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Dou Z, Zheng H, Shi Y, Li Y, Jia J. Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019. Autoimmun Rev 2024:103655. [PMID: 39366514 DOI: 10.1016/j.autrev.2024.103655] [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: 04/17/2024] [Revised: 09/11/2024] [Accepted: 09/29/2024] [Indexed: 10/06/2024]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a kind of chronic inflammatory disorders of the gastrointestinal tract with diverse prevalence rates and patterns globally. Accurate comprehension of the disease's epidemiological characteristics is imperative for disease control and prevention all over the world. OBJECTIVE To provide the most updated estimates on the global burden of IBD using the 2019 Global Burden of Disease (GBD) study data, to systematically analyze the IBD epidemiological characteristics at the global, regional, and national levels including the prevalence, incidence, and disability-adjusted life years (DALY) rates, and to analyze the correlations of the socioeconomic development level with IBD epidemiological characteristics. METHODS We conducted an overall analysis of the global, regional, and national burden of IBD from 1990 to 2019, data from the 2019 GBD study. The GBD's classification of the world into 21 regions and 204 countries and territories facilitated a thorough examination. Age-standardized estimated annual percentage changes (EAPCs) were computed to assess the temporal trends in IBD age-standardized rates (ASRs), with age standardization employed to mitigate potential confounding effects from age structure. The sociodemographic Index (SDI) was used to correlate the socioeconomic development level with the epidemiological characteristics of IBD. RESULTS From 1990 to 2019, the global age-standardized prevalence, incidence, and DALY rates of IBD remained high. There was a slight downward trend in the global age-standardized incidence and DALY rates of IBD and men exhibited higher DALY rates than women. In 2019, high-income North America recorded the highest age-standardized prevalence, incidence, and DALY rates, while Oceania had the lowest age-standardized prevalence and incidence rates. South Asia had the lowest age-standardized DALY rates. The age-standardized mortality and DALY rates decreased as SDI values increased and remained higher than the expected levels over the past three decades. A negative correlation was observed between age-standardized DALY rates and SDI at the national level. CONCLUSIONS This analysis of the GBD 2019 database demonstrates that the overall global burden of IBD is still high. Meanwhile, an increasing disease burden is observed in the middle and low SDI locations.
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Affiliation(s)
- Zhili Dou
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, PR China; Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, PR China
| | - Huiling Zheng
- Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, PR China
| | - Yanyan Shi
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, PR China.
| | - Yuan Li
- Department of Gastroenterology, Peking University International Hospital, Beijing 102206, PR China.
| | - Jinzhu Jia
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, PR China; Center for Statistical Science, Peking University, Beijing 100191, PR China.
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2
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Velasco Rodríguez-Belvís M, Palomino L, Pujol Muncunill G, Martin-Masot R, Muñoz Codoceo RA, Barrio Torres J, Navas-López VM, Martín de Carpi J. Impact of pediatric inflammatory bowel disease on caregivers' work productivity: A multicenter study by the SEGHNP. J Pediatr Gastroenterol Nutr 2024; 79:573-582. [PMID: 39072850 DOI: 10.1002/jpn3.12328] [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: 03/27/2024] [Revised: 07/03/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES/BACKGROUND Pediatric inflammatory bowel disease (PIBD) poses significant challenges not only to patients but also to their families, particularly affecting the work productivity of caregivers. This Spanish multicenter study aims to elucidate the extent of this impact. MATERIALS AND METHODS A cross-sectional, multicenter study was conducted between February 2021 and June 2023, involving parents or caregivers of PIBD patients aged 10-18 years. The study utilized the Work Productivity and Activity Impairment (WPAI) questionnaires alongside assessing disease activity and socioeconomic status to quantify work productivity loss and its economic implications. RESULTS The study included 370 patients from 37 centers, highlighting a significant loss of work productivity among caregivers, especially mothers. The global unemployment rate was notably higher in this group compared to national averages (22.9% vs. 13.8%), particularly among females (30.7% vs. 13.7%), with absenteeism and presenteeism rates (26.4% and 39.9%) significantly impacting the caregivers' ability to work. The study also identified active disease and treatment with biologics or steroids as risk factors for increased work productivity loss. CONCLUSIONS Caregivers of children with inflammatory bowel disease face considerable challenges in maintaining employment, with a notable economic impact due to lost work hours. The findings underscore the need for targeted support and interventions to assist these families, suggesting potential areas for policy improvement and support mechanisms to mitigate the socioeconomic burden of PIBD on affected families.
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Affiliation(s)
| | - Laura Palomino
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Gemma Pujol Muncunill
- Servicio de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Rafael Martin-Masot
- Departamento de Farmacología y Pediatría, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Sección de Gastroenterología y Nutrición Infantil, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Rosa Ana Muñoz Codoceo
- Servicio de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Josefa Barrio Torres
- Unidad de Gastroenterología Pediátrica, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - Víctor Manuel Navas-López
- Sección de Gastroenterología y Nutrición Infantil, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Javier Martín de Carpi
- Servicio de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
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3
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Veltkamp F, van Oers HA, Teela L, Mak-Nienhuis EM, Haverman L, Bouts AHM. Distress in parents of children with first-onset steroid-sensitive nephrotic syndrome. Pediatr Nephrol 2023; 38:4013-4022. [PMID: 37380933 PMCID: PMC10584702 DOI: 10.1007/s00467-023-06038-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Steroid-sensitive nephrotic syndrome (SSNS) is associated with a relapsing-remitting course that can be stressful for parents. As little is known of parental distress at the first onset of SSNS, this study aims to describe parental distress and everyday problems in mothers and fathers of a child with newly diagnosed SSNS participating in a randomized controlled trial of levamisole added to corticosteroids. METHODS To assess distress, the Distress Thermometer for Parents (DT-P) was used, which includes questions on distress (thermometer score 0-10, ≥ 4 "clinical distress") and presence of everyday problems in six domains: practical, social, emotional, physical, cognitive, and parenting. The DT-P was completed 4 weeks after the onset of SSNS. Total sum and individual items of everyday problems were compared with reference data from mothers and fathers of the Dutch general population. RESULTS There was no difference in clinically elevated parental distress between SSNS mothers (n = 37) and fathers (n = 25) and reference parents. Compared to reference fathers, fathers of a child with SSNS scored significantly higher on emotional problems (P = 0.030), while mothers experienced more parenting problems (P = 0.002). Regression analyses showed that lower parental age and having a girl with SSNS were significantly associated with more practical problems and higher distress thermometer scores, respectively. CONCLUSIONS Four weeks after onset, SSNS mothers and fathers experience equal distress as reference parents. However, both parents endorsed significantly more everyday problems. Therefore, monitoring parental distress, even in the first weeks of the disease, could contribute to timely interventions and prevent worsening of problems. CLINICAL TRIAL REGISTRY Dutch Trial Register ( https://onderzoekmetmensen.nl/en/trial/27331 ). A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Floor Veltkamp
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Child Development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Child Development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry & Psychosocial Care, Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Lorynn Teela
- Child Development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry & Psychosocial Care, Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Elske M Mak-Nienhuis
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Lotte Haverman
- Child Development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry & Psychosocial Care, Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Antonia H M Bouts
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Child Development, Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Post Box, 22660, 1100 DD, Amsterdam, The Netherlands.
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Zhang ZM, Lin ZL, He BX, Yan WT, Zhang XY, Zhang ZH, Wang L, Wang JQ, Liu DM, Zhang W, Li ZH. Epidemiological analysis reveals a surge in inflammatory bowel disease among children and adolescents: A global, regional, and national perspective from 1990 to 2019 - insights from the China study. J Glob Health 2023; 13:04174. [PMID: 38037705 PMCID: PMC10690112 DOI: 10.7189/jogh.13.04174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Background The burden of inflammatory bowel disease (IBD) among children and adolescents is rising globally, with substantial variation in levels and trends of disease in different countries and regions, while data on the burden and trends were sparse in children and adolescents. We aimed to assess the trends and geographical differences in children and adolescents aged zero to 19 in 204 countries and territories over the past 30 years. Methods Data on IBD among children and adolescents was collected from the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. We used the GBD data and methodologies to describe the change in the burden of IBD among children and adolescents involving prevalence, incidence, disability-adjusted life years (DALYs), and mortality. Results Globally, the IBD prevalence cases increased between 1990 and 2019. Annual percentage changes (AAPC) = 0.15; 95% confidence interval (CI) = 0.11-0.19, and incidence cases of IBD increased from 20 897.4 (95% CI = 17 008.6-25 520.2 in 1990 to 25 658.6 (95% CI = 21 268.5-31 075.6) in 2019, representing a 22.78% increase, DALYs cases decreased between 1990 and 2019 (AAPC = -3.02; 95% CI = -3.15 to -2.89), and mortality cases of IBD decreased from 2756.5 (95% CI = 1162.6-4484.9) in 1990 to 1208.0 (95% CI = 802.4-1651.4) in 2019, representing a 56.17% decrease. Decomposition analysis showed that IBD prevalence and incidence increased significantly, and a trend exhibited a decrease in underlying age and population-adjusted IBD DALYs and mortality rates. Correlation analysis showed that countries with high health care quality and access (HAQ) had relatively higher IBD age-standardised prevalence rate (ASPR) and age-standardised incidence rate (ASIR), but lower age-standardised DALYs rate (ASDR) and age-standardised mortality rate (ASMR). Conclusions Global prevalence and incidence rate of IBD among children and adolescents have been increasing from 1990 to 2019, while the DALYs and mortality have been decreasing. Rising prevalence and rising incidence in areas with historically low rates will have crucial health and economic implications.
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Affiliation(s)
- Zhong-mian Zhang
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zi-li Lin
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Bai-xiang He
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wei-tian Yan
- Rheumatology Department, Yunnan Provincial Hospital of Traditional Chinese Medicine, Yunnan University of Chinese Medicine, Yunnan, China
| | - Xi-yan Zhang
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhong-han Zhang
- College of Psychology and Mental Health, North China University of Science and Technology, Hebei, China
| | - Lan Wang
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jia-qi Wang
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Da-ming Liu
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wen Zhang
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-hong Li
- Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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5
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Patel R, Wong C. Illness-related parental stress and quality of life in children with kidney diseases. Pediatr Nephrol 2023; 38:2911-2913. [PMID: 37330454 DOI: 10.1007/s00467-023-06041-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 06/19/2023]
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6
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Nomura S, Hirano Y, Takeuchi I, Shimizu H, Arai K. Anxiety, Depression, and Quality of Life in Parents of Adolescents with Inflammatory Bowel Disease: A Longitudinal Study. Pediatr Gastroenterol Hepatol Nutr 2023; 26:239-248. [PMID: 37736216 PMCID: PMC10509017 DOI: 10.5223/pghn.2023.26.5.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/21/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose The parents of adolescents with inflammatory bowel disease may experience impaired mental health and quality of life. This longitudinal study aimed to verify whether the mental health and quality of life of the parents of adolescents with inflammatory bowel disease declined when their children had active disease. Methods Sociodemographic data, parental anxiety, depression, and quality of life were analyzed using validated questionnaires for each variable. After the baseline survey, the second and follow-up surveys were conducted at 3 and 12 months, respectively. The active disease group comprised eight parents whose children had active disease during the baseline and second surveys. The remission group comprised 14 parents whose children remained in remission during both surveys. The improved group comprised nine parents whose children experienced active disease at baseline and remission during the second survey. Parental mental health and quality of life were compared among the groups. Results Significantly higher levels of anxiety were observed in the active disease group in all surveys (p<0.050). Although depression levels and quality of life did not differ significantly among the three groups, pairing the active disease group with other groups showed some large effect sizes. Conclusion Parents tended to experience decreased mental health and quality of life when their adolescents experienced active inflammatory bowel disease. Consequently, our hypothesis was partially verified. Therefore, parents need support when their children have active disease; this finding highlights the need for parental support systems.
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Affiliation(s)
- Satomi Nomura
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
- Department of Child Nursing, National College of Nursing, Tokyo, Japan
| | - Yuri Hirano
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Takeuchi
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
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7
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Vernon-Roberts A, Rouse E, Bowcock NL, Lemberg DA, Day AS. Agreement Level of Inflammatory Bowel Disease Symptom Reports between Children and Their Parents. Pediatr Gastroenterol Hepatol Nutr 2023; 26:88-98. [PMID: 36950060 PMCID: PMC10025573 DOI: 10.5223/pghn.2023.26.2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/20/2022] [Accepted: 01/15/2023] [Indexed: 03/24/2023] Open
Abstract
Purpose Children with inflammatory bowel disease (IBD) frequently undergo clinical assessments, involving triadic communication between clinician, parent, and child. During such encounters parents are traditionally the main communicator of information on their child's IBD, including subjective symptom reports. The level of agreement between children and their parents for IBD symptoms is poorly understood, and this study aimed to examine this factor. Methods This was a cross-sectional study among children with IBD, and one parent. A validated paediatric IBD symptom report tool (IBDnow) enabled children and their parent to rate seven pain, well-being, and stool metrics, with dyads completing the tool concurrently. Results were assessed using: Individual agreement: proportion of identical symptom reports by each dyad (ideal score >0.7); Category agreement: percentage of identical reports for IBDnow metrics for the cohort; Inter-rater reliability: Gwet's AC1 coefficient with higher scores indicating better reliability (maximum=1). Results Seventy-four parent/child dyads participated; child's mean age 12.2 years (standard deviation [SD] 2.9, range 6-16), mean time since diagnosis 2.8 years (SD 3), 54% female, 73% had Crohn's Disease. Mean individual agreement level was 0.6, with 27% of dyads agreeing on ≥6/7 IBDnow metrics. Category agreement was reported by 61% of dyads, 20% of parents overestimated, and 19% underestimated, their child's symptoms. Inter-rater reliability ranged from fair to good. Conclusion These results should improve clinician awareness of how IBD symptom reports from parents may introduce bias. Children should be considered the most important source of symptom reports, and tools such as IBDnow utilised to enhance communication.
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Affiliation(s)
| | - Emma Rouse
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Nerissa L Bowcock
- Department of Paediatric Gastroenterology, Sydney Children’s Hospital, Randwick, Australia
| | - Daniel A Lemberg
- Department of Paediatric Gastroenterology, Sydney Children’s Hospital, Randwick, Australia
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
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8
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Rihm L, Dreier M, Rezvani F, Wiegand-Grefe S, Dirmaier J. The psychosocial situation of families caring for children with rare diseases during the COVID-19 pandemic: results of a cross-sectional online survey. Orphanet J Rare Dis 2022; 17:449. [PMID: 36572906 PMCID: PMC9791975 DOI: 10.1186/s13023-022-02595-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is affecting many areas of life and has posed additional strains on the highly vulnerable group of caregivers of children with rare diseases (RDs). The psychosocial situation of the family caregivers deserves more attention, both in research and practice. The current study explores the distress level of caregivers of children with RDs, their psychosocial information needs, and caregiver-reported health-related quality of life (HRQoL) of children with RDs in times of the COVID-19 pandemic. METHODS Data from a cross-sectional online survey conducted within the German CARE-FAM-NET project (children affected by rare diseases and their families-network) between March and August 2020 were examined. The study sample included 149 family caregivers, mostly mothers (83.2%) of 167 children with RDs. The survey assessed demographic and disease-related characteristics, distress and everyday problems of caregivers (Distress Thermometer for Parents; scale 0-10), psychosocial information needs (self-developed items; scale 0-100), and caregiver-reported HRQoL of the children with RDs (DISABKIDS Chronic Generic Measure, short-form; scale 0-100). Using descriptive statistics, we analyzed the psychosocial situation of families during the COVID-19 pandemic. We further conducted correlation analysis to investigate interrelations. RESULTS The distress level among caregivers was high (M = 6.84, SD = 2.43); 89.6% reported clinical distress (≥ 4). Everyday problems (e.g., sleep problems, fatigue, being out of shape, fears, feeling tense or nervous, and worry) were frequent. Caregivers reported a wide range of psychosocial information needs. In about half of the children (49.5%), caregiver-reported HRQoL was low, while average HRQoL (M = 58.7, SD = 19.5) was comparable to parent-reported norm data of children with severe clinical conditions. Distress correlated positively with psychosocial information needs (r = 0.40), and negatively with the caregiver-reported HRQoL of the children (r = - 0.46). CONCLUSIONS This study indicates a high psychosocial burden on family caregivers of children with RDs during the early COVID-19 pandemic, characterized by high distress levels and wide-ranging everyday problems, unmet psychosocial information needs, and reduced caregiver-reported HRQoL in children with RDs. The findings highlight the ongoing need for target group-specific, low-threshold support services (e.g., websites) during and after the pandemic.
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Affiliation(s)
- Lydia Rihm
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Mareike Dreier
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Farhad Rezvani
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Wiegand-Grefe
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Dirmaier
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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9
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Michel HK, Boyle B, David J, Donegan A, Drobnic B, Kren C, Maltz RM, McKillop HN, McNicol M, Oates M, Dotson JL. The Pediatric Inflammatory Bowel Disease Medical Home: A Proposed Model. Inflamm Bowel Dis 2022; 28:1420-1429. [PMID: 34562013 DOI: 10.1093/ibd/izab238] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Indexed: 12/09/2022]
Abstract
Care for patients with inflammatory bowel disease (IBD) can be complex and costly. Care delivery models to address these challenges and improve care quality are essential. The patient-centered medical home (PCMH), which was developed in the primary care setting, has recently been applied successfully to the adult IBD population. Following the tenets of the PCMH, this specialty medical home (SMH) emphasizes team-based care that is accessible, comprehensive, patient/family-centered, coordinated, compassionate, and continuous and has demonstrated improved patient outcomes. Children and young adults with IBD have equally complex care needs, with additional challenges not faced by the adult population such as growth, physical and psychosocial development, and transition of care from pediatric to adult providers. Thus, we advocate that the components of the PCMH are equally-if not more-important in caring for the pediatric patient population. In this article, we review what is known about the application of the PCMH model in adult IBD care, describe care delivery within the Center for Pediatric and Adolescent IBD at Nationwide Children's Hospital as an example of a pediatric IBD medical home, and propose a research agenda to further the development and dissemination of comprehensive care delivery for children and adolescents with IBD.
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Affiliation(s)
- Hilary K Michel
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Brendan Boyle
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Jennie David
- Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy Donegan
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Barb Drobnic
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - Courtney Kren
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - Ross M Maltz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA.,The Center for Microbial Pathogenesis, The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Hannah N McKillop
- Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA.,Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Megan McNicol
- Department of Pharmacy, Nationwide Children's Hospital, Columbus OH, USA
| | - Melanie Oates
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jennifer L Dotson
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA.,The Center for Innovation in Pediatric Practice, The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
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10
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Thapwong P, Norton C, Rowland E, Farah N, Czuber-Dochan W. A systematic review of the impact of inflammatory bowel disease (IBD) on family members. J Clin Nurs 2022; 32:2228-2238. [PMID: 35908208 DOI: 10.1111/jocn.16446] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/27/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Inflammatory Bowel Disease (IBD) affects patients and their family members, but most reviews have focused only on patients themselves. This review synthesises evidence on the impact of IBD on family members. METHODS A systematic review was undertaken, searching six bibliographic databases, focusing on the impact of IBD on family members, coping strategies, and interventions. A narrative synthesis was conducted. This review was reported following the Preferred Reporting Items for Systematic Reviews (PRISMA). RESULTS 3258 records were identified; 33 papers (2748 participants) were included. Three themes were identified: impact of IBD on family members; coping strategies for family members to overcome the impact of IBD; and the support needed by family members. IBD affects family members' well-being in many ways, including their emotional well-being, relationship with the patient, social life, work and finances, and leisure time and travel. Family members use adaptive coping patterns such as acceptance, developing resilience, and emotional support from others. Maladaptive coping patterns such as denial of diagnosis, self-distraction, and self-blame were also evident. Family members reported that they needed better information about IBD, support groups, and better access to a counsellor or psychologist. No studies assessed interventions to relieve family members' burden. CONCLUSIONS Family members of IBD patients require psychosocial support to facilitate better family function, cohesion, and enhanced coping strategies. Healthcare services should adopt a multidisciplinary care model with a bio-psycho-social approach including an IBD nurse, family therapist, and psychologist, to improve quality of life for patients and their families.
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Affiliation(s)
- Parichat Thapwong
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.,Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Emma Rowland
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Noora Farah
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Wladyslawa Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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11
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Cesa KT, Cunningham CA, Noll RB, Kim SC. Parental Distress in Pediatric Inflammatory Bowel Diseases: Associations With Time From Diagnosis, Disease Activity, and Demographic Factors. CROHN'S & COLITIS 360 2022; 4:otac019. [PMID: 35783219 PMCID: PMC9237933 DOI: 10.1093/crocol/otac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Indexed: 11/14/2022] Open
Abstract
Background There are limited studies examining caregiver distress when raising a child with inflammatory bowel disease (IBD). The aim of this study was to investigate the occurrence of symptoms of distress (anxiety, depression, and post-traumatic stress disorder [PTSD]) among parents with children with IBD and associations with disease severity, time from diagnosis, and demographic factors. Methods We conducted a cross-sectional study with parents of children (2-17 years) diagnosed with IBD. There were 2 cohorts: (1) recently diagnosed cohort (<6 months from diagnosis); (2) established diagnosis cohort (>1 year from diagnosis). Parents completed measures of anxiety, depression, and PTSD, while children completed surveys on the symptoms of their IBD. Results Fifty-two parents in the recently diagnosed cohort and 103 parents in the established diagnosis cohort completed surveys. For the entire cohort of parents, we found the mean scores on all measures of distress were within the normal ranges with 20%, 13%, and 8% of parents reporting moderate-to-severe symptoms of anxiety, depression, and PTSD, respectively. Symptoms of anxiety and depression were not significantly associated with time from diagnosis; symptoms of anxiety and PTSD were significantly associated with patients' IBD clinical activity. Conclusions Parents with children with IBD are remarkably resilient to distress even soon after their child's diagnosis. Despite considerable resilience, routine brief caregiver screening for symptoms of anxiety during annual visits seems reasonable and feasible.
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Affiliation(s)
- Kevin T Cesa
- Address correspondence to: Kevin T. Cesa, MD, Department of Pediatrics, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224, USA ()
| | - Catherine A Cunningham
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Robert B Noll
- Department of Child Development, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sandra C Kim
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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12
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Bösch F, Landolt MA, Baumgartner MR, Fernandez S, Forny P, Gautschi M, Grünert SC, Häberle J, Horvath C, Karall D, Lampis D, Rohrbach M, Scholl-Bürgi S, Szinnai G, Huemer M. Caregiver burden, and parents' perception of disease severity determine health-related quality of life in paediatric patients with intoxication-type inborn errors of metabolism. Mol Genet Metab Rep 2022; 31:100876. [PMID: 35762020 PMCID: PMC9233158 DOI: 10.1016/j.ymgmr.2022.100876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background Living with a non-acute (phenylketonuria) or acute (e.g. urea cycle disorders, organic acidurias) intoxication-type inborn error of metabolism (IT-IEM) can have a substantial impact on health-related quality of life (HrQoL) of paediatric patients and their families. Parents take primary responsibility for treatment monitoring and experience worry and fear about their child's health status. Quantitative evidence on parental psychological factors which may influence the HrQoL of patients with IT-IEM are sparse to non-existent. Methods In this multicenter survey study 50 parents of IT-IEM patients (ages 5–19) assessed the severity of their child's disease, reported on caregiver burden, and proxy-rated their child's HrQoL. Additionally, 35 patient self-reports on HrQoL were obtained (n = 16 female patients, n = 19 male patients). Multiple linear regressions were conducted to examine the predictive power of child age, sex, medical diagnosis type (acute / non-acute), parental perceived disease severity and caregiver burden on patients' HrQoL. Mediation analyses were used to investigate the relation of caregiver burden and parental ratings of disease severity with patients' HrQoL. Results Significant regression models for self-reported [F(5,34) = 10.752, p < .001, R2 adj.. = 0.59] and parent proxy reported HrQoL [F(5,49) = 20.513, p < .001, R2 adj.. = 0.67] emerged. High caregiver burden and perceived disease severity predicted significantly lower patient self- and proxy-reported HrQoL while type of diagnosis (acute versus non-acute) did not. Female sex predicted significantly lower self-reported HrQoL. High caregiver burden was the mediating factor between high perceived severity of the child's disease and lower proxy- by parent rated HrQoL. Conclusion Detecting elevated burden of care and providing support for parents seems crucial to prevent adverse consequences for their children's HrQoL. Intervention studies are needed, to assess which support programs are most efficient. Caregiver burden enforced by high parent-perceived disease severity is a considerable risk factor for low HrQoL in paediatric patients with IT-IEM. The parent perspective was a better estimator for the impact of disease than the mere medical type of diagnosis. Female sex predicted lower self-reported HrQoL
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13
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O’Mahony J, Banwell B, Laporte A, Brown A, Bolongaita L, Bar-Or A, Yeh EA, Marrie RA. The health-related quality of life of children with multiple sclerosis is mediated by the health-related quality of life of their parents. Mult Scler 2022; 28:1299-1310. [PMID: 35130081 PMCID: PMC9189724 DOI: 10.1177/13524585211061521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: We previously found that children with the chronic disease multiple sclerosis
(MS) reported lower health-related quality of life (HRQoL) when compared to
children who experienced the transient illness termed monophasic acquired
demyelinating syndromes (monoADS). Parents of children with MS also reported
lower HRQoL. Objectives: We evaluated whether parental HRQoL mediated the relationship between the
diagnosis of MS and the HRQoL of affected children. To ascertain the effect
of an MS diagnosis, we compared children with MS to those with monoADS. Methods: Children were enrolled in a prospective multi-site Canadian study. Random
effects models evaluated whether parental HRQoL mediated the relationship
between the diagnosis of MS and the HRQoL of affected children, adjusting
for child and family characteristics. Results: 207 parent-child dyads (65 MS; 142 monoADS) completed HRQoL questionnaires.
When we modeled the child’s HRQoL adjusting for covariates, but not the
parent’s HRQoL, the diagnosis of MS associated with lower HRQoL of the child
(p = 0.004). When we added parental HRQOL to the model,
the association between the diagnosis of MS and the child’s HRQoL diminished
(p = 0.13). Conclusions: Parental HRQoL mediated the relationship between the diagnosis of MS and the
HRQoL of affected children, emphasizing the importance of family-centered
care.
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Affiliation(s)
- Julia O’Mahony
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Brenda Banwell
- Division of Child Neurology, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Audrey Laporte
- Canadian Centre for Health Economics, Toronto, ON, Canada/Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Adalsteinn Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lady Bolongaita
- Canadian Centre for Health Economics, Toronto, ON, Canada/Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Amit Bar-Or
- Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - E Ann Yeh
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada/Division of Neurology, Neurosciences and Mental Health, The Hospital for Sick Children, SickKids Research Institute, Toronto, ON, Canada
| | - Ruth Ann Marrie
- Departments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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H Canbeyli F, Atasayan V, Tokgoz S, Tunaoglu FS, Oguz AD, Celik B, Kula S. Health-related quality of life and parental depression in children with pulmonary arterial hypertension. Pediatr Pulmonol 2022; 57:544-550. [PMID: 34842358 DOI: 10.1002/ppul.25777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/09/2021] [Accepted: 11/23/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Impaired health-related quality of life (HRQoL) is a common problem in pulmonary arterial hypertension (PAH), but there is limited data on HRQoL in children with PAH. We aimed to investigate the QoL, determine the potential risk factors for poor HRQoL in children with PAH, and assess the depression and anxiety of their families. METHODS We performed a prospective cross-sectional study of children with PAH, healthy peers, and their parents. HRQoL was measured by the self-reported and age-adapted KINDL questionnaire. Beck Depression Inventory (BDI) and hospital anxiety and depression scale (HADS) were used to assess the depression and anxiety of parents. RESULTS Children with PAH had statistically lower total HRQoL scores than healthy peers (p < 0.001). There was no correlation between HRQoL and duration of disease, World Health Organization functional class, pro-B-type natriuretic peptide, 6-min walk test, and combined or single treatment. BDI and HADS scores were significantly higher in the parents of patients (p < 0.001, p = 0.023, p < 0.001, respectively). There was a negative correlation between HRQoL and BDI in patients (p = 0.016), while there was no significant correlation between HRQoL and HADS (p > 0.05). CONCLUSION We demonstrated impairment of HRQoL of children with PAH. In addition, there was a correlation between the depression of the families and the QoL of the children.
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Affiliation(s)
- Fatma H Canbeyli
- Department of Pediatric Cardiology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Vildan Atasayan
- Department of Pediatric Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Semiha Tokgoz
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fatma S Tunaoglu
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayse D Oguz
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bulent Celik
- Department of Statistics, Faculty of Science, Gazi University, Ankara, Turkey
| | - Serdar Kula
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Lee Y, Wang LJ, Chou WJ, Chiang MC, Huang S, Lin YC, Lin JY, Chiu NM, Chen CH, Lee IK, Kung CT, Wang CC, Chong MY. Psychological Reactions of Hospital Workers to a Pandemic: A Comparison of SARS-CoV-2 in 2020 and SARS in 2003. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020833. [PMID: 35055654 PMCID: PMC8775670 DOI: 10.3390/ijerph19020833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023]
Abstract
Epidemic viral infections, including the outbreak of severe acute respiratory syndrome (SARS) in 2003 and SARS-CoV-2 in 2019, have brought tremendous loss to people across the nations. The aim of this study was to compare the psychological impact of the SARS-CoV-2 pandemic in 2020 and the SARS pandemic in 2003 on hospital workers. Hospital workers at a medical center in Southern Taiwan (n = 1816) were invited to complete questionnaires (SARS-CoV-2 Exposure Experience, the Impact of Event Scale, the Chinese Health Questionnaire, and the Distress Thermometer). The current data were compared to the data collected from hospital workers (n = 1257) at the same medical center during the SARS pandemic in 2003. We found the psychological impact on hospital workers during the SARS-CoV-2 pandemic was significantly lower than that during the previous SARS period. During the SARS-CoV-2 pandemic period, hospital workers with SARS experience were more accepting of the risk, felt a greater responsibility to take care of the SARS-CoV-2 patients, and were more likely to perceive the danger of becoming infected. The associated factors of psychiatric morbidity in hospital workers with SARS experience were being female, the degree of intrusion severity, and severity of psychological distress. Proper management strategies and lessons learned from the SARS experience might have led to low psychiatric morbidity during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (Y.L.); (N.-M.C.)
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
- Correspondence: (L.-J.W.); (M.-Y.C.); Tel.: +886-77-31-7123 (ext. 8753) (L.-J.W. & M.-Y.C.); Fax: +886-77-32-6817 (L.-J.W. & M.-Y.C.)
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ming-Chu Chiang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Shan Huang
- Administrative Offices, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.H.); (Y.-C.L.); (J.-Y.L.)
| | - Yi-Chun Lin
- Administrative Offices, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.H.); (Y.-C.L.); (J.-Y.L.)
| | - Jie-Yi Lin
- Administrative Offices, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.H.); (Y.-C.L.); (J.-Y.L.)
| | - Nien-Mu Chiu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (Y.L.); (N.-M.C.)
| | - Chih-Hung Chen
- Division of General Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ing-Kit Lee
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Chia-Te Kung
- Department of Emergency, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Chih-Chi Wang
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (Y.L.); (N.-M.C.)
- Correspondence: (L.-J.W.); (M.-Y.C.); Tel.: +886-77-31-7123 (ext. 8753) (L.-J.W. & M.-Y.C.); Fax: +886-77-32-6817 (L.-J.W. & M.-Y.C.)
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16
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van den Heuvel M, Fuller A, Zaffar N, Li X, Beck CE, Birken CS. Food insecurity during COVID-19 in a Canadian academic pediatric hospital: a cross-sectional survey. CMAJ Open 2022; 10:E82-E89. [PMID: 35135823 PMCID: PMC9259437 DOI: 10.9778/cmajo.20210223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hospital-based food insecurity is defined as the inability of caregivers to obtain adequate food during their child's hospital admission. We aimed to measure the prevalence of household and hospital-based food insecurity, and to explore the associations with caregiver distress in an academic pediatric hospital setting. METHODS We conducted a cross-sectional survey of caregivers of children admitted to the general pediatric ward of an academic pediatric hospital in Toronto, Ontario, from April to October 2020. We measured household food insecurity using the 18-item Household Food Security Survey Module, and included 3 adapted questions about hospital-based food insecurity. We measured caregiver distress with the Distress Thermometer for Parents. We used descriptive statistics to assess the proportion of respondents with food insecurity, and linear regression models to explore the relation of household (adult and child) and hospital-based food insecurity with caregiver distress. We used thematic analysis to explore caregivers' feedback. RESULTS We contacted 851 caregivers, and 775 (91.1%) provided consent to participate. Overall, 430 (50.5%) caregivers completed at least part of the survey. Caregivers described a high prevalence of household (34.2%) and hospital-based (38.1%) food insecurity. Adult (β = 0.21, 95% confidence interval [CI] 0.07-0.36), child (β = 0.38, 95% CI 0.10-0.66) and hospital-based (β = 0.56, 95% CI 0.30-0.83) food insecurity were significantly associated with caregiver distress, independent of covariates. We identified financial burden, emotional and practical barriers, stress obtaining food and advocacy for food as important themes in caregiver feedback. INTERPRETATION Both household and hospital-based food insecurity were highly prevalent among caregivers. To reduce caregiver distress, hospitals need to consider reducing barriers for caregivers in obtaining food for themselves during their child's admission.
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Affiliation(s)
- Meta van den Heuvel
- Department of Paediatrics (van den Heuvel, Fuller, Zaffar, Li, Beck, Birken), Faculty of Medicine, University of Toronto; Division of Paediatric Medicine (van den Heuvel, Fuller, Beck, Birken), and Child Health Evaluative Sciences (van den Heuvel, Zaffar, Li, Birken), The Hospital for Sick Children, Toronto, Ont.; Department of Health Research Methods, Evidence and Impact (Fuller), McMaster University, Hamilton, Ont.
| | - Anne Fuller
- Department of Paediatrics (van den Heuvel, Fuller, Zaffar, Li, Beck, Birken), Faculty of Medicine, University of Toronto; Division of Paediatric Medicine (van den Heuvel, Fuller, Beck, Birken), and Child Health Evaluative Sciences (van den Heuvel, Zaffar, Li, Birken), The Hospital for Sick Children, Toronto, Ont.; Department of Health Research Methods, Evidence and Impact (Fuller), McMaster University, Hamilton, Ont
| | - Nusrat Zaffar
- Department of Paediatrics (van den Heuvel, Fuller, Zaffar, Li, Beck, Birken), Faculty of Medicine, University of Toronto; Division of Paediatric Medicine (van den Heuvel, Fuller, Beck, Birken), and Child Health Evaluative Sciences (van den Heuvel, Zaffar, Li, Birken), The Hospital for Sick Children, Toronto, Ont.; Department of Health Research Methods, Evidence and Impact (Fuller), McMaster University, Hamilton, Ont
| | - Xuedi Li
- Department of Paediatrics (van den Heuvel, Fuller, Zaffar, Li, Beck, Birken), Faculty of Medicine, University of Toronto; Division of Paediatric Medicine (van den Heuvel, Fuller, Beck, Birken), and Child Health Evaluative Sciences (van den Heuvel, Zaffar, Li, Birken), The Hospital for Sick Children, Toronto, Ont.; Department of Health Research Methods, Evidence and Impact (Fuller), McMaster University, Hamilton, Ont
| | - Carolyn E Beck
- Department of Paediatrics (van den Heuvel, Fuller, Zaffar, Li, Beck, Birken), Faculty of Medicine, University of Toronto; Division of Paediatric Medicine (van den Heuvel, Fuller, Beck, Birken), and Child Health Evaluative Sciences (van den Heuvel, Zaffar, Li, Birken), The Hospital for Sick Children, Toronto, Ont.; Department of Health Research Methods, Evidence and Impact (Fuller), McMaster University, Hamilton, Ont
| | - Catherine S Birken
- Department of Paediatrics (van den Heuvel, Fuller, Zaffar, Li, Beck, Birken), Faculty of Medicine, University of Toronto; Division of Paediatric Medicine (van den Heuvel, Fuller, Beck, Birken), and Child Health Evaluative Sciences (van den Heuvel, Zaffar, Li, Birken), The Hospital for Sick Children, Toronto, Ont.; Department of Health Research Methods, Evidence and Impact (Fuller), McMaster University, Hamilton, Ont
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Smyth M, Jacobson K. Pediatric Quality of Life Inventory TM version 4.0 short form generic core scale across pediatric populations review data. Data Brief 2021; 39:107599. [PMID: 34901340 PMCID: PMC8639391 DOI: 10.1016/j.dib.2021.107599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
The Pediatric Quality of Life InventoryTM Version 4.0 Short Form Generic Core Scale (PedsQLTM) is a validated and widely used tool assessing the quality of life (QoL) of children and youth. It has been used extensively across healthy populations as well as those with chronic and acute illnesses, allowing for comparison of the psychosocial impact of chronic illness between pediatric disease cohorts. As part of the QoL initiative undertaken at the British Columbia Children's Hospital (BCCH) Inflammatory Bowel Disease (IBD) program and published in the Journal of Pediatrics titled “Cross-Sectional Analysis of Quality of Life in Pediatric Patients with IBD in British Columbia, Canada,” a limited literature review was conducted using Embasse and Ovid. Studies using the English version of the PedsQLTM short form generic scale (not a disease specific scale) were identified. Studies with populations greater than 50 patients with robust subgroup sample size were included, with an emphasis on studies with well-defined patients with chronic disease. These data were compared to the BCCH population, as discussed in the aforementioned journal article. Analysis within the BCCH cohort is described separately. Comparison between different populations from the existing literature was qualitative only, with no statistical analysis done given the heterogeneity of populations and studies. In a study of patients from the emergency department at BCCH (n=178), the mean (SD) QoL scores of the healthy patients was 89.2 (10.3). In a group of self-identified healthy patients in California (n=5079), their mean QoL score was 83.9 (12.5). Separating the BCCH IBD population by disease activity, those in remission (n=220, 84.4 (12.8)) have similar QoL scores to these healthy cohorts, though their scores remain slightly below the previously published BCCH cohort. For children with any degree of active IBD (n=98, 75.6 (15.8)), their QoL scores are below the healthy means and are lower than other groups with self-identified “chronic illnesses” (n=367, 77.2 (15.5)), diabetes (n=418, 82.3 (13.5)), mild asthma (n=281, 85.5 (13.3)), or Canadian patients 4 weeks post-concussion (n=1157, 80.3). BCCH IBD patients with moderately to severely active disease have QoL scores well below the other disease groups (n=33, 63.1 (18.8)); lower than oncology patients on induction chemotherapy regimens (n=105, 68.9 (16.0)), acute inpatients (n=359, 63.9 (20.3)), and asthmatics with moderate-severe, persistent asthma (n=86, 67.1 (18.6)). This data is useful for clinicians treating pediatric patients looking at how QoL is influenced by chronic illness and by factors such as disease type and severity.
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Affiliation(s)
- Matthew Smyth
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, British Columbia Children's Hospital, University of British Columbia, British Columbia, Canada.,British Columbia Children Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Kevan Jacobson
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, British Columbia Children's Hospital, University of British Columbia, British Columbia, Canada.,British Columbia Children Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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18
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Cross-Sectional Analysis of Quality of Life in Pediatric Patients with Inflammatory Bowel Disease in British Columbia, Canada. J Pediatr 2021; 238:57-65.e2. [PMID: 34293367 DOI: 10.1016/j.jpeds.2021.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To evaluate quality of life (QoL) in a large cohort of pediatric patients with inflammatory bowel disease (IBD) and to identify the clinical factors that influence QoL. STUDY DESIGN This cross-sectional study analyzes a quality improvement initiative in 351 pediatric patients with IBD in British Columbia, Canada using the self-reported Pediatric Quality of Life Inventory (PedsQL) 4.0 generic scale. The questionnaire was completed at outpatient clinic and biologic infusion appointments. Statistical analysis included the t test, ANOVA, and multilinear regressions to evaluate the relationships between clinical factors and QoL. RESULTS Mean (SE) QoL scores (79.95 [0.84]) fell between previously described healthy and chronically ill populations. Disease activity was the most significant predictor of QoL, with patients in remission scoring similar (84.42 [0.87]) to well established healthy norms, and those with moderately or severely active disease having some of the lowest published PedsQL scores (63.13 [3.27]), lower than most other chronic pediatric conditions. Twenty-five patients with moderately or severely active disease at the time of survey completion had follow-up surveys identified 1 year later and had a significant improvement of both their disease activity (P < .005) and their PedsQL scores (follow-up survey mean 76.13 [3.11]). Additional clinical factors independently associated with poor QoL were school nonattendance (15.5% decrease in QoL, P < .001), immune-modulator selection (methotrexate conferring a 9.5% lower mean QoL score than azathioprine, P = .005), and female gender (P = .031). CONCLUSION Pediatric patients with IBD experience a QoL significantly impacted by multiple clinical factors including current severity of IBD symptoms.
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19
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Ferro MA, Meyer SB, Yessis J, Reaume SV, Lipman E, Gorter JW. COVID-19-Related Psychological and Psychosocial Distress Among Parents and Youth With Physical Illness: A Longitudinal Study. Front Psychiatry 2021; 12:761968. [PMID: 34777063 PMCID: PMC8580883 DOI: 10.3389/fpsyt.2021.761968] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/24/2021] [Indexed: 01/07/2023] Open
Abstract
Despite the initial thrust of research aimed at understanding the impact of the COVID-19 pandemic on youth with physical illness and their parents, knowledge gaps in the literature remain, providing the impetus for additional investigation. This study described changes in psychological distress from prior to during the COVID-19 pandemic for parents and youth with physical illness, compared parent-proxy and youth self-reported perceptions of COVID-19-related psychosocial health, and modeled factors associated with psychological and psychosocial distress. There were 147 parent-youth dyads (2-16 years) from MY LIFE-a longitudinal study of youth with physical illness. The Kessler-6 (K6) measured psychological distress for the time before the COVID-19 lockdown (December 19 to March 20) and during the pandemic (December 20 to March 21) among parents and youth. COVID-19-related psychosocial health was measured using the CRISIS. Parents and youth reported increases in K6 scores (d = 0.62 and 0.38). Parent-proxy reports on the K6 were lower vs. youth self-reports prior to and during the pandemic (d = 0.63 for both). In contrast, parents reported lower proxy CRISIS scores for worries (d = 0.38) and effects of social restrictions (d = 0.52). Pandemic parent K6 scores were associated with age, combined in-person and online schooling for youth, COVID-19-related worries, and effects of social restrictions. For youth, only COVID-19-related worries and effects of social restrictions were associated with K6 scores. Parent worries were associated with youth sex, parental stress, family functioning, online and combination learning, and social restrictions. Parental depression and worries were associated with effects of social restrictions. Youth worries were associated with online and combination learning, and social restrictions. Youth disability, online learning, and worries were associated with effects of social restrictions. Few clinical factors are associated with COVID-19-related psychological and psychosocial distress. Instead, parent/family factors and youth learning environment have prominent roles in predicting outcomes and have implications for the health, education, and social services systems.
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Affiliation(s)
- Mark A. Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Samantha B. Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jennifer Yessis
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shannon V. Reaume
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Ellen Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jan Willem Gorter
- Department of Pediatric Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, Netherlands
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20
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van Muilekom MM, Luijten MAJ, van Oers HA, Conijn T, Maurice‐Stam H, van Goudoever JB, Grootenhuis MA, Haverman L, M. A. B, J. M. VDB, A. H. M. B, C. C. B, C. J. F, J. W. G, C. M. VDH, B. J, A. K, H. K, B. J. P. K, L. A. M, M. A. MH, M. P, M. A. J. VR, N. W. P. R, H. J. S, A. Y. N. S, F. S, M. M. T, A. S. P. T, F. A. W. Paediatric patients report lower health-related quality of life in daily clinical practice compared to new normative PedsQL TM data. Acta Paediatr 2021; 110:2267-2279. [PMID: 33838052 PMCID: PMC8360011 DOI: 10.1111/apa.15872] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 02/25/2021] [Accepted: 04/08/2021] [Indexed: 01/04/2023]
Abstract
Aim To compare Health‐Related Quality of Life (HRQOL) of paediatric patients with newly collected HRQOL data of the general Dutch population, explore responses to individual items and investigate variables associated with HRQOL. Methods Children (8–12y) and adolescents (13–17y) from the general population (N = 966) and from a paediatric population (N = 1209) completed the Pediatric Quality of Life Inventory (PedsQLTM) online via the KLIK Patient‐Reported Outcome Measures portal. PedsQLTM scale scores were compared between groups with independent t tests, by age group and gender. Responses to PedsQLTM items were explored using descriptive analyses. Linear regression analyses were performed to determine which variables were associated with HRQOL. Results Paediatric patients reported worse HRQOL than the general population on all PedsQLTM scales (p ≤ .001, d = 0.20–1.03), except social functioning, and a high proportion reported problems on PedsQLTM items, for example, ‘I have trouble sleeping’. Younger age, female gender and school absence were negatively associated with HRQOL (β = −0.37–0.10, p ≤ .008). Conclusion Paediatric patients reported lower HRQOL than the general population, and school absence, female gender and younger age were associated with lower HRQOL. The results underline the importance to structurally monitor paediatric patients’ HRQOL in clinical practice to detect problems and offer the right help on time.
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Affiliation(s)
- Maud M. van Muilekom
- Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam Reproduction and Development Amsterdam Public Health Emma Children's HospitalAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands
| | - Michiel A. J. Luijten
- Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam Reproduction and Development Amsterdam Public Health Emma Children's HospitalAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands
- Department of Epidemiology and Data Science Amsterdam Public Health Amsterdam UMCVrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Hedy A. van Oers
- Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam Reproduction and Development Amsterdam Public Health Emma Children's HospitalAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands
| | - Thirsa Conijn
- Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam Reproduction and Development Amsterdam Public Health Emma Children's HospitalAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands
| | | | - Johannes B. van Goudoever
- Department of Pediatrics Emma Children's HospitalAmsterdam UMCUniversity of AmsterdamVrije Universiteit Amsterdam The Netherlands
| | | | - Lotte Haverman
- Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam Reproduction and Development Amsterdam Public Health Emma Children's HospitalAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands
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21
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Touma N, Varay C, Baeza-Velasco C. Determinants of quality of life and psychosocial adjustment to pediatric inflammatory bowel disease: A systematic review focused on Crohn's disease. J Psychosom Res 2021; 142:110354. [PMID: 33465493 DOI: 10.1016/j.jpsychores.2020.110354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/18/2020] [Accepted: 12/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Crohn's disease is a chronic and unpredictable inflammatory bowel disease that leads to important psychosocial difficulties especially during sensitive developmental stages such as childhood and adolescence. While risk factors for mood disorders have been identified in the literature, those for quality of life and psychosocial functioning have not. OBJECTIVE This systematic review explored the determinants of quality of life and psychosocial adjustment to pediatric Crohn's disease. METHOD Four international databases were consulted in March 2020: PubMed, PsychInfo, PubPsych and Cochrane Library. A series of keywords were entered in each database to identify the most recent relevant studies. RESULTS One hundred and sixty-eight articles were identified, of which twenty-nine met the inclusion criteria. The majority explored the determinants of quality of life, depression and anxiety, with a few focusing on psychosocial functioning. Consistently with the literature on psychological morbidity, disease activity and parental stress were also strong predictors of quality of life and psychosocial functioning. New evidence showed that abdominal pain, negative illness perceptions and internalizing symptoms were also common predictors of these outcomes. CONCLUSIONS Some risk factors of quality of life, distress and psychosocial functioning are similar, which could indicate that some patients could be at risk of presenting an accumulation of difficulties adjusting to the disease. The identification of these risk factors is fundamental to propose appropriate interventions. Therapeutic education, therapies focused on pain management or on the parent-child relationship can be considered to allow a better adjustment or prevent difficulties.
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Affiliation(s)
- Nathalie Touma
- University of Paris, Laboratory of Psychopathology and Health Process (LPPS), 71 Av Edouard Vaillant, F-92100 Boulogne-Billancourt, France.
| | - Caroline Varay
- University of Paris, Laboratory of Psychopathology and Health Process (LPPS), 71 Av Edouard Vaillant, F-92100 Boulogne-Billancourt, France
| | - Carolina Baeza-Velasco
- University of Paris, Laboratory of Psychopathology and Health Process (LPPS), 71 Av Edouard Vaillant, F-92100 Boulogne-Billancourt, France; Department of Psychiatric Emergency and Post-Emergency, Montpellier University Hospital Center, 371 Av du Doyen Gaston Giraud, 34090 Montpellier, France
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22
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Sousa H, Oliveira J, Figueiredo D, Ribeiro O. The clinical utility of the Distress Thermometer in non-oncological contexts: A scoping review. J Clin Nurs 2021; 30:2131-2150. [PMID: 33555631 DOI: 10.1111/jocn.15698] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/18/2021] [Accepted: 01/29/2021] [Indexed: 12/22/2022]
Abstract
AIMS To assess the clinical utility of the Distress Thermometer (DT) in non-cancer populations. METHODS The search was performed between the 6th and the 18th of April 2020, on the following databases: Web of Science (all databases included), Scopus and Science Direct. One last update was performed on 5 June 2020. The findings were reported using the PRISMA-ScR. RESULTS Fifty-three studies were included. Overall results indicated that this tool has been used in several contexts and populations (clinical and non-clinical). The DT is highly accessible, suitable and relevant for health professionals and/or researchers who aim to use it as a distress screening tool, particularly in patients with chronic physical conditions. Assumptions about its practicality and acceptability in non-oncology care should be made with caution since few studies have explored the psychometric qualities of this instrument, the completers' perceptions about completing the DT and the perceptions of health professionals who administer the tool. CONCLUSIONS This lack of information undermines conclusions about the overall clinical utility of the DT as a screening tool for distress in individuals who do not have cancer. IMPLICATIONS FOR PRACTICE Future research should aim to fill this gap and investigate the psychometric qualities of the DT through validation studies and, thus, increase the rigour of its application and clinical utility in non-oncological contexts.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Jaime Oliveira
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Oscar Ribeiro
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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Abstract
OBJECTIVES The aim of the study was to determine quality of life (QoL), stress, and anxiety levels in parents of children with biliary atresia (BA), and to assess factors associated with parental QoL. METHODS Parents of children (6-16 years) with BA were included in this cross-sectional study. We used validated questionnaires to assess parental QoL, stress, and anxiety levels. We compared the results with reference data from the general population and determined associated factors using generalized linear mixed model analysis. Results are given as mean ± SD or median [min-max]. RESULTS We included 61 parents of 39 children (aged 11 ± 3 years). Thirty-one children (79%) had undergone a liver transplantation (LTx). Parents reported reduced family activities (88 [8-100] vs 95 [30-100], P = 0.002) and more emotional worry (83 [17-100] vs 92 [95-100], P < 0.001) compared with reference data, but a stronger family cohesion (85 [30-100] vs 60 [30-100], P = 0.05). Scores on parental QoL, anxiety and stress were similar to reference data. Fathers (16.0 [11-19]) and mothers (15.4 ± 1.4) scored higher on the psychological domain compared with reference data (vs 14.7 ± 2.2, P < 0.01). There was no significant difference in QoL of parents with children with native liver or those who had undergone LTx. Older age and high anxiety trait in parents were adversely associated with physical QoL. Household income below &OV0556;35 000/year and high anxiety trait were adversely associated with environmental QoL. CONCLUSIONS QoL in parents of school-aged children with BA appears to be unaffected. Parents with high-anxiety personality trait, older age, and low household income are at increased risk of impaired QoL.
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24
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Parent and Family Functioning in Pediatric Inflammatory Bowel Disease. CHILDREN-BASEL 2020; 7:children7100188. [PMID: 33080794 PMCID: PMC7603067 DOI: 10.3390/children7100188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/30/2020] [Accepted: 10/08/2020] [Indexed: 12/16/2022]
Abstract
Although the impact of pediatric inflammatory bowel disease (IBD) extends beyond the patient to their parents and families, the focus of previous literature has largely been on investigating the patient’s medical and psychosocial functioning, with less consideration of the family system. Having a comprehensive understanding of parent and family functioning within the context of pediatric IBD is important given the role parents and family members have in the successful management of the disease and caring of the child. The current review paper aggregates the empirical research regarding parent and family functioning, including comparisons to normative samples, other illness groups, and how functioning relates to child psychosocial and health outcomes. Extant literature on parents and families in pediatric IBD has largely focused on the variables of parenting stress, parent psychosocial functioning, parent quality of life, and family functioning. Summary findings elucidate the complex relationships between parents, families, and children affected by IBD and highlight the importance of assessing parent and family functioning within pediatric IBD. The current review also offers implications for clinical practice, notes the limitations of the present literature, and provides recommendations for future research.
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25
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Warnink-Kavelaars J, van Oers HA, Haverman L, Buizer AI, Alsem MW, Engelbert RHH, Menke LA. Parenting a child with Marfan syndrome: Distress and everyday problems. Am J Med Genet A 2020; 185:50-59. [PMID: 33034422 PMCID: PMC7756496 DOI: 10.1002/ajmg.a.61906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/06/2020] [Accepted: 09/20/2020] [Indexed: 12/25/2022]
Abstract
Marfan syndrome (MFS) is a multisystemic, autosomal dominant connective tissue disorder that occurs de novo in 25%. In many families, parent and child(ren) are affected, which may increase distress in parents. To assess distress, 42 mothers (29% MFS) and 25 fathers (60% MFS) of 43 affected children, completed the validated screening‐questionnaire Distress thermometer for parents of a chronically ill child, including questions on overall distress (score 0–10; ≥4 denoting “clinical distress”) and everyday problems (score 0–36). Data were compared to 1,134 control‐group‐parents of healthy children. Mothers reported significantly less overall distress (2, 1–4 vs. 3, 1–6; p = .049; r = −.07) and total everyday problems (3, 0–6 vs. 4, 1–8; p = .03; r = −.08) compared to control‐group‐mothers. Mothers without MFS reported significantly less overall distress compared to mothers with MFS, both of a child with MFS (1, 0–4 vs. 3.5, 2–5; p = .039; r = −.17). No significant differences were found between the father‐groups, nor between the group of healthy parents of an affected child living together with an affected partner compared to control‐group‐parents. No differences in percentages of clinical distress were reported between mothers and control‐group‐mothers (33 vs. 42%); fathers and control‐group‐fathers (28 vs. 32%); nor between the other groups. Distress was not associated with the children's MFS characteristics. Concluding, parents of a child with MFS did not show more clinical distress compared to parents of healthy children. However, clinical distress was reported in approximately one‐third and may increase in case of acute medical complications. We advise monitoring distress in parents of a child with MFS to provide targeted support.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Hedy A van Oers
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mattijs W Alsem
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Raoul H H Engelbert
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Center of Expertise Urban Vitality, University of Applied Sciences, Faculty of Health, Amsterdam, The Netherlands.,Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Leonie A Menke
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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26
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Michel HK, Kim SC, Siripong N, Noll RB. Gaps Exist in the Comprehensive Care of Children with Inflammatory Bowel Diseases. J Pediatr 2020; 224:94-101. [PMID: 32482390 PMCID: PMC7483573 DOI: 10.1016/j.jpeds.2020.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/18/2020] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe patterns of primary and specialty care delivery in pediatric patients with inflammatory bowel diseases (IBD), delineate which members of the healthcare team provided services, and identify gaps in care. STUDY DESIGN Cross-sectional survey of parents of children (2-17 years) with IBD and adolescents with IBD (13-17 years) at a free-standing, quaternary children's hospital regarding healthcare receipt. RESULTS There were 161 parents and 84 adolescents who responded to the survey (75% and 60% response, respectively). The mean patient age was 14 ± 3 years, 51% were male, 80% had Crohn's disease, 16% ulcerative colitis, and 4% IBD-unspecified. Most parents were white (94%), living in a suburban setting (57%). Sixty-nine percent of households had ≥1 parent with a bachelor's degree or higher. Most had private insurance (43%) or private primary with public secondary insurance (34%). Most patients received annual check-ups (70%), vaccinations (78%), and care for minor illnesses (74%) from their primary care provider. Check-ups for gastrointestinal symptoms, IBD monitoring, and changes in type/dosing of IBD treatment were provided by their gastroenterology provider (77%, 93%, and 86% of patients, respectively). Discussions about family/peer relationships, school/extracurricular activities, and mood were not addressed in 30%-40% of participants. Adolescents frequently reported that no one had talked to them about substance use (40%), sexual health (50%), or body image (60%); 75% of adolescents and 76% of their parents reported that no one had discussed transitioning to an adult provider. CONCLUSIONS There were gaps in the psychosocial care of pediatric patients with IBD. Coordinated, comprehensive care delivery models are needed.
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Affiliation(s)
- Hilary K. Michel
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States,Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, OH, United States
| | - Sandra C. Kim
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Nalyn Siripong
- Clinical Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Robert B. Noll
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
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27
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Barnes C, Ashton JJ, Borca F, Cullen M, Walker DM, Beattie RM. Children and young people with inflammatory bowel disease attend less school than their healthy peers. Arch Dis Child 2020; 105:671-676. [PMID: 31937567 DOI: 10.1136/archdischild-2019-317765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Chronic diseases, such as inflammatory bowel disease (IBD), can impact negatively on education and social development. Examining the impact of IBD on school/college attendance for children and young people (CYP) is vital to provide targeted support to patients, families and schools. METHODS We performed a cross-sectional survey to determine the school/college attendance rates, the reasons for absence related to IBD and facilitators or barriers to school/college attendance. In a subset of patients followed up locally, we performed a detailed review of hospital attendance data to assess healthcare burden. RESULTS Two hundred and thirty-one questionnaires were given to CYP with IBD aged 5-17 years. Response rate was 74% (final sample 169). The median school/college attendance rate was 92.5%, significantly lower than all children in England (95.2%). 39.6% of children with IBD were persistently absent, defined nationally as missing 10% or more of school. Only five children (3%) had a 100% attendance record. Increasing age and use of monoclonal therapy were predictors of poor school attendance. Concerns about feeling unwell at school/college, access to toilets, keeping up with work and teachers' understanding of IBD are the main issues for CYP with IBD. There was a significant negative correlation between number of days in hospital and school attendance. CONCLUSION IBD has a significant impact on school/college attendance, with hospital attendance, disease burden and school difficulties being major factors. Employing strategies to minimise healthcare burden and developing a partnership between health and education to support children with IBD will serve to facilitate school/college attendance.
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Affiliation(s)
- Claire Barnes
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | - James John Ashton
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK .,Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
| | - Florina Borca
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Mick Cullen
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | | | - Robert Mark Beattie
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
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28
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Parental Psychological Factors and Quality of Life of Children With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2020; 70:211-217. [PMID: 31978019 DOI: 10.1097/mpg.0000000000002548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Parents have a central role in the management of children with inflammatory bowel disease (IBD). Alterations in parental psychological well-being may affect the patient's health-related quality of life (HRQoL). This study aimed to evaluate the correlation between maternal and paternal distress, anxiety, depression and pain catastrophizing and the HRQoL of patients with IBD. METHODS Children with IBD ages 8 to 18 years and their parents were prospectively recruited. Children answered questionnaires on HRQoL while parents completed an assessment of distress, anxiety, depression, and pain catastrophizing. Univariate and multivariate regression models analysis were used to evaluate correlations between parental measures and patient's HRQoL and between the factors related to children health and parental psychological suffering. RESULTS One hundred patients (45 Crohn disease, 55 ulcerative colitis), 90 mothers and 62 fathers were enrolled. Parents had high levels of distress while anxiety, depression, and pain catastrophizing levels were relatively low. Parental distress had the most substantial correlation with children's HRQoL and was associated with patients' disease activity and recent flares. On multivariate regression analysis, parental factors explained less than 20% of the variance in the children's HRQoL scores. Mothers suffered from psychological alterations more frequently than fathers, but the parental inter-rater agreement was strong in regards to distress and anxiety. CONCLUSIONS Parental distress is high and correlates with the HRQoL of children with IBD. Interventions aimed at evaluating and managing parental distress should be considered during the management of children with IBD.
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29
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Vriesman MH, Rajindrajith S, Koppen IJN, van Etten-Jamaludin FS, van Dijk M, Devanarayana NM, Tabbers MM, Benninga MA. Quality of Life in Children with Functional Constipation: A Systematic Review and Meta-Analysis. J Pediatr 2019; 214:141-150. [PMID: 31399248 DOI: 10.1016/j.jpeds.2019.06.059] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/17/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To systematically review the literature on health-related quality of life (HRQoL) in children with functional constipation and to identify disease-related factors associated with HRQoL. STUDY DESIGN The Pubmed, Embase, and PsycINFO database were searched. Studies were included if they prospectively assessed HRQoL in children with functional constipation according to the Rome criteria. Articles were excluded if patients had organic causes of constipation and if HRQoL was only assessed after successful therapeutic interventions. A meta-analysis was performed calculating sample size-weighted pooled mean and SD of HRQoL scores. The quality of the studies was also assessed. RESULTS A total of 20 of 2658 studies were included, providing HRQoL data for 2344 children. Quality of evidence was considered to be poor in 9 of the 20 studies (45%); 13 of the 20 studies reported sufficient data to be included in the meta-analysis. Pooled total HRQoL scores of children with functional constipation were found to be lower compared with healthy reference samples (65.6 vs 86.1; P < .01). Similar HRQoL scores were found according to self-report and parent proxy report. Hospital-based studies reported lower HRQoL scores as compared with community-based studies. Two studies reported on HRQoL scores of children with and without fecal incontinence, but no significant difference was found. CONCLUSIONS HRQoL is compromised in children with functional constipation.
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Affiliation(s)
- Mana H Vriesman
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Shaman Rajindrajith
- Department of Pediatrics, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Ilan J N Koppen
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Marieke van Dijk
- Psychosocial Department, Emma Children's Hospital Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Niranga M Devanarayana
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Merit M Tabbers
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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30
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Can We Estimate Quality of Life in Pediatric Inflammatory Bowel Disease Patients? An Asian Multicenter Study. J Pediatr Gastroenterol Nutr 2019; 68:45-49. [PMID: 30052570 DOI: 10.1097/mpg.0000000000002119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Inflammatory bowel disease (IBD) is a chronic lifelong condition and is related to poor quality of life (QoL). The aim of this study was to evaluate the QoL of Asian pediatric patients with IBD and to determine the clinical factors that can influence QoL. METHODS Children and adolescents aged 9 to 18 years diagnosed with IBD were enrolled from 7 hospitals. The patients completed the IMPACT-III questionnaire, and clinical data were collected. The results of the questionnaire and the correlation with clinical data were analyzed. RESULTS A total of 208 patients (Crohn disease: n = 166; ulcerative colitis: n = 42) were enrolled. There was no definite QoL difference according to the Paris classification. Female sex (-5.92 ± 2.97, P = 0.0347) and active disease status (-10.79 ± 3.11, P = 0.0006) were significantly associated with poor QoL. Extreme body weight z score and older age at diagnosis were also associated with worse QoL. CONCLUSIONS Various clinical factors may affect the QoL in patients with IBD, but determining the overall QoL of patients using only these clinical factors is difficult. Therefore, regular direct measurements of QoL are necessary to better understand patients with IBD.
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