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Güney Yılmaz G, Tanrıverdi M, Şahin S, Çakır FB. Cross-cultural adaptation, reliability, and validity of the Turkish Pediatric Quality of Life Inventory-Cognitive Functioning Scale (PedsQL TM-CFS) in children with cancer. Child Neuropsychol 2024:1-15. [PMID: 38832834 DOI: 10.1080/09297049.2024.2364205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
The Pediatric Quality of Life Inventory-Cognitive Functioning Scale (PedsQLTM-CFS) was developed as a brief, general, symptom-specific tool to measure cognitive function. The 6-item PedsQL™ Cognitive Functioning Scale and PedsQL 3.0 Cancer Module answered 369 parents and 330 children with 5-18 years. Parents also completed Behavior Rating Inventory of Executive Function (BRIEF). The PedsQL™ Cognitive Functioning Scale evidenced excellent reliability (parent proxy-report α = 0.980/Fleiss Kappa: 0.794; children self-report α = 0.963/Fleiss Kappa: 0.790). Both child self-report and parent proxy-report PedsQL™ Cognitive Functioning Scale scores exhibited significant correlations with all parent-report BRIEF summary and subscale scores (p < .05). Both child self-report and parent proxy-report PedsQL™ Cognitive Functioning Scale scores exhibited significant correlations with PedsQL 3.0 Cancer Module total score and subscale scores (p < .05). The PedsQLTM-CFS can be used in high-risk populations with substantial to perfect reliability, both in regards to total/subcategory scores as well as in children with cancer.
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Affiliation(s)
- Güleser Güney Yılmaz
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Türkiye
| | - Müberra Tanrıverdi
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bezmialem Vakıf University, İstanbul, Türkiye
| | - Sedef Şahin
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Türkiye
| | - Fatma Betül Çakır
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Bezmialem Vakıf University, İstanbul, Türkiye
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Beattie H, Subramanian T, Scudamore E, Middleton T, MacDonald C, Lindley R, Murthi G. Assessment of long-term quality of life, bowel and voiding function outcomes in patients with anorectal malformation at a single UK centre. Pediatr Surg Int 2024; 40:95. [PMID: 38565744 DOI: 10.1007/s00383-024-05684-2] [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] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
AIMS Assess long-term quality of life (QoL), bowel and voiding function in anorectal malformation (ARM) paediatric patients. METHOD Retrospective review of ARM patients between 2007 and 2020 was performed. QoL (all patients), bowel and voiding function (> 5 yo) were assessed using the paediatric quality of life inventory (PedsQL), paediatric incontinence and constipation score (PICS) and dysfunctional voiding scoring system (DVSS), respectively. RESULTS There were 122 patients (49% female, 85 > 5 yo) with ARM. Two had died, four refused, twenty-two were non-contactable, leaving ninety-four patients (65 > 5 yo) included. Mean age was 89 months (19-183), and follow-up was 86 months (13-183). Patients had significantly poorer scores for QoL, bowel and voiding function compared to published healthy controls. 57% had poor bowel function, 32% had poor voiding function and 38% required 'ancillary aids' to facilitate function. Patients using 'ancillary aids' for voiding function had a significantly lower QoL (parent: 62 vs 77; p = 0.01, patient: 66 vs 79; p = 0.05). Bowel continence was worse in those with high vs low ARM (13 vs 20, p = 0.004) and timely vs delayed diagnosis (17 vs 24, p = 0.04). CONCLUSION Patients with ARM have significantly worse QoL, bowel and voiding function than normal healthy controls. There is a need for long-term monitoring of function and further support for these children. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Harriet Beattie
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
- The Medical School, University of Sheffield, Sheffield, S10 2RX, UK
| | - Thejasvi Subramanian
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Elizabeth Scudamore
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Thomas Middleton
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Caroline MacDonald
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Richard Lindley
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Govind Murthi
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK.
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Cesari A, Galeoto G, Panuccio F, Simeon R, Berardi A. Evaluation instruments for executive functions in children and adolescents: an update of a systematic review. Expert Rev Pharmacoecon Outcomes Res 2024; 24:487-508. [PMID: 38294492 DOI: 10.1080/14737167.2024.2311872] [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: 07/26/2023] [Accepted: 01/25/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The aim of this study is to update a systematic review of instruments for evaluating the executive functions (EFs) in a pediatric population to assess their measurement properties. AREA COVERED Studies describing evaluation tools of EFs were systematically searched on four electronic databases: PubMed, EBSCO, Scopus, and Web of Science. To be included studies had to be on a population aged 0 to 18 were included. The individuals were either healthy or presented a neurodevelopment disorder. Risk of Bias was evaluated through the Consensus-based Standards to select the health Measurement Instruments (COSMIN). EXPERT OPINION The search was conducted on April 2023. Eighty-four papers met the inclusion criteria and were included in the study; the studies refer to 72 different evaluation tools of EFs. Most of the studies analyzed through a methodological quality analysis received an 'adequate' score. The instrument most mentioned was the Behavior Rating Inventory of Executive Function-2 (BRIEF2) in seven articles.
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Affiliation(s)
- Arianna Cesari
- School of Occupational Therapy, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | - Rachele Simeon
- School of Occupational Therapy, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
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Greidanus-Jongejan JEM, van Gorp M, van Litsenburg RRL, Aarsen FK, van der Vlist MMN, Nijhof S, Grootenhuis MA. Fatigue mediates the relationship between emotional and cognitive functioning in children post-cancer treatment. Pediatr Blood Cancer 2023; 70:e30594. [PMID: 37540035 DOI: 10.1002/pbc.30594] [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: 03/16/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND/OBJECTIVES Children treated for cancer are at risk to develop cognitive problems. Insight in underlying associations with emotional functioning and fatigue can be used to optimize interventions. We therefore aim to study emotional functioning, fatigue, and cognitive functioning in children postcancer treatment and investigate whether fatigue mediates the relationship between emotional and cognitive functioning. DESIGN/METHODS Emotional functioning, fatigue, and cognitive functioning were assessed in children post-cancer treatment using subscales of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales, Multidimensional Fatigue Scale and Cognitive Functioning Scale. A one sample t-test was used to compare outcomes with general population peers and mediation analysis was used to address the effect of fatigue on the relationship between emotional and cognitive functioning. RESULTS A total of 137 children (mean age: 13.6, SD ± 3.3 years; mean time since end of treatment: 7.1 months, SD ± 5.9) participated. Lower scores on emotional functioning (Cohen's d [D]: 0.4), fatigue (D: 0.8) and cognitive functioning (D: 0.6) were found (p < .001) in children post-cancer treatment than in peers. A medium association was found between emotional and cognitive functioning (standardized regression coefficient [β]: 0.27, p < .001), which was mediated by fatigue (β = 0.16). CONCLUSIONS Outcomes on emotional and cognitive functioning are decreased and fatigue is increased in children postcancer treatment. Fatigue mediates the relationship between emotional and cognitive functioning. Our results show the importance to focus on fatigue amongst stress as a target for intervention to improve cognitive functioning.
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Affiliation(s)
| | - Marloes van Gorp
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Femke K Aarsen
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Merel M Nap- van der Vlist
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne Nijhof
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Schiller K, Berrahmoune S, Dassi C, Corriveau I, Ayash TA, Osterman B, Poulin C, Shevell MI, Simard-Tremblay E, Sébire G, Myers KA. Randomized placebo-controlled crossover trial of memantine in children with epileptic encephalopathy. Brain 2023; 146:873-879. [PMID: 36256600 DOI: 10.1093/brain/awac380] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 02/04/2023] Open
Abstract
Memantine is an N-methyl-D-aspartate receptor antagonist, approved for dementia treatment. There is limited evidence of memantine showing benefit for paediatric neurodevelopmental phenotypes, but no randomized placebo-controlled trials in children with developmental and epileptic encephalopathy. In this randomized double-blind placebo-controlled crossover trial (Trial registration: https://clinicaltrials.gov/ct2/show/NCT03779672), patients with developmental and epileptic encephalopathy received memantine and placebo, each for a 6-week period separated by a 2-week washout phase. Electroencephalography, seizure diary, patient caregivers' global impression, serum inflammatory markers and neuropsychological evaluation were performed at baseline and after each treatment phase. The primary outcome measure was classification as a 'responder', defined as ≥2 of: >50% seizure frequency reduction, electroencephalography improvement, caregiver clinical impression improvement or clear neuropsychological testing improvement. Thirty-one patients (13 females) enrolled. Two patients withdrew prior to initiating medication and two (twins) had to be removed from analysis. Of the remaining 27 patients, nine (33%) were classified as responders to memantine versus two (7%) in the placebo group (P < 0.02). Electroencephalography improvement was seen in eight patients on memantine compared to two on placebo (P < 0.04). Seizure improvement was observed in eight patients on memantine and two on placebo (P < 0.04). Caregivers reported overall clinical improvement in 10 patients on memantine compared to seven on placebo (not significant). Statistical analysis of neuropsychological evaluation suggested improvements in symptoms of attention-deficit hyperactivity disorder and autism. Memantine is a safe and effective treatment for children with developmental and epileptic encephalopathy, having the potential to improve both seizure control and cognitive function.
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Affiliation(s)
- Katharina Schiller
- Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Saoussen Berrahmoune
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Christelle Dassi
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Isabelle Corriveau
- Department of Psychology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Taghreed A Ayash
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Department of Pediatrics, McGill University, Montreal, QC H4A 3J1, Canada
| | - Bradley Osterman
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Chantal Poulin
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Michael I Shevell
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Elisabeth Simard-Tremblay
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Guillaume Sébire
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Kenneth A Myers
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada.,Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
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Liza MM, Iktidar MA, Roy S, Jallow M, Chowdhury S, Tabassum MN, Mahmud T. Gadget addiction among school-going children and its association to cognitive function: a cross-sectional survey from Bangladesh. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001759. [PMID: 36808098 PMCID: PMC9944298 DOI: 10.1136/bmjpo-2022-001759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/08/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND People are becoming more dependent on technology than ever before. Today's children and adults are heavily plugged into electronics, which raises concerns for their physical and cognitive development. This cross-sectional study was conducted to assess the relationship between media usage and cognitive function among school-going children. METHODS This cross-sectional study was conducted in 11 schools in 3 of Bangladesh's most populous metropolitan areas: Dhaka, Chattogram and Cumilla. A semistructured questionnaire with three sections was used to obtain data from the respondents: (1) background information, (2) PedsQL Cognitive Functioning Scale and (3) Problematic Media Use Measure Short Form. Stata (V.16) was used for statistical analysis. Mean and SD were used to summarise quantitative variables. Qualitative variables were summarised using frequency and percentage. The χ2 test was used to explore bivariate association between categorical variables, and a binary logistic regression model was fit to investigate the factors associated with the cognitive function of the study participants after adjusting for confounders. RESULTS The mean age of total of 769 participants was 12.0±1.8 years, and the majority (67.31%) were females. The prevalence of high gadget addiction and poor cognitive function was 46.9% and 46.5%, respectively, among the participants. After adjusting the factors, this study found a statistically significant relationship (adjusted OR 0.4, 95% CI 0.3 to 0.7) between gadget addiction and cognitive function. In addition, the duration of breast feeding was a predictor of cognitive function as well. CONCLUSION This study found digital media addiction as a predictor of decreased cognitive performance in children who use digital gadgets regularly. Although the cross-sectional design of the study precludes causal relationships from being determined, the study finding deserves further examination via longitudinal research.
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Affiliation(s)
- Mowshomi Mannan Liza
- Department of Public Health, North South University, Dhaka, Bangladesh.,Department of Public Health, School of Research, Chattogram, Bangladesh
| | - Mohammad Azmain Iktidar
- Department of Public Health, North South University, Dhaka, Bangladesh .,Department of Public Health, School of Research, Chattogram, Bangladesh
| | - Simanta Roy
- Department of Public Health, North South University, Dhaka, Bangladesh.,Department of Public Health, School of Research, Chattogram, Bangladesh
| | - Musa Jallow
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Sreshtha Chowdhury
- Department of Public Health, North South University, Dhaka, Bangladesh.,Department of Public Health, School of Research, Chattogram, Bangladesh
| | - Mustari Nailah Tabassum
- Department of Public Health, School of Research, Chattogram, Bangladesh.,Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
| | - Tarannum Mahmud
- Department of Public Health, School of Research, Chattogram, Bangladesh.,Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
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Balwani M, Passi GR. Screening Children with Epilepsy for Cognitive Deficits Using the Modified Mini-Mental Scale Examination and the Digit Letter Substitution Test. ANNALS OF CHILD NEUROLOGY 2022. [DOI: 10.26815/acn.2022.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Gaudioso C, Oo S, Mar S, Hendricks-Ferguson VL, Newland P, Varni JW. PedsQL Multiple Sclerosis Module Domain and Item Development: Qualitative Methods. J Child Neurol 2021; 36:901-910. [PMID: 34048290 DOI: 10.1177/08830738211015016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The objective of this qualitative methods study was to develop the domains and items to support the content validity for the Pediatric Quality of Life Inventory (PedsQL) Multiple Sclerosis Module for youth with pediatric-onset multiple sclerosis. METHODS A literature review of multiple sclerosis-specific questionnaires and clinical research was conducted to generate domains. An expert panel composed of 12 neurologists who were pediatric-onset multiple sclerosis specialists provided feedback on the conceptual framework. Focus interviews with 9 youth with pediatric-onset multiple sclerosis and 6 parents were conducted to develop the relevant domains and item content from the patient and parent perspective. In the cognitive interviews phase, 9 youth with pediatric-onset multiple sclerosis and 6 parents provided feedback on item content, relevance, importance, and understandability of the pediatric-onset multiple sclerosis-specific domains and items. The final interview phase with 5 youth with pediatric-onset multiple sclerosis and 5 parents comprised a pilot testing of the new PedsQL MS Module. RESULTS Eighteen domains were derived from the qualitative methods with item content saturation achieved at 100 items based on 40 interviews with 23 youth with pediatric-onset multiple sclerosis aged 10-21 years and 17 parents. The domains derived include general fatigue, sleep/rest fatigue, cognitive functioning, tingling sensations, numbness sensations, physical weakness, pain, speech, balance, fine motor, vision, urination, constipation, bowel incontinence, worry, communication, treatment, and medicines. CONCLUSIONS Qualitative methods involving 23 youth with pediatric-onset multiple sclerosis and 17 parents in the domain and item development process support the content validity for the new PedsQL MS Module. Future plans include a national field test of the PedsQL MS Module scales and items.
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Affiliation(s)
- Cristina Gaudioso
- Department of Neurology, Division of Pediatric Neurology, 12275Washington University School of Medicine, St Louis, MO, USA
| | - Samuel Oo
- Department of Neurology, Division of Pediatric Neurology, 12275Washington University School of Medicine, St Louis, MO, USA
| | - Soe Mar
- Department of Neurology, Division of Pediatric Neurology, 12275Washington University School of Medicine, St Louis, MO, USA
| | | | - Pamela Newland
- 499763Goldfarb School of Nursing, Barnes Jewish College, St Louis, MO, USA
| | - James W Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, 14736Texas A&M University, College Station, TX, USA
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van den Berg L, de Weerd AW, Reuvekamp MHF, van der Meere JJ. Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy. A systematic review. Child Neuropsychol 2021; 27:661-708. [PMID: 33726631 DOI: 10.1080/09297049.2021.1888906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
As children with epilepsy may have a number of learning and behavioral problems, it is important that insight into the underlying neurocognitive differences in these children, which may underlie these areas of challenge is gained. Executive function (EF) problems particularly are associated with specific learning abilities as well as behavioral problems. We aim to review systematically the current status of empirical studies on the association between EF problems and behavior and socioemotional problems in children with epilepsy. After search, 26 empirical studies were identified, most of them of moderate quality. Overall, attention problems were the most reported cognitive deficit in test assessment and the most reported problem by parents. In 54% of the studies, children with epilepsy scored below average compared to controls/normative samples on different aspects of EF. Most studies reported behavior problems, which ranged from mild to severe. Forty-two percent of the studies specifically reported relationships between EF deficits and behavioral problems. In the remaining studies, below average neuropsychological functioning seemed to be accompanied by above average reported behavioral problems. The association was most pronounced for cognitive control and attention in relation to externalizing behavior problems. This cognitive control is also associated with social functioning. Relevant epilepsy variables in this relationship were early age at onset and high seizure frequency.Future research should distinguish specific aspects of EF and take age into account, as this provides more insight on the association between EF and behavior in pediatric epilepsy, which makes it possible to develop appropriate and early intervention.
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Affiliation(s)
- Lydia van den Berg
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands.,RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Groningen, Netherlands
| | - Al W de Weerd
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | - Marieke H F Reuvekamp
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | - Jaap J van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Groningen, Netherlands
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Varni JW, Panepinto JA. Cognitive functioning, patient health communication, and worry mediate pain predictive effects on health-related quality of life in youth with sickle cell disease. Pediatr Blood Cancer 2020; 67:e28680. [PMID: 32860648 DOI: 10.1002/pbc.28680] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/25/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objective was to investigate the serial mediating effects of perceived cognitive functioning, patient health communication, and disease-specific worry in the relationship between pain and overall generic health-related quality of life (HRQOL) in youth with sickle cell disease (SCD) from the patient perspective. METHODS The pain, cognitive functioning, communication and worry scales from the Pediatric Quality of Life Inventory (PedsQL) Sickle Cell Disease Module and the PedsQL Multidimensional Fatigue Scale, and the PedsQL 4.0 Generic Core Scales were completed in a multisite national study by 233 youth with SCD of ages 5-18. Hierarchical multiple regression and serial multiple mediator model analyses were conducted to test the mediating effects of perceived cognitive functioning, health communication, and disease-specific worry as intervening variables in the association between the pain predictor variable and overall generic HRQOL. RESULTS Pain predictive effects on overall generic HRQOL were serially mediated by cognitive functioning, health communication, and disease-specific worry. In predictive analytics models utilizing hierarchical multiple regression analyses with age and gender demographic covariates, pain, cognitive functioning, health communication, and worry accounted for 65% of the variance in patient-reported overall generic HRQOL (P < .001), representing a large effect size. CONCLUSIONS Perceived cognitive functioning, patient health communication, and disease-specific worry explain in part the mechanism of pain predictive effects on overall generic HRQOL in youth with SCD. Identifying SCD-specific pain, perceived cognitive functioning, health communication, and disease-specific worry as predictor variables of overall generic HRQOL from the patient perspective may inform clinical interventions and future patient-centered clinical research.
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Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, Texas
| | - Julie A Panepinto
- Department of Pediatrics, Hematology/Oncology/Bone Marrow Transplantation, Children's Hospital of Wisconsin of the Children's Research Institute/Medical College of Wisconsin, Milwaukee, Wisconsin
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