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Nisbet LC, Ellis K, Mihai R, Croft E, Davey MJ, Nixon GM. Improvement in quality of life with continuous positive airway pressure outweighs the treatment burden in children with obstructive sleep apnea. Pediatr Pulmonol 2024; 59:1288-1297. [PMID: 38353401 DOI: 10.1002/ppul.26903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 04/30/2024]
Abstract
INTRODUCTION Continuous positive airway pressure (CPAP) for treatment of obstructive sleep apnea (OSA) may pose a significant burden on families. We assessed the impact of CPAP for children on quality of life (QOL) and caregiver treatment burden. METHODS Prospective cohort study of children commencing outpatient CPAP in a specialist sleep centre 2020-2022. Questionnaires regarding sleep-related symptoms (PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment), QOL (OSA-18, QI-Disability), caregiver burden (Caregiver Strain Questionnaire) and overall health impact (Glasgow Children's Benefit Inventory) were completed by caregivers at CPAP commencement and 6 weeks later. RESULTS Twenty-six patients completed follow-up (7 female; median age 11.4 year, baseline obstructive apnea hypopnea index 10.3/h; 77% overweight or obese, 73% comorbidity other than obesity). OSA-related QOL (OSA-18) significantly improved at follow-up (p < 0.01), as did child general QOL (p < 0.001), sleep disturbance (p < 0.01) and sleep-related impairment (p < 0.001). Caregivers mostly rated CPAP as beneficial to their child's health but 19% rated CPAP as harmful or having no effect. Caregiver strain reduced at follow-up (p < 0.001) and benefit outweighed inconvenience (p < 0.0001) in 81%. CPAP adherence was correlated with overall health impact (r = 0.67, p < 0.01) but not with caregiver rating of inconvenience. CONCLUSIONS CPAP resulted in improvements in QOL and sleep-related symptoms, and reduced caregiver strain. Perceived benefits outweighed the burden of treatment for most but not all families. CPAP adherence was moderately correlated with family-reported measures of benefit but not related to perceived inconvenience. This study provides reassuring evidence regarding the benefits and impacts of CPAP for children, many of whom already have complex health care needs.
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Affiliation(s)
- Lauren C Nisbet
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
| | - Kirsten Ellis
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
| | - Rebecca Mihai
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
| | - Emma Croft
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
| | - Margot J Davey
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Gillian M Nixon
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
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Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med 2024; 20:719-726. [PMID: 38169433 PMCID: PMC11063692 DOI: 10.5664/jcsm.10980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
STUDY OBJECTIVES Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy, we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals. METHODS We accrued the cohort between November 2019 and October 2020 and recruited children/youth who (1) were 8-18 years old; (2) had cerebral palsy with any Gross Motor Function Classification System level; and (3) could self-report pain and sleep disturbance. We collected self-reported baseline and weekly follow-up data using electronic questionnaires completed every week for 5 weeks. Sleep disturbance at 5 weeks was the primary outcome (pediatric Patient-Reported Outcomes Measurement Information System short form, v1.0-4a). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders. RESULTS A total of 190 individuals were eligible; 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% confidence interval, 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable, no/very mild pain, those in the stable, high-pain group had the greatest sleep disturbance (adjusted β = 5.7; 95% confidence interval, 1.2, 10.2). CONCLUSIONS Irrespective of pain trajectory, children and youth with cerebral palsy reported sleep disturbances. Those with a stable, high pain intensity in the previous 5 weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with cerebral palsy. CITATION Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med. 2024;20(5):719-726.
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Affiliation(s)
- Heather M. Shearer
- Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sheilah Hogg-Johnson
- Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Darcy L. Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Griffin BR, Trenoweth K, Dimanopoulos TA, De Young AC, Cobham VE, Williams H, Kimble R. Co-design of a paediatric post-trauma electronic psychosocial screen. J Pediatr Nurs 2024; 76:52-60. [PMID: 38359545 DOI: 10.1016/j.pedn.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE To optimise care pathways and provide greater transparency of the psychosocial needs of injured children after hospital discharge by extending post-discharge psychosocial screening to children admitted with traumatic injury for ≥24 h. DESIGN AND METHODS This mixed-methods study used a co-design approach informed by the Experience-Based Co-design (EBCD) framework. Interviews with carers were used to evaluate experiences and generate views on psychosocial support interventions. Online surveys by international child psychologists' indicated preferences for a psychosocial screening tool, and clinician-stakeholder consensus meetings facilitated the development of an electronic post-injury psychosocial screening tool. RESULTS Carers found the initial year of follow-up from trauma family support services helpful, appreciating the hospital connection. Flexible follow-up timings and additional resources were mentioned, and most carers were interested in participating in an electronic screening activity to predict their child's coping after injury. Child trauma experts recommended including several screening tools, and the multidisciplinary paediatric trauma service and study investigators collaborated over a year to workshop and reach a consensus on the screening tool and follow-up process. CONCLUSION The multidisciplinary team co-designed an electronic psychosocial screening and follow-up process for families with children with traumatic injuries. This tool improves the visibility of injured children's psychosocial needs post-injury and potentially aids clinical targeted resource allocation for trauma family support services. PRACTICE IMPLICATIONS The study emphasises the significance of specialised psychosocial screening tools in paediatric nursing, especially in trauma care, for understanding patients' psychosocial needs, tailoring follow-up plans, and promoting a patient-centred approach.
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Affiliation(s)
- Bronwyn R Griffin
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, QLD, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Kate Trenoweth
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Tanesha A Dimanopoulos
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, QLD, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.
| | - Alexandra C De Young
- Queensland Centre for Perinatal and Infant Mental Health, Children's Health Queensland, Hospital Health Service, Brisbane, QLD, Australia; Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia; Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, QLD, Australia
| | - Hayley Williams
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Roy Kimble
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
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Cesari A, Galeoto G, Panuccio F, Simeon R, Berardi A. Evaluation instruments for executive functions in children and adolescents: an update of a systematic review. Expert Rev Pharmacoecon Outcomes Res 2024; 24:487-508. [PMID: 38294492 DOI: 10.1080/14737167.2024.2311872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/25/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The aim of this study is to update a systematic review of instruments for evaluating the executive functions (EFs) in a pediatric population to assess their measurement properties. AREA COVERED Studies describing evaluation tools of EFs were systematically searched on four electronic databases: PubMed, EBSCO, Scopus, and Web of Science. To be included studies had to be on a population aged 0 to 18 were included. The individuals were either healthy or presented a neurodevelopment disorder. Risk of Bias was evaluated through the Consensus-based Standards to select the health Measurement Instruments (COSMIN). EXPERT OPINION The search was conducted on April 2023. Eighty-four papers met the inclusion criteria and were included in the study; the studies refer to 72 different evaluation tools of EFs. Most of the studies analyzed through a methodological quality analysis received an 'adequate' score. The instrument most mentioned was the Behavior Rating Inventory of Executive Function-2 (BRIEF2) in seven articles.
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Affiliation(s)
- Arianna Cesari
- School of Occupational Therapy, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | - Rachele Simeon
- School of Occupational Therapy, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
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Li R, Gibler RC, Rheel E, Slack K, Palermo TM. Recommendations for Patient-Reported Outcomes Measurement Information System pediatric measures in youth with chronic pain: a COnsensus-based Standards for the selection of health Measurement INstruments systematic review of measurement properties. Pain 2024; 165:258-295. [PMID: 37530676 DOI: 10.1097/j.pain.0000000000002998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/14/2023] [Indexed: 08/03/2023]
Abstract
ABSTRACT The Patient-Reported Outcome Measurement Information System (PROMIS) pediatric measures assess physical, emotional, and social health among children and adolescents. However, their measurement properties have not been systematically examined in youth with chronic pain. A systematic review applying the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) methodology was conducted to evaluate self-reported PROMIS pediatric measures in youth with chronic pain, assessing 8 measurement properties across all versions (item bank, short form, and computer adaptive testing) from 63 studies covering 25 measures. Moderate or high-quality evidence was most available for content validity, structural validity, internal consistency (measurement precision), and construct validity. Four short-form PROMIS pediatric measures-mobility, anxiety, depressive symptoms, and physical stress experiences-achieved recommendation for the use in chronic pain clinical trials; 7 approached recommendation and 14, including the commonly used PROMIS Pediatric Pain Interference Scale, would be recommended with further evidence. Recommendations were also provided for the use of each measure in observational studies. Overall, based on the existing evidence, a total of 11 self-reported PROMIS pediatric short-form measures, including pain intensity, pain behavior, mobility, sleep disturbance, sleep-related impairment, anxiety, depressive symptoms, psychological stress experiences, physical stress experiences, family relationships, and positive effect, are recommended or approaching recommendation for use in youth ages 8 to 19 years with chronic pain. Research is needed to further establish test-retest reliability, measurement errors, cross-cultural validity, and responsiveness. Future work should expand the evaluation of PROMIS pediatric measures in subpopulations of youth with chronic pain, particularly young children and those with neurodevelopmental disabilities.
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Affiliation(s)
- Rui Li
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Robert C Gibler
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Emma Rheel
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Katherine Slack
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Tonya M Palermo
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
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Keenan HT, Wade SL, Miron D, Presson AP, Clark AE, Ewing-Cobbs L. Reducing Stress after Trauma (ReSeT): study protocol for a randomized, controlled trial of an online psychoeducational program and video therapy sessions for children hospitalized after trauma. Trials 2023; 24:766. [PMID: 38017574 PMCID: PMC10683223 DOI: 10.1186/s13063-023-07806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Post-traumatic stress symptoms develop in a quarter to half of injured children affecting their longer-term psychologic and physical health. Evidence-based care exists for post-traumatic stress; however, it is not readily available in some communities. We have developed an eHealth program consisting of online, interactive educational modules and telehealth therapist support based in trauma-focused cognitive behavioral therapy, the Reducing Stress after Trauma (ReSeT) program. We hypothesize that children with post-traumatic stress who participate in ReSeT will have fewer symptoms compared to the usual care control group. METHODS This is a randomized controlled trial to test the effectiveness of the ReSeT intervention in reducing symptoms of post-traumatic stress compared to a usual care control group. One hundred and six children ages 8-17 years, who were admitted to hospital following an injury, with post-traumatic stress symptoms at 4 weeks post-injury, will be recruited and randomized from the four participating trauma centers. The outcomes compared across groups will be post-traumatic stress symptoms at 10 weeks (primary outcome) controlling for baseline symptoms and at 6 months post-randomization (secondary outcome). DISCUSSION ReSeT is an evidence-based program designed to reduce post-traumatic stress symptoms among injured children using an eHealth platform. Currently, the American College of Surgeons standards suggest that trauma programs identify and treat patients at high risk for mental health needs in the trauma system. If effectiveness is demonstrated, ReSeT could help increase access to evidence-based care for children with post-traumatic stress within the trauma system. TRIAL REGISTRATION ClinicalTrials.gov NCT04838977. 8 April 2021.
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Affiliation(s)
- Heather T Keenan
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
| | - Shari L Wade
- Cincinnati Children's Hospital Medical Center Division of Pediatric Rehabilitation, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Devi Miron
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave. #8055, New Orleans, LA, 70112, USA
| | - Angela P Presson
- Department of Internal Medicine, University of Utah School of Medicine, 30 N Mario Capecchi Dr. , Salt Lake City, UT, 84112, USA
| | - Amy E Clark
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Linda Ewing-Cobbs
- Children's Learning Institute, McGovern Medical School at UTHealth, 7000 Fannin, Suite 2401, Houston, TX, 77030, USA
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Meltzer LJ, Paisley C. Beyond Polysomnography: Clinical Assessment of Pediatric Sleep Health and Sleep Problems. Sleep Med Clin 2023; 18:147-160. [PMID: 37120158 DOI: 10.1016/j.jsmc.2023.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
This chapter reviews the Peds B-SATED model of pediatric sleep health and common pediatric sleep problems. Aspects of pediatric sleep health and sleep problems are considered across development, from infants through adolescents. Finally, information about clinical screening in both primary and specialty care is discussed, and subjective sleep questionnaires are reviewed.
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Affiliation(s)
- Lisa J Meltzer
- National Jewish Health, 1400 Jackson Street, G322, Denver, CO 80206, USA; University of Colorado Denver, Anschutz Medical Campus.
| | - Courtney Paisley
- University of Colorado Denver, Anschutz Medical Campus; Children's Hospital Colorado, Developmental Pediatrics, 13123 East 16th Avenue, Box B140, Aurora, CO 80045, USA
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Mansolf M, Blackwell CK. Sleep-related items on the school-age CBCL and the PROMIS sleep disturbance 4-item short-form: A psychometric comparison from the Environmental Influences on Child Health Outcomes (ECHO) program. Psychol Assess 2023; 35:443-452. [PMID: 36795437 PMCID: PMC10101929 DOI: 10.1037/pas0001220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The Child Behavior Checklist (CBCL) parent-report school-age form, a broad instrument widely used to evaluate youth's emotional and behavioral functioning, includes seven sleep-related items. These items are not an official subscale of the CBCL, but researchers have used them as a measure of general sleep problems. The primary objective of the present study was to evaluate the construct validity of the CBCL sleep items with a validated measure of sleep disturbance, the Patient-Reported Outcomes Measurement Information System Parent Proxy Short Form-Sleep Disturbance 4a (PSD4a). To do so, we used coadministered data on the two measures from 953 participants ages 5-18 years in the National Institutes of Health Environmental influences on Child Health Outcomes research program. Exploratory factor analysis (EFA) revealed two CBCL items were strictly jointly unidimensional with the PSD4a. To help prevent floor effects, we conducted further analyses that revealed three additional CBCL items could be included as an ad hoc measure of sleep disturbance. However, the PSD4a remains a psychometrically superior measure of child sleep disturbance. Researchers using these CBCL items to measure child sleep disturbance should account for these psychometric issues in their analysis and/or interpretation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Padmanabhan D, Tucker T, Murdaugh D, Ilonze C, Lebensburger J, Thomas SJ. The relationship between pain and sleep in pediatric sickle cell disease. Pediatr Blood Cancer 2023; 70:e30201. [PMID: 36628957 PMCID: PMC10983817 DOI: 10.1002/pbc.30201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Pain and sleep disturbances are prevalent complications experienced by pediatric patients with sickle cell disease (SCD). This study aims to identify associations between pain and sleep, and to characterize sleep chronotype and social jetlag in children and adolescent patients with SCD. METHODS We performed a cross-sectional survey of 105 pediatric patients with SCD aged 8-17 years using PROMIS (Patient Reported Outcomes Measurement System) pain interference, sleep disturbance, and sleep-related impairment item banks. The μMCTQ (Ultra-short Munich Chronotype Questionnaire) assessed chronotype and social jetlag. Analyses were performed to assess associations between PROMIS measures, sleep patterns, and clinical variables. RESULTS Female participants reported higher T-scores for sleep-related impairment than males (females: 56.7 ± 10 vs. males 50.2 ± 9.4, p = .0009). Patients with one or more emergency department (ED) visits for pain in the last 12 months reported greater sleep disturbance (55.0 ± 8.5 vs. 50.7 ± 10, p = .046) and sleep-related impairment (57.1 ± 9.3 vs. 52.1 ± 10.2, p = .03) than patients without any ED visits for pain in the last 12 months. Pain interference was significantly associated with both sleep disturbance (r = .49, p < .0001) and sleep-related impairment (r = .46, p < .0001). The average mid-sleep time was 4:14 ± 1:44 a.m. and the average social jetlag (hh:mm) was 2:32 ± 1:35. CONCLUSION Our study demonstrates that pain interference is associated with both sleep disturbance and sleep-related impairment. PROMIS measures can identify patients that suffer from pain and sleep disturbances and highlights the need to conduct longitudinal prospective studies to define the directionality of pain and sleep in SCD.
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Affiliation(s)
- Dakshin Padmanabhan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tiffany Tucker
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Donna Murdaugh
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Institute of Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chibuzo Ilonze
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeffrey Lebensburger
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - S Justin Thomas
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Fishbein AB, Lor J, Penedo FJ, Forrest CB, Griffith JW, Paller AS. Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: Cross-sectional study of the Patient Reported Outcomes Measurement Information System pediatric sleep measures and actigraphy. J Am Acad Dermatol 2023; 88:348-356. [PMID: 32504726 PMCID: PMC7710591 DOI: 10.1016/j.jaad.2020.05.138] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/09/2020] [Accepted: 05/07/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Most children with atopic dermatitis (AD) experience sleep disturbance, but reliable and valid assessment tools are lacking. OBJECTIVES To test the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep measures in pediatric AD and to develop an algorithm to screen, assess, and intervene to reduce sleep disturbance. METHODS A cross-sectional study was conducted with children with AD ages 5 to 17 years and 1 parent (n = 61), who completed sleep, itch, and AD-specific questionnaires; clinicians assessed disease severity. All children wore actigraphy watches for a 1-week objective sleep assessment. RESULTS PROMIS sleep disturbance parent proxy reliability was high (Cronbach α = 0.90) and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups (mean ± standard deviation in mild vs moderate vs severe was 55.7 ± 7.5 vs 59.8 ± 10.8 vs 67.1 ± 9.5; P < .01). Sleep disturbance correlated with itch (numeric rating scale, r = 0.48), PROMIS sleep-related impairment (r = 0.57), and worsened quality of life (Children's Dermatology Life Quality Index, r = 0.58), with all P values less than .01. Positive report on the POEM sleep disturbance question has high sensitivity (95%) for PROMIS parent proxy-reported sleep disturbance (T-score ≥ 60). An algorithm for screening and intervening on sleep disturbance was proposed. LIMITATIONS This was a local sample. CONCLUSIONS Sleep disturbance in pediatric AD should be screened using the POEM sleep question, with further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if needed.
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Affiliation(s)
- Anna B. Fishbein
- Department of Pediatrics, Division of Pediatric Allergy & Immunology, Ann & Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago IL, USA
| | - Jennifer Lor
- Department of Pediatrics, Division of Pediatric Allergy & Immunology, Ann & Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago IL, USA
| | - Frank J. Penedo
- Department of Psychology, University of Miami Sylvester Comprehensive Cancer Center, Miami FL, USA
| | - Christopher B. Forrest
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia PA, USA
| | - James W. Griffith
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago IL, USA
| | - Amy S. Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago IL, USA
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Schuchard J, Kaplan-Kahn EA, Carle AC, Holmes LG, Law K, Miller JS, Parish-Morris J, Forrest CB. Using percentiles in the interpretation of Patient-Reported Outcomes Measurement Information System scores: Guidelines for autism. Autism Res 2022; 15:2336-2345. [PMID: 36259546 DOI: 10.1002/aur.2833] [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: 05/22/2022] [Accepted: 10/04/2022] [Indexed: 12/15/2022]
Abstract
The objectives of this study were to (1) demonstrate the application of percentiles to advance the interpretation of patient-reported outcomes and (2) establish autism-specific percentiles for four Patient-Reported Outcomes Measurement Information System (PROMIS) measures. PROMIS measures were completed by parents of autistic children and adolescents ages 5-17 years as part of two studies (n = 939 parents in the first study and n = 406 parents in the second study). Data from the first study were used to develop autism-specific percentiles for PROMIS parent-proxy sleep disturbance, sleep-related impairment, fatigue, and anxiety. Previously established United States general population percentiles were applied to interpret PROMIS scores in both studies. Results of logistic regression models showed that parent-reported material hardship was associated with scoring in the moderate-severe range (defined as ≥75th percentile in the general population) on all four PROMIS measures (odds ratios 1.7-2.2). In the second study, the percentage of children with severe scores (defined as ≥95th percentile in the general population) was 30% for anxiety, 25% for sleep disturbance, and 17% for sleep-related impairment, indicating a high burden of these problems among autistic children. Few children had scores at or above the autism-specific 95th percentile on these measures (3%-4%), indicating that their scores were similar to other autistic children. The general population and condition-specific percentiles provide two complementary reference points to aid interpretation of PROMIS scores, including corresponding severity categories that are comparable across different PROMIS measures.
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Affiliation(s)
- Julia Schuchard
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elizabeth A Kaplan-Kahn
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Adam C Carle
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, USA
| | | | - Kiely Law
- Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Judith S Miller
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julia Parish-Morris
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christopher B Forrest
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Santucci NR, King C, El-Chammas KI, Wongteerasut A, Damrongmanee A, Graham K, Fei L, Sahay R, Jones C, Cunningham NR, Coghill RC. Effect of percutaneous electrical nerve field stimulation on mechanosensitivity, sleep, and psychological comorbidities in adolescents with functional abdominal pain disorders. Neurogastroenterol Motil 2022; 34:e14358. [PMID: 35293081 PMCID: PMC11093756 DOI: 10.1111/nmo.14358] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 12/21/2021] [Accepted: 02/04/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Percutaneous electrical nerve field stimulation (PENFS) improves symptoms in adolescents with functional abdominal pain disorders (FAPDs). However, little is known about its impact on sleep and psychological functioning. We evaluated the effects of PENFS on resting and evoked pain and nausea, sleep and psychological functioning, and long-term outcomes. METHODS Patient ages 11-19 years with FAPD requiring PENFS as standard care were recruited. Evoked pain was elicited by a Water Load Symptom Provocation Task (WL-SPT) before and after four weeks of treatment. Pain, gastrointestinal symptoms, sleep, somatic symptoms, and physical and psychological functioning were assessed. Actigraphy was used to measure daily sleep-wake patterns. KEY RESULTS Twenty patients (14.3 ± 2.2 years old) with FAPD were enrolled. Most patients were females (70%) and white (95%). During pain evoked by WL-SPT, visual analog scale (VAS) pain intensity and nausea were lower following PENFS compared with baseline (p = 0.004 and p = 0.02, respectively). After PENFS, resting VAS pain unpleasantness (p = 0.03), abdominal pain (p < 0.0001), pain catastrophizing (p = 0.0004), somatic complaints (0.01), functional disability (p = 0.04), and anxiety (p = 0.02) exhibited significant improvements, and some were sustained long-term. Self-reported sleep improved after PENFS (p's < 0.05) as well as actigraphy-derived sleep onset latency (p = 0.03). CONCLUSIONS AND INFERENCES We demonstrated improvements in resting and evoked pain and nausea, sleep, disability, pain catastrophizing, somatic complaints, and anxiety after four weeks of PENFS therapy. Some effects were sustained at 6-12 months post-treatment. This suggests that PENFS is a suitable alternative to pharmacologic therapy.
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Affiliation(s)
- Neha R Santucci
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Christopher King
- Behavioral Medicine and Clinical Psychology (BMCP), Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Khalil I. El-Chammas
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Anundorn Wongteerasut
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Alisara Damrongmanee
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kahleb Graham
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lin Fei
- Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Rashmi Sahay
- Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Cheryl Jones
- Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Robert C Coghill
- Behavioral Medicine and Clinical Psychology (BMCP), Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
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Wilaisakditipakorn TJ, Ievers-Landis CE, Malay S, Burkhart K, Ibrahim S, Kralovic S, Diekroger EA. Sleep and media use among children with neurodevelopmental disorders during the COVID-19 pandemic. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2021.2013222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Tanaporn Jasmine Wilaisakditipakorn
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Carolyn E. Ievers-Landis
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sindhoosha Malay
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kimberly Burkhart
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sally Ibrahim
- Division of Pediatric Pulmonology and Sleep Medicine, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Shanna Kralovic
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Elizabeth A. Diekroger
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Meltzer LJ, Wahlstrom KL, Plog AE, Strand MJ. Changing school start times: impact on sleep in primary and secondary school students. Sleep 2021; 44:zsab048. [PMID: 33855446 PMCID: PMC8271142 DOI: 10.1093/sleep/zsab048] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
STUDY OBJECTIVES To examine the impact of changing school start times on sleep for primary (elementary school: ES) and secondary (middle and high school: MS/HS) students. METHODS Students (grades 3-12) and parents (grades K-12) were surveyed annually, before and for 2 years after school start time changes (ES: 60 min earlier, MS: 40-60 min later; HS: 70 min later). Student sleep and daytime sleepiness were measured with school-administered student surveys and parent-proxy online surveys. RESULTS Approximately 28,000 students annually completed surveys (~55% White, ~21% free/reduced lunch [FRL]). One-year post-change, weekday bedtimes and wake times were slightly earlier for ES students, with an 11-min decrease in sleep duration. MS and HS students reported slightly later weekday bedtimes, significantly later wake times, and significantly longer sleep duration (MS: 29 min; HS: 45 min). The percent of ES students reporting sufficient sleep duration, poor sleep quality, or daytime sleepiness did not change, but the percent of MS and HS students reporting sufficient sleep duration significantly increased and clinically significant daytime sleepiness decreased. All results were maintained at the 2-year follow-up. Benefits of later start times were similar across racial and free/reduced lunch groups. CONCLUSIONS This is the first large scale, longitudinal, and representative study to concurrently examine the impact of changing school start times across students in primary/secondary school. Findings suggest a minimal impact of earlier start times on ES students' sleep or daytime sleepiness, while further supporting the significant benefits of delaying MS and HS start times on student sleep and daytime sleepiness.
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Affiliation(s)
| | | | - Amy E Plog
- Cherry Creek School District, Greenwood Village, CO,USA
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15
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Wasserman RC, Fiks AG. The Future(s) of Pediatric Primary Care. Acad Pediatr 2021; 21:414-424. [PMID: 33130066 DOI: 10.1016/j.acap.2020.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
Pediatric primary care (PPC) arose in the early 20th century as the fusion of acute and chronic pediatric illness care with preventive elements borrowed from public and maternal and child health. Well-established and thriving by the 1930s, PPC saw major changes in childhood morbidity and mortality in the latter half of the 20th century with the recognition of the "new morbidity" of school, behavior, and social problems. At the same time, PPC experienced changes in its workforce, which became increasingly female and added nurse practitioners and physician assistants as practitioners. Independent practice, previously the dominant business model, decreased in prominence at the end of the 20th century as health systems bought practices and other sites morphed into federally qualified health centers. In the present century, electronic health records (EHRs) have brought profound changes in PPC workflows and practitioner experience. In addition, disruptive market competition such as retail clinics and corporate telemedicine providers coupled with changes in health insurance from fee-for-service to value-based payment further challenge the care model and economics of PPC. Finally, recognition of family social circumstances as major determinants of children's health presents another challenge to the status quo. As such, although one PPC future may resemble its present state, a more innovative future is likely to include clinics and practices more oriented toward and linked to communities and directed at the social determinants of health. In addition, the rise in physical, behavioral, and social problems in practice call for a growing focus on wellness, including sleep, nutrition, and activity, that promises to reorient the PPC future in productive new directions. The half-way technology of current EHR systems will ideally be spun into electronic hubs that facilitate teamwork between PPC, specialists, and community groups. Research and practice improvement strategies including involvement in "learning health systems" will be critical to making PPC effective in an evolving society. Although threatened by 21st century forces and hard-to-anticipate change, PPC is ideally positioned to build upon its core functions to create multidisciplinary teams that reach into the community, promoting a holistic wellness for children consistent with the broadest definition of health.
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Affiliation(s)
- Richard C Wasserman
- Larner College of Medicine, University of Vermont (RC Wasserman), Charlotte, Vt.
| | - Alexander G Fiks
- Children's Hospital of Philadelphia, Department of Pediatrics, Center for Pediatric Clinical Effectiveness, and the Possibilities Project, Roberts Center for Pediatric Research (AG Fiks), Philadelphia, Pa
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Adebowale TO, Taylor BJ, Gray AR, Galland BC, Heath ALM, Fortune S, Meredith-Jones KA, Sullivan T, McIntosh D, Brosnan B, Taylor RW. Long-Term Follow-Up of a Randomized Controlled Trial to Reduce Excessive Weight Gain in Infancy: Protocol for the Prevention of Overweight in Infancy (POI) Follow-Up Study at 11 Years. JMIR Res Protoc 2020; 9:e24968. [PMID: 33252344 PMCID: PMC7735907 DOI: 10.2196/24968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 10/20/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
Background The Prevention of Overweight in Infancy (POI) randomized controlled trial assessed the effect of a more conventional food, physical activity, and breastfeeding intervention, with a more novel sleep intervention on weight outcomes at 2 years of age. The trial had 58% uptake at recruitment, and retention was 86% at age 2 years, 77% at age 3.5 years, and 69% at age 5 years. Children who received the brief sleep intervention in infancy had just half the risk of obesity at 2 years of age compared to those who did not receive the sleep intervention. Importantly, this substantially reduced risk was still apparent at our follow-up at 5 years of age. Objective The primary aim of this follow-up at age 11 years is to determine whether differences in BMI z-score and obesity risk remain apparent now that it is at least 9 years since cessation of the sleep intervention. Several secondary outcomes of interest will also be examined including 24-hour movement patterns, mental health and wellbeing, and use of electronic media, particularly prior to sleep. Methods We will seek renewed consent from all 734 of the original 802 POI families who expressed interest in further involvement. Children and parent(s) will attend 2 clinics and 1 home appointment to obtain measures of anthropometry and body composition (dual-energy x-ray absorptiometry scan), 24-hour movement patterns (sleep, sedentary time, and physical activity measured using an AX3 accelerometer), mental health and wellbeing (validated questionnaires), family functioning (validated questionnaires), use of electronic media (wearable and stationary cameras, questionnaires), and diet and eating behaviors (24-hour recall, questionnaires). Results This follow-up study has full ethical approval from the University of Otago Human Ethics Committee (H19/109) and was funded in May 2019 by the Health Research Council of New Zealand (grant 19/346). Data collection commenced in June 2020, and first results are expected to be submitted for publication in 2022. Conclusions Long-term outcomes of early obesity intervention are rare. Despite the growing body of evidence linking insufficient sleep with an increased risk of obesity in children, interventions targeting improvements in sleep have been insufficiently explored. Our initial follow-up at 5 years of age suggested that an early sleep intervention may have long-term benefits for effective weight management in children. Further analysis in our now preteen population will provide much-needed evidence regarding the long-term effectiveness of sleep interventions in infancy as an obesity prevention approach. Trial Registration ClinicalTrials.gov NCT00892983; https://tinyurl.com/y3xepvxf International Registered Report Identifier (IRRID) DERR1-10.2196/24968
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Affiliation(s)
| | - Barry J Taylor
- Department of Women's and Children's Health, Children's Pavilion Dunedin Public Hospital, University of Otago, Dunedin, New Zealand
| | - Andrew R Gray
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | | | - Sarah Fortune
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | | | - Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Deborah McIntosh
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Bradley Brosnan
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Daniel LC, Gross JY, Meltzer LJ, Flannery JL, Forrest CB, Barakat LP. Clinical validity of the PROMIS pediatric sleep short forms in children receiving treatment for cancer. Pediatr Blood Cancer 2020; 67:e28535. [PMID: 32649043 DOI: 10.1002/pbc.28535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Rates of sleep disturbances vary widely across pediatric cancer studies, partly due to differences in measurement tools. Patient-reported outcomes measurement information system (PROMIS) offers a rigorously developed, well-validated pair of pediatric sleep health instruments needed to advance sleep research and clinical practice in pediatric cancer. The current study evaluated the clinical validity of PROMIS pediatric sleep scales (sleep disturbances [SD] and sleep-related impairment [SRI]) among children in active cancer treatment. PROCEDURE Caregiver-patient dyads were enrolled during cancer treatment in 2-12 months after diagnosis: 45 children (ages 8-17 years) and 102 caregivers of children (ages 5-17 years) completed PROMIS SD and SRI 8-item short form self-report or caregiver-proxy scales, and caregivers reported the prior week's cancer treatments and blood counts. RESULTS Both scales demonstrated strong internal consistency reliability across reporters. SD and SRI were higher than the PROMIS general population calibration sample for caregivers and patients. Oncology caregivers reported lower SD and SRI than sleep clinic caregivers, but oncology patients were similar to sleep clinic patients. Convergent validity was evidenced through moderate correlations between scales by reporter and both scales being significantly higher in patients taking medications for sleep. There were no significant differences in SD or SRI by diagnostic group, receiving radiation, or having low blood counts. CONCLUSION The PROMIS SD and SRI short forms are promising measures for pediatric oncology, demonstrating strong internal consistency reliability and multiple indications of clinical validity. Although groups did not differ based on treatment variables, results suggest the need for universal screening for sleep problems during pediatric cancer treatment.
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Affiliation(s)
| | - J Yael Gross
- Department of Psychology, Rutgers University, Camden, NJ
| | | | | | - Christopher B Forrest
- The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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18
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Cohen LL, Cella D, Wakschlag, LS. Innovations in Pediatric Psychology Assessment: The Conversation Has Just Begun. J Pediatr Psychol 2020. [DOI: 10.1093/jpepsy/jsaa006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Meltzer LJ, Flewelling KD, Jump S, Gyorkos E, White M, Hauk PJ. Impact of atopic dermatitis treatment on child and parent sleep, daytime functioning, and quality of life. Ann Allergy Asthma Immunol 2020; 124:385-392. [PMID: 31923547 DOI: 10.1016/j.anai.2019.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/23/2019] [Accepted: 12/27/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a common childhood disorder that is associated with a variety of negative health outcomes in children and parents, including poor sleep and daytime functioning. Despite this, few studies have examined the impact of treatment for AD on sleep, and even fewer have included validated sleep questionnaires, child report of sleep disturbance, or objective measures of sleep. OBJECTIVE To address limitations in the literature by examining objective and subjective reports of sleep, as well as measures of daytime functioning before and after admission to an intensive treatment program for AD. METHODS Twenty-nine parent-child dyads who presented to an intensive day treatment program participated in this study. Sleep was objectively measured with 1 week of actigraphy both 1 week before admission and 1 month after discharge. Subjective questionnaires of sleep, daytime functioning, and quality of life were completed by children and parents at admission, discharge, 1 month after discharge, and 3 months after discharge. RESULTS Study results highlight the benefit of the treatment program on reducing AD severity, as well as improvements in objectively measured sleep duration and efficiency, self-reported measures of sleep, daytime functioning, and quality of life in children and parents up to 3 months after discharge. CONCLUSION This study highlights the importance of treatment for child AD on both child and parent health outcomes.
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Affiliation(s)
- Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
| | | | - Stephanie Jump
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | | | - Michael White
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Pia J Hauk
- Department of Pediatrics, National Jewish Health, Denver, Colorado
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