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Pearce E, Raj H, Emezienna N, Gilkey MB, Lazard AJ, Ribisl KM, Savage SA, Han PK. The Use of Social Media to Express and Manage Medical Uncertainty in Dyskeratosis Congenita: Content Analysis. JMIR INFODEMIOLOGY 2024; 4:e46693. [PMID: 38224480 PMCID: PMC10825764 DOI: 10.2196/46693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Social media has the potential to provide social support for rare disease communities; however, little is known about the use of social media for the expression of medical uncertainty, a common feature of rare diseases. OBJECTIVE This study aims to evaluate the expression of medical uncertainty on social media in the context of dyskeratosis congenita, a rare cancer-prone inherited bone marrow failure and telomere biology disorder (TBD). METHODS We performed a content analysis of uncertainty-related posts on Facebook and Twitter managed by Team Telomere, a patient advocacy group for this rare disease. We assessed the frequency of uncertainty-related posts, uncertainty sources, issues, and management and associations between uncertainty and social support. RESULTS Across all TBD social media platforms, 45.98% (1269/2760) of posts were uncertainty related. Uncertainty-related posts authored by Team Telomere on Twitter focused on scientific (306/434, 70.5%) or personal (230/434, 53%) issues and reflected uncertainty arising from probability, ambiguity, or complexity. Uncertainty-related posts in conversations among patients and caregivers in the Facebook community group focused on scientific (429/511, 84%), personal (157/511, 30.7%), and practical (114/511, 22.3%) issues, many of which were related to prognostic unknowns. Both platforms suggested uncertainty management strategies that focused on information sharing and community building. Posts reflecting response-focused uncertainty management strategies (eg, emotional regulation) were more frequent on Twitter compared with the Facebook community group (χ21=3.9; P=.05), whereas posts reflecting uncertainty-focused management strategies (eg, ordering information) were more frequent in the Facebook community group compared with Twitter (χ21=55.1; P<.001). In the Facebook community group, only 36% (184/511) of members created posts during the study period, and those who created posts did so with a low frequency (median 3, IQR 1-7 posts). Analysis of post creator characteristics suggested that most users of TBD social media are White, female, and parents of patients with dyskeratosis congenita. CONCLUSIONS Although uncertainty is a pervasive and multifactorial issue in TBDs, our findings suggest that the discussion of medical uncertainty on TBD social media is largely limited to brief exchanges about scientific, personal, or practical issues rather than ongoing supportive conversation. The nature of uncertainty-related conversations also varied by user group: patients and caregivers used social media primarily to discuss scientific uncertainties (eg, regarding prognosis), form social connections, or exchange advice on accessing and organizing medical care, whereas Team Telomere used social media to express scientific and personal issues of uncertainty and to address the emotional impact of uncertainty. The higher involvement of female parents on TBD social media suggests a potentially greater burden of uncertainty management among mothers compared with other groups. Further research is needed to understand the dynamics of social media engagement to manage medical uncertainty in the TBD community.
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Affiliation(s)
- Emily Pearce
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Hannah Raj
- Team Telomere, Coeur d'Alene, ID, United States
| | - Ngozika Emezienna
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sharon A Savage
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Paul Kj Han
- Division of Cancer Control and Population Sciences, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
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Kaşak M, Çıtak Kurt AN, Tural Hesapçıoğlu S, Ceylan MF. Psychiatric comorbidity and familial factors in childhood epilepsy: Parental psychopathology, coping strategies, and family functioning. Epilepsy Behav 2023; 148:109444. [PMID: 37748417 DOI: 10.1016/j.yebeh.2023.109444] [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: 06/12/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE This study aimed to examine the psychiatric diagnoses, parenting attitudes, family functioning among children and adolescents with epilepsy, coping styles of their mothers, and psychiatric symptoms of their mothers and fathers. METHODS Forty children and adolescents between the ages of 8 and 18 with epilepsy and 40 healthy controls were included in the study. The clinical interview and other measurements were used to assess psychiatric disorders and familial factors. RESULTS At least one psychiatric disorder was diagnosed in 65% of children and adolescents with epilepsy. It was determined that the mothers and fathers in the epilepsy group had higher anxiety and depression scores than the control group, and the fathers' hostility scores were also higher. The Family Assessment Device (FAD) (problem-solving and affective responsiveness), Coping Strategies Scale (COPE) (mental disengagement and substance use), and Parent Attitude Scale (PAS) (strictness/supervision) subtest scores of the epilepsy group were higher than the control group. CONCLUSION Psychiatric comorbidities, especially depression, anxiety disorders, and attention deficit hyperactivity disorder, are more common in children and adolescents with epilepsy. The mental health of parents, parent-child relationships, family functioning, and parental coping styles were adversely affected in families with children with epilepsy. It is essential to evaluate psychiatric comorbidity and family factors in children with epilepsy and to create a treatment plan for problem areas.
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Affiliation(s)
- Meryem Kaşak
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Turkey.
| | - Ayşegül N Çıtak Kurt
- Department of Pediatric Neurology, Ankara Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Selma Tural Hesapçıoğlu
- Department of Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
| | - Mehmet Fatih Ceylan
- Department of Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
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Cassedy A, Wray J, Qadir AA, Ernst MM, Brown K, Franklin R, Wernovsky G, Marino BS. Behavioral and Emotional Outcomes in Children with Congenital Heart Disease: Effects of Disease Severity, Family Life Stress, Disease-Related Chronic Stress, and Psychosocial Adaptation. J Pediatr 2023; 259:113450. [PMID: 37164178 DOI: 10.1016/j.jpeds.2023.113450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/03/2023] [Accepted: 04/21/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To evaluate whether effects of congenital heart disease (CHD) severity and family life stress on behavioral and emotional functioning are mediated by disease-related chronic stress and psychosocial adaptation. STUDY DESIGN A cross-sectional analysis of the Pediatric Cardiac Quality of Life Inventory Testing Study was performed. Relationships between CHD severity (comprising 3 groups: mild heart disease, moderate biventricular disease, and single ventricle) and family life stress, on patient- and parent disease-related chronic stress, psychosocial adaptation, and behavioral-emotional outcomes were assessed using structural equation modeling. Patient and parent models were reported separately. RESULTS There were 981 patient-parent dyads: 22% had mild heart disease, 63% biventricular, and 15% single ventricle; 19% of families reported moderate to major family life stress. Path models revealed that CHD severity and family life stress were mediated by disease-related chronic stress and psychosocial adaptation factors (R2 = 0.18-0.24 for patient outcomes and R2 = 0.33-0.34 for parent outcomes, P < .001, respectively). CONCLUSIONS The effects of greater CHD severity and family life stress on behavioral-emotional outcomes were mediated by worse disease-related chronic stress and psychosocial adaptation factors. Both disease-related chronic stress and psychosocial adaptation factors may be targets for interventions to improve behavioral and emotional outcomes.
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Affiliation(s)
- Amy Cassedy
- Division of Biostatistics and Epidemiology at Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Jo Wray
- Heart and Lung Directorate, Department of Pediatric Cardiology, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR GOSH BRC, London, United Kingdom
| | - Asad A Qadir
- Division of Cardiology, Pediatric Heart Center, University of Texas Health Science Center San Antonio, San Antonio, TX
| | - Michelle M Ernst
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Behavioral Medicine at Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Katherine Brown
- Heart and Lung Directorate, Department of Pediatric Cardiology, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR GOSH BRC, London, United Kingdom
| | - Rodney Franklin
- Department of Pediatric Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Gil Wernovsky
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Divisions of Cardiac Critical Care and Pediatric Cardiology, Children's National Hospital, Washington, DC
| | - Bradley S Marino
- Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, OH
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Scharping M, Brennenstuhl H, Garbade SF, Wild B, Posset R, Zielonka M, Kölker S, Haun MW, Opladen T. Unmet Needs of Parents of Children with Urea Cycle Disorders. CHILDREN 2022; 9:children9050712. [PMID: 35626889 PMCID: PMC9140128 DOI: 10.3390/children9050712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 12/26/2022]
Abstract
(1) Background: Phenotypic diversity and long-term health outcomes of individuals with urea cycle disorders (UCDs) have been described in detail. However, there is limited information on the burden on affected families. (2) Methods: To evaluate the family burden in parents with children suffering from UCDs, we used validated questionnaires. Socio-demographic characteristics were evaluated, and an adapted version of the Parental Need Scale for Rare Diseases questionnaire was used. The survey was conducted in families of UCD patients cared for at the University Children’s Hospital Heidelberg. (3) Results: From April to November 2021, 59 participants were interviewed (mothers n = 34, fathers n = 25). The affected patients most frequently suffered from ornithine transcarbamylase deficiency (OTC-D) (female n = 12, male n = 12), followed by argininosuccinate synthetase deficiency (ASS-D, n = 13) and argininosuccinate lyase deficiency (ASL-D, n = 8). About one-third of the participants were “dissatisfied” or “extremely dissatisfied” with health professionals’ disease knowledge. In addition, 30% of the participants reported a medium or high need for “additional information on the development of their children”, and 44% reported a medium or high need “for information on available services”. A majority of 68% reported a need for additional support regarding services such as support groups (42%) or psychological counseling (29%). (4) Conclusions: Our study indicates that there is an unmet need for sufficient information about the development of children with UCDs, as well as for information about available support services for families with UCD patients. Furthermore, the results highlight the importance of establishing or improving family-centered care approaches. This pilot study may serve as a template for the assessment of the family burden associated with other inherited metabolic diseases.
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Affiliation(s)
- Mara Scharping
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
| | - Heiko Brennenstuhl
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
| | - Sven F. Garbade
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
| | - Beate Wild
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, 69120 Heidelberg, Germany; (B.W.); (M.W.H.)
| | - Roland Posset
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
| | - Matthias Zielonka
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
| | - Stefan Kölker
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
| | - Markus W. Haun
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, 69120 Heidelberg, Germany; (B.W.); (M.W.H.)
| | - Thomas Opladen
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.S.); (H.B.); (S.F.G.); (R.P.); (M.Z.); (S.K.)
- Correspondence:
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Eraslan P, İlhan A, Eraslan E, Karacin C, Çakmak Öksüzoğlu ÖB. The Relationship Between Caregiver Burden and Posttraumatic Growth in Caregivers of Patients With Metastatic Cancer. Cureus 2022; 14:e23622. [PMID: 35494993 PMCID: PMC9049763 DOI: 10.7759/cureus.23622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Objective In this study, we aimed to examine the effect of post-traumatic growth and depressive symptoms on caregiver burden in caregivers of cancer patients. Methods This was a single-center cross-sectional observational descriptive study conducted at a medical oncology clinic. The study included 214 caregivers of cancer patients. Participants were assessed with a sociodemographic information form, the Turkish versions of the Zarit Caregiver Burden Scale (ZCBS), the Posttraumatic Growth Inventory (PTGI), and the Beck Depression Inventory (BDI). Results The mean ZCBS, PTGI, and BDI scores were 42.7 ±13.8, 67.8 ±22.3, and 13.5 ±9.8, respectively. There was a negative correlation (r=-0.407, p<0.001) between the ZCBS and the PTGI total scores, a positive correlation (r=0.636, p<0.001) between the ZCBS total and BDI scores, and a negative correlation (r=-0.426, p<0.001) between the PTGI total and BDI scores. Age, gender, income level, and history of psychiatric treatment were not independent predictive factors for the ZCBS total scores. PTGI total score (B=-0.107, 95% CI: -0.178 to -0.037, p=0.003) and BDI score (B=0.776, 95% CI: 0.602-0.950, p<0.001) were independent predictive factors for ZCBS total scores. Conclusions Our study revealed a significant negative relationship between caregiver burden and PTGI in caregivers of metastatic cancer patients, and it was found that depression negatively affects burden in caregivers. Posttraumatic growth can be a protective buffer against the burden of care and depression among caregivers.
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Rizakos S, Parmar A, Siden HH, Orkin J. The Parental Experience of Caring for a Child With Pain and Irritability of Unknown Origin. J Pain Symptom Manage 2022; 63:330-340. [PMID: 34343622 DOI: 10.1016/j.jpainsymman.2021.07.026] [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: 04/15/2021] [Revised: 06/30/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Approximately 73% of children with severe neurological impairment (SNI) can experience episodes of pain and irritability often of unknown origin (PIUO). Limited research exists on how these experiences of PIUO may affect parental caregivers and families. The primary objective of this study was to understand the parental caregiver experience of caring for a child with SNI who experiences persistent PIUO. METHODS We conducted a qualitative study using semi-structured interviews to explore the experience of parental caregivers of children with SNI. Interview guide questions focused on exploring pain behaviours, the diagnostic process, pharmacological and non-pharmacological management, healthcare-team support, discussion surrounding irritability, and family impact. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed verbatim, and coded and analyzed by 2 independent reviewers using thematic analysis. RESULTS 15 parental caregivers were interviewed, with 93% being mothers and 33% being a visible minority. Interviews revealed 3 major themes: 1) Variations in Clinical Care for PIUO; 2) The Experience and Challenges of Living with PIUO); 3) Managing the Impact of PIUO on Parental Well Being. Interviews demonstrated that parent and child can be viewed as a dyad, in which the child's experience is inherently linked to the parental experience. CONCLUSION Parental caregivers described caring for a child with persistent PIUO as physically and emotionally exhausting, and negatively impacting family quality of life. Interviews highlighted avenues of future exploration for clinical care, including both enhanced management pathways for children and supportive resources for education and coping for parents.
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Affiliation(s)
- Sara Rizakos
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Arpita Parmar
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada; Schulich School of Medicine and Dentistry, Western University, London ON, Canada
| | - Harold Hal Siden
- Department of Pediatrics, University of British Columbia, BC, Canada; Child and Family Research Institute, BC Children's Hospital, Vancouver, BC, Canada; Canuck Place Children's Hospice, Vancouver, BC, Canada
| | - Julia Orkin
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada; Division of Pediatric Medicine, Complex Care Program, The Hospital for Sick Children, Toronto, Canada.
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Olagunju AT, Bioku AA, Ohaeri JU, Oluwaniyi SO, Li A, Olagunju TO, Esezobor CI, Onwuameze OE, Chaimowitz GA. A comparative study of perceived burden in parent caregivers of adolescents with epilepsy in a resource-restricted setting: Investigating the explanatory factors of perceived burden. Epilepsy Behav 2021; 120:107992. [PMID: 33962249 DOI: 10.1016/j.yebeh.2021.107992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Parent caregivers often play vital roles in the care of adolescents with epilepsy (AWE) in resource-restricted settings; however, little is known about the burden borne by these parents. This study investigated the burden perceived by parents of AWE and described the explanatory factors. METHODS An equal number (n = 121) of age- and gender-matched parent caregivers of AWE (cases) and parents of adolescents with sickle cell disease (comparison group) were interviewed with the Parent Illness Intrusiveness Rating Scale to assess disruptions in their relationships and lifestyle. Parents of AWE were assessed for psychological distress with the 12-item General Health Questionnaire, and AWE were interviewed with the Hospital Depression-Anxiety Scale. RESULTS The majority of the cases and the comparison group were mothers (76%), with mean (SD) ages of 44.11 (SD = 6.92) versus 43.59 (SD = 6.39) years, respectively. The prevalence rate of psychological distress in cases was 38%, and depressive-anxiety symptom was prevalent in 39.7% of AWE. The level of perceived burden was significant in all parent caregivers, albeit higher in cases relative to the comparison group across multiple domains, including relationship/personal development, intimacy, instrumental and global. A high level of burden in parents of AWE was predicted by a poor family financial and material support to the adolescents, increased contact hours with adolescents, psychological distress in the parent caregivers, and anxiety-depressive symptoms in AWE after controlling for cofounders. CONCLUSION The study findings underscore the need for psychosocial support to bolster resilience and adaptive coping styles in parents of AWE, particularly in resource-restricted settings. A culturally sensitive interdisciplinary blueprint of locally viable actions model for psychosocial support for parent caregivers of AWE is strongly suggested. Future studies are indicated to shed more light on the modifiable risks of perceived burden, and the effectiveness of psychosocial interventions in parents of AWE.
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Affiliation(s)
- Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Department of Psychiatry, University of Lagos, Mushin, Lagos State, Nigeria; Discipline of Psychiatry, The University of Adelaide, Adelaide, SA, Australia.
| | | | - Jude U Ohaeri
- Department of Psychological Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | | | - Angela Li
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Tinuke O Olagunju
- Department of Health Research Method, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Obiora E Onwuameze
- Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL 62794, USA
| | - Gary A Chaimowitz
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Young M, Voll M, Noll RB, Fairclough DL, Flanagan-Priore C. Bright IDEAS problem-solving skills training for caregivers of children with sickle cell disease: A two-site pilot feasibility trial. Pediatr Blood Cancer 2021; 68:e28822. [PMID: 33355983 PMCID: PMC8665732 DOI: 10.1002/pbc.28822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Bright IDEAS problem-solving skills training (BI) is an evidence-based behavioral intervention that has been utilized extensively with caregivers of children recently diagnosed with cancer. Considerable evidence has shown that BI is acceptable to caregivers of children recently diagnosed with cancer, and improvements in problem-solving skills mediate reduced symptoms of distress. PROCEDURES A slightly modified version of BI was offered to caregivers of children with sickle cell disease (SCD) in a two-site pilot feasibility trial. BI was modified to reduce barriers to care, logistical challenges, and stigma associated with receiving behavioral health services. Our goal was to establish high rates of recruitment and retention among caregivers of children with SCD. Recruitment was acceptable (94%; N = 72) and retention reasonable (49%) across both sites with 35 caregivers successfully completing the BI program. RESULTS Results showed that caregivers of children with SCD, who successfully completed the BI program reported, significant improvements in problem-solving skills immediately and three months after intervention completion. Interestingly, initial levels of distress were low with few caregivers reporting clinically significant levels of distress; distress remained low over time. CONCLUSIONS Findings are discussed in the context of psychosocial screening and resilience of caregivers of children with SCD.
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Affiliation(s)
- Melissa Young
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, Ohio
| | - Megan Voll
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert B. Noll
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Diane L. Fairclough
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
| | - Cate Flanagan-Priore
- Joint Division of Hematology/Oncology, Oishei Childrens Hospital and Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Bioku AA, Ohaeri JU, Oluwaniyi SO, Olagunju TO, Chaimowitz GA, Olagunju AT. Emotional distress among parent caregivers of adolescents with sickle cell disease: Association with patients and caregivers variables. J Health Psychol 2020; 26:2851-2860. [DOI: 10.1177/1359105320935986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence suggests that impairment in caregiver wellbeing can alter the quality of care in children with sickle cell disease. We examined 121 parent caregivers of adolescents with sickle cell disease for emotional distress and disruptions to caregiver lifestyle and interests. Participants were predominantly mothers 92(76%) with mean age, 43.59 ( SD = 6.39) years. Four in every ten caregivers had emotional distress, and this was predicted by frequent hospital attendance and disruptions in caregiver lifestyle, relationships, and interests. Psychosocial support to promote resilience and adaptive coping-styles to deal with the stress from unforeseen crises, frequent hospital visits, and lifestyle disruptions are indicated to improve caregiver wellbeing.
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Affiliation(s)
| | | | | | | | | | - Andrew T Olagunju
- McMaster University, Canada
- University of Lagos, Nigeria
- University of Adelaide, Australia
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10
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Peay HL, Meiser B, Kinnett K, Tibben A. Psychosocial Needs and Facilitators of Mothers Caring for Children with Duchenne/Becker Muscular Dystrophy. J Genet Couns 2017; 27:197-203. [DOI: 10.1007/s10897-017-0141-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/26/2017] [Indexed: 01/15/2023]
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Banthia R, Moskowitz JT, Acree M, Folkman S. Socioeconomic Differences in the Effects of Prayer on Physical Symptoms and Quality of Life. J Health Psychol 2016; 12:249-60. [PMID: 17284489 DOI: 10.1177/1359105307074251] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The extent to which religiosity is related to well-being may differ as a function of race/ethnicity, education or income. We asked 155 caregivers to complete measures of religiosity, prayer, physical symptoms and quality of life. Lower education and, to a lesser extent, lower income were correlated with religiosity and prayer. There were few direct relationships of religiosity and prayer with quality of life and health symptoms. However, the relationships became significant when education and, to a lesser degree, income were taken into account. Prayer was associated with fewer health symptoms and better quality of life among less educated caregivers.
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Affiliation(s)
- Rajni Banthia
- University of California, San Francisco, CA 94143-1726, USA
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McGuire BK, Crowe TK, Law M, VanLeit B. Mothers of Children with Disabilities: Occupational Concerns and Solutions. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2016. [DOI: 10.1177/153944920402400203] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mothers of children with disabilities have identified multiple challenges associated with achieving occupational balance in their lives. Occupational therapists are just beginning to explore the occupational and time use strategies that mothers use to successfully care for their children and get through the day in a positive manner. The Person—Environment—Occupation model was used to guide an occupational therapy intervention program called “Project Bien Estar,” which was designed to increase the satisfaction, time use, and occupational performance of mothers of school-aged children with disabilities. This article focuses on the rich content of the group discussions and individual reflections, providing insight into the world of women caring for children with disabilities. Thematic analysis was used to identify person, environment, and occupation factors that contribute positively and negatively to the mothers' well-being, and the effects of the occupational therapy intervention are discussed.
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Sehlo MG, Kamfar HZ. Depression and quality of life in children with sickle cell disease: the effect of social support. BMC Psychiatry 2015; 15:78. [PMID: 25880537 PMCID: PMC4394397 DOI: 10.1186/s12888-015-0461-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 03/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms than those without. The present study aimed to: assess the prevalence of depression in a sample of children with SCD; evaluate the association between disease severity, social support and depression, and the combined and/or singular effect on health-related quality of life (HRQL) in children with SCD; and show the predictive value of social support and disease severity on depression. METHODS A total of 120 children were included in the study, 60 (group I) with SCD and 60 matched, healthy control children (group II). Depression was assessed in both groups using the Children's Depression Inventory (CDI) and the Children's Depression Inventory-Parent (CDI-P). Children with CDI and CDI-P scores of more than 12 were interviewed for further assessment of depression using the Diagnostic Interview Schedule for Children Version IV (DISC-IV). The Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) was used to assess HRQL in both groups, and social support was measured with the Child and Adolescent Social Support Scale (CASSS). RESULTS Eight (13%) of the 60 children with SCD had CDI and CDI-P scores of more than 12 (CDI mean score 14.50 ± 1.19, CDI-P mean score 14.13 ± 1.12), and were diagnosed as having clinical depression using the diagnostic interview DISC-IV. For group I, HRQL was poor across all PedsQL 4.0 domains in both self- and parent-reports (P < 0.001) compared with group II. A higher level of parent support was a significantly associated with decreased depressive symptoms, demonstrated by lower CDI scores. Better quality of life was shown by the associated higher total PedsQL 4.0 self-scores of children with SCD (B = -1.79, P = 0.01 and B = 1.89, P = 0.02 respectively). CONCLUSIONS The present study demonstrates that higher levels of parent support were significantly associated with decreased depressive symptoms and better quality of life in children with SCD. Interventions focused on increasing parent support may be an important part of treatment for depression in children with SCD.
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Affiliation(s)
- Mohammad Gamal Sehlo
- Department of Medicine, Psychiatry Unit, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, P. O. Box 80205, Jeddah, Kingdom of Saudi Arabia.
- Department of Psychiatry, Zagazig University, Zagazig, Egypt.
| | - Hayat Zakaria Kamfar
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Guilfoyle SM, Gray WN, Herzer-Maddux M, Hommel KA. Parenting stress predicts depressive symptoms in adolescents with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2014; 26:964-71. [PMID: 25003746 PMCID: PMC4307594 DOI: 10.1097/meg.0000000000000149] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Adolescents with inflammatory bowel disease (IBD) are at an increased risk for depression and poor IBD management. Although depression and family factors have been associated in cross-sectional analyses, their casual association over time has not been studied. The primary objective of this study was to assess the temporal association between parenting stress and adolescent depressive symptoms in IBD. METHODS Along with a primary parent, adolescents [Mage(years)=15.5±1.4] with a confirmed diagnosis of Crohn's disease or ulcerative colitis and prescribed a treatment regimen of a 5-ASA medication and/or 6-MP/azathioprine were recruited from routine gastroenterology clinic visits at two pediatric medical centers. The current study was nested in a larger IBD self-management trial. Adolescents completed the Children's Depression Inventory. Parents completed a sociodemographic questionnaire and the Pediatric Inventory for Parents. Gastroenterologists provided disease severity assessments on the basis of the clinic appointment corresponding to the study visit or the most recent clinic appointment. Questionnaires were readministered ∼6 months after the initial visit. RESULTS Participants include 93 families at baseline and 65 at follow-up (69.8% retention; N=65). A cross-lagged panel analysis was used to detect causal directionality and change in adolescent depression and parenting stress over 6 months. Baseline parenting stress accounted for a significant amount of the variance in depressive symptoms at follow-up [R-change=0.03, F(1,58)=35.6, P<0.05]. CONCLUSION Parenting stress impacts adolescent depressive symptoms in IBD. Identification of parenting stress and adolescent depression should occur early and possibly in the context of routine clinic visits.
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Affiliation(s)
- Shanna M. Guilfoyle
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, Ohio
| | - Wendy N. Gray
- Department of Psychology, Auburn University, Auburn, Alabama
| | - Michele Herzer-Maddux
- Children's Mercy Hospitals & Clinics, Division of Clinical Psychology, Developmental & Behavioral Medicine, Kansas City, Missouri, USA
| | - Kevin A. Hommel
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, Ohio
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Franck LS, McQuillan A, Wray J, Grocott MPW, Goldman A. Parent stress levels during children's hospital recovery after congenital heart surgery. Pediatr Cardiol 2010; 31:961-8. [PMID: 20495910 DOI: 10.1007/s00246-010-9726-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Accepted: 05/05/2010] [Indexed: 11/30/2022]
Abstract
The hospitalization of a child for cardiac surgery is known to be a stressful experience for parents. However, little is known about the time course or the relationships between parental stress and the child's actual or perceived recovery. This research aimed to investigate pre- and postoperative parental stress and to examine some of the influencing factors during the postoperative period for children undergoing elective cardiac surgery. Parents of 211 children completed questionnaires and structured interviews preoperatively and on postoperative days 3, 5, 8, and 15. The stress of the parents remained moderate to high throughout their children's hospitalization regardless of the severity of illness. Parents' perceptions of their children's level of illness correlated with an objective measure of postoperative morbidity. There were few differences between mothers' and fathers' stress or their perceptions of their children's illness. Parents in more deprived communities and mothers born outside the UK had higher stress levels. These findings indicate the negative impact of children's surgery and intensive care hospitalization on parents. Better identification of parents at risk for high stress and specific interventions to improve parental support and coping are needed.
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Tifferet S, Elizur Y, Constantini S, Friedman O, Manor O. Maternal adaptation to pediatric neurosurgical diagnosis: a growth curve analysis. Psychol Health 2010; 25:213-29. [PMID: 20391216 DOI: 10.1080/08870440802245298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To describe trajectories of change in maternal adaptation to chronic pediatric neurosurgical diagnosis and to identify variables predicting the level and rate of adaptation. METHODS One hundred and thirty seven mothers of children diagnosed with neurosurgical illness participated. Mothers reported socio-demographic variables, neuroticism, optimism, spouse support, mental health, and personal growth. The coordinating nurse assessed illness variables. Data were collected from diagnosis to 32+months post-diagnosis. RESULTS Results showed poor maternal mental health at diagnosis, followed by a gradual improvement over the next 18 months, and then a slight regression. Optimism, spouse support and religiosity were identified as resistance factors, while neuroticism, treatment needs, maternal age, and maternal education were identified as risk factors. The rate of change in mental health was moderated by neuroticism. CONCLUSIONS Maternal adaptation to pediatric illness changes over time. The trajectories of adaptation vary in relation to personal, social and medical variables.
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Affiliation(s)
- Sigal Tifferet
- Department of Social Sciences and Management, Ruppin Academic Center, Emek Hefer, Israel.
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Tifferet S, Manor O, Elizur Y, Friedman O, Constantini S. Maternal Adaptation to Pediatric Illness: A Personal Vulnerability Model. CHILDRENS HEALTH CARE 2010. [DOI: 10.1080/02739611003679840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Van Riper M. Genomics and the Family: Integrative Frameworks. HANDBOOK OF GENOMICS AND THE FAMILY 2010. [DOI: 10.1007/978-1-4419-5800-6_5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Brehaut JC, Kohen DE, Garner RE, Miller AR, Lach LM, Klassen AF, Rosenbaum PL. Health among caregivers of children with health problems: findings from a Canadian population-based study. Am J Public Health 2008; 99:1254-62. [PMID: 19059861 DOI: 10.2105/ajph.2007.129817] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We used population-based data to evaluate whether caring for a child with health problems had implications for caregiver health after we controlled for relevant covariates. METHODS We used data on 9401 children and their caregivers from a population-based Canadian study. We performed analyses to compare 3633 healthy children with 2485 children with health problems. Caregiver health outcomes included chronic conditions, activity limitations, self-reported general health, depressive symptoms, social support, family functioning, and marital satisfaction. Covariates included family (single-parent status, number of children, income adequacy), caregiver (gender, age, education, smoking status, biological relationship to child), and child (age, gender) characteristics. RESULTS Logistic regression showed that caregivers of children with health problems had more than twice the odds of reporting chronic conditions, activity limitations, and elevated depressive symptoms, and had greater odds of reporting poorer general health than did caregivers of healthy children. CONCLUSIONS Caregivers of children with health problems had substantially greater odds of health problems than did caregivers of healthy children. The findings are consistent with the movement toward family-centered services recognizing the link between caregivers' health and health of the children for whom they care.
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Affiliation(s)
- Jamie C Brehaut
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa Hospital, Civic Campus, ASB 2-004, Box 693, 1053 Carling Ave, Ottawa, ON, Canada, K1Y 4E9.
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Maurice-Stam H, Oort FJ, Last BF, Grootenhuis MA. Emotional functioning of parents of children with cancer: the first five years of continuous remission after the end of treatment. Psychooncology 2008; 17:448-59. [PMID: 17828715 DOI: 10.1002/pon.1260] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this study is to investigate parental emotional functioning during the first five years of continuous remission after the end of their child's treatment and to identify predictors of parental emotional functioning. METHODS Psychological distress and situation-specific emotional reactions were assessed in 122 mothers and 109 fathers from 130 families. Longitudinal mixed model analyses were performed to investigate to what extent generic and disease-related coping, family functioning and social support were predictive of parental emotional functioning over time. RESULTS Initial elevated levels of distress, disease-related feelings of uncertainty and helplessness returned to normal levels during the first two years after the end of treatment. Being more optimistic about the further course of the child's disease (predictive control) was correlated with lower psychological distress and less negative disease-related feelings, while more passive reaction patterns were correlated with higher psychological distress and more negative disease-related feelings. CONCLUSIONS Although in general the parents of children with successfully treated cancer showed adequate emotional resilience, support for these parents should not stop when treatment ends. Parents in need of help can be identified on the basis of their coping abilities.
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Affiliation(s)
- Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, The Netherlands.
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Aylward BS, Roberts MC, Colombo J, Steele RG. Identifying the Classics: An Examination of Articles Published in the Journal of Pediatric Psychology from 1976–2006. J Pediatr Psychol 2007; 33:576-89. [DOI: 10.1093/jpepsy/jsm122] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Clay OJ, Telfair J. Evaluation of a Disease-Specific Self-Efficacy Instrument in Adolescents with Sickle Cell Disease and its Relationship to Adjustment. Child Neuropsychol 2007; 13:188-203. [PMID: 17364574 DOI: 10.1080/09297040600770746] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The psychometric properties of a disease-specific instrument used to assess self-efficacy in adolescents with sickle cell disease, the Sickle Cell Self-Efficacy Scale, were evaluated in a sample of 131 adolescents ranging from 11 to 19 years of age. This nine-item instrument was associated with a one-item, general self-efficacy question and an item of self-control. After controlling for age, gender, highest grade of education completed, and the number of individuals in the household, high levels of self-efficacy were related to fewer physical, psychological, and total symptoms. Using the stress process framework to examine the relationship between self-efficacy and self-reported symptoms in adolescents may lead to the initiation of effective intervention programs capable of increasing levels of self-efficacy in adolescents. These interventions could lead to better outcomes for adolescents with sickle cell disease. Additional longitudinal investigations are needed to evaluate the ability of self-efficacy to predict adolescent adjustment over time.
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Affiliation(s)
- Olivio J Clay
- Department of Biostatistics, University of Alabama at Birmingham, AL 35294-0022, USA
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Moskowitz JT, Butensky E, Harmatz P, Vichinsky E, Heyman MB, Acree M, Wrubel J, Wilson L, Folkman S. Caregiving time in sickle cell disease: psychological effects in maternal caregivers. Pediatr Blood Cancer 2007; 48:64-71. [PMID: 16622841 DOI: 10.1002/pbc.20792] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Providing home care for a child with a chronic illness can be stressful for the family. The purpose of this paper is to examine patterns of caregiving and the associated psychological impact on maternal caregivers of children with sickle cell disease (SCD). PROCEDURE Fourteen maternal caregivers of children with SCD were interviewed as part of a larger study of maternal caregivers of children with chronic illness. Forty-four caregivers of children with HIV and 36 caregivers of healthy children were included as comparison groups. Interviews included questions regarding amount of time spent providing care for the child (technical care, non-technical care, health care management), hospitalization, emergency room visits, illness stigma, and mental health of the caregiver. RESULTS Children with SCD had significantly lower functional status and significantly more hospitalizations in the previous 3 months than children with HIV. Caregivers of children with SCD were more likely to work full-time and had higher incomes than caregivers of children with HIV. The three caregiving groups did not differ significantly on amount of total care, although caregivers of children with SCD and caregivers of children with HIV both reported significantly more time spent in technical care than caregivers of healthy children. Despite lower functional status of the children in the SCD group, when group comparisons on caregiving time variables were adjusted for child's functional status, the differences between groups increased. This appeared to be due to the fact that caregivers in the HIV group spent more time in all caregiving categories except skin, crisis, and other care. In terms of caregiver mental health, caregivers of children with HIV and SCD had significantly higher depressive mood scores than caregivers of healthy children but the groups did not differ on caregiving burden. CONCLUSIONS The perceived care burden of caregivers of children with SCD may be related to the unpredictable nature of the crisis care they provide. Additional attention is warranted to developing adequate resources for caregivers of children with SCD to mitigate the stress of unexpected crises.
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Affiliation(s)
- Judith Tedlie Moskowitz
- Department of Medicine, University of California San Francisco, Osher Center for Integrative Medicine, San Francisco, California, USA
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Hocking MC, Lochman JE. Applying the Transactional Stress and Coping Model to Sickle Cell Disorder and Insulin-Dependent Diabetes Mellitus: Identifying Psychosocial Variables Related to Adjustment and Intervention. Clin Child Fam Psychol Rev 2005; 8:221-46. [PMID: 16151619 DOI: 10.1007/s10567-005-6667-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This review paper examines the literature on psychosocial factors associated with adjustment to sickle cell disease and insulin-dependent diabetes mellitus in children through the framework of the transactional stress and coping (TSC) model. The transactional stress and coping model views adaptation to a childhood chronic illness as mediated by several psychosocial factors. This review examines the utility of the model in explaining adjustment in two different childhood diseases, identifies needed research and intervention targets, as well as highlights potential changes to the model. The major conclusions of this review suggest that, in addition to child-specific factors, family functioning is an area that interventions should address in sickle cell disease and insulin-dependent diabetes mellitus.
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Affiliation(s)
- Matthew C Hocking
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama 35406, USA.
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Hall E, Saxe G, Stoddard F, Kaplow J, Koenen K, Chawla N, Lopez C, King L, King D. Posttraumatic Stress Symptoms in Parents of Children with Acute Burns. J Pediatr Psychol 2005; 31:403-12. [PMID: 15788717 DOI: 10.1093/jpepsy/jsj016] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To develop a model of risk factors for posttraumatic stress disorder (PTSD) symptoms in parents of children with burns. METHODS Immediately following the burn and 3 months later, parents reported on their children's and their own psychological functioning and traumatic stress responses. RESULTS Approximately 47% of the parents reported experiencing significant posttraumatic stress symptoms 3 months after the burn. Our model indicates three independent pathways to PTSD symptoms (i.e., parent-child conflict, parents' dissociation, and children's PTSD symptoms). Additionally, parents' anxiety predicted increased parent-child conflict, conflict with extended family and size of the burn predicted parents' dissociation, and size of the burn and children's dissociation predicted children's PTSD symptoms. CONCLUSIONS This study suggests that many parents of children with burns suffer from posttraumatic stress symptoms. Interventions that target factors such as family conflict, children's symptoms, and parents' acute anxiety and dissociation may diminish the risk for PTSD.
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Affiliation(s)
- Erin Hall
- Child and Adolescent Psychiatry, Boston Medical Center, Boston University, Boston, Massachusetts 02118, USA.
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White MM, Chaney JM, Mullins LL, Wagner JL, Hommel KA, Andrews NR, Jarvis JN. Children's Perceived Illness Uncertainty as a Moderator in the Parent-Child Distress Relation in Juvenile Rheumatic Diseases. Rehabil Psychol 2005. [DOI: 10.1037/0090-5550.50.3.224] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
PURPOSE To assess levels of distress, the marital relationship, and styles of coping of parents of children with congenital heart disease, to evaluate any change in these parameters following elective cardiac surgery for their child, and to compare these parents with parents of children undergoing another form of hospital treatment, and with parents of healthy children. DESIGN A prospective study in which parents were assessed the day before the surgical procedure being undergone by their child, and 12 months afterwards. PARTICIPANTS We assessed three groups of parents of 75 children, aged from birth to 16.9 years. The first was a group whose children were undergoing surgery because of congenital heart disease, the second was a group whose children were undergoing transplantation of bone marrow, and the third was a group whose children were healthy. Measures used for assessment included the General Health Questionnaire, the Dyadic adjustment scale, and the Utrecht coping list. RESULTS Parents in both groups of children undergoing surgery had significantly higher rates of distress prior to the surgical procedures than did the parents of the healthy children, but within those whose children were undergoing cardiac surgery, there were no differences between parents of children with cyanotic and acyanotic lesions. Following treatment, there was a significant reduction in the levels of distress in both groups whose children had undergone surgery. There were few differences between any of the groups on the other parameters, and the evaluated indexes showed stability over time. CONCLUSION Despite elevated levels of psychological distress prior to surgical procedures, which had fallen after one year, the stability of other parameters of parental functioning over time suggests that the surgical interventions are of less significance than either factors attributable to the presence of chronic illness, or the individual characteristics of the parents.
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Affiliation(s)
- Jo Wray
- Paediatric Surgical Unit, Harefield Hospital, Harefield, Middlesex and Imperial College London, West Middlesex University Hospital, Isleworth, Middlesex, UK.
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Adjustment of Mothers of Children With Obstetrical Brachial Plexus Injuries: Testing a Risk and Resistance Model. Rehabil Psychol 2004. [DOI: 10.1037/0090-5550.49.3.233] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Berge JM, Patterson JM. Cystic fibrosis and the family: A review and critique of the literature. ACTA ACUST UNITED AC 2004. [DOI: 10.1037/1091-7527.22.1.74] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lutz MJ, Barakat LP, Smith-Whitley K, Ohene-Frempong K. Psychological Adjustment of Children With Sickle Cell Disease: Family Functioning and Coping. Rehabil Psychol 2004. [DOI: 10.1037/0090-5550.49.3.224] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
This article focused on two hematologic diseases that have received significant attention in the pediatric literature: sickle cell anemia and hemophilia. As the data indicate, these illnesses present lifelong challenges to individuals afflicted. With advances in medical interventions, many children with these hematologic diseases are living longer and with fewer serious complications. Intervention efforts only recently have begun to consider issues related to quality of life and increased psychological adjustment, including active coping strategies by children and their parents and necessary social support for all family members. Theoretical models [54] have highlighted the multiple factors that play a role in illness adjustment and the complex interactions of these factors. Individual, family, and community characteristics are impacted by and, in turn, impact on illness-related characteristics. The notion that illness severity is predictive of psychological adjustment has been discarded in favor of a model that recognizes multiple influences and multiple outcomes. Child coping, parent coping, social support, adaptive functioning, treatment compliance, and illness severity are being considered to better understand and influence overall psychological functioning. The field of pediatric psychology has made tremendous advances in improving knowledge of illness and its impact on development. Even with these advances, however, there remains much to be discovered. To date, pediatric psychology research has focused primarily on individual illness categories, making comparisons across illness types difficult. By considering different illnesses within the same study, characteristics that are crucial to improved adjustment and common across illnesses can be identified. As we continue to work for cures for these debilitating illnesses, our goal remains to improve quality of life for children.
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Affiliation(s)
- Robert L Casey
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06510, USA.
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Mérelle ME, Huisman J, Alderden-van der Vecht A, Taat F, Bezemer D, Griffioen RW, Brinkhorst G, Dankert-Roelse JE. Early versus late diagnosis: psychological impact on parents of children with cystic fibrosis. Pediatrics 2003; 111:346-50. [PMID: 12563062 DOI: 10.1542/peds.111.2.346] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To explore the relationship between the period preceding diagnosis and the way parents of children with cystic fibrosis (CF) experience and handle their child's disease. DESIGN A retrospective study. SETTING CF Center "Noordwest Nederland," the Netherlands. PARTICIPANTS Participants were the parents of children <13 years old with CF who were treated at the CF Center "Noordwest Nederland." The participants were divided into 2 groups according to the duration of prediagnostic period: <3 months (defined as early diagnosis) and >or=3 months (defined as late diagnosis). MAIN OUTCOME MEASURES Experience of the prediagnostic period, contact with the medical profession, coping, future perspective, and attitudes toward neonatal screening for CF. RESULTS Parents of 55 children were eligible for study participation; 45 were enrolled. Retrospectively, the period preceding an early diagnosis was less negatively experienced by parents than the period preceding a late diagnosis. Parents of children with an early diagnosis had retrospectively more confidence in the medical profession before confirmation of diagnosis. In general, parents in this study used adaptive coping styles. Duration of prediagnostic period was not significantly related to future perspective. Hopelessness seemed to be mainly determined by a severe course of disease as experienced by the parents. Ninety-eight percent of all parents were in favor of neonatal screening for CF. CONCLUSIONS A short prediagnostic period is associated with less negative feelings and increased confidence in the medical profession among parents of children with CF. Neonatal screening for CF may be of benefit to parents by removing the stress of a delayed diagnosis.
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Affiliation(s)
- Maria E Mérelle
- Cystic Fibrosis Center Noordwest Nederland, Department of Paediatrics, Vrije Universiteit Medical Center Amsterdam, The Netherlands
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Hughes C, Lerman C, Schwartz M, Peshkin BN, Wenzel L, Narod S, Corio C, Tercyak KP, Hanna D, Isaacs C, Main D. All in the family: evaluation of the process and content of sisters' communication about BRCA1 and BRCA2 genetic test results. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 107:143-50. [PMID: 11807889 DOI: 10.1002/ajmg.10110] [Citation(s) in RCA: 167] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite the potential importance of family communication, little is known about the process and content of communicating BRCA1/2 test results to relatives. The objectives of this observational study were to describe the process and content of communicating BRCA1/2 test results to sisters, and to evaluate whether the proband's carrier status influenced communication outcomes. Participants were 43 women who were the first family member to have genetic testing (probands). Probands reported on communication outcomes for 81 sisters. Process and content variables were evaluated 1-month after receipt of BRCA1/2 test results using the Family Communication Questionnaire (FCQ). Overall, BRCA1/2 test results were communicated to 85% of sisters, and carriers communicated their results to significantly more sisters compared to uninformative (96% vs. 76%, FET = 0.02). The most important reason for communicating results was to provide genetic risk information; however, compared to uninformatives, carriers communicated their results to significantly more sisters to obtain emotional support (74%) and to get advice about medical decisions (42%) (FET = 0.001). Carriers also discussed the possibility of discrimination and recommendations for cancer management with significantly more sisters. Among sisters to whom BRCA1/2 test results were not communicated, the most important reason for not sharing test results was because of emotionally distant relationships. The results of this study suggest that probands are likely to quickly communicate their BRCA1/2 test results to relatives and that although needs for social support may motivate family communication, emotionally distant relationships may be a barrier to communication with relatives.
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Affiliation(s)
- Chanita Hughes
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Goldbeck L, Storck M. Das Ulmer Lebensqualitäts-Inventar für Eltern chronisch kranker Kinder (ULQIE):. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2002. [DOI: 10.1026/0084-5345.31.1.31] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Die Messung der Lebensqualität von Eltern gewinnt im Kontext einer familienorientierten psychosozialen Betreuung und Rehabilitation chronisch kranker Kinder an Bedeutung. Fragestellung: Angestrebt wurde die Entwicklung eines kurzen psychometrischen Selbstbeurteilungs-Instruments für die klinische Routineanwendung. Methode: Die Fragebogen-Konstruktion erfolgte entsprechend der klassischen Testtheorie, die Subskalen wurden faktorenanalytisch gebildet. Ergebnisse: Der 29 Items umfassende Fragebogen enthält die Dimensionen Leistungsfähigkeit, Zufriedenheit mit der familiären Situation, emotionale Belastung, Selbstverwirklichung und Allgemeinbefinden. Cronbach’s alpha beträgt für die Unterskalen zwischen .75 und .88, für die Gesamtskala .91, die Retest-Reliabilität liegt zwischen .69 und .86. Angaben zur Validität des Fragebogens werden mitgeteilt. Schlussfolgerungen: Mit dem ULQIE wird ein Fragebogen vorgestellt, der für die Diagnostik und Verlaufskontrolle zum Aspekt der Lebensqualität von Eltern chronisch kranker Kinder geeignet ist.
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36
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Turner AP, Barlow JH, Wright CC. Residential workshop for parents of adolescents with juvenile idiopathic arthritis: A preliminary evaluation. PSYCHOL HEALTH MED 2001. [DOI: 10.1080/13548500126540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Atkin K, Ahmad WI. Living a 'normal' life: young people coping with thalassaemia major or sickle cell disorder. Soc Sci Med 2001; 53:615-26. [PMID: 11478541 DOI: 10.1016/s0277-9536(00)00364-6] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This qualitative paper explores the strategies and resources young people use to cope with sickle cell disorder or thalassaemia major, two haemoglobin disorders with serious implications for health and survival. By focusing on coping strategies, we explore how young people attempt to take control over their lives. The respondents, largely of South Asian and African Caribbean origin, aged between 10 and 19 years, valued maintaining a normal' life and struggled to achieve this normalcy. Strategies were employed to minimise difference from peers but these strategies remained vulnerable. Coping occurred in a dynamic space, involving negotiation and engagement with both personal and structural factors. Threats to normalcy did not always reside in the condition; life transitions, changes in social relationships and racist. disablist or sexist marginalisation also threatened coping strategies.
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Affiliation(s)
- K Atkin
- Centre for Research in Primary Care, School of Medicine, University of Leeds, UK
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Foster C, Eiser C, Oades P, Sheldon C, Tripp J, Goldman P, Rice S, Trott J. Treatment demands and differential treatment of patients with cystic fibrosis and their siblings: patient, parent and sibling accounts. Child Care Health Dev 2001; 27:349-64. [PMID: 11437838 DOI: 10.1046/j.1365-2214.2001.00196.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cystic fibrosis (CF) is a progressive disease with no known cure. Advances in diagnosis and treatment have resulted in patients living longer and thus families live with the illness for longer. Treatments are becoming increasingly demanding and are largely performed in the family home. Mothers are often reported to experience greater stress and poorer adjustment than mothers of well children or population norms. Patients and siblings are also reported to display adjustment difficulties. Siblings have rarely been included in research designs. This qualitative study investigates the impact of CF and treatment on eight patients, eight mothers, one father and eight siblings. A family systems perspective was adopted. Each individual was interviewed independently using semistructured interviews. Patients and siblings were aged between 9 and 21 years. Qualitative analyses revealed high levels of non-adherence (intentional and unintentional) and parental involvement in treatment, minimal involvement of siblings, and preferential treatment towards patients. Demanding treatment, coupled with the progressive nature of CF, promote high levels of parental involvement for younger children as well as older teenagers, often due to attempted or actual non-adherence. Siblings may receive less attention while patients' needs take priority. Future development of a measure of adherence suitable for children and adolescents should take into account different motivations for non-adherence, particularly regarding the level of personal control over adherence to treatment. In addition, the potential impact of having a brother or sister with CF should not be underestimated and the needs of siblings should not go unnoticed.
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Affiliation(s)
- C Foster
- Department of Psychological Medicine, The Institute of Cancer Research, Sutton, Surrey, UK.
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Brown RT, Lambert R, Devine D, Baldwin K, Casey R, Doepke K, Ievers CE, Hsu L, Buchanan I, Eckman J. Risk-resistance adaptation model for caregivers and their children with sickle cell syndromes. Ann Behav Med 2001; 22:158-69. [PMID: 10962709 DOI: 10.1007/bf02895780] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
This investigation examined the risk-resistance adaptation model for children with sickle cell disease and their primary caregivers. Participants were 55 children, ranging in age from 5 to 16 years with a mean age of 9 years 2 months, diagnosed with sickle cell disease and their primary caregivers, recruited from a university medical center. Measures included adjustment (i.e. primary caregiver and child adjustment), risk factors (i.e. disease and disability, functional independence, and psychosocial stressors), resistance factors (i.e. intrapersonal health locus of control, social-ecological), and stress processing (coping). Primary caregivers' adjustment was associated with developmental coping, changeR2 = .08, and child adaptation was associated with an internal health locus of control, changeR2 = .22. An indirect effect of primary caregivers' coping on child adjustment was found through influence on primary caregivers' adjustment, changeR2 = .11. The findings support research among other chronically ill populations that suggests an association between coping and disease adjustment. The results were interpreted to support the use of theoretically driven models in predicting the adaptation of children with chronic illness and adjustment in their caregivers.
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Affiliation(s)
- R T Brown
- Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA
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40
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McCubbin HI, McCubbin MA, Cauble E, Goldbeck L. Fragebogen zur elterlichen Krankheitsbewältigung: Coping Health Inventory for Parents (CHIP) - Deutsche Version. KINDHEIT UND ENTWICKLUNG 2001. [DOI: 10.1026//0942-5403.10.1.28] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Mit dem Coping Health Inventory for Parents (CHIP) wurde ein bewährtes Selbstbeurteilungsinstrument zur Erfassung der Krankheitsbewältigung von Eltern chronisch kranker Kinder ins Deutsche übertragen und psychometrisch überprüft. Nach einer Darstellung des theoretischen Hintergrundes des CHIP werden die drei Dimensionen des Fragebogens beschrieben: I. Aufrechterhalten der familiären Integration, Kooperation und einer optimistischen Sichtweise der Situation, II. Aufrechterhalten von sozialer Unterstützung, Selbstwertgefühl und psychologischer Stabilität, III. Verstehen der medizinischen Situation durch Kommunikation mit anderen Eltern und medizinischem Personal. Die interne Konsistenz der Skalen liegt bei .75, .76 und .71. Die Retest-Reliabilität beträgt .75, .63 und .57 und verweist damit auf eine mittlere Veränderungssensitivität des CHIP. Die externe Validität wurde durch Korrelationen mit einzelnen Skalen der Trierer Skalen zur Krankheitsbewältigung (TSK) demonstriert. Referenzwerte für unterschiedliche klinische Gruppen werden mitgeteilt. Mit dem CHIP steht ein international bewährtes spezifisches Instrument zur Messung des Copingverhaltens von Eltern chronisch kranker Kinder und Jugendlicher erstmals in deutscher Sprache zur Verfügung. Anwendungsgebiete sind vor allem die pädiatrische Psychologie und familienorientierte Rehabilitation.
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Lemanek KL, Jones ML, Lieberman B. Mothers of Children With Spina Bifida: Adaptational and Stress Processing. CHILDRENS HEALTH CARE 2000. [DOI: 10.1207/s15326888chc2901_2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Testing Theoretical Models and Frameworks in Child Health Research. ISSUES IN CLINICAL CHILD PSYCHOLOGY 2000. [DOI: 10.1007/978-1-4615-4165-3_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Luescher JL, Dede DE, Gitten JC, Fennell E, Maria BL. Parental burden, coping, and family functioning in primary caregivers of children with Joubert syndrome. J Child Neurol 1999; 14:642-8; discussion 669-72. [PMID: 10511336 DOI: 10.1177/088307389901401004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with Joubert syndrome have physical and intellectual disabilities. The purpose of this study was to assess the impact of Joubert syndrome on parental burden, coping, and family functioning. Forty-nine primary caregivers were surveyed. Forty-three primary caregivers were mothers and six were fathers; their mean age was 34 years. The following measures were used: Beck Depression Inventory, Child Development Inventory, Caregiver Strain Index, Family Assessment Device, and Ways of Coping Checklist-Revised. The data show that caregiver burden is not related to the severity of the child's illness, but that caregivers report significant burden. Higher burden was associated with the use of palliative coping methods, and family functioning was problematic. The results of this study suggest that for parents of children with Joubert syndrome, degree of parental burden depends more on the parents' coping skills and the level of family functioning rather than on the degree of the child's impairment. These findings highlight the importance of assessing caregiver burden, as well as decreased family functioning or coping abilities, since these problems often can be managed with psychologic intervention.
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Affiliation(s)
- J L Luescher
- Department of Clinical and Health Psychology, University of Florida, Gainesville 32610-0165, USA
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Gartstein MA, Short AD, Vannatta K, Noll RB. Psychosocial adjustment of children with chronic illness: an evaluation of three models. J Dev Behav Pediatr 1999; 20:157-63. [PMID: 10393072 DOI: 10.1097/00004703-199906000-00004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was designed to assess social, emotional, and behavioral functioning of children with chronic illness and to evaluate three models addressing the impact of chronic illness on psychosocial functioning: discrete disease, noncategorical, and mixed. Families of children with cancer, sickle cell disease, hemophilia, and juvenile rheumatoid arthritis participated, along with families of classroom comparison peers without a chronic illness who had the closest date of birth and were of the same race and gender (COMPs). Mothers, fathers, and children provided information regarding current functioning of the child with chronic illness or the COMP child. Child Behavior Checklist and Children's Depression Inventory scores were examined. Results provided support for the noncategorical model. Thus, the mixed model evaluated in this study requires modifications before its effectiveness as a classification system can be demonstrated.
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Affiliation(s)
- M A Gartstein
- Division of Hematology/Oncology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA
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Kronenberger WG, Carter BD, Edwards J, Morrow C, Stewart J, Sender L. Psychological Adjustment of Mothers of Children Undergoing Bone Marrow Transplantation: The Role of Stress, Coping, and Family Factors. CHILDRENS HEALTH CARE 1998. [DOI: 10.1207/s15326888chc2702_1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Janus M, Goldberg S. Treatment characteristics of congenital heart disease and behaviour problems of patients and healthy siblings. J Paediatr Child Health 1997; 33:219-25. [PMID: 9259296 DOI: 10.1111/j.1440-1754.1997.tb01583.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine behaviour problems of children in families where one child was diagnosed with congenital heart disease (CHD), in relation to the intensity of treatment required for the CHD. METHODOLOGY Treatment intensity was based on patients' hospitalizations, surgical operations, current treatment, frequency of check-ups and finality of surgical repair. Mothers of 29 patients and 43 healthy siblings (4-14 years old), and a sub-sample of fathers, reported on behaviour problems of their children and rated the frequency of considering patient's CHD while performing routine child care in nine areas of family life (accommodation of illness). RESULTS High treatment intensity was associated with high accommodation of illness and elevated behaviour problems among patients. In contrast, siblings in families where treatment intensity was low, but accommodation of illness high were at most risk for behaviour problems. CONCLUSIONS Treatment intensity has a markedly different impact on behaviour problems of patients and healthy siblings. It is important for parents and healthcare professionals to provide both patients and siblings with information about the patient's medical condition, regardless how much treatment that condition may need.
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Affiliation(s)
- M Janus
- Psychiatry Research, Hospital for Sick Children, Toronto, Ontario, Canada
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Abstract
Difficulties experienced by mothers caring for a child with cystic fibrosis were assessed. Difficulties were categorized as: (1) developmental, which included tasks generic to all families (bedtimes, socialization, siblings and communication with others); and (2) illness, which were especially pertinent to the care of the child with cystic fibrosis (mealtimes, physiotherapy and home-based medical care). Age differences were found in stresses associated with developmental routines, with mothers of younger children reporting more difficulties. With regard to illness routines, more difficulties were reported for children in better health (higher Shwachman scores). The data suggest that parents experience increasing difficulties in implementing home-based medical care where the child is in better health. Clinic staff need to be more aware of these difficulties and target information to parents appropriately.
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Affiliation(s)
- C Eiser
- Department of Psychology, University of Exeter, U.K
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