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Everhart RS, Lohr KD, Holder RL, Morton SCM, Miller A, Corona R, Mazzeo SE, Thacker Ii LR, Schechter MS. Results of the RVA Breathes randomized controlled trial. J Pediatr Psychol 2024:jsae052. [PMID: 38994892 DOI: 10.1093/jpepsy/jsae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/17/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVE This study tested a randomized controlled trial of RVA Breathes, a community asthma program, in reducing asthma-related healthcare utilization among children living in an area with a high poverty rate. METHODS Participants included 250 caregivers (78% African American/Black; 73.3% household income<$25,000/year) and their children with asthma (5-11 years). Inclusion criteria included an asthma-related emergency department (ED) visit, hospitalization, unscheduled doctor's visit, or systemic steroids in the past 2 years. Families were randomized to a full active intervention (asthma education with community health workers [CHWs], home remediation with home assessors, and a school nurse component; n = 118), partial active intervention (asthma education and home remediation; n = 69), or a control group (n = 63) for 9 months. Measures on healthcare utilization and asthma-related factors were collected. Follow-up assessments occurred across a 9-month period. RESULTS Although we did not find any significant effects, there was a trend toward significance for a group by time effect with objective healthcare utilization as the outcome (F4,365 = 2.28, p = .061). The full intervention group experienced a significant decrease from baseline to 9-month follow-up compared with the other groups (p < .001). Only the full intervention group experienced a significant increase in reported asthma action plans across time (no significant group effect). CONCLUSIONS In the context of the unprecedented COVID-19 pandemic, which led to a substantial global decrease in healthcare utilization, the study's main hypotheses were not supported. Nevertheless, findings support the benefit of community asthma programs that integrate care across multiple settings and connect families with CHWs.
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Affiliation(s)
- Robin S Everhart
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Katherine D Lohr
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Rachel L Holder
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Sarah C M Morton
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Ashley Miller
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Rosalie Corona
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Leroy R Thacker Ii
- Department of Biostatistics, Virginia Commonwealth University, Richmond, United States
| | - Michael S Schechter
- Department of Pediatrics, Virginia Commonwealth University, Richmond, United States
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Mpundu-Kaambwa C, Bulamu NB, Lines L, Chen G, Whitehurst DGT, Dalziel K, Devlin N, Ratcliffe J. Exploring the Use of Pictorial Approaches in the Development of Paediatric Patient-Reported Outcome Instruments: A Systematic Review. PHARMACOECONOMICS 2024; 42:9-37. [PMID: 38349590 PMCID: PMC11168995 DOI: 10.1007/s40273-024-01357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Children may find self-reporting health-related quality of life (HRQoL) using patient-reported outcome measures (PROMs) presented in text-based formats difficult, particularly younger children and children with developmental delays or chronic illness. In such cases, pictorial PROMs (where pictorial representations are used alongside or to replace text) may offer a valid alternative. AIM This systematic literature review focused on identifying and describing paediatric PROMs that incorporate pictorial approaches, providing children with more effective means to express their HRQoL. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Seven electronic databases were searched from inception to 1 March 2022. There were no country restrictions applied to the search; all English-language studies were considered for inclusion in the review. Characteristics and development methods of the identified pictorial PROMs were evaluated against context-specific good practice guidelines published by The Professional Society for Health Economics and Outcomes Research (ISPOR). RESULTS A total of 22 paediatric pictorial PROMs, comprising 28 unique versions, were identified. These PROMs were predominantly developed in the USA and the UK, targeting children aged 3-18 years. Likert scales with pictorial anchors, particularly happy-sad faces, were commonly used for response options, appearing in 15 (54%) of the PROMs. Various graphic methods, such as happy-sad faces, cartoons, and thermometers, were adapted to specific content domains. These PROMs covered a wide range of domains, including physical and emotional health and social functioning. Emphasis was placed on content validity, including active child participation in developing pictorial elements. Notably, children's participation was sought during the development of the pictorial elements for 13 (46%) of the PROMs. Various development methods were employed, with 43% of paediatric PROMs using literature reviews, 43% using focus groups, and 32% involving expert consultation. Interviews emerged as the primary method, being employed in 61% of the studies. Additionally, three measures specifically addressed cross-cultural considerations. CONCLUSION Paediatric pictorial PROMs offer child-friendly tools for assessing HRQoL for application with children who find reading and understanding text-based PROMs challenging. There is some evidence that pictorial PROMs facilitate self-report in this population and improve measurement properties compared to text-only PROMs. Further research is needed to develop, validate, and test paediatric pictorial PROMs, with an emphasis on including children from the inception in the co-design process.
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Affiliation(s)
- Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia.
| | - Norma B Bulamu
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Lauren Lines
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | | | - Kim Dalziel
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Nancy Devlin
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia
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Muhammad J, Ngah ND, Ahmad I. Written Asthma Action Plan Improves Asthma Control and the Quality of Life among Pediatric Asthma Patients in Malaysia: A Randomized Control Trial. Korean J Fam Med 2023; 44:44-52. [PMID: 36709960 PMCID: PMC9887449 DOI: 10.4082/kjfm.22.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 12/03/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND A written asthma action plan (WAAP) is one of the treatment strategies to achieve good asthma control in children. METHODS This randomized controlled trial was conducted to observe the effect of WAAP on asthma control and quality of life using the Asthma Control Questionnaire and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) at baseline and after 3 months. A repeated measure analysis of variance was used to analyze the mean score difference between the two groups. RESULTS There was no significant difference in mean score for asthma control at baseline between groups (F[degree of freedom (df)]=1.17 [1, 119], P=0.282). However, at 3 months, a significant difference in mean scores between groups was observed (F[df]=7.32 [1, 119], P=0.008). The mean±standard deviation (SD) scores in the intervention and control groups were 0.96±0.53 and 1.21±0.49, respectively. For the analysis of the PAQLQ, no significant difference was observed in the mean score for the quality of life baseline in both groups. There were significant mean score changes for the quality of life (F[df]=10.9 [1, 119], P=0.001) at 3 months follow-up, where those in the intervention group scored a mean±SD score of 6.19±0.45, and those in the control group scored 5.94±0.38. A time-group interaction analysis using repeated-measures analysis of variance showed significant differences in mean score changes (F[df]=5.03 [1, 116], P=0.027) and (F[df]=11.55 [1, 116], P=0.001) where a lower mean score was observed in the intervention group, indicating better asthma control and quality of life, respectively. A significant (P<0.001) negative Pearson correlation between asthma control and quality of life (-0.65) indicated a moderate correlation. CONCLUSION WAAP, along with standard asthma treatment, improves asthma care.
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Affiliation(s)
- Juliawati Muhammad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia,Corresponding Author: Juliawati Muhammad https://orcid.org/0000-0002-0274-1502 Tel: +60-14-806-4530, Fax: +60-9-765-3370, E-mail:
| | - Najwa Diyana Ngah
- Department of Family Medicine, Klinik Kesihatan Ketengah, Ketengah Jaya, Malaysia
| | - Imran Ahmad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Everhart RS, Dempster KW, Withers D, Mazzeo SE, Corona R, Thacker LR, Schechter MS. Adaptations to the RVA Breathes clinical trial due to the COVID-19 pandemic. Contemp Clin Trials Commun 2021; 24:100871. [PMID: 34805614 PMCID: PMC8592848 DOI: 10.1016/j.conctc.2021.100871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/05/2021] [Accepted: 11/13/2021] [Indexed: 11/30/2022] Open
Abstract
RVA Breathes, a community program to improve asthma management and care coordination among children living in a low-income, urban area, is being evaluated in a randomized clinical trial. In March 2020, RVA Breathes was converted to a remote program due to the COVID-19 pandemic; this report provides an update on the modifications made to the RVA Breathes trial. Additionally, given that families in the program have been disproportionally impacted by both COVID-19 and significant social unrest at both the local and national level, strategies used to enroll and engage families in the trial who bore disproportionately high burdens during this time period are outlined. Remote sessions (telephone or video) for families enrolled in the program prior to the onset of COVID-19 began in April 2020; enrollment of new families began remotely in July 2020 using adapted consent procedures. Baseline, intervention, and follow-up sessions were delivered either via the telephone or video depending upon family preference. Strategies were implemented to engage caregivers and children in completing measures over the telephone or video versus in person. Tangible intervention materials and participant payments were dropped off at family homes using contactless procedures. Our team was able to adapt and safely continue a large, community-based clinical trial, despite the increased health risks and social isolation mandates from the pandemic, by transitioning to a remote format. Challenges remain in determining whether RVA Breathes as a remote program has had the same impact on child asthma as the face-to-face interventions that comprised its original format.
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Everhart RS, Mazzeo SE, Corona R, Holder RL, Thacker LR, Schechter MS. A community-based asthma program: Study design and methods of RVA Breathes. Contemp Clin Trials 2020; 97:106121. [PMID: 32822827 DOI: 10.1016/j.cct.2020.106121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/06/2020] [Accepted: 08/16/2020] [Indexed: 11/15/2022]
Abstract
Disparities in pediatric asthma morbidity and healthcare utilization exist on the basis of race, ethnicity, environment, and income; interventions are needed to address these inequities. The following protocol describes an evidence-based intervention, RVA Breathes, designed to coordinate pediatric asthma care across family, home, community, and medical sectors. Community stakeholder feedback was utilized to refine the intervention specifically for the Richmond, Virginia community. The aims of this study are to assess the effect of RVA Breathes on asthma-related healthcare utilization, as well as secondary outcomes of asthma control, asthma symptoms, and quality of life. We will enroll 300 elementary school children from the Richmond City Public School system. Participants will be between the ages of 5-11, have a diagnosis of asthma, and have had an asthma exacerbation (as indicated by an asthma-related ED visit, hospitalization, unscheduled PCP visit, or use of systemic steroids) in the last two years. Participants will be randomized to one of three groups: asthma education + home environment remediation + school intervention, asthma education + home environment remediation, or a comparator condition. Data will be collected across one baseline research visit, four intervention sessions, and four follow-up research visits over the course of 18 months. A General Linear Mixed Model (GLMM) will be used to test primary aims. We expect the findings will provide support for coordination of asthma care across sectors. Further, we hope RVA Breathes will serve as a model of community-based pediatric asthma care.
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Affiliation(s)
- Robin S Everhart
- Virginia Commonwealth University, Richmond, VA, United States of America.
| | - Suzanne E Mazzeo
- Virginia Commonwealth University, Richmond, VA, United States of America
| | - Rosalie Corona
- Virginia Commonwealth University, Richmond, VA, United States of America
| | - Rachel L Holder
- Virginia Commonwealth University, Richmond, VA, United States of America
| | - Leroy R Thacker
- Virginia Commonwealth University, Richmond, VA, United States of America
| | - Michael S Schechter
- Children's Hospital of Richmond at VCU, Richmond, VA, United States of America
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Everhart RS, Greenlee JL, Winter MA, Fiese BH. Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are They Comparable? APPLIED RESEARCH IN QUALITY OF LIFE 2018; 13:371-383. [PMID: 29910839 PMCID: PMC5998812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE This study aimed to compare primary and secondary caregiver QOL within families of children with asthma and determine the potential importance of including secondary caregiver QOL in clinical and research settings. METHODS Participants included 118 families of children with asthma that had primary and secondary caregivers. Families completed measures in a single research session. Caregivers reported on QOL, psychological functioning, and family burden; children completed a measure of QOL. Child lung function was determined from objective spirometry. Adherence to prescribed controller medication was measured for 6 weeks following the research visit. RESULTS Primary caregiver QOL was significantly lower than secondary caregiver QOL (Mean overall QOL of 5.85 versus 6.17, p < .05). Better medication adherence was associated with higher primary caregiver QOL (ρ = .22, p = .02); secondary caregiver QOL, not primary caregiver QOL, was positively associated with child QOL (ρ = .20, p = .03). Families with discrepant QOL scores between caregivers (difference in scores of at least .50) were characterized by more family burden and primary caregiver psychological symptoms. CONCLUSIONS Differences in QOL scores between caregivers may be a reflection of primary caregivers' greater investment in daily asthma management. In families reporting low burden and few psychological difficulties in the primary caregiver, QOL assessments from either caregiver may may be informative and representative of how parents are adapting to child asthma. In families experiencing high levels of burden or more primary caregiver psychological difficulties, QOL reports from secondary caregivers may not be as clinically meaningful.
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Affiliation(s)
- Robin S. Everhart
- Virginia Commonwealth University, Department of Psychology, P.O. Box 842018, Richmond, VA, 23284
| | - Jessica L. Greenlee
- Virginia Commonwealth University, Department of Psychology, P.O. Box 842018, Richmond, VA, 23284
| | - Marcia A. Winter
- Virginia Commonwealth University, Department of Psychology, P.O. Box 842018, Richmond, VA, 23284
| | - Barbara H. Fiese
- University of Illinois at Urbana-Champaign, Family Resiliency Center, Department of Human Development and Family Studies, 904 W. Nevada St., Urbana, IL 61801
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Al Ghriwati N, Winter MA, Everhart RS, Fiese BH. Family functioning and child asthma severity: A bio-behavioral approach. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2017; 35:439-449. [PMID: 28406652 PMCID: PMC5640451 DOI: 10.1037/fsh0000264] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Family factors are directly associated with the psychosocial adjustment of children with chronic illnesses such as asthma (Kaugars, Klinnert, & Bender, 2004). Research indicates that negative family factors may also contribute to child disease severity via bio-behavioral mechanisms of effect. For instance, children from more conflicted families often experience greater internalizing symptoms that subsequently impact their asthma severity (Wood et al., 2006). These pathways have yet to be examined with a comprehensive focus on strength-based family factors. This study examined whether factors such as family cohesion, problem-solving abilities, and communication influence asthma severity via their effects on child depression and anxiety symptoms. METHOD Participants were 215 children (136 males and 79 females), ages 5 to 12 years old, and their families. Primary caregiver, child, and teacher ratings of child and family functioning in addition to objective measures of parent-child interactions and asthma severity were collected. RESULTS Using structural equation modeling, the authors identified significant indirect associations between family factors and child asthma severity via child depressive symptoms; however, these associations were not present in models with child anxiety symptoms. DISCUSSION Results suggest an indirect effect of family functioning on children's lung function, with differential roles of anxiety and depression in these pathways. This article also highlights the importance of incorporating multirater multimethod measures to understand children's experiences in pediatric asthma. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Barbara H Fiese
- Department of Human Development and Family Studies, Family Resiliency Center, University of Illinois at Urbana-Champaign
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Miadich SA, Everhart RS, Borschuk AP, Winter MA, Fiese BH. Quality of Life in Children With Asthma: A Developmental Perspective. J Pediatr Psychol 2015; 40:672-9. [PMID: 25680363 DOI: 10.1093/jpepsy/jsv002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 01/07/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The current study investigated whether factors associated with quality of life (QOL) in children with asthma (e.g., family functioning, asthma routines, asthma severity) differed by child age. METHODS Participants included 192 children with asthma (5-12 years) and their caregivers. Both children and caregivers completed questionnaires at an initial research session. Family functioning was determined from a mealtime observation that occurred in family homes. RESULTS Child age moderated the association between asthma severity and child QOL and between routine burden and QOL in children with asthma. Post hoc probing analyses revealed that among older children, QOL levels were lower in the presence of worse asthma severity and more routine burden. CONCLUSIONS Findings suggest that associations between asthma severity, routine burden, and QOL may differ by child age. Treatment programs and health-care recommendations addressing QOL in children with asthma may need to be tailored to address differences in factors associated with QOL by child age.
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Affiliation(s)
| | | | | | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University and
| | - Barbara H Fiese
- Department of Human and Community Development, University of Illinois at Urbana-Champaign
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Everhart RS, Kopel SJ, Esteban CA, McQuaid EL, Klein R, McCue CE, Koinis-Mitchell D. Allergic rhinitis quality of life in urban children with asthma. Ann Allergy Asthma Immunol 2014; 112:365-70.e1. [PMID: 24589166 DOI: 10.1016/j.anai.2014.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 01/14/2014] [Accepted: 02/05/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Urban children with asthma and allergic rhinitis (AR) are at risk for experiencing worse AR-related quality of life (QOL). Although AR may be underdiagnosed and undertreated in urban minority children, research has not considered which illness-related indicators (eg, AR control) may contribute to AR QOL in this population. OBJECTIVE To examine associations among AR control, asthma control, allergy symptoms, asthma symptoms, and AR QOL in a sample of 195 urban caregivers and their children with asthma (7-9 years of age) from African American, Latino, and non-Latino white backgrounds. Racial and ethnic differences in AR QOL were also examined. METHODS Families resided in 1 of 4 cities selected as recruitment sources because of their high concentrations of ethnic minority and non-Latino white, urban families. Caregivers and children completed a series of interview-based and clinician-based assessments across one academic year and 4-week periods to track daily asthma and nasal symptoms. RESULTS Better AR control was associated with higher AR QOL (β = -.32, P < .01) and all QOL subscales. AR control predicted AR QOL over and above asthma control (β = -.28, P < .01). Controlling for AR control, non-Latino white children reported better QOL related to practical problems than both Latino and African American children (P < .05). CONCLUSION Findings suggest that strategies to enhance AR control in urban children with asthma may assist in improving AR QOL. Non-Latino white children may experience less impairment of their AR QOL because of practical problems (eg, blow nose) than African American or Latino children with asthma.
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Affiliation(s)
- Robin S Everhart
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
| | - Sheryl J Kopel
- Bradley/Hasbro Children's Research Center, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Cynthia A Esteban
- Bradley/Hasbro Children's Research Center, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Elizabeth L McQuaid
- Bradley/Hasbro Children's Research Center, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Robert Klein
- Bradley/Hasbro Children's Research Center, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Christine E McCue
- Bradley/Hasbro Children's Research Center, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Daphne Koinis-Mitchell
- Bradley/Hasbro Children's Research Center, Alpert Medical School, Brown University, Providence, Rhode Island
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Ma L, Poulin P, Feldstain A, Chasen M. The association between malnutrition and psychological distress in patients with advanced head-and-neck cancer. Curr Oncol 2013; 20:e554-60. [PMID: 24311956 PMCID: PMC3851352 DOI: 10.3747/co.20.1651] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Malnutrition and psychological distress are often seen in patients with head-and-neck cancer, but little is known about the interrelationships between those two symptoms. The present study examined the relationship between malnutrition and psychological distress in patients with advanced head-and-neck cancer. METHODS Using the Patient-Generated Subjective Global Assessment, 99 patients with advanced-stage head-and-neck cancer were screened for nutrition status. The patients were also screened for psychosocial distress (using the Distress Thermometer) and for psychosocial issues (using the Problem Checklist). Any relationship between malnutrition and psychosocial distress was determined by regression and correlation analysis. We also used t-tests to compare distress levels for patients with and without specific nutrition-related symptoms. RESULTS The study group included 80 men and 19 women [mean age: 58.4 ± 10.9 years (range: 23-85 years)]. The correlation between poorer nutrition status and level of psychological distress was significant r = 0.37 (p < 0.001). Specifically, reduced food intake and symptoms were both positively associated with distress: r = 0.27 and r = 0.29 respectively, both significant at p < 0.01. After controlling for the effects of psychosocial problems and pain, nutrition status remained a significant predictor of distress, explaining 3.8% of the variance in the distress scores of the patients (p < 0.05). CONCLUSIONS Malnutrition and symptoms were strongly related to distress in patients with advanced head-and-neck cancer. Our results suggest the need for further research into the complex relationship between nutrition status and distress and into the management of both nutrition and distress in cancer care.
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Affiliation(s)
- L. Ma
- Ottawa Hospital Research Institute, The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - P. Poulin
- Psychosocial Oncology Program, The Ottawa Hospital Health Institute, Ottawa, ON
| | - A. Feldstain
- School of Psychology, University of Ottawa, Ottawa, ON
| | - M.R. Chasen
- Ottawa Hospital Research Institute, The Ottawa Hospital Cancer Centre, Ottawa, ON
- Division of Palliative Care, The Ottawa Hospital Cancer Centre, Ottawa, ON
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Raymond KP, Fiese BH, Winter MA, Knestel A, Everhart RS. Helpful hints: caregiver-generated asthma management strategies and their relation to pediatric asthma symptoms and quality of life. J Pediatr Psychol 2012; 37:414-23. [PMID: 22408054 DOI: 10.1093/jpepsy/jss001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This mixed-methods study examined the relation between caregiver-generated asthma management strategies and asthma severity in a sample of 200 children with persistent asthma (ages 5-12 years). METHODS Caregivers were interviewed about asthma management strategies they found helpful in controlling their child's symptoms. A qualitative content analysis was used to identify household strategies. Indicators of asthma severity included lung functioning (FEV(1)) and functional severity (FSS). Child quality of life was also assessed (PQLQ). RESULTS Six primary household strategies were identified: Reactive, Planning Ahead, Social, Emotional, Avoiding Triggers, and Cleaning. In general, strategies offered by caregivers did not differ by socioeconomic status. Caregivers who endorsed Avoiding Triggers as effective strategies had children with better lung functioning. Caregivers who endorsed Planning Ahead or Emotional strategies had children with better asthma-related quality of life. CONCLUSION These household strategies hold promise for reducing pediatric asthma symptoms and improving child quality of life.
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Affiliation(s)
- Kimberly P Raymond
- Family Resiliency Center, Department of Human and Community Development, University of Illinois at Urbana-Champaign, 904 W. Nevada, Urbana, IL 61801, USA
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12
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Wilson SR, Rand CS, Cabana MD, Foggs MB, Halterman JS, Olson L, Vollmer WM, Wright RJ, Taggart V. Asthma outcomes: quality of life. J Allergy Clin Immunol 2012; 129:S88-123. [PMID: 22386511 PMCID: PMC4269375 DOI: 10.1016/j.jaci.2011.12.988] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 12/23/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND "Asthma-related quality of life" (QOL) refers to the perceived impact that asthma has on the patient's QOL. OBJECTIVE National Institutes of Health institutes and other federal agencies convened an expert group to recommend standardized measures of the impact of asthma on QOL for use in future asthma clinical research. METHODS We reviewed published documentation regarding the development and psychometric evaluation; clinical research use since 2000; and extent to which the content of each existing QOL instrument provides a unique, reliable, and valid assessment of the intended construct. We classified instruments as core (required in future studies), supplemental (used according to the study's aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an National Institutes of Health-organized workshop convened in March 2010 and finalized in September 2011. RESULTS Eleven instruments for adults and 6 for children were identified for review. None qualified as core instruments because they predominantly measured indicators of asthma control (symptoms and/or functional status); failed to provide a distinct, reliable score measuring all key dimensions of the intended construct; and/or lacked adequate psychometric data. CONCLUSIONS In the absence of existing instruments that meet the stated criteria, currently available instruments are classified as either supplemental or emerging. Research is strongly recommended to develop and evaluate instruments that provide a distinct, reliable measure of the patient's perception of the impact of asthma on all of the key dimensions of QOL, an important outcome that is not captured in other outcome measures.
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Affiliation(s)
- Sandra R Wilson
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
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Fiese BH, Winter MA, Botti JC. The ABCs of family mealtimes: observational lessons for promoting healthy outcomes for children with persistent asthma. Child Dev 2011; 82:133-45. [PMID: 21291433 DOI: 10.1111/j.1467-8624.2010.01545.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Family mealtimes have the potential to promote healthy child development. This observational study of 200 family mealtimes examined the relation between child health in a group of children (ages 5 to 12) with persistent asthma and 3 dimensions of mealtime interaction: Action, Behavior Control, and Communication. Percent time spent in Action and Positive Communication varied by asthma severity, child quality of life, and sociodemographic variables. Positive communication during mealtimes predicted child quality of life. Significant interactions between demographic variables and behavior control suggested that higher levels of behavior control affected child quality of life in the context of lower maternal education. Guidance is offered for practitioners and policy makers toward promoting healthy family mealtimes as a public health priority.
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Affiliation(s)
- Barbara H Fiese
- The University of Illinois at Urbana-Champaign, The Family Resiliency Center, Urbana, IL 61801-3811, USA.
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Li Q, Li X, Stanton B, Wang B. Psychometric properties of a pictorial scale measuring correct condom use. AIDS Behav 2011; 15:432-40. [PMID: 21046220 DOI: 10.1007/s10461-010-9838-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was designed to assess the psychometric properties of a pictorial scale of correct condom use (PSCCU) using data from female sex workers (FSWs) in China. The psychometric properties assessed in this study include construct validity by correlations and known-group validation. The study sample included 396 FSWs in Guangxi, China. The results demonstrate adequate validity of the PSCCU among the study population. FSWs with a higher level of education scored significantly higher on the PSCCU than those with a lower level of education. FSWs who self-reported appropriate condom use with stable partners scored significantly higher on PSCCU than their counterparts. The PSCCU should provide HIV/STI prevention researchers and practitioners with a valid alternative assessment tool among high-risk populations, especially in resource-limited settings.
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Affiliation(s)
- Qing Li
- Prevention Research Center, Carman and Ann Adams Department of Pediatrics, School of Medicine, Wayne State University, Hutzel Building, 4707 St Antoine, Detroit, MI 48201, USA.
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