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Sleath B, Beznos B, Carpenter D, Thomas K, Annis I, Tudor G, Garcia N, Adjei A, Anastopoulos A, Leslie L, Coyne I. A pre-visit video/question prompt list intervention to increase youth question-asking about attention deficit hyperactivity disorder during pediatric visits. PATIENT EDUCATION AND COUNSELING 2024; 127:108320. [PMID: 38851012 DOI: 10.1016/j.pec.2024.108320] [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: 09/17/2023] [Revised: 04/09/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To conduct a pragmatic randomized controlled trial to test the effectiveness of an ADHD question prompt list with video intervention to increase youth question-asking and provider education about ADHD during visits. METHODS English-speaking youth ages 11-17 with ADHD and their caregivers were enrolled from two pediatric clinics. Youth were randomized to intervention or usual care groups. Intervention group adolescents watched the video and then completed an ADHD question prompt list before their visits. Multivariable regression was used to analyze the data. RESULTS Twenty-one providers and 102 of their patients participated. Intervention group youth were significantly more likely to ask one or more questions about ADHD and its treatment than usual care youth (odds ratio=5.4, 95 % Confidence Interval (CI)= 1.8, 15.9). Providers were significantly more likely to educate youth who asked one or more questions during visits about more ADHD medication areas (unstandardized beta=0.98, 95 % CI=0.31 to 1.64) and more non-medication strategies for ADHD (unstandardized beta=0.50, 95 % CI=0.13 to 0.88). CONCLUSION The intervention increased youth question-asking about ADHD and its treatment. Providers provided more education to youth who asked one or more questions about ADHD and its treatment. PRACTICE IMPLICATIONS Providers and practices should consider having youth complete ADHD question prompt lists and watch the video before visits to increase youth question-asking during visits.
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Affiliation(s)
- Betsy Sleath
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Bethany Beznos
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | - Delesha Carpenter
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Kathleen Thomas
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Izabela Annis
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | - Gail Tudor
- Southern New Hampshire University, Manchester, NH, USA.
| | - Nacire Garcia
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
| | - Abena Adjei
- Department of Pharmaceutical Outcomes and Policy, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | | | - Laurel Leslie
- American Board of Pediatrics, Chapel Hill, NC, USA; Tufts University School of Medicine, Boston, MA, USA.
| | - Imelda Coyne
- Trinity College Dublin, College Green, Dublin 2, Ireland.
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Duss I, Rüdisüli C, Wustmann Seiler C, Lannen P. Playfulness from children's perspectives: development and validation of the Children's Playfulness Scale as a self-report instrument for children from 3 years of age. Front Psychol 2023; 14:1287274. [PMID: 38115980 PMCID: PMC10728552 DOI: 10.3389/fpsyg.2023.1287274] [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: 09/01/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Children's playfulness refers to children's enjoyment, motivation, and engagement in play and has been predominantly assessed from an adult perspective. To assess children's perspectives on their own playfulness, we adapted and modified the Children's Playfulness Scale (CPS) for children from 3 years and used a two-level response format with a total of four answer options. We tested the self-report scale with 564 children between 3 and 8 years of age who attended childcare center or kindergarten. Results indicated that the adapted version of the CPS identified the five distinct domains of playfulness: social spontaneity, cognitive spontaneity, physical spontaneity, sense of humor, and manifest joy; furthermore, results showed invariance across multiple groups for gender, age, and language skills. A highly significant positive correlation was found between children's self-reported playfulness and children's self-reported social self-concept (r = 0.54, p < 0.001), which demonstrates convergent validity. No association was found with teacher proxy report of children's playfulness (r = 0.03, p = 0.92). Overall, our study confirmed first indications of the validity of the modified CPS as a reliable instrument for assessing children's self-reported playfulness. This enables children as young as 3 years old to be assessed on their own playfulness, which is a valuable supplement to the adult perspective.
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Affiliation(s)
- Isabelle Duss
- Marie Meierhofer Children’s Institute, Associated Institute of the University of Zurich, Zürich, Switzerland
| | | | | | - Patricia Lannen
- Marie Meierhofer Children’s Institute, Associated Institute of the University of Zurich, Zürich, Switzerland
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Chodavadia P, Teo I, Poremski D, Fung DSS, Finkelstein EA. Healthcare utilization and costs of singaporean youth with symptoms of depression and anxiety: results from a 2022 web panel. Child Adolesc Psychiatry Ment Health 2023; 17:60. [PMID: 37170138 PMCID: PMC10173927 DOI: 10.1186/s13034-023-00604-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/14/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND There is evidence that the prevalence of depression and anxiety among youth is increasing and that these factors contribute to high healthcare costs and poor school performance. The goal of this study is to provide up-to-date estimates of the prevalence and economic burden of depression and anxiety among youth in Singapore. METHODS Using an existing web panel, 991 parents filled out the PHQ-4 screener on behalf of 1,515 youth. 104 of these parents whose children (ages 4 to 21) had symptoms consistent with depression or anxiety filled out a full survey with questions on mental health symptoms, school absences, school performance, and healthcare utilization. The survey was fielded between April and June 2022. Publicly available prices were used to estimate the cost associated with the observed rates of health service use. FINDINGS Based on parental responses, 11.7% (95% CI:10.2 - 13.5%) of youth had symptoms consistent with depression and 12.8% (95% CI:11.2 - 14.6%) had symptoms consistent with anxiety. In total, 16.2% (95% CI:14.5 - 18.3%) were reported to have symptoms consistent with at least one of these conditions. These youths missed an average of 190 (95% CI: 126-254) hours of school per year due to their mental health conditions and parents reported that school and daily activities performance was significantly degraded. Per capita annual healthcare costs averaged S$10,250 (95% CI: 7,150-13,350), with 64% of youth receiving emergency or inpatient services. In aggregate, annual costs associated with these conditions were estimated to be S$1.2 billion (95% CI:S$1.1bn - S$1.4bn). INTERPRETATION Even with significant potential for underreporting, these results reveal concerning rates of Singaporean youth with symptoms consistent with depression or anxiety, many of whom remain untreated. Results also reveal the short-term economic burden caused by these symptoms and hint at longer-term consequences resulting from poor school performance. This study should represent a call to action for Singapore to address poor mental health among youth.
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Affiliation(s)
- Parth Chodavadia
- Duke University School of Medicine, 8 Searle Center Drive, Durham, NC, 27705, USA
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore
| | | | | | - Eric A Finkelstein
- Duke University School of Medicine, 8 Searle Center Drive, Durham, NC, 27705, USA.
- Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore.
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A Machine Learning Approach to Assess Differential Item Functioning of the KINDL Quality of Life Questionnaire Across Children with and Without ADHD. Child Psychiatry Hum Dev 2022; 53:980-991. [PMID: 33963488 DOI: 10.1007/s10578-021-01179-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to investigate differential item functioning (DIF) of the child and parent reports of the KINDL measure across children with and without Attention-deficit/hyperactivity disorder (ADHD). The sample included 122 children with ADHD and 1086 healthy peers, alongside 127 and 1061 of their parents, respectively. The generalized partial credit model with lasso penalization, as a machine learning method, was used to assess DIF of the KINDL across the two groups. The findings showed that three out of 24 items of the child reports and seven out of 24 items of the parent reports of the KINDL exhibited DIF between children with and without ADHD. Accordingly, Iranian children with and without ADHD along with their parents perceive almost all items in the KINDL similarly. Hence, the observed difference in quality of life scores between children with and without ADHD is a real difference and not a reflection of measurement bias.
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Takura T, Koike T, Matsuo Y, Sekimoto A, Mutou M. Proxy responses regarding quality of life of patients with terminal lung cancer: preliminary results from a prospective observational study. BMJ Open 2022; 12:e048232. [PMID: 35210333 PMCID: PMC8883223 DOI: 10.1136/bmjopen-2020-048232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE This prospective study used the EQ-5D utility and Visual Analogue Scale (VAS) scores to analyse the potential usefulness of proxy responses in quality of life assessments of Japanese patients with terminal lung cancer sufficiently healthy to communicate and reply by themselves. We did not investigate the potential usefulness of using proxy responses for patients who could not respond by themselves. DESIGN A prospective observational study. SETTING Single centre. PARTICIPANTS The EQ-5D and VAS responses were gathered from 30 in-hospital patients with lung cancer for a total of three observation points. At nearly the same time, two nurses responded by providing proxy responses. PRIMARY AND SECONDARY OUTCOME MEASURES EQ-5D and VAS responses. RESULTS There were no significant differences between the patients' and nurses' responses for EQ-5D utility and VAS scores. For the five dimensions of the EQ-5D, significant differences were found between the patients' and nurses' responses for usual activities (patients' response 1.64±0.07, nurses' response 1.41±0.05, p=0.03) and anxiety/depression (patients' response: 1.40±0.05, nurses' response: 1.19±0.03, p=0.02). There was a significant weak positive correlation between patients' and nurses' responses regarding changes in responses from the first to the third observation point (Spearman's rank correlation coefficient ρ=0.228; p<0.01). CONCLUSION The results suggest that proxy responses are useful because there were no significant differences between the patients' and nurses' responses for EQ-5D utility and VAS scores at the three observation points. These findings should, however, be verified in future large-scale trials.
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Affiliation(s)
- Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Tomoko Koike
- Keio University Faculty of Nursing And Medical Care Graduate School of Health Management, Fujisawa, Kanagawa, Japan
| | - Yoko Matsuo
- W. L. Gore & Associates, G.K, Minato-ku, Tokyo, Japan
| | | | - Masami Mutou
- National Cancer Center-Hospital East, Kashiwa, Chiba, Japan
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Alamolhoda M, Farjami M, Bagheri Z, Ghanizadeh A, Jafari P. Assessing whether child and parent reports of the KINDL questionnaire measure the same constructs of quality of life in children with attention-deficit hyperactivity disorder. Health Qual Life Outcomes 2021; 19:19. [PMID: 33446186 PMCID: PMC7809741 DOI: 10.1186/s12955-020-01649-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Discrepancy between child self-report and parent proxy-report has long been documented in the health-related quality of life (HRQoL) measurement of children with chronic health conditions. This study aims to assess whether child and parent reports of the Kinder Lebensqualität fragebogen (KINDL) questionnaire measure the same construct of HRQoL in children with attention-deficit hyperactivity disorders (ADHD). Methods Participants were 122 Iranian children with ADHD and 127 of their parents, who completed the child and parent reports of the KINDL, respectively. Internal consistency of the child and parent reports were assessed by Cronbach's alpha. The intra-class correlation (ICC) coefficient and factor analysis were applied to assess whether the child self-report and the parent proxy-report measured the same construct of HRQoL. Additionally, convergent and discriminant validity were assessed using the Spearman correlation. Results The results of factor analysis revealed that the child self-report and parent proxy-report measure two different aspects of HRQoL. Moreover, both versions of the KINDL instrument showed excellent convergent and discriminant validity. The internal consistency was close to or greater than 0.7 for all domains of both child and parent reports. Conclusions Although the child self-report and the parent proxy-report of the Persian version of the KINDL have good psychometric properties, they are not interchangeable. This finding indicates that Iranian children with ADHD and their parents evaluate children's HRQoL from their own viewpoints.
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Affiliation(s)
- Marzieh Alamolhoda
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Farjami
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Bagheri
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Ghanizadeh
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran.
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Machado-Nascimento N, Kümmer AME, Lemos SMA. Relationship between symptoms of attention-deficit/hyperactivity disorder and speech-language-hearing aspects. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/202123212120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Purpose: to investigate the association of symptoms of inattention and hyperactivity with language development and cognitive, environmental, socioeconomic, and quality of life aspects in children with attention-deficit/hyperactivity disorder. Methods: an observational, analytical, cross-sectional study with a sex-stratified sample of 38 children 7 to 12 years old, diagnosed with attention-deficit/hyperactivity disorder. The assessments approached sociodemographic and environmental aspects, the quality of life, language comprehension, rapid automatic naming, phonological working memory, vocabulary, reading and writing processes and metalinguistic skills. Descriptive and bivariate analyses were conducted at the 5% significance level. Results: there was a statistically significant association between the profile of attention-deficit/hyperactivity disorder and behavioral aspects. There was no significant association of the forms of manifestation of attention-deficit/hyperactivity disorder with the quality of life, oral language, written language and phonological processing skills. Conclusion: children with hyperactive profiles had a better performance, whereas children with combined and predominantly inattentive profiles had similar performances. Although no statistically significant associations were found between attention-deficit/hyperactivity disorder and most of the variables analyzed in this research, it contributes to the discussion of the speech-language-hearing diagnosis.
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Mierau JO, Kann-Weedage D, Hoekstra PJ, Spiegelaar L, Jansen DEMC, Vermeulen KM, Reijneveld SA, van den Hoofdakker BJ, Buskens E, van den Akker-van Marle ME, Dirksen CD, Groenman AP. Assessing quality of life in psychosocial and mental health disorders in children: a comprehensive overview and appraisal of generic health related quality of life measures. BMC Pediatr 2020; 20:329. [PMID: 32620157 PMCID: PMC7333319 DOI: 10.1186/s12887-020-02220-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/22/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Mental health problems often arise in childhood and adolescence and can have detrimental effects on people's quality of life (QoL). Therefore, it is of great importance for clinicians, policymakers and researchers to adequately measure QoL in children. With this review, we aim to provide an overview of existing generic measures of QoL suitable for economic evaluations in children with mental health problems. METHODS First, we undertook a meta-review of QoL instruments in which we identified all relevant instruments. Next, we performed a systematic review of the psychometric properties of the identified instruments. Lastly, the results were summarized in a decision tree. RESULTS This review provides an overview of these 22 generic instruments available to measure QoL in children with psychosocial and or mental health problems and their psychometric properties. A systematic search into the psychometric quality of these instruments found 195 suitable papers, of which 30 assessed psychometric quality in child and adolescent mental health. CONCLUSIONS We found that none of the instruments was perfect for use in economic evaluation of child and adolescent mental health care as all instruments had disadvantages, ranging from lack of psychometric research, no proxy version, not being suitable for young children, no age-specific value set for children under 18, to insufficient focus on relevant domains (e.g. social and emotional domains).
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Affiliation(s)
- Jochen O Mierau
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
- Aletta Jacobs School of Public Health, Groningen, The Netherlands
| | | | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lisan Spiegelaar
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik Buskens
- University Medical Center Groningen and Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - M Elske van den Akker-van Marle
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Carmen D Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Annabeth P Groenman
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, freepostnumber 176, 9700VB, Groningen, The Netherlands.
- Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.
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Bentley N, Hartley S, Bucci S. Systematic Review of Self-Report Measures of General Mental Health and Wellbeing in Adolescent Mental Health. Clin Child Fam Psychol Rev 2020; 22:225-252. [PMID: 30617936 DOI: 10.1007/s10567-018-00273-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The assessment of general mental health and wellbeing is important within child and adolescent mental health services (CAMHS) for both clinicians and policy makers. Measurement tools are routinely relied upon to aid assessment and to monitor and evaluate treatment and service effectiveness. We conducted a systematic review using the COSMIN checklist to identify measures of general mental health and wellbeing for an adolescent mental health population. A systematic database search was performed using PsychINFO, MEDLINE, EMBASE, and CINAHL in accordance with PRISMA guidelines. Database searching produced 9587 records, with 27 papers meeting eligibility criteria and 16 measures identified and critically appraised. The Y-QOL-R and the Y-QOL.30.1 had the most robust psychometric properties. When considering the clinical utility of measures alongside psychometric properties of measures, the GHQ-12, ORS and YP CORE had the greatest clinical utility. The psychometric quality of measures reviewed overall, however, were generally poor in quality. Measuring outcomes in CAMHS and ensuring appropriate treatment pathways for young people is important. This review highlights the need for more robust testing of the psychometric properties of adolescent measures. When selecting measurement tools, clinicians should not only consider the purpose of the measure, (i.e., discriminative, predictive, and evaluative) and characteristics of the instrument (e.g., intended population, measure length), but should also the quality of the psychometric properties of the instrument.
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Affiliation(s)
- Natalie Bentley
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
| | - Samantha Hartley
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.,Pennine Care NHS Foundation Trust, Manchester, M13 9PL, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. .,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
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Macek J, Battelino T, Bizjak M, Zupanc C, Bograf AK, Vesnic S, Klemencic S, Volk E, Bratina N. Impact of attention deficit hyperactivity disorder on metabolic control in adolescents with type1 diabetes. J Psychosom Res 2019; 126:109816. [PMID: 31493719 DOI: 10.1016/j.jpsychores.2019.109816] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Diabetes mellitus type 1 (T1D) incidence is increasing in pediatric population. Good metabolic control, measured by glycated hemoglobin (HbA1c), significantly reduces the risk for chronic complications. Comorbid disorders, including attention-deficit hyperactivity disorder (ADHD), may influence glycemic control. To date little is known about the prevalence of ADHD among adolescents with T1D and its influence on diabetes self-management. Therefore, we aimed to identify adolescents with T1D and ADHD and assess the effect of ADHD on metabolic control. METHOD This cross-sectional case-control study included 101 patients (11-17 years old) with T1D. Development and Well-Being Assessment (DAWBA) questionnaire and subsequent psychiatric clinical examination were used to identify ADHD in a group with T1D. Indicators of metabolic control were collected from available medical documentation for preceding 12 months and compared between the group of patients with T1D and ADHD and the group of T1D patients without ADHD. RESULTS ADHD was diagnosed in 11.9% adolescents with T1D (12 of 101). We found a statistically significant difference (p = .022) in HbA1c between the two groups - higher in the group with T1D and ADHD (8.4% or 68.3 mmol/mol) than in the group with T1D without ADHD (7.8% or 61.7 mmol/mol). CONCLUSIONS Almost 12% of adolescents with type 1 diabetes were diagnosed with ADHD and they had poorer glycemic control. Adolescents with T1D and ADHD must be diagnosed early and offered appropriate treatment focused on preventing negative ADHD impact on metabolic control.
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Affiliation(s)
- Jerneja Macek
- Department of Child Psychiatry, University Children's Hospital, University Medical Center Ljubljana, Bohoriceva 20, Ljubljana, Slovenia.
| | - Tadej Battelino
- Clinical Department of Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Center Ljubljana, Bohoriceva 20, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Masa Bizjak
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Cita Zupanc
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Ana Kovac Bograf
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Sabina Vesnic
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Simona Klemencic
- Clinical Department of Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Center Ljubljana, Bohoriceva 20, Ljubljana, Slovenia
| | - Eva Volk
- Clinical Department of Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Center Ljubljana, Bohoriceva 20, Ljubljana, Slovenia
| | - Natasa Bratina
- Clinical Department of Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Center Ljubljana, Bohoriceva 20, Ljubljana, Slovenia
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Yazar A, Akın F, Akça ÖF, Eklioğlu BS, Türe E, Coşkun F, Atabek ME. The effect of attention deficit/hyperactivity disorder and other psychiatric disorders on the treatment of pediatric diabetes mellitus. Pediatr Diabetes 2019; 20:345-352. [PMID: 30652399 DOI: 10.1111/pedi.12819] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/01/2018] [Accepted: 12/17/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Psychiatric diagnoses of patients with type 1 diabetes mellitus (T1DM), the severity of attention deficit/hyperactivity disorder (ADHD) symptoms of the patients and their primary caregivers, and the effects of these factors on treatment were investigated. METHODS Sixty-one patients with T1DM were included in the study along with their parents. Psychiatric diagnoses of the patients were determined using a semistructured psychiatric interview, and their depression and ADHD symptom severities were evaluated with self-report scales. The ADHD symptom severities of the parents were evaluated using self-report scales. The relationships among the psychiatric symptoms and the hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PBG) levels of the patients were investigated. RESULTS HbA1c levels were found to correlate with the hyperactivity levels of children and the number of diagnoses they had. FBG and PBG values of patients diagnosed with ADHD were found to be higher than in those who did not have ADHD. HbA1c, FBG, and PBG values of the patients who had any disruptive behavior disorder were found to be higher than in those who did not. ADHD total scores, gender (being female), having diagnoses of ADHD or depression were found to be predictive of HbA1c levels according to the regression analyses. No relationship between the clinical findings of the children and their parents' ADHD levels was found. CONCLUSIONS The findings of this study implicate that children with T1DM should be evaluated in terms of ADHD which could have negative effects on the treatment.
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Affiliation(s)
- Abdullah Yazar
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Akın
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Ömer F Akça
- Department of Child and Adolescent Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Beray S Eklioğlu
- Department of Pediatric Endocrinology and Diabetes, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Esra Türe
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatma Coşkun
- Department of Child and Adolescent Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet E Atabek
- Department of Pediatric Endocrinology and Diabetes, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Galloway H, Newman E, Miller N, Yuill C. Does Parent Stress Predict the Quality of Life of Children With a Diagnosis of ADHD? A Comparison of Parent and Child Perspectives. J Atten Disord 2019; 23:435-450. [PMID: 27178062 DOI: 10.1177/1087054716647479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There are indicators that parental psychological factors may affect how parents evaluate their child's quality of life (QoL) when the child has a health condition. This study examined the impact of parents' perceived stress on parent and child ratings of the QoL of children with ADHD. METHOD A cross-sectional sample of 45 matched parent-child dyads completed parallel versions of the KIDSCREEN-27. Children were 8 to 14 years with clinician diagnosed ADHD. RESULTS Parents who rated their child's QoL lower than their child had higher perceived stress scores. Parent stress was a unique predictor of child QoL from parent proxy-rated but not child-rated QoL scores. CONCLUSION Parents' perceived stress may play an important role in their assessments of their child's QoL, suggesting both parent and child perspectives of QoL should be utilized wherever possible. Interventions that target parent stress may contribute to improvements in the child's QoL.
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Al-Habib DM, Alhaidar FA, Alzayed IM, Youssef RM. Consistency of child self-reports with parent proxy reports on the quality of life of children with attention-deficit/hyperactivity disorder in Riyadh, 2016. J Family Community Med 2019; 26:9-16. [PMID: 30697099 PMCID: PMC6335840 DOI: 10.4103/jfcm.jfcm_19_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The quality of life (QoL) of children with attention-deficit/hyperactivity disorder (ADHD) has not been addressed in Saudi Arabia despite the considerable attention it has on account of its prevalence, duration of illness, and sociopsychological effects. The aim of this study was to report on the QoL of children with ADHD and test the concord between children's and parents' reports. MATERIALS AND METHODS Using the generic PedsQL™ (version 4.0) from both children's and parents' perspectives, a cross-sectional study of 112 children was conducted on children aged 5-18 years with an established diagnosis of ADHD attending child psychiatry clinics of three referral hospitals in Riyadh between December 2015 and May 2016. RESULTS A total of 112 children with an established diagnosis of ADHD were recruited from the Child Psychiatry Clinic of Al Amal Mental Health Complex (41.1%), Prince Sultan Military Medical City (PSMMC), (33%), and King Khalid University Hospital (KKUH), (25.9%). The majority were boys (74.1%) and Saudi nationals (93.8%). The mean age of children with ADHD was 10.45 ± 3.06 years (Range 5 - 18 years). One-fourth of the mothers of children with ADHD had completed high school and 41.1% had a diploma, university, or postgraduate degree. One-third of the fathers of these children had completed high school (34%) and 38.4% had a diploma, university, or postgraduate degree. The intra-class correlation coefficients between the scores of children and parents were good for physical functioning, fair for social functioning, but moderate for school, emotional, and psychosocial functioning. Children rated themselves significantly better than their parents for emotional, social, school, and psychosocial functioning. The standardized response means indicated a small difference for social functioning and medium differences for the other three domains. The only significant discrepancy was observed in social functioning in relation to the child's age. CONCLUSION Parents mirrored adequately the observable physical component of the QoL of their children. The QoL report of children with ADHD with respect to communications and intellectual abilities should be taken into account whenever possible and their parents' report also should be sought to provide a more comprehensive view of the child's status.
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Affiliation(s)
- Dina M Al-Habib
- Department of Family and Community Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Fatima A Alhaidar
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahem M Alzayed
- Department of Psychiatry, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Randa M Youssef
- Department of Family and Community Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,Prince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Park BE, Lee JS, Kim HY, Bae JN, Kim WH, Kim HY, Rim MR, Kang SG, Choi SH. The Influence of Depression and School Life on the Quality of Life of Korean Child and Adolescent Patients with Attention-Deficit/Hyperactivity Disorder:A Comparison of the Perspectives of the Patients and Their Caregivers. Soa Chongsonyon Chongsin Uihak 2019; 30:2-8. [PMID: 32595314 PMCID: PMC7289493 DOI: 10.5765/jkacap.180027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life reported by the patients and their caregivers. Methods The patients' quality of life and their degree of depression and anxiety were measured using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-Report, the Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale, respectively. The caregivers' perception of the patients' quality of life and severity of the ADHD symptoms were measured using the PedsQL 4.0 Parent Proxy Report and the Conners' Parent Rating Scale (CPRS), respectively. A total of 66 participants completed the survey. The independent-samples t-test, Pearson's correlation analysis, and multiple regression analysis were conducted. Results The mean score of the PedsQL 4.0 Child Self-Report was significantly higher than the mean score of the PedsQL 4.0 Parent Proxy Report. However, for school function, the PedsQL 4.0 Child Self-Report score was significantly lower than that of Parent Proxy Report. The correlation between the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores was significant only for emotional function and social function. The multiple regression analysis showed that the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores were significantly predicted by the CDI and CPRS scores, respectively. Conclusion Our results demonstrate that there are clear differences between the quality of life reported by the patient themselves and that reported by their caregivers. In addition, the findings suggest that it is critical to treat the patients' accompanying depressive symptoms.
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Affiliation(s)
- Byeong-Eon Park
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Jeong-Seop Lee
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Hee-Yun Kim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Jae-Nam Bae
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Hye-Young Kim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Mi-Roo Rim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Sang-Gu Kang
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Seo-Hyun Choi
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
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Ghimire P, Hasegawa H, Kalyal N, Hurwitz V, Ashkan K. Patient-Reported Outcome Measures in Neurosurgery: A Review of the Current Literature. Neurosurgery 2018; 83:622-630. [PMID: 29165605 DOI: 10.1093/neuros/nyx547] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 10/02/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) play an important role in the evaluation of health outcomes, quality of life, and satisfaction, and have been successfully utilized in many areas of clinical medicine and surgical practice. The prevalence of PROMs in neurosurgery is not known. OBJECTIVE To review the PROMs that have been utilized in the published neurosurgery literature to date. METHODS Articles were searched in MEDLINE, EMBASE, HMIC Health Management Information Consortium, PsycARTICLES, and PsycINFO using search terms related to neurosurgery and PROMs, published from 1806 to August 2016. A total of 268 articles were identified that were stratified by the inclusion and exclusion criteria leading to a total of 137 articles. Twenty-six PROMs, involving both adult and pediatric populations, were identified. RESULTS A large number of generic and disease-specific PROMs are used in the neurosurgical literature. Generic PROMs are usually nonspecific measures of health status. Disease-specific PROMs may not address issues relevant to neurosurgical procedures. There are very few neurosurgery-specific PROMs that take into account the impact of a neurosurgical procedure on a specific condition. CONCLUSION PROMs that currently feature in the neurosurgical literature may not address the specific outcomes relevant to neurosurgical practice. There is an emergent need for generic and disease-specific PROMs to be validated in neurosurgical patients and neurosurgery-specific PROMs developed to address unmet needs of patients undergoing neurosurgical procedures.
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Affiliation(s)
- Prajwal Ghimire
- Department of Neurosurgery, King's Coll-ege Hospital, London, United Kingdom
| | - Harutomo Hasegawa
- Department of Neurosurgery, King's Coll-ege Hospital, London, United Kingdom
| | - Nida Kalyal
- Department of Neurosurgery, King's Coll-ege Hospital, London, United Kingdom
| | - Victoria Hurwitz
- Department of Neurosurgery, King's Coll-ege Hospital, London, United Kingdom
| | - Keyoumars Ashkan
- Department of Neurosurgery, King's Coll-ege Hospital, London, United Kingdom
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Gerzson LR, Ranzan J, Almeida CSD, Riesgo RDS. O impacto do acidente vascular cerebral na qualidade de vida de crianças e adolescentes. FISIOTERAPIA E PESQUISA 2018. [DOI: 10.1590/1809-2950/17007025032018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar a qualidade de vida (QV) de crianças/adolescentes com diagnóstico de acidente vascular cerebral (AVC) segundo as percepções do responsável e das próprias crianças/adolescentes comparados com um grupo controle (GC). Participaram 78 sujeitos divididos em: Grupo de crianças/adolescentes que tiveram histórico de AVC (GAVC, n=39) e um Grupo de crianças/adolescentes saudáveis como Controle (GC, n=39), sendo pareados por sexo e idade. Utilizou-se de entrevista semiestruturada para descrever os aspectos sociodemográficos e do instrumento Pediatric Quality of Life Inventory (PedsQLTM 4.0) para avaliar a QV dos sujeitos no seu desenvolvimento. A mediana de idade do diagnóstico de AVC do GAVC foi sete meses, sendo que a maioria apresentou AVC isquêmico (71,8%) e hemiparesia. De acordo com os responsáveis do GAVC, a Capacidade Funcional dos seus filhos foi significativamente diferente, apresentando inferioridade em relação ao GC. Para os responsáveis também a variável escolaridade do pai manteve efeito positivo significativo nos aspectos emocionais da criança, e a variável idade da criança/adolescente e tempo do AVC >29 dias de vida apresentou efeito negativo nos aspectos escolares. Já para as crianças/adolescentes, a variável idade em que entrou na escola e gênero apresentou efeito significativo negativo no desfecho de aspectos escolares em relação ao GC. Concluímos que a percepção dos responsáveis difere da percepção da criança/adolescente em relação à capacidade funcional desta; a escolaridade do pai influenciou positivamente nos aspectos emocionais da criança, e as crianças sentem-se com um prejuízo no desempenho escolar, principalmente os meninos.
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Affiliation(s)
| | | | | | - Rudimar dos Santos Riesgo
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
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17
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Talarska D, Michalak M, Talarska P, Steinborn B. Children with epilepsy against their healthy peers and those with headaches: Differences-similarities. Neurol Neurochir Pol 2017; 52:35-43. [PMID: 29129379 DOI: 10.1016/j.pjnns.2017.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 09/08/2017] [Accepted: 10/18/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Epilepsy, like most chronic diseases, affects bio-psycho-social functioning of children and adolescents. The aim of this work was to assess functioning of children with epilepsy compared with the group of healthy children and those with headaches carried out by children themselves and their mothers. MATERIAL AND METHODS The study included 209 children with epilepsy and 173 children with headaches and 182 healthy students and their mothers. The research tool was Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL™ 4.0) questionnaire. RESULTS Quality of life of healthy children was rated the highest in all areas by both children and mothers. In younger and older children, difference was demonstrated between the assessment of the quality of life of healthy children and the ones with epilepsy or healthy children and the ones with and headaches in all areas of the PedsQL™ 4.0 questionnaire (p<0.05). Children with epilepsy had the most difficulties in subscale School Functioning in their own and their mothers' opinion. Healthy children and their mothers rated the subscale Emotional Functioning lowest. CONCLUSIONS The functioning of children with epilepsy in the assessment of children and their mothers was the closest to the functioning of children with headaches. Quality of children's life assessment by children with epilepsy and by healthy children differed between the group of girls and boys and between older and younger children in all PedsQLTM 4.0 questionnaire areas. A medium response compatibility between children with epilepsy and their mothers was shown in individual questions.
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Affiliation(s)
- Dorota Talarska
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland.
| | - Michał Michalak
- Department of Computer Science and Statistics, University of Medical Sciences, Poznań, Poland
| | | | - Barbara Steinborn
- Developmental Neurology Clinic, University of Medical Sciences, Poznań, Poland
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18
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Lee YC, Yang HJ, Lee WT, Teng MJ. Do parents and children agree on rating a child’s HRQOL? A systematic review and Meta-analysis of comparisons between children with attention deficit hyperactivity disorder and children with typical development using the PedsQLTM. Disabil Rehabil 2017; 41:265-275. [DOI: 10.1080/09638288.2017.1391338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Yi-Chen Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan (R.O.C)
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Wan-Ting Lee
- Department of Rehabilitation, Occupational Therapy Room, Sing Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ming-Jen Teng
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
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19
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Galloway H, Newman E. Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2017; 9:11-29. [PMID: 28005216 PMCID: PMC5323486 DOI: 10.1007/s12402-016-0210-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 11/23/2016] [Indexed: 12/05/2022]
Abstract
There are contemporary indicators that parent proxy-ratings and child self-ratings of a child's quality of life (QoL) are not interchangeable. This review examines dual informant studies to assess parent-child agreement on the QoL of children with attention-deficit/hyperactivity disorder. A systematic search of four major databases (PsycINFO, MEDLINE, EMBASE and Cochrane databases) was completed, and related peer-reviewed journals were hand-searched. Studies which reported quantitative QoL ratings for matched parent and child dyads were screened in accordance with relevant inclusion and exclusion criteria. Key findings were extracted from thirteen relevant studies, which were rated for conformity to the recommendations of an adapted version of the STROBE statement guidelines for observational studies. In the majority of studies reviewed, children rated their QoL more highly than their parents. There was some evidence for greater agreement on the physical health domain than psychosocial domains.
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Affiliation(s)
- Helen Galloway
- Clinical Psychology to General Adult Psychiatry, NHS Tayside, Alloway Centre, Dundee, DD4 8UA, UK.
| | - Emily Newman
- Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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20
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Farrell LJ, Oar EL, Waters AM, McConnell H, Tiralongo E, Garbharran V, Ollendick T. Brief intensive CBT for pediatric OCD with E-therapy maintenance. J Anxiety Disord 2016; 42:85-94. [PMID: 27395805 DOI: 10.1016/j.janxdis.2016.06.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 06/04/2016] [Accepted: 06/15/2016] [Indexed: 12/21/2022]
Abstract
Cognitive behaviour therapy (CBT), incorporating exposure and response prevention (ERP), has received strong empirical support for the treatment of paediatric OCD, and moreover, is considered the first line treatment of choice (Geller & March, 2012). However, despite the availability of effective treatments for this chronic and debilitating disorder, only a small proportion of youth receive these evidence-based approaches. The present study aimed to examine the effectiveness of an intensive ERP-based treatment for youth OCD, using a multiple baseline controlled design. Children and youth (N=10; aged 11-16 years) with a primary diagnosis of OCD were randomly assigned to a 1- or 2-week baseline monitoring condition followed by the intervention. The efficacy of the intensive treatment, involving 1 session psychoeducation, 2-sessions ERP plus e-therapy maintenance was examined across parent- child- and clinician-rated measures at post-treatment and 6-month follow-up. Overall, there were significant reductions across time on almost all measures (except self-report anxiety), and moreover, the majority of the sample (80%) were considered reliably improved, and meeting clinically significant change. At post-treatment, 60% were in remission of symptoms, and at 6-month follow-up this increased to 70%. These findings provide strong support for intensive, time-limited approaches to ERP-based CBT for children and youth with OCD.
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Affiliation(s)
- Lara J Farrell
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Australia.
| | - Ella L Oar
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Australia
| | - Allison M Waters
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Australia
| | - Harry McConnell
- School of Medicine and Menzies Health Institute QLD, Griffith University, Australia
| | - Evelin Tiralongo
- School of Pharmacy and Menzies Health Institute QLD, Griffith University, Australia
| | | | - Thomas Ollendick
- Child Study Centre, Department of Psychology, Virginia Polytechnic Institute and State University, USA
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21
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Oar EL, Farrell LJ, Waters AM, Ollendick TH. Blood-Injection-Injury Phobia and Dog Phobia in Youth: Psychological Characteristics and Associated Features in a Clinical Sample. Behav Ther 2016; 47:312-24. [PMID: 27157026 DOI: 10.1016/j.beth.2016.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 12/26/2022]
Abstract
Blood-Injection-Injury (BII) phobia is a particularly debilitating condition that has been largely ignored in the child literature. The present study examined the clinical phenomenology of BII phobia in 27 youths, relative to 25 youths with dog phobia-one of the most common and well-studied phobia subtypes in youth. Children were compared on measures of phobia severity, functional impairment, comorbidity, threat appraisals (danger expectancies and coping), focus of fear, and physiological responding, as well as vulnerability factors including disgust sensitivity and family history. Children and adolescents with BII phobia had greater diagnostic severity. In addition, they were more likely to have a comorbid diagnosis of a physical health condition, to report more exaggerated danger expectancies, and to report fears that focused more on physical symptoms (e.g., faintness and nausea) in comparison to youth with dog phobia. The present study advances knowledge relating to this poorly understood condition in youth.
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Janssens A, Rogers M, Gumm R, Jenkinson C, Tennant A, Logan S, Morris C. Measurement properties of multidimensional patient-reported outcome measures in neurodisability: a systematic review of evaluation studies. Dev Med Child Neurol 2016; 58:437-51. [PMID: 26661333 PMCID: PMC5031226 DOI: 10.1111/dmcn.12982] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 12/15/2022]
Abstract
AIM To identify and appraise the quality of studies that primarily assessed the measurement properties of English language versions of multidimensional patient-reported outcome measures (PROMs) when evaluated with children with neurodisability, and to summarize this evidence. METHOD MEDLINE, Embase, PsycINFO, CINAHL, AMED, and the National Health Service Economic Evaluation Database were searched. The methodological quality of the papers was assessed using the COnsensus-based Standards for selection of health Measurement INstruments checklist. Evidence of content validity, construct validity, internal consistency, test-retest reliability, proxy reliability, responsiveness, and precision was extracted and judged against standardized reference criteria. RESULTS We identified 48 studies of mostly fair to good methodological quality: 37 papers for seven generic PROMs (CHIP, CHQ, CQoL, KIDSCREEN, PedsQL, SLSS, and YQOL), seven papers for two chronic-generic PROMs (DISABKIDS and Neuro-QOL), and four papers for three preference-based measures (HUI, EQ-5D-Y, and CHSCS-PS). INTERPRETATION On the basis of this appraisal, the DISABKIDS appears to have more supportive evidence in samples of children with neurodisability. The overall lack of evidence for responsiveness and measurement error is a concern when using these instruments to measure change, or to interpret the findings of studies in which these PROMs have been used to assess change.
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Affiliation(s)
- Astrid Janssens
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Morwenna Rogers
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gumm
- Royal Devon and Exeter NHS Foundation TrustExeterUK
| | - Crispin Jenkinson
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Alan Tennant
- Department of Rehabilitation MedicineUniversity of LeedsLeedsUK
| | - Stuart Logan
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Christopher Morris
- PenCRU and PenCLAHRCUniversity of Exeter Medical SchoolUniversity of ExeterExeterUK
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23
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Lee YC, Yang HJ, Chen VCH, Lee WT, Teng MJ, Lin CH, Gossop M. Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:160-172. [PMID: 26829402 DOI: 10.1016/j.ridd.2015.11.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 11/11/2015] [Accepted: 11/12/2015] [Indexed: 06/05/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a prevalent developmental disorder that seriously and negatively impacts a child's health-related quality of life (HRQOL). However, no meta-analysis has been conducted to examine the magnitude of impact, domains affected and factors moderating the impact. This review included nine studies that compared HRQOL of children or adolescents with ADHD with those with typical development using both child self-reports and parent proxy-reports. Seven among nine studies were meta-analytically synthesized to examine the degree of impact of ADHD on children and adolescents, parent-child discrepancy, and the moderators. The results indicate that ADHD impact a child's or adolescent's HRQOL negatively with a moderate effect in physical and a severe effect in psychosocial (i.e., emotional, social, and school) domains. Parental ratings of overall HRQOL in children or adolescents with ADHD were not significantly different from child's ratings when compared with typically developing children and adolescents. Age was negatively associated with all domains of HRQOL in children and adolescents with ADHD both by parent- and child-ratings, and the strongest effect was found in parental ratings of child's emotional HRQOL, with a moderate correlation. This meta-analysis suggests that HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports, and that interventions may be planned accordingly. Future meta-analysis may explore how measures of HRQOL and other factors including child, parental, familiar and school characteristics influence the impact of ADHD and the parent-child agreement in children and adolescents.
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Affiliation(s)
- Yi-chen Lee
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Vincent Chin-Hung Chen
- Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Taiwan; Chang Gung University, Taiwan
| | - Wan-Ting Lee
- Department of Rehabilitation, Occupational Therapy Room, Sing Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ming-Jen Teng
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Chung-Hui Lin
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Michael Gossop
- King's College London, Institute of Psychyatry, London, UK
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24
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Coghill D, Hodgkins P. Health-related quality of life of children with attention-deficit/hyperactivity disorder versus children with diabetes and healthy controls. Eur Child Adolesc Psychiatry 2016; 25:261-71. [PMID: 26054300 PMCID: PMC4769721 DOI: 10.1007/s00787-015-0728-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/23/2015] [Indexed: 01/30/2023]
Abstract
The impact of attention-deficit/hyperactivity disorder (ADHD) on health-related quality of life (HRQoL) is reported to be similar to that of other mental health and physical disorders. In this cross-sectional study, we hypothesized that children with ADHD and children with type 1 diabetes mellitus (T1DM) would have significantly worse HRQoL compared with healthy children, and that better clinical status in ADHD and T1DM would be associated with better HRQoL. Children were recruited from three outpatient services in Scotland. Responses to two frequently used validated HRQoL instruments, the Paediatric Quality of Life Inventory (PedsQL) and Child Health and Illness Profile-child edition (CHIP-CE), were obtained from parents/carers and children (6-16 years) with/without ADHD or T1DM. Child and parent/carer-completed HRQoL measurements were evaluated for 213 children with ADHD, 58 children with T1DM and 117 healthy children (control group). Significantly lower self and parent/carer ratings were observed across most PedsQL (P < 0.001) and CHIP-CE (P < 0.05) domains (indicating reduced HRQoL) for the ADHD group compared with the T1DM and control groups. Parent/carer and child ratings were significantly correlated for both measures of HRQoL (PedsQL total score: P < 0.001; CHIP-CE all domains: P < 0.001), but only with low-to-moderate strength. Correlation between ADHD severity and HRQoL was significant with both PedsQL and CHIP-CE for all parent/carer (P < 0.01) and most child (P < 0.05) ratings; more ADHD symptoms were associated with poorer HRQoL. These data demonstrate that ADHD has a significant impact on HRQoL (as observed in both parent/carer and child ratings), which seems to be greater than that for children with T1DM.
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Affiliation(s)
- David Coghill
- University of Dundee, Dundee, Scotland, UK.
- Division of Neuroscience, Medical Research Institute, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
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Knight SJ, Harvey A, Hennel S, Lubitz L, Rowe K, Reveley C, Dean N, Clarke C, Scheinberg A. Measuring quality of life and fatigue in adolescents with chronic fatigue syndrome: estimates of feasibility, internal consistency and parent–adolescent agreement of the PedsQLTM. FATIGUE-BIOMEDICINE HEALTH AND BEHAVIOR 2015. [DOI: 10.1080/21641846.2015.1090816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Longitudinal Associations Between Internalizing and Externalizing Comorbidities and Functional Outcomes for Children with ADHD. Child Psychiatry Hum Dev 2015; 46:736-48. [PMID: 25341948 DOI: 10.1007/s10578-014-0515-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined functional outcomes for children with ADHD by comorbidity status. Children with ADHD (5-13 years) were recruited from 21 pediatric practices and followed up 12 months later (n = 199). Parent and teacher-reported baseline and 12 month surveys measured peer problems, daily functioning, quality of life (QoL), parent mental health, and family QoL. The Anxiety Disorders Interview Schedule for Children IV assessed mental health comorbidities at baseline. Linear regression models were conducted, adjusting for socio-demographics, ADHD severity, and baseline functioning (where possible). In adjusted analyses, children with ADHD and co-occurring internalizing and externalizing comorbidities had poorer QoL, greater peer problems, and poorer family QoL, compared to children with ADHD alone. The parents of children with ADHD and internalizing and externalizing comorbidities alone, also reported poorer family QoL, compared to children with ADHD alone. Children with ADHD and co-occurring internalizing and externalizing comorbidities appear particularly vulnerable to poorer functioning.
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Lanning BA, Baier MEM, Ivey-Hatz J, Krenek N, Tubbs JD. Effects of equine assisted activities on autism spectrum disorder. J Autism Dev Disord 2014; 44:1897-907. [PMID: 24526337 DOI: 10.1007/s10803-014-2062-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Quality of life assessments were used in this study to determine the behavioral changes of children diagnosed with autism spectrum disorder (ASD) who participated in equine assisted activities. Behavioral changes of children with ASD participating in 9 weeks of equines assisted activities (EAA) (N = 10) were compared to behavioral changes of children who participated in a non-equine intervention (N = 8). Parents noted significant improvements in their child's physical, emotional and social functioning following the first 6 weeks of EAA. The children participating in the non-equine program also demonstrated improvement in behavior, but to a lesser degree. The favorable outcome of this study lends support for continuation of programs utilizing EAA in the treatment of children with ASD.
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Affiliation(s)
- Beth A Lanning
- Health, Human Performance, and Recreation Department, Baylor University, One Bear Place, 97313, Waco, TX, 76798, USA,
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Morris C, Janssens A, Allard A, Thompson Coon J, Shilling V, Tomlinson R, Williams J, Fellowes A, Rogers M, Allen K, Beresford B, Green C, Jenkinson C, Tennant A, Logan S. Informing the NHS Outcomes Framework: evaluating meaningful health outcomes for children with neurodisability using multiple methods including systematic review, qualitative research, Delphi survey and consensus meeting. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02150] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BackgroundThe identification of suitable outcome measures will improve the evaluation of integrated NHS care for the large number of children affected by neurodisability, and has the potential to encourage the provision of more appropriate and effective health care. This research sought to appraise the potential of patient-reported outcome measures (PROMs) for children and young people with neurodisability.AimThis research aimed (i) to identify key outcomes of health care for children with neurodisability, beyond morbidity and mortality, from the perspectives of children, parents and professionals; (ii) to critically appraise existing generic multidimensional PROMs; and (iii) to examine whether or not the key outcomes might be measured by existing PROMs. We also sought agreement on a definition of neurodisability.MethodsData were gathered in three main ways, (i) a systematic review identified eligible generic multidimensional PROMs and peer-reviewed studies evaluating psychometric performance using English-language questionnaires. Studies were appraised for methodological quality and psychometric performance was appraised using standard criteria. (ii) Focus groups and interviews with children and young people with neurodisability, and separately with parents, sought to identify important outcomes of NHS care, and their feedback on example PROM questionnaires. (iii) An online Delphi survey was conducted with a multidisciplinary sample of health professionals to seek agreement on appropriate NHS outcomes. In addition, we convened a consensus meeting with a small nominal group of young people, parents and professionals; the group sought agreement on a core set of important health outcomes.ResultsFrom the systematic review, we identified 126 papers that reported eligible evidence regarding the psychometric performance of 25 PROMs. Evidence of psychometric robustness was more favourable for a small number of PROMs: KIDSCREEN (generic), DISABKIDS (chronic-generic) and Child Health Utility 9D (preference-based measure). The Pediatric Quality of Life Inventory and KINDL offer both self-report and a proxy report version for a range of age bands, but evidence of their psychometric performance was weaker. Evidence was lacking in one or more respects for all candidate PROMs, in both general populations and those with neurodisability. Proxy reporting was found generally to be poorly correlated with self-report. Focus groups and interviews included 54 children and young people, and 53 parents. The more important health outcomes were felt to be communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, parents of children with intellectual impairment identified behaviour, toileting and safety as important outcomes. Participants suggested problems with the face validity of example PROM questionnaires for measuring NHS care. In the Delphi survey, 276 clinicians from a wide range of professions contributed to at least one of four rounds. Professionals rated pain, hearing, seeing, sleep, toileting, mobility and communication as key goals for the NHS but also identified treating neurological symptoms as important. Professionals in the Delphi survey and parents working with the research team agreed a proposed definition for neurodisability. The consensus meeting confirmed overlap between the outcomes identified as important by young people, parents and professionals, but not complete agreement.ConclusionsThere was agreement between young people, parents and professionals regarding a core suite of more important health outcomes: communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, behaviour, toileting and safety were identified as important by parents. This research suggests that it would be appropriate to measure these constructs using PROMs to assess health care. None of the candidate PROMs in the review adequately captures all of the identified constructs, and there is inadequate evidence that candidate PROMs are psychometrically robust for use across children with neurodisability. Further consultation with young people, families and professionals is warranted to support the use of PROMs to measure NHS outcomes. Research to test potential PROMs with different age groups and conditions would be valuable.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
| | - Astrid Janssens
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Amanda Allard
- Council for Disabled Children, National Children’s Bureau, London, UK
| | | | - Valerie Shilling
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Richard Tomlinson
- Department of Child Health, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Jane Williams
- Department of Child Health and Paediatrics, Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew Fellowes
- Council for Disabled Children, National Children’s Bureau, London, UK
| | - Morwenna Rogers
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Karen Allen
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Colin Green
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Alan Tennant
- Department of Rehabilitation Medicine, University of Leeds, Leeds, UK
| | - Stuart Logan
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Weiss PF, Klink AJ, Faerber J, Feudtner C. The pediatric rheumatology quality of life scale: validation of the English version in a US cohort of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2013; 11:43. [PMID: 24206654 PMCID: PMC3830514 DOI: 10.1186/1546-0096-11-43] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 09/28/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study aims to validate the English version of the Pediatric Rheumatology Quality of Life Scale (PRQL), a concise Health Related Quality of Life (HRQoL) measure, in a US cohort of children with juvenile idiopathic arthritis (JIA). METHODS The PRQL is a 10-item HRQoL measure with two subscales: physical health and psychological health. The original version of this measure was validated using an Italian-speaking cohort of 472 JIA patients and 796 healthy controls and found to have acceptable psychometric properties. The English language version has not been validated in a US pediatric population. The English PRQL was administered to 161 JIA subjects from a US Rheumatology clinic. We assessed the reliability (internal consistency and test-retest) and validity (convergent, discriminative, and criterion) of the PRQL. RESULTS The English PRQL was feasible to administer and demonstrated good psychometric properties. Cronbach alpha (reliability) coefficients ranged from 0.72 to 0.81. Factor analysis yielded the existing subscales. The PRQL total and subscales were found to have moderate correlations with other HRQoL instruments, the Pediatric Quality of Life Inventory (PedsQL) generic core scale and the PedsQL rheumatology. The PRQL discriminated between subjects with active versus inactive disease and was responsive to an improvement or worsening in disease activity over time. CONCLUSIONS Our results suggest that the English version of the instrument is suitable for use in JIA patients in the US. This tool provides a relatively easy method to integrate at least one patient-reported outcome into routine clinical or research assessment.
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Affiliation(s)
- Pamela F Weiss
- Division of Rheumatology, The Children's Hospital of Philadelphia, Room 1526, North Campus, 3535 Market Street, Philadelphia, PA, USA.
| | - Andrew J Klink
- Division of Rheumatology, The Children’s Hospital of Philadelphia, Room 1526, North Campus, 3535 Market Street, Philadelphia, PA, USA,Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer Faerber
- Division of General Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Chris Feudtner
- Division of General Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Department of Pediatrics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA,Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Hinds PS, Nuss SL, Ruccione KS, Withycombe JS, Jacobs S, DeLuca H, Faulkner C, Liu Y, Cheng YI, Gross HE, Wang J, DeWalt DA. PROMIS pediatric measures in pediatric oncology: valid and clinically feasible indicators of patient-reported outcomes. Pediatr Blood Cancer 2013; 60:402-8. [PMID: 22829446 DOI: 10.1002/pbc.24233] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/22/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Establishing the ability of children and adolescents with cancer to complete the NIH-sponsored PROMIS pediatric measures electronically and the preliminary validity estimates of the measures (both full item banks and short forms) in pediatric oncology will contribute to our knowledge of the impact of cancer treatment on these young patients. PROCEDURES A total of 203 8- to 17-year olds were administered eight PROMIS pediatric measures in a cross-sectional study design to establish known-group validity. Of the 200 who completed all or most of the items, a slight majority were male (55.5%) and white (54%). Patients were either undergoing treatment for cancer (n = 93) or in survivorship following treatment for cancer (n = 107). Measures were completed using computer interface during an in-person interaction with researchers. RESULTS Only 3 of 203 participants did not complete the PROMIS pediatric measures. As hypothesized, participants in treatment were significantly different (worse) on parent-reported clinical indicators (blood counts, fatigue, and appetite) and on seven self-reported measures (depression, anxiety, peer relationships, pain interference, fatigue, upper extremity function, and mobility) from participants in survivorship. Females reported worse fatigue, anger, and pain interference than males. Worse patient-reported outcomes for patients in active treatment persisted after adjusting for potential confounding variables. CONCLUSIONS Children and adolescents in treatment for cancer or in survivorship and ranging from 8 to 17 years of age can complete multiple PROMIS pediatric measures using a computer interface during an outpatient clinic visit or inpatient admission. Findings establish known-group validity for PROMIS pediatric measures in pediatric oncology.
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Affiliation(s)
- Pamela S Hinds
- Children's National Medical Center, Washington, District of Columbia, USA.
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Dey M, Landolt MA, Mohler-Kuo M. Assessing parent-child agreement in health-related quality of life among three health status groups. Soc Psychiatry Psychiatr Epidemiol 2013; 48:503-11. [PMID: 22864560 DOI: 10.1007/s00127-012-0556-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 07/16/2012] [Indexed: 12/29/2022]
Abstract
PURPOSE To examine parent-child agreement regarding a child's health-related quality of life (HRQOL) among three health status groups. METHODS Parent-child agreement was evaluated for three health status groups of a population-based sample: (1) children with mental health problems (N = 461), (2) children with physical health problems (N = 281), and (3) healthy controls (N = 699). The KIDSCREEN-27 was used to assess HRQOL. The children were 9-14 years of age. RESULTS Intraclass correlation coefficients were mostly good across all HRQOL scores and health status groups. This relatively high level of agreement was also reflected by the following findings: first, the AGREE group was the largest in three out of five HRQOL subscales in all health status groups; second, when disagreement occurred, it was often minor in magnitude. Despite this relatively high level of agreement, the means of self-ratings were significantly higher for all HRQOL scores and health status groups than the means of proxy ratings. These higher self-ratings were especially pronounced among children with mental health problems in certain HRQOL domains. CONCLUSIONS Even though the level of parent-child agreement regarding a child's HRQOL is relatively high, it should be considered that children (especially those with mental health problems) often report better HRQOL than their parents. It is, therefore, highly recommended that both proxy- and self-ratings are used to evaluate a child's HRQOL comprehensively.
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Affiliation(s)
- Michelle Dey
- Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001, Zürich, Switzerland.
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Selewski DT, Collier DN, MacHardy J, Gross HE, Pickens EM, Cooper AW, Bullock S, Earls MF, Pratt KJ, Scanlon K, McNeill JD, Messer KL, Lu Y, Thissen D, DeWalt DA, Gipson DS. Promising insights into the health related quality of life for children with severe obesity. Health Qual Life Outcomes 2013; 11:29. [PMID: 23452863 PMCID: PMC3598567 DOI: 10.1186/1477-7525-11-29] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 02/19/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Childhood obesity is a growing health concern known to adversely affect quality of life in children and adolescents. The Patient Reported Outcomes Measurement Information System (PROMIS) pediatric measures were developed to capture child self-reports across a variety of health conditions experienced by children and adolescents. The purpose of this study is to begin the process of validation of the PROMIS pediatric measures in children and adolescents affected by obesity. METHODS The pediatric PROMIS instruments were administered to 138 children and adolescents in a cross-sectional study of patient reported outcomes in children aged 8-17 years with age-adjusted body mass index (BMI) greater than the 85th percentile in a design to establish known-group validity. The children completed the depressive symptoms, anxiety, anger, peer relationships, pain interference, fatigue, upper extremity, and mobility PROMIS domains utilizing a computer interface. PROMIS domains and individual items were administered in random order and included a total of 95 items. Patient responses were compared between patients with BMI 85 to<99th percentile versus ≥99th percentile. RESULTS 136 participants were recruited and had all necessary clinical data for analysis. Of the 136 participants, 5% ended the survey early resulting in missing domain scores at the end of survey administration. In multivariate analysis, patients with BMI ≥ 99th percentile had worse scores for depressive symptoms, anger, fatigue, and mobility (p<0.05). Parent-reported exercise was associated with better scores for depressive symptoms, anxiety, and fatigue (p<0.05). CONCLUSIONS Children and adolescents ranging from overweight to severely obese can complete multiple PROMIS pediatric measures using a computer interface in the outpatient setting. In the 5% with missing domain scores, the missing scores were consistently found in the domains administered last, suggesting the length of the assessment is important. The differences in domain scores found in this study are consistent with previous reports investigating the quality of life in children and adolescents with obesity. We show that the PROMIS instrument represents a feasible and potentially valuable instrument for the future study of the effect of pediatric obesity on quality of life.
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Affiliation(s)
- David T Selewski
- Division of Nephrology, Department of Pediatrics, University of Michigan, CS Mott Children's Hospital Room 12-250, 1540 E Hospital Drive, SPC 4297, Ann Arbor, MI 48109-4297, USA.
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Dey M, Landolt MA, Mohler-Kuo M. Health-related quality of life among children with mental disorders: a systematic review. Qual Life Res 2013; 21:1797-1814. [PMID: 22298200 DOI: 10.1007/s11136-012-0109-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE To systematically review studies about the quality of life (QOL) of children with various mental disorders relative to healthy controls and to describe limitations in these studies. METHODS Relevant articles were searched using different databases, by checking reference lists and contacting experts. We included articles that either compared children with mental disorders to healthy controls/norm values or made such a comparison possible. RESULTS Sixteen out of 4,560 articles met the pre-defined inclusion criteria. These studies revealed that the QOL of children with various mental disorders is compromised across multiple domains. The largest effect sizes were found for psychosocial and family-related domains and for the total QOL score, whereas physical domains generally were less affected. The most important limitations in the existing literature include the lack of study samples drawn from the general population, the failure to use self-ratings, not considering item overlap between measuring QOL and assessing for the presence of a particular mental disorder, and not determining whether the children were receiving medication for their mental disorder. CONCLUSIONS Children with mental disorders experience a considerable reduction in QOL across various domains. Research studies that avoid previous limitations are crucial to fill existing knowledge gaps.
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Affiliation(s)
- Michelle Dey
- Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
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Payakachat N, Tilford JM, Kovacs E, Kuhlthau K. Autism spectrum disorders: a review of measures for clinical, health services and cost-effectiveness applications. Expert Rev Pharmacoecon Outcomes Res 2012; 12:485-503. [PMID: 22971035 PMCID: PMC3502071 DOI: 10.1586/erp.12.29] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Autism spectrum disorders (ASDs) are characterized by impairments in social interaction, communication and behavioral functioning that can affect the health-related quality-of-life outcomes of the affected child and the family. ASDs have increased in prevalence, leading to a demand for improved understanding of the comparative effectiveness of different pharmacologic, behavioral, medical and alternative treatments for children as well as systems for providing services. This review describes outcome instruments that can be used for clinical, health services and cost-effectiveness applications. There is a pressing need to identify the most appropriate instruments for measuring health-related quality-of-life outcomes in this population. Studies evaluating the cost-effectiveness of interventions or treatments for children with ASDs using the cost per quality-adjusted life year metric are lacking. Researchers have the potential to contribute greatly to the field of autism by quantifying outcomes that can inform optimal treatment strategies.
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Affiliation(s)
- Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, USA.
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Dey M, Mohler-Kuo M, Landolt MA. Health-related quality of life among children with mental health problems: a population-based approach. Health Qual Life Outcomes 2012; 10:73. [PMID: 22709358 PMCID: PMC3420327 DOI: 10.1186/1477-7525-10-73] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 06/18/2012] [Indexed: 11/23/2022] Open
Abstract
Background Children with mental health problems have been neglected in health-related quality of life (HRQOL) studies. Therefore, the aims of the current study were 1) to assess the influence of the presence of mental or physical health problems on HRQOL; and 2) to analyze the effects of item overlap between mental health problems and HRQOL-measurements. Methods Proxy- and self-rated HRQOL (KIDSCREEN-27) of children 9–14 years old was assessed across children with mental health problems (n = 535), children with physical health problems (n = 327), and healthy controls (n = 744). Multiple linear regression analyses were conducted with health status, severity of symptoms, status of medication use, gender and nationality as independent, and HRQOL scores as dependent variables. The effects of item overlap were analyzed by repeating regression analyses while excluding those HRQOL items that contextually overlapped the most frequently-occurring mental health problem (attention deficits). Results Severity of symptoms was the strongest predictor of reduced HRQOL. However, all other predictors (except for the status of medication use) also contributed to the prediction of some HRQOL scores. Controlling for item overlap did not meaningfully alter the results. Conclusions When children with different health constraints are compared, the severity of their particular health problems should be considered. Furthermore, item overlap seems not to be a major problem when the HRQOL of children with mental health problems is studied. Hence, HRQOL assessments are useful to gather information that goes beyond the clinical symptoms of a health problem. This information can, for instance, be used to improve clinical practice.
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Affiliation(s)
- Michelle Dey
- Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
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