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Barry JN, Moses JD, Kim SC. A Clinician's Guide To Effectively Transitioning and Transferring Care For Pediatric Patients With Inflammatory Bowel Diseases From The Pediatric To Adult Gastroenterologist. Curr Gastroenterol Rep 2024:10.1007/s11894-024-00936-6. [PMID: 39009946 DOI: 10.1007/s11894-024-00936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE OF REVIEW Transition of care for pediatric patients with inflammatory bowel diseases (IBD) is a continuous, dynamic process that takes place over several years with a coordinated approach executed by a multidisciplinary team. We review the concepts, tools, and research in effective transitioning and transfer of care for adolescent/young adult patients with IBD. RECENT FINDINGS Given the constraints within the healthcare system, effective transitioning can be challenging to implement in everyday clinical practice. Different barriers include resources and expertise in effective transitioning by pediatric and adult gastroenterology healthcare providers and the impact of non-gastrointestinal issues facing young adult patients who are learning to manage and coordinate all aspects of their medical care and health maintenance. Factors that facilitate successful care transitioning and transfer include structured transitioning programs, utilization of validated transition checklists, and IBD medical summaries. Proactive transitioning by pediatric gastroenterologists in partnership with their emerging young adult patients with IBD leads to better clinical and psychosocial outcomes and ultimately, effective transfer of care to adult gastroenterology. By utilizing utilize comprehensive transition assessment tools and medical summaries in partnership with their patients, pediatric and adult gastroenterology teams can better prepare patients as they transfer to independent care and health maintenance.
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Affiliation(s)
- Jessica N Barry
- Cleveland Clinic, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland, OH, USA
| | - Jonathan D Moses
- Stanford Medicine Children's Health Division of Gastroenterology, Hepatology, and Nutrition, Palo Alto, CA, USA
| | - Sandra C Kim
- Cleveland Clinic, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland, OH, USA.
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Alqahtani RM, Alghanemi A, Aljifri AM, Ghulman IM, Ashram SY, Alghamdi EA, Azhar AE, Ibrahim ZA, Alsudais MM, Banaja AW. Public Knowledge of Inflammatory Bowel Diseases in Saudi Arabia: A Cross-Sectional Survey Study. Cureus 2023; 15:e40114. [PMID: 37425509 PMCID: PMC10329281 DOI: 10.7759/cureus.40114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Lack of public understanding and perception may lead to a general downplaying of inflammatory bowel disorder (IBD) symptoms as they affect a less socially acceptable area of the body, which may be a significant component in the everyday struggles of an individual with IBD. AIM The aim is to assess the public knowledge of Crohn's disease and ulcerative colitis in Saudi Arabia. METHOD This was an online survey study that examined public knowledge of IBD in Saudi Arabia for the duration between February and March 2023. Participants were invited to participate in this study using social media websites. The questionnaire tool comprised three sections: a sociodemographic characteristics section (seven questions), an awareness section (two questions), and a knowledge section (24 questions). A binary logistic regression analysis was utilized to identify the factors that influenced the participants' knowledge of Crohn's disease and ulcerative colitis. RESULTS A total of 630 individuals participated in this study. Around 28% of the participants reported that they had never heard of, read about, or dealt with Crohn's disease. Around 16% of them reported that they had never heard of, read about, or dealt with ulcerative colitis. The mean overall knowledge score of the study participants was 8.3 (standard deviation: 2.4) out of 24, which is equal to 34.6% and represents a weak level of knowledge of IBD. The participants showed a weak level of knowledge for all sub-scales of knowledge related to IBD general knowledge, diet, treatments, and complications. The knowledge sub-scale level ranged between 30% and 36.7%. Females, the participants in the moderate and high-income category, those who lived in urban areas, those with a higher level of education, and those who reported having osteoarthritis were more likely to be knowledgeable about IBD compared to others (p≤0.001). CONCLUSION In Saudi Arabia, a low level of IBD awareness was identified among the general population, supporting findings from other countries. Future research should aim to identify effective educational interventions to increase public awareness of this group of diseases, which would ultimately facilitate early diagnosis and improve patient outcomes.
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Affiliation(s)
- Reem M Alqahtani
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Aseel Alghanemi
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Ibraheem M Ghulman
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Saif Y Ashram
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Essam A Alghamdi
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Abdulrahman E Azhar
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Ziad A Ibrahim
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Meshal M Alsudais
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Abdulaziz W Banaja
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, SAU
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Vernon-Roberts A, Musto F, Aloi M, Day AS. Italian Cross-Cultural Adaptation of a Knowledge Assessment Tool (IBD-KID2) for Children with Inflammatory Bowel Disease. GASTROINTESTINAL DISORDERS 2023; 5:187-197. [DOI: 10.3390/gidisord5020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
Background: For children with inflammatory bowel disease (IBD), understanding their condition may lead to better outcomes. Knowledge assessment is imperative to identify where education may be required. An IBD knowledge assessment tool (IBD-KID2) is available in English; the aim of this study was to translate IBD-KID2 in to Italian and assess its validity/reliability among children with IBD. Methods: IBD-KID2 has fifteen items, scoring one point per correct answer. IBD-KID2 items were assessed for cultural comprehension/relevance by Italian gastroenterologists using a content validity index; those items with a maximum score proportion <0.78 were reviewed. IBD-KID2 was then translated using ‘forward–backward’ process and reviewed for content/meaning. A prospective study among Italian children with IBD enabled score comparisons with established populations (z test), and reliability was assessed using test–retest completion (Pearson correlation (r), paired t-test). Results: Twenty-five children participated: 16 (64%) male, mean age 14.9 years (SD2.4), Crohn’s disease 13 (52%). The mean IBD-KID2 score was 8.8 (SD2.8), with no association with independent variables. Test–retest showed strong correlation between scores (r = 0.78, p < 0.001), with no mean difference (p = 0.39). Comparison with other pediatric IBD populations (NZ/Australia/Canada) showed no score difference (p = 0.62, CI −0.9 to 1.5). Conclusions: The translation of IBD-KID2 to Italian used a rigorous methodology. Scores showed the translated tool has equivalence and generalizability to Italian children with IBD.
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Affiliation(s)
| | - Francesca Musto
- Pediatric Gastroenterology and Liver Unit, Department of Maternal and Child Health, Umberto I Hospital, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Marina Aloi
- Pediatric Gastroenterology and Liver Unit, Department of Maternal and Child Health, Umberto I Hospital, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Andrew S. Day
- Department of Paediatrics, University of Otago, Christchurch 8011, New Zealand
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Menze L, Wenzl TG, Pappa A. [KARLOTTA (Kids + Adolescents Research Learning On Tablet Teaching Aachen) - randomized controlled pilot study for the implementation of a digital educational app with game of skill for pediatric patients with inflammatory bowel disease]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:155-163. [PMID: 35672003 DOI: 10.1055/a-1799-9267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Improvement of disease-specific knowledge in pediatric patients with inflammatory bowel disease (IBD) using a digital app and individualized teaching from physician to patient. METHODS We developed an app for Android Software called KARLOTTA (Kids + Adolescents Research Learning On Tablet Teaching Aachen) with a game of skill and IBD questionnaire with visual feedback and high scores. Randomized controlled study as a pilot project with 30 IBD patients, aged 10-18 years. The intervention group used the KARLOTTA app on a tablet before every consultation during a 12-month period. Outcome parameters were an increase in knowledge, changes in quality of life and analysis of the feedback questionnaires for patient and physician. The statistical analysis was carried out with the X2 -test, Mann-Whitney-U test and descriptive analysis. RESULTS KARLOTTA was played 55 times by 14 patients. In all patients (100%) gaps in knowledge could be discovered and specific teaching took place. In the KARLOTTA group, 11 of 14 patients (79%) had an increase in knowledge, in the control group 7 of 15 patients (47%), p-value of 0.08 with the X2 -test. There were no differences in results for quality of life. The app could be used without any problems in 87% of the appointments. CONCLUSIONS The KARLOTTA app reveals individual gaps in knowledge, provides tailor-made physician-patient teaching and can be easily implemented in the outpatient clinic.
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Affiliation(s)
- Lukas Menze
- Klinik für Kinder- und Jugendmedizin, Uniklinik RWTH Aachen, Aachen, Germany
| | - Tobias G Wenzl
- Klinik für Kinder- und Jugendmedizin, Uniklinik RWTH Aachen, Aachen, Germany
| | - Angeliki Pappa
- Klinik für Kinder- und Jugendmedizin, Uniklinik RWTH Aachen, Aachen, Germany
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Buerkle KS, Vernon-Roberts A, Ho C, Schultz M, Day AS. A Short Knowledge Assessment Tool Is Valid and Acceptable for Adults with Inflammatory Bowel Disease. Dig Dis Sci 2022; 67:2049-2058. [PMID: 35511411 PMCID: PMC9068503 DOI: 10.1007/s10620-022-07507-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/28/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND For people with inflammatory bowel disease, validated knowledge questionnaires are valuable to identify gaps in understanding and explore the impact on disease variables. AIMS The aim of this study was to validate the short knowledge questionnaire Inflammatory Bowel Disease Knowledge Inventory Device 2, known as IBD-KID2, for use with adults with inflammatory bowel disease. METHODS Concurrent validity of IBD-KID2 was assessed by comparing scores with those achieved on the Crohn's and Colitis Knowledge Score (CCKNOW). IBD-KID2 reliability was assessed with test-retest completion at two time points, generalizability assessed by comparing IBD-KID2 cohort scores at different recruitment centres, and acceptability assessed using participant survey. RESULTS Seventy-five adults with inflammatory bowel disease completed the study. The mean percentage scores achieved on the IBD-KID2 and CCKNOW were 72.8% (SD 16.0) and 49.7% (SD 18.2), respectively. There was a significant correlation between IBD-KID2 and CCKNOW scores (R 0.573, P < 0.005), confirming concurrent validity. IBD-KID2 reliability was confirmed as no significant difference was seen between scores at test and retest (mean difference -0.2, P = 0.92). Generalizability was established as no significant score difference was seen between recruitment centres after controlling for population differences. The acceptability survey showed that 49 (69%) participants preferred IBD-KID2 to the CCKNOW, 60 (85%) found the IBD-KID2 easier to complete, and 38 (53%) considered the CCKNOW as most suitable for adults. CONCLUSIONS IBD-KID2 is a valid, reliable, and generalizable tool for measuring knowledge in adults with inflammatory bowel disease with good acceptability. IBD-KID2 is easy and quick to complete, hence limiting respondent burden.
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Affiliation(s)
- Katrin S. Buerkle
- Department of Medicine, University of Otago (Dunedin), PO Box 56, Dunedin, 9054 New Zealand
| | - Angharad Vernon-Roberts
- Department of Paediatrics, University of Otago (Christchurch), Riccarton Ave, Christchurch, 8011 New Zealand
| | - Christine Ho
- Gastroenterology Department, Southern District Health Board, Private Bag 1921, Dunedin, 9054 New Zealand
| | - Michael Schultz
- Department of Medicine, University of Otago (Dunedin), PO Box 56, Dunedin, 9054 New Zealand
| | - Andrew S. Day
- Department of Paediatrics, University of Otago (Christchurch), Riccarton Ave, Christchurch, 8011 New Zealand
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van Gaalen MAC, van Pieterson M, van den Brink G, de Ridder L, Rizopoulos D, van der Woude CJ, Escher JC. Rotterdam Transition Test: A Valid Tool for Monitoring Disease Knowledge in Adolescents With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2022; 74:60-67. [PMID: 34371508 DOI: 10.1097/mpg.0000000000003278] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Disease knowledge is important in adolescents with inflammatory bowel disease (IBD) transitioning to adult care. We developed an IBD-specific knowledge questionnaire, the Rotterdam Transition Test (RTT), and aimed to validate this tool. METHODS This is a prospective longitudinal validation study. The RTT has 25 open questions on IBD, medication, lifestyle, and transition to adult care. A scoring model was developed, and inter-rater agreement was assessed. Using a Rasch model, we determined the difficulty and performance of the questions. Cronbach alpha was used to demonstrate reliability. Patient factors (age, disease, education, medication use, illness acceptance, and independence) were correlated to RTT score. RESULTS A total of 207 RTTs were evaluated in 111 adolescent IBD patients. The scoring model showed a kappa score of >0.61 for all questions. Reliability with Cronbach alpha was good (0.81). Mean total result of the RTT was 58% (girls) and 55% (boys) of maximal score.The RTT discriminated well between the different levels of knowledge. Knowledge scores increased in patients who did repeated RTTs during the transition period. Male sex, low educational level, disease acceptance issues, and dependence on parents associated with a significantly lower total RTT score. Prednisone use within 3 months and treatment without biologics associated with significantly higher RTT scores. Disease activity was not a significant factor. CONCLUSIONS The RTT is a reliable and valid tool to assess IBD knowledge. The RTT can be used to detect and discuss knowledge gaps in adolescents with IBD transitioning to adult healthcare.
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Affiliation(s)
| | - Merel van Pieterson
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital
| | | | - Lissy de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital
| | | | | | - Johanna C Escher
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital
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Vernon-Roberts A, Lopez RN, Lewindon P, Lemberg DA, Bowcock NL, Alex G, Otley A, Jacobson K, Roberts AJ, Evans HM, Gearry RB, Day AS. Assessment of Disease-related Knowledge Among Children With Inflammatory Bowel Disease and their Family Using IBD-KID2: Evaluating Tool Generalizability. JPGN REPORTS 2021; 2:e093. [PMID: 37205959 PMCID: PMC10191511 DOI: 10.1097/pg9.0000000000000093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/06/2021] [Indexed: 05/21/2023]
Abstract
Children with inflammatory bowel disease (IBD) and their families benefit from improved knowledge of their disease and treatment. Knowledge levels of individual family members are infrequently studied but may identify where education is best directed. We aimed to assess disease-specific knowledge among children with IBD, parents, and siblings, using a validated assessment tool (IBD-KID2), and to establish generalizability of IBD-KID2. Methods Children with IBD and family members were recruited from tertiary IBD clinics in New Zealand, Australia, and Canada. All participants completed IBD-KID2 online at baseline, and the children with IBD again after 2 weeks to assess reliability. Results Participants included 130 children with IBD, 118 mothers, 55 fathers, and 37 siblings. Children with IBD had a mean score of 9.1 (SD 2.9) (maximum 15 points), significantly lower than parents (P < 0.005) and higher than siblings (P < 0.005). Scores of children with IBD were positively associated with current age (P < 0.005), age at diagnosis (P = 0.04) and fathers education level (P = 0.02). Significant score correlations were seen between children with IBD and their mother (P < 0.005) but not father. Sibling scores were not correlated with either parent. Test-retest reliability was high. The cohorts from each country were comparable, and no difference in group scores was seen between countries. Conclusion IBD-KID2 is a generalizable and reliable tool for the assessment of disease and treatment knowledge for children with IBD and their families. Score correlations between parents and children with IBD suggest transfer of knowledge, but sibling knowledge is low and targeted education may be beneficial.
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Affiliation(s)
- Angharad Vernon-Roberts
- From the Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand
| | - Robert N Lopez
- Department of Paediatric Gastroenterology, Queensland Children's Hospital, Brisbane, Australia
| | - Peter Lewindon
- Department of Paediatric Gastroenterology, Queensland Children's Hospital, Brisbane, Australia
| | - Daniel A Lemberg
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Australia
| | - Nerissa L Bowcock
- Department of Paediatric Gastroenterology, School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - George Alex
- Department of Paediatric Gastroenterology, Royal Children's Hospital, Melbourne, Australia
| | - Anthony Otley
- Department of Pediatrics, Dalhousie University, Nova Scotia, Canada
| | - Kevan Jacobson
- Department of Paediatric Gastroenterology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Amin J Roberts
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Helen M Evans
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago (Christchurch), Christchurch, New Zealand
| | - Andrew S Day
- From the Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand
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Kowalska-Duplaga K, Gawlik-Scislo A, Krzesiek E, Jarocka-Cyrta E, Łazowska-Przeorek I, Duplaga M, Banaszkiewicz A. Determinants of disease-specific knowledge among children with inflammatory bowel disease and their parents: A multicentre study. World J Gastroenterol 2021; 27:4468-4480. [PMID: 34366617 PMCID: PMC8316911 DOI: 10.3748/wjg.v27.i27.4468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/02/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Disease knowledge is associated with increased treatment compliance and improvement of symptoms in inflammatory bowel disease (IBD). IBD-knowledge inventory device (IBD-KID) was developed and validated specifically as a tool to measure disease-related knowledge in children with IBD and their parents. AIM To prospectively assess the determinants of disease-related knowledge regarding paediatric IBD patients and their parents, using the IBD-KID. METHODS A questionnaire-based survey was carried out in paediatric patients and their parents. The determinants of patients' and parents' IBD-KID scores were assessed according to hierarchical linear regression models. RESULTS The study group consisted of 269 IBD patients and 298 parents. The patients' mean (standard deviation, SD) IBD-KID score was 10.87 (± 3.97), while the parents' was 11.95 (± 3.97). Both groups exhibited poor knowledge of the side effects of steroid therapy, the role of surgical treatment in IBD, dietary restrictions and the risks associated with the use of herbal medicines. The patients' IBD-KID scores were statistically associated with patient sex [B coefficient (standard error, SE) = 1.03 (0.44), P = 0.021] and patient age [B (SE) = 0.03 (0.01), P < 0.001]. The parents' IBD-KID scores were significantly related to patient age [B (SE) = 0.02 (0.01), P = 0.003], and treatment with immunosuppressive agent [B (SE) = 1.85 (0.48), P < 0.001]. The final models explained 26.9% of the variance of patients' IBD-KID scores and 18.5% of the variance of parents' scores. CONCLUSION The variables originating from parents' knowledge were significantly associated with patients' IBD-KID scores. The study results indicate the need to implement better education programmes for patients and parents.
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Affiliation(s)
- Kinga Kowalska-Duplaga
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, Kraków 30-663, Poland
| | - Anita Gawlik-Scislo
- Children's Hospital of the Medical University of Warsaw, Medical University of Warsaw, Warsaw 02-091, Poland
| | - Elzbieta Krzesiek
- Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw 50-369, Poland
| | | | - Izabella Łazowska-Przeorek
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw 02-091, Poland
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Jagiellonian University Medical College, Kraków 31-066, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw 02-091, Poland
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Maddux M, Gordy A, Schurman C, Cole T, Staggs V. Initial Validation of IBD KNOW-IT: Measuring Patient and Caregiver Knowledge of a Child's Disease and Treatment Regimen. J Clin Psychol Med Settings 2021; 27:480-489. [PMID: 31144222 DOI: 10.1007/s10880-019-09636-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The present study describes the development and initial validation of a newly developed measure of child and caregiver knowledge of the child's own IBD and treatment, called IBD KNOW-IT. One hundred and fifty-five children and their caregivers completed the IBD KNOW-IT as well as a scale designed to compare each dyad's perceived knowledge to their actual knowledge. Initial psychometric evaluation of IBD KNOW-IT was completed by conducting factor analysis and determining internal consistency, convergent validity, and associations with demographic and medical characteristics. Results supported the validity of a 12-item measure with 4 subscales including Symptoms, Medication Regimen, Disease Monitoring, and Medical Team. Support for the internal consistency of IBD KNOW-IT was obtained. Evidence of validity was demonstrated by significant correlations between child and caregiver scales, and high congruence between perceived and actual knowledge across all subscales. The reliability of the measure was demonstrated by good internal consistency and test-retest reliability. Preliminary psychometric evaluation suggests that IBD KNOW-IT is reliable and valid.
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Affiliation(s)
- Michele Maddux
- Division of Developmental & Behavioral Sciences/Division of Gastroenterology, Children's Mercy-Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
- Division of Gastroenterology, Children's Mercy-Kansas City, Kansas City, MO, USA.
| | - Allison Gordy
- Division of Gastroenterology, Children's Mercy-Kansas City, Kansas City, MO, USA
| | - Corey Schurman
- Division of Gastroenterology, Children's Mercy-Kansas City, Kansas City, MO, USA
| | - Trevor Cole
- Division of Gastroenterology, Children's Mercy-Kansas City, Kansas City, MO, USA
| | - Vincent Staggs
- Division of Health Services and Outcomes Research, Children's Mercy-Kansas City, Kansas City, MO, USA
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Overview of Self-Management Skills and Associated Assessment Tools for Children with Inflammatory Bowel Disease. GASTROINTESTINAL DISORDERS 2021. [DOI: 10.3390/gidisord3020007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Self-management is a multi-modal approach for managing chronic conditions that encompasses a number of different elements; knowledge, adherence, self-regulation, communication, and cognitive factors. Self-management has been shown to be beneficial for adults with inflammatory bowel disease (IBD), and for children with IBD it may help them learn to take control of their complex treatment regimens and lead to positive disease outcomes. The development of self-management skills for children with IBD is vital in order to maximize their potential for health autonomy, but it is still an emergent field in this population. This review provides an over-arching view of the self-management elements specific to children with IBD, and highlights outcome measures that may be used to assess skills within each field as well as the efficacy of targeted interventions.
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Gray WN, Wagoner ST, Schaefer MR, Reed B, Morgan P, Holbrook E, Yacyshyn B, Mackner L, Young M, Maddux M, Saeed SA, Denson LA, Hommel K. Transition to Adult IBD Care: A Pilot Multi-Site, Telehealth Hybrid Intervention. J Pediatr Psychol 2021; 46:1-11. [PMID: 33236097 DOI: 10.1093/jpepsy/jsaa088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Transition to adult IBD care continues to be a challenge. Efficacious models of improving transition to adult care in the United States are lacking. We present data from a pilot, prospective, non-randomized, intervention implemented at IBD centers in the Midwest and Southeast United States. DESIGN AND METHODS Adolescents and young adults (AYAs; 16-20 years) with IBD and their parents completed a 4- to 5-month transition program (1 in-person group session; 4 individual telehealth sessions). Primary outcomes were feasibility (i.e., recruitment, retention, fidelity) and acceptability (i.e., program satisfaction). Secondary outcomes were changes in transition readiness, self-management skill acquisition, perceived readiness to transfer to adult care, and disease knowledge. RESULTS The study exceeded goals for recruitment (target N = 20; actual: 36) and retention (target: 80%; actual: 86.11%). On average, it took participants 20.91 ± 3.15 weeks to complete our 4- to 5-month intervention and there were no deviations from the study protocol. Participant ratings for overall program satisfaction, perceived helpfulness, and program length and format were positive. Increases in transition readiness, t(30) = 8.30, d = 1.49, p < .001, self-management skill acquisition, t(30) = 3.93, d = 0.70, p < .001, and disease knowledge, t(30) = 8.20, d = 1.58, p < .001 were noted. AYA- and parent-perceived transfer readiness also improved (p's < .05; d's = 0.76-1.68). CONCLUSIONS This article presents feasibility and acceptability data for a 4- to 5-month transition intervention. Improvements in AYA transition readiness, self-management skill acquisition, IBD knowledge, and AYA/parent perceived transfer readiness were also observed.
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Affiliation(s)
- Wendy N Gray
- Department of Psychology, Auburn University.,Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | | | | | - Bonney Reed
- Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine
| | - Pamela Morgan
- Department of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center
| | - Erin Holbrook
- Department of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center
| | - Bruce Yacyshyn
- Department of Internal Medicine, University of Cincinnati College of Medicine
| | - Laura Mackner
- Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Department of Pediatrics, Center for Biobehavioral Health, The Ohio State University
| | | | - Michele Maddux
- Division of Developmental and Behavioral Sciences/Division of Gastroenterology, Department of Pediatrics, Children's Mercy-Kansas City, University of Missouri-Kansas City School of Medicine
| | - Shehzad A Saeed
- Department of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center
| | - Lee A Denson
- Department of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center
| | - Kevin Hommel
- Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
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Disease-Related Knowledge in New Zealand Children with Inflammatory Bowel Disease (IBD) and Their Parents. GASTROINTESTINAL DISORDERS 2021. [DOI: 10.3390/gidisord3010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Insufficient disease-related knowledge can be a barrier to the effective management of the unpredictable and lifelong course of inflammatory bowel disease (IBD). Patients with chronic illnesses have high non-adherence rates, with direct clinical consequences. While no single intervention strategy can improve the adherence of all patients, the success of attempts to improve patient adherence depends upon the realistic assessment of patients’ knowledge and their understanding of the regimen. The aim of this study was to assess the disease-specific knowledge of the parents and patients with IBD in the South Island of New Zealand, and identify areas of poor knowledge. Families of children diagnosed with IBD were asked to complete the IBD Knowledge Inventory Device (IBD-KID). Patients 10 years and older were asked to participate along with their parents. Of 110 families, 91 responded, with completed questionnaires received from 153 parents and 66 patients. Overall, parents scored significantly higher (13.64 ± 3.88) than their children (10.03 ± 4.07; p < 0.001). Areas of poor knowledge included aspects of treatment (both conventional and alternative), along with long-term disease outcomes. This study has shown clear areas of concern in this population’s disease-specific knowledge of their disease. This should be addressed through targeted education for both the patient and the parents to improve not only their knowledge, but also their adherence and disease self-management.
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Vernon-Roberts A, Gearry RB, Day AS. The Level of Public Knowledge about Inflammatory Bowel Disease in Christchurch, New Zealand. Inflamm Intest Dis 2020; 5:205-211. [PMID: 33313073 DOI: 10.1159/000510071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction There is a high degree of perceived stigma among adults with inflammatory bowel disease (IBD), with up to 84% considering a social stereotype against them due to their condition. This may negatively impact their treatment adherence and quality of life, as well as practical issues such as gaining urgent access to public bathroom facilities. It has been demonstrated that higher public knowledge levels can reduce public stigma, yet little is known about the general level of understanding of IBD in the community. A study was performed to ascertain the public knowledge levels of IBD in Christchurch, New Zealand, using a validated assessment tool. Objectives The aims of this study were to implement a validated knowledge survey (IBD-KID2) among members of the general public in Christchurch, New Zealand, and to assess the level of understanding about IBD. Methods Recruitment took place at a Health Research and Education showcase event at the University of Otago (Christchurch), which is a free event open to members of the public. All people over the age of 8 years were invited to participate. Demographic information was collected and the disease-specific knowledge assessment survey IBD-KID2 completed by all participants consenting to the research. Results One hundred people consented to the study, and the mean age 39.9 was years (SD 20, range 12-82 years). Of these 100 participants, 71 were female and 71 had a post-secondary education. Twelve participants had a family history of IBD. The mean IBD-KID2 score was 8.7 (SD 2.9), equal to a percentage total score of 58%. No independent variable was found to be significantly associated with IBD-KID2 scores. The frequency of correct answers showed knowledge deficiencies in the areas of nutrition, treatment, growth, and the cause of IBD. Conclusions This study highlighted knowledge deficiencies among members of the general public in Christchurch, New Zealand. These topics may be addressed with awareness campaigns in order to maximise community support for adults and children with IBD.
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Affiliation(s)
| | - Richard B Gearry
- Department of Medicine, University of Otago (Christchurch), Christchurch, New Zealand
| | - Andrew S Day
- Department of Pediatrics, University of Otago (Christchurch), Christchurch, New Zealand
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Vernon-Roberts A, Gearry RB, Day AS. Assessment of Knowledge Levels Following an Education Program for Parents of Children With Inflammatory Bowel Disease. Front Pediatr 2020; 8:475. [PMID: 32903635 PMCID: PMC7438864 DOI: 10.3389/fped.2020.00475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/07/2020] [Indexed: 01/22/2023] Open
Abstract
Children with inflammatory bowel disease (IBD) and their parents have increasing roles in disease management and require sufficient, appropriate information for communication with their clinical team. Formal education is effective at improving disease knowledge, disease outcomes, and mental health, yet few interventions have been targeted for parents of children with IBD. A two day parent education program was held at the annual residential camp for children with IBD in New Zealand with knowledge levels tested pre and post intervention using a validated assessment tool: IBD-KID2. Thirty parents consented, 25 completed the study, 70% were female and 83% had a child with Crohn's disease. The pre-intervention mean score (maximum fifteen) was 10.6 (SD 2.9), with no associations with independent variables. Knowledge levels increased significantly following the education program to a mean 12.6 (SD 2.0) (p < 0.005). Disease specific knowledge may improve outcomes and should, therefore, be reinforced during clinic encounters, and regarded as an ongoing endeavor.
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Affiliation(s)
| | - Richard B. Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Andrew S. Day
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
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Lim JK, Lee YJ, Park JH. Medication-Related Knowledge and Medication Adherence in Pediatric and Adolescent Patients with Inflammatory Bowel Disease. J Korean Med Sci 2020; 35:e92. [PMID: 32281312 PMCID: PMC7152532 DOI: 10.3346/jkms.2020.35.e92] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/05/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Non-adherence to oral maintenance therapy in adolescents with inflammatory bowel disease (IBD) is a significant healthcare problem. Knowledge of the prescribed medication can increase medication adherence. We aimed to investigate the relationship between medication adherence and disease-related knowledge of pediatric and adolescent patients with IBD. METHODS We conducted a "pop quiz" to investigate the disease-related knowledge of pediatric patients with IBD who were followed-up at our institution and reviewed their medical records, including data on sex, diagnosis, age at diagnosis, and disease duration. Medication adherence was evaluated by the doctor in charge, and ≥ 80% of patients constituted the "good adherence group." RESULTS Of 93 patients, 59 (63.4%) were males, and 78 (83.9%) had Crohn's disease. The mean age at diagnosis was 13.8 ± 2.8 years; mean follow-up duration, 4.8 ± 3.4 years; and mean patient age, 18.6 ± 3.7 years. Only 65 patients (69.9%) knew the exact name of the medication they were currently taking, and 34 (36.6%) knew the correct dose. Only 15 patients (16.1%) knew the name of the medications they were previously taking. A total of 64 patients (66.8%) showed an adherence rate of 80% for the weekly prescribed oral medication. The patients in the poor adherence group were significantly older than those in the good adherence group (P = 0.035). The number of hospitalizations per year was statistically higher in the good adherence group (P = 0.024). The proportion of patients who knew the names of the medications they were previously taking and were aware of the side effects of the medications was significantly higher in the good adherence group (P = 0.008 and P = 0.020, respectively). CONCLUSION Adolescent IBD patients have lower oral medication adherence. Knowledge of the prescribed medications taken previously, and the adverse effects of these medications are associated with good adherence. IBD specialists should educate the patients regarding the disease and about their medication.
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Affiliation(s)
- Jong Keon Lim
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Lopez RN, McCombie A, Gearry RB, Day AS. Impact of a Camp upon Disease-Specific Knowledge and Quality of Life in Children and Adolescents with Inflammatory Bowel Disease. Inflamm Intest Dis 2020; 5:65-69. [PMID: 32596256 DOI: 10.1159/000505918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 01/14/2020] [Indexed: 01/01/2023] Open
Abstract
Children with inflammatory bowel disease (IBD) who attend residential camps derive various psycho-social benefits from their attendance. This study evaluated the impact of camp attendance on participants' disease-specific knowledge and quality of life (QOL). Prior to attending a dedicated camp for children with IBD, all campers were contacted and asked to participate in an evaluation of outcomes. Campers were asked to complete questionnaires regarding background disease status, demographic information, disease-specific knowledge (Inflammatory Bowel Disease Knowledge Inventory Device [IBD-KID]) and QOL (IMPACT-III). Assessments were completed before the camp and then again 1 month and 6 months after the camp. The camp consisted of adventure-based experiences and did not include specific IBD-related educational activities. Thirty-nine of 44 campers provided baseline information. The responders comprised 21 boys, and the median age was 14 years. Most (n = 35) were diagnosed with Crohn's disease. Twenty-five of the baseline responders were in clinical remission. Mean IBD-KID scores increased from baseline at both 1 month and 6 months (p = 0.03 and p = 0.04, respectively). Although mean QOL scores did not increase after 1 or 6 months, body image sub-scores were increased at 6 months (p = 0.015). Children and adolescents with IBD attending this residential camp demonstrated enhanced disease-specific knowledge following the camp, which was maintained 6 months following the camp. QOL scores were not increased overall at either time point. These results demonstrate a further benefit of residential camps for children and adolescents with IBD.
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Affiliation(s)
- Robert N Lopez
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Andrew McCombie
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Andrew S Day
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
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Vernon-Roberts A, Otley A, Frampton C, Gearry RB, Day AS. Validation of a Revised Knowledge Assessment Tool for Children with Inflammatory Bowel Disease (IBD-KID2). Inflamm Intest Dis 2020; 5:70-77. [PMID: 32596257 DOI: 10.1159/000506200] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/24/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction For children with inflammatory bowel disease (IBD), acquired knowledge of their condition and treatment is integral to their adherence and self-management. Assessing their knowledge is vital to identify deficits that may affect disease management. IBD-KID2 is a knowledge assessment tool written for children aged 8 years and over with IBD. Objectives In order to examine validity and reliability, a study was carried out using IBD-KID2 in a paediatric IBD population and a number of comparator groups with established levels of IBD knowledge. Methods IBD-KID2 was administered to 4 participant groups in Christchurch Hospital, New Zealand: children with IBD (n = 22), children without IBD (n = 20), medical staff (n = 15), and administration staff (n = 15). Between-group differences were tested using ANOVA and pairwise comparisons made with the IBD group. Repeat assessments by the IBD group determined test-retest reliability (n = 21). Results The mean age (range) of the paediatric groups were: IBD 13.3 years (8-18), without IBD 11.9 years (8-15). Group mean scores (SD) were: IBD 8.5 (±2.3), without IBD 3.7 (±2.2), medical staff 13.5 (±1.3), administration staff 6.3 (±2.5). Group means were all significantly different to the IBD group. Test-retest mean at baseline (8.4, CI ±2.4) and repeat (9.0, CI ±2.4) were not significant. Intraclass correlation coefficient was 0.82. Internal reliability was 0.85, and item-total statistics showed no improvement by specific item removal. Conclusions IBD-KID2 could distinguish between groups with different knowledge levels. Repeat assessment shows comparable scores on retest and good reproducibility. IBD-KID2 is a valid and reliable tool for use in the paediatric IBD population.
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Affiliation(s)
| | - Anthony Otley
- Dalhousie University Department of Pediatrics, Halifax, Nova Scotia, Canada
| | - Chris Frampton
- University of Otago (Christchurch), Department of Medicine, Christchurch, New Zealand
| | - Richard B Gearry
- University of Otago (Christchurch), Department of Medicine, Christchurch, New Zealand
| | - Andrew S Day
- University of Otago (Christchurch), Department of Pediatrics, Christchurch, New Zealand
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Vernon-Roberts A, Otley A, Frampton C, Gearry RB, Day AS. Response pattern analysis of IBD-KID: A knowledge assessment tool for children with inflammatory bowel disease. J Paediatr Child Health 2020; 56:155-162. [PMID: 31243856 DOI: 10.1111/jpc.14547] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 04/10/2019] [Accepted: 05/31/2019] [Indexed: 12/11/2022]
Abstract
AIM Paediatric inflammatory bowel disease (IBD) is a chronic relapsing condition requiring adherence to complex treatment regimens to achieve best outcomes. Adherence is frequently low in this population but can be improved by increasing disease- and treatment-related knowledge. The IBD-knowledge inventory device (IBD-KID) is a knowledge assessment tool specifically developed and validated for children with IBD. To analyse IBD-KID participant response patterns in order to review the strength of the tool. METHODS A cohort of children with IBD completed IBD-KID, and their responses were used to assess the tool's validity and feasibility. Item response analysis assessed the item difficulty and the ability of items to discriminate between high/low scorers. The analysis considered item structure, readability and the effectiveness of multiple choice items. RESULTS A total of 105 completed IBD-KID assessments showed that 12 items (52%) had an acceptable difficulty level, and 17 (74%) were effective at discriminating between high/low scorers. Nine (61%) had good readability, but comprehension levels ranged from 5 to 18 years. Seven (30%) had elevated 'don't know' responses, highlighting the need for content and construction review. Of the 10 multiple choice items, 9 were complex and not functioning efficiently. Internal consistency was acceptable but could be improved by removing two items. CONCLUSIONS The response analysis metrics were reviewed by an expert panel and provided a framework for IBD-KID improvements with the aim of increasing discrimination and reducing difficulty without adversely affecting reliability. The proposed revisions will address components that may have caused children to answer incorrectly due to confusion rather than lack of knowledge.
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Affiliation(s)
| | - Anthony Otley
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chris Frampton
- Department of Medicine, Otago University, Christchurch, New Zealand
| | - Richard B Gearry
- Department of Medicine, Otago University, Christchurch, New Zealand
| | - Andrew S Day
- Department of Medicine, Otago University, Christchurch, New Zealand
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Cousin C, Bevilacqua C, Roman C, Roquelaure B, Loundou A, Baumstarck K, Fabre A. MICI-MINOTS: Linguistic and metric validation of a pediatric questionnaire on knowledge about inflammatory bowel disease. Arch Pediatr 2019; 27:110-116. [PMID: 31796231 DOI: 10.1016/j.arcped.2019.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/23/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Therapeutic education is an essential part of the treatment of chronic diseases, such as inflammatory bowel disease (IBD). The IBD-KID, developed in Canada in English, assesses children's and adolescents' acquired knowledge about their condition and has been validated in Canadian and Australian populations. However, there is no pediatric questionnaire in French to assess patients' knowledge about IBD. OBJECTIVE To report the linguistic validation process and metric validity of the MICI-MINOTS, the French version of the IBD-KID. METHOD The translation process consisted of three consecutive steps: forward-backward translation, acceptability testing, and cognitive interviews. The IBD-KID consists of 23 questions, but a 24th question about immunomodulatory therapy was added in the MICI-MINOTS. Psychometric testing was conducted with five groups: children with IBD, their parents, children in a control group, their parents, and health workers recruited from the Timone Pediatric Hospital and the Saint-Sébastien Maternal and Child Protection Center, Marseille, France. A total of 15 individuals completed the tool twice, with a 15-day interval. Internal consistency, reliability, external validity, reproducibility, and sensitivity to change were tested. RESULTS A total of 38 children with IBD (sex: 20 boys, 18 girls; age: 13.90 [±2.88] years; 25 with Crohn's disease), 20 children in the control group, 58 parents (every child was included with one parent), and 62 health workers were included in the analysis. Intraclass correlation was 0.94 (95% confidence interval 0.83-0.98) for test-retest assessment. Readability using the Scolarius score corresponded to elementary school level. Among the children with IBD, 89.5% answered all 24 questions. For 23 questions, the mean score of children with IBD was higher than among children in the control group: 9.58 (±3.01) versus 5.47 (±3.56), respectively (P<0.01). Parents of children with IBD scored higher than parents of children in the control group: 10.63 (±3.16) versus 8.4 (±3.07), respectively (P=0.012). In the health workers' group, pediatric residents (17.82±3.46) scored higher than nurses 11.75 (±3.4) and ward clerks (8.67±2.40; P<0.01). Patients' knowledge score was significantly related to their parents' knowledge score (r=0.402, P=0.012) for 23 questions. CONCLUSION The French version of the IBD-KID showed satisfactory psychometric properties to assess knowledge about the disease in French-speaking children.
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Affiliation(s)
- C Cousin
- Service de pédiatrie multidisciplinaire, Timone Pediatric Hospital, 13385 Marseille, France
| | - C Bevilacqua
- Pédiatrie maladies des enfants, Centre Hospitalier Sainte-Musse, 83100 Toulon, France
| | - C Roman
- Service de pédiatrie multidisciplinaire, Timone Pediatric Hospital, 13385 Marseille, France
| | - B Roquelaure
- Service de pédiatrie multidisciplinaire, Timone Pediatric Hospital, 13385 Marseille, France
| | - A Loundou
- EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseille University, 13385 Marseille, France
| | - K Baumstarck
- EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseille University, 13385 Marseille, France
| | - A Fabre
- Service de pédiatrie multidisciplinaire, Timone Pediatric Hospital, 13385 Marseille, France; Aix-Marseille University, Inserm, GMGF, 13385 Marseille, France.
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Evaluation of a Novel Educational Tool in Adolescents With Inflammatory Bowel Disease: The NEAT Study. J Pediatr Gastroenterol Nutr 2019; 69:564-569. [PMID: 31261247 PMCID: PMC8024984 DOI: 10.1097/mpg.0000000000002431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Among adolescents with inflammatory bowel disease (IBD), nonadherence rates are 50 to 88% across medications. Improving education in adults with IBD has been shown to improve coping and adherence to treatment in adults with IBD. Therapeutic patient education (TPE) has been used in patients with chronic diseases to train patients in skills to support treatment adaptation and condition management. This study tested the feasibility and preliminary efficacy of a novel TPE intervention in adolescents with IBD. METHODS In this pilot, mixed-methods study, we evaluated the feasibility and preliminary efficacy of TPE with the IBD Pocket Guide on medication adherence, IBD knowledge, and transition readiness in adolescents ages 11 to 18 years. Medication adherence was monitored using a MedMinder Pill Dispensing system. Participants who were <90% adherent during a 4-week pre-intervention monitoring period were randomized to either a usual care group or an educational intervention (EI) group. Participants were followed for an additional 4 weeks after intervention. RESULTS Trends were found in the EI group indicating improved medication adherence and IBD knowledge compared with the usual care group, though differences between groups did not reach statistical significance. Qualitative data showed that participants perceived that they had improved knowledge after the educational intervention. CONCLUSIONS Therapeutic patient education may be beneficial for improving patient medication adherence and IBD knowledge. Future directions include testing the effects of the intervention with a larger sample.
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Improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator. J Pediatr Gastroenterol Nutr 2019; 69:194-199. [PMID: 30964817 DOI: 10.1097/mpg.0000000000002350] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Deficits in the preparation of patients with inflammatory bowel disease (IBD) who are transitioning to adult care are known yet studies presenting outcome data of transition interventions in IBD are lacking. We present data evaluating the impact of a transition coordinator on behavioral and clinical transition outcomes. METHODS A retrospective chart review identified 135 patients who had met with our transition coordinator and completed the Transition Readiness Assessment Questionnaire before, and 1 year after, the intervention. Changes in transition readiness, self-management skill acquisition, and clinical outcomes (eg, number of patients transferred vs "bounced back" to pediatrics, percentage of patients over age 21, changes in disease remission) were examined and compared with patients who received no intervention. RESULTS Intervention participants demonstrated a significant increase in transition readiness, F(1, 134) = 24.34, P < 0.001, and self-management skill acquisition, F(1, 134) = 5.61, P < 0.05. The percentage of patients in remission significantly increased from pre- to post-intervention, χ(134) = 9.03, P < 0.01. There were no significant changes in the comparison population (Ps > 0.05). Following implementation of our programming, the percentage of patients over age 21 decreased by 33.07%. CONCLUSIONS A 1-time transition coordinator-led intervention improved adolescent transition readiness and acquisition of self-management skills. The proportion of young adult patients retained in pediatric care was reduced. Benefits of hiring a transition coordinator are discussed.
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Yoon H, Yang SK, So H, Lee KE, Park SH, Jung SA, Choh JH, Shin CM, Park YS, Kim N, Lee DH. Development, validation, and application of a novel tool to measure disease-related knowledge in patients with inflammatory bowel disease. Korean J Intern Med 2019; 34:81-89. [PMID: 29172400 PMCID: PMC6325432 DOI: 10.3904/kjim.2017.104] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/07/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/AIMS The Crohn's and Colitis Knowledge (CCKNOW) score does not reflect updated knowledge relating to inflammatory bowel disease (IBD). The aim of this study was to develop, validate, and apply a novel tool to measure disease-related knowledge in IBD patients. METHODS A questionnaire composed of 24 items regarding knowledge of IBD was developed: Inflammatory Bowel Disease Knowledge (IBD-KNOW). Discriminate ability of IBD-KNOW was validated in three occupational groups (14 doctors, 20 nurses, and 19 clerks). The CCKNOW and IBD-KNOW were administered to IBD patients. Factors affecting the level of IBD-related knowledge were analyzed. RESULTS The median Inflammatory Bowel Disease Knowledge (IBD-KNOW) score was significantly different among the three groups for validation (22 doctors, 20 nurses, and five clerks; p < 0.001). The IBD-KNOW showed excellent internal consistency (Cronbach α = 0.952) and high correlation with CCKNOW (Spearman ρ = 0.827, p = 0.01). A total of 200 IBD patients (120 Crohn's disease, 80 ulcerative colitis) completed questionnaires. Multivariate analysis showed that a higher IBDKNOW score than the median was associated with hospitalization history (odds ratio [OR], 2.625; p = 0.003), high education level (OR, 2.498; p = 0.012), and information acquired from patient organization (OR, 3.305, p = 0.035). CONCLUSION The IBD-KNOW demonstrated excellent test characteristics. Hospitalization history, education level, and information acquired from patient organization play an important role in correct IBD-related knowledge.
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Affiliation(s)
- Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Suk-Kyun Yang, M.D. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3901 Fax: +82-2-476-0824 E-mail:
| | - Hoonsub So
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ko Eun Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Ae Jung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Joong Haeng Choh
- International Healthcare Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Assessing the Transition Intervention Needs of Young Adults With Inflammatory Bowel Diseases. J Pediatr Gastroenterol Nutr 2018; 66:281-285. [PMID: 28753177 DOI: 10.1097/mpg.0000000000001677] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The transition of inflammatory bowel disease (IBD) patients from pediatric to adult care can be challenging. Developing an effective transition intervention requires assessing the current transition experience for potential improvements, determining preferred content and format, and assessing patients' transition skills. METHODS This mixed-methods study of 20 transitioned IBD patients (ages 17-20 years) used semistructured interviews and validated assessments of self-management/self-advocacy and IBD knowledge. Interviews were analyzed thematically. Assessment scores were compared with published reference data by estimating proportion or mean differences and 95% confidence intervals (CIs). RESULTS The concept of a transition intervention was well-received by participants. Preferred content centered on medications, disease and what to expect. Preferred ways to acquire knowledge were one-on-one instruction, handouts, and websites. Identified themes were "individualized and multifaceted," "teach about transition," and "support the shift in responsibility." Among participants, 95% did not achieve 90% mastery of transition skills (0.6% higher [95% CI -10.7% to 9.5%] than the reference estimate) and the mean knowledge score was 15.15 (3.86 [95% CI 2.27 to 5.45] points higher than the reference estimate). CONCLUSIONS We have identified preferred intervention formats and content as well as skill areas to target for improvement. As a result of this work, we will design a website intervention pertaining to identified themes.
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van Rheenen PF, Aloi M, Biron IA, Carlsen K, Cooney R, Cucchiara S, Cullen G, Escher JC, Kierkus J, Lindsay JO, Roma E, Russell RK, Sieczkowska-Golub J, Harbord M. European Crohn's and Colitis Organisation Topical Review on Transitional Care in Inflammatory Bowel Disease. J Crohns Colitis 2017; 11:1032-1038. [PMID: 28158494 DOI: 10.1093/ecco-jcc/jjx010] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND This European Crohn's and Colitis Organisation [ECCO] topical review focuses on the transition of adolescents with inflammatory bowel disease [IBD] from child-centred to adult-oriented care. The aim was to provide evidence-supported, expert consensus for health professionals taking part in the transition. METHODS An online survey determined the areas of importance for health professionals involved in the transition of adolescents with IBD. Thereafter an expert panel of nine paediatric and five adult gastroenterologists was formed to identify the critical elements of the transition programme, and to prepare core messages defined as 'current practice points'. There is limited literature about transition, therefore this review is mainly based on expert opinion and consensus, rather than on specific evidence. RESULTS A total of 21 practice points were generated before the first [online] voting round. Practice points that reached >80% agreement were accepted, while those that did not reach 80% agreement were refined during a consensus meeting and subjected to voting. Ultimately, 14 practice points were retained by this review. CONCLUSION We present a consensus-based framework for transitional care in IBD that provides a guidance for clinical practice.
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Affiliation(s)
- Patrick F van Rheenen
- Department of Paediatric Gastroenterology, University of Groningen, University Medical Centre Groningen,Groningen, The Netherlands
| | - Marina Aloi
- Paediatric Gastroenterology and Liver Unit, Sapienza University of Rome, University Hospital Umberto I, Rome, Italy
| | - Irit Avni Biron
- Department of Gastroenterology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Katrine Carlsen
- Department of Paediatrics, Hvidovre University Hospital, Hvidovre, Denmark
| | - Rachel Cooney
- Department of Gastroenterology, Queen Elizabeth Hospital,Birmingham, UK
| | - Salvatore Cucchiara
- Paediatric Gastroenterology and Liver Unit, Sapienza University of Rome, University Hospital Umberto I, Rome, Italy
| | - Garret Cullen
- Department of Gastroenterology, Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Johanna C Escher
- Department of Paediatric Gastroenterology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jaroslaw Kierkus
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Children's Memorial Health Institute, Warsaw, Poland
| | - James O Lindsay
- Department of Gastroenterology, Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Eleftheria Roma
- First Department of Paediatrics, Gastroenterology Unit, University of Athens, Athens, Greece
| | - Richard K Russell
- Department of Paediatric Gastroenterology, The Royal Hospital for Children, Glasgow, UK
| | - Joanna Sieczkowska-Golub
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Children's Memorial Health Institute, Warsaw, Poland
| | - Marcus Harbord
- Imperial College, London; and Chelsea and Westminster Hospital, London, UK
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Day AS, Mylvaganam G, Shalloo N, Clarkson C, Leach ST, Lemberg DA. Assessment of disease-specific knowledge in Australian children with inflammatory bowel disease and their parents. J Paediatr Child Health 2017; 53:778-781. [PMID: 28430383 DOI: 10.1111/jpc.13544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 01/08/2017] [Accepted: 01/23/2017] [Indexed: 12/13/2022]
Abstract
AIMS Disease-specific knowledge may influence disease outcome and quality of life in children with inflammatory bowel disease (IBD). This prospective study aimed to define IBD-related knowledge in a group of Australian children with IBD and their parents using a validated measure of disease-specific knowledge, the Inflammatory Bowel Disease Knowledge Inventory Device (IBD-KID). METHODS Children (less than 18 years) diagnosed with IBD who were members of the Australian patient support organisation were identified. Each family was sent copies of the IBD-KID. Children aged 10-18 years and all parents were asked to complete the IBD-KID and to also provide demographic details and disease characteristics. RESULTS Replies were received from 196 families: 262 parents and 128 children completed questionnaires. Most children had a diagnosis of Crohn disease (65%) and 51% were male. Children diagnosed in the preceding 6 years scored higher than those with longer time since diagnosis. Parents had better scores in the IBD-KID than the children (P < 0.0001). Overall, parents and children had poor understanding of key management issues for IBD (such as side effects of steroids), important outcomes (e.g. growth) and the use of complementary therapies. CONCLUSIONS Consistent patterns of IBD-related knowledge were noted in this large group of Australian children with IBD and their parents. Measurement of disease-related knowledge with the IBD-KID can identify gaps in understanding, thereby permitting focused educational activities. Although these knowledge gaps may impact upon outcomes, further prospective studies are now required to elucidate the relationships between enhanced knowledge and specific outcomes.
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Affiliation(s)
- Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Gaithri Mylvaganam
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Nollaig Shalloo
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Cathy Clarkson
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Steven T Leach
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Daniel A Lemberg
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
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Gerfaud A, Bridoux-Henno L, Bretagne JF, Siproudhis L, Bouguen G, Dabadie A. Évaluation de la transition pédiatrie-gastroentérologie d’adultes des enfants atteints de maladie inflammatoire cryptogénique intestinale. Arch Pediatr 2017; 24:534-541. [DOI: 10.1016/j.arcped.2017.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/26/2017] [Accepted: 03/10/2017] [Indexed: 01/28/2023]
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Abstract
OBJECTIVES Data suggest physicians poorly assess disease-specific literacy and transition readiness in pediatric patients with inflammatory bowel disease (IBD). We piloted an electronic, interactive iPad quiz game that could be used in a clinical setting, with the aims of measuring IBD-related knowledge, and concomitant mood and quality of life (QOL) in a pediatric population. METHODS Two pediatric IBD clinics developed and tested 2 versions of "Emma." Patients between 10 and 18 years of age played Emma during an office visit. Each patient answered 12 randomly selected disease-related questions and 4 mood-related questions. RESULTS Sites 1 and 2 tested Emma v1 between May and August 2013. Emma v2 was tested from November 2013 to January 2014 and from September 2013 to January 2014. A total of 56 patients played Emma v1, whereas 60 played Emma v2. In Emma v2, 73.1% of questions were answered correctly. Patients recognized signs of IBD (88%), causes of diarrhea in addition to IBD (79.4%), and could define lactose intolerance (95.8%), but fewer patients understood serological testing used for disease monitoring (68%) or knew that magnetic resonance enterography did not involve radiation (22.9%). Patients tended to report good functioning in the areas of energy, mood, anxiety, and school-related QOL. Patients with Crohn disease, however, reported higher stress levels compared with patients with ulcerative colitis; older patients reported lower energy levels, and postsurgical patients reported lower QOL. CONCLUSIONS The Emma iPad game has the potential to evaluate gaps in IBD knowledge, assess emotional functioning, and increase patient engagement as a transition tool in the clinical setting.
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The Emerging Adult with Inflammatory Bowel Disease: Challenges and Recommendations for the Adult Gastroenterologist. Gastroenterol Res Pract 2015; 2015:260807. [PMID: 26064089 PMCID: PMC4434201 DOI: 10.1155/2015/260807] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 03/25/2015] [Accepted: 04/16/2015] [Indexed: 12/12/2022] Open
Abstract
Incidence of pediatric inflammatory bowel disease (IBD) is rising. Adult gastroenterologists are seeing increasing numbers of young adults with IBD, a subpopulation with unique needs and challenges that can impair their readiness to thrive in an adult healthcare system. Most adult gastroenterologists might not have the training or resources to address these needs. “Emerging adulthood” is a useful developmental lens through which this group can be studied. With complex disease phenotype and specific concerns of medication side effects and reproductive health, compounded by challenges of geographical and social flux and lack of adequate health insurance, emerging adults with IBD (EAI) are at risk of disrupted care with lack of continuity. Lessons learned from structured healthcare transition process from pediatric to adult services can be applied towards challenges in ongoing care of this population in the adult healthcare system. This paper provides an overview of the challenges in caring for the post transition EAI from the perspective of adult gastroenterologists and offers a checklist of provider and patient skills that enable effective care. This paper discusses the system-based challenges in care provision and search for meaningful patient-oriented outcomes and presents a conceptual model of determinants of continuity of care in this unique population.
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29
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Maignant S, Pélatan C, Breton E, Cagnard B, Chaillou E, Giniès JL, Le Hénaff G, Ségura JF, Willot S, Bridoux L, Jobert A, Darviot E, Delaperrière N, Lapeyre D, Carré E, Grimal I, Hankard R, Wagner AC, Balençon M, Caldari D, Tourtelier Y, Dabadie A. [Knowledge of adolescents with inflammatory bowel disease: Results of a multicenter cross-sectional survey]. Arch Pediatr 2015; 22:468-75. [PMID: 25725972 DOI: 10.1016/j.arcped.2015.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/14/2014] [Accepted: 01/22/2015] [Indexed: 10/23/2022]
Abstract
AIM To assess knowledge acquired by adolescents about their inflammatory bowel disease (IBD). METHODS An anonymous questionnaire was given during consultation to adolescents followed for IBD by pediatricians from 13 hospitals between 1 September 2012 and 1 July 2013. After parental consent, these physicians completed a form at the inclusion of each patient, in which the characteristics of IBD were detailed. The patients mailed back their questionnaire. RESULTS A total of 124 patients from 12 to 19 years of age were included with a response rate of 82% (all anonymous); 23% of the patients thought that diet was a possible cause of IBD and 22% that one of the targets of their treatment was to cure their disease for good. Of the patients reported having Crohn disease, 46% knew the anoperineal location and 14% knew that Crohn disease can affect the entire digestive tract. Twenty-five percent of the patients were able to name one side effect of azathioprine (88% had already received this treatment), 24% were able to name one side effect of infliximab (54% had already received this treatment), 70% of the adolescents knew that smoking worsens Crohn disease, 68% declared they had learned about their IBD from their pediatrician, and 81% said they would like to receive more information. CONCLUSION Adolescents with IBD have gaps in their general knowledge and the different treatments of their disease. Their main source of information is their pediatrician, warranting the implementation of customized patient education sessions.
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Affiliation(s)
- S Maignant
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France.
| | - C Pélatan
- Service de pédiatrie, centre hospitalier Le Mans, 194, avenue Rubillard, 72037 Le Mans cedex 09, France
| | - E Breton
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France; Service de pédiatrie, hôpital Yves-Le-Foll, centre hospitalier Saint-Brieuc, 10, rue M.-Proust, 22000 Saint-Brieuc, France
| | - B Cagnard
- Service de pédiatrie, hôpital Bretagne Atlantique, centre hospitalier Auray-Vannes, boulevard du Général Guillaudot, 56017 Vannes cedex, France
| | - E Chaillou
- Service de pédiatrie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France
| | - J-L Giniès
- Service de pédiatrie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France
| | - G Le Hénaff
- Service de pédiatrie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - J-F Ségura
- Département de pédiatrie, centre hospitalier Morvan, CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France
| | - S Willot
- Service de pédiatrie, centre hospitalier Clocheville, CHU de Tours, 49, boulevard Béranger, 37044 Tours cedex, France
| | - L Bridoux
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France
| | - A Jobert
- Service de pédiatrie, centre hospitalier Saint-Nazaire, boulevard Georges-Charpak, 44600 Saint-Nazaire, France
| | - E Darviot
- Service de pédiatrie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France
| | - N Delaperrière
- Département de pédiatrie, centre hospitalier Morvan, CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France
| | - D Lapeyre
- Service de pédiatrie, centre hospitalier La Rochelle, rue du Dr Schweitzer, 17019 La Rochelle, France
| | - E Carré
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France; Service de pédiatrie, centre hospitalier Saint-Malo, 1, rue de la Marne, 35400 Saint-Malo, France
| | - I Grimal
- Service de pédiatrie, centre hospitalier Cholet, 1, rue Marengo, 49325 Cholet cedex, France
| | - R Hankard
- Service de pédiatrie, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France
| | - A-C Wagner
- Service de pédiatrie, centre hospitalier Saint-Nazaire, boulevard Georges-Charpak, 44600 Saint-Nazaire, France
| | - M Balençon
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France
| | - D Caldari
- Service de pédiatrie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - Y Tourtelier
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France
| | - A Dabadie
- Pôle de pédiatrie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France
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Day AS, Lemberg DA, Nichol A, Clarkson C, Otley AR. Generalisability of the inflammatory bowel disease knowledge inventory device to assess disease-related knowledge in Australian children. J Paediatr Child Health 2014; 50:591-5. [PMID: 24893755 DOI: 10.1111/jpc.12612] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 11/28/2022]
Abstract
AIM Disease knowledge may affect disease outcome, adherence to therapy and quality of life in inflammatory bowel disease (IBD). The IBD knowledge inventory device (IBD-KID) was specifically developed and validated for children to measure disease-specific knowledge. The relevance of the IBD-KID was now determined in an Australian population of children with IBD. METHODS Twenty children with an established diagnosis of IBD for 2 years or greater, and their parents, were asked to complete the IBD-KID and the Crohn's and Colitis Knowledge Score (CCKNOW). Twenty children recently diagnosed with IBD completed the IBD-KID alone, as did three populations of health workers within a paediatric hospital. RESULTS Children with longstanding disease scored 12.1 ± 4.6 (from 23 questions) in the IBD-KID and 13.2 ± 5 (from 30 questions) in the CCKNOW device (P < 0.05). Children had fewer 'don't know' answers with the IBD-KID. Areas of poor knowledge included aspects of IBD therapies and IBD outcome. Recently diagnosed children performed less well than those with longer period of illness (P = 0.03). Parents scored more highly in both scores than their children (16.8 ± 2.7 and 18.1 ± 4.2: P = 0.008). Medical staff had higher scores in the IBD-KID (19.5 ± 2.1) than did nursing (13.2 ± 2.7) or clerical (7.3 ± 4.1) staff (P < 0.005). CONCLUSIONS The IBD-KID provides a reliable and appropriate assessment of disease knowledge in Australian children with IBD and can now be used in activities targeting disease-related education and as a tool to ascertain where knowledge can be improved in children with IBD.
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Affiliation(s)
- Andrew S Day
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia; Department of Paediatrics, University of Otago, Christchurch, New Zealand
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Abstract
Increasing numbers of adolescents are being diagnosed with Crohn's disease or ulcerative colitis, the two main subtypes of inflammatory bowel disease. These young people face many short- and long-term challenges; one or more medical therapies may be required indefinitely; their disease may have great impact, in terms of their schooling and social activities. However, the management of adolescents with one of these incurable conditions needs to encompass more than just medical therapies. Growth, pubertal development, schooling, transition, adherence, and psychological well-being are all important aspects. A multidisciplinary team setting, catering to these components of care, is required to ensure optimal outcomes in adolescents with inflammatory bowel disease.
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Affiliation(s)
- J Bishop
- Paediatric Gastroenterology, Starship Children’s Hospital, Auckland, New Zealand
| | - DA Lemberg
- Department of Gastroenterology, Sydney Children’s Hospital, Sydney, Australia
| | - AS Day
- Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand
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