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Kamalaporn H, Preutthipan A, Coates AL. Weaning strategies for children on home invasive mechanical ventilation. Pediatr Pulmonol 2024; 59:2131-2140. [PMID: 38593235 DOI: 10.1002/ppul.27008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024]
Abstract
Children who require home mechanical ventilation (HMV) with an artificial airway or invasive mechanical ventilation (HMV) have a possibility of successful weaning due to the potential of compensatory lung growth. Internationally accepted guidelines on how to wean from HMV in children is not available, we summarize the weaning strategies from the literature reviews combined with our 27-year experience in the Pediatric Home Respiratory Care program at the tertiary care center in Thailand. The readiness to wean is considered in patients with hemodynamic stability, having effective cough measured by maximal inspiratory pressure, requiring a fraction of inspired oxygen (FiO2) < 40%, positive end expiratory pressure <5 cmH2O, and acceptable arterial blood gases. The strategies of weaning is start weaning during the daytime while the child is awake and close monitoring is feasible. Disconnect time is gradually increased through naps and sleeping hours. Weaning from the conventional mechanical ventilator to Bilevel PAP or CPAP are optional. Factors affected the successful weaning are mainly the underlying diseases, complications, growth and development, caregivers, and resources. Weaning should be stopped during acute illness or increased work of breathing. The readiness for decannulation could be determined by using the speaking devices, tracheostomy capping, and measurement of end-expiratory pressure. Polysomnography and airway evaluation by bronchoscopy are recommended before decannulation. Weaning when the child is ready is crucial because living with HMV can be challenging and stressful. Failure to remove a tracheostomy when indicated can result in delayed speech, social problems as well as risk for infection.
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Affiliation(s)
- Harutai Kamalaporn
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Aroonwan Preutthipan
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Allan L Coates
- The Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Canada
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Robeson M, Hayes K, Rossetti K, Ahlich E, Zlomke K. What is in a Day? Investigating the Relationship Between Sleep Quality and Quality of Life Among Caregivers of Children With Autism. J Dev Behav Pediatr 2024:00004703-990000000-00195. [PMID: 39023857 DOI: 10.1097/dbp.0000000000001278] [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: 09/20/2023] [Accepted: 03/18/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate the relationship between sleep quality and quality of life (QOL), or overall level of well-being, in caregivers of children with autism spectrum disorder (ASD) on the daily level. METHOD This study utilizes mobile ecological momentary assessment (mEMA) to capture daily experiences of caregivers of children with ASD over a period of 14 days. Utilizing mEMA, this study examines relations between sleep quality and QOL and the role of mood and physical health as mediators on the daily level, specifically for caregivers of children with ASD (n = 51). The data were analyzed using multilevel modeling by MLMed macro. RESULTS The results suggest that there is a significant positive relation between sleep quality and QOL across individuals. Surprisingly, there was a negative relation between sleep quality and QOL within individuals. The positive relationship between sleep quality and QOL across participants was explained through positive mood across individuals. Furthermore, this relationship also occurred through better physical health across and within individuals. CONCLUSION For caregivers of children with ASD, daily positive mood and better physical health explain the relationship between daily sleep quality and QOL. Understanding daily experiences of caregivers of children with ASD may inform interventions and practices aimed at improving sleep and its associated outcomes to ultimately improve caregiver well-being.
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Toly VB, Zauszniewski JA, Wang M, Russell KN, Ross K, Musil CM. Efficacy of a Resourcefulness Intervention to Enhance the Physical and Mental Health of Parents Caring for Technology-dependent Children at Home: A Randomized Controlled Trial. J Pediatr Health Care 2024; 38:337-353. [PMID: 37897454 PMCID: PMC11045667 DOI: 10.1016/j.pedhc.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Parent caregivers of children who require lifesaving medical technology (e.g., mechanical ventilation, feeding tubes) must constantly maintain vigilance. Poor physical and psychological health can negatively impact their ability to do so. METHOD A two-arm randomized controlled trial was conducted with 197 parent caregivers of technology-dependent children (aged < 18 years) to test the efficacy of Resourcefulness Training1, a cognitive-behavioral intervention that teaches social (help-seeking) and personal (self-help) resourcefulness skills, in improving key outcomes including mental health-related quality of life (HRQOL), depressive cognitions and symptoms, perceived and physiological chronic stress, burden, and physical HRQOL at five-time points. RESULTS Mixed-effects models using the intent-to-treat principle indicated statistically significant improvement with intervention participants at six and/or nine months postintervention for depressive cognitions, perceived stress, and physical HRQOL, controlling for covariates. DISCUSSION Study findings support the efficacy of Resourcefulness Training to significantly decrease perceived stress and improve psychological/physical outcomes with these vulnerable caregivers.
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Andrade LMC, Lemos SRM, Barbieri-Figueiredo MDCA, Lima LMM. Quality of life and family management of paediatric chronic condition amidst the COVID-19 pandemic. J Pediatr Nurs 2024; 75:e34-e41. [PMID: 38216349 DOI: 10.1016/j.pedn.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE This study aimed to describe the perception of parents of children/adolescents with chronic conditions of their quality of life and family functioning during the COVID-19 pandemic and explore how the COVID-19 pandemic affected family management of children/adolescents' chronic conditions. DESIGN AND METHODS A total of 237 parents of children/adolescents with chronic conditions participated in this cross-sectional study. Data were collected through an online questionnaire using the Paediatric Quality of Life Inventory™ Family Impact Module and an open-ended question about the impact of the pandemic on the family management of the paediatric chronic condition. RESULTS The Total Score of PedsQL™ FIM was slightly higher than the midpoint of the scale (M = 60.27; SD = 19.04), and the impact of the pandemic on the family's management of the chronic condition was perceived by 30% of parents as high or moderate. Statistically significant differences were found between parents who reported a high or moderate impact of the pandemic and those reporting little or no impact of the pandemic regarding parental quality of life and family functioning (t (233) = 8.13, p = .00, Cohen's d = 1.14). Two themes emerged from the analysis of the open-ended question: Impact on the child/adolescent and Impact on the family. CONCLUSIONS Parents of children/adolescents with chronic conditions reported an average quality of life, and the COVID-19 pandemic significantly impacted the family management of chronic conditions. PRACTICE IMPLICATIONS These results highlight the importance of developing interventions to support families in complex situations and contexts, targeting family functioning, family quality of life, and emotional management.
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Affiliation(s)
- Luísa Maria Costa Andrade
- Nursing School of Porto, Porto, Portugal; Center for Health Technology and Services Research at the Health Research Network (CINTESIS@RISE), Porto, Portugal.
| | | | - Maria Do Céu Aguiar Barbieri-Figueiredo
- Nursing School of Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; University of Huelva, Huelva, Spain.
| | - Lígia Maria Monteiro Lima
- Nursing School of Porto, Porto, Portugal; Center for Health Technology and Services Research at the Health Research Network (CINTESIS@RISE), Porto, Portugal.
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Xavier WDS, Abreu MP, Nunes MDR, Silva-Rodrigues FM, da Silva LF, de Araújo BBM, De Bortoli PS, Neris RR, Nascimento LC. The Sleep Patterns of Children and Adolescents with Chronic Conditions and Their Families: An Integrative Literature Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:207. [PMID: 38397320 PMCID: PMC10887388 DOI: 10.3390/children11020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Sleep is of vital necessity for health, and it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose of this study was to identify the scientific production on sleep patterns in children and adolescents with chronic conditions and their families. This integrative review was conducted between March and June 2022 using the databases of MEDLINE, Web of Science, CINAHL and PsycINFO. The articles included were original papers published between January 2007 and mid-2022. Excluded were review studies that did not evaluate sleep and whose participants did not have chronic conditions or were not children, adolescents and/or their families. The searches returned 814 abstracts. After exclusions, 47 studies were selected to be read in full; of these, 29 were selected and were grouped empirically into four categories: major alterations in the sleep patterns of children and adolescents with chronic conditions; the relationship between sleep disorders and symptoms in children and adolescents with chronic conditions; the impaired sleep patterns of families of children and adolescents with chronic conditions; and sleep alterations and their relationship with other problems in families of children and adolescents with chronic conditions. All studies showed sleep pattern impairment in children and adolescents with chronic conditions as well as their families.
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Affiliation(s)
- Welker da Silva Xavier
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Madalena Paulos Abreu
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Michelle Darezzo Rodrigues Nunes
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Fernanda Machado Silva-Rodrigues
- Maternal-Infant and Psychiatric Nursing Department, School of Nursing, University of Sao Paulo, São Paulo 05403-000, SP, Brazil;
| | - Liliane Faria da Silva
- Maternal-Infant and Psychiatric Nursing Department, Aurora de Afonso Costa School of Nursing, Fluminense Federal University, Niteroi 22020-091, RJ, Brazil;
| | - Barbara Bertolossi Marta de Araújo
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Paula Saud De Bortoli
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
| | - Rhyquelle Rhibna Neris
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
| | - Lucila Castanheira Nascimento
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
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Chukwuemeka NA, Obioha CW. Emotion regulation strategies on psychological distress and psychological well-being of caregivers of mentally challenged children: moderating role of social support. PSYCHOL HEALTH MED 2024; 29:79-91. [PMID: 38084707 DOI: 10.1080/13548506.2023.2289473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
This study investigates the moderating role of social support in the relationship between emotion regulation, psychological distress, and psychological well-being of caregivers of mentally challenged children. A total of 315 caregivers aged 18-62 (Mage = 36.99, SD = 9.90; 38.7% male, 61.3% female) completed the Emotion Regulation Questionnaire, Multidimensional Scale of Perceived Social Support, Depression Anxiety Stress Scale, and Psychological Well-being Scale. The results indicated that social support significantly moderated the relationship between cognitive reappraisal, expressive suppression, and psychological well-being. However, the moderating effect of social support in the relationship between cognitive reappraisal, expressive suppression, and psychological distress was insignificant. The findings suggest that caregivers of mentally challenged children with high social support will report higher psychological well-being when they adopt cognitive reappraisal and expressive suppression strategies.
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Affiliation(s)
| | - Chidiebere Wisdom Obioha
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- Health Promotion and Public Health, Robert Gordon University, Aberdeen, UK
- Zonal Administrative Unit, Central Hospital, Oleh, Isoko South, Delta State, Nigeria
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Ryan H, Burgess A, Jackson C, Hewson-Ravenscroft A, Meiser-Stedman R. High prevalence of depression in parents of children with Type 1 diabetes in a meta-analysis of data from five continents. Acta Paediatr 2023. [PMID: 38140731 DOI: 10.1111/apa.17059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
AIM This meta-analysis identified the prevalence of depression in parents of children with Type 1 diabetes. METHODS MEDLINE, PsycINFO and CINAHL databases were searched for papers published in English from 1980 to May 2022, yielding 18 studies (N = 2044 participants). The prevalence of parental depression was pooled across the studies. RESULTS The prevalence of depression among parents of children with Type 1 diabetes was high. Random-effects meta-analyses estimated the prevalence of moderate depression and above in the total sample as 18.4% (95% CI 12.8-24.6; k = 17, N = 2044), with rates of 17.3% in mothers (95% CI 12.7-22.5; k = 12, N = 1106) and 9% in fathers (95% CI 4.3-15.1; k = 6, N = 199). The estimated prevalence of mild depression and above in the total sample was 32.7% (95% CI 20.3-46.6; k = 8, N = 797), with rates of 29.4% in mothers (95% CI 17.8-42.6; k = 4 N = 330) and 13.6% in fathers (95% CI 5.2-25.2; k = 2 N = 44). All results were characterised by high levels of heterogeneity. The risk of publication bias was low. CONCLUSION More than 1 in 6 parents of children with Type 1 diabetes had depression in the moderate plus category. The limitations and implications of these results are discussed.
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Affiliation(s)
- Hayley Ryan
- Central Norfolk Stroke Services, Norwich Community Health and Care NHS Trust, Norwich Community Hospital, Norwich, Norfolk, UK
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Aaron Burgess
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Clare Jackson
- Department of Psychological Medicine, Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK
- Addenbrookes Hospital, Cambridge, UK
| | - Alyssa Hewson-Ravenscroft
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
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Shi ZS, Wang XB, Wang MC, Zeng YY. Effects of WeChat follow-up management on the psychological distress, care burden, and quality of life of parents of infants with bronchopulmonary dysplasia: a retrospective cohort study. Front Pediatr 2023; 11:1239527. [PMID: 37635790 PMCID: PMC10449024 DOI: 10.3389/fped.2023.1239527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Objective The objective was to explore the impact of WeChat follow-up management on the psychological distress, care burden, and quality of life of parents of infants with bronchopulmonary dysplasia (BPD) receiving in-home care. Methods This was a retrospective cohort study. A total of 101 parents of infants with BPD who were followed up from January 2016 to January 2022 were included in this study. According to different follow-up methods, these patients were classified into the WeChat group and the routine group. The Depression, Anxiety, and Stress Scale-21 (DASS-21), Zarit Caregiver Burden Interview (ZBI), and WHOQOL-BREF were used. The data on the psychological distress, care burden, and quality of life of the parents in the two groups were analyzed and compared at discharge and at the 3-month follow-up. Results There was no significant difference in the DASS-21 and ZBI scores at discharge between the parents in the two groups. During the 3-month follow-up, the scores of the DASS-21 anxiety and stress subscale and the ZBI of parents in the WeChat group were significantly lower than those of parents in the routine group (P < 0.05); however, there was no significant difference in the depression subscale score between the two groups (P > 0.05). A comparison of the WHOQOL-BREF score between the two groups showed that the total quality of life score in the WeChat group was significantly higher than that in the routine group (P < 0.05). The scores of the psychological and social relationship fields in the WeChat group were significantly higher than those in the routine group (P < 0.05). The incidence of adverse events during follow-up was significantly lower in the WeChat group than in the routine group (P < 0.05). Conclusion WeChat follow-up management is helpful to decrease the anxiety and stress, reduce the care burden, and improve the quality of life of parents of infants with BPD receiving in-home care.
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Affiliation(s)
- Zhong-Shan Shi
- Department of Pediatrics, Shishi General Hospital, Quanzhou, China
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Vu HM, Tran TH, Dang AK, Hoang TN, Nguyen CT, Nguyen HLT, Latkin CA, Ho CSH, Ho RCM. Sleep disorders among patients suffering from road traffic injuries in an urban setting of Vietnam: an exploratory study. Sci Rep 2023; 13:11496. [PMID: 37460778 PMCID: PMC10352290 DOI: 10.1038/s41598-023-38693-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
Sleep quality is an important indicator of treatment outcome for patients with traffic accident injuries. In Vietnam, the impacts of injury on sleep status are usually amplified in urban areas due to disproportionate distribution of mental care services between the city and less developed settings. Our study investigated deterioration in sleep quality and identified associated demographic factors among traffic injury patients in an small urban setting of Vietnam. A cross-sectional study was conducted among 408 patients in one provincial hospital and five district hospitals in Thai Binh, Vietnam from October to December 2018. A structured questionnaire was designed based on 3 standardized scales: Health-related Quality of Life, the Pittsburgh Sleep Quality Index and the Kessler Scale. Face-to-face interviews and medical records were conducted by trained health professionals on patients hospitalized in the Trauma-Orthopedic/Burn Department and Surgery and General Department. About 16.9% of respondents had sleep disturbances, and there was a statistically significant difference between age group (p < 0.01), education level (p < 0.01), and monthly household income (p < 0.01) between participants who with and without sleep disturbances. Furthermore, more than half (50.7%) of respondents sleep less than 5 h per day, while 18.7% of the sampled also reported that the habitual sleep efficiency was below 85%. Current results indicated that people being female, suffering from traumatic brain injury, being comatose at hospitalization, and having higher psychological distress scores were more likely to suffer from sleep problems. Our study is one of the first evidence in Vietnam to assess sleep disturbances in road traffic injury patients and their correlated factors. It is important to identify patients who are at risk of sleep disturbances based on socio-demographic and clinical characteristics, as well as psychological distress status. Therefore, a holistic approach should be taken to include sleep quality and psychological state in the treatment process and outcome assessment for road traffic injury patients.
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Affiliation(s)
- Hai Minh Vu
- Department of Trauma, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - Tung Hoang Tran
- Institute of Orthopaedic and Trauma Surgery, Vietnam-Germany Hospital, Hanoi, 100000, Vietnam
| | - Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Trong Nang Hoang
- Department of Ophthalmology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Huong Lan Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119077, Singapore
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Foster C, Noreen P, Grage J, Kwon S, Hird-McCorry LP, Janus A, Davis MM, Goodman D, Laguna T. Predictors for invasive home mechanical ventilation duration in bronchopulmonary dysplasia. Pediatr Pulmonol 2023. [PMID: 37114844 DOI: 10.1002/ppul.26437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Children with bronchopulmonary dysplasia (BPD) who require invasive home mechanical ventilation (IHMV) are medically vulnerable and experience high caregiving and healthcare costs. Predictors for duration of IHMV in children with BPD remain unclear, which can make prognostication and decision-making challenging. METHODS A retrospective cohort study of children with BPD requiring IHMV was conducted from independent children's hospital records (2005-2021). The primary outcome was IHMV duration, defined as time from initial discharge home on IHMV until cessation of positive pressure ventilation (day and night). Two new variables were included: discharge age corrected for tracheostomy (DACT) (chronological age at discharge minus age at tracheostomy) and level of ventilator support at discharge (minute ventilation per kg per day). Univariable Cox regression was performed with variables of interest compared to IHMV duration. Significant nonlinear factors (p < 0.05) were included in the multivariable analysis. RESULTS One-hundred-and-nineteen patients used IHMV primarily for BPD. Patient median index hospitalization lasted 12 months (interquartile range [IQR] 8.0,14.4). Once home, half of the patients were weaned off IHMV by 36.0 months and 90% by 52.2 months. Being Hispanic/Latinx ethnicity (hazard ratio [HR] 0.14 (95% confidence interval [CI] 0.04, 0.53), p < 0.01) and having a higher DACT were associated with increased IHMV duration (HR 0.66 (CI 0.43, 0.98), p < 0.05). CONCLUSIONS Disparity in IHMV duration exists among patients using IHMV after prematurity. Prospective multisite studies that further investigate new analytic variables, such as DACT and level of ventilator support, and address standardization of IHMV care are needed to create more equitable IHMV management strategies.
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Affiliation(s)
- Carolyn Foster
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Digital Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Paige Noreen
- McGaw Medical Center, Northwestern University, Chicago, Illinois, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Jennifer Grage
- McGaw Medical Center, Northwestern University, Chicago, Illinois, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Soyang Kwon
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Lindsey P Hird-McCorry
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Pulmonary Habilitation Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Angela Janus
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Pulmonary Habilitation Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Matthew M Davis
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Denise Goodman
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Pulmonary Habilitation Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Theresa Laguna
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Pulmonary Habilitation Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Ergenekon AP, Gümüş Z, Yegit CY, Cenk M, Gulieva A, Kalyoncu M, Selcuk M, Karabulut S, Ozturk G, Eralp EE, Unver O, Karadag B, Gokdemir Y. Depression, anxiety, and sleep quality of caregivers of children with spinal muscular atrophy. Pediatr Pulmonol 2023; 58:1697-1702. [PMID: 36856268 DOI: 10.1002/ppul.26379] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the prevalence of anxiety, depression, sleep, and associated factors in caregivers of children with spinal muscular atrophy (SMA). MATERIALS AND METHODS Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory-State (STAI-S), the State-Trait Anxiety Inventory-Trait (STAI-T), and Pittsburgh Sleep Quality Index (PSQI) were used to assess the anxiety, depression, and sleep quality of the caregivers of children with SMA. Higher scores indicated worse outcome for all three questionnaires. RESULTS Fifty-six caregivers of children with SMA were included in the study. Median age of children was 6 (3.2-10) years and mean age of the caregivers was 37.0 ± 6.5 years. Median scores of the BDI, STAI-S, STAI-T, and PSQI were 12 (7.2-17), 35.5 (31-44), 40.5 (35-48), and 7.0 (5.0-10.0), respectively. There was a positive correlation between BDI and PSQI scores (p < 0.05). There was a negative correlation between the age of the caregivers and PSQI, BDI, STAI-T scores (p = 0.01, r = -0.341; p = 0.006, r = -0.364; p = 0.003, r = -0.395, respectively). There was a negative correlation between the age of the patients and the PSQI scores of the caregivers (p = 0.01, r = -0.33). There was a negative correlation between BDI scores and household income (p = 0.01, r = -0.34). CONCLUSION Caregivers of children with SMA had elevated depression and anxiety levels and they also had decreased sleep quality. Economic and social support resources are needed to help caregivers of those children.
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Affiliation(s)
- Almala Pinar Ergenekon
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Zeynep Gümüş
- Marmara University School of Medicine, Istanbul, Turkey
| | - Cansu Yilmaz Yegit
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Muruvvet Cenk
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Aynur Gulieva
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mine Kalyoncu
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Merve Selcuk
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Seyda Karabulut
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gulten Ozturk
- Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Olcay Unver
- Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
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12
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Lee DMX, Tan AKS, Ng YPM, Amin Z. Quality of life of patients and caregivers affected by bronchopulmonary dysplasia: a systematic review. Qual Life Res 2022:10.1007/s11136-022-03311-y. [DOI: 10.1007/s11136-022-03311-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
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13
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Smith S, Tallon M, Smith J, Angelhoff C, Mörelius E. Parental sleep when their child is sick: A phased principle-based concept analysis. J Sleep Res 2022; 31:e13575. [PMID: 35468663 PMCID: PMC9786861 DOI: 10.1111/jsr.13575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic literature search including databases CINAHL, Embase, MEDLINE, PsychARTICLES, PsychINFO, Pubmed, Scopus and Web of Science, identified 546 articles. The final dataset comprised 74 articles published between 2005 and 2021 and was assessed using a criteria tool for principle-based concept analysis. Data were managed using NVivo, and thematic analysis was undertaken. A precise definition is not present in the literature. Various tools have been used to measure parents' sleep, as well as exploration via interviews, open-ended questions, and sleep diaries. The terminology used varied. Parental sleep when their child is sick is interrelated with other concepts (e.g., stress). A recommended definition is offered. A conceptual understanding of parental sleep when their child is sick will help to guide translational research and to conduct studies critical to clinical practice and research. Future research includes developing a measurement tool for parental sleep when their child is sick to be used in study design and future interventions.
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Affiliation(s)
- Stephanie Smith
- School of Nursing and MidwiferyEdith Cowan UniversityPerthWAAustralia,Perth Children's HospitalNedlands, PerthWAAustralia
| | - Mary Tallon
- School of NursingCurtin UniversityPerthWAAustralia
| | - James Smith
- Centre for Precision HealthCollaborative Genomics and Translation GroupSchool of Medical and Health SciencesEdith Cowan UniversityPerthWAAustralia,Centre for Healthcare Resilience and Implementation ScienceAustralian Institute for Health InnovationMacquarie UniversitySydneyNSWAustralia
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Evalotte Mörelius
- School of Nursing and MidwiferyEdith Cowan UniversityPerthWAAustralia,Perth Children's HospitalNedlands, PerthWAAustralia
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14
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Ischander M, Lozowski-Sullivan S. Psychologist's Unique Role in Improving Quality of Life of Children with Chronic Lung Diseases and Their Families. Pediatr Clin North Am 2022; 69:951-963. [PMID: 36207105 DOI: 10.1016/j.pcl.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pediatric chronic lung diseases burden their patients and families with heavy treatment loads, frequent extensive clinic visits to multiple providers, frequent emergency department visits and hospitalizations, and contribute to significant psychosocial issues with caregiver's burnout. The purpose of this chapter is to outline the psychosocial impact of the major pediatric chronic lung diseases and the unique role of the psychologist in relieving this burden. These include severe asthma, cystic fibrosis, bronchopulmonary dysplasia, and dependence on home mechanical ventilation.
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Affiliation(s)
- Mariam Ischander
- Department of Pediatric and Adolescent Medicine, Division of Pulmonology and Sleep Medicine, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
| | - Sheryl Lozowski-Sullivan
- Department of Pediatric and Adolescent Medicine, Division of Psychology, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
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15
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Marthinsen GN, Helseth S, Småstuen M, Bjorvatn B, Bandlien SM, Fegran L. Sleep patterns and psychosocial health of parents of preterm and full-born infants: a prospective, comparative, longitudinal feasibility study. BMC Pregnancy Childbirth 2022; 22:546. [PMID: 35794538 PMCID: PMC9258469 DOI: 10.1186/s12884-022-04862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background The early birth and hospitalization of a preterm infant in neonatal intensive care unit can produce several emotional and behavioural responses including sleep problems for parents. Few studies have explored sleep and its associations with health and HRQoL over time in this vulnerable parent population. This purpose of this study was to evaluate the feasibility of a prospective, comparative, longitudinal study of the sleep patterns and psychosocial health of preterm and full-born infants’ parents during the first postpartum year. Methods A prospective, comparative, longitudinal feasibility study was conducted. Parents of preterm infants were compared to parents of full-born infants to identify if there were differences in outcomes between the groups. The parents were instructed to wear actigraphs and complete sleep diaries for two consecutive weeks, and responded to a digital questionnaire covering stress, insomnia, fatigue, depression, social support, self-efficacy, and health-related quality of life. Survey data were collected at infant ages of 2, 6, and 12 months, actigraphy and sleep diary data were collected at infant age of 2 months only. Descriptive analysis was used to describe recruitment and attrition rates. Differences between completers and dropouts were analysed with a chi-square test (categorical data) and Mann–Whitney–Wilcoxon test for two independent samples (continuous variables). Results Between June 2019 and March 2020, 25 parents of a preterm infant and 78 parents of a full-born infant were recruited from four neonatal intensive care units and two maternity wards, respectively, in four Norwegian hospitals. Feasibility was predefined as recruiting ≥ 75 parents each of preterm and full-born infants. The target for the full-born group was reached. However, the preterm group recruitment was challenging. Actigraphs, sleep diaries, and questionnaires were evaluated as feasible for use in a future study. Attrition rates were high in both groups at 6 and 12 months. No parent-related characteristics were associated with participation at 6 months. At 12 months, dropouts had a statistically significantly lower age in the full-born group (both parents) and higher age and body mass index in the preterm group (fathers). Conclusions A longitudinal study is feasible; however, procedural changes, including using active methods and contacting participants, are necessary to increase the recruitment of preterm infants’ parents. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04862-1.
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16
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Foster CC, Shaunfield S, Black LE, Labellarte PZ, Davis MM. Improving Support for Care at Home: Parental Needs and Preferences When Caring for Children with Medical Complexity. J Pediatr Health Care 2022; 36:154-164. [PMID: 34688541 DOI: 10.1016/j.pedhc.2020.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/12/2020] [Accepted: 08/20/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We sought to characterize the current supports used by parents to care for children with medical complexity (CMC) at home and parental preferences for additional supports to meet identified gaps. METHOD Semistructured interviews were conducted with parents of 18 CMC. Interviews were transcribed then analyzed using a constant comparative approach. RESULTS Extended family and community offloaded nonmedical tasks, assisted financially, gave emotional reinforcement, and cared for CMC. Home health providers also directly cared for CMC, but access and quality varied. Government programs paid for in-home care, but eligibility varied. Parents wanted more paid home care but also more support completing nonmedical tasks, mitigating financial strains, and accessing mental health services. DISCUSSION Parents of CMC relied on family and community members to help fill existing gaps in-home care, but gaps remained, suggesting the need for more medical and social supports for the in-home care of CMC and their families.
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17
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Fucà E, Costanzo F, Ursumando L, Vicari S. Parenting Stress in Mothers of Children and Adolescents with Down Syndrome. J Clin Med 2022; 11:jcm11051188. [PMID: 35268278 PMCID: PMC8911183 DOI: 10.3390/jcm11051188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022] Open
Abstract
Parenting stress has deleterious effects on parents, children, and overall family functioning. Parents of children with intellectual disability, including Down Syndrome (DS), show higher levels of parenting stress than parents of typically developing children. This research aimed to (i) evaluate parenting stress levels in a group of mothers of youths with DS using a parent-report questionnaire, (ii) identify children’s individual and clinical features associated with maternal stress, and (iii) identify specific situational life/demographics factors related to maternal stress. Seventy-eight youths with DS underwent a neuropsychological evaluation, whereas mothers completed questionnaires for the assessment of parenting stress and of the child’s emotional and behavioral problems. We found that Parent–Child Difficult Interaction was the domain with the highest percentage of clinical scores (39.7%). Both internalizing and externalizing problems correlated with maternal stress, as well as autistic symptoms. The levels of maternal stress were not associated with any socio-demographic variable. After controlling for child-related correlates of maternal stress and for mothers’ age and education level, unemployed mothers exhibited higher levels of parental distress than employed mothers. The present study highlights that unemployment is related with parenting stress and potentially amenable to policy interventions supporting parents in combining work and family care.
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Affiliation(s)
- Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (E.F.); (L.U.); (S.V.)
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (E.F.); (L.U.); (S.V.)
- Correspondence: ; Tel.: +39-06-6859-7091
| | - Luciana Ursumando
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (E.F.); (L.U.); (S.V.)
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (E.F.); (L.U.); (S.V.)
- Department of Life Sciences and Public Health, Catholic University, 00168 Rome, Italy
- Casa San Giuseppe, Centro di Riabilitazione Opera Don Guanella, 00165 Rome, Italy
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18
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Morse BL, Serna RW, LaLumiere M, Rogal M, Foley K, Lombardo M, Manganello C, Pugh V, Veloz A, Solodiuk JC, Mauskar S. Leveraging Parent Pain Perspectives to Improve Pain Practices for Children with Medical Complexity. Pain Manag Nurs 2020; 22:169-176. [PMID: 33384241 DOI: 10.1016/j.pmn.2020.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/02/2020] [Accepted: 11/21/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Children with medical complexity (MC) must rely on others to notice and address pain. Parents are aware of child pain behaviors and can serve as reliable proxy reporters. Thus, there is a critical need to understand parent perspectives to improve pain practices. DESIGN Individual interviews were used as a data collection method in this qualitative study. METHODS Participants were recruited via mail and social media postings. Interviews were audio-recorded and transcribed verbatim. Transcribed documents were imported to NVIVO for qualitative analysis. Conventional and directed approaches to qualitative content analysis were used. RESULTS From the data analysis, major themes included: pain experiences, confidence in caregivers, parents are partners, proactive communication, and a spontaneous theme, "they can hear us." Emotional pain and challenges identifying the source pain were identified as sub-themes of pain experiences. CONCLUSIONS Parents in this study shared methods helpful to identifying pain in their children, as well as suggestions for discussing pain with caregivers. Priorities for future research include identifying methods for sharing pain information that are thorough, but do not burden parents or providers. Researchers should also determine how parents and caregivers can partner to identify and address pain in children with MC. Going forward, conversations about pain should be a key part of any admission assessment or first encounter. As pain episodes among children with MC can be complex and may not always be re-created in front of a provider, nurses may advise parents to take photos or videos to share with caregivers.
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Affiliation(s)
- Brenna L Morse
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts.
| | - Richard W Serna
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts Lowell, Lowell, Massachusetts
| | - McKenzie LaLumiere
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Micaela Rogal
- Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Kerri Foley
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Miranda Lombardo
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts
| | | | - Victoria Pugh
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Amy Veloz
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Jean C Solodiuk
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Sangeeta Mauskar
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
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19
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Ghasemi SR, Khezeli M, Rajabi-Gilan N, Koulani M, Moloudi-Safa N, Hemati A, Afkari M, Zolfaghari F. Sleep Quality and Health-Related Quality of Life in Workers of Kermanshah Industrial Town: A Correlation Study. Indian J Occup Environ Med 2020; 24:72-77. [PMID: 33281375 PMCID: PMC7703823 DOI: 10.4103/ijoem.ijoem_219_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/24/2020] [Accepted: 04/21/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Sleep Quality (SQ) is one of the most important predictors of quality of life in individuals. This study was conducted to evaluate the quality of life and SQ of industrial male workers in Kermanshah. Materials and Methods: In this cross-sectional study, 404 male workers selected by stratified sampling in the Kermanshah Industrial Town participated. The research questionnaires included demographic information checklist, the 36-Item Short-Form Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by SPSS18 software, using descriptive statistics, Pearson's correlation, and partial correlation tests. Results: The mean age of respondents was 35.33 ± 7.31; ranged from 20 to 62 years old. The mean score of mental health and physical health were 55.01 ± 21.62 and 54.96 ± 21.93, respectively. Out of all participants, 58.6% of participants had a score of 50 or less in terms of health-related quality of life (HRQL). Two dimensions of subjective SQ (1.48 ± 0.97) and sleep duration (1.48 ± 0.97) had the worst mean score, and sleep efficiency (0.05 ± 0.3) had the most favorable mean score. The results of the Pearson's correlation test showed that the total score of SQ had a negative and significant correlation with the main dimensions of quality of life (P < 0.001). The highest correlation was found between physical pain (r = 0.350) and mental health (r = 0.332) with SQ. Conclusion: This study showed that more than half of the workers reported poor HRQL. Besides, a considerable number of workers had some degree of sleep disorders. The results of the study showed that there is a moderate correlation between SQ and HRQL.
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Affiliation(s)
- Seyed-Ramin Ghasemi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Khezeli
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
| | - Nader Rajabi-Gilan
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
| | - Manoochehr Koulani
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
| | - Nooshin Moloudi-Safa
- Health Center of Kermanshah, Health Deputy, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Hemati
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
| | - Mojgan Afkari
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Zolfaghari
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah, University of Medical Sciences, Kermanshah, Iran
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20
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Toledano-Toledano F, Moral de la Rubia J, Nabors LA, Domínguez-Guedea MT, Salinas Escudero G, Rocha Pérez E, Luna D, Leyva López A. Predictors of Quality of Life among Parents of Children with Chronic Diseases: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:healthcare8040456. [PMID: 33153086 PMCID: PMC7712866 DOI: 10.3390/healthcare8040456] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
Quality of life (QOL) is a key aspect of the health care process for children with chronic diseases and their families. Although clinical evidence regarding the impact of chronic disease on children exists, few studies have evaluated the effects of the interaction between sociodemographic and psychosocial factors on the family caregiver's QOL, indicating a significant gap in the research literature. The present study aimed to identify the predictors of the QOL of parents of children with chronic diseases. Three parental sociodemographic predictors (age, schooling, and family income) and four psychosocial predictors (family functioning, social support, depression, and resilience) were examined. In this cross-sectional study, 416 parents of children with chronic diseases who were hospitalized at a National Institute of Health in Mexico City were interviewed. The participants completed a sociodemographic variables questionnaire (Q-SV) designed for research on family caregivers of children with chronic disease. The predicted variable was assessed through the World Health Organization Quality of Life Questionnaire. The four psychosocial predictors were assessed through the Family Functioning Scale, Social Support Networks Scale, Beck Depression Inventory, and Measurement Scale of Resilience. The regression model explained 42% of the variance in parents' QOL. The predictors with positive weights included age, schooling, monthly family income, family functioning, social support networks, and parental resilience. The predictors with negative weights included depression. These findings suggest that strong social relationships, a positive family environment, family cohesion, personal resilience, low levels of depression, and a family income twice the minimum wage are variables associated with better parental QOL.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Evidence-Based Medicine Research Unit, Hospital Infantil de Mexico Federico Gómez, National Institute of Health, Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Correspondence: ; Tel.: +52-55-8009-4677
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Carlos Canseco, 110, Esq. Aguirre Pequeño, Col. Mitras Centro, Monterrey 64460, Mexico;
| | - Laura A. Nabors
- School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH 45221-0068, USA;
| | - Miriam Teresa Domínguez-Guedea
- Department of Psychology and Communication Sciences, University of Sonora, Blvd. Luis Encinas y Rosales, Col. Centro S/N Hermosillo, Sonora 83000, Mexico;
| | - Guillermo Salinas Escudero
- Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de Mexico Federico Gómez, National Institute of Health, Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico;
| | - Eduardo Rocha Pérez
- Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria (Senasica), Anillo Perif. 5010, Insurgentes Cuicuilco, Coyoacán, Mexico City 04530, Mexico;
| | - David Luna
- Comisión Nacional de Arbitraje Médico, Mitla No. 250-8° Piso, esq. Eje 5 Sur (Eugenia), Vertiz Narvarte, Benito Juárez, Mexico City 03020, Mexico;
| | - Ahidée Leyva López
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca Morelos 62100, Mexico;
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21
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Mai K, Davis RK, Hamilton S, Robertson-James C, Calaman S, Turchi RM. Identifying Caregiver Needs for Children With a Tracheostomy Living at Home. Clin Pediatr (Phila) 2020; 59:1169-1181. [PMID: 32672065 DOI: 10.1177/0009922820941209] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study sought to understand caregiver needs of children with tracheostomies (CWT) living at home and inform development of standardized tracheostomy simulation training curricula. Long-term goals are decreasing hospital readmissions following tracheostomy placement and improving family experiences while implementing a medical home model. We recruited caregivers of CWT and conducted semistructured interviews, subsequently recorded, transcribed, and analyzed for emerging themes using NVivo. Demographic data were collected via quantitative surveys. Twenty-seven caregivers participated. Emerging themes included the following: (1) caregivers felt overwhelmed, sad, frightened when learning need for tracheostomy; (2) training described as adequate, but individualized training desired; (3) families felt prepared to go home, but transition was difficult; (4) home nursing care fraught with difficulty and yet essential for families of CWT. Families of CWT have specific needs related to discharge training, resources, support, and home nursing. Provider understanding of caregiver needs is essential for child well-being, patient-/family-centered care, and may improve health outcomes.
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Affiliation(s)
- Katherine Mai
- Drexel University, Philadelphia, PA, USA.,St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | | | - Sue Hamilton
- St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | | | - Sharon Calaman
- St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Renee M Turchi
- Drexel University, Philadelphia, PA, USA.,St. Christopher's Hospital for Children, Philadelphia, PA, USA
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22
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Berrocoso S, Amayra I, Lázaro E, Martínez O, López-Paz JF, García M, Pérez M, Al-Rashaida M, Rodríguez AA, Luna PM, Pérez-Núñez P, Blanco R, Nevado J. Coping with Wolf-Hirschhorn syndrome: quality of life and psychosocial features of family carers. Orphanet J Rare Dis 2020; 15:293. [PMID: 33076957 PMCID: PMC7574588 DOI: 10.1186/s13023-020-01476-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 07/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Wolf-Hirschhorn Syndrome (WHS) is a rare, congenital disease characterized by a distinctive facial phenotype, seizures, intellectual disability and developmental delay, and pre and postnatal growth requiring lifelong care. The psychosocial status of the family caregivers of children diagnosed with WHS is unknown. This study aims to characterize the sociodemographic and psychosocial profile of WHS caregivers and analyze how these variables impact their quality of life (QoL) and well-being. RESULTS The sociodemographic and clinical profile of 22 Spanish caregivers of children with WHS and the characteristics of those affected have been described. Significant relationships were found between sociodemographic and psychosocial characteristics among caregivers. The impact on the parents' QoL and negative relationship with the symptomatology were assessed. The use of engagement strategies such as problem focused coping was associated with improved psychological QoL and social support. CONCLUSIONS WHS caregivers share similarities in their profile and needs with caregivers of children with other rare diseases. Pychosocial support groups involving parents caring for children with the same disease could improve caregivers' well-being and QoL by strengthening their social support network and using positive coping styles.
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Affiliation(s)
- Sarah Berrocoso
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Imanol Amayra
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Esther Lázaro
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Oscar Martínez
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Juan Francisco López-Paz
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Maitane García
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Manuel Pérez
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Mohammad Al-Rashaida
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Alicia Aurora Rodríguez
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Paula Maria Luna
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Paula Pérez-Núñez
- Facultad de Psicología y Educación, Neuro-e-Motion, Investigación sobre aspectos Neuropsicológicos y Psicosociales de las Enfermedades Raras, Universidad de Deusto, Avda. Universidades 24, 48007 Bilbao, Spain
| | - Raquel Blanco
- Hospital Universitario Central de Asturias, Neurología Pediátrica, Oviedo, Spain
| | - Julián Nevado
- INGEMM Hospital Universitario La Paz Madrid, Instituto de Genética Médica y Molecular; CIBERER, Madrid, Spain
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Irwanto , Ratwita M, Prihaningtyas RA, Mustakim MRD. Impact of Caregiver's Psychological Aspects towards Quality of Life of Children with Acute Lymphoblastic Leukemia (ALL). Asian Pac J Cancer Prev 2020; 21:2683-2688. [PMID: 32986369 DOI: 10.31557/apjcp.2020.21.9.2683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Families who have children with Acute Lymphoblastic Leukemia (ALL) are at high risk of experiencing stress. Stress on the family can cause the formation of negative communication in children so that families tend to spend more time in dealing with negative emotions through negative actions. This study aimed to analyze the correlation between stress, anxiety, and depression in caregiver with pediatric ALL outcome. METHODS A cross sectional study was conducted on children with ALL and their caregivers at the Pediatric Ward, Dr. Soetomo Hospital, Surabaya. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) questionnaire were used to measure anxiety and depression in caregivers. Previous stressful experiences in children and caregivers were assessed by The Perceived Stress Scale (PSS), Children quality of life was assessed by pediatric quality of life inventory (PedsQL™) questionnaire. Pearson and Spearman correlation strength test was performed for the statistical analysis. RESULTS There is no significant correlation between stress level of caregivers with the quality of life of children with ALL (P > 0.05). There is negative correlation between the level of anxiety and depression in caregivers with the quality of life of children (P < 0.05). There is negative correlation between children stress level with the quality of life of children (P < 0.05). CONCLUSION The psychological condition of the caregiver affects the quality of life of children. The higher the level of anxiety and depression in caregivers, the lower the quality of life of children.<br />.
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Affiliation(s)
- - Irwanto
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Mia Ratwita
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Rendi Aji Prihaningtyas
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
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24
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Lynch MK, Thompson KA, Dimmitt RA, Barnes MJ, Goodin BR. Risk models for predicting the health-related quality of life of caregivers of youth with gastrointestinal concerns. Qual Life Res 2020; 29:3343-3351. [PMID: 32794088 DOI: 10.1007/s11136-020-02601-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the usefulness of cumulative and additive risk models in predicting the healthy-related quality of life (HRQOL) of caregivers of youth with chronic gastrointestinal conditions. METHODS 203 caregivers (82.8% mothers; 77.3% white) of youth (M = 11.27 years; 44.3% female; 78.8% White) completed self-report questionnaires focused on potential environmental, child health, and family risk factors that could impact caregiver HRQOL. Cumulative risk models, evaluating overall combined risk level, as well as an additive risk model, exploring individual risk variables, were evaluated. RESULTS Higher levels of cumulative risk were associated with poorer caregiver HRQOL after controlling for child and caregiver sex. A linear cumulative risk model was a better fit than a quadratic cumulative risk model for predicting caregiver HRQOL, while an additive model identified child HRQOL, child pain interference and family functioning as the most individually impactful risk variables. CONCLUSION This study illustrates the usefulness of both additive and cumulative risk approaches in identifying caregivers at risk for poor HRQOL. Provision of appropriate referrals and interventions based on the caregiver's risk factors can help protect caregiver quality of life and, in turn, benefit the care children with chronic conditions receive at home.
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Affiliation(s)
- Mary K Lynch
- Department of Psychiatry, Section of Psychology, Indiana University School of Medicine, IU Health Neuroscience Center Goodman Hall, 355 West 16th Street, Indianapolis, IN, 46202, USA.
| | - Kathryn A Thompson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Reed A Dimmitt
- Division of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Margaux J Barnes
- Division of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
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25
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Wang S, Cheung DSK, Leung AYM, Davidson PM. Factors associated with caregiving appraisal of informal caregivers: A systematic review. J Clin Nurs 2020; 29:3201-3221. [DOI: 10.1111/jocn.15394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 05/23/2020] [Accepted: 06/21/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Shanshan Wang
- Center for Gerontological Nursing School of Nursing The Hong Kong Polytechnic University Hong Kong China
- School of Nursing and Health Zhengzhou University Zhengzhou China
| | - Daphne Sze Ki Cheung
- Center for Gerontological Nursing School of Nursing The Hong Kong Polytechnic University Hong Kong China
| | - Angela Yee Man Leung
- Center for Gerontological Nursing School of Nursing The Hong Kong Polytechnic University Hong Kong China
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26
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Feeley CA, Sereika SM, Chasens ER, Siminerio L, Charron-Prochownik D, Muzumdar RH, Viswanathan P. Sleep in Parental Caregivers and Children With Type 1 Diabetes. J Sch Nurs 2019; 37:259-269. [PMID: 31366301 DOI: 10.1177/1059840519865942] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The purpose of this cross-sectional, descriptive, pilot study was to examine the correlations in sleep between caregivers (≥18 years) and young (6-12 years) children with type 1 diabetes. Sleep was measured in both parent and child over 7 days using actigraphy and a sleep diary. Parents completed questionnaires on sleep, stress, depressive symptoms, and demographics. Children completed pediatric anxiety and fatigue questionnaires, and A1C (Hemoglobin A1c) was documented at clinic. Descriptive statistics and Pearson correlations were used to analyze data. Parents (N = 18, mean age: 39.3 ± 5.4 years, 100% Caucasian, 83% mothers) and children (N = 18, mean age: 9.6 ± 2.4 years, diagnosed for mean 3.0 ± 2.4 years, 66% female, mean A1C: 7.5 ± 0.8%) were recruited. Strong to moderate correlations were found for several measures including sleep measures based on actigraphy: mean sleep duration (hours; 7.6 ± 0.7 for parents and 8.8 ± 0.8 for children; r = .638, p = .004), mean sleep efficiency (r = .823, p < .001), and mean daily wake after sleep onset (minutes; r = .530, p = .024).
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Affiliation(s)
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eileen R Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Linda Siminerio
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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27
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Foster CC, Agrawal RK, Davis MM. Home Health Care For Children With Medical Complexity: Workforce Gaps, Policy, And Future Directions. Health Aff (Millwood) 2019; 38:987-993. [DOI: 10.1377/hlthaff.2018.05531] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Carolyn C. Foster
- Carolyn C. Foster is an assistant professor of pediatrics in the Division of Academic General Pediatrics and Primary Care at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, in Chicago, Illinois
| | - Rishi K. Agrawal
- Rishi K. Agrawal is an associate professor of pediatrics in the Division of Hospital-Based Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine
| | - Matthew M. Davis
- Matthew M. Davis is a professor and division head of Academic General Pediatrics and Primary Care at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine
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28
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Torres GCS, Paragas ED. Social determinants associated with the quality of life of baccalaureate nursing students: A cross-sectional study. Nurs Forum 2019; 54:137-143. [PMID: 30332518 DOI: 10.1111/nuf.12306] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/12/2018] [Accepted: 09/26/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND There is a paucity of studies that have explored the quality of life (QoL) of nursing students in the Philippines. OBJECTIVES The study assessed the QoL and identified the social determinants associated with the four domains of QoL among nursing students. METHODS This cross-sectional study was conducted among 444 randomly selected baccalaureate nursing students in a university in the Philippines. The QoL was determined using an adapted WHOQOL-BREF questionnaire (∝ = 0.89). Multiple linear regression determined the association between the variables of the study. RESULTS The students exhibited better scores in social relationships and environment than psychological and physical health domains of QoL. Physical health was significantly correlated to sex, hours of sleep, and medical condition, whereas sex, year level, academic load, hours of sleep, and medical condition were correlated to psychological domain. However, no significant association was noted between the factors and social relationships, but monthly allowance was positively correlated with the environment domain. CONCLUSIONS Various social determinants influence the QoL; thus, it is essential to be considered as a critical element in planning the curriculum to improve the QoL among baccalaureate students.
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Affiliation(s)
- Gian Carlo Sy Torres
- College of Nursing, University of Santo Tomas, España Blvd., Sampaloc, Manila, Philippines
| | - Emmanuel Dayao Paragas
- College of Nursing, University of Santo Tomas, España Blvd., Sampaloc, Manila, Philippines
- Nursing Services Department, J.W. Ruby Memorial Hospital, West Virginia University Medicine, Morgantown, West Virginia
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29
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Kang A, Yu Z, Foo M, Chan CM, Griva K. Evaluating Burden and Quality of Life among Caregivers of Patients Receiving Peritoneal Dialysis. Perit Dial Int 2019; 39:176-180. [DOI: 10.3747/pdi.2018.00049] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Peritoneal dialysis (PD) is advocated as treatment of choice for most end-stage renal disease (ESRD) patients, including elderly and frail patients. It typically requires caregiver involvement to support care at home. The purpose of this study was to examine changes in burden and quality of life (QOL) in caregivers of prevalent PD patients over 12 months. Data were collected in 44 caregivers of PD patients (mean age 38.4 ± 6.3 years; 60% female) in Singapore at baseline and 12 months. Measures included demographics, the Lay Care-Giving for Adults Receiving Dialysis (LC-GAD), Zarit Burden Interview (ZBI), and the World Health Organization Quality of Life instrument (WHOQOL-BREF). Paired t-tests indicate a significant decrease in task-related aspects of caregiving ( p = 0.04), particularly in relation to personal hygiene ( p < 0.01), over time. Cognitive aspects of caregiving remained unchanged. Perceived burden, however, significantly increased ( p < 0.01), with significantly more caregivers reporting moderate to severe caregiver burden at follow-up (28%) relative to baseline (13%; p < 0.01). There was a significant reduction in psychological health (under WHOQOL) ( p = 0.01). Study findings indicate an increase in caregiver burden and a reduction in psychological health despite a reduction in task-related aspects of caregiving, supporting a further exploration of the “wear-and-tear” hypothesis among this population. Intervention strategies are needed.
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Affiliation(s)
- Augustine Kang
- Department of Psychology Brown University School of Public Health Providence, RI, USA
- National University of Singapore, Singapore Department of Behavioral and Social Sciences Brown University School of Public Health Providence, RI, USA
| | - Zhenli Yu
- Department of Psychology Brown University School of Public Health Providence, RI, USA
| | - Marjorie Foo
- Department of Renal Medicine Singapore General Hospital, Singapore
| | - Choong Meng Chan
- Department of Renal Medicine Singapore General Hospital, Singapore
| | - Konstadina Griva
- Department of Psychology Brown University School of Public Health Providence, RI, USA
- Center for Population Health Sciences Imperial College London & Nanyang Technological University, Singapore
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30
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Ho S, Soong W, Wang KK. Stress and uncertainty in parents of children with tracheobronchial malacia and stenosis. Nurs Crit Care 2019; 24:399-406. [DOI: 10.1111/nicc.12413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/01/2018] [Accepted: 12/11/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Shing‐Huey Ho
- Paediatric Intensive Care UnitTaipei Veteran General Hospital Taipei City Taiwan, R.O.C
| | - Wen‐Jue Soong
- Paediatrics DepartmentTaipei Veteran General Hospital Taipei City Taiwan, R.O.C
| | - Kai‐Wei K Wang
- Department of NursingMackay Medical College New Taipei City Taiwan, R.O.C
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31
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Feeley CA, Clougherty M, Siminerio L, Charron-Prochownik D, Allende AL, Chasens ER. Sleep in Caregivers of Children With Type 1 Diabetes. DIABETES EDUCATOR 2018; 45:80-86. [PMID: 30465480 DOI: 10.1177/0145721718812484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose The purpose of this study was to explore caregivers’ descriptions of their experience of nighttime sleep. Design and Methods Caregivers (N = 22) of children 10 to 18 years of age with type 1 diabetes (T1D) were recruited for this descriptive study. Anonymous questionnaires contained demographic information and both open- and closed-ended questions that focused on caregiving as it related to sleep. Open-ended questions were reviewed to help understand the effect of nocturnal caregiving activities on parental sleep. Results The sample of caregivers were all female and had a mean age of 43 years; 96% graduated high school, 68% were married or partnered, and 100% were white. Children had been diagnosed with T1D for a mean of 5 years, with a mean age of 12.2 years. Caregivers reported short sleep duration (mean, 5.8 hours). Over half of the participants reported they required ≥7 hours of sleep to feel their best, 64% indicated trouble sleeping at night, and 86% reported that caregiving interfered with their nighttime sleep, while 54% responded that sleep was “very important.” Content analysis of the open-ended questions revealed 2 themes: (1) anxiety about the child’s blood glucose levels and (2) nighttime disruptions. Conclusions Caregivers are frequently sleep deprived and worry about their child’s nighttime glucose. Caregiving duties, anxiety, and sleep fragmentation may contribute to their poor sleep.
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Affiliation(s)
| | | | - Linda Siminerio
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Anna L Allende
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
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32
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Starks SA, Outlaw F, Graff JC, Likes W, White-Means S, Melaro L, Wicks MN. Quality of Life and African American Women Who are Family Caregivers: A Literature Review with Implications for Psychiatric Mental Health Advanced Practice Registered Nurses. Issues Ment Health Nurs 2018; 39:467-481. [PMID: 29451830 DOI: 10.1080/01612840.2017.1423427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE To identify factors affecting the quality of life (QOL) of African American women (AAW) family caregivers of individuals with kidney failure. METHODS Ferrans' Conceptual Model of QOL provided the framework for this literature review. Included studies were (a) peer- reviewed, (b) published within the last ten years, (c) written in English, and (d) examined QOL of AAW family caregivers. Using CINAHL© and PubMed©, we found 14 studies that described factors associated with these caregivers' QOL. SCOPE Few studies document the QOL of AAW who are family caregivers, especially in the context of kidney failure. Psychiatric Mental Health Advanced Practice Registered Nurses need to learn about the factors influencing the QOL of these caregivers. RESULTS No studies were found within the last ten years that explored the QOL of AAW family caregivers of individuals with kidney failure. Findings reflected the QOL of AAW family caregivers in the context of other chronic conditions. Various factors such as stress, insomnia, and employment were linked to an impaired QOL. Implications for practice, research and education for PMH-APRNs are suggested. CONCLUSION PMH-APRNs are uniquely trained to address many factors that affect the QOL of these caregivers and may provide holistic care aimed at promoting satisfactory QOL for these caregivers.
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Affiliation(s)
- Shaquita A Starks
- a University of Tennessee Health Science Center, Department of Health Promotion and Disease Prevention, College of Nursing , Memphis , Tennessee , USA
| | - Freida Outlaw
- b Substance Abuse and Mental Health Services Administration Minority Fellowship Program, American Nurses Association , Silver Spring , Maryland , USA
| | - J Carolyn Graff
- c University of Tennessee Health Science Center, Nursing Science Program Director , Memphis , Tennessee , USA
| | - Wendy Likes
- d University of Tennessee Health Science Center, College of Nursing , Memphis , Tennessee , USA
| | - Shelley White-Means
- e University of Tennessee Health Science Center, Department of Clinical Pharmacy, Consortium on Health Education, Economic Empowerment and Research (CHEER) , Memphis , Tennessee , USA
| | - Laura Melaro
- f University of Tennessee Health Science Center, Nursing Practice Psychiatric Mental Health Concentration Coordinator , Memphis , Tennessee , USA
| | - Mona N Wicks
- a University of Tennessee Health Science Center, Department of Health Promotion and Disease Prevention, College of Nursing , Memphis , Tennessee , USA
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33
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Keilty K, Cohen E, Spalding K, Pullenayegum E, Stremler R. Sleep disturbance in family caregivers of children who depend on medical technology. Arch Dis Child 2018; 103:137-142. [PMID: 29074731 DOI: 10.1136/archdischild-2016-312205] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Family caregivers of children who depend on medical technology (CMT) provide highly skilled care up to 24 hours per day. Sleep disruption places family caregivers at risk for poor health and related outcomes that threaten their long-term caregiving capacity. Few studies exist that have measured sleep in family caregivers, and most have relied entirely on subjective measures. METHODS In a prospective cohort study, family caregivers of CMT (n=42) and caregivers of healthy children (n=43) were recruited. Actigraphy data and a concurrent sleep diary were collected for 6 days/7 nights. Measures of sleep quality, depression, sleepiness, fatigue and quality of life were also administered. RESULTS Family caregivers of CMT averaged fewer hours of sleep per night (mean (SD)) (6.56 ± 1.4 vs 7.21 ± 0.6, p=0.02) of poorer quality (7.75 ± 2.9 vs 5.45 ± 2.8, p<0.01) than the control group. Three times as many family caregivers of CMT scored in the range for significant depressive symptomatology (12(33%) vs 4(10%), p=0.01) and experienced excessive daytime sleepiness (16(38%) vs 5(12%), p<0.01). Fatigue was also more problematic among family caregivers of CMT (22.12 ± 9.1 vs 17.44 ± 9.0, p=0.02). CONCLUSIONS Family caregivers of CMT are at risk of acute and chronic sleep deprivation, psychological distress and impaired daytime function that may threaten their capacity for sustained caregiving. Family caregivers of CMT may be important targets for screening for sleep disorders and the development of novel sleep-promoting interventions.
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Affiliation(s)
- Krista Keilty
- Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Eyal Cohen
- Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Karen Spalding
- University of Toronto, Toronto, Ontario, Canada.,Ryerson University, Toronto, Ontario, Canada
| | - Eleanor Pullenayegum
- Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Robyn Stremler
- Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
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Abstract
Rett syndrome (RTT) requires total caregiver attention and leads to potential difficulties throughout life. The Caregiver Burden Inventory, designed for Alzheimer disease, was modified to a RTT Caregiver Inventory Assessment (RTT CIA). Reliability and face, construct, and concurrent validity were assessed in caregivers of individuals with RTT. Chi square or Fisher's exact test for categorical variables and t tests or Wilcoxon two-sample tests for continuous variables were utilized. Survey completed by 198 caregivers; 70 caregivers completed follow-up assessment. Exploratory factor analysis revealed good agreement for physical burden, emotional burden, and social burden. Internal reliability was high (Cronbach's alpha 0.898). RTT CIA represents a reliable and valid measure, providing a needed metric of caregiver burden in this disorder.
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35
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Macedo EC, da Silva LR, Paiva MS, Ramos MNP. Burden and quality of life of mothers of children and adolescents with chronic illnesses: an integrative review. Rev Lat Am Enfermagem 2017; 23:769-77. [PMID: 26444180 PMCID: PMC4623740 DOI: 10.1590/0104-1169.0196.2613] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: to identify and analyze the evidence available regarding evaluation of burden and
quality of life of mothers who are caregivers for children and adolescents with
chronic illnesses. Method: an integrative review, undertaken in the electronic sources MEDLINE; Academic
Search Premier; CINAHL; LILACS; SciELO and PubMed, between 2010 and 2014. Results: among the 22 documents selected, there was a predominance of convenience samples
and non-experimental transversal designs, at the levels IV and III2. The caregiver
burden scales used were the Zarit Burden Interview and Montgomery-Borgatta
Caregiver Burden Scale-Revised along with the following instruments for evaluating
quality of life: The World Health Organization Quality of Life-BREF Scale;
Self-report questionnaires; The Ulm Quality of Life Inventory for Parents of
chronically ill children; Asthma Caregiver Quality of Life Questionnaire; and the
Nottingham Health Profile. Quality-of-life appears to be influenced in a complex
and interrelated way by the physical and mental health of the mothers who are
caregivers, in accordance with their level of independence, social relationships,
environment, and the extent to which they see themselves as burdened. Conclusion: the revealing of the results for the evaluation of burden and quality of life of
mothers who are caregivers has implications for the planning and implementation of
effective interventions, by the multidisciplinary team, if they are to relieve the
burden.
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Ekim A, Hecan M, Oren S. Psychometric Properties of the Turkish Version of Caregiver Burden Index (CBI) for Parents of Children with Allergies. J Pediatr Nurs 2017; 35:78-82. [PMID: 28728773 DOI: 10.1016/j.pedn.2017.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 03/18/2017] [Accepted: 03/18/2017] [Indexed: 11/26/2022]
Abstract
UNLABELLED Childhood chronic diseases have a great impact, including physiological, social and financial burdens, on parents. The concept of "caregiver burden" is gaining importance to understand the effects of allergic diseases and plan family-centered strategies. PURPOSE The purpose of this study was to examine the psychometric properties of the Caregiver Burden Index (CBI) in Turkish mothers of children with allergies. METHOD The participants of this methodological study were 213 mothers of children with allergies between 6 and 12years. Construct validity was evaluated through factor analysis and reliability was evaluated through internal consistency and item-total correlation. RESULTS In reliability analysis, the overall Cronbach's alpha value (0.85) demonstrated a high level of reliability. The corrected item-total correlation varied between 0.63 and 0.84. In exploratory factor analysis, it was detected that 3 factors structure explained 73.6% of the total variance. CONCLUSION This study indicated that the CBI is a valid and reliable tool to assess the caregiver burden of mothers of Turkish children with allergies. IMPLICATION FOR PRACTICES The results of this study contribute to the development and implementation of evidence based models of care that address the caregiver burden needs of parents whose children have allergies.
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Affiliation(s)
- Ayfer Ekim
- Department of Nursing, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey.
| | - Melis Hecan
- Department of Nursing, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
| | - Serkan Oren
- Department of Nursing, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
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37
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Abstract
Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption.
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Affiliation(s)
- Goran Medic
- Market Access, Horizon Pharma B.V., Utrecht
- Unit of Pharmacoepidemiology & Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
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38
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Moura MRS, Araújo CGA, Prado MM, Paro HBMS, Pinto RMC, Abdallah VOS, Mendonça TMS, Silva CHM. Factors associated with the quality of life of mothers of preterm infants with very low birth weight: a 3-year follow-up study. Qual Life Res 2016; 26:1349-1360. [DOI: 10.1007/s11136-016-1456-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
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Wang KWK, Lin HC, Lee CT, Lee KS. Primary caregivers of in-home oxygen-dependent children: predictors of stress based on characteristics, needs and social support. J Adv Nurs 2016; 72:1592-601. [PMID: 26899798 DOI: 10.1111/jan.12934] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 12/21/2022]
Abstract
AIM To identify the predictors of primary caregivers' stress in caring for in-home oxygen-dependent children by examining the association between their levels of stress, caregiver needs and social support. BACKGROUND Increasing numbers of primary caregivers of oxygen-dependent children experience caregiving stress that warrants investigation. DESIGN The study used a cross-sectional design with three psychometric scales - Modified-Parenting Stress Index, Caregiver Needs Scale and Social Support Index. METHODS The data collected during 2010-2011 were from participants who were responsible for their child's care that included oxygen therapy for ≧6 hours/day; the children's ages ranged from 3 months-16 years. Descriptive statistics and multivariable linear regression were used. RESULTS A total of 104 participants (M = 34, F = 70) were recruited, with an average age of 39·7 years. The average age of the oxygen-dependent children was 6·68 years and their daily use of oxygen averaged 11·39 hours. The caregivers' overall levels of stress were scored as high and information needs were scored as the highest. The most available support from family and friends was emotional support. Informational support was mostly received from health professionals, but both instrumental and emotional support were important. Levels of stress and caregiver needs were significantly correlated. Multivariable linear regression analyses identified three risk factors predicting stress, namely, the caregiver's poor health status, the child's male gender and the caregiver's greater financial need. CONCLUSION To support these caregivers, health professionals can maintain their health status and provide instrumental, emotional, informational and financial support.
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Affiliation(s)
- Kai-Wei K Wang
- Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Hung-Ching Lin
- Department of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei City, Taiwan
| | - Chin-Ting Lee
- Department of Nursing, Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Kuo-Sheng Lee
- Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan
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40
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Abstract
Transition from hospital to home is a complex and multidimensional phenomenon for parents of prematurely born infants (<37 weeks of gestation). The absence of a clear conceptualization of this particular transition coupled with the challenges parents have when they return home and higher costs of healthcare service usage postdischarge dictates the need for a better understanding of this phenomenon. A literature review was undertaken using Whittemore and Knafl's theoretical framework for integrative review as a guide. A systematic search of the electronic databases (PsycINFO, PubMed, Medline, Cumulative Index of Nursing and Allied Health Literature, EMBASE, Cochrane Database for Systematic Reviews, and EBSCO) was performed. Fifty selected reports of research conducted on parents of preterm infants during 1980-2014 are included in this article. Five themes emerged from the review-disruption of parental role development, distorted development of parent-infant relationships, psychological consequences of a preterm birth and infant hospitalization, learning caregiving and parenting, and need for social and professional supports-which appear to reflect parental challenges during transition from hospital to home after discharge. Several inconsistencies in results of the studies dictate the need for further research in this vulnerable population; the better conceptualization and measurement of transitional challenges are warranted.
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Bray L, Shaw NJ, Snodin J. Living and managing with the long-term implications of neonatal chronic lung disease: The experiences and perspectives of children and their parents. Heart Lung 2015; 44:512-6. [DOI: 10.1016/j.hrtlng.2015.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/23/2015] [Accepted: 08/10/2015] [Indexed: 12/01/2022]
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Meltzer LJ, Sanchez-Ortuno MJ, Edinger JD, Avis KT. Sleep patterns, sleep instability, and health related quality of life in parents of ventilator-assisted children. J Clin Sleep Med 2015; 11:251-8. [PMID: 25515280 DOI: 10.5664/jcsm.4538] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/06/2014] [Indexed: 01/22/2023]
Abstract
STUDY OBJECTIVES Parents of children with chronic illnesses have poorer health related quality of life (HRQoL), shorter sleep duration, and poorer sleep quality than parents of healthy children. However, night-to-night variability of sleep in parents has not previously been considered. This study compared the sleep patterns of parents of ventilator-assisted children (VENT) and healthy, typically developing children (HEALTHY), and examined the relationship between sleep variability and perceived HRQoL. METHODS Seventy-nine mothers and 33 fathers from 42 VENT families (n = 56) and 40 HEALTHY (n = 56) families completed the SF-36 and wore an actigraph for 2 weeks. Reported bedtime and wake time, along with actigraphic total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE) were examined using both average values and night-tonight instability (mean square successive differences). RESULTS VENT parents showed significantly later bedtimes, shorter TST, longer WASO, and lower SE than HEALTHY parents. VENT parents also exhibited greater instability in their reported wake time, WASO, and SE. Adjusting for family type and gender, greater instability of wake times, WASO and SE were related to poorer SF-36 subscale scores, while averaged sleep values were not. CONCLUSIONS Many parents of ventilator-assisted children experience deficient sleep and show significant instability in their sleep, which was related to HRQoL. Similar to shift workers, variable sleep schedules that may result from caregiving responsibilities or stress may impact parental caregivers' health and well-being. Additional studies are needed to determine how support and other interventions can reduce sleep disruptions in parental caregivers.
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Christian BJ. Multidimensional nature of caregiving: translating research into everyday practice. J Pediatr Nurs 2014; 29:83-5. [PMID: 24291620 DOI: 10.1016/j.pedn.2013.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Becky J Christian
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL.
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