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Nesser W, Snyder S, Driscoll KA, Modi AC. Factors associated with quality of life for cystic fibrosis family caregivers. DISCOVER MENTAL HEALTH 2023; 3:20. [PMID: 37982907 PMCID: PMC10579194 DOI: 10.1007/s44192-023-00046-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/11/2023] [Indexed: 11/21/2023]
Abstract
Cystic Fibrosis (CF) is a genetic and chronic disease affecting 32,100 people in the United States as of 2021, with a life expectancy of 56 years for people with CF (PwCF) born between 2018 and 2022. While there is extensive literature about cystic fibrosis, there are few studies examining the complexity and challenges experienced by family caregivers for PwCF. The aim of this study was to examine the Caregiver Quality of Life Cystic Fibrosis (CQOLCF) scale using data (N = 217) from two separate studies that used the scale to determine if its items represent multiple factors relevant to CF family caregiver QoL. Factor analysis was conducted on the Seven distinct factors were found with analysis of the CQOLCF. Factors were Existential Dread (12%), Burden (11%), Strain (7%), Support (7%), Positivity (6%), Finance (5%) and Guilt (3%). Study findings indicated it is important for healthcare providers and researchers who use the CQOLCF to be knowledgeable and aware of the multiple factors associated with quality of life in this population in addition to an overall quality of life score.
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Affiliation(s)
- Whitney Nesser
- Department of Applied Clinical and Educational Sciences, Indiana State University, 401 N. 7th Street, Room 302B, Terre Haute, IN, 47809, USA.
| | - Scott Snyder
- School of Education, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kimberly A Driscoll
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Avani C Modi
- Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Glasscoe C, Hope HF, Lancaster GA, McCray G, West K, Patel L, Patel T, Hill J, Quittner AL, Southern KW. Development and preliminary validation of the challenges of living with cystic fibrosis (CLCF) questionnaire: a 46-item measure of treatment burden for parent/carers of children with CF. Psychol Health 2023; 38:1309-1344. [PMID: 35259034 DOI: 10.1080/08870446.2021.2013483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/29/2021] [Accepted: 11/28/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Treatments for cystic fibrosis (CF) are complex, labour-intensive, and perceived as highly burdensome by caregivers of children with CF. An instrument assessing burden of care is needed. DESIGN A stepwise, qualitative design was used to create the CLCF with caregiver focus groups, participant researchers, a multidisciplinary professional panel, and cognitive interviews. MAIN OUTCOME MEASURES Preliminary psychometric analyses evaluated the reliability and convergent validity of the CLCF scores. Cronbach's alpha assessed internal consistency and t-tests examined test-retest reliability. Correlations measured convergence between the Treatment Burden scale of the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and the CLCF. Discriminant validity was assessed by comparing CLCF scores in one vs two-parent families, across ages, and in children with vs without Pseudomonas aeruginosa (PA). RESULTS Six Challenge subscales emerged from the qualitative data and the professional panel constructed a scoresheet estimating the Time and Effort required for treatments. Internal consistency and test-retest reliability were adequate. Good convergence was found between the Total Challenge score and Treatment Burden on the CFQ-R (r=-0.49, p = 0.02, n = 31). A recent PA infection signalled higher Total Challenge for caregivers (F(23)11.72, p = 0.002). CONCLUSIONS The CLCF, developed in partnership with parents/caregivers and CF professionals, is a timely, disease-specific burden measure for clinical research.
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Affiliation(s)
- Claire Glasscoe
- Institute of Translational Medicine, Department of Women's & Children's Health, University of Liverpool, Liverpool, UK
| | - Holly F Hope
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | | | | | - Kiri West
- DMOPS (Movement Disorders), Liverpool University Hospitals NHS Foundation Trust (Aintree site), Liverpool, UK
| | - Latifa Patel
- Respiratory Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Tulsi Patel
- Evelina London Children's Hospital, London, UK
| | - Jonathan Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Kevin W Southern
- Institute of Translational Medicine, Department of Women's & Children's Health, University of Liverpool, Liverpool, UK
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Chung JOK, Li WHC, Ho LLK, Cheung AT. The Association of Resilience with Way of Coping, Psychological Well-Being and Quality of Life in Parents of Children with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105765. [PMID: 37239492 DOI: 10.3390/ijerph20105765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (n = 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (p < 0.001), more depressive symptoms (p < 0.001), and poorer quality of life (p < 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (p < 0.001), fewer depressive symptoms (p < 0.001), and better quality of life (p < 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (p < 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.
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Affiliation(s)
| | - William Ho Cheung Li
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Laurie Long Kwan Ho
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Ankie Tan Cheung
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Abstract
Children who survive the pediatric intensive care unit (PICU) are at risk of developing post-intensive care syndrome in pediatrics (PICS-p). PICS-p, defined as new physical, cognitive, emotional, and/or social health dysfunction following critical illness, can affect the child and family. Historically, synthesizing PICU outcomes research has been challenging due to inconsistency in study design and in outcomes measurement. PICS-p risk may be mitigated by implementing intensive care unit best practices that limit iatrogenic injury and by supporting the resiliency of critically ill children and their families.
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Nesser W, Grace Yi EH, Wotring AJ, Hutchins MD, Snyder S. A Partial Picture, Without a Frame: Measuring Quality of Life in Cystic Fibrosis Caregivers. AMERICAN JOURNAL OF HEALTH EDUCATION 2023. [DOI: 10.1080/19325037.2023.2186984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Neris RR, Bolis LO, Leite ACAB, Alvarenga WDA, Garcia-Vivar C, Nascimento LC. Functioning of structurally diverse families living with adolescents and children with chronic disease: A metasynthesis. J Nurs Scholarsh 2023; 55:413-428. [PMID: 36209360 DOI: 10.1111/jnu.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/15/2022] [Accepted: 09/27/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The diagnosis of children and adolescents with a chronic disease may affect the entire family system. When families have diverse structures, additional tensions can be present and affect the balance of family functioning. This metasynthesis aims to analyze and synthesize qualitative evidence on the functioning of structurally diverse families who live with adolescents and children with chronic disease. DESIGN Qualitative metasynthesis. METHODS Systematic searches up to 2021 were performed in PubMed, CINAHL, PsycINFO, SCOPUS, LILACS, and Web of Science and supplemented by manual search strategies. It followed guidelines from the statement in the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme. Data synthesis was conducted according to the thematic synthesis approach. FINDINGS Of a total of 6538 references identified, 9 studies were included in the metasynthesis. The thematic synthesis enabled the construction of three analytical themes: "Family structural changes and weakened co-parenting"; "Family rearrangements and the challenges faced by families"; and "Committed to healthy family functioning for the child's well-being: Searching for family homeostasis". CONCLUSIONS The themes showed that the causes of the rupture in the family unit interfere in family functioning, making it ineffective. In most families, family functioning is centered on the mothers. Faced with the need to care for children and adolescents and to control chronic disease, structurally diverse families need to adjust their family functioning and search for family homeostasis. CLINICAL RELEVANCE The results of this review can support nurses to target their care toward these families and formulate effective interventions that promote, strengthen, or maintain the healthy functioning of these families.
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Affiliation(s)
- Rhyquelle Rhibna Neris
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Letícia Onelli Bolis
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Andrade Biaggi Leite
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | - Cristina Garcia-Vivar
- Universidad Pública de Navarra, IdiSNA - Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
| | - Lucila Castanheira Nascimento
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Russell LT, Ganong L, Beckmeyer JJ. Understanding and Serving All Families: Introduction to the Special Issue on Supporting Structurally Diverse Families. JOURNAL OF FAMILY NURSING 2022; 28:299-307. [PMID: 36221247 DOI: 10.1177/10748407221131118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Dogan M, Hirschfeld G, Blankenburg M, Frühwald M, Ahnert R, Braun S, Marschall U, Zernikow B, Wager J. A randomized controlled trial on long-term effectiveness of a psychosocial aftercare program following pediatric chronic pain treatment: Who benefits the most? Eur J Pain 2022; 26:1746-1758. [PMID: 35762280 DOI: 10.1002/ejp.1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND For pediatric chronic pain patients, intensive interdisciplinary pain treatment (IIPT) is a well-established treatment. The treatment's short-term effectiveness can be improved by an additive psychosocial aftercare (PAC). However, neither the program's long-term effectiveness nor the patients in particular need have been investigated yet. METHODS This study aimed at determining the long-term effects of PAC and detecting predictors of treatment outcome within a multicenter randomized controlled trial measured at five time points up to twelve months after discharge. At inpatient admission to IIPT, patients (N=419, 14.3 years of age, 72.3% female) were randomly assigned to intervention or control group. After IIPT discharge, the intervention group received PAC, whereas the control group received treatment as usual (TAU). Patient-reported outcomes included pain and emotional characteristics. Clinicians assessed potential psychosocial risk factors and their prognosis of treatment outcome. Statistical analyses included mixed-models and univariable logistic regressions. RESULTS Data at the 12-month follow-up (n=288) showed a significant benefit of PAC compared with TAU; the majority (59.0%) of patients in the PAC-group reported no chronic pain compared to 29.2% of TAU-patients (p<.001). Patients with a single parent specifically benefited from PAC compared to TAU. Clinicians were able to make a reliable prognosis of treatment outcome, but did not successfully predict which patients would benefit the most from PAC. CONCLUSIONS Study results suggest that PAC is highly effective irrespective of patient characteristics, but particularly for patients with single parents. Its broad implementation could help to improve the long-term outcomes of youth with severely disabling chronic pain.
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Affiliation(s)
- Meltem Dogan
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Gerrit Hirschfeld
- Faculty of Business and Health, University of Applied Sciences Bielefeld, Bielefeld, Germany
| | - Markus Blankenburg
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.,Paediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Michael Frühwald
- University Children's Hospital Augsburg, Swabian Children's Pain Center, Augsburg, Germany
| | - Rosemarie Ahnert
- University Children's Hospital Augsburg, Swabian Children's Pain Center, Augsburg, Germany
| | - Sarah Braun
- Paediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany
| | - Ursula Marschall
- Department of Medicine and Health Services Research, BARMER Health Insurance, Wuppertal, Germany
| | - Boris Zernikow
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
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The impact of the depletion, accumulation, and investment of personal resources on work–life balance satisfaction and job retention: A longitudinal study on working mothers. JOURNAL OF VOCATIONAL BEHAVIOR 2021. [DOI: 10.1016/j.jvb.2021.103656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Morone JF, Teitelman AM, Cronholm PF, Hawkes CP, Lipman TH. Influence of social determinants of health barriers to family management of type 1 diabetes in Black single parent families: A mixed methods study. Pediatr Diabetes 2021; 22:1150-1161. [PMID: 34713537 DOI: 10.1111/pedi.13276] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE US disparities in pediatric type 1 diabetes treatment and outcomes are increasing disproportionately among Black youth and compounded for youth from single parent homes. Despite worsened outcomes, Black youth from single parent homes and their caregivers are underrepresented in pediatric type 1 diabetes research. The purpose of this study was to understand the social determinants of health (SDOH) barriers that may contribute to health disparities and family management in Black youth with type 1 diabetes from single parent homes. RESEARCH DESIGN AND METHODS A three-phase mixed methods study with self-identified Black single parents of youth with type 1 diabetes from an urban US pediatric diabetes center was conducted. Focus groups and interviews informed development of a parent-generated survey of SDOH barriers to diabetes management. Survey results are presented. RESULTS A resulting 71 item parent-generated survey was administered to 105 parents. Among all items, most problematic SDOH barriers included lack of social support, managing parent/child diabetes-related stress, difficulties accessing diabetes supplies, pain management, cost of food and diabetes camp, need to take time off from work, lack of skilled school staff, school absences and unsafe neighborhoods. Structural racism related to child welfare reporting, and police targeting were also notable concerns. CONCLUSIONS There is a critical need for clinical, community, and policy-related research and interventions, designed to reduce type 1 diabetes racial health disparities by addressing the impacts of SDOH as drivers of family management outcomes among Black youth from single parent families.
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Affiliation(s)
- Jennifer F Morone
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, Veterans Health Administration, New Haven, Connecticut, USA
| | - Anne M Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Peter F Cronholm
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Colin P Hawkes
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Terri H Lipman
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Willems LM, Schubert-Bast S, Grau J, Hertzberg C, Kurlemann G, Wiemer-Kruel A, Bast T, Bertsche A, Bettendorf U, Fiedler B, Hahn A, Hartmann H, Hornemann F, Immisch I, Jacobs J, Kieslich M, Klein KM, Klotz KA, Kluger G, Knuf M, Mayer T, Marquard K, Meyer S, Muhle H, Müller-Schlüter K, Noda AH, Ruf S, Sauter M, Schlump JU, Syrbe S, Thiels C, Trollmann R, Wilken B, Zöllner JP, Rosenow F, Strzelczyk A. Health-related quality of life in children and adolescents with tuberous sclerosis complex and their caregivers: A multicentre cohort study from Germany. Eur J Paediatr Neurol 2021; 35:111-122. [PMID: 34673401 DOI: 10.1016/j.ejpn.2021.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/17/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to measure health-related quality of life (HRQOL) in children and adolescents with tuberous sclerosis complex (TSC) and quality of life (QOL) and depressive symptoms among caregivers. METHODS Adequate metrics were used to assess HRQOL in children and adolescents with TSC (4-18 years, KINDLR) as well as QOL (EQ-5D) and symptoms of depression (BDI-II) among caregivers. Predictors for reduced HRQOL and depressive symptoms were identified by variance analysis, ordinal regression, and bivariate correlation. RESULTS The mean HRQOL score was 67.9 ± 12.7, and significantly lower values were associated with increasing age, attending special needs education, TSC-associated psychiatric symptoms, and drug-related adverse events. The mean QOL of caregivers was 85.4 ± 15.7, and caregiver's sex, TSC mutation locus, familial TSC clustering, special needs education, degree of disability, care dependency, presence of TSC-associated psychiatric symptoms, and TSC severity were significant predictors of lower QOL. Depressive symptoms were identified in 45.7% of caregivers, associated with female sex of the caregiver, familial TSC clustering, special needs education, and presence of TSC-associated psychiatric symptoms of the child. Multivariate regression analysis revealed adolescence and drug-related adverse events as significant predictors for lower HRQOL in TSC children, and TSC2 variants predicted lower QOL and depressive symptoms in caregivers. CONCLUSION Compared with other chronic diseases, such as headache, diabetes or obesity, children with TSC have significantly lower HRQOL, which further decreases during adolescence. A decreased HRQOL of patients correlates with a lower QOL and increased symptoms of depression of their caregivers. These results may improve the comprehensive therapy and care of children and adolescents with TSC and their families and caregivers. TRIAL REGISTRATION DRKS, DRKS00016045. Registered 01 March 2019, http://www.drks.de/DRKS00016045.
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Affiliation(s)
- Laurent M Willems
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Susanne Schubert-Bast
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany; Department of Neuropediatrics, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Janina Grau
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | | | | | | | - Thomas Bast
- Epilepsy Center Kork, Clinic for Children and Adolescents, Kehl-Kork, Germany
| | - Astrid Bertsche
- Department of Neuropediatrics, University Hospital for Children and Adolescents, Rostock, Germany
| | | | - Barbara Fiedler
- Department of General Pediatrics, Division of Neuropediatrics, University Hospital Münster, Germany
| | - Andreas Hahn
- Department of Neuropediatrics, Justus-Liebig-University Gießen, Gießen, Germany
| | - Hans Hartmann
- Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Frauke Hornemann
- Department of Neuropediatrics, Leipzig University Hospital for Children and Adolescents, Leipzig, Germany
| | - Ilka Immisch
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Julia Jacobs
- Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg i.Br., Germany; Department of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matthias Kieslich
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Department of Neuropediatrics, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Karl Martin Klein
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany; Departments of Clinical Neurosciences, Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kerstin A Klotz
- Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg i.Br., Germany; Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg i.Br., Germany
| | - Gerhard Kluger
- Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Clinic Vogtareuth, Germany; Research Institute, Rehabilitation, Transition and Palliation, PMU Salzburg, Salzburg, Austria
| | - Markus Knuf
- Department of Pediatrics, Klinikum Worms, Worms, Germany; Department of Pediatrics, University Medicine Mainz, Mainz, Germany
| | - Thomas Mayer
- Epilepsy Center Kleinwachau, Dresden-Radeberg, Germany
| | - Klaus Marquard
- Department of Pediatric Neurology, Psychosomatics and Pain management, Klinikum Stuttgart, Stuttgart, Germany
| | - Sascha Meyer
- Department of Neuropediatrics, University Children's Hospital of Saarland, Homburg, Germany
| | - Hiltrud Muhle
- Department of Neuropediatrics, Christian-Albrechts-University Kiel & University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Karen Müller-Schlüter
- Epilepsy Center for Children, University Hospital Neuruppin, Brandenburg Medical School, Neuruppin, Germany
| | - Anna H Noda
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Susanne Ruf
- Department of Neuropediatrics, University Hospital Tübingen, Tübingen, Germany
| | - Matthias Sauter
- Klinikum Kempten, Klinikverbund Allgäu, Kempten/Allgäu, Germany
| | - Jan-Ulrich Schlump
- Department of Neuropediatrics, University of Witten/Herdecke, Herdecke, Germany
| | - Steffen Syrbe
- Division of Pediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Charlotte Thiels
- Department of Neuropediatrics and Social Pediatrics, Ruhr University Bochum, Bochum, Germany
| | - Regina Trollmann
- Department of Neuropediatrics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Bernd Wilken
- Department of Neuropediatrics, Klinikum Kassel, Kassel, Germany
| | - Johann Philipp Zöllner
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany; Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany.
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12
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Quast LF, Williamson Lewis R, Lee JL, Blount RL, Gilleland Marchak J. Psychosocial Functioning Among Caregivers of Childhood Cancer Survivors Following Treatment Completion. J Pediatr Psychol 2021; 46:1238-1248. [PMID: 34363683 DOI: 10.1093/jpepsy/jsab061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To inform efforts to better support caregivers of children with cancer during the transition from treatment to survivorship, this study sought to characterize caregiver mental health-related quality of life (HRQOL) and anxiety, and examine the influence of family psychosocial risk and caregiver problem-solving on these outcomes. METHOD Participants included 124 caregivers (child age M = 10.05 years; SD = 4.78), 12-19 months from the conclusion of cancer-directed treatment. Participants' self-reported mental HRQOL, anxiety, and problem-solving were compared with community norms using t-tests. Correlations and hierarchical multiple regressions examined the influence of psychosocial risk and problem-solving on caregiver mental HRQOL and anxiety. RESULTS Overall, caregivers reported HRQOL and anxiety within normal limits. Caregivers also reported more adaptive patterns of problem-solving than community norms. Subsets of caregivers reported clinical levels of psychosocial risk (11%) and at-risk levels of mental HRQOL (2.5%) and anxiety (5.7%). Females reported greater anxiety than males. Psychosocial risk and negative problem orientation (NPO) were both related to poorer mental HRQOL and greater anxiety (r = .40-.51, p's < .001). Positive problem orientation related to better mental HRQOL and lower anxiety (r = .18-.21, p's < .05). Impulsivity/carelessness and avoidance were associated with greater anxiety (r = .19-.25, p's < .05). Only NPO accounted for additional variance in mental HRQOL and anxiety, over and above psychosocial risk and demographic characteristics. CONCLUSIONS The majority of caregivers appear to be resilient and experience limited distress during the off therapy period. Targeting negative cognitive appraisals (NPO) through cognitive-behavioral therapy or problem-solving skills training may further improve caregiver psychosocial functioning.
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Affiliation(s)
| | | | - Jennifer L Lee
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta.,Emory University School of Medicine.,Evidation Health, Inc
| | | | - Jordan Gilleland Marchak
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta.,Emory University School of Medicine
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13
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Mitchell AE, Morawska A, Vickers-Jones R, Bruce K. A Systematic Review of Parenting Interventions to Support Siblings of Children with a Chronic Health Condition. Clin Child Fam Psychol Rev 2021; 24:651-667. [PMID: 34184174 DOI: 10.1007/s10567-021-00357-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
This systematic review summarises the parenting intervention literature for parents of children who have a sibling with a chronic health condition, and evaluates intervention efficacy for improving parent (parenting skills, parenting efficacy) and child (emotional and behavioural adjustment, condition knowledge, quality of life) outcomes. Electronic databases were searched to identify relevant papers published in English from inception until May 2020. Reference lists of eligible papers were further searched for relevant articles. Six papers (two controlled trials, four uncontrolled trials) evaluating four separate intervention programs met inclusion criteria. All included parent- and child-focused intervention components. Results showed an overall trend for pre- to post-intervention improvement in children's behavioural and emotional adjustment and health condition knowledge. Few studies examined effects on parent outcomes, and there was no evidence of change on these measures. Overall, results suggest that parenting interventions may help to improve siblings' emotional and behavioural adjustment and condition knowledge; however, all of the interventions combined parent- and child-directed intervention components, making it difficult to determine which intervention elements drive change. Further research is needed to test mechanisms by which parenting interventions may improve outcomes for siblings of children with chronic health conditions, and to establish the efficacy of this approach.
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Affiliation(s)
- Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia.
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia
| | - Raine Vickers-Jones
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia
| | - Kathryn Bruce
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia
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Parent and Family Functioning in Pediatric Inflammatory Bowel Disease. CHILDREN-BASEL 2020; 7:children7100188. [PMID: 33080794 PMCID: PMC7603067 DOI: 10.3390/children7100188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/30/2020] [Accepted: 10/08/2020] [Indexed: 12/16/2022]
Abstract
Although the impact of pediatric inflammatory bowel disease (IBD) extends beyond the patient to their parents and families, the focus of previous literature has largely been on investigating the patient’s medical and psychosocial functioning, with less consideration of the family system. Having a comprehensive understanding of parent and family functioning within the context of pediatric IBD is important given the role parents and family members have in the successful management of the disease and caring of the child. The current review paper aggregates the empirical research regarding parent and family functioning, including comparisons to normative samples, other illness groups, and how functioning relates to child psychosocial and health outcomes. Extant literature on parents and families in pediatric IBD has largely focused on the variables of parenting stress, parent psychosocial functioning, parent quality of life, and family functioning. Summary findings elucidate the complex relationships between parents, families, and children affected by IBD and highlight the importance of assessing parent and family functioning within pediatric IBD. The current review also offers implications for clinical practice, notes the limitations of the present literature, and provides recommendations for future research.
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15
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Chung JOK, Li WHC, Cheung AT, Ho LLK, Xia W, Chan GCF, Lopez V. Relationships among resilience, depressive symptoms, self-esteem, and quality of life in children with cancer. Psychooncology 2020; 30:194-201. [PMID: 32916019 DOI: 10.1002/pon.5548] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/16/2020] [Accepted: 09/07/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the interrelationships among resilience, self-esteem, and depressive symptoms and determine whether resilience was a factor associated with quality of life for Hong Kong Chinese children with cancer. METHODS We used a cross-sectional study design. Participants were 138 Hong Kong Chinese children (aged 7-14 years) who were admitted to the pediatric oncology units of an acute public hospital. The resilience, depressive symptoms, self-esteem, and quality of life of participating children were assessed. The primary outcome was the association between resilience and quality of life in children with cancer. RESULTS In total, 72 boys and 66 girls were recruited for this study (mean age 10.6 years). The mean levels of resilience, depressive symptoms, self-esteem, and quality of life were 23.4, 30.0, 23.0, and 63.6, respectively. There was a statistically significant strong positive correlation between resilience and quality of life (r = 0.60, p < 0.01), indicating that greater resilience was associated with better quality of life. Children with cancer from single-parent families, those diagnosed with a brain tumor, and those who received multiple treatments reported significantly lower levels of resilience, self-esteem, and quality of life, and greater depressive symptoms than other children (all p's < 0.001). Results of a multiple regression analysis revealed that resilience (p < 0.001) was a strong factor associated with quality of life among children with cancer. CONCLUSIONS It is essential that healthcare professionals implement interventions to boost the resilience of children with cancer, thereby enhancing their quality of life.
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Affiliation(s)
| | | | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Wei Xia
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, China
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16
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Influence of single parenthood on cardiopulmonary function in pediatric patients with sickle cell anemia. Blood Adv 2020; 4:3311-3314. [PMID: 32706890 DOI: 10.1182/bloodadvances.2020002077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/22/2020] [Indexed: 11/20/2022] Open
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17
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Yarboi J, Prussien KV, Bemis H, Williams E, Watson KH, McNally C, Henry L, King AA, DeBaun MR, Compas BE. Responsive Parenting Behaviors and Cognitive Function in Children With Sickle Cell Disease. J Pediatr Psychol 2019; 44:1234-1243. [PMID: 31579920 PMCID: PMC6823101 DOI: 10.1093/jpepsy/jsz065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Children with sickle cell disease (SCD) are at increased risk for cognitive impairment as a result in part from biological characteristics of the disease; however, limited research has explored possible social and contextual factors associated with risk for cognitive problems. The primary aim of the present study was to examine the relation between children's cognitive functioning and responsive parenting, a potentially important contextual factor in children with SCD, accounting for family socioeconomic disadvantage, child disease severity, and caregivers' perceived stress. METHODS Forty-eight children completed standardized cognitive assessments and caregivers provided self-reports of general and disease-related stress. Parent-child dyads completed a video recorded puzzle-solving task and observed parenting was quantified using two coding systems. Bivariate Pearson correlations were used to assess preliminary hypotheses, and linear multiple regression analyses were used to assess the primary hypothesis. RESULTS Results suggested that increased levels of parental stress were related to fewer observations of responsive parenting and provided evidence of an association between children's cognitive function and responsive parenting. Specifically, increased disease-related parent stress and reduced parental use of expansive language were associated with significantly lower cognitive functioning in children with SCD. CONCLUSIONS Findings suggest that social environmental factors along with disease characteristics are sources of risk for cognitive problems with children with SCD. Further, these findings highlight the need to develop targeted interventions for parents of children with SCD to decrease levels of stress and enhance parenting skills, with the aim improving cognitive functioning in youth.
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Affiliation(s)
- Janet Yarboi
- Department of Psychology of Human Development, Vanderbilt University
| | - Kemar V Prussien
- Department of Psychology of Human Development, Vanderbilt University
| | - Heather Bemis
- Department of Psychology of Human Development, Vanderbilt University
| | - Ellen Williams
- Department of Psychology of Human Development, Vanderbilt University
| | - Kelly H Watson
- Department of Psychology of Human Development, Vanderbilt University
| | - Collen McNally
- Department of Psychology of Human Development, Vanderbilt University
| | - Lauren Henry
- Department of Psychology of Human Development, Vanderbilt University
| | - Allison A King
- Department of Pediatrics, Washington University School of Medicine
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt University School of Medicine
| | - Bruce E Compas
- Department of Psychology of Human Development, Vanderbilt University
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18
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Hebert D, Geisthardt C, Hoffman H. Insights and Recommendations From Parents Receiving a Diagnosis of Pediatric Multiple Sclerosis for Their Child. J Child Neurol 2019; 34:464-471. [PMID: 31012369 DOI: 10.1177/0883073819842420] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Forty-two parents of 41 children reported on their experiences receiving a diagnosis of pediatric-onset multiple sclerosis for their child through semistructured phone interviews. Time to diagnosis ranged from 8 hours to 16 years, with the mean age at diagnosis of 13.7 years. The most common initial symptoms included visual disturbances and numbness. The mean number of medical visits to receive a diagnosis was 3.6. Parents reported feeling frustrated and overwhelmed during the diagnosis process, as well as shocked when told their child had multiple sclerosis. Parents emphasized the need for more awareness of pediatric-onset multiple sclerosis. Numerous parents reported encountering physicians who believed multiple sclerosis did not occur in childhood, contributing to a longer time to diagnosis. Parents preferred physicians first share the diagnosis with the parents without the child present. Finally, parents appreciated when physicians provided a variety of resources to help them cope with the diagnosis.
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Affiliation(s)
- Danielle Hebert
- 1 Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Cheryl Geisthardt
- 2 College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
| | - Holly Hoffman
- 2 College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
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19
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Rafferty KA, Hutton K, Heller S. "I Will Communicate With You, But Let Me Be In Control": Understanding How Parents Manage Private Information About Their Chronically Ill Children. HEALTH COMMUNICATION 2019; 34:100-109. [PMID: 29072494 DOI: 10.1080/10410236.2017.1384432] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Parents have a significant role in the management of a child's chronic condition. Parents are often the only consistent individuals managing a child's health across his or her childhood and adolescence (e.g., present for all appointments and medical procedures). Many of the responsibilities required of parents involve communication work, where parents must strategically and actively design messages as they interact with medical professionals, other family, and friends. Using communication privacy management theory, we analyzed interviews conducted with 35 parents to understand the motivations and strategies involved in their regulation of information about their child's chronic condition. These findings have important practical implications because parental involvement in a chronically ill child's care has direct effects on familial adaptation and adjustment.
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Affiliation(s)
- Katherine A Rafferty
- a Department of Psychology, Communication Studies Program , Iowa State University
| | - Kara Hutton
- a Department of Psychology, Communication Studies Program , Iowa State University
| | - Sarah Heller
- a Department of Psychology, Communication Studies Program , Iowa State University
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20
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Battles H, Bedoya SZ, Pao M, Mullins LL, Wiener L. Caring for a child with cancer: The experience of the "lone" parent, and why it matters. Psychooncology 2018; 27:2869-2872. [PMID: 30161277 DOI: 10.1002/pon.4871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/21/2018] [Accepted: 08/10/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Haven Battles
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sima Zadeh Bedoya
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Maryland Pao
- National Institute of Mental Health, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Lori Wiener
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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21
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Kobylianskii A, Jegathesan T, Young E, Fung K, Huber J, Minhas RS. Experiences of Inner-City Fathers of Children With Chronic Illness. Clin Pediatr (Phila) 2018; 57:792-801. [PMID: 28969464 DOI: 10.1177/0009922817734361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aim to explore the experiences of fathers from inner-city families caring for children affected by chronic health conditions or disabilities. A systematic scoping review was conducted using the Arskey and O'Malley framework. Fourteen of the 5114 articles were included in the full review and were qualitatively evaluated in terms of stressors, resources, perception, coping, and adaptation according to the Double ABCX model. Stressors included financial strain and health care access barriers. Resources ranging from immediate to extended family members depended on ethnicity. Fathers' perceptions of their primary caregiver roles depended on ethnicity in the context of cultural gender norms. While inner-city fathers desired information about their children's health, some were uncomfortable asking physicians. They had a higher risk for coping difficulties and maladaptation, including depression. We highlight a need for pediatricians to advocate for additional resources to provide comprehensive care for inner-city fathers caring for their children with chronic health conditions or disabilities.
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Affiliation(s)
- Anna Kobylianskii
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Thivia Jegathesan
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Elizabeth Young
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Kimmy Fung
- 2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Joelene Huber
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada.,3 The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ripudaman S Minhas
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
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22
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Psychosocial implications of disorders of sex development treatment for parents. Curr Opin Urol 2018; 27:11-13. [PMID: 27584026 DOI: 10.1097/mou.0000000000000344] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Historically, studies of caregivers of children with disorders of sex development (DSD) have been limited. RECENT FINDINGS Recent data reveal that parents of young children with DSD report increased stress, anxiety, depression, and decreased quality of life in ways that are similar to parents of children with other types of chronic illnesses. Also similar to other chronic illnesses of childhood, parents of children with DSD exhibit overprotective parenting and perceive their child as being vulnerable. These emotions and behaviors exhibited by parents are concerning as they may limit an affected child's emotional and social development over time. Perhaps, more unique to the situation of DSD is the perceived, or real, child-focused stigma experienced by parents of children with DSD. SUMMARY Interventions to improve parents' psychosocial adaptation to their child's medical condition, including coaching in how to discuss their child's condition in a manner that makes them feel safe and supported, are needed to optimize outcomes for families.
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Russell LT, Beckmeyer JJ, Su-Russell C. Family-Centered Care and Positive Developmental Outcomes for Youth With Special Health Care Needs: Variations Across Family Structures. JOURNAL OF FAMILY NURSING 2018; 24:29-59. [PMID: 29318920 DOI: 10.1177/1074840717745520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Drawing on a social determinants of health framework, we evaluated associations between perceived family-centered care (FCC) and positive developmental outcomes for youth with special health care needs across six different family structures (married biological families, cohabiting biological families, married stepfamilies, cohabiting stepfamilies, divorced/separated single-mother families, and never-married single-mother families). Using data from the 2011-2012 National Survey of Children's Health, we found that married biological families perceive greater FCC than do other family structures. Perceived FCC was positively associated with all three positive youth outcomes evaluated (children's health, participation in extracurricular activities, and flourishing) in married biological families, and two of the three outcomes (children's health and flourishing) in married stepfamilies and divorced/separated single-mother families. Implications for health care provision and future research with structurally diverse families are discussed.
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24
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Cortes A, Castillo A, Sciaraffia A. Food allergy: Children's symptom levels are associated with mothers' psycho-socio-economic variables. J Psychosom Res 2018; 104:48-54. [PMID: 29275785 DOI: 10.1016/j.jpsychores.2017.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/13/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Allergies affect children's health as well as their quality of life, stress levels, and family budget. The available literature suggests that family, social and psychological factors are affected by allergic pathologies such as rhinitis, asthma and atopic dermatitis. However, few studies have focused on quantifying such association in child food allergy. This study aims to enhance the understanding of the associations between caregiver variables and children's Food Allergy (FA). METHODS The study involved 206 participants: 103 mothers plus 103 children with IgE mediated FA. The analyses excluded two outliers comprising 101 subjects. For statistical analyses, each dyad -mother/child- was considered to be one subject unity. A between-subjects one-way ANOVA determined the association of children's cutaneous, gastric and respiratory symptoms with anxiety, depression, perceived social support and socioeconomic factors in the mothers. RESULTS There are significant associations between children's allergic symptoms (gastric and cutaneous) and mothers' psychological state (anxiety and depression); family budget; social interactions (with friends, family and partner); understanding of health care required by their child; and sleep disorders. Respiratory symptoms did not show any significant associations with the dependent variables. CONCLUSION FA is a process in which children's symptoms are significantly associated with socioeconomic and psychological variables of the mothers. The presence or absence of some specific symptoms is directly associated with specific impacts on the mothers. An understanding of such dynamics supports the consideration of a comprehensive and multidisciplinary therapeutic approach to offer more ecological healthcare for "families living with FA."
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Affiliation(s)
- Aaron Cortes
- Departamento de Traumatología, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - Angela Castillo
- Sección de Medicina, Hospital Carlos Van Buren, Valparaiso, Chile
| | - Alicia Sciaraffia
- Sección de Inmunología, VIH y Alergias, Hospital Clínico Universidad de Chile, Santiago, Chile
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25
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Wallenwein A, Schwarz M, Goldbeck L. Quality of life among German parents of children with cystic fibrosis: the effects of being a single caregiver. Qual Life Res 2017; 26:3289-3296. [DOI: 10.1007/s11136-017-1662-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
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26
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de Freitas C, dos Reis V, Silva S, Videira PA, Morava E, Jaeken J. Public and patient involvement in needs assessment and social innovation: a people-centred approach to care and research for congenital disorders of glycosylation. BMC Health Serv Res 2017; 17:682. [PMID: 28950866 PMCID: PMC5615629 DOI: 10.1186/s12913-017-2625-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/18/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Public and patient involvement in the design of people-centred care and research is vital for communities whose needs are underserved, as are people with rare diseases. Innovations devised collectively by patients, caregivers, professionals and other members of the public can foster transformative change toward more responsive services and research. However, attempts to involve lay and professional stakeholders in devising community-framed strategies to address the unmet needs of rare diseases are lacking. In this study, we engaged with the community of Congenital Disorders of Glycosylation (CDG) to assess its needs and elicit social innovations to promote people-centred care and research. METHODS Drawing on a qualitative study, we conducted three think tanks in France with a total of 48 participants, including patients/family members (n = 18), health care professionals (n = 7), researchers (n = 7) and people combining several of these roles (n = 16). Participants came from 20 countries across five continents. They were selected from the registry of the Second World Conference on CDG through heterogeneity and simple random sampling. Inductive and deductive approaches were employed to conduct interpretational analysis using open, axial and selective coding, and the constant-comparison method to facilitate the emergence of categories and core themes. RESULTS The CDG community has unmet needs for information, quality health care, psychosocial support and representation in decision-making concerned with care and research. According to participants, these needs can be addressed through a range of social innovations, including peer-support communities, web-based information resources and a CDG expertise platform. CONCLUSION This is one of the few studies to engage lay and professional experts in needs assessment and innovation for CDG at a global level. Implementing the innovations proposed by the CDG community is likely to have ethical, legal and social implications associated with the potential donation of patients' clinical and biological material that need to be assessed and regulated with involvement from all stakeholders. To promote people-centred care for the CDG community, and increase its participation in the governance of care and research, it is necessary to create participatory spaces in which the views of people affected by CDG can be fully expressed.
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Affiliation(s)
- Cláudia de Freitas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Institutional address 1: Rua das Taipas 135, 4050-600, Porto, Portugal
- Centre for Research and Studies in Sociology - University Institute of Lisbon, Porto, Portugal
- Institutional address 2: Avenida das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Vanessa dos Reis
- Founder of the Portuguese Association for CDG (APCDG), Porto, Portugal
- Institutional address: Rua Manuel da Fonseca 46, 2820-389, Almada, Portugal
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Institutional address 1: Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Paula A. Videira
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisbon, Portugal
- Institutional address: Glycoimmunology group Lab 3.19 - Departamento Ciências da Vida (Ed Departamental), Faculdade de Ciências e Tecnologia, 2829-516 Caparica, Portugal
| | - Eva Morava
- School of Medicine, Tulane University, New Orleans, USA
- Institutional address: Hayward Genetics Center SL#31, Tulane University Medical School, 1430 Tulane Ave, New Orleans, LA 70112 USA
| | - Jaak Jaeken
- Department of Pediatrics, Center for Metabolic Disease, University Hospital Gasthuisberg, Leuven, Belgium
- Institutional Address: Herestraat 49, 3000, Leuven, Belgium
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Wiener L, Battles H, Bedoya SZ, Baldwin A, Widemann BC, Pao M. Identifying Symptoms of Distress in Youth Living with Neurofibromatosis Type 1 (NF1). J Genet Couns 2017; 27:115-123. [PMID: 28735371 DOI: 10.1007/s10897-017-0128-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/30/2017] [Indexed: 12/20/2022]
Abstract
Children and adolescents with Neurofibromatosis type 1 (NF1) are at increased risk for wide-ranging behavioral, developmental, and cognitive impairments and decreased quality of life. To date, no psychosocial screening tool has been developed to quickly assess the symptoms that 1) can be addressed during routine medical appointments in children with NF1, 2) can produce interpretable and actionable results, 3) can be integrated into medical care, and 4) can quickly identify patients at risk in order to better address that the provision of appropriate care are available. This study was conducted to test the overall usability of the Distress Thermometer (DT) and symptom checklist and concordance of DT ratings between pediatric patients, their caregivers and medical providers. Eighty youth (ages 7-21) living with NF1 completed the DT and an accompanying checklist. The findings of this study suggest the DT and symptom checklist was acceptable and feasible to complete in a clinic setting. A small subset reported high distress that required further assessment and intervention. Significant discordance between distress ratings of caregivers and children and healthcare providers was also found. Overall, the DT and accompanying symptom checklist provide important information to identify the presence of distress and contextualize the child's distress but is limited by not assessing whether these symptoms interfere with the child's daily life.
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Affiliation(s)
- Lori Wiener
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Pediatric Oncology Branch, 10 Center Drive, Room 1-6466, Bethesda, MD, 20892, USA.
| | - Haven Battles
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Pediatric Oncology Branch, 10 Center Drive, Room 1-6466, Bethesda, MD, 20892, USA
| | - Sima Zadeh Bedoya
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Pediatric Oncology Branch, 10 Center Drive, Room 1-6466, Bethesda, MD, 20892, USA
| | - Andrea Baldwin
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Pediatric Oncology Branch, 10 Center Drive, Room 1-6466, Bethesda, MD, 20892, USA
| | - Brigitte C Widemann
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Pediatric Oncology Branch, 10 Center Drive, Room 1-6466, Bethesda, MD, 20892, USA
| | - Maryland Pao
- National Institute of Mental Health, Office of the Clinical Director, Bethesda, MD, USA
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McAuliffe T, Cordier R, Vaz S, Thomas Y, Falkmer T. Quality of Life, Coping Styles, Stress Levels, and Time Use in Mothers of Children with Autism Spectrum Disorders: Comparing Single Versus Coupled Households. J Autism Dev Disord 2017; 47:3189-3203. [DOI: 10.1007/s10803-017-3240-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Nieuwesteeg A, Hartman E, Emons W, van Bakel H, Aanstoot HJ, van Mil E, Pouwer F. Paediatric parenting stress in fathers and mothers of young children with Type 1 diabetes: a longitudinal study. Diabet Med 2017; 34:821-827. [PMID: 27973688 DOI: 10.1111/dme.13300] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/27/2016] [Accepted: 12/08/2016] [Indexed: 01/02/2023]
Abstract
AIM To compare levels of paediatric parenting stress in the fathers and mothers of young children with Type 1 diabetes and study the variation in this stress over time. METHODS One hundred and twelve parents (56 mothers and 56 fathers) of young children (0-7 years) with Type 1 diabetes participated in this study. They completed the Pediatric Inventory for Parents to assess paediatric parenting stress (frequency and difficulty scores on the Communication, Emotional Distress, Medical Care and Role Functioning subscales and Total Score); 44 mothers (79%) and 31 fathers (55%) completed the questionnaire again, 1 year later. Independent and paired sample t-tests were used to examine the differences between fathers and mothers and the changes over time. Cohen's d effect sizes were also calculated. RESULTS Mothers scored significantly higher than fathers on the stress subscales for Communication frequency and difficulty, Emotional Distress frequency and difficulty, Medical Care frequency and Total Score frequency and difficulty (d ranged from -0.44 to -0.56). Furthermore, fathers reported a decrease in Medical Care frequency (d = 0.10) and an increase in Emotional Distress difficulty (d = -0.32) and Total Score difficulty (d = -0.29), whereas mothers reported a decrease in Emotional Distress frequency, Medical Care frequency and Total Score frequency (d ranged from 0.31 to 0.66) over a 1-year period. CONCLUSIONS These results show that within families with a young child with Type 1 diabetes, the burden of care increases in fathers and decreases in mothers, suggesting that fathers assume more responsibility for care of their child with Type 1 diabetes as the child grows.
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Affiliation(s)
- A Nieuwesteeg
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E Hartman
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - W Emons
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - H van Bakel
- Department of Tranzo, Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands
| | | | - E van Mil
- Kidz&Ko, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands
| | - F Pouwer
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Yarboi J, Compas BE, Brody GH, White D, Patterson JR, Ziara K, King A. Association of social-environmental factors with cognitive function in children with sickle cell disease. Child Neuropsychol 2017; 23:343-360. [PMID: 26568287 PMCID: PMC4867297 DOI: 10.1080/09297049.2015.1111318] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to examine the relationship between cognitive function in pediatric sickle cell disease (SCD) patients and mothers' reports of social-environmental stress, depressive symptoms, and parenting. A total of 65 children with SCD completed comprehensive neuropsychological testing to assess several domains of cognitive functioning, including general intellectual ability, academic achievement, and executive function. Mothers reported on demographics, social-environmental stress, depressive symptoms, and parenting. As predicted, children with SCD significantly underperformed relative to normative data on measures of cognitive function. Associations between maternal social-environmental stress, maternal depressive symptoms, and parenting were mixed. The results show partial support for the hypothesis that greater stress and depressive symptoms and less positive parenting are associated with poorer cognitive function in children with SCD. Linear regression analyses showed that maternal financial stress was the strongest predictor across all domains of cognitive function. The findings replicate and extend past research, reaffirming that children with SCD are at risk for cognitive impairment across multiple domains. Additionally, social-environmental stress, particularly financial strain, is linked to mothers' depressive symptoms and parenting behaviors as well as children's cognitive function. Future studies using direct observations of parenting behaviors are needed. These findings, along with recent research on parenting interventions, may inform the development of concrete, teachable parenting and coping skills to improve cognitive functioning in children with SCD.
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Affiliation(s)
- Janet Yarboi
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - Bruce E. Compas
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - Gene H. Brody
- Department of Child & Family Development and Center for Family Research, University of Georgia, Athens, GA, USA
| | - Desiree White
- Department of Pediatric Hematology & Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jenny Rees Patterson
- Department of Pediatric Hematology & Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kristen Ziara
- Department of Pediatric Hematology & Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Allison King
- Department of Pediatric Hematology & Oncology, Washington University School of Medicine, St. Louis, MO, USA
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Acri M, Zhang S, Adler JG, Gopalan G. Peer-Delivered Models for Caregivers of Children and Adults with Health Conditions: A Review. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 25:337-344. [PMID: 28785158 PMCID: PMC5543992 DOI: 10.1007/s10826-016-0616-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Peer-delivered health models may hold important benefits for family members, yet their prevalence, components, and outcomes are unknown. We conducted a review of peer-delivered services for families of children and adults with serious health problems. Studies of interventions published between 2000 and 2016 were included if the intervention contained a component for family members. Of 88 studies that were assessed for their eligibility, five met criteria. Familial components included information about the health condition and management, strategies to enhance communication and stress, and the provision of emotional support. Outcomes were largely favorable, including reductions in distress and symptoms of trauma, enhanced quality of life, and positive perceptions of the peer therapeutic alliance. Peer-delivered services for family members may hold important benefits to caregivers; however, the research base remains thin. A research agenda to develop and examine these models is discussed.
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Affiliation(s)
- Mary Acri
- New York University Medical Center, The McSilver Institute for Poverty, Policy, and Research
| | - Shirley Zhang
- The McSilver Institute for Poverty, Policy, and Research
| | - Joshua G Adler
- 17 Steinhardt School of Culture, Education, and Human Development
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Peeters B, Vriesman MH, Koppen IJN, van Dijk M, Grootenhuis MA, Di Lorenzo C, Benninga MA. Parental characteristics and functional constipation in children: a cross-sectional cohort study. BMJ Paediatr Open 2017; 1:e000100. [PMID: 29637129 PMCID: PMC5862187 DOI: 10.1136/bmjpo-2017-000100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/18/2017] [Accepted: 10/03/2017] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To evaluate personality, psychological health, physical health and childrearing practices in mothers and fathers of children with functional constipation (FC) compared with mothers and fathers of healthy controls. DESIGN Cross-sectional cohort study. SETTING Outpatient paediatric gastroenterology clinic at a tertiary hospital in the Netherlands. PATIENTS Parents of children (4-16 years) presenting with FC were included between January 2010 and August 2012. Participating parents were asked to recruit parents of another child of the same age without FC as their own controls. Data of 116 mothers and 115 fathers of 127 children with FC, and 84 mothers and 73 fathers of 91 children without FC were collected. MAIN OUTCOME MEASURES Parental characteristics were evaluated by using the NEO Five-Factor Inventory to assess personality, the Brief Symptom Inventory and Physical Symptom Checklist to assess psychological and physical health and the Ghent Parental Behavior Scale to assess childrearing practices. RESULTS Mothers of constipated children had significant higher scores on the neuroticism personality factor and reported higher rates of overall psychological distress and depression. Both mothers and fathers of children with FC reported significant more physical symptoms than parents of children without FC. Mothers of children with FC showed more positive childrearing practices compared with controls. CONCLUSIONS Personality, psychological and physical health, and childrearing practices differ significantly between parents of children with FC and parents of control subjects. Parental factors should be taken into account when evaluating children with FC.
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Affiliation(s)
- Babette Peeters
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Mana H Vriesman
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Ilan J N Koppen
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Marieke van Dijk
- Department of Psychology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital/Academic Medical Center, Amsterdam, North Holland, The Netherlands
| | - Carlo Di Lorenzo
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
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Toly VB, Blanchette JE, Musil CM, Zauszniewski JA. Journaling as reinforcement for the resourcefulness training intervention in mothers of technology-dependent children. Appl Nurs Res 2016; 32:269-274. [PMID: 27969041 DOI: 10.1016/j.apnr.2016.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/12/2016] [Accepted: 08/14/2016] [Indexed: 10/21/2022]
Abstract
Resourcefulness, a set of cognitive and behavioral skills used to attain, maintain, or regain health, is a factor related to depressive symptoms in mothers of children with chronic conditions and complex care needs who are dependent on medical technology such as mechanical ventilation or feeding tubes. The purpose of this secondary analysis of a randomized, controlled pilot intervention study was to determine the feasibility, acceptability and fidelity of daily journal writing as a method of reinforcement of resourcefulness training (RT) that teaches the use of social and personal resourcefulness skills. Participants returned their journals to the study office at the end of the four-week journaling exercise. Content analysis from exit interviews and journals supported the feasibility, acceptability and fidelity of daily journaling for reinforcement of RT in this population. Journal writing can be used by pediatric nurses to reinforce and promote resourcefulness skill use in parents of technology-dependent children.
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Affiliation(s)
- Valerie Boebel Toly
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA, 44106.
| | - Julia E Blanchette
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA, 44106.
| | - Carol M Musil
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA, 44106.
| | - Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA, 44106.
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Russell LT, Coleman M, Ganong LH, Gayer D. Divorce and Childhood Chronic Illness: A Grounded Theory of Trust, Gender, and Third-Party Care Providers. JOURNAL OF FAMILY NURSING 2016; 22:252-278. [PMID: 27021310 DOI: 10.1177/1074840716639909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Divorced parents face distinct challenges in providing care for chronically ill children. Children's residence in two households necessitates the development of family-specific strategies to ensure coparents' supervision of regimen adherence and the management of children's health care. Utilizing a risk and resilience perspective, a grounded theory study was conducted with 14 divorced parents of children with chronic illnesses. The importance of trust, gender, and relationships with third-party care providers emerged as key themes related to the development of effective coparenting relationships for maintaining children's health. Divorced parents were best able to support the management of their children's chronic conditions when care providers operated as neutral third parties and intermediaries. Collaborative family care may require health care practitioners to avoid being drawn into contentious inter-parental conflicts.
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Brigham EL, Goldenberg L, Stolfi A, Mueller GA, Forbis SG. Associations Between Parental Health Literacy, Use of Asthma Management Plans, and Child's Asthma Control. Clin Pediatr (Phila) 2016; 55:111-7. [PMID: 25994320 DOI: 10.1177/0009922815587089] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND There are some studies demonstrating the effectiveness of the provision of written asthma action plans in improving asthma outcomes. There exist little data on the ability of parents to use these plans to make asthma care decisions. OBJECTIVE To assess the associations between parental health literacy (HL), parental ability to use a written asthma management plan (WAMP), and child's asthma control. METHODS Parents completed a survey with questions related to WAMPs and child's asthma, a HL screening tool, and 5 asthma vignettes. For vignettes, parents identified asthma control zone and then made decisions about asthma management. WAMP scores were totaled (0-32) and converted to a percent correct score. Associations between parental HL, WAMP scores, child's asthma control, and demographics were determined with independent t tests or 1-way analysis of variance, and chi-square tests. Variables significantly associated with WAMP scores or asthma control were included in multiple logistic regression or multiple linear regression analyses. RESULTS A total of 176 surveys were included; the mean ± SD WAMP score was 58.9% ± 22.2%, and 25% of respondents had limited HL. Of respondents' children, 38% had not well/poorly controlled asthma. In multiple regression analysis controlling for education level, limited HL was significantly associated with WAMP score (b = 11.3, standard error 3.8, P = .004). WAMP score was not associated with asthma control. Limited HL was associated with poor asthma control in univariate analysis, but not in a logistic regression model controlling for other significant variables. Only unmarried marital status (adjusted odds ratio 4.4, 95% CI 1.8-10.8, P = .001) was associated with asthma control. CONCLUSION HL is associated with parental ability to use WAMPs to respond to asthma scenarios. Parental HL may play a role in parents' ability to appropriately use WAMPs.
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Affiliation(s)
- Erin L Brigham
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | | | - Adrienne Stolfi
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Gary A Mueller
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Shalini G Forbis
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
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Jelenova D, Prasko J, Ociskova M, Latalova K, Karaskova E, Hruby R, Kamaradova D, Mihal V. Quality of life and parental styles assessed by adolescents suffering from inflammatory bowel diseases and their parents. Neuropsychiatr Dis Treat 2016; 12:665-72. [PMID: 27042077 PMCID: PMC4809331 DOI: 10.2147/ndt.s104260] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Inflammatory bowel diseases (IBDs) in adolescents are chronic medical conditions with a substantial influence on the quality of life (QoL) of the families. METHODS A total of 27 adolescents suffering from IBD, 39 healthy adolescents, and their parents were included in the cross-sectional study. The adolescents completed the questionnaires ADOR (parenting styles), KidScreen-10 (QoL), SAD (The Scale of Anxiety in Children), and CDI (Children's Depression Inventory). The parents completed the BAI (Beck Anxiety Inventory), BDI-II (Beck Depression Inventory, second version), and PedsQL (Pediatrics Quality of Life) Family Impact Module. RESULTS The parental styles of the parents of the IBD adolescents and controls were without significant differences. The only exception was that fathers' positive parental style was significantly higher in the fathers of the controls. There were no statistically significant differences between the IBD children and controls in the QoL assessed using KidScreen-10. However, the QoL of the parents of the ill children was significantly lower than that of the parents of the controls (PedsQL total scores in mothers 66.84±14.78 vs 76.17±14.65 and in fathers 68.86±16.35 vs 81.74±12.89, respectively). The mothers of the IBD adolescents were significantly more anxious (BAI scores 9.50±10.38 vs 5.26±4.75) and the fathers more depressed (BDI-II scores 7.23±6.50 vs 3.64±3.51) than the parents of the controls, but there was no difference in the levels of anxiety or depression between the IBD adolescents and the controls. The positive parental style of both the parents of the children suffering from IBD positively correlated with the QoL of the adolescents evaluated by KidScreen-10. The positive parental style of the fathers negatively correlated with the children's state and trait anxiety and negatively correlated with the severity of childhood depression. CONCLUSION The fathers of the IBD adolescents may exhibit low levels of positive parenting style and be mildly depressed, and the mothers tend to exhibit higher levels of anxiety.
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Affiliation(s)
- Daniela Jelenova
- Department of Psychiatry, Palacký University, University Hospital, Olomouc, Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Palacký University, University Hospital, Olomouc, Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Palacký University, University Hospital, Olomouc, Czech Republic
| | - Klara Latalova
- Department of Psychiatry, Palacký University, University Hospital, Olomouc, Czech Republic
| | - Eva Karaskova
- Department of Pediatrics, Faculty of Medicine and Dentistry, Palacký University, University Hospital, Olomouc, Czech Republic
| | | | - Dana Kamaradova
- Department of Psychiatry, Palacký University, University Hospital, Olomouc, Czech Republic
| | - Vladimir Mihal
- Department of Pediatrics, Faculty of Medicine and Dentistry, Palacký University, University Hospital, Olomouc, Czech Republic
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Wiener L, Viola A, Kearney J, Mullins LL, Sherman-Bien S, Zadeh S, Farkas-Patenaude A, Pao M. Impact of Caregiving for a Child With Cancer on Parental Health Behaviors, Relationship Quality, and Spiritual Faith: Do Lone Parents Fare Worse? J Pediatr Oncol Nurs 2015; 33:378-86. [PMID: 26668211 DOI: 10.1177/1043454215616610] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Caregiving stress has been associated with changes in the psychological and physical health of parents of children with cancer, including both partnered and single parents. While parents who indicate "single" on a demographic checklist are typically designated as single parents, a parent can be legally single and still have considerable support caring for an ill child. Correspondingly, an individual can be married/partnered and feel alone when caring for a child with serious illness. In the current study, we report the results from our exploratory analyses of parent self-reports of behavior changes during their child's treatment. Parents (N = 263) of children diagnosed with cancer were enrolled at 10 cancer centers. Parents reported significant worsening of all their own health behaviors surveyed, including poorer diet and nutrition, decreased physical activity, and less time spent engaged in enjoyable activities 6 to 18 months following their child's diagnosis. More partnered parents found support from friends increased or stayed the same since their child's diagnosis, whereas a higher proportion of lone parents reported relationships with friends getting worse. More lone parents reported that the quality of their relationship with the ill child's siblings had gotten worse since their child's diagnosis. Spiritual faith increased for all parents.
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Affiliation(s)
- Lori Wiener
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Adrienne Viola
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA Rutgers Robert Wood Johnson Medical School, Newark, NJ, USA
| | - Julia Kearney
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Sima Zadeh
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | | | - Maryland Pao
- National Institute of Mental Health, Bethesda, MD, USA
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Kazak AE, Abrams AN, Banks J, Christofferson J, DiDonato S, Grootenhuis MA, Kabour M, Madan-Swain A, Patel SK, Zadeh S, Kupst MJ. Psychosocial Assessment as a Standard of Care in Pediatric Cancer. Pediatr Blood Cancer 2015; 62 Suppl 5:S426-59. [PMID: 26700916 DOI: 10.1002/pbc.25730] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/03/2015] [Indexed: 12/22/2022]
Abstract
This paper presents the evidence for a standard of care for psychosocial assessment in pediatric cancer. An interdisciplinary group of investigators utilized EBSCO, PubMed, PsycINFO, Ovid, and Google Scholar search databases, focusing on five areas: youth/family psychosocial adjustment, family resources, family/social support, previous history/premorbid functioning, and family structure/function. Descriptive quantitative studies, systematic reviews, and meta-analyses (n = 149) were reviewed and evaluated using grading of recommendations, assessment development, and evaluation (GRADE) criteria. There is high quality evidence to support a strong recommendation for multifaceted, systematic assessments of psychosocial health care needs of youth with cancer and their families as a standard of care in pediatric oncology.
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Affiliation(s)
- Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, Delaware.,Center for Pediatric Traumatic Stress, Nemours Children's Health System, Wilmington, Delaware.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Annah N Abrams
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Jennifer Christofferson
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, Delaware.,Center for Pediatric Traumatic Stress, Nemours Children's Health System, Wilmington, Delaware
| | - Stephen DiDonato
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, Delaware.,Center for Pediatric Traumatic Stress, Nemours Children's Health System, Wilmington, Delaware
| | | | | | - Avi Madan-Swain
- University of Alabama Birmingham at Children's of Alabama, Birmingham, Alabama
| | - Sunita K Patel
- City of Hope Medical Center and Beckman Research Institute, Duarte, California
| | - Sima Zadeh
- National Cancer Institute Pediatric Oncology Branch, Bethesda, Maryland
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Crerand CE, Rosenberg J, Magee L, Stein MB, Wilson-Genderson M, Broder HL. Parent-Reported Family Functioning Among Children With Cleft Lip/Palate. Cleft Palate Craniofac J 2015; 52:651-9. [PMID: 25405543 PMCID: PMC4436087 DOI: 10.1597/14-050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To examine family functioning related to sociodemographic and clinical characteristics in youth with cleft lip and/or palate (CL/P). DESIGN Cross-sectional, multi-site investigation. SETTING Six U.S. cleft centers. PATIENTS/PARTICIPANTS A diverse sample of 1200 children with CL/P and their parents. MAIN OUTCOME MEASURE Parents completed the Family Environment Scale (FES), which assesses three domains of family functioning: cohesion (or closeness), expressiveness (open expression of feelings), and conflict. Demographic and clinical characteristics were also assessed including race, ethnicity, type of insurance, and surgical recommendations. RESULTS The FES scores for families seeking team evaluations for their youth with CL/P (mean age = 11.6 years) fall within the average range compared with normative samples. Families receiving surgical recommendations for their youth also had FES scores in the average range, yet families of children recommended for functional surgery reported greater cohesion, expressiveness, and less conflict compared with those recommended for aesthetic surgery (P < .05). For cohesion and expressiveness, significant main effects for race (P = .012, P < .0001, respectively) and ethnicity (P = .004, P < .0001, respectively) were found but not for their interaction. No significant differences were found on the conflict domain. Families with private insurance reported significantly greater cohesion (P < .001) and expressiveness (P < .001) than did families with public insurance. CONCLUSIONS Family functioning across domains was in the average range. However, observed differences by race, ethnicity, type of insurance, and surgical recommendation may warrant consideration in clinical management for patients and families.
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Ichikawa CRDF, Bousso RS, Misko MD, Mendes-Castillo AMC, Bianchi ERF, Damião EBC. Cultural adaptation of the Family Management Measure among families of children and adolescents with chronic diseases. Rev Lat Am Enfermagem 2015; 22:115-22. [PMID: 24553711 PMCID: PMC4292687 DOI: 10.1590/0104-1169.2978.2379] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 09/23/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to perform the cultural adaptation of the Family Management Measure into the Brazilian Portuguese language. METHOD the method complied with international recommendations for this type of study and was composed of the following steps: translation of the instrument into the Portuguese language; reaching consensus over the translated versions; assessment by an expert committee; back translation; and pretest. RESULTS these stages enabled us to obtain conceptual, by-item, semantic, idiomatic, and operational equivalences, in addition to content validation. CONCLUSION the Family Management Measure is adapted to the Brazilian Portuguese language and that version is named Instrumento de Medida de Manejo Familiar.
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Affiliation(s)
- Carolliny Rossi de Faria Ichikawa
- Universidade Estadual de Londrina, Centro de Ciências da Saúde, LondrinaPR, Brazil, MSc, Assistant Professor, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Regina Szylit Bousso
- Universidade de São Paulo, Escola de Enfermagem, São PauloSP, Brazil, PhD, Associate Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maira Deguer Misko
- Universidade Federal de São Carlos, São Carlos, Brazil, PhD, Professor, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Estela Regina Ferraz Bianchi
- Universidade de São Paulo, Escola de Enfermagem, São PauloSP, Brazil, PhD, Associate Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elaine Buchhorn Cintra Damião
- Universidade de São Paulo, Escola de Enfermagem, São PauloSP, Brazil, PhD, Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
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41
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Bemis H, Yarboi J, Gerhardt CA, Vannatta K, Desjardins L, Murphy LK, Rodriguez EM, Compas BE. Childhood Cancer in Context: Sociodemographic Factors, Stress, and Psychological Distress Among Mothers and Children. J Pediatr Psychol 2015; 40:733-43. [PMID: 25840446 DOI: 10.1093/jpepsy/jsv024] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 02/24/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine associations between sociodemographic factors (single parenthood, family income, education level, race), stress, and psychological distress among pediatric cancer patients and their mothers. METHODS Participants completed measures assessing sociodemographic variables, depressive symptoms, posttraumatic stress symptoms, general stress, and cancer-related stress within the first year of the child's (ages 5-17 years) cancer diagnosis or relapse. Mothers (N = 318) provided self-reports and parent report of their children; children aged 10-17 years (N = 151) completed self-reports. RESULTS Each sociodemographic variable demonstrated unique associations with mothers' and children's stress and distress in bivariate analyses. A cumulative sociodemographic risk measure was positively correlated with all stress and distress variables. In regression analyses predicting mothers' and children's distress, independent and cumulative sociodemographic measures were no longer significant when accounting for levels of stress. CONCLUSIONS Findings highlight the need to consider the ecological context of pediatric cancer, particularly the impact of sociodemographic disadvantage on stress and distress in this population.
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Affiliation(s)
| | | | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital, and The Ohio State University
| | - Kathryn Vannatta
- The Research Institute at Nationwide Children's Hospital, and The Ohio State University
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Harver A, Dyer A, Ersek J, Kotses H, Humprhies CT. Reliability and predictors of resistive load detection in children with persistent asthma: a multivariate approach. J Asthma 2015; 52:146-54. [PMID: 25144552 PMCID: PMC4662862 DOI: 10.3109/02770903.2014.955188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Resistive load detection tasks enable analysis of individual differences in psychophysical outcomes. The purpose of this study was to determine both the reliability and predictors of resistive load detection in children with persistent asthma who completed multiple testing sessions. METHODS Both University of North Carolina (UNC) Charlotte and Ohio University institutional review boards approved the research protocol. The detection of inspiratory resistive loads was evaluated in 75 children with asthma between 8 and 15 years of age. Each child participated in four experimental sessions that occurred approximately once every 2 weeks. Multivariate analyses were used to delineate predictors of task performance. RESULTS Reliability of resistive load detection was determined for each child, and predictors of load detection outcomes were investigated in two groups of children: those who performed reliably in all four sessions (n = 31) and those who performed reliably in three or fewer sessions (n = 44). Three factors (development, symptoms, and compliance) accounted for 66.3% of the variance among variables that predicted 38.7% of the variance in load detection outcomes (Multiple R = 0.62, p = 0.004) and correctly classified performance as reliable or less reliable in 80.6% of the children, χ(2)(12) = 28.88, p = 0.004. CONCLUSIONS Cognitive and physical development, appraisal of symptom experiences, and adherence-related behaviors (1) account for a significant proportion of the interrelationships among variables that affect perception of airflow obstruction in children with asthma and (2) differentiate between children who perform more or less reliably in a resistive load detection task.
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Affiliation(s)
- Andrew Harver
- University of North Carolina Charlotte, Charlotte, NC
| | - Allison Dyer
- University of North Carolina Charlotte, Charlotte, NC
| | | | | | - C. Thomas Humprhies
- University of North Carolina Charlotte, Charlotte, NC
- Asthma and Allergy Specialists, PA, Charlotte, NC
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McCann D, Bull R, Winzenberg T. Sleep deprivation in parents caring for children with complex needs at home: a mixed methods systematic review. JOURNAL OF FAMILY NURSING 2015; 21:86-118. [PMID: 25527511 DOI: 10.1177/1074840714562026] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A significant number of children with a range of complex conditions and health care needs are being cared for by parents in the home environment. This mixed methods systematic review aimed to determine the amount of sleep obtained by these parents and the extent to which the child-related overnight health or care needs affected parental sleep experience and daily functioning. Summary statistics were not able to be determined due to the heterogeneity of included studies, but the common themes that emerged are that parents of children with complex needs experience sleep deprivation that can be both relentless and draining and affects the parents themselves and their relationships. The degree of sleep deprivation varies by diagnosis, but a key contributing factor is the need for parents to be vigilant at night. Of particular importance to health care professionals is the inadequate overnight support provided to parents of children with complex needs, potentially placing these parents at risk of poorer health outcomes associated with sleep deprivation and disturbance. This needs to be addressed to enable parents to remain well and continue to provide the care that their child and family require.
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Caccavale LJ, Weaver P, Chen R, Streisand R, Holmes CS. Family Density and SES Related to Diabetes Management and Glycemic Control in Adolescents With Type 1 Diabetes. J Pediatr Psychol 2015; 40:500-8. [PMID: 25596386 DOI: 10.1093/jpepsy/jsu113] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 12/02/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Youth with Type 1 diabetes (T1D) from single-parent families have poorer glycemic control; a finding confounded with socioeconomic status (SES). Family density (FD), or youth:adult ratio, may better characterize family risk status. METHODS Structural equation modeling assessed the relation of single-parent status, SES, and FD to parenting stress, diabetes-related conflict, parental monitoring, adherence, and glycemic control using cross-sectional parent and youth data (n = 257). RESULTS Single-parent status exhibited similar relations as SES and was removed. Lower FD was associated with better glycemic control (β = -.29, p = .014) via less conflict (β = .17, p = .038) and greater adherence (β = -.54, p < .001). CONCLUSIONS Beyond SES, FD plays a significant role in adherence and glycemic control via diabetes-related conflict. In contrast, the effects of single-parent status were indistinguishable from those of SES. FD provides distinct information related to adolescent glycemic control.
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Affiliation(s)
- Laura J Caccavale
- Virginia Commonwealth University, Georgetown University, and Children's National Medical Center, Washington, DC, USA
| | - Patrick Weaver
- Virginia Commonwealth University, Georgetown University, and Children's National Medical Center, Washington, DC, USA
| | - Rusan Chen
- Virginia Commonwealth University, Georgetown University, and Children's National Medical Center, Washington, DC, USA
| | - Randi Streisand
- Virginia Commonwealth University, Georgetown University, and Children's National Medical Center, Washington, DC, USA
| | - Clarissa S Holmes
- Virginia Commonwealth University, Georgetown University, and Children's National Medical Center, Washington, DC, USA Virginia Commonwealth University, Georgetown University, and Children's National Medical Center, Washington, DC, USA
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45
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Lord JH, Young MT, Gruhn MA, Grey M, Delamater AM, Jaser SS. Effect of race and marital status on mothers' observed parenting and adolescent adjustment in youth with type 1 diabetes. J Pediatr Psychol 2014; 40:132-43. [PMID: 25248850 DOI: 10.1093/jpepsy/jsu078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To examine demographic differences in parenting behaviors and adjustment in youth with type 1 diabetes. METHODS Adolescents' psychosocial adjustment was assessed via self-reports and parent reports, and clinical data were obtained from adolescents' medical records. Mother-adolescent dyads (N = 93) engaged in a videotaped discussion task, which was coded for observed parenting behaviors. RESULTS Single and non-White mothers exhibited significantly more overinvolved and less collaborative parenting behaviors. Higher levels of overinvolved parenting and lower levels of collaborative parenting were associated with poorer adolescent adjustment (i.e., higher levels of externalizing problems). Observed parenting was not significantly associated with glycemic control. There was an indirect effect of marital status and race/ethnicity on externalizing behaviors through parenting. CONCLUSIONS The current study highlights parenting as a potential target for interventions, especially in single and minority mothers, to improve adjustment in this population.
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Affiliation(s)
- Jadienne H Lord
- Department of Pediatrics, Vanderbilt University, School of Nursing, Yale University, and Department of Pediatrics, University of Miami
| | - Mackenzie T Young
- Department of Pediatrics, Vanderbilt University, School of Nursing, Yale University, and Department of Pediatrics, University of Miami
| | - Meredith A Gruhn
- Department of Pediatrics, Vanderbilt University, School of Nursing, Yale University, and Department of Pediatrics, University of Miami
| | - Margaret Grey
- Department of Pediatrics, Vanderbilt University, School of Nursing, Yale University, and Department of Pediatrics, University of Miami
| | - Alan M Delamater
- Department of Pediatrics, Vanderbilt University, School of Nursing, Yale University, and Department of Pediatrics, University of Miami
| | - Sarah S Jaser
- Department of Pediatrics, Vanderbilt University, School of Nursing, Yale University, and Department of Pediatrics, University of Miami
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Hirsh CD, Friebert S. Primary pediatric palliative care: psychological and social support for children and families. Pediatr Rev 2014; 35:390-5. [PMID: 25183774 DOI: 10.1542/pir.35-9-390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Cassandra D Hirsh
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH
| | - Sarah Friebert
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH
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Moreira MCN, Gomes R, Sá MRCD. Doenças crônicas em crianças e adolescentes: uma revisão bibliográfica. CIENCIA & SAUDE COLETIVA 2014; 19:2083-94. [DOI: 10.1590/1413-81232014197.20122013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 11/22/2013] [Indexed: 11/22/2022] Open
Abstract
O artigo analisa artigos publicados entre 2003 e 2011 enfocando discussões sobre condições crônicas ou doenças crônicas de crianças e adolescentes. Metodologicamente conjuga a revisão de literatura a uma análise de conteúdo temática com vistas a identificar quais os elementos que caracterizam doenças crônicas em crianças e adolescentes e as especificidades geradas por essas condições. A revisão resultou na descrição do conjunto dos artigos, caracterizando-os quanto ano de publicação, país, tipo de estudo, população e condição de cronicidade abordada. A análise de conteúdo temática gerou dois temas: Definição de Doença Crônica e Formas de se lidar com as doenças crônicas em crianças e adolescentes. Destaca-se como conclusão que as transições etárias quando uma doença é diagnosticada e tratada desde a infância, vai passar por transformações que incluem a maneira como se dá o seu fluxo entre os serviços e as mudanças que envolvem processos de alta, de tomada de decisão e de construção de rede que inclua família, hospital, escola e sistema de garantia de direitos.
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Pedrón-Giner C, Calderón C, Martínez-Costa C, Borraz Gracia S, Gómez-López L. Factors predicting distress among parents/caregivers of children with neurological disease and home enteral nutrition. Child Care Health Dev 2014; 40:389-97. [PMID: 23461829 DOI: 10.1111/cch.12038] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND & AIMS Caregivers of children with chronic diseases included in a home enteral nutrition (HEN) programme are at risk of experiencing a feeling of burden, high level of anxiety and psychological distress. The aims of this study were: first, to examine the prevalence of symptoms of anxiety-depression in caregivers of children with neurological diseases requiring HEN by gastrostomy tube (GT); second, to compare the characteristics of caregivers with high or low risk of exhibiting symptoms of anxiety-depression; and third, to investigate possible associations to child disease severity and nutrition support mode. METHODS A cross-sectional observational study was performed in 58 caregivers of children (31 boys, aged 0.3-18 years) with neurological diseases and GT feeding. The characteristics of caregivers with high or low risk of presenting symptoms of anxiety-depression were compared regarding the following variables: socio-demographic characteristics, the primary caregiver's intrapsychic factors, anthropometric parameters of the child, length of HEN, type of nutrients delivered by GT and infusion regime. RESULTS All primary caregivers were mothers. Fifty-three per cent of them showed high risk of exhibiting symptoms of anxiety-depression. Mothers with high or low risk of presenting symptoms of anxiety-depression were comparable in age and family socio-economic status. They were also similar in terms of age, anthropometric conditions and length of HEN in their children.No differences were found between the two groups of mothers according to the level of the child's motor function impairment, type of nutrients delivered by GT and infusion regime. Higher levels of psychological distress and perception of burden overload were found in mothers with high risk of exhibiting symptoms of anxiety-depression. CONCLUSIONS This study found a high prevalence of symptoms of anxiety-depression, perception of burden overload and psychological distress in caregivers of children with HEN. Thus, greater practical and emotional support is required for these families.
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Affiliation(s)
- C Pedrón-Giner
- Division of Gastroenterology and Nutrition, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Smith G, Wagner J, Andrews J, Austin J, Mueller M, Carter E, Griesemer K. Caregiving in pediatric epilepsy: results of focus groups and implications for research and practice. Epilepsy Behav 2014; 34:34-41. [PMID: 24681383 DOI: 10.1016/j.yebeh.2014.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/28/2014] [Accepted: 03/02/2014] [Indexed: 11/28/2022]
Abstract
The process of caring for youth with epilepsy (YWEs) has been understudied. Previous research has identified that caregivers of YWEs report increased parenting stress, unanticipated caregiving responsibilities, and negative effects on family life. Using the adapted Caregiving Process Model, perceptions of the caregiving process were explored in four focus groups of caregivers of youth with epilepsy diagnosed at <1 year, between 1 and 5 years, and >5 years. Thematic analysis guided the data analysis. The prevalent theme that emerged during the data analysis was navigating the noncontingencies (lack of a perceived relationship between action and outcome, unpredictability). This was supported by the subthemes, namely, blessings and sacrifices, uncertainty today and tomorrow, constant vigilance, and caregiving is more than parenting. The focus groups displayed similarities and differences in caregiving perceptions across the three postdiagnosis time periods, providing support for conceptualization of the caregiving as multifactorial, multidirectional, and fluid process. With this knowledge, epilepsy health-care professionals are encouraged to promote patient and family centeredness, provide information on how to access community resources, and work with caregivers to enhance epilepsy self-management skills.
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Affiliation(s)
- Gigi Smith
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA.
| | - Janelle Wagner
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
| | - Jeanette Andrews
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Joan Austin
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Emma Carter
- Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
| | - Kimberly Griesemer
- Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
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Parham R, Jacyna N, Hothi D, Marks SD, Holttum S, Camic P. Development of a measure of caregiver burden in paediatric chronic kidney disease: The Paediatric Renal Caregiver Burden Scale. J Health Psychol 2014; 21:193-205. [DOI: 10.1177/1359105314524971] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To inform the development of a measure of caregiver burden for carers of children with chronic kidney disease, interviews were conducted with 16 caregivers and 10 renal healthcare professionals. A pool of 97 items generated from interviews was reduced to 60 items following review. A piloting exercise provided evidence for the usability, readability and relevance of items and informed further adaptations resulting in the 51-item Paediatric Renal Caregiver Burden Scale. Further to assessment of its psychometric properties, it is hoped that that the Paediatric Renal Caregiver Burden Scale will serve as a useful measure of caregiver burden in paediatric chronic kidney disease.
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Affiliation(s)
| | | | - Daljit Hothi
- Great Ormond Street Hospital for Children NHS Foundation Trust, London
| | - Stephen D Marks
- Great Ormond Street Hospital for Children NHS Foundation Trust, London
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