, fathers, p < .001). CONCLUSION The severity of conditions identified through NBS can affect parents' perceptions of their child's vulnerability and attachment. Infant feeding problems in the context of chronic health conditions, like CF, could represent signs of more deeply rooted concerns regarding the parent-child relationship that merit additional clinical evaluation.
Collapse
Affiliation(s)
| | - Roseanne Clark
- School of Medicine and Public Health, Department of Psychiatry
| | | | - Roger L. Brown
- University of Wisconsin-Madison, School of Nursing
- University of Wisconsin-Madison, Department of Family Medicine
| |
Collapse
|
13
|
Tluczek A, Laxova A, Grieve A, Heun A, Brown RL, Rock MJ, Gershan WM, Farrell PM. Long-term follow-up of cystic fibrosis newborn screening: psychosocial functioning of adolescents and young adults. J Cyst Fibros 2013; 13:227-34. [PMID: 24157354 DOI: 10.1016/j.jcf.2013.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/30/2013] [Accepted: 10/02/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Long-term psychosocial outcomes of cystic fibrosis (CF) patients diagnosed through newborn screening remain unknown. METHODS This cross-sectional study compared three groups of youths (16 to 22 years): CF patients diagnosed through NBS (CF-NBS, n = 13), CF patients diagnosed through standard practice (CF-SP, n = 26) and healthy peers (H, n = 42), plus 72 of their parents. We hypothesized that adolescent psychological functioning would be mediated by parent depression and quality of parent-child communication and cohesiveness. RESULTS A path analysis showed significantly more depression among CF-NBS group parents (p = .006-.008). Parent-child cohesiveness was related to communication (p < .001). Cohesiveness and communication were associated with youth Internalizing Problems (p = .037, p = .009), Emotional Symptoms (p = 0.018, p = 0.022), and Personal Adjustment (communication only, p = 0.009). Parent depression was related to youth Personal Adjustment (p = 0.022). CONCLUSIONS CF patients report psychosocial function similar to healthy peers. Parents of children diagnosed with CF through NBS may be at risk for depressive symptoms when their children reach adolescence.
Collapse
Affiliation(s)
- Audrey Tluczek
- University of Wisconsin, School of Nursing, Madison, WI, United States; University of Wisconsin, School of Medicine and Public Health, Department of Pediatrics, Madison, WI, United States.
| | - Anita Laxova
- University of Wisconsin, School of Medicine and Public Health, Department of Pediatrics, Madison, WI, United States
| | - Adam Grieve
- University of Wisconsin, School of Medicine and Public Health, Department of Psychiatry, Madison, WI, United States
| | - Anne Heun
- Iowa Health Des Moines, Blank Children's Hospital and John Stoddard Cancer Center, Des Moines, IA, United States
| | - Roger L Brown
- University of Wisconsin, School of Nursing, Madison, WI, United States
| | - Michael J Rock
- University of Wisconsin, School of Medicine and Public Health, Department of Pediatrics, Madison, WI, United States
| | - William M Gershan
- University of Utah, School of Medicine, Department of Pediatrics, Salt Lake City, UT, United States
| | - Philip M Farrell
- University of Wisconsin, School of Medicine and Public Health, Department of Pediatrics, Madison, WI, United States
| |
Collapse
|
14
|
Grossoehme DH, Ragsdale JR, Snow A, Seid M. We were chosen as a family: parents' evolving use of religion when their child has cystic fibrosis. JOURNAL OF RELIGION AND HEALTH 2012; 51:1347-58. [PMID: 21409481 PMCID: PMC4609445 DOI: 10.1007/s10943-011-9477-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Parental coping with new CF diagnoses often includes religion; however, little is known about how the use of religion changes over time. Longitudinal grounded theory method, in which parents were interviewed twice the 2 years after their child's diagnosis, was used. Parents constructed the meaning that parenting a child with CF is their vocation, in accordance with "God's plan." A shift from isolation to an outward focus and reentry into the community was clear. The use of faith evolved over time and continues to be a source of support and hope for parents. Clinical implications of parental religion are discussed.
Collapse
Affiliation(s)
- Daniel H Grossoehme
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | | | | | | |
Collapse
|
15
|
Abstract
Cystic fibrosis (CF) is a multisystemic life-limiting genetic disorder, primarily affecting respiratory functioning. Most patients with CF are diagnosed by 2 years of age, and the current median predicted survival rate is 37.4 years old, with 95% of patients dying from complications related to pulmonary infection. Given the chronic, progressive, and disabling nature of CF, multiple treatments are prescribed, most on a daily basis. Thus, this illness requires children, with the aid of their families, to adopt multiple health-related behaviors in addition to managing more typical developmental demands. The morbidity and mortality factors pose cognitive, emotional, and behavioral challenges for many children with CF and their families. This article applies a developmental perspective to describing the psychosocial factors affecting psychological adjustment and health-related behaviors relevant to infants, preschool and school-age children, and adolescents with CF. Topics particularly pertinent to developmental periods and medical milestones are noted, with clinical implications highlighted.
Collapse
Affiliation(s)
- Michelle M Ernst
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
| | | | | |
Collapse
|
16
|
Besier T, Born A, Henrich G, Hinz A, Quittner AL, Goldbeck L. Anxiety, depression, and life satisfaction in parents caring for children with cystic fibrosis. Pediatr Pulmonol 2011; 46:672-82. [PMID: 21384564 DOI: 10.1002/ppul.21423] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 12/27/2010] [Accepted: 12/27/2010] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the prevalence of symptoms of anxiety and depression and the extent of life satisfaction in parents caring for children with cystic fibrosis (CF) in Germany. METHODS The study included 650 caregivers of 564 children with CF ages 0-17, who completed the Hospital Anxiety Depression Scale (HADS), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Questions on Life Satisfaction (FLZ(M) ). RESULTS More than one-third (37.2%) of parents showed elevated levels of anxious symptoms, compared to 18.9% of a population sample (P≤0.001) and significantly more parents reported elevated levels of depressive symptoms compared to a community sample (28% vs. 21%, P=0.01). Higher levels of anxious and depressive symptoms were associated with lower life satisfaction (P<0.001). CONCLUSIONS High levels of anxious and depressive symptoms among parents of children with CF suggested that annual symptom screening is warranted. This will facilitate identification of those at risk and provide referrals and intervention for those who are in need of it.
Collapse
Affiliation(s)
- Tanja Besier
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Steinhoevelstrasse 5, Ulm, Germany.
| | | | | | | | | | | | | |
Collapse
|
17
|
McCullough C, Price J. Caring for a child with cystic fibrosis: the children's nurse's role. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2011; 20:164-7. [PMID: 21378637 DOI: 10.12968/bjon.2011.20.3.164] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article presents a narrative literature review of the psychosocial impact on family life of caring for a child diagnosed with cystic fibrosis. Diagnosis of long-term illness in a child causes major upheaval in the lives of both the child and family. Normal family life is often emotionally, socially, physically and financially disrupted. Amid such disruption, parents attempt to cope by creating a semblance of order in their lifestyle. Within an interdisciplinary approach to caring, the children's nurse plays a pivotal role in supporting families to establish such order and reconstruct their lives, while coming to terms with the knowledge that their child could die prematurely. In addition, the nurse, in his/her role as teacher and educator, empowers parents, children and young people with the knowledge to make informed decisions and assists parents in developing the skills (often technical) to care for their child. Cystic fibrosis is one such condition in childhood, and this article explores the main psychosocial issues experienced by families caring for their child following diagnosis of CF, as raised in the literature.
Collapse
|
18
|
Grossoehme DH, Ragsdale J, Wooldridge JL, Cotton S, Seid M. We can handle this: parents' use of religion in the first year following their child's diagnosis with cystic fibrosis. J Health Care Chaplain 2010; 16:95-108. [PMID: 20658424 DOI: 10.1080/08854726.2010.480833] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The diagnosis of a child's life-shortening disease leads many American parents to utilize religious beliefs. Models relating religious constructs to health have been proposed. Still lacking are inductive models based on parent experience. The specific aims of this study were: 1. develop a grounded theory of parental use of religion in the year after diagnosis; 2. describe whether parents understand a relationship between their religious beliefs and their follow-through with their child's at-home treatment regimen. Fifteen parent interviews were analyzed using grounded theory method. Parents used religion to make meaning of their child's cystic fibrosis (CF) diagnosis. Parents imagined God as active, benevolent, and interventionist; found hope in their beliefs; felt supported by God; and related religion to their motivation to adhere to their child's treatment plan. Religious beliefs are clinically significant in working with many parents of children recently diagnosed with CF. Interventions that improve adherence to treatment may be enhanced by including religious aspects.
Collapse
Affiliation(s)
- Daniel H Grossoehme
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
| | | | | | | | | |
Collapse
|
19
|
Smith BA, Modi AC, Quittner AL, Wood BL. Depressive symptoms in children with cystic fibrosis and parents and its effects on adherence to airway clearance. Pediatr Pulmonol 2010; 45:756-63. [PMID: 20597082 DOI: 10.1002/ppul.21238] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Little is currently known about the co-morbidity of depression and cystic fibrosis (CF) and there is currently no empirical research on the effects of depressive symptoms on adherence in children and adolescents with CF. The primary aim of this study was to evaluate the extent of depressive symptoms in children and adolescents with CF and their parents, and determine whether depressive symptoms in the child and/or parent was associated with adherence to airway clearance. We also evaluated whether children's perceptions of relational security with a parent were associated with adherence to airway clearance. METHODS Participants included 39 children with CF ages 7-17 years and their primary caregivers. Depressive symptoms were measured with the Children's Depression Inventory (CDI) and the Center for Epidemiological Studies-Depression Scale (CES-D). The Relatedness Questionnaire assessed the quality of parent-child relational security. Adherence to airway clearance was measured using the daily phone diary (DPD), an empirically validated adherence measure for youth with CF. RESULTS Rates of depressive symptoms were elevated in children with CF and their parents (29% for children; 35% for mothers; 23% for fathers). Child depressive symptoms were significantly associated with lower rates of adherence to airway clearance, after controlling for demographic variables (r = -0.34, P = 0.02). Child depressive symptoms were associated with worse perceptions of parental relationships (t(35) = 3.2; P = 0.002) and the quality of this relationship was also related to worse adherence (r = 0.42, P = 0.005). CONCLUSIONS A large percentage of youth with CF and their parents reported elevated symptoms of depression. Children scoring in the depressed range on a standardized screening measure and those with less secure parent-child relationships were at greatest risk for poor adherence. Thus, depressive symptoms and family relationships are appropriate targets for adherence promotion interventions, which may ultimately improve health outcomes.
Collapse
Affiliation(s)
- Beth A Smith
- Division of Child and Adolescent Psychiatry, State University of New York at Buffalo, Buffalo, New York 14222, USA.
| | | | | | | |
Collapse
|
20
|
Grossoehme DH, Ragsdale J, Cotton S, Wooldridge JL, Grimes L, Seid M. Parents' religious coping styles in the first year after their child's cystic fibrosis diagnosis. J Health Care Chaplain 2010; 16:109-22. [PMID: 20658425 DOI: 10.1080/08854726.2010.480836] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Parents of children diagnosed with cystic fibrosis described it as "devastating." Given religion's importance to many Americans, parents may utilize religious coping. Relatively little is known about parents' use of religious coping to handle their child's illness. Interviews with 15 parents about their use of religion in the year following their child's cystic fibrosis diagnosis were coded for religious coping styles. Sixteen styles were identified. Positive religious coping styles were more frequent than negative styles (previously associated with poorer health outcomes), and occurred more frequently than in other studies. Religious coping styles used to make meaning, gain control, or seek comfort/intimacy with God were equally prevalent. The most common styles were: Pleading, Collaboration, Benevolent Religious Reappraisals, and Seeking Spiritual Support. Parents described active rather than passive coping styles. Religious coping involving religious others was rare. Clinical attention to negative religious coping may prevent it becoming chronic and negatively affecting health.
Collapse
Affiliation(s)
- Daniel H Grossoehme
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
| | | | | | | | | | | |
Collapse
|
21
|
Tluczek A, Clark R, McKechnie AC, Orland KM, Brown RL. Task-oriented and bottle feeding adversely affect the quality of mother-infant interactions after abnormal newborn screens. J Dev Behav Pediatr 2010; 31:414-26. [PMID: 20495477 PMCID: PMC2946358 DOI: 10.1097/dbp.0b013e3181dd5049] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine effects of newborn screening and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding. METHODS Study compared the quality of mother-infant feeding interactions among 4 groups of infants classified by severity of newborn screening and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal newborn screening. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3 to 19 weeks (M = 9.19, SD = 3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety. RESULTS Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality. CONCLUSIONS Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding after a neonatal CF diagnosis.
Collapse
Affiliation(s)
- Audrey Tluczek
- School of Nursing, University of Wisconsin, Madison, Wisconsin 53792, USA.
| | | | | | | | | |
Collapse
|
22
|
Abstract
Cystic fibrosis (CF) is a multisystemic life-limiting genetic disorder, primarily affecting respiratory functioning. Most patients with CF are diagnosed by 2 years of age, and the current median predicted survival rate is 37.4 years old, with 95% of patients dying from complications related to pulmonary infection. Given the chronic, progressive, and disabling nature of CF, multiple treatments are prescribed, most on a daily basis. Thus, this illness requires children, with the aid of their families, to adopt multiple health-related behaviors in addition to managing more typical developmental demands. The morbidity and mortality factors pose cognitive, emotional, and behavioral challenges for many children with CF and their families. This article applies a developmental perspective to describing the psychosocial factors affecting psychological adjustment and health-related behaviors relevant to infants, preschool and school-age children, and adolescents with CF. Topics particularly pertinent to developmental periods and medical milestones are noted, with clinical implications highlighted.
Collapse
Affiliation(s)
- Michelle M. Ernst
- Assistant Professor, Division of Behavioral Medicine and Clinical Psychology,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Mark C. Johnson
- Assistant Professor, Division of Child and Adolescent Psychiatry,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lori J. Stark
- Professor, Division of Behavioral Medicine and Clinical Psychology,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| |
Collapse
|
23
|
Driscoll KA, Johnson SB, Barker D, Quittner AL, Deeb LC, Geller DE, Gondor M, Silverstein JH. Risk factors associated with depressive symptoms in caregivers of children with type 1 diabetes or cystic fibrosis. J Pediatr Psychol 2010; 35:814-22. [PMID: 20097908 DOI: 10.1093/jpepsy/jsp138] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Evaluate depressive symptoms in caregivers of children with type 1 diabetes (T1D) or cystic fibrosis (CF) and identify associated risk factors. METHODS A total of 195 caregivers completed demographic, stress, and depressive symptoms questionnaires. Children's health status was obtained from medical records. RESULTS Approximately 33% of caregivers reported elevated symptoms of depression (i.e., exceeded clinical cutoff of 16 on the Center for Epidemiological Studies-Depression Scale). For caregivers of children with T1D, elevations were associated with less caregiver education, more family stress, older child age, and worse glycemic control. For caregivers of children with CF, more family stress and lack of employment outside of the home were associated with elevated depressive symptoms. CONCLUSIONS Many caregivers of children with T1D or CF experience depressive symptoms, although risk factors may differ in these two populations. Screening of caregiver depressive symptoms as part of routine clinic visits may provide opportunities for needed intervention.
Collapse
Affiliation(s)
- Kimberly A Driscoll
- Florida State University College of Medicine, Department of Medical Humanities and Social Sciences, Tallahassee, FL 32306, USA.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Driscoll KA, Montag-Leifling K, Acton JD, Modi AC. Relations between depressive and anxious symptoms and quality of life in caregivers of children with cystic fibrosis. Pediatr Pulmonol 2009; 44:784-92. [PMID: 19598276 PMCID: PMC3102434 DOI: 10.1002/ppul.21057] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Little is known about depressive and anxious symptoms and quality of life (QOL) in caregivers of children with cystic fibrosis (CF). The aims of this study were to: (1) assess rates of female and male caregiver depressive and anxious symptoms, and (2) evaluate relations between depressive and anxious symptoms, caregiver QOL, and health outcomes. PATIENTS AND METHODS Eligible participants were caregivers of children with CF who completed three questionnaires assessing depressive and anxious symptoms and caregiver QOL during routine CF Clinic appointments. RESULTS Rates of depressive and anxious symptoms were elevated in female and male caregivers of children with CF. Rates were higher for anxious (51% for females, 43% for males) than depressive symptoms (20-28% for females; 14-31% for males). Female caregiver depressive symptoms increased as child lung functioning decreased. As depressive and anxious symptoms increased, caregiver QOL decreased. In addition, female caregiver depressive and anxious symptoms were positively correlated with male caregiver anxious and depressive symptoms in a small subsample of couples. CF disease severity and caregiver depressive symptoms predicted caregiver QOL. CONCLUSION Rates of depressive and anxious symptoms are high among caregivers of children with CF. The results of this study highlight the need to screen for female and male caregiver depressive and anxious symptoms in the CF Clinic as CF Team members are well positioned to provided assistance around solving CF-related challenges. In addition, alleviation of depressive and anxious symptoms could potentially lead to improvements in the psychological functioning and well-being of caregivers of children with CF.
Collapse
Affiliation(s)
- Kimberly A Driscoll
- Department of Medical Humanities and Social Sciences, Florida State University, Tallahassee, Florida, USA.
| | | | | | | |
Collapse
|
25
|
Current World Literature. Curr Opin Pulm Med 2008; 14:600-2. [DOI: 10.1097/mcp.0b013e328316ea6b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
26
|
|
27
|
Yilmaz O, Sogut A, Gulle S, Can D, Ertan P, Yuksel H. Sleep quality and depression-anxiety in mothers of children with two chronic respiratory diseases: asthma and cystic fibrosis. J Cyst Fibros 2008; 7:495-500. [PMID: 18585104 DOI: 10.1016/j.jcf.2008.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 05/13/2008] [Accepted: 05/15/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sleep quality and psychological well being of parents are expected to be influenced by the child's health and disease status. The aim of this study was to compare sleep quality and depression-anxiety parameters in mothers of children with cystic fibrosis (CF) asthma and healthy controls. METHODS The study included mothers of 62 children with asthma, 21 children with CF and 35 healthy children. All mothers filled in the Pittsburgh Sleep Quality Index (PSQI) questionnaire and hospital anxiety depression scale (HADS). RESULTS Comparison of the three groups with Kruskall Wallis analysis demonstrated that subjective sleep, sleep efficiency and total PSQI scores were significantly different between the groups (p=0.02, p=0.01 and p=0.04 respectively). Comparisons of the groups in pairs with Mann Whitney U test with Bonferroni correction revealed that subjective sleep quality scores in mothers of children with asthma were significantly higher than the ones in the control group (1.0+/-0.9 vs 0.6+/-0.7, p=0.015). The other PSQI scores as well as the anxiety and depression scores were higher in CF and asthma groups when compared to the control group but did not reach statistical significance. Anxiety and depression scores were significantly correlated with PSQI total score in CF (rho=0.54 and 0.49 respectively) and asthma groups (rho=0.45 and 0.60 respectively) but not in the control group. CONCLUSION In conclusion, presence of a chronic respiratory disease in a child may be associated with disturbed sleep quality and increased depression and anxiety in mothers.
Collapse
Affiliation(s)
- Ozge Yilmaz
- Celal Bayar University, Medical Faculty, Dept. of Pediatric Allergy and Pulmonology, Manisa, Turkey.
| | | | | | | | | | | |
Collapse
|
28
|
Correlates of Maternal and Paternal Adjustment to Chronic Childhood Disease. J Clin Psychol Med Settings 2007. [DOI: 10.1007/s10880-007-9069-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|