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Minneci PC, Gil LA, Cooper JN, Asti L, Nishimura L, Lutz CM, Deans KJ. Laser Epilation as an Adjunct to Standard Care in Reducing Pilonidal Disease Recurrence in Adolescents and Young Adults: A Randomized Clinical Trial. JAMA Surg 2024; 159:19-27. [PMID: 37938854 PMCID: PMC10633416 DOI: 10.1001/jamasurg.2023.5526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/07/2023] [Indexed: 11/10/2023]
Abstract
Importance Recurrence continues to be a significant challenge in the treatment and management of pilonidal disease. Objective To compare the effectiveness of laser epilation (LE) as an adjunct to standard care vs standard care alone in preventing recurrence of pilonidal disease in adolescents and young adults. Design, Setting, and Participants This was a single-institution, randomized clinical trial with 1-year follow-up conducted from September 2017 to September 2022. Patients aged 11 to 21 years with pilonidal disease were recruited from a single tertiary children's hospital. Intervention LE and standard care (improved hygiene and mechanical or chemical depilation) or standard care alone. Main Outcomes and Measures The primary outcome was the rate of recurrence of pilonidal disease at 1 year. Secondary outcomes assessed during the 1-year follow-up included disability days, health-related quality of life (HRQOL), health care satisfaction, disease-related attitudes and perceived stigma, and rates of procedures, surgical excisions, and postoperative complications. Results A total of 302 participants (median [IQR] age, 17 [15-18] years; 157 male [56.1%]) with pilonidal disease were enrolled; 151 participants were randomly assigned to each intervention group. One-year follow-up was available for 96 patients (63.6%) in the LE group and 134 (88.7%) in the standard care group. The proportion of patients who experienced a recurrence within 1 year was significantly lower in the LE treatment arm than in the standard care arm (-23.2%; 95% CI, -33.2 to -13.1; P < .001). Over 1 year, there were no differences between groups in either patient or caregiver disability days, or patient- or caregiver-reported HRQOL, health care satisfaction, or perceived stigma at any time point. The LE group had significantly higher Child Attitude Toward Illness Scores (CATIS) at 6 months (median [IQR], 3.8 [3.4-4.2] vs 3.6 [3.2-4.1]; P = .01). There were no differences between groups in disease-related health care utilization, disease-related procedures, or postoperative complications. Conclusions and Relevance LE as an adjunct to standard care significantly reduced 1-year recurrence rates of pilonidal disease compared with standard care alone. These results provide further evidence that LE is safe and well tolerated in patients with pilonidal disease. LE should be considered a standard treatment modality for patients with pilonidal disease and should be available as an initial treatment option or adjunct treatment modality for all eligible patients. Trial Registration ClinicalTrials.gov Identifier: NCT03276065.
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Affiliation(s)
- Peter C. Minneci
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatric Surgery, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
- Department of Surgery, Nemours Children’s Health, Delaware Valley, Wilmington
| | - Lindsay A. Gil
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatric Surgery, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | - Jennifer N. Cooper
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
| | - Lindsey Asti
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
| | - Leah Nishimura
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
| | - Carley M. Lutz
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
| | - Katherine J. Deans
- Department of Surgery, Nemours Children’s Health, Delaware Valley, Wilmington
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Harrison A, Mtukushe B, Kuo C, Wilson-Barthes M, Davidson B, Sher R, Galárraga O, Hoare J. Better Together: acceptability, feasibility and preliminary impact of chronic illness peer support groups for South African adolescents and young adults. J Int AIDS Soc 2023; 26 Suppl 4:e26148. [PMID: 37909178 PMCID: PMC10618872 DOI: 10.1002/jia2.26148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/14/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Peer support can help navigate the isolation and psychological strain frequently experienced by youth living with chronic illness. Yet, data are lacking on the impact of providing support for youth living with mixed chronic conditions. We assessed the acceptability, feasibility and preliminary mental health impacts of a clinic-based peer support group for South African youth living with chronic illnesses, including HIV. METHODS This mixed-methods pilot study (September 2021-June 2022) enrolled 58 young patients, ages 13-24, at an urban hospital in Cape Town, South Africa. In-depth interviews elicited the perspectives of 20 young people in relation to their participation in the Better Together programme, a recurring clinic-based peer support group for patients with mixed chronic illnesses. Self-reported resilience, attitudes towards illness, stigma and mental health were captured via established measures. T-tests and multivariate analysis of variance compared psychosocial outcomes for 20 group participants and 38 control patients, controlling for socio-demographic characteristics at enrolment. Logistic regression analyses estimated the predicted probability of a positive depression or anxiety screening given peer group participation. RESULTS All interviewees valued being able to compare treatment regimens and disease management habits with peers living with different conditions. Adolescents living with HIV stated that understanding the hardships faced by those with other conditions helped them accept their own illness and lessened feelings of isolation. Compared to patients who did not participate in Better Together, those who attended ≥5 groups had statistically significantly higher individual-level resilience, a more positive attitude towards their illness(es), lower internalised stigma and a more positive self-concept. The probability of being screened positive for depression was 23.4 percentage points lower (95% CI: 1.5, 45.3) for Better Together participants compared to controls; the probability of a positive anxiety screening was 45.8 percentage points lower (95% CI: 18.1, 73.6). CONCLUSIONS Recurring, clinic-based peer support groups that integrate youth living with HIV and other chronic diseases are novel. Group sustainability will depend on the commitment of experienced peer leaders and providers, routine scheduling and transportation support. A fully powered randomised trial is needed to test the optimal implementation and causal mental health effects of the Better Together model.
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Affiliation(s)
- Abigail Harrison
- International Health Institute, Brown University School of Public Health, Providence, Rhode Island, USA
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Bulelwa Mtukushe
- Division of Psychiatry & Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Caroline Kuo
- Division of Psychiatry & Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Department of Health Studies, American University, Washington, DC, USA
| | - Marta Wilson-Barthes
- International Health Institute, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Bianca Davidson
- Division of Psychiatry & Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Rebecca Sher
- Division of Psychiatry & Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Omar Galárraga
- International Health Institute, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Jacqueline Hoare
- Division of Psychiatry & Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Güngör MCK, Özdemir FK. Evaluation of disease related attitudes and quality of LIFE in children with chronic illness. J Pediatr Nurs 2023:S0882-5963(23)00120-3. [PMID: 37246071 DOI: 10.1016/j.pedn.2023.05.012] [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: 03/06/2023] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
AIM This study was conducted as a descriptive method in order to evaluate the attitudes towards illness of children with chronic diseases and their quality of life. METHOD The population of the study consisted of children with a chronic illness who were admitted to the pediatrics outpatient clinic of a hospital located in a province in the north-east of Turkey. The sample of the study consisted of 105 children who came to the hospital between October 2020 and June 2022, who met the criteria, and whose permission was obtained from themselves and their families. The study data were collected by using the 'Introductory Information Form', the 'Pediatric Quality of Life Inventory (PedsQL) (8-12 and 13-18 years)' and the 'Child Attitude Towards Illness Scale (CATIS)'. Data were analyzed using the SPSS for Windows 22 package program. RESULTS The mean age of the children who participated in the study was 13.90 ± 2.55 and 73.3% of them were in the adolescent age group. The average PedsQL total score of the children participating in the research was 64.59 ± 18.99 and the average CATIS total score was 3.05 ± 0.71. CONCLUSION It was determined that as the quality of life of the children with chronic diseases in the study increased, their attitudes towards their diseases became more positive. PRACTICE IMPLICATIONS While caring for children with chronic diseases, nurses should consider that supporting the child's quality of life positively affects the child's attitude towards the disease.
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Clifford LM, Brothers SL, Lang A. Self-Disclosure Patterns Among Children and Youth with Epilepsy: Impact of Perceived-Stigma. Adolesc Health Med Ther 2023; 14:27-43. [PMID: 36776152 PMCID: PMC9910097 DOI: 10.2147/ahmt.s336124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
This review aimed to synthesize the minimal existing literature on the impact of perceived stigma on self-disclosure patterns among children and youth with epilepsy (YWE). Initial literature searches were conducted in PsycInfo, Scopus, Web of Science, and PubMed using search terms focused on epilepsy, pediatrics, disclosure, and/or stigma. Articles were included if they were original human research articles published in peer-reviewed journals that were accessible in English through Cincinnati Children's Hospital Medical Center Pratt Library and fit study aims. Thirteen articles, which primarily used qualitative self-report methodologies, fit the study's inclusion criteria. YWE report greater perceived stigma and lower illness disclosure compared to youth with other chronic health conditions. Across studies, perceived stigma was consistently identified as a barrier to YWE disclosing their epilepsy diagnosis. Consequences of perceived stigma included lower self-esteem, poorer perceived competency, lack of self-confidence, social withdrawal, and lower quality of life. YWE's reluctance to disclose epilepsy was associated with worry about differential treatment, negative impact on close relationships, negative impact on others' perceptions, and negative self-perceptions. While WHO and ILAE have identified stigma as contributing to higher disease burden in people with epilepsy and have highlighted the importance of prioritizing social policy focused on decreasing epilepsy-related stigma, progress has been incremental and much work remains. Future research is needed to understand socio-cultural factors perpetuating stigma among YWE in order to further develop, evaluate, and disseminate evidence-based clinical and education programming to combat epilepsy-related stigma.
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Affiliation(s)
- Lisa M Clifford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Correspondence: Lisa M Clifford, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 3015, Cincinnati, OH, 45229, USA, Tel +1 513 803 3409, Fax +1 513 636 7756, Email
| | - Shannon L Brothers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Amy Lang
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Lins de Holanda Coelho G, Pereira Monteiro R, DunnGalvin A. Attitudes Towards Food Allergy Scale: Psychometric properties and associations with food allergy quality of life and anxiety. Clin Transl Allergy 2022; 12:e12205. [PMID: 36286529 PMCID: PMC9594965 DOI: 10.1002/clt2.12205] [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: 03/29/2022] [Revised: 08/22/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Daily, we tend to evaluate things positively or negatively, according to whether they follow the general information available about them. This attitudinal assessment is represented through evaluative dimensions (e.g., good‐bad) that vary in terms of valence (positive or negative) and strength (less or more). Despite its importance, there is an urge in food allergy (FA) research to properly assess attitudes based on the underlying mechanisms that define attitudes. Objective The present research aimed to develop the Attitudes Towards Food Allergy scale (ATFAS), the first attitudinal measure of FA. Method: Two studies were performed (n = 1049), using a range of robust statistical analyses (e.g., Item Response Theory, Exploratory Factor Analysis, Confirmatory Factor Analysis). Results Our results provided strong evidence for a unidimensional attitudinal structure, across groups of non‐allergic individuals and food‐allergic, besides recommended reliability levels. All items presented suitable parameters (i.e., discrimination, difficulty, information). Finally, the ATFAS significantly predicted FA quality of life, mediated by FA anxiety. Conclusion We are confident that the ATFAS is a novel and necessary measure, that can help to widen how we view and assess FA. The development of studies that assess attitudes towards FA based on our general information about the disorder would help to deepen our understanding of their links to other health‐related variables and their potential impact on quality of life, reduce FA's stigma, and develop more positive attitudes.
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Kwon CS, Jacoby A, Ali A, Austin J, Birbeck GL, Braga P, Cross JH, de Boer H, Dua T, Fernandes PT, Fiest KM, Goldstein J, Haut S, Lorenzetti D, Mifsud J, Moshe S, Parko KL, Tripathi M, Wiebe S, Jette N. Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy. Epilepsia 2022; 63:573-597. [PMID: 34985782 DOI: 10.1111/epi.17135] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors. METHODS Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy. RESULTS Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status. SIGNIFICANCE Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurosurgery, Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - Joan Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen L Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA
- Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Patricia Braga
- Facultad de Medicina, Institute of Neurology, Universidad de la República, Montevideo, Uruguay
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-NIHR BRC Great Ormond Street Institute of Child Health, London, UK
| | - Hanneke de Boer
- SEIN - Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Kirsten M Fiest
- Department of Critical Care Medicine and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Goldstein
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Sheryl Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Diane Lorenzetti
- Department of Community Health Sciences, University of Calgary and Health Sciences Library, University of Calgary, Calgary, Alberta, Canada
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Solomon Moshe
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Karen L Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California, USA
- Epilepsy Center, San Francisco VA Medical Center, San Francisco, California, USA
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Samuel Wiebe
- Department of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jette
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
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Austin JK, Birbeck G, Parko K, Kwon CS, Fernandes PT, Braga P, Fiest KM, Ali A, Cross JH, de Boer H, Dua T, Haut SR, Jacoby A, Lorenzetti DL, Mifsud J, Moshé SL, Tripathi M, Wiebe S, Jette N. Epilepsy-related stigma and attitudes: Systematic review of screening instruments and interventions - Report by the International League Against Epilepsy Task Force on Stigma in Epilepsy. Epilepsia 2022; 63:598-628. [PMID: 34985766 DOI: 10.1111/epi.17133] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This is a systematic review aimed at summarizing the evidence related to instruments that have been developed to measure stigma or attitudes toward epilepsy and on stigma-reducing interventions. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. A broad literature search (1985-2019) was performed in 13 databases. Articles were included if they described the development and testing of psychometric properties of an epilepsy-related stigma or attitude scale or stigma-reducing interventions. Two reviewers independently screened abstracts, reviewed full-text articles, and extracted data. Basic descriptive statistics are reported. RESULTS We identified 4234 abstracts, of which 893 were reviewed as full-text articles. Of these, 38 met inclusion criteria for an instrument development study and 30 as a stigma-reduction intervention study. Most instruments were initially developed using well-established methods and were tested in relatively large samples. Most intervention studies involved educational programs for adults with pre- and post-evaluations of attitudes toward people with epilepsy. Intervention studies often failed to use standardized instruments to quantify stigmatizing attitudes, were generally underpowered, and often found no evidence of benefit or the benefit was not sustained. Six intervention studies with stigma as the primary outcome had fewer design flaws and showed benefit. Very few or no instruments were validated for regional languages or culture, and there were very few interventions tested in some regions. SIGNIFICANCE Investigators in regions without instruments should consider translating and further developing existing instruments rather than initiating the development of new instruments. Very few stigma-reduction intervention studies for epilepsy have been conducted, study methodology in general was poor, and standardized instruments were rarely used to measure outcomes. To accelerate the development of effective epilepsy stigma-reduction interventions, a paradigm shift from disease-specific, siloed trials to collaborative, cross-disciplinary platforms based upon unified theories of stigma transcending individual conditions will be needed.
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Affiliation(s)
- Joan K Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA.,Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Karen Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California, USA.,Epilepsy Center, San Francisco VA Medical Center, San Francisco, California, USA
| | - Churl-Su Kwon
- Departments of Neurosurgery and Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Patricia Braga
- Institute of Neurology, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Kirsten M Fiest
- Department of Critical Care Medicine and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-Great Ormond Street Institute of Child Health, London, UK
| | | | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Sheryl R Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Diane L Lorenzetti
- Department of Community Health Sciences, University of Calgary and Heath Sciences Library, University of Calgary, Calgary, Alberta, Canada
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Solomon L Moshé
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Samuel Wiebe
- Department of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jette
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Engel ML, Shanley R, Scal PB, Kunin-Batson A. Anxiety and depressive symptoms in adolescents and young adults with epilepsy: The role of illness beliefs and social factors. Epilepsy Behav 2021; 116:107737. [PMID: 33493808 DOI: 10.1016/j.yebeh.2020.107737] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE This study examined (1) the prevalence of anxiety and depressive symptoms among adolescents and young adults (AYA) with epilepsy and (2) demographic and medical characteristics, illness beliefs, and social factors associated with anxiety and depressive symptoms to guide intervention development. METHODS A community-based sample of AYA with epilepsy (n = 179, ages 13-24 years, 39% male) completed online questionnaires measuring anxiety symptoms (GAD-7), depressive symptoms (PHQ-9), illness beliefs (helplessness; acceptance; perceived benefits), and social factors (family functioning; social stigma; connectedness). Participants also reported medical information (epilepsy type; years since diagnosis; time since last seizure; current medications). RESULTS Prevalence of clinically significant symptoms of anxiety and depression, 36% and 35%, respectively, was high compared to population prevalence. In multivariable regression models, demographic and medical factors explained only 2% of the variance in depressive symptoms and 6% in anxiety symptoms. Illness beliefs and social factors accounted for a majority of the explanatory power of both models (partial R2 = 0.37 for anxiety; 0.44 for depression). Specifically, acceptance, family functioning, and social stigma accounted for the greatest variance (p's < 0.01). CONCLUSIONS This study found a high prevalence of anxiety and depressive symptoms among AYA with epilepsy. Epilepsy variables (seizure type, medications, and years since diagnosis) were not associated with these psychological symptoms. Rather, the majority of variance in symptoms was accounted for by potentially modifiable beliefs and social factors. Interventions that promote illness acceptance, enhance family functioning, and reduce social stigma may ameliorate psychological distress among AYA with epilepsy.
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Affiliation(s)
- Melissa L Engel
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA 30322, USA.
| | - Ryan Shanley
- Masonic Cancer Center Biostatistics Core, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Peter B Scal
- Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Alicia Kunin-Batson
- Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55455, USA
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Stafstrom CE. Using artwork to understand and address the psychosocial challenges facing children and adolescents with epilepsy. Epilepsy Behav 2019; 101:106572. [PMID: 31711867 DOI: 10.1016/j.yebeh.2019.106572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 09/14/2019] [Indexed: 01/08/2023]
Abstract
Artwork is a valuable and underutilized technique for exploring the self-esteem and psychological challenges facing children and adolescents with epilepsy and other chronic diseases. Having children with epilepsy draw a picture of their seizure correlates reliably with seizure type, provides insight into the child's developmental level, and allows expression of inner feelings such as helplessness, vulnerability, and self-concept. Art therapy focus groups are beneficial in helping children with epilepsy express their feelings nonverbally and get to know peers facing similar challenges. On the occasion of Epilepsy and Behavior's 20th anniversary, this article reviews the usefulness of art for exploring the self-concept of patients with epilepsy and acknowledges the journal's support of this informative, inexpensive, and empowering adjunctive technique. "Special Issue: Epilepsy & Behavior's 20th Anniversary".
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Affiliation(s)
- Carl E Stafstrom
- Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins Hospital and University School of Medicine, Baltimore, MD, United States of America.
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O'Toole S, Gallagher P, Benson A, Shahwan A, Austin JK, Lambert V. Exploring the relationship between parent-child communication about epilepsy and psychosocial well-being. J Health Psychol 2019; 26:1207-1221. [PMID: 31448626 DOI: 10.1177/1359105319871642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study examined the relationship between parent-child communication and psychosocial well-being of 47 children living with epilepsy and 72 parents of children living with epilepsy. Open communication was associated with positive illness attitude, positive self-perception and greater health-related quality of life for children living with epilepsy; positive response to illness for parents; and more perceived social support and less need for epilepsy-related support for children living with epilepsy and parents. By contrast, closed communication was associated with poorer psychosocial well-being in children living with epilepsy and parents. Healthcare professionals should provide guidance for families living with childhood epilepsy on the importance of open communication in promoting greater psychosocial well-being.
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Affiliation(s)
| | | | | | - Amre Shahwan
- Children's Health Ireland at Temple Street, Ireland
| | - Joan K Austin
- Indiana University-Purdue University Indianapolis, USA
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Le Marne FA, Butler S, Beavis E, Gill D, Bye AME. EpApp: Development and evaluation of a smartphone/tablet app for adolescents with epilepsy. J Clin Neurosci 2018; 50:214-220. [PMID: 29422360 DOI: 10.1016/j.jocn.2018.01.065] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 11/16/2022]
Abstract
The study aimed to comprehensively evaluate a mobile application (EpApp), designed with stakeholder input, to educate and facilitate management of adolescents with epilepsy. A prospective cohort of adolescents with epilepsy (13-19 years) and their parent/carer participated between June 2015 and December 2016. Primary outcome measure was knowledge acquisition. Secondary outcomes were psychosocial variables (attitude towards illness and seizure self-efficacy) and clinical parameters (medication adherence, seizure burden). Functionality, design, content and app utility were appraised via survey and open-ended questions. 51 adolescents completed baseline surveys (mean age 14.49 years), 36 follow-up surveys. Both self and general epilepsy knowledge increased following intervention (p ≤ 0.005). Significantly fewer medication reminders were required during intervention (M = 2.93, p = .002) and follow-up (M = 3.54, p = .030) compared to baseline (M = 6.64). Measures of app design, content, functionality and utility were very favourable. There was no significant improvement in seizure burden, or psychosocial parameters. Educational page-visits reflected interests and concerns. This study demonstrates that EpApp increases knowledge and is engaging. The app is available free, internationally via Android/Apple platforms.
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Affiliation(s)
- Fleur A Le Marne
- Department of Neurology, Level 4 Emergency Wing, Sydney Children's Hospitals Network, High Street, Randwick, NSW 2031, Australia; School of Women's and Children's Health, University of New South Wales, High Street, Randwick, NSW 2031, Australia.
| | - Sharlene Butler
- Department of Neurology, Level 4 Emergency Wing, Sydney Children's Hospitals Network, High Street, Randwick, NSW 2031, Australia
| | - Erin Beavis
- Department of Neurology, Level 4 Emergency Wing, Sydney Children's Hospitals Network, High Street, Randwick, NSW 2031, Australia
| | - Deepak Gill
- TY Nelson Department of Neurology and Neurosurgery, Children's Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Ann M E Bye
- Department of Neurology, Level 4 Emergency Wing, Sydney Children's Hospitals Network, High Street, Randwick, NSW 2031, Australia; School of Women's and Children's Health, University of New South Wales, High Street, Randwick, NSW 2031, Australia
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12
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Chew J, Haase AM, Carpenter J. Individual and family factors associated with self-esteem in young people with epilepsy: A multiple mediation analysis. Epilepsy Behav 2017; 66:19-26. [PMID: 27987477 DOI: 10.1016/j.yebeh.2016.09.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE As young people experience added demands from living with epilepsy, which may lead to poor psychosocial adjustment, it is essential to examine mechanisms of change to provide practitioners with knowledge to develop effective interventions. The aim of this study was to examine individual and family-level factors - stress and illness perceptions, coping behaviors and family resilience - that promote or maintain young people's self-esteem. METHODS From November 2013 to August 2014, young people attending a neurology clinic in KK Women's and Children's Hospital, Singapore, participated in a cross-sectional survey (n=152; 13-16years old). Multiple mediation analyses were conducted to evaluate whether these variables mediated the relationship between illness severity (i.e., low, moderate, high) and self-esteem. RESULTS Multiple mediation analyses demonstrated that illness severity had a direct effect on young people's self-esteem. Compared to those with moderate illness severity (reference group), young people with low severity had significantly higher self-esteem (c=3.42, p<0.05); while those with high severity had a more negative view of themselves (c=-3.93, p<0.001). Illness severity also had an indirect influence on self-esteem through its effects on mediators, such as perceived stress, illness perceptions and family resilience (D1: Total ab=3.46, 95% CI 1.13, 5.71; D2: Total ab=-2.80, 95% CI -4.35, -1.30). However, young people's coping levels did not predict their self-esteem, when accounting for the effects of other variables. SIGNIFICANCE The continued presence of seizure occurrences is likely to place greater demands on young people and their families: in turn, increased stress and negative illness perceptions negatively affected family processes that promote resilience. As the mediating effect of these modifiable factors were above and beyond the contributions of illness characteristics and young people's levels of coping, this has implications for developing individual and family interventions aimed to support young people living with epilepsy.
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Affiliation(s)
- Judith Chew
- School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, United Kingdom.
| | - Anne M Haase
- School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, United Kingdom
| | - John Carpenter
- School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, United Kingdom
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13
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Chew J, Haase AM. Psychometric properties of the Family Resilience Assessment Scale: A Singaporean perspective. Epilepsy Behav 2016; 61:112-119. [PMID: 27337164 DOI: 10.1016/j.yebeh.2016.05.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/26/2016] [Accepted: 05/13/2016] [Indexed: 11/28/2022]
Abstract
Families of young people with chronic illnesses are more likely to experience higher levels of stress. In turn, their ability to cope with multiple demands is likely to affect young people's adaptation. The purpose of this study was to examine psychometric properties of the Family Resilience Assessment Scale (FRAS), an assessment tool that measures the construct of family resilience. A total of 152 young people with epilepsy, aged 13 to 16years old, from KK Women's and Children's Hospital, Singapore, completed the FRAS along with the Rosenberg Self-Esteem Scale. Factor structure of the FRAS was examined. Exploratory factor analysis resulted in a 7-factor solution - meaning-making and positive outlook, transcendence and spirituality, flexibility and connectedness, social and economic resources (community), social and economic resources (neighbors), clarity and open emotional expression, and collaborative problem-solving - accounting for 83.0% of the variance. Internal consistency of the scale was high (α=0.92). Family resilience was significantly correlated with higher levels of self-esteem. Our study provides preliminary findings that suggest that FRAS is a reliable and valid scale for assessing the construct of family resilience among young people with epilepsy in Singapore.
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Affiliation(s)
- Judith Chew
- School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, United Kingdom; Medical Social Work Department, KK Women's and Children's Hospital, 100 Bukit Timah Road, S 229899, Singapore.
| | - Anne M Haase
- School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, United Kingdom
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Mullins LL, Cushing CC, Suorsa KI, Tackett AP, Molzon ES, Mayes S, McNall-Knapp R, Mullins AJ, Gamwell KL, Chaney JM. Parent illness appraisals, parent adjustment, and parent-reported child quality of life in pediatric cancer. Pediatr Hematol Oncol 2016; 33:314-326. [PMID: 27437562 DOI: 10.1080/08880018.2016.1198443] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Psychosocial distress is a salient construct experienced by families of children with newly diagnosed cancer, but little is known about parental appraisal of the child's illness and the subsequent impact this may have on child and parent functioning. The goal of the present study was to examine the interrelationships among multiple parent illness appraisals, parent adjustment outcomes, and parent-reported child quality of life in parents of children diagnosed with cancer. Parents completed measures of illness appraisal (illness uncertainty and attitude toward illness), parent adjustment (general distress, posttraumatic stress, parenting stress), and child quality of life (general and cancer-related). Path analysis revealed direct effects for parent illness uncertainty and illness attitudes on all 3 measures of parent adjustment. Illness uncertainty, but not illness attitudes, demonstrated a direct effect on parent-reported child general quality of life; parenting stress had direct effects on general and cancer-related quality of life. Exploratory analyses indicated that parent illness uncertainty and illness attitudes conferred indirect effects on parent-reported general and cancer-related quality of life through parenting stress. Negative parent illness appraisals appear to have adverse impacts on parents' psychosocial functioning and have implications for the well-being of their child with cancer.
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Affiliation(s)
- Larry L Mullins
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | | | - Kristina I Suorsa
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Alayna P Tackett
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Elizabeth S Molzon
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Sunnye Mayes
- c Department of Pediatrics , University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma , USA
| | - Rene McNall-Knapp
- c Department of Pediatrics , University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma , USA
| | - Alexandria J Mullins
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Kaitlyn L Gamwell
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | - John M Chaney
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
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15
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Attitudes of Children with Diabetes Toward Their Disease. IRANIAN JOURNAL OF PEDIATRICS 2016. [DOI: 10.5812/ijp.4901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Ramsey RR, Ryan JL, Fedele DA, Mullins LL, Chaney JM, Wagner JL. Child Attitude Toward Illness Scale (CATIS): A systematic review of the literature. Epilepsy Behav 2016; 59:64-72. [PMID: 27096812 DOI: 10.1016/j.yebeh.2016.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to systematically review the literature utilizing the Child Attitude Toward Illness Scale (CATIS) as a measure of illness attitudes within pediatric chronic illness, including epilepsy, and provide recommendations for its use. This review includes an examination of the psychometric properties of the CATIS and the relationship between the CATIS and psychological, academic, behavioral, and illness variables. METHOD Electronic searches were conducted using Medline and PsychINFO to identify twenty-two relevant publications. RESULTS The CATIS was identified as a reliable and valid self-report assessment tool across chronic illnesses, including pediatric epilepsy. Although originally developed for children ages 8-12, the CATIS has demonstrated reliability and validity in youth ages 8-22. The CATIS scores were reliably associated with cognitive appraisal variables and internalizing symptoms. Initial support exists for the relation between illness attitudes and externalizing behavior, academic functioning, and psychosocial care needs. Mixed findings were reported with regard to the relation between illness attitudes and demographic and disease variables, as well as both social and family functioning. CONCLUSION The CATIS is a psychometrically sound self-report instrument for measuring illness attitudes and demonstrates clinical utility for examining adjustment outcomes across chronic illnesses, particularly pediatric epilepsy.
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Affiliation(s)
- Rachelle R Ramsey
- Center for Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Jamie L Ryan
- Center for Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, United States
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - John M Chaney
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Janelle L Wagner
- Comprehensive Epilepsy Center, College of Nursing, Department of Pediatrics, Medical University of South Carolina, United States.
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Rizou I, De Gucht V, Papavasiliou A, Maes S. The contribution of illness perceptions to fatigue and sleep problems in youngsters with epilepsy. Eur J Paediatr Neurol 2016; 20:93-9. [PMID: 26497901 DOI: 10.1016/j.ejpn.2015.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/10/2015] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The present study aims to explore the extent to which gender, epilepsy severity and illness perceptions predict fatigue and sleep problems in youngsters with epilepsy. METHOD Structured interviews were conducted in 100 young patients (Mage = 13,9, SD = 2.21; 41% girls) and data were analyzed by means of multiple hierarchical regression analyses. RESULTS Most patients (91%) were well controlled by anti-epileptics; 3% had infrequent seizures and 6% were pharmacoresistant. At a multivariate level it appeared that youngsters with epilepsy who believe that they have less personal control over their illness and who feel that the illness has a high emotional impact on their lives reported higher levels of fatigue. In addition, more sleep problems were reported by youngsters who think they have less personal control over the disease, who believe that treatment controls epilepsy and report that the disease has a high emotional impact on their lives. CONCLUSION Given the importance of illness perceptions, it is suggested that they are targets for future interventions that aim to reduce fatigue and sleep problems in youngsters with epilepsy.
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Affiliation(s)
- Ioanna Rizou
- Child Psychiatry Department, Mental Health Center of General Hospital of Athens "G. Gennimatas", Athens, Greece.
| | - Veronique De Gucht
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands.
| | | | - Stan Maes
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands.
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18
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Jacob ML, Johnco C, Dane BF, Collier A, Storch EA. Psychosocial functioning in Barth syndrome: Assessment of individual and parental adjustment. CHILDRENS HEALTH CARE 2015. [DOI: 10.1080/02739615.2015.1124768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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19
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Bultas MW, Schmuke AD, Moran V, Taylor J. Psychosocial Outcomes of Participating in Pediatric Diabetes Camp. Public Health Nurs 2015. [DOI: 10.1111/phn.12218] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Vicki Moran
- School of Nursing; Saint Louis University; St. Louis Missouri
| | - John Taylor
- School of Nursing; Saint Louis University; St. Louis Missouri
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20
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Rizou I, De Gucht V, Papavasiliou A, Maes S. Illness perceptions determine psychological distress and quality of life in youngsters with epilepsy. Epilepsy Behav 2015; 46:144-50. [PMID: 25900225 DOI: 10.1016/j.yebeh.2015.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 03/19/2015] [Accepted: 03/21/2015] [Indexed: 10/23/2022]
Abstract
The aim of this cross-sectional study was to explore the extent to which gender, epilepsy severity, and self-regulation concepts (illness perceptions, autonomous treatment regulation, perceived autonomy support by parents) predict psychological distress and quality of life (QoL) in young patients with epilepsy. Structured interviews were conducted in 100 patients (Mage=13.9, SD=2.21, 41% girls), and data were analyzed by means of multiple hierarchical regression analyses. Seizures of most patients (91%) were well controlled by antiepileptics, 3% of the patients had infrequent seizures, and seizures in 6% were pharmacoresistant. At a multivariate level, it appeared that youngsters with epilepsy who expect that their disease will last for a long time, who believe that they have less personal control over their illness, and who expect the illness to have a high emotional impact reported higher levels of distress. In addition, a better QoL was reported by youngsters who believed that treatment did not control their illness and who thought that their epilepsy would not affect them emotionally. Findings indicate the importance of illness perceptions, and it is suggested that they should be targeted in future interventions in youngsters with epilepsy.
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Affiliation(s)
- Ioanna Rizou
- Child Psychiatry Department, Mental Health Center of General Hospital of Athens "G. Gennimatas", Athens, Greece.
| | - Veronique De Gucht
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands
| | | | - Stan Maes
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands
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21
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Eaton CK, Gutierrez-Colina AM, Lee JL, Blount RL. Predictors of Experiences and Attitudes at a Summer Camp for Children and Adolescents With Tourette Syndrome. CHILDRENS HEALTH CARE 2014. [DOI: 10.1080/02739615.2014.948159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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Austin JK, Perkins SM, Dunn DW. A model for internalized stigma in children and adolescents with epilepsy. Epilepsy Behav 2014; 36:74-9. [PMID: 24866252 PMCID: PMC4096577 DOI: 10.1016/j.yebeh.2014.04.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 04/19/2014] [Accepted: 04/21/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Perceptions of stigma in children and adolescents with epilepsy are associated with higher rates of mental health problems. The purpose of this study was to test relationships in a model that identified variables most strongly associated with perceptions of stigma in children and adolescents with epilepsy. Our ultimate goal is to develop a theoretical foundation for future intervention research by identifying variables associated with perceptions of stigma that are potentially amenable to psychosocial interventions. METHODS Participants were 173 children and adolescents with epilepsy who were between 9 and 14 years of age. Data were collected in telephone interviews. Stigma was measured using a self-report scale. Data were analyzed using structural equation modeling. RESULTS Greater need for information and support, more fear and worry related to having epilepsy, greater seizure severity, and younger age were significantly associated with greater perceptions of stigma. Female gender, greater need for information and support, having at least one seizure in the past year, and lower self-efficacy for seizure management were significantly associated with more fear and worry related to having epilepsy. CONCLUSIONS Findings suggest that perceptions of stigma are associated with two variables that are amenable to psychosocial interventions: fear and worry about having epilepsy and need for information and support. Future research should test the efficacy of interventions that reduce fear and worry, provide information about epilepsy, and reduce need for support.
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Affiliation(s)
- Joan K. Austin
- Corresponding author; Joan K. Austin, PhD, RN, FAAN, Indiana University School of Nursing, 3040 N Ramble Road West, Bloomington, IN 47408, Tel: 812-332-8278,
| | - Susan M. Perkins
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
| | - David W. Dunn
- Departments of Psychiatry and Neurology, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
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23
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Valizadeh L, Barzegar M, Akbarbegloo M, Zamanzadeh V, Rahiminia E, Ferguson C. The relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy. Epilepsy Behav 2013; 27:267-71. [PMID: 23453530 DOI: 10.1016/j.yebeh.2012.11.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 11/08/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
Abstract
Epilepsy is a significant health problem in Iran and other countries. Previous epilepsy studies conducted in Iran have often focused on physiological aspects and pharmacological therapy, and little attention has been paid to the psychological and social aspects of care, particularly in adolescence. This paper aims to fill this gap by assessing the relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy. A descriptive correlational design was adopted, and 74 adolescents who experienced generalized seizures and were treated at the neurology clinic affiliated with the Tabriz University of Medical Sciences in 2010 were examined. The data were collected using instruments including (1) the patient demographic characteristics, (2) the Child Report of Psychosocial Care Scale, and (3) the Child's Attitude Toward Illness Scale. There was a significant positive correlation between psychosocial care and attitudes toward illness (p<.05). There is no evidence for routine psychological consultation for our sample; it would be helpful if psychological consultation with and without parents made available to adolescents with epilepsy.
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Affiliation(s)
- Leila Valizadeh
- Tabriz Pediatric Health Research Center, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran.
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Ryan JL, Ramsey RR, Fedele DA, Wagner JL, Smith G, Chaney JM. Exploration of age and sex differences in depressive symptoms and illness attitudes for youth with epilepsy and juvenile rheumatic disease. J Child Neurol 2012; 27:1004-10. [PMID: 22290860 DOI: 10.1177/0883073811431109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim was to explore the relationship of youth age and sex to depressive symptoms and illness attitudes in youth with epilepsy and juvenile rheumatic disease. Youth with epilepsy or juvenile rheumatic disease between the ages of 7 and 19 years completed measures of depressive symptoms and illness attitudes. A significant 3-way interaction, Disease Group × Sex × Age, was found when predicting depressive symptoms. Post hoc analyses revealed a simple 2-way Disease Group × Age interaction for males and females. Younger males and adolescent females with epilepsy reported greater depressive symptoms than younger males and adolescent females with a juvenile rheumatic disease. Youth with epilepsy reported more negative illness attitudes than youth diagnosed with a juvenile rheumatic disease, but no other main effects or interactions were found. Results suggest early screening of depressive symptoms, with particular attention to younger males and adolescent females with epilepsy.
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Affiliation(s)
- Jamie L Ryan
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
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25
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Art therapy focus groups for children and adolescents with epilepsy. Epilepsy Behav 2012; 24:227-33. [PMID: 22554978 DOI: 10.1016/j.yebeh.2012.03.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 03/18/2012] [Indexed: 11/24/2022]
Abstract
Children with epilepsy are at risk for numerous psychological and social challenges. We hypothesized that art therapy focus groups would enhance the self-image of children and adolescents with epilepsy. Sixteen children with epilepsy, ages 7-18 years, were recruited from pediatric neurology clinics at the University of Wisconsin to participate in four art therapy sessions. Pre-group assessments included psychological screens (Piers-Harris Children's Self-Concept Scale; Childhood Attitude Toward Illness Scale; Impact of Childhood Neurologic Disability Scale) and art therapy instruments (Formal Elements Art Therapy Scale; Seizure Drawing Task; Levick Emotional and Cognitive Art Therapy Assessment). Developmental levels of drawings were significantly below age-expected standards. Following completion of focus groups, a repeat Childhood Attitude Toward Illness Scale showed no differences between pre- and post-test scores on any measure of this scale. However, subjects and parents were uniformly positive about their group experiences, suggesting a qualitative benefit from participation in art therapy focus groups.
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26
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Newcombe PA, Dunn TL, Casey LM, Sheffield JK, Petsky H, Anderson-James S, Chang AB. Breathe Easier Online: evaluation of a randomized controlled pilot trial of an Internet-based intervention to improve well-being in children and adolescents with a chronic respiratory condition. J Med Internet Res 2012; 14:e23. [PMID: 22356732 PMCID: PMC3374545 DOI: 10.2196/jmir.1997] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 12/18/2011] [Accepted: 01/13/2012] [Indexed: 01/08/2023] Open
Abstract
Background Chronic respiratory illnesses are the most common group of childhood chronic health conditions and are overrepresented in socially isolated groups. Objective To conduct a randomized controlled pilot trial to evaluate the efficacy of Breathe Easier Online (BEO), an Internet-based problem-solving program with minimal facilitator involvement to improve psychosocial well-being in children and adolescents with a chronic respiratory condition. Methods We randomly assigned 42 socially isolated children and adolescents (18 males), aged between 10 and 17 years to either a BEO (final n = 19) or a wait-list control (final n = 20) condition. In total, 3 participants (2 from BEO and 1 from control) did not complete the intervention. Psychosocial well-being was operationalized through self-reported scores on depression symptoms and social problem solving. Secondary outcome measures included self-reported attitudes toward their illness and spirometry results. Paper-and-pencil questionnaires were completed at the hospital when participants attended a briefing session at baseline (time 1) and in their homes after the intervention for the BEO group or a matched 9-week time period for the wait-list group (time 2). Results The two groups were comparable at baseline across all demographic measures (all F < 1). For the primary outcome measures, there were no significant group differences on depression (P = .17) or social problem solving (P = .61). However, following the online intervention, those in the BEO group reported significantly lower depression (P = .04), less impulsive/careless problem solving (P = .01), and an improvement in positive attitude toward their illness (P = .04) compared with baseline. The wait-list group did not show these differences. Children in the BEO group and their parents rated the online modules very favorably. Conclusions Although there were no significant group differences on primary outcome measures, our pilot data provide tentative support for the feasibility (acceptability and user satisfaction) and initial efficacy of an Internet-based intervention for improving well-being in children and adolescents with a chronic respiratory condition. Trial registration Australian New Zealand Clinical Trials Registry number: ACTRN12610000214033; http://www.anzctr.org.au/trial_view.aspx?ID=308074 (Archived by WebCite at http://www.webcitation.org/63BL55mXH)
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Affiliation(s)
- Peter A Newcombe
- School of Psychology, University of Queensland, Brisbane, Australia.
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Molzon ES, Suorsa KI, Hullmann SE, Ryan JL, Mullins LL. The Relationship of Allergy Severity to Depressive and Anxious Symptomatology: The Role of Attitude toward Illness. ISRN ALLERGY 2012; 2011:765309. [PMID: 23724239 PMCID: PMC3658500 DOI: 10.5402/2011/765309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 12/27/2011] [Indexed: 11/23/2022]
Abstract
The current study examined the relationship between self-reported allergy severity, depressive and anxious symptoms, and attitude toward illness in adolescents and young adults (AYAs) with allergies. Participants were 214 undergraduate students between the ages of 17–25 years with self-reported allergies. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D), the Zung Self-Rating Anxiety Scale (SAS), and the Child Attitude Toward Illness Scale (CATIS) as measures of depressive symptoms, anxious symptoms, and attitude toward illness, respectively. Using the bootstrapping method, results revealed that attitude toward illness mediated the relationship between self-reported disease severity and depressive and anxious symptoms. Results of the current study suggest that attitude toward illness is one pathway by which subjective disease severity impacts psychological functioning in AYAs with allergies.
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Affiliation(s)
- Elizabeth S Molzon
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078, USA
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Ho J, Lee A, Kaminsky L, Wirrell E. Self-concept, attitude toward illness and family functioning in adolescents with type 1 diabetes. Paediatr Child Health 2011; 13:600-4. [PMID: 19436558 DOI: 10.1093/pch/13.7.600] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2008] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The primary objective of the present study was to assess self-concept in adolescents with type 1 diabetes, and to determine whether this is associated with attitudes toward having chronic disease, family functioning or severity of diabetes. The secondary objective was to assess the impact of family income, sex, age and age at diagnosis on adolescent self-concept. METHODS A cross-sectional, self-report survey of 48 adolescents with type 1 diabetes (22 boys and 26 girls; mean +/- SD age at time of study 15.2+/-1.7 years [range 12.2 to 18.0 years]; mean age at diagnosis 9.2+/-3.3 years [range 1.3 to 14.9 years]) was performed using the Piers-Harris Children's Self-Concept (PHCSC) scale, second edition; the Child Attitude Toward Illness Scale; and the Family Assessment Measure scale, version III. Demographic information including net family income and a symptom inventory form to assess disease severity was collected. RESULTS Adolescents' self-concept measured by the PHCSC scale was significantly positively correlated with a more positive attitude toward chronic illness as measured by the Child Attitude Toward Illness Scale. The PHCSC scale was found to have a significant negative correlation with the Family Assessment Measure scale score, indicating that a better self-concept was correlated with enhanced family functioning. Self-concept was not significantly correlated with disease severity, income of family, sex, age at diagnosis, age at time of study, episodes of diabetic ketoacidosis or episodes of hypoglycemia. CONCLUSIONS Adolescents with better self-concept had more positive attitudes toward their chronic illness and enhanced family functioning. Although no correlation with diabetes disease severity was seen in the study population, interventions aimed at improving adolescent self-concept may have a positive impact on diabetes treatment by improving attitude toward living with type 1 diabetes.
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Affiliation(s)
- Josephine Ho
- Division of Pediatric Endocrinology, Alberta Children's Hospital, Calgary, Alberta
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Wagner JL, Smith G, Ferguson P, van Bakergem K, Hrisko S. Feasibility of a pediatric cognitive-behavioral self-management intervention: Coping Openly and Personally with Epilepsy (COPE). Seizure 2011; 20:462-7. [DOI: 10.1016/j.seizure.2011.02.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 02/16/2011] [Accepted: 02/21/2011] [Indexed: 11/24/2022] Open
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Frizzell CK, Connolly AM, Beavis E, Lawson JA, Bye AME. Personalised epilepsy education intervention for adolescents and impact on knowledge acquisition and psychosocial function. J Paediatr Child Health 2011; 47:271-5. [PMID: 21244556 DOI: 10.1111/j.1440-1754.2010.01952.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Patients frequently have poor knowledge of epilepsy, and this is associated with low self-esteem in adolescence. There is a paucity of data determining whether education alone can improve psychosocial outcome. The study investigated whether an educational intervention in adolescence: 1 Increased understanding of epilepsy syndrome and general epilepsy knowledge. 2 Improved self-esteem, seizure self-efficacy and attitudes towards epilepsy. METHODS In session 1, adolescents were educated about their epilepsy syndrome in a one-on-one session, producing a personalised epilepsy medical record. In session 2, the impact of epilepsy on life-style was discussed. Pre- and post-intervention measures of knowledge, self-esteem, seizure self-efficacy and attitudes towards epilepsy were completed using validated scales. Focus groups explored the intervention's value. RESULTS Thirty adolescents with epilepsy participated (female: 24, male: 6; median age: 16 years; partial symptomatic epilepsy: 15, generalised idiopathic epilepsy: 15). Self-knowledge of syndrome (P < 0.0001), general knowledge of epilepsy (P < 0.0001), attitudes towards epilepsy (P= 0.008) and seizure self-efficacy (P= 0.049) improved. Focus group data indicated that sessions were enjoyable and valuable, and the medical record was helpful. CONCLUSIONS The intervention significantly improved self-knowledge and general knowledge of epilepsy, attitudes towards epilepsy and seizure self-efficacy. This is the first study to demonstrate a positive impact on psychosocial outcomes following an educational intervention without a psychological component. The model has widespread application.
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Affiliation(s)
- Claire K Frizzell
- Department of Paediatric Neurology, Sydney Children's Hospital, Randwick, New South Wales, Australia
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Assessment of psychological distress among children and adolescents with food allergy. J Allergy Clin Immunol 2010; 124:1282-8. [PMID: 19910035 DOI: 10.1016/j.jaci.2009.08.045] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 07/31/2009] [Accepted: 08/25/2009] [Indexed: 11/22/2022]
Abstract
BACKGROUND Youth with food allergy may experience psychosocial stressors including limitations in activities, differences from peers, and anxiety. Factors such as allergy-related medical history, children's attitudes toward their allergies, and parental anxiety may function as risk and resilience factors associated with psychological distress in this population. OBJECTIVE To assess mean scores and rates of elevated scores on standardized measures of psychological distress among youth with food allergy and identify factors associated with distress. METHODS A total of 141 mothers of children age 2 to 17 years with food allergy completed questionnaires about child medical history, child anxiety and depressive symptoms, and maternal anxiety symptoms. A total of 69 children age 8 to 17 years completed self-report measures of anxiety and depressive symptoms, social stress, and attitudes toward food allergy. RESULTS Mean scores on self-report and parent-report measures of child anxiety symptoms, depressive symptoms, and social stress fell in the average range on standardized measures of child distress. Comparisons with normative scores generally indicated either no differences or lower rates of distress in our sample of youth with food allergy, with the exception of child-reported anxious coping and separation anxiety symptoms, which were significantly higher than normative scores. Maternal reports of child symptoms were significantly higher than child self-reports. Multiple regression analyses yielded models in which child attitudes toward food allergy and maternal anxiety were associated with child distress for children 8 to 17 years old. CONCLUSION Results suggest targets for prevention of distress, including assessment of attitudes toward food allergy and support for parental anxiety management.
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Bellin MH, Zabel TA, Dicianno BE, Levey E, Garver K, Linroth R, Braun P. Correlates of depressive and anxiety symptoms in young adults with spina bifida. J Pediatr Psychol 2009; 35:778-89. [PMID: 19880443 PMCID: PMC2908707 DOI: 10.1093/jpepsy/jsp094] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Based on social ecological theory, this study was designed to examine the unique relationships between multi-level ecological factors and psychological symptoms in young adults with spina bifida (SB). METHOD A sample of 61 individuals with SB, 18-25 years of age, completed standardized self-report measures of attitude toward SB, satisfaction with family functioning, Chronic Care Model (CCM) services, and depressive and anxiety symptoms. A chart review yielded SB clinical data. RESULTS High rates of depressive and anxiety symptoms were found. Hierarchical regression analysis identified the proximal individual (attitude toward SB) and family (satisfaction with family functioning) factors as more strongly related to depressive symptoms than the distal healthcare system factor (CCM services). Self-reported pain was the only ecological factor associated with anxiety symptoms. CONCLUSIONS Study findings provide a potential foundation for multi-factor screening of young adults with SB at risk for psychological symptoms.
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Affiliation(s)
- Melissa H Bellin
- University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA.
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Hamiwka L, Singh N, Niosi J, Wirrell E. Perceived health in children presenting with a "first seizure". Epilepsy Behav 2008; 13:485-8. [PMID: 18617444 DOI: 10.1016/j.yebeh.2008.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 05/21/2008] [Accepted: 05/28/2008] [Indexed: 11/30/2022]
Abstract
The goal of this study was to determine health perceptions of children and parents after a "first seizure." Children 5-17 years of age referred with a first recognized seizure (FRS) were included in the study. Children and primary caregivers completed the Child Health Questionnaire. Sixty-seven of 70 (96%) participated (mean age=11.2, SD=3.4; 48 seizure, 19 nonseizure). Parents of children with a first recognized epileptic seizure (FRS-e) had significantly lower scores on Psychosocial Summary scores (P<0.001) and on 6 of 12 subscales. Children who had had their first recognized nonepileptic seizure (FRS-ne) tended to have poorer Parental Time-Emotional scores (P=0.05). Although children did not receive lower scores, they did report a change in perceived health (P=0.017). While parents of children presenting with a FRS report increased emotional impact, those with a FRS-e report more significant difficulties in several domains of perceived health. It is important for physicians and health care providers to be aware of these concerns as they might impact further interventions.
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Affiliation(s)
- Lorie Hamiwka
- Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada.
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Wagner JL, Smith G, Ferguson PL, Horton S, Wilson E. A hopelessness model of depressive symptoms in youth with epilepsy. J Pediatr Psychol 2008; 34:89-96. [PMID: 18539619 DOI: 10.1093/jpepsy/jsn052] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To test the cognitive diathesis-stress and mediational components of the theory of learned hopelessness in youth with epilepsy. METHODS Seventy-seven participants ages 9-17 (35 girls, 42 boys) completed measures of depressive symptoms, hopelessness, self-efficacy for seizure management, and attitude toward epilepsy. Caregivers provided information on seizure activity. Diagnostic and treatment information was obtained via medical record review. RESULTS Regression analyses revealed that hopelessness mediated the attitude towards epilepsy-depressive symptom relationship. While attitude toward epilepsy and self-efficacy were independent predictors of depressive symptoms, the relationship of attitudes toward epilepsy and depressive symptoms was not enhanced with low self-efficacy for seizure management. CONCLUSIONS Findings support the mediation component of the learned hopelessness theory in youth with epilepsy, suggesting the importance of interventions that assist youth in identifying epilepsy-related aspects of functioning over which they can realistically exercise control and challenging negative thoughts about situations they cannot control.
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Affiliation(s)
- Janelle L Wagner
- Medical University of South Carolina, Developmental Pediatrics, Charleston, SC 29425, USA.
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Lee A, Hamiwka LD, Sherman EMS, Wirrell EC. Self-concept in adolescents with epilepsy: biological and social correlates. Pediatr Neurol 2008; 38:335-9. [PMID: 18410849 DOI: 10.1016/j.pediatrneurol.2008.01.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 01/03/2008] [Accepted: 01/21/2008] [Indexed: 11/20/2022]
Abstract
The purposes of this study were to (1) compare self-esteem in teens with epilepsy to the normative mean, and (2) identify which neurologic/epilepsy and social/familial variables are associated with self-esteem. Thirty-seven adolescents (aged 12-18 years) attending a pediatric neurology clinic completed the Piers-Harris 2 Self-Concept Scale, Family Assessment Measure III, Child Attitude to Illness Scale, and a brief questionnaire about current seizure status (frequency, severity, and number of antiepileptic drugs). Neurology clinic charts were reviewed for seizure types, etiology, age at diagnosis, and number of failed therapies. While Total Piers-Harris t score and most subscales did not differ significantly from the normative mean, teens with epilepsy had higher scores on Behavioral Adjustment (P < 0.04) and Physical Appearance and Attributes (P < 0.03). On univariate analysis, number of current antiepileptic drugs (P < 0.05) and Attitude to Illness and Family Function scores (P < 0.02 for both) were significantly associated with self-esteem. On linear regression analysis, only the Family Function score (P < 0.02) and number of antiepileptic drugs (P < 0.05) were associated with total self-concept. We conclude that self-concept in teens with epilepsy is most strongly associated with Family Function. With the exception of current number of antiepileptic drugs used, epilepsy-specific factors are of minimal importance.
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Affiliation(s)
- Arden Lee
- Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Rimmer RB, Fornaciari GM, Foster KN, Bay CR, Wadsworth MM, Wood M, Caruso DM. Impact of a pediatric residential burn camp experience on burn survivors' perceptions of self and attitudes regarding the camp community. J Burn Care Res 2007; 28:334-41. [PMID: 17351455 DOI: 10.1097/bcr.0b013e318031a0f4] [Citation(s) in RCA: 24] [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
Summer camp is reported to be a positive and valuable experience for burn and nonburned children. Objective studies comparing the effectiveness, similarities, and differences of rehabilitative vs recreational camps are limited. The aim of this study, year 1, was to assess the effect of burn camp on self-esteem and integration as reported by burn children via the Rosenberg Self-Esteem Scale and a community integration survey. During year 2, burn campers completed these measures again and their self-esteem and integration scores were compared with a group of nonburn campers. The first year results showed significant improvement in burn camper's self-esteem from the beginning to end of camp and successful integration into the camp community. During year 2, burn surviving children reported significantly lower self-esteem before camp than the comparison group, but after camp, burn children's self-esteem was comparable with that of nonburn campers. White non-Hispanic campers reported more sustained improvement in self-esteem than other ethnic groups. Burn campers reported a high level of integration into the camp across sex, years since burn, years at camp, or ethnicity, scoring slightly higher than the comparison group. Age was positively correlated with integration among the burn, but not the nonburn campers. Helping children deal with their burn injuries through a rehabilitative program such as burn camp appears to provide benefit for child burn survivors.
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Affiliation(s)
- Ruth B Rimmer
- Arizona Burn Center, Maricopa Medical Center, Phoenix, Arizona 85008, USA
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Abstract
Stigma related to chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, mental illness and epilepsy is a global phenomenon with a severe impact on individuals and their families, and on the effectiveness of public health programmes. To compare stigma measurement in different disciplines, a literature review was conducted. References were obtained through a search of literature databases and through examining relevant bibliographies. Sixty-three papers were selected that addressed the issue of measurement of stigma or related constructs and that contained a sample of the instrument or items used. Five unpublished studies were also included in the review. The aspects of health-related stigma used for assessment can be grouped in five categories. First, the experience of actual discrimination and/or participation restrictions on the part of the person affected; second, attitudes towards the people affected; third, perceived or felt stigma; fourth, self or internalized stigma; and fifth, discriminatory and stigmatizing practices in (health) services, legislation, media and educational materials. Within each of these areas, different research methods have been used, including questionnaires, qualitative methods, indicators and scales. The characteristics of the instruments considered most promising are described and compared. The purpose of stigma assessment is to increase our understanding of stigma and its determinants and dynamics, to determine its extent or severity in a given setting or target group and to monitor changes in stigma over time. The conclusions from this review are that (a) the consequences of stigma are remarkably similar in different health conditions, cultures and public health programmes; (b) many instruments have been developed to assess the intensity and qualities of stigma, but often these have been condition-specific; and (c) development of generic instruments to assess health-related stigma may be possible. To achieve this aim, existing instruments should be further validated, developed or adapted for generic use, where possible.
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Affiliation(s)
- Wim H Van Brakel
- Royal Tropical Institute, Leprosy Unit, Amsterdam, The Netherlands.
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Austin JK, Dunn DW, Perkins SM, Shen J. Youth With Epilepsy: Development of a Model of Children's Attitudes Toward Their Condition. CHILDRENS HEALTH CARE 2006; 35:123-140. [PMID: 17075611 PMCID: PMC1627850 DOI: 10.1207/s15326888chc3502_2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A model of children's attitudes toward their epilepsy was tested in 173 children (9-14 years) with epilepsy and their parents. Predictor variables tested were child characteristics, family mastery, child worry, child self-efficacy for seizure management, child psychosocial care needs, and seizure variables. Data were analyzed using structural equation modeling, leading to a revised model in which less child worry, greater family mastery, and greater child seizure self-efficacy were directly related to more child positive attitudes. Discussion focuses on potential targets for psychosocial interventions aimed at improving attitudes toward epilepsy.
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LeBovidge JS, Lavigne JV, Miller ML. Adjustment to chronic arthritis of childhood: the roles of illness-related stress and attitude toward illness. J Pediatr Psychol 2005; 30:273-86. [PMID: 15784923 DOI: 10.1093/jpepsy/jsi037] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine the relationship of psychosocial stress and attitude toward illness to psychological adjustment among youth with chronic arthritis. METHODS Seventy-five youths with chronic arthritis aged 8-18 years were administered a semi-structured interview assessing illness-related and nonillness-related stressors in important life domains. Children also completed measures of attitude toward illness, depressive symptoms, and anxiety. Parents completed a measure of child psychosocial adjustment. RESULTS Higher levels of illness-related and nonillness-related stress were associated with higher levels of anxiety and depressive symptoms and parent-reported adjustment problems, while a more positive attitude toward illness was associated with lower levels of anxiety and depressive symptoms. Attitude toward illness moderated the relationship between stress and depressive symptoms. CONCLUSIONS Results suggest the importance of assessing life stress and attitude toward illness among youth with arthritis and developing interventions to help children cope with arthritis-related stressors and promote a more positive attitude toward illness.
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Räty LKA, Söderfeldt BA, Larsson G, Larsson BMW. The relationship between illness severity, sociodemographic factors, general self-concept, and illness-specific attitude in Swedish adolescents with epilepsy. Seizure 2004; 13:375-82. [PMID: 15276140 DOI: 10.1016/j.seizure.2003.09.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to describe the relationship between the epilepsy condition (illness severity), sociodemographic factors, general self-concept, and illness-specific attitude in adolescents with uncomplicated epilepsy. METHODS Adolescents, aged 13-22, fulfilling criteria registered in four Swedish hospitals, answered questionnaires (n = 149). The instruments "I think I am" and "Sense of coherence" measured the patients' general self-concept. The "Child Attitude Toward Illness Scale" measured illness-specific attitude. A summary score (index) calculated from seizure frequency, seizure type, and antiepileptic drug (AED) with side effects measured "Illness Severity". RESULTS Illness severity was significantly related to the participants' general self-concept, as well as to their attitude toward their condition; i.e. higher illness severity scores were correlated with lower sense of coherence (SOC), poorer self-esteem, and a more negative attitude towards the epilepsy condition. Females had more severe illness according to the Illness Severity Index, with almost 80% found in the moderate and high severity groups as compared to 63% of males in the moderate/high severity groups. CONCLUSIONS It was concluded that the severity of the epilepsy condition was related to the adolescents' general self-concept and illness-specific attitude, but further research is needed to understand the causality of the relationship. The brief assessment of illness severity, constructed and used in this study should be addressed and developed further.
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Affiliation(s)
- Lena K A Räty
- Division for Health and Caring Sciences, Karlstad University, SE-651 88 Karlstad, Sweden.
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Fastenau PS, Shen J, Dunn DW, Perkins SM, Hermann BP, Austin JK. Neuropsychological predictors of academic underachievement in pediatric epilepsy: moderating roles of demographic, seizure, and psychosocial variables. Epilepsia 2004; 45:1261-72. [PMID: 15461681 PMCID: PMC2736953 DOI: 10.1111/j.0013-9580.2004.15204.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Academic underachievement is common in pediatric epilepsy. Attempts to identify seizure and psychosocial risk factors for underachievement have yielded inconsistent findings, raising the possibility that seizure and psychosocial variables play a complex role in combination with other variables such as neuropsychological functioning. This study cross-validated a neuropsychological measurement model for childhood epilepsy, examined the relation between neuropsychological functioning and academic achievement, and tested the degree to which demographic, seizure, and psychosocial variables moderate that relation. METHODS Children with chronic epilepsy (N = 173; ages 8 to 15 years; 49% girls; 91% white/non-Hispanic; 79% one seizure type; 79% taking one medication; 69% with active seizures) completed a comprehensive neuropsychological battery. Children diagnosed with mental retardation were excluded. RESULTS Structural equation modeling identified a three-factor measurement model of neuropsychological function: Verbal/Memory/Executive (VME), Rapid Naming/Working Memory (RN/WM), and Psychomotor (PM). VME and RN/WM were strongly related to reading, math, and writing; PM predicted writing only. Family environment moderated the impact of neuropsychological deficits on writing (p < or = 0.01) and possibly for reading (p = 0.05); neuropsychological deficits had a smaller impact on achievement for children in supportive/organized homes compared with children in unsupportive/disorganized homes. CONCLUSIONS These findings lend partial support for our theoretical model showing direct effects of neuropsychological function on achievement and the moderating role of family factors. This study suggests that a subgroup of children with epilepsy (those who have not only neuropsychological deficits but also disorganized/unsupportive home environments) are particularly at risk for adverse academic outcomes. Implications for intervention are discussed.
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Affiliation(s)
- Philip S Fastenau
- Department of Psychology, Purdue School of Science, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, USA.
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Austin JK, MacLeod J, Dunn DW, Shen J, Perkins SM. Measuring stigma in children with epilepsy and their parents: instrument development and testing. Epilepsy Behav 2004; 5:472-82. [PMID: 15256183 DOI: 10.1016/j.yebeh.2004.04.008] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Accepted: 04/21/2004] [Indexed: 11/18/2022]
Abstract
PURPOSE The goal of this work is to describe psychometric properties of two scales measuring perceived stigma in children with epilepsy and their parents. METHODS Data were collected for the parent scale in two samples: parents of 173 children with epilepsy and of 224 children with new-onset seizures. The child scale was tested in the chronic sample. Content validity, internal consistency reliability, and construct validity were tested. RESULTS Both scales had strong internal consistency reliability and construct validity. Higher scores were associated with greater seizure severity scores. In the parent scale, lower scores were associated with more positive mood, less worry, and more family leisure activities. In the child scale, higher scores were correlated with more negative attitude, greater worry, poorer self-concept, and more depression symptoms. CONCLUSIONS Both scales were found to have strong psychometric properties. They are short, and items are easy to understand. These scales have potential for use in research and in the clinical setting to measure stigma.
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Affiliation(s)
- Joan K Austin
- Indiana University School of Nursing, Indianapolis, IN 46202-5107, USA.
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Caplin D, Austin JK, Dunn DW, Shen J, Perkins S. Development of a Self-Efficacy Scale for Children and Adolescents With Epilepsy. CHILDRENS HEALTH CARE 2002. [DOI: 10.1207/s15326888chc3104_3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sbarra DA, Rimm-Kaufman SE, Pianta RC. The behavioral and emotional correlates of epilepsy in adolescence: a 7-year follow-up study. Epilepsy Behav 2002; 3:358-367. [PMID: 12609334 DOI: 10.1016/s1525-5050(02)00035-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This 7-year follow-up study examined the behavioral and emotional adjustment of 29 adolescents who experienced regular moderate seizures during middle childhood. Compared with national nonreferred norms on Achenbach checklists, both mothers and adolescents reported clinically significant difficulties in multiple areas regardless of current seizure status. Adolescents who currently experience regular seizures (N=10) reported no differences on psychological outcomes compared with nonseizing counterparts; in contrast, current seizure status was a strong predictor of mother-reported externalizing problems. Hierarchical regression analyses indicated that feelings about having or having had a seizure disorder and mother-adolescent relationship factors were significant predictors of current adjustment over and above current seizure status. Early mother-child relationship process variables and early medical risk were not associated with current adolescent outcomes. The findings are discussed in terms of the multidetermined nature of psychological adjustment to chronic medical illness and factors that may produce versus maintain behavioral and emotional problems in children and adolescents with seizure disorders.
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Affiliation(s)
- David A. Sbarra
- Department of Psychology, University of Virginia, 102 Gilmer Hall, P.O. Box 400400, 22904-4400, Charlottesville, VA, USA
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