1
|
Düken ME, Zengin M. The mediating role of social support in the relationship between psychosocial problems and sleep patterns of adolescents with epilepsy. Epilepsy Behav 2024; 152:109656. [PMID: 38277846 DOI: 10.1016/j.yebeh.2024.109656] [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: 11/06/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024]
Abstract
AIM This study was conducted to examine the mediating role of social support in the relationship between psychosocial problems of adolescents with epilepsy and their sleep patterns. METHODS The data were collected with Adolescent Information Form, Strength and Difficulties Questionnaire, Sleep Disturbance Scale for Children and Multidimensional Scale of Perceived Social Support in this descriptive and correlational study. The mediating role of multidimensional social support that children with epilepsy received with the Process Macro program was examined in the relationship between their psychosocial problems and their sleep status. Process model 4 was used and analysis was made based on the Bootstrap method. RESULTS As a result of the analysis, it was found that the participants had been diagnosed with epilepsy for a mean of 6.0 ± 1.61 years and had a mean of 3.1 ± 2.48 seizures per week. It was found that the sleep problems experienced by adolescents with epilepsy affected their psychosocial health and this effect was at the level of 84 % (β = 0.933; p < 0.001). The effect of perceived social support on the dependent variable sleep disturbance in adolescents with epilepsy was found to be statistically significant (β = -0.540; p < 0.001). It was determined that the Psychosocial Health Status score of adolescents diagnosed with epilepsy explained 87 % of the change in sleep disturbance experienced with perceived social support (p < 0.001). The effect of social support perceived by adolescents with epilepsy on sleep disturbance was found to be statistically significant. Perceived social support has no effect on the psychosocial problems they experience. CONCLUSIONS It was found that social support was not a mediator in the relationship between psychosocial problems of adolescents with epilepsy and their sleep status.
Collapse
Affiliation(s)
- Mehmet Emin Düken
- Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Mürşide Zengin
- Health Sciences of Faculty, Department of Child Health and Diseases Nursing, Adıyaman University, Adıyaman, Turkey.
| |
Collapse
|
2
|
Kubek LA, Claus B, Rostasy K, Bertolini A, Schimmel M, Frühwald MC, Classen G, Zernikow B, Wager J. Development and preliminary validation of the Sleep Screening for Children and Adolescents with Complex Chronic Conditions (SCAC). J Sleep Res 2023:e13881. [PMID: 36929532 DOI: 10.1111/jsr.13881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
Children and adolescents with complex chronic conditions, including those with life-threatening or life-limiting conditions, are a heterogeneous population. Many individuals exhibit sleep abnormalities that are measurable by proxy questionnaires. No suitable instrument to assess the wide range of different complex chronic conditions is currently available. The aim of the present study was to develop a screening tool-the Sleep Screening for Children and Adolescents with Complex Chronic Conditions-to effectively obtain sleep behaviour information in this population. Following a mixed-method design, potential items for the Sleep Screening for Children and Adolescents with Complex Chronic Conditions questionnaire were defined through literature research and expert meetings. In a pre-test with N = 60 family and professional caregivers, the items' relevance and comprehensibility as well as the instrument's overall design were assessed. For the main test, N = 315 participants were recruited in three tertiary paediatric hospitals. A principal components analysis detected the questionnaire's scales. Item analysis focused on mean values, range, difficulty and discriminatory power. Convergent validation of the Sleep Screening for Children and Adolescents with Complex Chronic Conditions was assessed via correlations between scale items. Most patients had neurological or neuromuscular diseases. Four scales ("Falling and staying asleep", "Sleep-associated respiration and arousal", "Daytime sleepiness" and "Sleep-associated movements") emerged. The item analysis showed satisfactory discriminative power. In the preliminary validation, all scales correlated positively with a child's care level and with various sleep circumstances items. Three scales additionally correlated with the number of complex chronic condition diagnoses. This newly developed questionnaire can provide clinicians with first indications of possible sleep problems in a growing paediatric population.
Collapse
Affiliation(s)
- Larissa Alice Kubek
- PedScience Research Institute, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Benedikt Claus
- PedScience Research Institute, Datteln, Germany.,Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, Datteln, Germany
| | - Kevin Rostasy
- Department of Pediatric Neurology, Children's and Adolescents' Hospital Datteln, Witten/Herdecke University, Witten, Germany
| | - Annikki Bertolini
- Department of Pediatric Neurology, Children's and Adolescents' Hospital Datteln, Witten/Herdecke University, Witten, Germany
| | - Mareike Schimmel
- Pediatric Neurology, University Medical Center Augsburg, Augsburg, Germany
| | - Michael C Frühwald
- Pediatrics and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany
| | - Georg Classen
- Department of Pediatric Neurology, Bethel Evangelical Hospital, Bielefeld, Germany
| | - Boris Zernikow
- PedScience Research Institute, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.,Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, Datteln, Germany
| | - Julia Wager
- PedScience Research Institute, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.,Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, Datteln, Germany
| |
Collapse
|
3
|
Oyegbile-Chidi T, Harvey D, Dunn D, Jones J, Hermann B, Byars A, Austin J. Characterizing Sleep Phenotypes in Children With Newly Diagnosed Epilepsy. Pediatr Neurol 2022; 137:34-40. [PMID: 36215818 PMCID: PMC9970008 DOI: 10.1016/j.pediatrneurol.2022.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Children with epilepsy frequently have sleep, behavior, and cognitive problems at the time of or before the epilepsy diagnosis. The primary goal of this study was to determine if specific sleep disturbance phenotypes exist in a large cohort of children with new-onset epilepsy and if these phenotypes are associated with specific cognitive and behavioral signatures. METHODS A total of354 children with new-onset epilepsy, aged six to 16 years, were recruited within six weeks of initial seizure onset. Each child underwent evaluation of their sleep along with self, parent, and teacher ratings of emotional-behavioral status. Two-step clustering using sleep disturbance (Sleep Behavior Questionnaire), naps, and sleep latency was employed to determine phenotype clusters. RESULTS Analysis showed three distinct sleep disturbance phenotypes-minimal sleep disturbance, moderate sleep disturbance, and severe sleep disturbance phenotypes. Children who fell into the minimal sleep disturbance phenotype had an older age of onset with the best cognitive performance compared with the other phenotypes and the lowest levels of emotional-behavioral problems. In contrast, children who fell into the severe sleep disturbance phenotype had the youngest age of onset of epilepsy with poor cognitive performance and highest levels of emotional-behavioral problems. CONCLUSIONS This study indicates that there are indeed specific sleep disturbance phenotypes that are apparent in children with newly diagnosed epilepsy and are associated with specific comorbidities. Future research should determine if these phenotypic groups persist over time and are predictive of long-term difficulties, as these subgroups may benefit from targeted therapy and intervention.
Collapse
Affiliation(s)
| | - Danielle Harvey
- Department of Public Health Sciences, University of California Davis, Sacramento, California
| | - David Dunn
- Departments of Psychiatry and Neurology, Indiana University, Indianapolis, Indiana
| | - Jana Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Anna Byars
- Department of Pediatrics, Cincinnati Children's Hospital at the University of Cincinnati, Cincinnati, Ohio
| | - Joan Austin
- Distinguished Professor Emerita, School of Nursing, Indiana University, Indianapolis, Indiana
| |
Collapse
|
4
|
Kubek LA, Kutz P, Roll C, Zernikow B, Wager J. Applicability of Actigraphy for Assessing Sleep Behaviour in Children with Palliative Care Needs Benchmarked against the Gold Standard Polysomnography. J Clin Med 2022; 11:jcm11237107. [PMID: 36498681 PMCID: PMC9739292 DOI: 10.3390/jcm11237107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
In children with life-limiting conditions and severe neurological impairment receiving pediatric palliative care (PPC), the degree to which actigraphy generates meaningful sleep data is uncertain. Benchmarked against the gold standard polysomnography (PSG), the applicability of actigraphy in this complex population was to be assessed. An actigraph was placed on N = 8 PPC patients during one-night polysomnography measurement in a pediatric tertiary care hospital's sleep laboratory. Patient characteristics, sleep phase data, and respiratory abnormalities are presented descriptively. Bland-Altman plots evaluated actigraphy's validity regarding sleep onset, sleep offset, wake after sleep onset (WASO), number of wake phases, total sleep time (TST) and sleep efficiency compared to PSG. PSG revealed that children spent most of their time in sleep stage 2 (46.6%) and most frequently showed central apnea (28.7%) and irregular hypopnea (14.5%). Bland-Altman plots showed that actigraphy and PSG gave similar findings for sleep onset, sleep offset, wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency. Actigraphy slightly overestimated TST and sleep efficiency while underestimating all other parameters. Generally, the Actiwatch 2 low and medium sensitivity levels showed the best approximation to the PSG values. Actigraphy seems to be a promising method for detecting sleep problems in severely ill children.
Collapse
Affiliation(s)
- Larissa Alice Kubek
- PedScience Research Institute, 45711 Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany
| | - Patrizia Kutz
- Department of Neonatology, Pediatric Intensive Care and Sleep Medicine, Children's and Adolescents' Hospital, Witten/Herdecke University, 45711 Datteln, Germany
| | - Claudia Roll
- Department of Neonatology, Pediatric Intensive Care and Sleep Medicine, Children's and Adolescents' Hospital, Witten/Herdecke University, 45711 Datteln, Germany
| | - Boris Zernikow
- PedScience Research Institute, 45711 Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany
- Palliative Care Centre, Children's and Adolescents' Hospital, 45711 Datteln, Germany
| | - Julia Wager
- PedScience Research Institute, 45711 Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany
- Palliative Care Centre, Children's and Adolescents' Hospital, 45711 Datteln, Germany
| |
Collapse
|
5
|
Oyegbile-Chidi T, Harvey D, Eisner J, Dunn D, Jones J, Byars A, Hermann B, Austin J. The Relationship Between Sleep, Cognition and Behavior in Children With Newly-Diagnosed Epilepsy Over 36 Months. Front Neurol 2022; 13:903137. [PMID: 35959398 PMCID: PMC9360804 DOI: 10.3389/fneur.2022.903137] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction There is substantial evidence that children with epilepsy experience more sleep, behavior and cognitive challenges than children without epilepsy. However, the literature is limited in describing the relationship between sleep, epilepsy, cognition and behavioral challenges and the interactions amongst these factors over time. This study aims to understand the nature and strength of the relationship between sleep, cognition, mood and behavior in children with new-onset epilepsy as assessed by multiple informants at multiple time periods using multiple different dependent measures. Methods 332 participants (6-16years) were recruited within 6 weeks of their first recognized seizure. The comparison group was comprised of 266 healthy siblings. Participants underwent sleep evaluation by a parent using the Sleep Behavioral Questionnaire (SBQ), cognitive evaluation using a comprehensive neuropsychological test battery, a behavioral evaluation using the Child Behavior Checklist (CBCL from parents and TRF from teachers) and the Children's Depression Inventory (CDI). These evaluations were completed at baseline (B), at 18 months, and at 36 months. Results Compared to siblings, children with new-onset epilepsy had more sleep disturbance (SBQ), higher rates of behavioral problems (CBCL and TRF), lower cognitive testing scores, and higher rates of depression; which persisted over the 36-month study. Sleep significantly correlated with behavioral problems, cognitive scores and depression. When divided into categories based of sleep disturbance scores, 39.7% of children with epilepsy experienced "Persistently Abnormal Sleep", while 14.8% experienced "Persistently Normal Sleep". Children with persistently abnormal sleep experienced the highest rates of behavioral problems, depression and cognitive impairment compared to those with persistently normal sleep, regardless of epilepsy syndrome. Younger age of seizure onset, younger age at testing, and lower grade level at baseline were associated with persistently abnormal sleep. Conclusions To our knowledge, this is the first demonstration of the nature, strength, reliability, stability and persistence of the relationship between sleep, cognition, and behavioral problems over time in a large cohort of children with newly diagnosed epilepsy, as assessed by multiple informants at different timepoints. The results of this study indicate that children with epilepsy are at a high risk of significant persisting neurobehavioral multimorbidity. Therefore, early screening for these challenges may be essential for optimizing quality of life long-term.
Collapse
Affiliation(s)
- Temitayo Oyegbile-Chidi
- Department of Neurology, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Danielle Harvey
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Jordan Eisner
- Department of Neurology, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - David Dunn
- Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Jana Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Anna Byars
- Department of Pediatrics, Cincinnati Children's Hospital at the University of Cincinnati, University of Cincinnati, Cincinnati, OH, United States
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Joan Austin
- School of Nursing, Indiana University, Indianapolis, IN, United States
| |
Collapse
|
6
|
How Does the Cause of Infantile Hemiparesis Influence Other Conditioning Factors? A Preliminary Study in a Spanish Population. CHILDREN-BASEL 2021; 8:children8050323. [PMID: 33922203 PMCID: PMC8145471 DOI: 10.3390/children8050323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 02/04/2023]
Abstract
Infantile hemiparesis may be associated with significant morbidity and may have a profound impact on a child’s physical and social development. Infantile hemiparesis is associated with motor dysfunction as well as additional neurologic impairments, including sensory loss, mental retardation, epilepsy, and vision, hearing, or speech impairments. The objective of this study was to analyze the association between the cause of infantile hemiparesis and birth (gestational age), age of diagnosis, and associated disorders present in children with infantile hemiparesis aged 0 to 3 years. An observational and cross-sectional study was performed. A simple and anonymous questionnaire was created ad hoc for parents of children diagnosed with infantile hemiparesis aged between 0 and 3 years about the situation regarding the diagnosis of hemiparesis, birth, cause of hemiparesis, and presence of other associated disorders. Perinatal stroke (60.1%) was the most common cause of hemiparesis, and the most typical associated disorder was epilepsy (34.2%), with the second largest percentage in this dimension corresponding to an absence of associated disorders (20.7%). The most frequent birth was “no premature” (74.1%). The mean age of diagnosis of infantile hemiparesis was registered at 8 months (IQR: 0–36). Knowing the possible association between different conditioning factors and the cause of infantile hemiparesis facilitates the prevention of severe sequelae in children and family, implementing an early comprehensive therapeutic approach in children with infantile hemiparesis.
Collapse
|
7
|
Bearden DJ, Shakil S, O'Banion D, Ono KE, Drane DL, Loring DW, Tarquinio DC. Methylphenidate treatment for cognitive symptoms associated with ADHD in a pediatric epilepsy patient following resection of a left frontal cortical dysplasia. Epilepsy Behav Rep 2021; 16:100435. [PMID: 33981985 PMCID: PMC8085698 DOI: 10.1016/j.ebr.2021.100435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/02/2021] [Accepted: 01/17/2021] [Indexed: 11/17/2022] Open
Abstract
ADHD symptoms can emerge or worsen after epilepsy surgery. Methylphenidate use improved cognitive symptoms of ADHD in our patient. Seizure aggravation did not occur following use of a neurostimulant in our patient. Our patient benefitted from a multidisciplinary intervention approach.
We present data on a 10-year-old patient with drug-resistant epilepsy who was treated with methylphenidate for symptoms of attention deficit hyperactivity disorder (ADHD) that developed after she underwent surgical resection of a left frontal cortical dysplasia. . The patient’s parents reported methylphenidate was helpful in improving their child’s reading performance. Based on parents’ report, we examined benefits of methylphenidate on our patient’s cognitive problems in a controlled setting. The patient underwent a neuropsychological evaluation completed in three sessions over a five-day period. Methylphenidate was administered prior to the second testing session only and was associated with improvements in the patient’s attention, executive function, processing speed, and short-term memory performances. In comparison, word-reading performance, a task less susceptible to neurological impairment, was stable over the three sessions. The patient remained seizure-free after surgery and use of methylphenidate did not reduce seizure threshold. These findings support the use of methylphenidate in treating targeted cognitive problems associated with ADHD emerging after epilepsy surgery in children.
Collapse
Affiliation(s)
- Donald J. Bearden
- Department of Neuropsychology, Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Corresponding author at: Center for Advanced Pediatrics, Children’s Healthcare of Atlanta, 1400 Tullie Rd. NE, Ste. 430, Atlanta, GA 30329, USA.
| | - Sidra Shakil
- Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - David O'Banion
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Developmental Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Kim E. Ono
- Department of Neuropsychology, Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Daniel L. Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology University of Washington School of Medicine, Seattle, WA, USA
| | - David W. Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | | |
Collapse
|
8
|
Tsai SY, Lee WT, Jeng SF, Lee CC, Weng WC. Sleep and Behavior Problems in Children With Epilepsy. J Pediatr Health Care 2019; 33:138-145. [PMID: 30149961 DOI: 10.1016/j.pedhc.2018.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/20/2018] [Accepted: 07/15/2018] [Indexed: 01/14/2023]
Abstract
We designed a cross-sectional study to examine the association between sleep and behavior problems in toddlers and preschool-age children with epilepsy. We found that 71 (78.9%) children slept less than 10 hours in a 24-hour period according to the actigraphy, with 75 (83.3%) children waking for more than an hour during nocturnal sleep. Twenty-five (27.8%) children usually or sometimes had an inconsistent bedtime, and 24 (26.7%) did not sleep the same amount each day. Twenty-nine (32.2%) and 18 (20.0%) children had an internalizing and externalizing problem in clinical range, respectively. Sleep anxiety was significantly (p < .01) associated with increased internalizing and externalizing problems, even after the relevant epilepsy variables were controlled for. Findings from our study suggest that screening of sleep and behavior problems should be part of routine epilepsy care to identify children with problematic sleep and unrecognized sleep disorders and those at risk of behavioral dysfunction.
Collapse
|
9
|
Dreier LA, Wager J, Blankenburg M, Zernikow B. The Unfavorable Alliance of Pain and Poor Sleep in Children with Life-Limiting Conditions and Severe Psychomotor Impairment. CHILDREN 2018; 5:children5070082. [PMID: 29933542 PMCID: PMC6068563 DOI: 10.3390/children5070082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 01/16/2023]
Abstract
A high prevalence of sleep problems exists in children and adolescents with life-limiting conditions (LLC) and severe psychomotor impairment (SPMI). This study aimed to compare the impacts of various child-related (pain, epilepsy, repositioning, medical care) and environment-related (light, noise, TV/radio, open door) factors on sleep in this vulnerable population. Data were obtained through the “Sleep Questionnaire for Children with Severe Psychomotor Impairment” (SNAKE) by proxy assessment. n = 212 children (mean age: 10.4 years) were included in the analyses. Logistic and linear regression models were used to compare child- and environment-related factors against the global rating of children’s sleep quality, five SNAKE scales, children’s sleep duration, and sleep efficacy. Pain increased the risk of sleeping poorly four-fold (OR (odds ratio) = 4.13; 95% CI (confidence interval): 1.87–9.13) and predicted four sleep problems as assessed by the SNAKE. Children who needed to reposition during the night were at three times greater risk of sleeping poorly (OR = 3.08; 95% CI: 1.42–6.69). Three of the five SNAKE scales were predicted through nocturnal repositioning. Repositioning and epilepsy predicted a reduced sleep duration and low sleep efficacy. None of the environment-related factors exhibited statistically significant results. This study emphasizes the urgent need for reliable pain detection in the context of sleep disturbances in severely ill children.
Collapse
Affiliation(s)
- Larissa Alice Dreier
- Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711 Datteln, Germany.
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany.
| | - Julia Wager
- Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711 Datteln, Germany.
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany.
| | - Markus Blankenburg
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany.
- Paediatric Neurology, Psychosomatics and Pain Therapy, Center for Child, Youth and Women's Health, Klinikum Stuttgart, Olgahospital/Frauenklinik, 70174 Stuttgart, Germany.
| | - Boris Zernikow
- Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711 Datteln, Germany.
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany.
| |
Collapse
|
10
|
Gaudet CE, Cook NE, Kavanaugh BC, Studeny J, Holler K. Prevalence of low test scores in a pediatric psychiatric inpatient population: Applying multivariate base rate analyses. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 8:163-173. [PMID: 29308918 DOI: 10.1080/21622965.2017.1417126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The understanding of neuropsychological functioning in pediatric psychiatric inpatient populations is growing, but limited, resulting in interpretive challenges. This study examined the application of multivariate base rate (MVBR) analysis in a clinical sample to appraise its utility in characterizing the frequency of low scores, as well as predictors of low scores, when using a flexible test battery. Participants included 99 children from a psychiatric inpatient unit referred for neuropsychological testing. Children hospitalized with psychiatric disorders exhibited high rates of low scores at varying criteria across the battery of tests. Hierarchical multiple regression analyses revealed that after accounting for demographic and psychiatric factors, intellectual functioning accounted for approximately 26% of the variance in observed low scores. The results suggest that a substantial percentage of this population produces low scores on neuropsychological testing and, consistent with prior research, intellectual functioning is strongly associated with low score frequency. To our knowledge, this is the first study to examine the clinical application of MVBR analysis in a pediatric psychiatric inpatient population using a flexible test battery. Taken together, this investigation highlights the potential clinical utility of MVBR analysis when interpreting neuropsychological performance in clinical pediatric populations.
Collapse
Affiliation(s)
- Charles E Gaudet
- a Psychology Department , University of Rhode Island , Kingston , Rhode Island , USA
| | - Nathan E Cook
- a Psychology Department , University of Rhode Island , Kingston , Rhode Island , USA.,b Department of Psychiatry , Massachusetts General Hospital , Boston , Massachusetts , USA.,c MassGeneral Hospital for Children Sport Concussion Program , Boston , Massachusetts , USA
| | - Brian C Kavanaugh
- d Department of Psychiatry & Human Behavior , Alpert Medical School, Brown University , Providence , Rhode Island , USA
| | - Jane Studeny
- e Psychology Department , Antioch University - New England , Keene , New Hampshire , USA
| | - Karen Holler
- d Department of Psychiatry & Human Behavior , Alpert Medical School, Brown University , Providence , Rhode Island , USA
| |
Collapse
|