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Adedeji A, Witt S, Innig F, Quitmann J. A comprehensive systematic review of health-related quality of life measures in short stature paediatric patients. Endocrine 2024:10.1007/s12020-024-03938-6. [PMID: 39017834 DOI: 10.1007/s12020-024-03938-6] [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: 04/30/2024] [Accepted: 06/20/2024] [Indexed: 07/18/2024]
Abstract
This systematic review investigates Patient-reported Outcome Measures (PROMs) and Observed Reported Outcome Measures (ObsROMs) pertinent to assessing Health-Related Quality of Life (HRQoL) in short-stature paediatric patients, focusing on Achondroplasia (ACH), Growth Hormone Deficiency (GHD), Isolated Growth Hormone Deficiency (IGHD), and Small-for-Gestational-Age (SGA) diagnoses. Utilising rigorous selection criteria, 53 studies published from 1998 to 2023 were analysed, revealing a predominance of European-based research. Notably, the review elucidated the utilisation of disease-specific and generic HRQoL measures, showcasing the multifaceted nature of short-stature conditions and their impact across physical, emotional, and social domains. The Quality of Life in Short Stature Youth (QoLISSY), Paediatric Quality of Life Inventory (PedsQL), and KIDSCREEN emerged as frequently employed instruments, offering nuanced insights into HRQoL perceptions across diverse age demographics. Additionally, the review highlighted the adaptation of adult HRQoL measures for adolescent populations, signalling a need for age-appropriate assessment tools. Furthermore, integrating PROMs and ObsROMs in HRQoL assessment underscored a comprehensive approach, considering both subjective patient perspectives and observed outcomes. Future research directions encompass comprehensive search strategies, longitudinal studies with diverse populations, and the development of age-appropriate HRQoL assessment tools. In conclusion, this review emphasises the importance of comprehensive HRQoL assessment to address the diverse needs of short-stature paediatric patients effectively.
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Affiliation(s)
- Adekunle Adedeji
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Witt
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Innig
- BKMF Federal Association for People of Short Stature and their Families (Bundesverband Kleinwüchsige Menschen und ihre Familien e.V.), BKMF, Hamburg, Germany
| | - Julia Quitmann
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany.
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
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Incardona RM, Tremolada M. The Psychosocial Impact of the COVID-19 Pandemic on Italian Families: The Perception of Quality of Life and Screening of Psychological Symptoms. Pediatr Rep 2024; 16:519-529. [PMID: 38921708 PMCID: PMC11206805 DOI: 10.3390/pediatric16020043] [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: 05/11/2024] [Revised: 06/07/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
Throughout the COVID-19 period, families were forced to stay indoors, adapting to online schooling, remote work, and virtual social engagements, inevitably altering the dynamics within households. There was a notable increase in mental health challenges in terms of anxiety and depression in children and adolescents. This study intended to explore the psychosocial effects of the COVID-19 pandemic on Italian families by adopting self- and proxy-report questionnaires on anxiety, anger, and health-related quality of life. The results showed that approximately 20% obtained a clinical anxiety score and only 10% obtained a clinical anger score. There was a difference in the perception of the quality of life reported by the child and that perceived by the parent. A stepwise regression model showed that total anxiety scores were predicted by sex, quality of life scores from the parents' self-report version, and the total anger score. Another stepwise regression model identified physiological and social anxiety as the best predictors that impact quality of life. Parental well-being actively influences the well-being of children, so it is fundamental to implement preventive programs and promote child well-being by providing parents the most adequate support possible.
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Affiliation(s)
| | - Marta Tremolada
- Department of Development and Social Psychology, University of Padua, Via Venezia 8, 35131 Padova, Italy;
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Abraham S, Edginton E, Cottrell D, Tubeuf S. Measuring health-related quality of life measures in children: lessons from a pilot study. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25. [PMID: 35532026 PMCID: PMC9153752 DOI: 10.4081/ripppo.2022.581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/02/2022] [Indexed: 12/30/2022]
Abstract
There is a debate in the health outcomes literature regarding who the most appropriate respondent is when assessing children’s health-related quality of life (HRQoL). In some cases, parent-proxy may be the only practical option where children are unable to self-complete an HRQoL questionnaire. However, children’s self-reported values may be preferable because HRQoL is subjective and represents the respondent own perception of health. We collected the youth version of the EQ-5D-3L as part of a feasibility study comparing psychoanalytic child psychotherapy with usual care for children aged 5-11 years with treatment resistant conduct disorders. The questionnaires were completed at baseline and 4-month follow-up by the child via face-to-face researcher administration, and by one parent as a proxy respondent. We present percentages of completion at each time-point and investigate the level of agreement between child and proxy-respondent on the child’s health. About two thirds of children (65.5%) were able to complete the EQ-5D-Y at baseline and 34.4% at follow-up. Children and primary carers were mostly concordant regarding overall child’s health. Parents reported more problems in ‘doing usual activities’ and ‘feeling worried, sad or unhappy’ and fewer problems with ‘pain’ and ‘looking after oneself’ than children did. The reports regarding ‘mobility’ were very similar between children and proxy-respondents. The assessment of quality of life by children using selfreport questionnaires is possible with the help of a face-to-face researcher, providing evidence that children should be asked to self-complete HRQoL questionnaires in trial studies.
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Affiliation(s)
- Sarah Abraham
- School of Health and Related Research, University of Sheffield.
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Mpundu-Kaambwa C, Chen G, Dalziel K, Devlin N, Ratcliffe J. International guidelines for self-report and proxy completion of paediatric health-related quality of life measures: a protocol for a systematic review. BMJ Open 2021; 11:e052049. [PMID: 34880018 PMCID: PMC8655531 DOI: 10.1136/bmjopen-2021-052049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Measures of health-related quality of life (HRQoL), accompanied by the values (or utilities) required to estimate quality-adjusted life-years, are crucial for determining health benefits within economic evaluation and health technology assessment. Several generic and condition-specific measures or instruments of HRQoL, accompanied by values, currently exist for application with child populations. However, there is a lack of a structured summary of guidelines and recommendations for applying these measures in practice. This protocol describes a systematic review of guidelines and recommendations for child and proxy completion of child-specific measures of HRQoL. The aims of the review are to (1) identify and summarise published guidelines and recommendations for existing child-specific measures of HRQoL, (2) determine whether the identified guidelines and recommendations differ by instrument and child characteristics, (3) identify current gaps in these guidelines and recommendations and (4) identify best practices for child self and proxy assessment in paediatric HRQoL measurement for economic evaluation and health technology assessment. METHODS AND ANALYSIS The review will identify, collate and synthesise published guidelines and recommendations for existing child-specific utility measures of HRQoL. Electronic databases to be searched include the Cochrane Library, Medline, Scopus, Web of Science, EconLit, PsycINFO, CINAHL, Embase and Informit. The search will be extended to websites of (1) international organisations for health technology assessment, (2) regulation, health economics and HRQoL outcomes research and (3) instrument developers. Three reviewers will independently screen titles and abstracts against the inclusion criteria. A narrative synthesis will describe the key features of the guidelines identified. ETHICS AND DISSEMINATION Ethical approval is not required as the proposed systematic review will not use primary data. A paper of the systematic review will be submitted to a peer-reviewed journal for publication. PROSPERO REGISTRATION NUMBER CRD42020207160.
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Affiliation(s)
- Christine Mpundu-Kaambwa
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Kim Dalziel
- Health Economics Unit, The University of Melbourne School of Population Health, Melbourne, Victoria, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Nancy Devlin
- Health Economics Unit, The University of Melbourne School of Population Health, Melbourne, Victoria, Australia
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Butler G, Turlejski T, Wales G, Bailey L, Wright N. Growth hormone treatment and health-related quality of life in children and adolescents: A national, prospective, one-year controlled study. Clin Endocrinol (Oxf) 2019; 91:304-313. [PMID: 31077606 DOI: 10.1111/cen.14011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) may improve as an additional benefit of the growth hormone treatment (GHT) in children with short stature, but this effect has not been conclusively proven. OBJECTIVES To explore the direct effect of GHT on HRQOL in children starting GHT due to isolated or multiple GH deficiency (IGHD), acquired GH deficiency (AGHD) and Turner syndrome (TS), in comparison with untreated short stature controls in 18 UK centres. METHODS We used recognized measures of HRQOL, the PedsQL, the Strengths and Difficulties Questionnaire and Youth Life Optimism Test scales to investigate the effect of GHT at 0, 6 and 12 months in children and adolescents 6-16 years with IGHD (n = 73) and AGHD (n = 45), and 22 girls with TS. 49 children with non-GHD short stature served as the controls. RESULTS Children rated their HRQOL better than their parents. Those with IGHD and TS rated their overall HRQOL lower than the controls at baseline, psychosocial scores significantly lower in IGHD. After 12 months, the control and TS groups scored higher than UK norms. Those with AGHD had lowest HRQOL scores at all time points, due to poorer physical functioning. The controls showed the greatest improvement in the strength and difficulties scale. All measures evaluated, whether from child, parent or teacher showed an equal improvement over the year of GHT with no discernible direct treatment effect, despite reduced numbers in some patient groups. CONCLUSIONS Children with short stature resulting from GHD have lower functioning than controls but HRQOL appears to improve with GHT, most likely on account of greater attention and as a result of the retest phenomenon. We were not able to demonstrate an absolute and independent effect of GHT in itself. HRQOL should not be used as a primary measure, as in adults, to determine whether children should receive GHT.
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Affiliation(s)
- Gary Butler
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Tymoteusz Turlejski
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
| | | | | | - Neil Wright
- Sheffield Children's Hospital, Sheffield, UK
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Shemesh-Iron M, Lazar L, Lebenthal Y, Nagelberg N, Tenenbaum A, Ezra R, Leffler N, Yackobovitch-Gavan M, Schoenberg-Taz M, Phillip M. Growth hormone therapy and short stature-related distress: A randomized placebo-controlled trial. Clin Endocrinol (Oxf) 2019; 90:690-701. [PMID: 30721549 DOI: 10.1111/cen.13944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/11/2019] [Accepted: 01/31/2019] [Indexed: 01/19/2023]
Abstract
CONTEXT Growth hormone (GH) treatment of short healthy children is based on the belief that short stature is associated with psychosocial problems and a diminished quality of life. OBJECTIVE To determine the impact of GH therapy on psychosocial well-being and the ability of psychological metrics to define short stature-related distress. METHODS Sixty prepubertal boys with idiopathic short stature (age: 10.0 ± 1.4 years, height-SDS: -2.38 ± 0.3) were enrolled in this 4-year intervention study (1-year double-blinded, randomized, placebo-controlled [GH/placebo-2:1] and 3-year open-labelled GH therapy). Explicit (conscious/voluntary) psychological metrics (Pediatric Quality of Life Inventory [PedsQL], Silhouette Apperception Test [SAT], Rosenberg Self-Esteem Scale [RSES], Child Behavior Checklist [CBCL]) and implicit (unconscious/involuntary) psychological metrics (Single-Category Implicit Association Test for height [SC-IAT-H], Height Perception Picture Test [HPPT]). Psychosocial evaluations were performed at study entry, after 1 and 4 years. RESULTS At study entry, PedsQL of boys with idiopathic short stature was lower than Israeli norms (P = 0.001). After 1-year blinded intervention, only the GH-treated boys improved their actual and anticipated adult height perception (SAT, P < 0.001 and P = 0.022) with reduced short stature-related distress (SC-IAT-H, P < 0.001). At study end, RSES and SC-IAT-H improved significantly (P < 0.001), with no change in PedsQL and CBCL. CONCLUSIONS Our finding of improved psychosocial functioning only in the GH-treated boys after 1-year blinded intervention suggests that it was the GH therapy, rather than being enrolled in a clinical trial, which contributed to the outcome. Long-term open-labelled GH treatment significantly improved height perception and self-esteem. Future studies are needed to fully assess the relevance of complementing the routinely used explicit self-report measures with the implicit measures.
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Affiliation(s)
- Moran Shemesh-Iron
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Liora Lazar
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lebenthal
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nessia Nagelberg
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Ariel Tenenbaum
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Revital Ezra
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Nir Leffler
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Michal Yackobovitch-Gavan
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Michal Schoenberg-Taz
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Moshe Phillip
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Culen C, Ertl DA, Schubert K, Bartha-Doering L, Haeusler G. Care of girls and women with Turner syndrome: beyond growth and hormones. Endocr Connect 2017; 6:R39-R51. [PMID: 28336768 PMCID: PMC5434744 DOI: 10.1530/ec-17-0036] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 01/10/2023]
Abstract
Turner syndrome (TS), although considered a rare disease, is the most common sex chromosome abnormality in women, with an incident of 1 in 2500 female births. TS is characterized by distinctive physical features such as short stature, ovarian dysgenesis, an increased risk for heart and renal defects as well as a specific cognitive and psychosocial phenotype. Given the complexity of the condition, patients face manifold difficulties which increase over the lifespan. Furthermore, failures during the transitional phase to adult care result in moderate health outcomes and decreased quality of life. Guidelines on the optimal screening procedures and medical treatment are easy to find. However, recommendations for the treatment of the incriminating psychosocial aspects in TS are scarce. In this work, we first reviewed the literature on the cognitive and psychosocial development of girls with TS compared with normal development, from disclosure to young adulthood, and then introduce a psychosocial approach to counseling and treating patients with TS, including recommendations for age-appropriate psychological diagnostics. With this work, we aim to facilitate the integration of emphasized psychosocial care in state-of-the-art treatment for girls and women with TS.
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Affiliation(s)
- Caroline Culen
- University Clinic of Pediatrics and Adolescent MedicineMedical University of Vienna, Vienna, Austria
| | - Diana-Alexandra Ertl
- University Clinic of Pediatrics and Adolescent MedicineMedical University of Vienna, Vienna, Austria
| | - Katharina Schubert
- University Clinic of Pediatrics and Adolescent MedicineMedical University of Vienna, Vienna, Austria
| | - Lisa Bartha-Doering
- University Clinic of Pediatrics and Adolescent MedicineMedical University of Vienna, Vienna, Austria
| | - Gabriele Haeusler
- University Clinic of Pediatrics and Adolescent MedicineMedical University of Vienna, Vienna, Austria
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