1
|
Taft TH, Aswani-Omprakash T. Caregiver burden of IBD patients in Asian Emerging Nations is significant and necessitates attention and resource allocation. Indian J Gastroenterol 2024:10.1007/s12664-024-01653-8. [PMID: 39088167 DOI: 10.1007/s12664-024-01653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Affiliation(s)
- Tiffany H Taft
- The Rome Foundation Research Institute, Chapel Hill, NC, USA.
| | | |
Collapse
|
2
|
Pasek M, Stoietskyi M, Goździalska A, Jochymek M. A Child with Crohn's Disease: Problems and Stress Level of Parents-Caregivers-A Cross-Sectional Study. NURSING REPORTS 2024; 14:444-454. [PMID: 38391079 PMCID: PMC10885082 DOI: 10.3390/nursrep14010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Crohn's disease (CD) is a chronic inflammatory bowel disease. The perception of the disease, its troublesome symptoms and the highly involved treatment mean that living with CD requires not only the affected child having to learn to cope with it, but also their parents. The aim of the study was to examine the problems and levels of stress in parents-caregivers of children with CD. The study was cross-sectional and conducted using the diagnostic survey method. An original questionnaire was used to assess the socio-demographic situation and problems of caring for a child with CD, and the standardised PSS-10 questionnaire was added. The study group consisted of 60 parents who accompanied their children during hospitalization. The surveyed caregivers of children with CD found it difficult to maintain a specialised diet and deal with the need for hospitalization and the chronic use of medications. Access to the necessary knowledge about the disease posed the least difficulty in everyday life for a child with CD. The vast majority of parents (50, 83.34%) felt a high level of stress related to caring for a child with CD and, simultaneously, a lack of acceptance of the child's disease (39, 65%). The age of the respondents did not have a statistically significant effect on the occurrence of problems related to everyday functioning. The acceptance of the child's disease by the parents and informal caregivers of children with CD reduced their stress level. Parents could count on support from their relatives but, unfortunately, institutional support was not properly provided.
Collapse
Affiliation(s)
- Małgorzata Pasek
- Department of Nursing, Faculty of Health, University of Applied Sciences in Tarnów, 8th Mickiewicz St, 33-100 Tarnów, Poland
| | - Monika Stoietskyi
- Faculty of Health and Medical Studies, Andrzej Frycz Modrzewski Krakow University, 1st Grudziński St, 30-705 Krakow, Poland
| | - Anna Goździalska
- Faculty of Health and Medical Studies, Andrzej Frycz Modrzewski Krakow University, 1st Grudziński St, 30-705 Krakow, Poland
| | - Małgorzata Jochymek
- Faculty of Health and Medical Studies, Andrzej Frycz Modrzewski Krakow University, 1st Grudziński St, 30-705 Krakow, Poland
| |
Collapse
|
3
|
Zhou M, Xu Y, Zhou Y. Factors influencing the healthcare transition in Chinese adolescents with inflammatory bowel disease: a multi-perspective qualitative study. BMC Gastroenterol 2023; 23:445. [PMID: 38110881 PMCID: PMC10729466 DOI: 10.1186/s12876-023-03080-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/08/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The development and implementation of the transition from pediatric to adult healthcare systems for adolescents with inflammatory bowel disease (IBD) should consider stakeholders' perceptions. This study aimed to explore the factors influencing the transition of Chinese adolescents with IBD from the perspectives of patients, parents, and healthcare providers. METHODS A descriptive qualitative research was conducted. Purposive sampling was used to recruit 36 participants, including 13 patients, 13 parents, and 10 providers, from a tertiary pediatric IBD center, a tertiary adult IBD center, and the China Crohn's & Colitis Foundation in Zhejiang Province, China. Individual semi-structured interviews were used to collect data on facilitators and barriers to the transition process. Conventional content analysis was used to analyze the interview transcripts. RESULTS Nine primary themes were identified. Patients with young age, prolonged disease duration, severe disease, academic pressures such as the Gaokao, low level of disease acceptance, limited transition consciousness, low self-efficacy, poor transition communication, and inadequate medical transition system serve as barriers. While patients with the mentality of guilt towards their parents; parents with low education levels and intensive work schedules, high levels of disease acceptance, and situations of parent-child separation; stakeholders with high transition consciousness, high transition self-efficacy, and effective transition communication act as facilitators. Furthermore, community support and hospital guide services were also contributing factors during the transition. CONCLUSIONS This study offers comprehensive insights into the factors affecting the transition of Chinese adolescent IBD patients. The process is continuously influenced by stakeholders, community, and healthcare environments and policies. Identifying these factors provides healthcare providers with a reference for developing and implementing targeted transition interventions.
Collapse
Affiliation(s)
- Mi Zhou
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, China
| | - Youjun Xu
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, China.
| |
Collapse
|
4
|
Zhou XJ, Huang S. A qualitative analysis of stress experiences and coping strategies in adolescents with Crohn's disease. BMC Psychiatry 2023; 23:768. [PMID: 37864158 PMCID: PMC10590037 DOI: 10.1186/s12888-023-05241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/30/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND In this study, we investigated the coping mechanisms and stress perceptions of adolescent patients with Crohn's disease. METHODS Using semi-structured face-to-face interviews, we conducted an extensive qualitative study of the disease perceptions, stress experiences, and corresponding coping mechanisms in adolescent patients with Crohn's disease. We used Colaizzi content analysis to synthesize the themes. RESULTS The two main themes in this study were inappropriate coping mechanisms and physical and psychological stress. The primary initiators of physical and psychological stress in adolescents with Crohn's disease were weak disease perception, symptom distress, negative emotions, lack of support, and multiple stressors. The decrease in self-management and self-control induced by the initiators led to changes in cognition, emotions, and attitudes, which subsequently led to poor coping behavior. CONCLUSION Adolescents with Crohn's disease can better combat the condition by implementing appropriate coping strategies. Their mental health should be given attention, and a multidisciplinary team should be assembled to provide them with supportive care.
Collapse
Affiliation(s)
- Xiao-Juan Zhou
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kangjiang Road, Yangpu District, Shanghai, 200082, China
| | - Shuai Huang
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kangjiang Road, Yangpu District, Shanghai, 200082, China.
| |
Collapse
|
5
|
Fang N, Deng H, Fu T, Zhang Z, Long X, Wang X, Tian L. Association between caregiver ability and quality of life for people with inflammatory bowel disease: The mediation effect of positive feelings of caregivers. Front Psychol 2022; 13:988150. [PMID: 36267073 PMCID: PMC9577491 DOI: 10.3389/fpsyg.2022.988150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Inflammatory bowel disease (IBD) is an incurable digestive disease. Since patients have to live with it, improving patients' quality of life is important. Caregiver's positive feelings and closeness may have a positive effect on patients' quality of life. We hypothesized that caregiver's positive feeling affected patient's quality of life through caregiver's caring ability, and closeness might be the upstream of this chain. In this study, we conducted a single-center cross-sectional survey by questionnaire in China to tested the hypothesis. A total of 181 patient-caregiver pairs were included. The short version of the IBD questionnaire (SIBDQ), the twelve-item short-form health survey (SF-12), the positive aspects of caregiving (PAC) and Capacity Scale of caregivers were used to collect data. All the data were collected in one interview. Spearman correlation and Bootstrap method were used to analyze the data. Mediation analysis results indicated that caregiver's caring ability mediated the association between caregiver's positive feelings and patients' quality of life (p < 0.01), which explained 34.1% of the total variation of patients' quality of life. Mediation analysis results also revealed that patient-evaluated or caregiver-evaluated closeness had a positive effect on patients' quality of life through caregiver's positive feeling and caregiver's caring ability (p < 0.05), which explained 2.1 and 2.3% of the variation of patients' quality of life. Caregiver's positive feelings were related to caregivers' quality of life (p < 0.01), but there was no significant association between caregivers' ability and caregivers' quality of life. In summary, our model revealed that caregiver's positive feeling affected patients' quality of life through caregiver's caring ability.
Collapse
Affiliation(s)
- Ning Fang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Haijun Deng
- Department of Statistics, Guizhou University of Finance and Economics, Guiyang, Guizhou, China
| | - Tian Fu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zinan Zhang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiuyan Long
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoyan Wang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Li Tian
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|
6
|
Baudino MN, Roberts CM, Edwards CS, Gamwell KL, Tung J, Jacobs NJ, Grunow JE, Chaney JM. The impact of illness intrusiveness and overparenting on depressive symptoms in parents of youth with inflammatory bowel disease. J SPEC PEDIATR NURS 2022; 27:e12362. [PMID: 34811881 DOI: 10.1111/jspn.12362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/11/2021] [Accepted: 10/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Inflammatory bowel disease (IBD) management creates significant caregiver demands that can interfere with parents' ability to engage in a number of role functions (i.e., illness intrusiveness) well into their child's adolescence, potentially resulting in excessive or misdirected parenting (i.e., overparenting). Disruptions and limited access to routine and valued activities (e.g., family, work, and leisure) due to IBD and excessive parenting may result in parents neglecting their own personal and emotional self-care needs, increasing their risk for depressive symptoms. To explore these associations, the present study examined parents' experience of illness intrusiveness and subsequent overparenting as serial mediators in the association between disease severity and parent depressive symptoms. DESIGN AND METHODS Participants were 146 caregivers of adolescents with IBD from an outpatient pediatric gastroenterology clinic. During a scheduled outpatient visit, parents completed measures of illness intrusiveness, overparenting, and depressive symptoms. Pediatric gastroenterologists provided ratings of disease severity. RESULTS Several direct and indirect associations were observed among the modeled variables. Notably, mediation analysis revealed a significant disease severity → illness intrusiveness → overparenting → depressive symptoms serial indirect effect. CONCLUSIONS Parents' experience of greater IBD-induced lifestyle disruptions is associated with increased overparenting and a heightened risk for depressive symptoms. PRACTICE IMPLICATIONS Parents should be encouraged to establish and maintain a healthy balance between parenting and self-care/role function activities, especially during adolescence when greater youth autonomy and independence are crucial. These types of clinical efforts may reduce the likelihood of parents experiencing depressive symptoms, and have the added benefit of improving adolescent IBD self-management.
Collapse
Affiliation(s)
- Marissa N Baudino
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Caroline M Roberts
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Clayton S Edwards
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Kaitlyn L Gamwell
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jeanne Tung
- Pediatric Gastroenterology, University of Oklahoma Children's Physicians, Oklahoma City, Oklahoma, USA
| | - Noel J Jacobs
- General and Community Pediatrics, University of Oklahoma Children's Physicians, Oklahoma City, Oklahoma, USA
| | - John E Grunow
- Pediatric Gastroenterology, University of Oklahoma Children's Physicians, Oklahoma City, Oklahoma, USA
| | - John M Chaney
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| |
Collapse
|