1
|
Li L, Zhang Y, Xiao F, Qu W, Zhang H, Zhu Z. Liver retransplantation: Timing is equally important. Medicine (Baltimore) 2023; 102:e35165. [PMID: 37713841 PMCID: PMC10508473 DOI: 10.1097/md.0000000000035165] [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: 10/05/2022] [Accepted: 08/21/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND AND AIM To evaluate the effect of transplantation interval on patient and graft survival in liver retransplantation (reLT) using meta-analytical techniques. METHODS Literature search was undertaken until January 2022 to identify comparative studies evaluating patient survival rates, graft survival rates, and the interval time. Pooled hazard ratio (HR) or risk ratio (RR) and 95% confidence intervals (95% CI) were calculated with either the fixed or random effect model. RESULTS The 12 articles were included in this meta-analysis. The late reLT survival rate is better than the early reLT in the 30 days group, and there is no statistical significance in other time groups. The patient survival was significantly higher in late reLT than early reLT at 1 and 5 years (respectively: RR, 0.81 [95% CI, 0.73-0.89]; RR, 0.64 [95% CI, 0.46-0.88]). The graft survival was significantly higher in late reLT than early reLT at 1 year (RR, 0.75 [95% CI, 0.63-0.89]). The risk of death after reLT in early group was 1.43 times higher than that in late group (HR, 1.43 [95% CI, 1.21-1.71]). CONCLUSIONS Late reLT had significantly better survival rates than early reLT, and the transplantation interval was more reasonable to divide the early or late groups by 30 days.
Collapse
Affiliation(s)
- Le Li
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Hepatobiliary Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Yuhong Zhang
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fei Xiao
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Qu
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haiming Zhang
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhijun Zhu
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Agerskov H, Thiesson HC, Pedersen BD. Parenting a child with a kidney transplant-A study of everyday life experiences. J Ren Care 2022; 49:134-143. [PMID: 35106917 DOI: 10.1111/jorc.12410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Kidney transplantation in children shows excellent long-term outcomes. However, parents feel responsible for ensuring that their child adheres to complex medical interventions. The dual role - as both parent and medical caregiver - gives rise to fatigue, stress, and emotional pain. Parental and family functioning are critically important to a child's disease course, development and well-being. OBJECTIVE To explore the experiences and perspectives of mothers and fathers of children with a kidney transplant. DESIGN An explorative study using a qualitative method. PARTICIPANTS Twelve parents (seven mothers and five fathers) of seven children with a kidney transplant. APPROACH A qualitative exploratory study taking a phenomenological-hermeneutic approach. METHOD Semi-structured individual interviews were conducted. The data were analysed using Ricoeur's theory of narrative and interpretation on three levels: naïve reading, structural analysis, and critical interpretation and discussion. FINDINGS Four themes were generated: Kidney transplantation as a turning point, the importance of a close collaboration with health care professionals, being the child's voice, and managing the dual role as a parent, and medical caregiver in everyday life. CONCLUSION Child kidney transplantation led to a transformation in the child, on the physical, mental, and social levels; however, the child was still in need of special attention and support. Problems with the kidney graft functioning resulted in frustration and disappointment in parents. Teamwork between a child's parents became evident, in coping with the dual role as a parent and medical caregiver. Parents aimed to maintain a clear structure related to medication and disease-related treatment. A close and trustful relationship and collaboration with health care professionals were significant and included listening to the voice of the child.
Collapse
Affiliation(s)
- Hanne Agerskov
- Department of Nephrology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Family Focused Health Care Research Center, University of Southern Denmark, Odense, Denmark
| | - Helle C Thiesson
- Department of Nephrology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Birthe D Pedersen
- Department of Clinical Research, University of Southern Denmark, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
3
|
Takahashi T, Okamoto T, Yokota I, Sato Y, Hayashi A, Ueda Y, Aoyagi H, Ueno M, Kobayashi N, Uetake K, Nakanishi M, Ariga T. The effect of rituximab on the quality of life of children with refractory nephrotic syndrome. Pediatr Int 2022; 64:e14725. [PMID: 33826766 DOI: 10.1111/ped.14725] [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: 12/20/2020] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rituximab (RTX) is an effective treatment for maintaining remission in patients with nephrotic syndrome (NS), but there are few reports on the effect of RTX treatment on quality of life (QOL). The purpose of this study was to examine the effect of periodically repeated RTX treatment from the perspective of QOL. METHODS We systematically assessed the QOL of pediatric patients with refractory NS and parents' perceptions of their children's QOL through a 2 year RTX treatment protocol. Pediatric patients from Hokkaido University Hospital with refractory NS who met our specific criteria were enrolled between January 2015 and December 2015. The RTX infusion was performed 4 times at 6-month intervals, followed by mizoribine administration with early discontinuation of calcineurin inhibitors. Quality of life scores were measured by the Pediatric Quality of Life Inventory version 4.0 (PedsQL) at each RTX administration and evaluated 2 years later. RESULTS Twenty-two patients were analyzed. The patients' QOL and their parents' perceptions of their QOL improved over our 2 year treatment protocol. Nevertheless, the parents' scores were lower than the patients' scores on all scales, with slower improvement. CONCLUSIONS Our treatment protocol showed a significant improvement of QOL in patients with refractory NS. Although the risk of the RTX treatment should be considered, the treatment is useful for patients with refractory NS.
Collapse
Affiliation(s)
- Toshiyuki Takahashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Isao Yokota
- Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuyuki Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Asako Hayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuhiro Ueda
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Japan
| | - Michihiko Ueno
- Department of Pediatrics, Nikko Memorial Hospital, Muroran, Japan
| | - Norio Kobayashi
- Department of Pediatrics, Oji General Hospital, Tomakomai, Japan
| | - Kimiaki Uetake
- Department of Pediatrics, Obihiro Kosei Hospital, Obihiro, Japan
| | | | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| |
Collapse
|
4
|
Duvant P, Fillat M, Garaix F, Roquelaure B, Ovaert C, Fouilloux V, Tsimaratos M, Auquier P, Fabre A, Baumstarck K. Quality of life of transplanted children and their parents: a cross-sectional study. Orphanet J Rare Dis 2021; 16:364. [PMID: 34404428 PMCID: PMC8369793 DOI: 10.1186/s13023-021-01987-y] [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: 01/28/2020] [Accepted: 07/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transplantation is a saving therapeutic that has heavy consequences. The quality of life (QoL) of transplanted children and their parents has been little studied and should help physicians better manage these patients. The objectives of the study were to assess: (1) the QoL of transplanted children and parents and compare it with that of children with other chronic conditions associated with long-term consequences, and (2) potential variables modulating the QoL. METHODS This cross-sectional study was performed in a multidisciplinary paediatric unit (Timone Hospital, Marseille, France). Children were less than 18 years old; had a liver, kidney or heart transplant; and had a time since transplantation of 1-10 years. Socio-demographics and clinical data were recorded from medical forms. The QoL was assessed using the VSP-A (Vécu et Santé Perçue de l'Adolescent et de l'Enfant) and the WhoQoL self-reported questionnaires. RESULTS Forty-five families were included (response rate: 76%). The transplanted organs were the liver for 20 children, the kidney for 15 children, and the heart for 10 children. The QoL of transplanted children reported by their parents was better than that of children with inborn errors of metabolism and similar to that of childhood leukaemia survivors. The QoL of parents of transplanted children was better than that of parents of children with inborn errors of metabolism and did not differ from French norms. The QoL did not differ according to the nature of the transplanted organ, sex or the main sociodemographic data. The main modulators decreasing QoL were residual treatment level, medications switch and the presence of another regular treatment. CONCLUSION Transplanted children and their families reported a fairly preserved QoL compared to children with other chronic health conditions. Special attention should be given to QoL modulators related to therapeutic management (medication switches, regular treatments) that might be amenable to improve the QoL. Trial registration Ethics committee of Aix-Marseille University, France (reference number: 2014-08-04-03, 24/4/2015; https://www.univ-amu.fr/fr/public/comite-dethique ).
Collapse
Affiliation(s)
- Pauline Duvant
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Magali Fillat
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Florentine Garaix
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Bertrand Roquelaure
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Caroline Ovaert
- Service médico-chirurgical de cardiologie pédiatrique et congénitale, Hôpital de la Timone, Marseille, France
| | - Virginie Fouilloux
- Service médico-chirurgical de cardiologie pédiatrique et congénitale, Hôpital de la Timone, Marseille, France
| | - Michel Tsimaratos
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Pascal Auquier
- EA 3279 CEReSS - Health Service Research and Quality of Life Center, Aix-Marseille Univ, 27 bd Jean Moulin, 13385, Marseille Cedex 05, France
| | - Alexandre Fabre
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Karine Baumstarck
- EA 3279 CEReSS - Health Service Research and Quality of Life Center, Aix-Marseille Univ, 27 bd Jean Moulin, 13385, Marseille Cedex 05, France.
| |
Collapse
|
5
|
Hager A, Mager D, Robert C, Nicholas D, Gilmour S. Health-Related Quality of Life 10 Years after Liver Transplantation: A Longitudinal Retrospective Review. Diagnostics (Basel) 2021; 11:diagnostics11010111. [PMID: 33445652 PMCID: PMC7827867 DOI: 10.3390/diagnostics11010111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 02/07/2023] Open
Abstract
As survival post-liver transplantation (LTx) improves, it becomes increasingly important to understand how long-term health-related quality of life (HRQOL) is impacted. This was a longitudinal review examining HRQOL measured by Pediatric Liver Transplant Quality of Life (PeLTQL) in children between 8-17 years who underwent LTx (1.4 [0.8–3.3] years) at least one year prior to assessment. Demographic, medical, anthropometric, and HRQOL data (self-reported and parent proxy) were retrospectively collected over four years (2014–2017) at annual LTx clinic visits. The study included 35 patients (18M, 17F) and their parents/guardians. Parent-proxy and child PeLTQL scores (total, subdomain) showed good to excellent agreement (p > 0.05) and did not change over four years (p > 0.05). Younger age (<12 years) and Caucasian ancestry were associated with higher parental and self-reported perceptions of HRQOL, respectively (future health, coping and adjustment, total scores). Parent perceived lower HRQOL in social–emotional sub-domain (p = 0.03) and the child reported lower sub-domain scores related to coping and adjustment (p = 0.04) when the child was noted to have co-morbid conditions related to mental health and neurocognitive development (25.7%). While child–parent perceptions of HRQOL in a multi-ethnic population of pediatric LTx recipients remain unchanged 10 years post-LTx, adolescents of non-Caucasian ancestry remain a population at risk for lower HRQOL.
Collapse
Affiliation(s)
- Amber Hager
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, AB T6G 2E1, Canada; (A.H.); (D.M.)
| | - Diana Mager
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, AB T6G 2E1, Canada; (A.H.); (D.M.)
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Cheri Robert
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - David Nicholas
- Department of Social Work, University of Calgary, Calgary, AB T5J 4P6, Canada;
| | - Susan Gilmour
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada;
- Division of Pediatric Gastroenterology & Nutrition/Transplant Services, The Stollery Children’s Hospital, Alberta Health Services, Edmonton, AB T6G 1C9, Canada
- Correspondence: ; Tel.: +1-780-248-5410
| |
Collapse
|
6
|
Abstract
Although overall donation and transplantation activity is higher in Europe than on other continents, differences between European countries in almost every aspect of transplantation activity (for example, in the number of transplantations, the number of people with a functioning graft, in rates of living versus deceased donation, and in the use of expanded criteria donors) suggest that there is ample room for improvement. Herein we review the policy and clinical measures that should be considered to increase access to transplantation and improve post-transplantation outcomes. This Roadmap, generated by a group of major European stakeholders collaborating within a Thematic Network, presents an outline of the challenges to increasing transplantation rates and proposes 12 key areas along with specific measures that should be considered to promote transplantation. This framework can be adopted by countries and institutions that are interested in advancing transplantation, both within and outside the European Union. Within this framework, a priority ranking of initiatives is suggested that could serve as the basis for a new European Union Action Plan on Organ Donation and Transplantation.
Collapse
|
7
|
Nasr AS, Rehm RS. Understanding the Long-Term Impact of Living-Related Liver Transplantation on Youth and Young Adults and their Family. J Pediatr Nurs 2020; 55:217-223. [PMID: 32966961 DOI: 10.1016/j.pedn.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The purpose of this mixed methods study was to better understand the long term impact of living-related liver donation (LRLD) on youth and young adult (YYA) recipients and their family. DESIGN AND METHODS Semistructured interviews were conducted with YYA, aged 11-18 years, who received a living donation from a parent. Interviews were audiotaped, transcribed, and analyzed to aggregate themes that represented the participants' views as live-liver recipients. An ethnographic process was conducted to understand the participants' social behavior. At interview, participants completed a demographics questionnaire and the Youth Quality of Life Instrument-Research Version (YQOL-R). RESULTS Thirteen adolescents were interviewed; six were re-interviewed as key informants. Three major categories were created from the data: Developing Identity, Redefining Family Relationships, Feeling Gratitude to Donors. The overarching theme was Resiliency. Findings from the YQOL-R showed no difference in overall scores or separate domains when compared with a reference population with no chronic illness. CONCLUSION Qualitative and quantitative data highlight the positive effect that LRLD can have on pediatric patients as they transition from childhood to adolescence to young adulthood. PRACTICE IMPLICATIONS As pediatric transplant centers in the United States soon mark 30 years of performing live-liver donation, recipients are becoming adults and understanding more clearly that the long-term effects of such donations will lead to improvements in future care.
Collapse
Affiliation(s)
- Annette S Nasr
- Nursing Research and Evidence-Based Practice, Stanford Children's Hospital, United States; University of California at San Francisco School of Nursing, Department of Family Health Care Nursing, CA, United States; Stanford School of Medicine, CA, United States.
| | - Roberta S Rehm
- University of California at San Francisco School of Nursing, Department of Family Health Care Nursing, CA, United States
| |
Collapse
|
8
|
Butsriphum N, Getsuwan S, Prabpram W, Chuthapisith J, Tanpowpong P, Lertudomphonwanit C, Treepongkaruna S. Family Function in Pediatric Liver Transplant Recipients Residing In a Developing Country. Transplant Proc 2020; 52:920-925. [PMID: 32173590 DOI: 10.1016/j.transproceed.2020.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pediatric liver transplantation (LT) can affect recipients' family function; however, inconsistent results between studies exist, and data from developing nations are sparse. We aimed to evaluate family function and identify factors associated with suboptimal function in pediatric LT recipients. METHODS A cross-sectional study was performed at a teaching hospital in Bangkok, Thailand between May 2018 and December 2018. We included the families of children aged 2 to 18 years who underwent LT for at least 1 year. Chulalongkorn Family Inventory (CFI) was used to evaluate the family function in these children comparing with families of healthy children. Family function was interpreted from the total CFI score and characterized as dysfunctional, normal-functioned, and well-functioned. RESULTS We enrolled families of 82 LT recipients and 72 healthy children. LT recipients had median age of 7.4 (interquartile range: 4.5-10.3) years. Eighteen children (22%) had a single parent, and at least one unemployed parent was reported in 25%. Most (96%) had well-functioned families, and none had a dysfunctional family. Furthermore, the total score was not significantly different between families of LT and healthy children (P = .95). LT families had a higher score in problem-solving (P < .01) and lower score in the affective involvement and general functioning dimension (P < .01 and .02, respectively). Among the LT children, postoperative bile leakage was associated with lower overall family function score. CONCLUSIONS Even though most recipients had good family function, physicians should pay close attention to specific aspects of family function, especially in children with certain postoperative complications.
Collapse
Affiliation(s)
- N Butsriphum
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - S Getsuwan
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - W Prabpram
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - J Chuthapisith
- Division of Child Development, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - P Tanpowpong
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - C Lertudomphonwanit
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - S Treepongkaruna
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
9
|
Childhood Adversity and Associated Psychosocial Function in Adolescents with Complex Trauma. CHILD & YOUTH CARE FORUM 2019; 48:305-322. [PMID: 31467469 DOI: 10.1007/s10566-018-9479-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background Childhood adversity is linked to a number of adult health and psychosocial outcomes; however, it is not clear how to best assess and model childhood adversity reported by adolescents with known maltreatment exposure. Objective This study sought to identify an empirically-supported measurement model of childhood adversity for adolescents in child protective custody and associations among childhood adversity and adolescent outcomes. Methods Self-report survey data assessed childhood adversity and adolescent outcomes, including psychological wellbeing, quality of life, and substance use, in 151 adolescents ages 16 to 22 in protective custody with a documented maltreatment history. Results Findings suggest that, among youth with complex trauma histories, it is important to distinguish among risk related to unexpected tragedy (e.g., natural disaster, parental divorce), family instability (e.g., parental substance abuse or mental health concerns), and family violence (e.g., physical or sexual abuse). Family violence was associated with poorer psychological wellbeing and quality of life, while family instability was associated with cigarette and marijuana use. Conclusions Among adolescents with complex trauma histories, childhood adversity assessments reflect multiple domains of adversity, each of which are differentially related to adolescent risks. Properly assessing childhood adversity in adolescents with complex trauma histories may help target interventions for specific risks (e.g., substance use) based on which types of childhood adversity youth have been exposed to.
Collapse
|
10
|
Walker RC, Naicker D, Kara T, Palmer SC. Parents' perspectives and experiences of kidney transplantation in children: A qualitative interview study. J Ren Care 2019; 45:193-200. [DOI: 10.1111/jorc.12292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/25/2019] [Accepted: 04/08/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Rachael C. Walker
- School of NursingEastern Institute of TechnologyHawke's Bay New Zealand
| | - Derisha Naicker
- Department of NephrologyStarship Children's HealthAuckland New Zealand
| | - Tonya Kara
- Department of NephrologyStarship Children's HealthAuckland New Zealand
| | - Suetonia C. Palmer
- Department of MedicineUniversity of Otago Christchurch8140 New Zealand
- Department of NephrologyCanterbury District Health BoardChristchurch New Zealand
| |
Collapse
|
11
|
Passamonti SM, Cannavò A, Espadas de Arias A, Innocente A, Ramondetta M, Regalia A, Messa P, Ferraresso M, Cardillo M. Pretransplant Single Antigen Bead-Detected HLA Antibodies in Kidney Transplant Long-term Outcome: A Single-Center Cohort Experience. Transplant Proc 2019; 51:707-714. [PMID: 30979454 DOI: 10.1016/j.transproceed.2019.01.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/14/2018] [Accepted: 01/17/2019] [Indexed: 11/17/2022]
Abstract
Single-antigen bead (SAB) platform permits the identification of antibodies not detectable by complement-dependent lymphocytotoxicity test, but their clinical significance is not completely understood. The aim of this study was to evaluate whether the presence of pretransplant SAB-detected antibodies is associated with the development of allograft failure. This is a single-center cohort study with 10-year follow-up in which 573 kidney recipients with negative pretransplant complement-dependent lymphocytotoxicity crossmatch who received transplants at the Kidney Transplant Center of Policlinico, Milan, from deceased donors between 1996 and 2005 were evaluated. Pretransplant plasma samples were retrospectively analyzed by SAB assay. Survival analyses were performed to assess the risk of allograft failures by SAB-detected antibodies. Pretransplant antibodies were found in 160 (28.0%) recipients, of whom 42 subsequently developed an allograft failure for a survival rate of 70.9% (95% confidence interval [CI), 63.5-78.4). Among those without antibodies, 58 (14.0%) returned to dialysis with a survival rate of 84.7% (95% CI, 81.0-88.4). In Cox regression analyses, patients with SAB-positivity had 2-fold higher risk of allograft failure than those who were SAB-negative (hazard ratio, 2.07; 95% CI, 1.39-2.79). Results did not change after adjustment for putative confounders. In conclusion, in this single-center cohort, 10-year allograft survival rate was significantly influenced by the presence of SAB-detected antibodies.
Collapse
Affiliation(s)
- S M Passamonti
- North Italy Transplant program (NITp), UOC Coordinamento Trapianti, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
| | - A Cannavò
- North Italy Transplant program (NITp), UOC Coordinamento Trapianti, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A Espadas de Arias
- North Italy Transplant program (NITp), UOC Coordinamento Trapianti, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A Innocente
- North Italy Transplant program (NITp), UOC Coordinamento Trapianti, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - M Ramondetta
- North Italy Transplant program (NITp), UOC Coordinamento Trapianti, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A Regalia
- Unit of Nephrology, Dialysis, and Renal Transplant, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy and University of Milan
| | - P Messa
- Unit of Nephrology, Dialysis, and Renal Transplant, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy and University of Milan
| | - M Ferraresso
- Kidney Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy and University of Milan
| | - M Cardillo
- North Italy Transplant program (NITp), UOC Coordinamento Trapianti, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
12
|
Agerskov H, Thiesson H, Specht K, D Pedersen B. Parents' experiences of donation to their child before kidney transplantation: A qualitative study. J Clin Nurs 2019; 28:1482-1490. [PMID: 30552722 DOI: 10.1111/jocn.14734] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVES To explore parents' experiences of donation to their child before kidney transplantation. BACKGROUND Transplantation is the treatment of choice for paediatric patients with end-stage renal disease. Living donor kidney transplantation has shown a higher long-term transplant survival compared to deceased donor transplantation and entails a more controllable process, with shorter waiting time. Besides complex care and treatment of their child, parents must reflect on the prospects of being a donor for their child. However, little is known about the parent donor and parent caregiver perspective. DESIGN A qualitative exploratory study taking a phenomenological-hermeneutic approach. METHOD The study was conducted in a Danish university hospital. Interviews were conducted with the parents of seven children, aged between 5-15 years, with end-stage renal disease in the period before kidney transplantation. Data were analysed with inspiration from Ricoeur's theory of interpretation on three levels: naïve reading, structural analysis and critical interpretation and discussion. RESULTS The decision about donation was experienced as a matter of course and commitment. There were preferences for a kidney from a living donor, including the hope of being accepted as a donor. Being refused as a donor revealed feelings of powerlessness. However, transformation was performed into having a new role providing care and comfort to the child during the transplant process. Asking family and friends about donation could feel like crossing a line. CONCLUSION The prospect of donating to one's child had an impact on the well-being of the entire family. Parents were in a vulnerable situation and in need of support, regarding both living and deceased donation. Waiting time included hopeful thoughts and reflections on a new caregiver role for the child during transplantation. RELEVANCE TO CLINICAL PRACTICE Health professionals' attention, engagement and dialogue are essential in order to gain extensive and varied knowledge about the individual parent's experiences and the well-being of the entire family to provide care and support before, during and after the donation and transplantation process.
Collapse
Affiliation(s)
- Hanne Agerskov
- Department of Nephrology, Odense University Hospital, Odense C, Denmark.,Department of Clinical Institute, University of Southern Denmark, Odense C, Denmark
| | - Helle Thiesson
- Department of Nephrology, Odense University Hospital, Odense C, Denmark.,Department of Clinical Institute, University of Southern Denmark, Odense C, Denmark
| | - Kirsten Specht
- Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark.,Faculty of Health Science, Department of Regional Health Research, University of Southern Denmark, Odense C, Denmark
| | - Birthe D Pedersen
- Department of Clinical Institute, University of Southern Denmark, Odense C, Denmark
| |
Collapse
|
13
|
Hsu CN, Lin HW, Pickard AS, Tain YL. EQ-5D-Y for the assessment of health-related quality of life among Taiwanese youth with mild-to-moderate chronic kidney disease. Int J Qual Health Care 2018; 30:298-305. [PMID: 29447362 DOI: 10.1093/intqhc/mzy011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 01/16/2018] [Indexed: 12/19/2022] Open
Abstract
Objective To assess if health-related quality of life (HRQOL) of children with chronic kidney disease (CKD) and different comorbid conditions can be identified based on the EQ-5D child-friendly version (EQ-5D-Y). Design Prospective cross-sectional study. Setting A tertiary care medical center in Taiwan. Study participants All CKD patients aged 7-18 years treated at the center between May 2014 and December 2016. Main Outcome Measures HRQOL assessment was done using EQ-5D-Y. Spearman correlation tests were used for construct validity of the traditional Chinese version of EQ-5D-Y. Test-retest reliability was determined through Cohen's kappa values and intraclass correlation coefficients (ICC). Laboratory results and CKD-related morbid conditions were ascertained and assessed their associations with HRQOL score using multivariate linear regression. Results Of 68 participants, 53 of them completed two HRQOL assessments of HRQOL at least 6-month. Cross-sectional analysis revealed fair to moderate correlations between EQ visual analogue score and patient characteristics. Older children at assessment (P < 0.01), girls (P = 0.03) and presence of mineral bone disorders had a significantly negative impact on HRQOL. Children self-reported EQ-5D-Y dimensions were found to be fairly to highly reliable (kappa = 0.2 to 0.8), except for 'pain/discomfort' and 'anxiety/depression'. Conclusions The EQ-5D-Y discriminated among children with different level of CKD-related clinical burden, but the psychometric properties may be limited in some HRQOL dimensions. Further research will need to address factors that may threaten validity and reliability data provided by children and adolescents.
Collapse
Affiliation(s)
- Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, 123 Dabi Rd., Niausung, Kaohsiung 83301, Taiwan.,School of Pharmacy, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Kaohsiung 80708, Taiwan
| | - Hsiang-Wen Lin
- College of Pharmacy, China Medical University, 91 Hsueh-Shih Rd., Taichung 40402, Taiwan.,Department of Pharmacy, China Medical University Hospital, China Medical University, 91, Hsueh-Shih Rd., Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, 91, Hsueh-Shih Rd., Taichung, Taiwan
| | - A Simon Pickard
- Department of Medical Research, China Medical University Hospital, China Medical University, 91, Hsueh-Shih Rd., Taichung, Taiwan.,Department of Pharmacy System, Outcomes, and Policy, College of Pharmacy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL 60612, USA
| | - You-Lin Tain
- Department of Pediatrics, Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Dabi Road, Niausung, Kaohsiung 83301, Taiwan
| |
Collapse
|
14
|
Hamasaki Y, Yamaguchi T, Takahashi Y, Hashimoto J, Muramatsu M, Kawamura T, Sakai K, Shishido S, Tazaki M. Change in the quality of life of caregivers of pediatric department patients undergoing kidney transplantation: a single-center prospective study. Clin Exp Nephrol 2018; 22:1198-1204. [DOI: 10.1007/s10157-018-1604-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 06/18/2018] [Indexed: 02/05/2023]
|
15
|
Rastogi M, Rangnekar S, Rastogi R. Enhancing quality of work life in India: the role of workplace flexibility. INDUSTRIAL AND COMMERCIAL TRAINING 2018. [DOI: 10.1108/ict-10-2017-0086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Purpose
It has been claimed that workplace flexibility is beneficial for employees as well as employers. However, not many studies have attempted to examine the impact of workplace flexibility on employees. The purpose of this paper is to examine the impact of flexibility dimensions on quality of work life (QWL) of employees.
Design/methodology/approach
Data were collected from a sample of 380 middle-level employees from service and manufacturing sector in India. Analyses were carried out using multiple regressions with the help of SPSS AMOS 21.
Findings
Flexibility in time and place as well as operations has a significant impact on QWL of middle-level employees. Additionally, flexibility in time and place is indicated to be a strong predictor for enhanced QWL particularly for married female employees as compared to their male counterparts. The type of organisation and sector also influences QWL of middle-level employees.
Research limitations/implications
This study has projected theoretical justification indicating how workplace flexibility satisfies needs of middle-level employees and promotes their QWL. It contributes to positive psychology literature by illustrating empirical evidence supporting the crucial role of flexibility at workplace in enhancing QWL of employees in India.
Practical implications
The findings may be valuable in all kinds of organisational settings when reviewing and proposing motivational employee well-being related policies. The empirical findings may have practical implications when it comes to designing jobs for enhanced work engagement.
Originality/value
The variables examined in this study reflect an understanding about how support mechanism at workplace creates a positive effect in employees’ well-being in unique cultural settings of India. Thus, this study is a significant contribution to the well-being literature in India.
Collapse
|
16
|
Yadav P, Nunia S, Bansal A, Sureka SK, Jena R, Ansari MS, Srivastava A. Multidimensional assessment of quality of life of children and problems of parents in Indian society after pediatric renal transplant: Beyond the conventional thoughts. Pediatr Transplant 2017; 21. [PMID: 28718221 DOI: 10.1111/petr.13001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2017] [Indexed: 11/29/2022]
Abstract
This study evaluated multidimensional QoL after renal transplant to find the physical, psychosocial, and economic issues after pediatric transplant. Sixty-two patients under the age of 18 at the time of assessment were asked to complete WHOQOL questionnaires. Assessment of behavioral, emotional status of child, problems of parents, and SEC of family were also performed. The beneficial effect of transplantation was observed across all domains of QoL (physical, psychological, social, environmental, and overall QoL). The greatest change was observed in QoL domains that dealt with overall satisfaction (81.28±15.76 vs 45.32±10.98; P<.0001). The domain dealing with environmental factors showed the least variation after transplantation (65.58±17.45 vs 51.34±17.81; P<.0001). Feelings of happiness and peer group socialization were reported in 81% and 69% of patients, respectively. There was no marital disharmony in 52% of families. However, SEC deteriorated in 16% of families and 59% of the families availed financial assistance. Sixty-nine percent of children had not attended school after one year of transplantation, but return to school after transplant was reduced to 8% at 5 years. Pre- and post-transplant social and psychological support may help these patients and their families adjust in society and have a positive outlook for their future.
Collapse
Affiliation(s)
- Priyank Yadav
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sandeep Nunia
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ankur Bansal
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sanjoy K Sureka
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Rahul Jena
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Mohd Sualeh Ansari
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Aneesh Srivastava
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|
17
|
Sheikh SI, Pitts J, Ryan-Wenger NA, Kotha K, McCoy KS, Stukus DR. Improved quality-of-life of caregivers of children with asthma through guideline-based management. J Asthma 2016; 54:768-776. [PMID: 27831828 DOI: 10.1080/02770903.2016.1258077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The quality of life (QOL) of caregivers of children with asthma may be related to children's responses to asthma management. AIM To evaluate change in QOL over time of caregivers of children with asthma through guideline-based management. DESIGN This was a 3-year prospective cohort study of children with asthma referred to our pediatric asthma center. Families completed Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), the Asthma Control Test™ (ACT), and reported the number of days/month of albuterol use and wheezing at each clinic visit. RESULTS We enrolled 143 children, ages 7-17 years (mean = 10.6 ± 2.9), 56.6% male, 70.6% Caucasian. Patients were managed by the same MD (n = 65,45.5%) or APN (n = 78,54.5%) over time. The mean total PACQLQ significantly increased over the 3-year period (F = 67.418, p < .001). Total scores at the first visit were 4.8 ± 1.6, which improved to 6.1 ± 1 at the 3-month follow-up visit. This improvement was sustained at the 1, 2, and 3-year clinic visits. PACQLQ emotional function (F = 60.798, p < .001) and activity limitation (F = 41.517, p < .001) domains significantly improved as well. PACQLQ scores were significantly associated with improved ACT scores (r = .37 to .47, p < .05), fewer days/month of albuterol use (r = -.25 to -.36., p < .05), and wheezing (r = -.28 to -.33, p < .05). There were no significant differences in PACQLQ, or asthma clinical outcome measures between MD and APN providers. CONCLUSION Use of National Asthma Education and Prevention Program (NAEPP) guidelines significantly improved QOL of caregivers of children with asthma and in asthma-related symptoms. Improvements over time were independent of type of providers.
Collapse
Affiliation(s)
- Shahid I Sheikh
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.,c Section of Allergy & Immunology , Nationwide Children's Hospital , Columbus , OH , USA
| | - Judy Pitts
- b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - Nancy A Ryan-Wenger
- b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - Kavitha Kotha
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - Karen S McCoy
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - David R Stukus
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,c Section of Allergy & Immunology , Nationwide Children's Hospital , Columbus , OH , USA
| |
Collapse
|
18
|
Your Child's Transplant Surgery: Building Blocks to Help You Cope during the Early Days. Prog Transplant 2016. [DOI: 10.1177/152692480401400411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
19
|
Tjaden LA, Grootenhuis MA, Noordzij M, Groothoff JW. Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice. Pediatr Nephrol 2016; 31:1579-91. [PMID: 26310616 PMCID: PMC4995226 DOI: 10.1007/s00467-015-3186-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 07/21/2015] [Accepted: 07/27/2015] [Indexed: 11/14/2022]
Abstract
Health-related quality of life (HRQoL) is increasingly recognized as a key outcome in both clinical and research settings in the pediatric population with end-stage renal disease (ESRD). This review aims to: (1) summarize the current knowledge on HRQoL and socioprofessional outcomes and (2) provide strategies for incorporation of HRQoL assessment into clinical practice. Studies report that pediatric patients with ESRD have significantly lower HRQoL scores compared with children with other chronic diseases. Patients treated by dialysis are at particularly high risk for impaired HRQoL. Furthermore, patients more often have impaired neurocognitive functioning and lower academic achievement. Important determinants of impaired HRQoL include medical factors (i.e., receiving dialysis, disabling comorbidities, cosmetic side effects, stunted growth), sociodemographic factors (i.e., female gender, non-Western background) and psychosocial factors (i.e., noneffective coping strategies). Contrary to the situation in childhood, adult survivors of pediatric ESRD report a normal mental HRQoL. Despite this subjective feeling of well-being, these patients have on average experienced significantly more difficulties in completing their education, developing intimate relationships, and securing employment. Several medical and psychosocial strategies may potentially improve HRQoL in children with ESRD. Regular assessment of HRQoL and neurocognitive functioning in order to identify areas in which therapies and interventions may be required should be part of standard clinical care.
Collapse
Affiliation(s)
- Lidwien A Tjaden
- Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Marlies Noordzij
- Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Jaap W Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|
20
|
BÜYÜKKARAGÖZ B, BUYAN N, DOĞRUCAN N, ÇELİK B. Health-related quality of life of pediatric renal transplant recipientsand their parents: the role of associated factors and clinical counseling. Turk J Med Sci 2016; 46:1481-1485. [DOI: 10.3906/sag-1505-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 01/22/2016] [Indexed: 11/03/2022] Open
|
21
|
Mavis AM, Ertl A, Chapman S, Cassidy LD, Lerret SM. Vulnerability and Chronic Illness Management in Pediatric Kidney and Liver Transplant Recipients. Prog Transplant 2015; 25:139-46. [DOI: 10.7182/pit2015551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Context— Solid-organ transplant is the treatment of choice for end-stage organ failure and requires a transition from management of a life-threatening condition to a chronic illness. Despite research focusing on quality of life after transplant, there is a gap addressing the role of managing a chronic illness focusing on vulnerability and impact on family. Objective— Identify patient and family patterns of adaptation among kidney and liver transplant recipients in regard to (1) vulnerability, (2) impact of illness on the family, (3) family functioning, and (4) quality of life (parent and child report). Design— Cross-sectional study enrolling children 5 to 18 years old and their parent at a single time point after kidney or liver transplant. Validated self-report tools were completed. Results— In all, 47 participants (24 kidney and 23 liver) were recruited. Mean age at transplant was 4.0 (kidney) and 2.1 (liver) years. Mean age at report was 12.1 (kidney) and 7.1 (liver) years. Child vulnerability correlated negatively with (1) family impact in the kidney ( P < .05) and liver ( P < .05) transplant groups, (2) PedsQL subscales including Parent Emotional ( P < .05), Parent Social ( P < .01), Parent Psychosocial ( P < .01), Parent Physical ( P < .05), Parent School ( P < .05), and Child Social ( P < .01) in the kidney transplant group, (3) PedsQL Parent Emotional subscale ( P < .01) in the liver transplant group, and (4) Functional status ( P < .01) in the liver transplant group. Conclusions— Child vulnerability provides insight into quality of life and the impact of illness on the family and family functioning.
Collapse
Affiliation(s)
- Alisha M. Mavis
- Medical College of Wisconsin (AMM, AE, LDC, SML), Children's Hospital of Wisconsin (SC), Milwaukee, Wisconsin
| | - Allison Ertl
- Medical College of Wisconsin (AMM, AE, LDC, SML), Children's Hospital of Wisconsin (SC), Milwaukee, Wisconsin
| | - Shelley Chapman
- Medical College of Wisconsin (AMM, AE, LDC, SML), Children's Hospital of Wisconsin (SC), Milwaukee, Wisconsin
| | - Laura D. Cassidy
- Medical College of Wisconsin (AMM, AE, LDC, SML), Children's Hospital of Wisconsin (SC), Milwaukee, Wisconsin
| | - Stacee M. Lerret
- Medical College of Wisconsin (AMM, AE, LDC, SML), Children's Hospital of Wisconsin (SC), Milwaukee, Wisconsin
| |
Collapse
|
22
|
Kikuchi R, Kamibeppu K. Parents' quality of life and family functioning in pediatric organ transplantation. J Pediatr Nurs 2015; 30:463-77. [PMID: 25605616 DOI: 10.1016/j.pedn.2014.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 12/16/2014] [Accepted: 12/19/2014] [Indexed: 11/15/2022]
Abstract
Solid organ transplantation is an important treatment option for pediatric patients in end-stage organ failure. The impact of pediatric organ transplantation on parents' quality of life and family functioning has been found to be substantial, but findings on this topic have not previously been consolidated. Thirty-one studies were selected for analysis after a database search on this topic. We present future research questions and suggestions to improve clinical practice based on the integration of this knowledge.
Collapse
Affiliation(s)
- Ryota Kikuchi
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo.
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo
| |
Collapse
|
23
|
Kikuchi R, Ono M, Kinugawa K, Endo M, Mizuta K, Urahashi T, Ihara Y, Yoshida S, Ito S, Kamibeppu K. Health-related quality of life in parents of pediatric solid organ transplant recipients in Japan. Pediatr Transplant 2015; 19:332-41. [PMID: 25651866 DOI: 10.1111/petr.12435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2015] [Indexed: 01/19/2023]
Abstract
Few studies have examined HRQOL in pediatric Tx recipients' parents. This study investigated HRQOL in these parents and relationships between HRQOL and perceived burden of nurturing, family functioning, and social support. Self-report anonymous questionnaires and a survey of medical records were completed between September and December 2013. The SF-36v2, which evaluates physical, psychological, and social health, was used to measure HRQOL. While values for physical and psychological health were higher than standard values (Cohen's d = 0.34 and 0.17, respectively), social health scores were lower (d = 0.21). "Parental consultation unrelated to donation" (standardized partial regression coefficient: β = -0.52) was associated with physical health. "Family functioning" and "Commuting time between home and primary follow-up hospital" (β = 0.57 and -0.31) were related to psychological health. "Total score for perceived burden of nurturing" (β = -0.31) was related to social health. Regarding parental HRQOL, while physical and psychological health was favorable, social health was impaired. In clinical practice, interventions targeting parents' physical conditions and facilitation of community and family understanding and support to share recipients' nurturing are important in improving parental HRQOL.
Collapse
Affiliation(s)
- Ryota Kikuchi
- Department of Family Nursing, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan; Department of Transplant Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Julian V, Amat F, Petit I, Pereira B, Fauquert JL, Heraud MC, Labbé G, Labbé A. Impact of a short early therapeutic education program on the quality of life of asthmatic children and their families. Pediatr Pulmonol 2015; 50:213-221. [PMID: 24574193 DOI: 10.1002/ppul.23013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 01/19/2014] [Accepted: 01/26/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Few studies have been made on the impact of therapeutic education (TE) on the quality of life (QOL) of asthmatic primary-school aged children. We attempted to assess the beneficial effects on the QOL of children and their parents of a short TE program initiated immediately after the first consultation with a pediatric pulmonologist. METHODS The QOL of 31 families of asthmatic children (aged 5-11) was measured before and 3 months after a short and early programme of TE by the French version of the Pictured Child's Quality of Life Self Questionnaire (AUQUEI, AUtoquestionnaire QUalité de vie Enfant Imagé) for the children, and by the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) for the parents. The other criteria studied were asthma management, school and workplace absenteeism and functional respiratory parameters. RESULTS TE did not significantly alter the AUQUEI score (P = 0.67). No change was observed in the different areas studied: autonomy (P = 0.97), leisure activities (P = 0.64), functions (P = 0.88), and social relations (P = 0.51). In contrast, the PACQLQ score considerably improved after TE (P < 0.001), as evidenced by reduced activity limitations (P < 0.001) and improved emotional functioning of parents (P < 0.001). These results were accompanied by a significant improvement in asthma management, with, in particular, a major decrease in the use of medication (P < 0.001) and the number of unscheduled medical consultations (P < 0.001) and visits to the emergency department (P = 0.02); a decrease in school absenteeism (P = 0.009); and an improvement in forced expiratory volume in 1 sec (FEV1 ) (P = 0.05). CONCLUSIONS Our TE program had rapid and beneficial effects on numerous objective and subjective parameters, thereby contributing to the well-being of the families and probably to a subsequent decrease in the overall cost of asthma management. Pediatr Pulmonol. 2015; 50:213-221. © 2014 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Valérie Julian
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France
| | - Flore Amat
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France.,Centre de l'asthme et des allergies, Service d'allergologie, Hôpital Armand Trousseau, Paris Cedex 12, France
| | - Isabelle Petit
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France
| | - Bruno Pereira
- Direction de la Recherche Clinique, Unité de Biostatistique, Place Henri Dunant, Centre Hospitalier Universitaire Gabriel Montpied, Université d'Auvergne-Clermont I, Clermont-Ferrand, France
| | - Jean-Luc Fauquert
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France
| | - Marie-Christine Heraud
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France
| | - Guillaume Labbé
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France
| | - André Labbé
- Unité de Pneumologie et allergologie pédiatrique, 1 Place Lucie et Raymond Aubrac, Centre Hospitalier Universitaire Estaing, Université d'Auvergne-Clermont I, Clermont-Ferrand Cedex 1, France
| |
Collapse
|
25
|
Kari JA, Alzahrany M, El-Deek B, Maimani M, El-Desoky S. Social impact of dialysis on children and their families. Indian J Pediatr 2014; 81:1020-6. [PMID: 24122420 DOI: 10.1007/s12098-013-1236-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 08/26/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the social consequences of dialysis on children and their parents. METHODS From January through June 2012 short structured interviews with parents or caregivers of children on peritoneal dialysis (PD) or hemodialysis (HD) who were followed up at King Abdulaziz University Hospital, King Faisal Specialty Hospital and Research Center, or the Kidney Center at King Fahad Hospital were conducted. Data were analyzed using the Statistical Package for the Social Sciences. RESULTS Thirty six children (20 boys and 16 girls [corrected] ) and their families were included. The mean (SD) age of the children was 11.5±6.87 y, and the mean (SD) duration of dialysis was 28±11.32 mo. Only one third of the families had the opportunity to choose the modality of dialysis. Both modalities of dialysis had a negative effect on fathers' jobs in over 50% of the cases. Similarly, both modalities of treatment had a considerable impact on the quality of care provided by the mothers to other family members. There was no difference between the two modalities on the frequency of admissions. CONCLUSIONS Both PD and HD had a negative impact on fathers' jobs and on the level of care provided by mothers to the rest of the family.
Collapse
|
26
|
Meaux JB, Green A, Nelson MK, Huett A, Boateng B, Pye S, Schmid B, Berg A, LaPorte K, Riley L. Transition to Self-Management after Pediatric Heart Transplant. Prog Transplant 2014; 24:226-33. [DOI: 10.7182/pit2014911] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Context Little is known about adolescent transition to self-management after heart transplant. This gap in knowledge is critically important because the consequences of poor self-management are costly and life-threatening, often resulting in nonadherence, rejection, repeated hospitalizations, and poor quality of life. Objective To explore how adolescents and parents perceive their roles in self-management, and how adolescents integrate self-management into their daily lives and navigate the transition from parent-dominated to self-management. Design Qualitative descriptive design, using online focus groups. Setting Online focus groups using itracks, an online qualitative software program. Participants A purposive sample of 4 adolescents, 13 to 21 years old, who were at least 6 months posttransplant, and of 6 parents of adolescent heart transplant recipients. Results Several parallel themes emerged from the parent and adolescent online focus groups. Managing medications was the predominant theme for both parents and adolescents. For the remaining themes, parents and adolescents expressed similar ideas that were categorized into parallel themes, which included staying on top of things/becoming independent, letting them be normal/being normal, and worries and stressors. Conclusions The transition to self-management after heart transplant was a clear goal for both parents and adolescents. The transition is a shared responsibility between parents and adolescents with a gradual shift from parent-directed to self-management. The process of transition was not linear or smooth, and in several instances, parents described efforts to transfer responsibility to the adolescent only to take it back when complications arose. Additional research with a larger sample is needed in order to fully understand adolescent heart transplant recipients' transition to self-management.
Collapse
Affiliation(s)
- Julie B. Meaux
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Angela Green
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Mary Kathryn Nelson
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Amy Huett
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Beatrice Boateng
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Sherry Pye
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Barbara Schmid
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Alex Berg
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Kelci LaPorte
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| | - Linda Riley
- University of Central Arkansas, Conway (JBM), Arkansas Children's Hospital (AG, MKN, AH, SP, BS) and University of Arkansas for Medical Sciences (AG, BB), Little Rock, Arkansas, Children's Healthcare of Atlanta (AB, KL, LR), Georgia
| |
Collapse
|
27
|
Lopes M, Ferraro A, Koch VH. Health-related quality of life of children and adolescents with CKD stages 4-5 and their caregivers. Pediatr Nephrol 2014; 29:1239-47. [PMID: 24577804 DOI: 10.1007/s00467-014-2769-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 12/28/2013] [Accepted: 01/20/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Renal replacement therapies may affect the quality of life of patients and their primary caregivers (PC). METHODS This study describes the perception of health-related quality of life (HRQoL) of children/adolescents with CKD stages 4-5, as well as of their PC (n = 64), in comparison to healthy peers and their PC (n = 129), respectively, based on the Peds QL™ 4.0 and Short Form-36 (SF-36) questionnaires and selected biomarkers. RESULTS Patients reported a deleterious impact on physical capacity and on social and school activities. A negative influence on emotional aspects was reported by older patients, but not by their PC. Hemodialysis, followed by peritoneal dialysis, had a more negative impact on patients' physical functioning domain. PC HRQol proxy reports differed from those of their children, especially in older patients. PC of both groups presented similar SF-36 scores. An association was demonstrated between the magnitude of treatment target inadequacies, lower specific dominion scores in the patients/PC proxy reports and PC SF-36 general health scores. CONCLUSION The HRQoL of patients with CKD stages 4-5 is negatively affected to different degrees depending on age and treatment modality. The results suggest an association between worsening HRQoL parameters and inadequate control of recognized therapeutic CKD treatment targets.
Collapse
Affiliation(s)
- Marcos Lopes
- Department of Pediatrics, Pediatric Nephrology Unit, Instituto da Criança Hospital das Clinicas of the University of Sao Paulo Medical School, Rua das Mangabeiras 91/81, 01233-010, São Paulo, Brazil
| | | | | |
Collapse
|
28
|
Psychosocial aspects of nephrotic syndrome among children and their caregivers. MIDDLE EAST CURRENT PSYCHIATRY 2013. [DOI: 10.1097/01.xme.0000430427.21352.ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
29
|
Tozzi AE, Mazzotti E, Di Ciommo VM, Dello Strologo L, Cuttini M. Quality of life in a cohort of patients diagnosed with renal failure in childhood and who received renal transplant. Pediatr Transplant 2012; 16:840-5. [PMID: 22943602 DOI: 10.1111/j.1399-3046.2012.01774.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Studies on HRQOL on kidney-transplanted young adults who had a diagnosis of chronic renal failure (CRF) in the pediatric age are uncommon. We studied HRQOL and its predictors in a sample of young adults with CRF in childhood who underwent a renal transplant. We recruited patients ≥18 yr old with renal transplant. We measured HRQOL by a standardized questionnaire on lifestyle, Short Form-36 (SF-36; including a PCS and a MCS; scale: 0-100), the GHQ (for short-term changes in mental health; scale: 0-36), and the MSPSS (with scales for family, friends, and significant others; scale: 0-100). We assessed the association of potential predictors of HRQOL through multiple linear regression models. We studied 66 patients aged 18-34 yr. The average PCS score was 76.4, and the average MCS score was 73.9. The mean GHQ total score was 14.8, and the total scale MSPSS mean score was 70. Severe comorbidities significantly affected the PCS score. Individuals with severe comorbidities had lower PCS scores.
Collapse
|
30
|
Roblin E, Audhuy F, Boillot O, Rivet C, Lachaux A. Qualité de vie à long terme après transplantation hépatique chez l’enfant. Arch Pediatr 2012; 19:1039-52. [DOI: 10.1016/j.arcped.2012.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 04/21/2012] [Accepted: 06/29/2012] [Indexed: 10/26/2022]
|
31
|
[Paediatric features in childhood renal transplantation: quality of life, school, adherence, transfer to adult nephrologists]. Nephrol Ther 2012; 7:599-603. [PMID: 22118789 DOI: 10.1016/j.nephro.2011.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The quality of life of children having undergone renal transplantation is slightly lower than in the general population, whereas it is rather better in transplanted adolescents. The parent's quality of life is often affected. School attendance is affected by the disease and school performances lower as an outcome, however the level of unemployment at adulthood remains similar to the general population. Treatment compliance is high in young children, but low in adolescents, resulting in frequent rejection episodes and reduced graft survival. Multidisciplinary patient management is essential, possibly in a patient's therapeutic education unit. Implementation of special measures is recommended to reduce the risks associated with the transition from pediatric to adult unit.
Collapse
|
32
|
Wallon M, Kieffer F, Binquet C, Thulliez P, Garcia-Méric P, Dureau P, Franck J, Peyron F, Bonnin A, Villena I, Bonithon-Kopp C, Gouyon JB, Masson S, Félin A, Cornu C. Toxoplasmose congénitale : comparaison randomisée de stratégies de prévention des rétinochoroïdites. Therapie 2011; 66:473-80. [DOI: 10.2515/therapie/2011070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 06/25/2011] [Indexed: 11/20/2022]
|
33
|
Quality of life of adolescent kidney transplant recipients. J Pediatr 2011; 159:670-5.e2. [PMID: 21621222 DOI: 10.1016/j.jpeds.2011.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/24/2011] [Accepted: 04/06/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To elicit utility-based quality of life (QOL) of adolescent kidney transplant recipients. STUDY DESIGN We measured QOL in adolescent transplant recipients by using a visual analog scale (VAS), and 2 utility-based QOL measures, the Health Utilities Index (HUI) Mark 2/3 (HUI2/3), and the time trade-off. Participants aged 11-19 years old were recruited from 5 transplantation centers in Australia. Mean scores were compared by using paired t tests, and linear multiple regression was used to define predictors for time trade-off QOL weights. RESULTS Twenty-six adolescents participated in the study. On a scale with extremes of 0 (death) and 1 (full health), the participants had a mean (SD) time trade-off QOL weight of 0.99 ± 0.01 and HUI2/3 utility scores of 0.86 ± 0.16 and 0.85 ± 0.21, respectively. Time trade-off values were significantly higher than HUI Mark 2 values (P = .01) and HUI Mark 3 values (P = .02). From the HUI measure, decrements were observed in specific QOL domains, including vision, emotion (depression and anxiety), cognition, and pain. CONCLUSION Adolescent kidney transplant recipients had consistent and high values for their current QOL, which suggests that they perceive themselves to be close to full health. However, adequate emotional and cognitive support may improve their overall QOL.
Collapse
|
34
|
Green A, Meaux J, Huett A, Ainley K. “It Has its Ups and Downs”: Adolescents' Quality of Life after Heart Transplantation. Prog Transplant 2011; 21:115-20. [DOI: 10.1177/152692481102100205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Context Heart transplantation is not curative and results in a high-morbidity chronic illness. Despite this, little research has focused on adolescents' quality of life after heart transplant. Such research is critically needed because of the complex developmental changes experienced by adolescents and the need for transition to self-management during this vulnerable period. Objective To examine adolescents' perceptions of their quality of life and factors affecting it. Design Focused ethnography. Setting and Participants Fourteen adolescents (mean age, 17 years) who had received a heart transplant at least 6 months earlier were recruited from a large children's hospital. The ethnically diverse sample (7 black, 5 white, 1 Asian, and 1 Hispanic) included 8 females and 6 males. Data Collection and Analysis The adolescents participated in audio-taped qualitative interviews, which were transcribed verbatim and entered into Ethnograph to assist with data management. Thematic analysis was used to identify recurrent themes. Results Participants described life after transplant by saying, “It has its ups and downs.” Major themes included these: (1) I am normal and I am not normal, (2) I am grateful and I am resentful, and (3) I am managing and I am not managing. The themes reflect the dichotomous nature of the adolescents' experiences and provide insight into the complex needs of adolescents after heart transplant.
Collapse
Affiliation(s)
- Angela Green
- Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas (AG, AH, KA); University of Central Arkansas, Conway, Arkansas (JM)
| | - Julie Meaux
- Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas (AG, AH, KA); University of Central Arkansas, Conway, Arkansas (JM)
| | - Amy Huett
- Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas (AG, AH, KA); University of Central Arkansas, Conway, Arkansas (JM)
| | - Kathy Ainley
- Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas (AG, AH, KA); University of Central Arkansas, Conway, Arkansas (JM)
| |
Collapse
|
35
|
Green A, Meaux J, Huett A, Ainley K. "It has its ups and downs": adolescents' quality of life after heart transplantation. Prog Transplant 2011. [DOI: 10.7182/prtr.21.2.241422g788454811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
36
|
Evaluation of the quality of life of children with celiac disease and their parents: a case-control study. Qual Life Res 2011; 21:77-85. [PMID: 21598063 DOI: 10.1007/s11136-011-9930-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the quality of life (QoL) of children with CD and of their parents and to compare it with that of children without CD and of their parents. METHODS A case-control study was conducted to evaluate the quality of life of children (5-12 years) with CD and one of their parents, compared to the QoL of children without CD (and their parents as their caregivers ). The QoL was assessed by applying the following questionnaires: AUQUEI (children) and WHOQOL-BREF (parents). RESULTS QoL was evaluated in 33 children with CD, 63 children without CD, and of their respective parents as their parent caregivers (96 adults). QoL total scores were similar between the groups of children with and without CD. However, in the Leisure dimension, the scores of children with CD were significantly lower than those of the controls (P = 0.029). Similarly, when assessing the QoL of the parents, we found scores significantly lower in the social dimension (P = 0.0196) for parents of children with CD compared to parents of children without CD. Family income presented an impact on the QoL in adults, but did not affect children. In CD group, children of mothers who had lower educational levels presented better scores in the function dimension, regarding self-care and autonomy. CONCLUSIONS There is an impairment of the QoL of children with CD and of their parents, with regard to social life, particularly in the leisure (children) and social (adults) dimensions.
Collapse
|
37
|
Tong A, Morton R, Howard K, McTaggart S, Craig JC. "When I had my transplant, I became normal." Adolescent perspectives on life after kidney transplantation. Pediatr Transplant 2011; 15:285-93. [PMID: 21281416 DOI: 10.1111/j.1399-3046.2010.01470.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to explore experiences and perspectives of adolescent kidney transplant recipients following kidney transplantation. We conducted 22 in-depth, face-to-face interviews with adolescent kidney transplant recipients (aged 12-19 yr) from five Australian pediatric transplant units. We analyzed the interview transcripts for descriptive and analytical themes. The overarching theme was achieving a sense of normality. Having the same opportunities and potential to achieve as other adolescents facilitated better adjustment, well-being and positive development after transplant. Five facilitators and five barriers to achieving a sense of normality were identified. The facilitators were developing their own identity, peer acceptance, making medications routine, freedom and energy, and support structures. The barriers included identity crisis, peer rejection, aversion to medications, lifestyle limitations, and fear and uncertainty. The adolescents felt more knowledge was needed on the technical, medical, and experiential aspects of transplantation and on pertinent issues such as alcohol, drugs, and substance use. Adolescent kidney transplant recipients value normality and have specific information needs about the effect of kidney transplantation on their physical appearance and the tolerance of drugs and alcohol. Novel approaches are needed to foster self-confidence and sense of normality and to provide comprehensive information on the patient journey following kidney transplantation.
Collapse
Affiliation(s)
- Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
| | | | | | | | | |
Collapse
|
38
|
Diseth TH, Tangeraas T, Reinfjell T, Bjerre A. Kidney transplantation in childhood: mental health and quality of life of children and caregivers. Pediatr Nephrol 2011; 26:1881-92. [PMID: 21520007 PMCID: PMC3163767 DOI: 10.1007/s00467-011-1887-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/29/2011] [Accepted: 03/29/2011] [Indexed: 01/14/2023]
Abstract
Our objective was to assess the mental health and health-related quality of life (HRQOL) in children and their parents after renal transplantation (TX) compared to healthy controls and children with acute lymphoblastic leukemia (ALL) and to identify possible health status variables associated with impaired mental health and HRQOL. Thirty-eight TX children with a median age of 13 (range 3-19) years were investigated. Mental health was assessed by the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and the Strength and Difficulties Questionnaire (SDQ-20). Each mother's own mental health and QOL were assessed by the General Health Questionnaire (GHQ-30) and the Quality of Life Scale (QOLS). Forty children with ALL [median age 11 (8.5-15.4) years] and 42 healthy children [median age 11 (8.9- 15) years] served as controls. Treadmill exercise results from 22 of the 38 patients were included in the analysis. TX children showed significantly higher levels of mental health problems and lower HRQOL at 2 to 16 years after transplantation compared to both control groups. Body mass index and maximal oxygen uptake (n = 22/38) were significant predictors of child mental health (SDQ) and child QOL (PedsQL), respectively. Based on these results, we suggest that rehabilitation after TX should include a focus on physical activity and QOL to reduce interconnected physical and psychological morbidity in kidney TX children.
Collapse
Affiliation(s)
- Trond H. Diseth
- grid.55325.340000000403898485Department of Clinical Neurosciences for Children, Women and Children’s Division, Oslo University Hospital and University of Oslo, Oslo, Norway ,grid.55325.340000000403898485Barne- og ungdomspsykiatrisk seksjon, Barneklinikken, Oslo universitetssykehus HF, Rikshospitalet, PO Box 4950, Nydalen, NO-0424 Oslo Norway
| | - Trine Tangeraas
- grid.55325.340000000403898485Department of Paediatric Medicine, Women and Children’s Division, Oslo University Hospital, Oslo, Norway
| | - Trude Reinfjell
- grid.52522.320000000406273560Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Anna Bjerre
- grid.55325.340000000403898485Department of Paediatric Medicine, Women and Children’s Division, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
39
|
Quality of life in children with chronic kidney disease (with child and parent assessments). Pediatr Nephrol 2010; 25:1487-96. [PMID: 20383649 DOI: 10.1007/s00467-010-1486-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 01/25/2010] [Accepted: 01/27/2010] [Indexed: 02/05/2023]
Abstract
Herein the results of a multicenter study from the Turkish Pediatric Kidney Transplantation Study Group are reported. The aims of this study were to compare the quality of life (QoL) scores of Turkish children who are dialysis patients (DP), renal transplant recipients (TR), and age-matched healthy controls and to compare child-self and parent-proxy scores. The Turkish versions of the Kinder Lebensqualität Fragebogen (KINDL(R)) questionnaires were used as a QoL measure. The study group consisted of 211 children and adolescents with chronic kidney disease (CKD) (139 TR and 72 DP aged between 4-18 years; 13.7 +/- 3.5 years) from 11 university hospitals, 129 parents of these patients, 232 age-matched healthy children and adolescents (aged between 4-18 years; 13.1+/-3.5 years) and 156 of their parents. Patients with CKD had lower scores in all subscales except for physical well-being than those in the control group. TR had higher scores in physical well-being, self-esteem, friends' subscales, and total scores than DP. Child-self scores were lower than parent-proxy scores, especially in CKD, DP, and control groups. Concordance between parent-proxy and child-self reports in the TR, DP, CKD, and control groups was only moderate for the majority of subscales (r = 0.41-0.61). It was concluded that parent-proxy scores on the QoL were not equivalent to child-self scores and that evaluating both children's and parents' perspectives were important. Additionally, psychosocial counseling is crucial not only for patients with CKD but also for their parents.
Collapse
|
40
|
Dommergues JP, Letierce A, Gravereau L, Plainguet F, Bernard O, Debray D. Current lifestyle of young adults after liver transplantation during childhood. Am J Transplant 2010; 10:1634-42. [PMID: 20346060 DOI: 10.1111/j.1600-6143.2010.03054.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The authors studied the psychosocial adjustment of pediatric liver transplant (LT) recipients reaching adulthood. The study comprised phone interviews of 116 volunteers aged 17-33 years. Results were compared to those for healthy peers and 65 patients who were eligible for inclusion but did not participate. Participants' median age at LT was 6 years and the median period since LT was 15 years. Of the 116 participants, 76% considered their quality of life as good or very good. Seventy-five patients (65%) were attending schools, 27 of whom were 2 years or more below the age-appropriate level. Of the remaining 41 patients, 26 had a job and 15 were unemployed. Poor compliance with medications was reported by 52 patients (45%). Alcohol consumption was lower than in the reference population (p < 0.001). Anxiety, loneliness and negative thoughts were expressed by 53, 84 and 47% of the participants, respectively. Thirteen patients (11%) were being cared for by psychologists or psychiatrists. The 65 nonparticipants had greater psychological problems than the participants, and a lower educational level. In conclusion, after LT in early life, most patients displayed psychological vulnerability during early adulthood. The educational level of patients was lower than that of theirs peers.
Collapse
Affiliation(s)
- J P Dommergues
- AP-HP, Hôpital Bicêtre, Pédiatrie Générale, Le Kremlin-Bicêtre, France
| | | | | | | | | | | |
Collapse
|
41
|
Castelo PM, Barbosa TS, Gavião MBD. Quality of life evaluation of children with sleep bruxism. BMC Oral Health 2010; 10:16. [PMID: 20546581 PMCID: PMC2896917 DOI: 10.1186/1472-6831-10-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 06/14/2010] [Indexed: 12/04/2022] Open
Abstract
Background The study of potential factors associated with sleep bruxism (SB) may help in determining the etiology of such parafunction. Thus, this study aimed to evaluate the quality of life (QoL) of children with SB by means of a generic scale, in addition to the association of sociodemographic characteristics and other parafunctional habits. Methods This cross-sectional study included healthy children of both genders, aged 7.18 ± 0.59 years, with (n = 25) and without (n = 69) signs and symptoms of SB. Data were collected in caries-free children from public schools by applying a translated and validated version of the Autoquestionnaire Qualite de Vie Enfant Image (AUQUEI), clinical examination and interview with the parents. The psychometric properties evaluated for the scale referred to internal consistency (ceiling and floor effects, Cronbach's Alpha coefficient, Items Correlation Matrix, and corrected Item-Total Correlation) and the discriminant validity (t-test). By means of logistic regression with stepwise backward elimination, associations were evaluated between SB and age, gender, body mass index, maternal use of alcohol/tobacco/medicine during pregnancy, maternal age at birth, parent's schooling, presence of sucking habit, nail biting, enuresis, number of children, child's order (first born), occurrence of divorce/parent's death, and AUQUEI scores. Results The results of the AUQUEI psychometric analysis showed homogeneity of items and a Cronbach's alpha coefficient of 0.65; no negative correlations between the items were found. The mean AUQUEI scores for children with SB did not differ significantly from those of children without the parafunction. Only the independent variable "maternal age at birth" showed a significant negative association with SB. Conclusions In the studied sample, children with SB presented scores of QoL that were similar to those without the parafunction, and children from the youngest mothers were more likely to present SB.
Collapse
Affiliation(s)
- Paula M Castelo
- Department of Biological Sciences, Federal University of São Paulo, R Artur Riedel, 275 Diadema, SP, Brazil.
| | | | | |
Collapse
|
42
|
Kaller T, Boeck A, Sander K, Richterich A, Burdelski M, Ganschow R, Schulz KH. Cognitive abilities, behaviour and quality of life in children after liver transplantation. Pediatr Transplant 2010; 14:496-503. [PMID: 20070560 DOI: 10.1111/j.1399-3046.2009.01257.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS We investigated interrelations between cognitive abilities, behavioural problems, quality of life and disease-related variables of children after LTX. METHODS Our sample consisted of 25 children. They were 8.5/2.8 (M/SD) years old and had received the transplant 5.5/3.1 years previously. For assessment we used well-established instruments. RESULTS Liver transplanted children scored below the population mean on the cognitive as well as on the behavioural instrument and showed scores below average in the scales Self-esteem, Friends and Total Score regarding QoL. Behavioural problems were associated with poorer cognitive performance (r=-0.38 to -0.63). QoL regarding physical well-being was correlated with sequential processing (r=0.41). Lower sequential processing scores were associated with lower QoL. Also between behavioural parameters and QoL correlations could be determined. Children with more behavioural problems experienced lower QoL (r=-0.40 to r=-0.76). Age at onset of disease showed correlations with behavioural and QoL parameters (r=-0.49 resp. r=0.44). Cognitive functioning was associated with medical complications (r=-0.44). CONCLUSIONS High interrelations between cognitive functioning, behavioural deficits and QoL were obtained. Especially noticeable are correlations between sequential processing and internalized behavioural functions as both are associated with left lateralized brain functioning. This relationship could indicate differential effects on brain development during the preoperative phase.
Collapse
Affiliation(s)
- T Kaller
- Institute for Medical Psychology, University Hospital Eppendorf, Hamburg, Germany.
| | | | | | | | | | | | | |
Collapse
|
43
|
El-Husseini A, Hassan R, Sobh M, Ghoneim M. The effects of gender on health-related quality of life in pediatric live-donor kidney transplantation: a single-center experience in a developing country. Pediatr Transplant 2010; 14:188-95. [PMID: 19413720 DOI: 10.1111/j.1399-3046.2009.01174.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To evaluate the effects of gender on HRQOL and overall health status in our pediatric kidney transplants. We performed a cross-sectional study in 77 children who received living renal allo-transplants in our center between 1981 and 2003. The patients were given a questionnaire at a post-transplant visit. After completing, the patients returned it in a closed envelope. The questionnaire included demographic questions plus 57 multiple-choice questions designed to analyze various aspects of post-transplant life. Overall, the patients show satisfactory HRQOL. Most of the patients lived with their parents (79.2%). The current health status did not cause difficulties at work in 70.1% and did not interfere with the social life in 62.3% of patients. Physical and sexual growth was delayed in 48% and 85.7% of patients, respectively. A total of 67.5% of patients had normal health life or minor symptoms with normal activity. There was no significant effect of gender on HRQOL except for onset of puberty, sexual function, practicing sports, and obesity. Overall, the patients show satisfactory HRQOL. There was mild significant effect of gender on HRQOL. These findings may help health care professionals to develop gender-specific interventions to optimize HRQOL of kidney transplants.
Collapse
Affiliation(s)
- Amr El-Husseini
- Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
| | | | | | | |
Collapse
|
44
|
Anthony SJ, Hebert D, Todd L, Korus M, Langlois V, Pool R, Robinson LA, Williams A, Pollock-BarZiv SM. Child and parental perspectives of multidimensional quality of life outcomes after kidney transplantation. Pediatr Transplant 2010; 14:249-56. [PMID: 19686446 DOI: 10.1111/j.1399-3046.2009.01214.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Kidney transplantation is an optimal therapy for pediatric patients with end-stage kidney disease. This pilot study sought to examine multidimensional QOL outcomes after kidney transplant using VAQOL and General Health, the PedsQL 4.0, PedsQL End Stage Renal Disease Module, and Impact on Family Module. Sample included 12 adolescents aged 13-18 yr and their parent; three children aged eight to 12 yr and their parent; and six parents of children aged two to seven yr. All were 73 months post transplant. The median age at transplant was 9.3 yr and median time since transplant was 3.2 yr. VAQOL mean was 7.7/10 (child report) and 7.3/10 (parent report); the mean general health was 7.4/10. High levels of fatigue (> or =5/10) were reported in 43%. PedsQL subscale mean values were lower than healthy reference scores. PedsQL Renal Module demonstrated great concern with physical appearance and physical symptoms (thirst and headaches), difficulty with peer and family interaction, and school disruption. Low scores on parental emotional function depict the negative impact of transplant on family functioning. Discordance exists between child and parental reports of QOL. Prospective studies are needed to explore multidimensional QOL to improve long-term outcomes after pediatric kidney transplant.
Collapse
Affiliation(s)
- Samantha J Anthony
- SickKids Transplant Centre, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Kistler KD, Molleston J, Unalp A, Abrams SH, Behling C, Schwimmer JB. Symptoms and quality of life in obese children and adolescents with non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2010; 31:396-406. [PMID: 19863497 PMCID: PMC2807909 DOI: 10.1111/j.1365-2036.2009.04181.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Data on the quality of life (QOL) of children with non-alcoholic fatty liver disease (NAFLD) are needed to estimate the true burden of illness in children with NAFLD. AIM To characterize QOL and symptoms of children with NAFLD and to compare QOL in children with NAFLD with that in a sample of healthy children. METHODS Quality of life and symptoms were assessed in children with biopsy-proven NAFLD enrolled in the NASH Clinical Research Network. PedsQL scores were compared with scores from healthy children. For children with NAFLD, between-group comparisons were made to test associations of demography, histological severity, symptoms and QOL. RESULTS A total of 239 children (mean age 12.6 years) were studied. Children with NAFLD had worse total (72.8 vs. 83.8, P < 0.01), physical (77.2 vs. 87.5, P < 0.01) and psychosocial health (70.4 vs. 81.9, P < 0.01) scores compared with healthy children. QOL scores did not significantly differ by histological severity of NAFLD. Fatigue, trouble sleeping and sadness accounted for almost half of the variance in QOL scores. Impaired QOL was present in 39% of children with NAFLD. CONCLUSIONS Children with NAFLD have a decrement in QOL. Symptoms were a major determinant of this impairment. Interventions are needed to restore and optimize QOL in children with NAFLD.
Collapse
Affiliation(s)
- K. D. Kistler
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego, La Jolla, CA,Joint Doctoral Program in Public Health, San Diego State University and University of California San Diego, La Jolla, CA
| | - J. Molleston
- Pediatric Gastroenterology, Hepatology and Nutrition, James Whitcomb Riley Hospital for Children, Indianapolis, IN
| | - A. Unalp
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - S. H. Abrams
- Texas Children's Hospital, Houston, TX,Baylor College of Medicine, Houston, TX
| | - C. Behling
- Pacific Rim Pathology Group, Sharp Memorial Hospital, San Diego, CA
| | - J. B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego, La Jolla, CA,Department of Gastroenterology, Rady Children's Hospital, San Diego, CA
| | | |
Collapse
|
46
|
Gerson AC, Wentz A, Abraham AG, Mendley SR, Hooper SR, Butler RW, Gipson DS, Lande MB, Shinnar S, Moxey-Mims MM, Warady BA, Furth SL. Health-related quality of life of children with mild to moderate chronic kidney disease. Pediatrics 2010; 125:e349-57. [PMID: 20083528 PMCID: PMC3663134 DOI: 10.1542/peds.2009-0085] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To compare the health-related quality of life (HRQoL) of children with chronic kidney disease (CKD) with healthy children; to evaluate the association between CKD severity and HRQoL; and to identity demographic, socioeconomic, and health-status variables that are associated with impairment in HRQoL in children with mild to moderate CKD. METHODS This was a cross-sectional assessment of HRQoL in children who were aged 2 to 16 and had mild to moderate CKD using the Pediatric Inventory of Quality of Life Core Scales (PedsQL). Overall HRQoL and PedsQL domain means for parents and youth were compared with previously published norms by using independent sample t tests. Study participants were categorized by kidney disease stage (measured by iohexol-based glomerular filtration rate [iGFR]), and group differences in HRQoL were evaluated by using analysis of variance and Cuzick trend tests. The association between hypothesized predictors of HRQoL and PedsQL scores was evaluated with linear and logistic regression analyses. RESULTS The study sample comprised 402 participants (mean age: 11 years, 60% male, 70% white, median iGFR: 42.5 mL/min per 1.73 m(2), median CKD duration: 7 years). Youth with CKD had significantly lower physical, school, emotional, and social domain scores than healthy youth. iGFR was not associated with HRQoL. Longer disease duration and older age were associated with higher PedsQL scores in the domains of physical, emotional, and social functioning. Older age was associated with lower school domain scores. Maternal education > or =16 years was associated with higher PedsQL scores in the domains of physical, school, and social functioning. Short stature was associated with lower scores in the physical functioning domain. CONCLUSIONS Children with mild to moderate CKD, in comparison with healthy children, reported poorer overall HRQoL and poorer physical, school, emotional, and social functioning. Early intervention to improve linear growth and to address school functioning difficulties is recommended.
Collapse
Affiliation(s)
- Arlene C Gerson
- Johns Hopkins University School of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, 200 N Wolfe St, #3060, Baltimore, MD 21287, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Health- and Vision-Related Quality of Life in Intellectually Disabled Children. Optom Vis Sci 2010; 87:37-44. [DOI: 10.1097/opx.0b013e3181c1d533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
48
|
Tong A, Morton R, Howard K, Craig JC. Adolescent experiences following organ transplantation: a systematic review of qualitative studies. J Pediatr 2009; 155:542-9. [PMID: 19555971 DOI: 10.1016/j.jpeds.2009.04.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Revised: 03/02/2009] [Accepted: 04/03/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To describe the experiences of adolescents who underwent organ transplantation. STUDY DESIGN We conducted a systematic review of qualitative studies that explored the experiences of adolescents who underwent organ transplantation. We searched 5 electronic databases (to week 3 of July 2008) and reference lists of relevant articles. RESULTS Eighteen articles reporting the experiences of 313 adolescent organ transplant recipients were included. Five major themes were identified: (1) redefining identity (seeking normality, anxiety and disappointment, adopting a positive attitude, desiring independence); (2) family functioning (parental overprotection, sibling support); (3) social adjustment (support networks, peer rejection, maintaining schoolwork, participation in physical activities); (4) managing medical demands (assuming responsibility, dependence on caregivers, disruption to lifestyle, vigilant adherence, pain and discomfort); and (5) attitude toward the donor (obligation of gratitude, strengthened relationship, concerns about risks to donor). CONCLUSIONS Although transplantation offers adolescents a better chance of survival and increased freedom and energy, it poses many challenges. A multifaceted response is needed to equip adolescent transplant recipients with skills and capacities to help them achieve a sense of normality, cope with fear of death and organ rejection, gain acceptance among their peers, build confidence in learning, and resolve relationship tensions with the living donor.
Collapse
Affiliation(s)
- Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
| | | | | | | |
Collapse
|
49
|
Ulmer FF, Landolt MA, Vinh RH, Huisman TAGM, Neuhaus TJ, Latal B, Laube GF. Intellectual and motor performance, quality of life and psychosocial adjustment in children with cystinosis. Pediatr Nephrol 2009; 24:1371-8. [PMID: 19294426 DOI: 10.1007/s00467-009-1149-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Revised: 02/05/2009] [Accepted: 02/06/2009] [Indexed: 12/18/2022]
Abstract
Cystinosis is a rare multisystemic progressive disorder mandating lifelong medical treatment. Knowledge on the intellectual and motor functioning, health-related quality of life and psychosocial adjustment in children with cystinosis is limited. We have investigated nine patients (four after renal transplantation) at a median age of 9.7 years (range 5.3-19.9 years). Intellectual performance (IP) was analysed with the Wechsler Intelligence Scale for Children-III (seven children) and the Kaufman Assessment Battery for Children (two children). Motor performance (MP) was evaluated using the Zurich Neuromotor Assessment Test, and quality of life (QOL) was studied by means of the Netherlands Organization for Applied Scientific Research Academical Medical Center Child Quality of Life Questionnaire. Psychosocial adjustment was assessed by the Child Behavior Checklist. The overall intelligence quotient (IQ) of our patient cohort (median 92, range 71-105) was significantly lower than that of the healthy controls (p = 0.04), with two patients having an IQ < 85. Verbal IQ (93, range 76-118) was significantly higher than performance IQ (90, range 68-97; p = 0.03). The MP was significantly below the norm for pure motor, pegboard and static balance, as well as for movement quality. The patients' QOL was normal for six of seven dimensions (exception being positive emotions), whereas parents reported significant impairment in positive emotions, autonomy, social and cognitive functions. Significant disturbance was noted in terms of psychosocial adjustment. Based on the results from our small patient cohort, we conclude that intellectual and motor performance, health-related QOL and psychosocial adjustment are significantly impaired in children and adolescents with cystinosis.
Collapse
Affiliation(s)
- Francis F Ulmer
- Nephrology Unit, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | | | | | | | | | | | | |
Collapse
|
50
|
Mendes AMC, Bousso RS. Not being able to live like before: the family dynamics during the experience of pediatric liver transplantation. Rev Lat Am Enfermagem 2009; 17:74-80. [DOI: 10.1590/s0104-11692009000100012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Accepted: 12/16/2008] [Indexed: 08/30/2023] Open
Abstract
This study aims to understand families' dynamics during the experience of pediatric liver transplantation, and to identify families' demands and resources. Symbolic interactionism was used as the theoretical framework and grounded theory as the methodological reference. Data were collected through semi-structured interviews with eight families at a public hospital in Sao Paulo, SP, Brazil. Two phenomena were identified: having life controlled by the transplantation represents the vulnerability of families experiencing uncertainty and fear during their children's disease experience; and struggling to reacquire autonomy refers to families' reaction when exposed to the first phenomenon, which consists of continuous adaptation to overcome suffering caused by the situation. The relationship of these two phenomena allowed for the identification of the central category: not being able to live like before. Based on this analysis, a theoretical model could be proposed to explain the experience.
Collapse
|