1
|
Giles ML, Ball GDC, Bonder R, Buchholz A, Gorter JW, Morrison KM, Perez A, Walker M, McPherson AC. Exploring the complexities of weight management care for children with spina bifida: a qualitative study with children and parents. Disabil Rehabil 2024; 46:3440-3448. [PMID: 37665663 DOI: 10.1080/09638288.2023.2251878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE 1) To explore how children with spina bifida (SB) and their parents understand bodyweight, health and weight management; and 2) To identify what services and supports children with SB and their families feel are most appropriate to help them manage their health and weight. METHODS The study used interpretive description within a qualitative design. Participants were children with SB (aged 10-18) attending two Canadian SB clinics and their parents. Data were collected through individual interviews and analyzed using inductive thematic analysis. RESULTS Five children and five parents participated in the study. Children and parents had a weight-centric approach to health, which was related to the child's mobility. Weight was considered to be under individual control and mostly through diet. Trusting relationships between healthcare providers, children and families were important to discuss weight in a non-judgemental manner. Children should be involved in setting meaningful and achievable weight management goals. CONCLUSION Greater knowledge of how children with SB and their families understand weight and health offers opportunities for non-judgemental discussions about their needs and wishes. Helping families to place more value on health over weight may reduce feelings of stigma, while allowing children to develop some autonomy over health-related decisions.
Collapse
Affiliation(s)
- Madison L Giles
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Annick Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jan Willem Gorter
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands. Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Arnaldo Perez
- Educational Research & Scholarship Unit, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Amy C McPherson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
2
|
Dawson A, Hayes LC, Papadakis JL, McLeod D. Learning from the past: How lessons from Hinman syndrome can inform the psychological management of lower urinary tract dysfunction. J Pediatr Urol 2024; 20:376-383. [PMID: 38302319 DOI: 10.1016/j.jpurol.2024.01.018] [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: 10/20/2023] [Revised: 12/19/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Pediatric patients with lower urinary tract dysfunction (LUTD) experience a variety of medical and psychosocial concerns that can negatively impact their clinical management and quality of life. When initially described by Drs Hinman and Baumann, patients with a form of severe LUTD, later dubbed Hinman syndrome, were characterized as having a "general attitude of being failures." While this mention was noteworthy as it incorporated an understanding of the interplay between psychological factors and urologic conditions, there have been delays in implementing psychological intervention as a standard of care in patients with LUTD broadly, and perhaps too keen of a focus on youth diagnosed with Hinman syndrome specifically. METHODS A non-systematic reviewed of LUTD related to psychological management was performed. Clinical recommendations were developed by a multicenter and multidisciplinary team of care providers with topic expertise. OBJECTIVE The aim of this paper is to propose a systems thinking paradigm for how to involve psychology, or psychological principles, across the spectrum of patients with LUTD with the hope of improving attention to specific aspects of care that may improve clinical management. DISCUSSION Children across the spectrum of LUTD are likely to benefit from psychological interventions and would benefit from such involvement early on to mitigate the impact of psychosocial concerns on medical outcomes. Pediatric psychologists are well-suited to identify and provide individualized care to patients in greatest need of intervention, such as through pre-procedural preparedness, addressing non-adherence, and with the use of evidence-based, targeted mental health interventions. Psychologists are also apt at implementing interventions while taking into consideration the severity of LUTD, in the context of the patient's psychological, developmental, cultural, familial, and social determinants of health considerations. Youth with severe forms of LUTD, such as Hinman syndrome, likely exemplify the challenges of LUTD that benefit from multidisciplinary intervention. CONCLUSION Medical and psychological collaboration are key to ensuring symptom mitigation and emotional support for patients across the entire spectrum of LUTD.
Collapse
Affiliation(s)
- Anne Dawson
- Department of Pediatric Psychology and Neuropsychology, Kidney and Urinary Tract Center, Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University School of Medicine, USA
| | - Lillian C Hayes
- Boston Children's Hospital, Department of Urology and Department of Psychiatry and Behavioral Sciences, Harvard Medical School, Department of Psychiatry, USA
| | - Jaclyn L Papadakis
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | - Daryl McLeod
- The Kidney and Urinary Tract Center, Nationwide Children's Hospital, Columbus, OH, USA; Department of Urology, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, OH, USA.
| |
Collapse
|
3
|
Kelly MS, Liu T, Routh JC, Castillo H, Tanaka ST, Smith K, Krach LE, Zhang A, Sherburne E, Castillo J, David J, Wiener JS. Comparing binary & ordinal definitions of urinary & stool continence outcomes: Data from the National Spina Bifida Patient Registry. J Pediatr Urol 2024:S1477-5131(24)00070-6. [PMID: 38368164 PMCID: PMC11303588 DOI: 10.1016/j.jpurol.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION The National Spina Bifida Patient Registry (NSBPR) assesses bladder and bowel incontinence using ordinal categories, but prior NSBPR analyses employed binary classification. Our aims were to 1) perform the first NSBPR analysis of bladder and bowel incontinence as ordinal outcomes to compare to the binary definition and subject variables; 2) explore the correlation of incontinence with undergarment usage, and 3) assess incontinence status following continence surgeries. METHODS Data from NSBPR participants' most recent clinic visit from 2013 to 2020 were analyzed. Ordinal categories of incontinence were compared to previously used binary definitions. Incontinence surgical outcomes were analyzed for those with data at least three months post-operatively. Chi-square tests evaluated associations among categorical variables. Univariate and ordinal logistic regression models were used to test associations of ordinal incontinence status with patient and condition factors. Statistical tests were 2-sided; p values < 0.05 were considered significant. RESULTS Analysis of 7217 individuals using ordinal incontinence outcomes showed little difference from previously used binary outcomes. The final multivariable logistic regression models with ordinal multinomial outcomes showed that associations of incontinence with age, sex, race/ethnicity, health insurance, level of lesion, and continence management technique were similar to prior studies. Among those reporting never being incontinent of both bladder and bowel, 14% reported using protective undergarments. Of the 500 individuals who had bladder outlet surgery, 38% reported never being incontinent of urine. Of 1416 individuals who had appendicostomy (ACE) bowel surgery, 48% reported never being incontinent of stool. DISCUSSION Our current analysis showed that ordinal continence outcome classification had similar continence findings as previous studies using the binary definition of continence. Expanding the binary definition of continence to include monthly episodes of incontinence did not greatly increase the proportion of continent individuals and, therefore, would have not likely made meaningful differences in continence outcomes in prior NSBPR analyses. However, it is known that even mild incontinence can affect quality of life, therefore, capturing any level of incontiennce is of clinical importance. Confirmation of the association of continence outcomes with sociodemographic, condition-related, and interventional factors with both approaches further validates previous analyses using the binary definition of continence. CONCLUSION The previously used binary definition of bladder and bowel continence appears robust. Undergarment choice was a poor surrogate for reported incontinence. After bladder and bowel continence surgeries, 38% and 48%, respectively, reported never being incontinent.
Collapse
Affiliation(s)
- Maryellen S Kelly
- Division of Healthcare of Women and Children, Duke University School of Nursing, Durham NC, USA; Division of Pediatric Urology, Department of Urology, Duke University School of Medicine, Durham NC, USA.
| | - Tiebin Liu
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jonathan C Routh
- Division of Pediatric Urology, Department of Urology, Duke University School of Medicine, Durham NC, USA.
| | - Heidi Castillo
- Division of Developmental and Behavioral Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
| | - Stacy T Tanaka
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Kathryn Smith
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Linda E Krach
- Physical Medicine and Rehabilitation, Gillette Children's Specialty Healthcare, St. Paul, MN, USA.
| | - Amy Zhang
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
| | - Eileen Sherburne
- Children's Hospital and Health System, Inc., Milwaukee, WI, USA.
| | - Jonathan Castillo
- Division of Developmental and Behavioral Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
| | - Joseph David
- Section of Pediatric Urology, University of Alabama Medical Center, Birmingham, AL, USA.
| | - John S Wiener
- Division of Pediatric Urology, Department of Urology, Duke University School of Medicine, Durham NC, USA.
| |
Collapse
|
4
|
Tucker S, Heneghan NR, Gardner A, Rushton A, Alamrani S, Soundy A. Factors Influencing Participation in Physical Activity, Sports, and Exercise in Children and Adolescents with Spinal Pain or Spinal Conditions: A Systematic Review and Meta-Ethnography. Behav Sci (Basel) 2023; 13:486. [PMID: 37366738 DOI: 10.3390/bs13060486] [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: 03/23/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Physical activity is an effective treatment for paediatric spinal pain. However, participation rates remain low and review evidence is needed to establish why. This review identifies factors influencing participation in sports, exercise, and physical activity in those aged 18 or under with spinal pain or spinal conditions. Trends or differences between discrete sub-populations are identified. METHODS A meta-ethnographic review was undertaken. Qualitative papers were identified and appraised using the JBI checklist. Thematic trends were mapped onto the biopsychosocial model and subthemes identified. Uniqueness was calculated and the confidence in the evidence was evaluated using the GRADE-CERQual tool. RESULTS Data were gathered from nine qualitative papers (384 participants). Three themes were identified: (1) biological: physical challenges and bladder and bowel care; (2) psychological: perceptions of differences to peers, struggle, anger, sadness, adjustment, and acceptance; and (3) sociological: influence of friends, social acceptance, negative attitudes from others, and the influence of their disability on family routine. CONCLUSIONS Sociological factors were most influential on exercise participation alongside related psychological and biological factors. Adolescents over 14 years offered greater critical insight compared to the younger children. Results are best applied to neuromuscular conditions with further robust evidence required in paediatric musculoskeletal spinal pain.
Collapse
Affiliation(s)
- Susanna Tucker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Adrian Gardner
- Spinal Surgery, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham B31 2AP, UK
| | - Alison Rushton
- School of Physical Therapy, Western University Canada, London, ON N6A 3K7, Canada
| | - Samia Alamrani
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
- Physical Therapy Department, University of Tabuk, Tabuk 47512, Saudi Arabia
| | - Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| |
Collapse
|
5
|
Baram M, Zuk L, Stattler T, Katz-Leurer M. The Prevalence of Bladder and Bowel Dysfunction in Children with Cerebral Palsy and its Association with Motor, Cognitive, and Autonomic Function. Dev Neurorehabil 2023; 26:155-162. [PMID: 36943141 DOI: 10.1080/17518423.2023.2193268] [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] [Indexed: 03/23/2023]
Abstract
PURPOSE To describe the prevalence of bladder and bowel dysfunction (BBD) in 8-10-year-old children with cerebral palsy and its association with motor, cognitive, and autonomic dysfunction. METHODS A cross-sectional, random sample study of parents of 8-10-year-old children with cerebral palsy. Tools: The Enuresis/Urinary Incontinence Parental Questionnaire, the Functional Independence Measure children's version, the autonomic signs questionnaire, and the Gross Motor Function Classification System. RESULTS 39 out of 59 parents consented to participate, whereas 25.64% reported complete continence. Of the 29 children with BBD, 21 (72.4%) had lower urinary tract symptoms and bowel problems. Only two of the children received conservative and noninvasive treatments. Lastly, motor, cognitive and autonomic impairments were associated with incontinence. CONCLUSIONS BBD is common in 8-10-year-old children with cerebral palsy at all levels of functioning. Most having both lower urinary tract symptoms and bowel problems.
Collapse
Affiliation(s)
- Moriah Baram
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Luba Zuk
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Tohar Stattler
- ALYN Hospital Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel
| | | |
Collapse
|
6
|
Choi EK, Park J, Kim K, Bae E, Ji Y, Yang SH, Chinbayar A, Yun H. Factors affecting the transition to adulthood of Korean young adults with spina bifida: a qualitative study. BMC Nurs 2023; 22:46. [PMID: 36803401 PMCID: PMC9940440 DOI: 10.1186/s12912-023-01194-z] [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: 06/13/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Transition to adulthood to live independently while self-managing health and daily life without parental help is crucial for young adults with chronic conditions. Despite its importance as a precursor to effectively managing lifelong conditions, little is known about the experiences of young adults with spina bifida (SB) in transition to adulthood in Asian countries. This study aimed to explore the experiences of Korean young adults with SB to identify the facilitators or barriers to the transition from adolescence to adulthood from their perspectives. METHODS This study used a qualitative descriptive design. The data were collected in South Korea through three focus group interviews with 16 young adults with SB, aged 19-26, from August to November 2020. We conducted a qualitative content analysis using a conventional approach to identify the factors that facilitated and hindered the participants' transition to adulthood. RESULTS Two themes emerged as facilitators and barriers to the transition to adulthood. a) Facilitators: understanding and acceptance of SB, acquiring self-management skills, parenting styles encouraging autonomy, parents' emotional support, school teachers' thoughtful consideration, and participation in self-help groups. b) Barriers: overprotective parenting style, experience of being bullied by peers, damaged self-concept, concealing one's chronic condition from others, and the lack of privacy in school restrooms. CONCLUSIONS Korean young adults with SB shared their experiences of struggling to properly manage their chronic conditions on their own, particularly concerning regular bladder emptying, during the transition from adolescence to adulthood. To facilitate the transition to adulthood, education on the SB and self-management for adolescents with SB and on parenting styles for their parents are important. To eliminate barriers to the transition to adulthood, improving negative perceptions of disability among students and teachers and making school restrooms CIC-friendly are needed.
Collapse
Affiliation(s)
- Eun Kyoung Choi
- grid.15444.300000 0004 0470 5454College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Jisu Park
- grid.15444.300000 0004 0470 5454Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Kyua Kim
- grid.15444.300000 0004 0470 5454Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Eunjeong Bae
- grid.15444.300000 0004 0470 5454College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, 03722 Seoul, Republic of Korea
| | - Yoonhye Ji
- grid.15444.300000 0004 0470 5454Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Seung Hyeon Yang
- grid.15444.300000 0004 0470 5454College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, 03722 Seoul, Republic of Korea
| | - Altantuya Chinbayar
- grid.15444.300000 0004 0470 5454Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Hyeseon Yun
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.
| |
Collapse
|
7
|
Pediatric neurogenic bowel dysfunction: ICCS review document. J Pediatr Urol 2023:S1477-5131(23)00024-4. [PMID: 36828731 DOI: 10.1016/j.jpurol.2023.01.015] [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: 09/20/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The International Children's Continence Society (ICCS) aims to improve the quality of life in children with lower urinary tract dysfunction. A substantial portion of children also have problems with bowel dysfunction. There is a lack of evidence-based information on managing neurogenic bowel dysfunction (NBD) in children. OBJECTIVE/METHODS The ICCS aimed to provide an up-to-date, selective, non-systematic review of NBD's definitions, assessment, and treatment. RESULTS Specific definitions and terminology are defined within the document. Recommendations and considerations for physical assessment, history taking, and diagnostic studies are made. Management updates, both surgical and non-surgical, are provided as well as recommendations for follow-up and monitoring of individuals with NBD. CONCLUSION This review of the current literature will help guide NBD management and research to improve NBD care.
Collapse
|
8
|
Ji Y, Kim SW, Han SW, Lee YS. Analysis of factors affecting permanent clean intermittent catheterization and bladder function after primary neurosurgical repair of lipomyelomeningocele. Neurourol Urodyn 2023; 42:177-187. [PMID: 36259772 DOI: 10.1002/nau.25064] [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: 07/14/2022] [Revised: 09/21/2022] [Accepted: 10/06/2022] [Indexed: 01/03/2023]
Abstract
AIMS This study was conducted to identify potential risk factors for permanent clean intermittent catheterization (CIC) and incontinence in patients with lipomyelomeningocele (LMMC) and evaluate how LMMC affects bladder function prognosis, measured by urodynamic (UD) score. METHODS This retrospective study analyzed the electronic health records of patients who underwent primary neurosurgical repair for LMMC at a single tertiary referral center between January 2012 and December 2016 and were followed at least 3 years after surgery. Data regarding bladder function were obtained from medical records for multiple time points, including before surgery, after surgery but before hospital discharge, 3 months after surgery, and at outpatient visits during follow-up. RESULTS This study enrolled 120 patients. At a mean follow-up of 62.6 ± 13.9 months after primary neurosurgical LMMC repair, 22 (18.3%) patients continued to require CIC for bladder emptying, only 7 (31.8%) of whom maintained bladder continence. A multivariate logistic regression model identified age at the time of surgery and the type of LMMC as significant presurgical prognostic risk factors for permanent CIC. In addition, postoperative urinary retention and a UD score greater than or equal to 5 measured 3 months after surgery were identified as significant postsurgical risk factors for permanent CIC and urinary incontinence. A linear mixed model adjusted for age at the time of surgery showed that patients with a transitional or chaotic LMMC type were more likely to experience gradual bladder function decline than patients with other LMMC types. CONCLUSIONS This study identified both presurgical (age at the time of surgery, LMMC type) and postsurgical (postoperative urinary retention, UD score greater than or equal to 5 at 3 months postsurgery) risk factors for permanent CIC and urinary incontinence. In addition, LMMC type was identified as a prognostic risk factor for bladder function decline. These results will enhance the current understanding of bladder function outcomes in patients who undergo surgical treatment for LMMC.
Collapse
Affiliation(s)
- Yoonhye Ji
- Pediatric Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Healthcare System, Seoul, Republic of Korea
| | - Sang Woon Kim
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Won Han
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong Seung Lee
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
9
|
Sun XC, Wang H, Li JH, Yin LQ, Yan YF, Ma X, Xia HF. Active bone material containing modified recombinant human bone morphogenetic protein-2 induces bone regeneration in rabbit spina bifida. Exp Biol Med (Maywood) 2022; 247:1701-1711. [PMID: 36151747 PMCID: PMC9638956 DOI: 10.1177/15353702221120112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This study focuses on spina bifida, which is a high incidence among the current clinical manifestations of human birth defects. Because in the treatment of bone defects, the source of autologous bone is limited and it is easy to cause secondary injury to the patient. At the same time, since the bone tissue in animals needs to perform a variety of biological functions, its complex structure cannot be replaced by a single material. Therefore, in this study, we used Japanese white rabbits to establish an animal model similar to human congenital spina bifida. The established animal model is used to screen the best regenerative repair products for the treatment of congenital spondylolisthesis defects, and to evaluate the safety of regenerative repair products. The results show that bone morphogenetic protein (BMP)-2 combined with collagen material has a better regeneration effect than collagen material alone, and it did not negatively affect the health of animals. This study is not only suitable for the screening of large-scale biomaterials, accelerating the research progress of regenerative repair products, but also conducive to the research on the mechanism of regeneration and repair of various materials.
Collapse
Affiliation(s)
- Xue-Cheng Sun
- Reproductive and Genetic Center, NHC Key Laboratory of Reproductive Health Engineering Technology Research (NRIFP), National Research Institute for Family Planning, Beijing 100081, China,Medical Genetics, Zibo Maternal and Child Health Hospital, Zibo 255000, China
| | - Hu Wang
- Reproductive and Genetic Center, NHC Key Laboratory of Reproductive Health Engineering Technology Research (NRIFP), National Research Institute for Family Planning, Beijing 100081, China,Graduate Schools, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jian-Hui Li
- Reproductive and Genetic Center, NHC Key Laboratory of Reproductive Health Engineering Technology Research (NRIFP), National Research Institute for Family Planning, Beijing 100081, China
| | - Li-Qiang Yin
- Yantai Zhenghai Bio-Tech Co., Ltd., Yantai 264006, China
| | - Yu-Fang Yan
- Yantai Zhenghai Bio-Tech Co., Ltd., Yantai 264006, China
| | - Xu Ma
- Reproductive and Genetic Center, NHC Key Laboratory of Reproductive Health Engineering Technology Research (NRIFP), National Research Institute for Family Planning, Beijing 100081, China,Graduate Schools, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Hong-Fei Xia
- Reproductive and Genetic Center, NHC Key Laboratory of Reproductive Health Engineering Technology Research (NRIFP), National Research Institute for Family Planning, Beijing 100081, China,Graduate Schools, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China,Hong-Fei Xia.
| |
Collapse
|
10
|
Managing incontinence in low-and middle income-countries: A qualitative case study from Pakistan. PLoS One 2022; 17:e0271617. [PMID: 35839232 PMCID: PMC9286225 DOI: 10.1371/journal.pone.0271617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Incontinence is a complex health and social issue, which involves the involuntary loss of urine or faeces or both. Individuals with disabilities are particularly vulnerable to incontinence. The management of incontinence has largely been overlooked in low and middle-income settings (LMICs). This study aimed to explore the incontinence management strategies employed by disabled people with severe incontinence and their caregivers in Sindh Province, Pakistan. Methods Incontinence management was explored through in-depth interviews with people with incontinence (PWI) and their caregivers, photovoice, and a market survey and product attribute assessment. Data was analysed thematically through inductive coding and evaluated against existing disability and caregiver frameworks. Results Incontinence management affected all aspects of daily life for PWI and caregivers. Effective management of incontinence was prioritised because caregivers viewed it to be part of their familial duty and a requirement for the household to remain pure in the eyes of God. Coping strategies included strict adherence to routines, reducing food and drink intake, creative uses of locally available natural resources, and a heavy reliance on soap and water for maintaining hygiene. Products such as adult diapers were largely unavailable, costly and were not deemed suitable for regular use. There were no social or medical interventions in the region to support incontinence management. The main impacts of incontinence on the household were social isolation, stigma, role shifts within the family, the development of physical ailments among caregivers, and decreased income. Conclusion The complex health, psychological, social, economic, and cultural impacts of incontinence are exacerbated in LMICs due a lack of recognition of the condition, the absence of social or medical interventions and limited access to basic WASH infrastructure, and assistive devices or products. Appropriate solutions need to be developed in partnership with PWI and caregivers and need to be contextualised, affordable and sustainable.
Collapse
|
11
|
Experiences and impact of living with incontinence associated stigma: A protocol for a systematic review and narrative synthesis of qualitative studies. PLoS One 2022; 17:e0270885. [PMID: 35802573 PMCID: PMC9269749 DOI: 10.1371/journal.pone.0270885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/14/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Incontinence is global health and social issue, with urinary incontinence alone affecting over 400 million people. Incontinence can lead to physical harms such as skin damage, but it also commonly causes social and psychological harms, including those associated with stigma. For many people, treatment to cure incontinence does not work or is not suitable and they live with the long-term consequences of incontinence. At the moment, no stigma reduction interventions (increasingly used with other conditions such as mental health problems and HIV) have been developed for people living with incontinence. As a starting point for developing such an intervention, this review will address the questions 1) What are the incontinence (urinary or faecal) associated experiences of stigma of people living with incontinence? 2) What is the impact of incontinence associated stigma on their lives? Methods The reviewers will search Embase, Medline, PsychINFO and the Cumulative Index to Nursing and Allied Health Literature using controlled vocabulary and relevant search terms. Articles assessed to meet inclusion criteria will be included. Once duplicates have been removed, titles and abstracts will be screened and full texts of selected research articles will be reviewed. An adapted Joanna Briggs Institute Data Extraction Form will be used to collect the data and quality will be assessed using the Joanna Briggs Institute checklist for qualitative research appraisal tool. A framework approach (using the Revised Framework for Understanding Non-communicable Disease Related Stigma) will be used to organise, integrate, interpret and summarise findings from included articles. The review will be reported in accordance with the Enhancing Transparency in reporting the synthesis of qualitative research statement. Prospero registration number CRD42021259065. Discussion The systematic review described in this protocol will provide the first in-depth, comprehensive understanding of people’s experiences of the stigma associated with incontinence and the impact that it has on their lives. It will identify broader influences of contextual variables such as age, sex, cause and type of incontinence, socio-economic culture and geographical location. The review aims to provide insights to support the development of incontinence associated stigma reduction interventions.
Collapse
|
12
|
Peck B, Terry D, Martin B, Matthews B, Green A. Group‐urotherapy for children with complex elimination disorder: An Australian study. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Blake Peck
- Institute of Health and Wellbeing Federation University Ballarat Australia
| | - Daniel Terry
- Institute of Health and Wellbeing Federation University Ballarat Australia
| | - Benita Martin
- Ballarat Health Services Queen Elizabeth Centre, Grampians Regional Continence Service Ballarat Australia
| | - Belinda Matthews
- Ballarat Health Services Queen Elizabeth Centre, Grampians Regional Continence Service Ballarat Australia
| | - Andrea Green
- Ballarat Health Services Queen Elizabeth Centre, Grampians Regional Continence Service Ballarat Australia
| |
Collapse
|
13
|
Sebesta EM, Connors EL, Rourke E, Reynolds WS, McKernan LC. Psychosocial Factors in Neurogenic Lower Urinary Tract Dysfunction: Implications for Multidisciplinary Care. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-021-00641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
14
|
Queally JT, Barnes MA, Castillo H, Castillo J, Fletcher JM. Neuropsychological care guidelines for people with spina bifida. J Pediatr Rehabil Med 2021; 13:663-673. [PMID: 33285647 PMCID: PMC7838972 DOI: 10.3233/prm-200761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
While the neuropsychological profile for individuals with Spina Bifida (SB) can vary, often certain patterns of strengths and weaknesses are evident across the lifespan. Understanding variability related to neural structure, genetics, ethnicity, and the environment is key to understanding individual differences in outcomes and can be vital in planning interventions and tracking progress. This article outlines the SB Guideline for the Neuropsychological Care of People with Spina Bifida from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida and acknowledges that further research in SB neurocognitive profiles is warranted.
Collapse
Affiliation(s)
- Jennifer T. Queally
- Department of Psychiatry, Children’s Hospital Boston, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Marcia A. Barnes
- Department of Special Education, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Heidi Castillo
- The Meyer Center for Developmental Pediatrics, Texas Children’s Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Jonathan Castillo
- The Meyer Center for Developmental Pediatrics, Texas Children’s Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Jack M. Fletcher
- Department of Psychology, University of Houston, Houston, TX, USA
| |
Collapse
|
15
|
Lim SW, Yi M. Illness Experiences of Adults with Spina Bifida: Protecting the Whole Self. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:67-75. [PMID: 33359223 DOI: 10.1016/j.anr.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To understand and describe the illness experiences of adults with spina bifida (SB) which is an incurable birth defect and chronic condition that must be managed throughout life. METHODS A qualitative study using grounded theory was adopted. Data were collected through individual interviews with 16 adults with SB between 2016 and 2017 in South Korea. All interviews were audiotaped, and the transcribed data were analyzed using constant comparative analysis. RESULTS The basic socio-psychological process that underlies the illness experiences of adults with SB was identified as protecting the whole self. This consists of three stages: strict self-concealment, attempting self-disclosure, and balancing between self-concealment and self-disclosure. These stages reveal a process of establishing a firm sense of self by freeing oneself from the shame and stigma of society. Three different patterns of living emerged as a result: living as a non-disabled person, living as a marginal person between non-disabled and disabled, and living as a disabled person. CONCLUSION Adults with SB struggle to protect their whole self while managing their chronic conditions by having to constantly balance between self-concealment and self-disclosure. Intervention for adults with SB needs to be based on the stage of sociopsychological maturation. In the early stage, intervention needs to be focused on self-concealment to help establish a firm sense of self. On the other hand, in the later stage when psychological maturity occurs, an intervention that focuses on self-disclosure would be helpful so as not to be isolated from society.
Collapse
Affiliation(s)
- Seoung-Wha Lim
- Department of Nursing, Dongshin University, Naju, Republic of Korea.
| | - Myungsun Yi
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
16
|
Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Guideline No. 410: Prevention, Screening, Diagnosis, and Pregnancy Management for Fetal Neural Tube Defects. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:124-139.e8. [PMID: 33212246 DOI: 10.1016/j.jogc.2020.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This revised guideline is intended to provide an update on the genetic aspects, prevention, screening, diagnosis, and management of fetal neural tube defects. TARGET POPULATION Women who are pregnant or may become pregnant. Neural tube defect screening should be offered to all pregnant women. OPTIONS For prevention: a folate-rich diet, and folic acid and vitamin B12 supplementation, with dosage depending on risk level. For screening: second-trimester anatomical sonography; first-trimester sonographic screening; maternal serum alpha fetoprotein; prenatal magnetic resonance imaging. For genetic testing: diagnostic amniocentesis with chromosomal microarray and amniotic fluid alpha fetoprotein and acetylcholinesterase; fetal exome sequencing. For pregnancy management: prenatal surgical repair; postnatal surgical repair; pregnancy termination with autopsy. For subsequent pregnancies: prevention and screening options and counselling. OUTCOMES The research on and implementation of fetal surgery for prenatally diagnosed myelomeningocele has added a significant treatment option to the previous options (postnatal repair or pregnancy termination), but this new option carries an increased risk of maternal morbidity. Significant improvements in health and quality of life, both for the mother and the infant, have been shown to result from the prevention, screening, diagnosis, and treatment of fetal neural tube defects. BENEFITS, HARMS, AND COSTS The benefits for patient autonomy and decision-making are provided in the guideline. Harms include an unexpected fetal diagnosis and the subsequent management decisions. Harm can also result if the patient declines routine sonographic scans or if counselling and access to care for neural tube defects are delayed. Cost analysis (personal, family, health care) is not within the scope of this clinical practice guideline. EVIDENCE A directed and focused literature review was conducted using the search terms spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis, and neural tube defect management in order to update and revise this guideline. A peer review process was used for content validation and clarity, with appropriate ethical considerations. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE Maternity care professionals who provide any part of pre-conception, antenatal, delivery, and neonatal care. This guideline is also appropriate for patient education. RECOMMENDATIONS (GRADE RATINGS IN PARENTHESES).
Collapse
|
17
|
Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Directive clinique n o 410 : Anomalies du tube neural : Prévention, dépistage, diagnostic et prise en charge de la grossesse. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:140-157.e8. [PMID: 33212245 DOI: 10.1016/j.jogc.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIF La présente directive clinique révisée vise à fournir une mise à jour sur les aspects génétiques, la prévention, le dépistage, le diagnostic et la prise en charge des anomalies du tube neural. POPULATION CIBLE Les femmes enceintes ou qui pourraient le devenir. Il convient d'offrir le dépistage des anomalies du tube neural à toutes les femmes enceintes. OPTIONS Pour la prévention : un régime alimentaire riche en acide folique et des suppléments d'acide folique et de vitamine B12 selon une posologie d'après le niveau de risque. Pour le dépistage : l'échographie obstétricale du deuxième trimestre, le dépistage échographique du premier trimestre, le dosage de l'alphafœtoprotéine sérique maternelle et l'imagerie par résonance magnétique prénatale. Pour les tests génétiques : l'amniocentèse diagnostique avec analyse chromosomique sur micropuce et le dosage de l'alphafœtoprotéine et de l'acétylcholinestérase dans le liquide amniotique et le séquençage de l'exome fœtal. Pour la prise en charge de la grossesse : la réparation chirurgicale prénatale, la réparation chirurgicale postnatale et l'interruption de grossesse avec autopsie. Pour les grossesses subséquentes : les options de prévention et de dépistage et les conseils. RéSULTATS: La recherche et la mise en œuvre du traitement chirurgical fœtal en cas de diagnostic prénatal de myéloméningocèle ont ajouté une option thérapeutique fœtale importante aux options précédentes (réparation postnatale ou interruption de grossesse), mais cette nouvelle option comporte un risque accru de morbidité maternelle. La prévention, le dépistage, le diagnostic et le traitement des anomalies du tube neural se révèlent entraîner des améliorations importantes à la mère et au nourrisson en matière de santé et de qualité de vie. BéNéFICES, RISQUES ET COûTS: Le type et l'ampleur des bénéfices, risques et coûts attendus pour les patientes grâce à la mise en œuvre de la présente directive clinique par un établissement de soins de santé intègrent un canal maternel préconception et prénatal adéquat comprenant l'accès des patientes aux soins, les conseils, les analyses et examens, l'imagerie, le diagnostic et l'interprétation. Les bénéfices relatifs à l'autonomie de la patiente et au processus décisionnel sont énoncés dans la présente directive clinique. Les risques comprennent un diagnostic fœtal inattendu et les décisions de prise en charge subséquentes. Le fait que la patiente refuse les échographies habituelles et le retard du conseil ou d'accès aux soins en cas d'anomalie du tube neural comportent également des risques. L'analyse des coûts (personnels, familiaux, santé publique) ne fait pas partie de la portée de la présente directive clinique. DONNéES PROBANTES: Afin de mettre à jour et réviser la présente directive, une revue de la littérature ciblée et dirigée a été effectuée à l'aide des termes de recherche suivants : spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis et neural tube defect management. Un processus d'examen par les pairs a été utilisé pour la validation et la clarté du contenu, avec des considérations appropriées d'ordre éthique. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant l'approche d'évaluation, de développement et d'évaluation (GRADE). Consulter l'annexe A en ligne (le tableau A1 pour les définitions et le tableau A2 pour les interprétations des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Professionnels des soins de maternité qui offrent des soins préconception, prénataux, obstétricaux ou néonataux. La présente directive clinique convient également aux fins d'éducation des patientes. RECOMMANDATIONS (CLASSEMENT GRADE ENTRE PARENTHèSES).
Collapse
|
18
|
Malhotra NR, Kuhlthau KA, Rosoklija I, Migliozzi M, Nelson CP, Schaeffer AJ. Children's experience with daytime and nighttime urinary incontinence - A qualitative exploration. J Pediatr Urol 2020; 16:535.e1-535.e8. [PMID: 33148456 PMCID: PMC9764822 DOI: 10.1016/j.jpurol.2020.10.002] [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: 04/03/2020] [Revised: 09/01/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Much of our knowledge about the impact of urinary incontinence (UI) on children is derived from surveys. While these studies provide an overview of the UI experience, personal interviews may offer additional nuances and a more detailed perspective of what the experience of UI is for children. Objective To conduct interviews and use qualitative analysis to explore the experiences of children with UI, with a particular focus on (1) the impact of UI on participants' lives, (2) which coping strategies children with UI use, and (3) the emotional effects of UI. STUDY DESIGN Semi-structured interviews of children with non-neurogenic and non-anatomic UI recruited from a pediatric urology clinic were audio recorded and verbatim transcribed. Eligibility included: age 8-17 years, history of UI, English fluency, and being able to participate in a 30 min interview. Conventional content analysis was performed to identify themes directly from the transcripts. Coders independently and iteratively coded transcripts (intercoder reliability >0.85) until inductive thematic saturation was achieved. RESULTS There were substantial practical and emotional impacts on the 30 (14 males, 16 females) children (median age 11.5 years) with UI. Participants relayed significant interference with social activities like sports and sleepovers, which often lead to avoidant behavior of these activities. By contrast, most stated that UI did not impair school performance. The most strongly and consistently expressed emotions were embarrassment and anxiety. Nevertheless, children described a wide variety of adaptations, including behavioral and cognitive, to manage their incontinence and its effects on their lives (Summary Table). DISCUSSION This is the first qualitative study that describes the experiences and perspectives of children with UI. Surveys of this population suggest a lower health-related quality of life, particularly in emotional well-being, self-esteem and relationships. This work augments this body of literature and shows how UI interferes with their daily life and is a major source of embarrassment and anxiety. Despite this, children with UI display strong resilience and adapt to their condition. The study was limited in that the sample was biased to those presenting to a urology clinic and was not designed to compare differences in UI experience between ages, genders, or treatment types. CONCLUSION This study, the first qualitative exploration of the emotional responses and coping behaviors of children with UI, shows significant social impact and negative emotional responses but marked resiliency. These findings should be considered when developing a comprehensive treatment strategy for children with UI.
Collapse
Affiliation(s)
- Neha R Malhotra
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
| | - Karen A Kuhlthau
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Ilina Rosoklija
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Caleb P Nelson
- Department of Urology, Boston Children's Hospital, Boston, MA, USA
| | - Anthony J Schaeffer
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
19
|
Martins G, Siedlikowski M, Coelho AKS, Rauch F, Tsimicalis A. Bladder and bowel symptoms experienced by children with osteogenesis imperfecta. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
20
|
Driscoll CFB, Ohanian DM, Ridosh MM, Stern A, Wartman EC, Starnes M, Holmbeck GN. Pathways by which Maternal Factors are Associated With Youth Spina Bifida-Related Responsibility. J Pediatr Psychol 2020; 45:610-621. [PMID: 32337548 DOI: 10.1093/jpepsy/jsaa020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Achieving condition-related autonomy is an important developmental milestone for youth with spina bifida (SB). However, the transfer of condition-related responsibility to these youth can be delayed due to parent factors. This study aimed to investigate two potential pathways by which maternal factors may be associated with condition-related responsibility among youth with SB: (a) Maternal adjustment → perception of child vulnerability (PPCV) → youth condition-related responsibility; and (b) Maternal PPCV → overprotection → youth condition-related responsibility. METHODS Participating youth with SB (N = 140; Mage=11.4 years, range = 8-15 years) were recruited as part of a longitudinal study; data from three time points (each spaced 2 years apart) from the larger study were used. Mothers reported on personal adjustment factors, PPCV, and overprotection. An observational measure of overprotection was also included. Mothers, fathers, and youth with SB reported on youths' degree of responsibility for condition-related tasks. Analyses included age, lesion level, IQ, and the dependent variables at the prior wave as covariates. RESULTS Bootstrapped mediation analyses revealed that PPCV significantly mediated the relationship between maternal distress and youth responsibility for medical tasks such that higher levels of distress at Time 1 predicted higher levels of PPCV at Time 2 and lower youth medical responsibility at Time 3. Furthermore, self-reported maternal overprotection significantly mediated the relationship between maternal PPCV and youth responsibility for medical tasks. CONCLUSIONS Maternal personal distress, PPCV, and self-reported overprotection are interrelated and affect youth's condition-related responsibility. Interventions for mothers of youth with SB that target these factors may improve both maternal and youth outcomes.
Collapse
Affiliation(s)
| | | | | | - Alexa Stern
- Psychology Department, Loyola University Chicago
| | | | | | | |
Collapse
|
21
|
Bladder and bowel symptoms experienced by children with osteogenesis imperfecta. J Pediatr (Rio J) 2020; 96:472-478. [PMID: 30802423 PMCID: PMC9432044 DOI: 10.1016/j.jped.2018.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To estimate the prevalence and presentation of bladder, bowel, and combined bladder and bowel symptoms experienced by children with osteogenesis imperfecta and to describe the socio-demographic and clinical profile of these children. METHOD A descriptive study was conducted with a convenience sample of parent-child pairs of toilet-trained children aged from 3 to 18 years. Pairs were interviewed using three tools: (1) Socio-Demographic and Clinical Questionnaire; (2) Dysfunctional Voiding Scoring System; (3) Rome III Criteria along with the Bristol Stool Scale. Data were stratified by socio-demographic and clinical variables and analyzed using descriptive statistics. RESULTS Thirty-one parent-child pairs participated in the study; 38.7% (n=12) children reported bowel symptoms, 19.4% (n=6) reported a combination of bladder issues (such as holding maneuvers and urgency) and bowel symptoms (such as hard or painful bowel movements and large diameter stools). There were no reports of isolated bladder issues. Among the child participants, 16 (51.7%) identified as female and 20 (64.5%) were 5-14 years old. The most prevalent type of osteogenesis imperfecta was type III (n=12; 38.7%) and eight (25.8%) children reported using a wheelchair. CONCLUSION This is the first study to examine the prevalence and presentation of bladder, bowel, and combined bladder and bowel symptoms in children with osteogenesis imperfecta, offering a preliminary socio-demographic and clinical profile of these children. This research is an important step toward effective screening, detection, and access to care and treatment, especially for clinicians working with this group of very fragile patients.
Collapse
|
22
|
Lindsay S, Cagliostro E, Leck J, Stinson J. Career aspirations and workplace expectations among youth with physical disabilities. Disabil Rehabil 2019; 43:1657-1668. [PMID: 31589070 DOI: 10.1080/09638288.2019.1671505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE Youths with disabilities have lower employment rates than youths without disabilities, which are often a result of inaccessible environments, employer's lack of knowledge about people with disabilities and discriminatory attitudes. Exploring youths' career aspirations is important because it can prompt or hinder career planning, and contribute to youths' preparation for adult life. The purpose of our study was to explore the career aspirations and workplace expectations of youths with physical disabilities. METHOD We drew on qualitative discussion forum data from a larger study focusing on employment preparation e-mentoring intervention for youths with physical disabilities. Our sample comprised 44 youths aged 15-25 years (mean age 18.9, 47% female) with physical disabilities. We analyzed the data using a qualitative, content analysis approach. RESULTS Youths described several areas that helped to develop their occupational capacity including self-advocacy, pursuing post-secondary education, volunteering/co-op, family support, and social networks. Areas where youths anticipated encountering occupational constraints involved: transportation, attitudes and discrimination, physicality of work and self-care, communication skills, and finding work or volunteer positions. Youths' expectations for the workplace included: disability disclosure and requesting accommodations, and a respectful environment. CONCLUSIONS Our findings highlighted that youths with physical disabilities had diverse career aspirations that are shaped by various occupational capacities and constraints.Implications for rehabilitationYouth with physical disabilities may need further support with accessing and navigating public transportation independently to gain employment, and also developing their communication skills, specifically how to disclose their condition to employers and coping with potential discrimination.Clinicians and educators should help youth with disabilities to gain exposure to a variety of career options (including STEM) while supporting them to find accessible positions that are compatible with their abilities.Clinicians and educators could consider helping to foster self-advocacy skills among youth with disabilities which are needed to disclose their condition and request accommodations.
Collapse
Affiliation(s)
- Sally Lindsay
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Elaine Cagliostro
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Joanne Leck
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Jennifer Stinson
- Hospital for Sick Children, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| |
Collapse
|
23
|
Patel SK, Staarmann B, Heilman A, Mains A, Woodward J, Bierbrauer KS. Growing up with spina bifida: bridging the gaps in the transition of care from childhood to adulthood. Neurosurg Focus 2019; 47:E16. [DOI: 10.3171/2019.7.focus19441] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 07/26/2019] [Indexed: 11/06/2022]
Abstract
Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with spina bifida are now adults, there are few publications in the neurosurgical literature regarding the care of adults with spina bifida, associated medical conditions, surgical interventions, and long-term complications. The major goals for transitioning adult patients with spina bifida are preservation of function and promotion of independence as well as general overall health. Nevertheless, many gaps exist in our knowledge and understanding of the complex needs of this aging patient population. The goal of this paper was to provide a comprehensive updated review of the literature regarding the challenges and considerations involved in the transitional care to adulthood for patients with spina bifida. Unique to this review, the authors provide a first-hand personal communication and interview with an adult patient with spina bifida that discusses many of these challenges with transition.
Collapse
Affiliation(s)
- Smruti K. Patel
- 1Department of Neurological Surgery, University of Cincinnati College of Medicine; and
| | - Brittany Staarmann
- 1Department of Neurological Surgery, University of Cincinnati College of Medicine; and
| | - Alexander Heilman
- 1Department of Neurological Surgery, University of Cincinnati College of Medicine; and
| | - Allie Mains
- 1Department of Neurological Surgery, University of Cincinnati College of Medicine; and
| | - Jason Woodward
- 3Center for Spina Bifida Care, Division of Developmental and Behavioral Pediatrics, and
- 4Transition Medicine, Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Karin S. Bierbrauer
- 1Department of Neurological Surgery, University of Cincinnati College of Medicine; and
- 2Division of Pediatric Neurological Surgery,
- 3Center for Spina Bifida Care, Division of Developmental and Behavioral Pediatrics, and
| |
Collapse
|
24
|
Page DT, Coetzee BJ. South African adolescents living with spina bifida: contributors and hindrances to well-being. Disabil Rehabil 2019; 43:920-928. [PMID: 31368378 DOI: 10.1080/09638288.2019.1647293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Spina bifida myelomeningocele is a major cause of disability among adolescents. However, little research is available in low-income nations such as South Africa. Investigating the contributors and hindrances to well-being in adolescents with spina bifida myelomeningocele may yield novel insights. In this study we included both adolescents and their primary caregivers to examine their perspectives on caring for and facilitating improvements in the life of the adolescents living with spina bifida myelomeningocele. OBJECTIVES To identify and document the perceptions of adolescents with spina bifida myelomeningocele and their primary caregivers on the factors that contribute to and hinder the well-being of adolescents living with spina bifida myelomeningocele in South Africa. METHOD An explorative qualitative research design was utilized, guided by a positive psychology theoretical framework. Fourteen participants, consisting of seven adolescent-primary caregiver dyads, were interviewed. Data were analyzed using thematic analysis and coded inductively using ATLAS.ti software. RESULTS We identified eight themes describing participants' perceptions on contributors and hindrances to the well-being of adolescents with spina bifida myelomeningocele. Contributing factors included: family support, social groups, special needs education, sport participation, striving for independence, and finding meaning in life. Hindrances included: structural (lack of resources, medical care and mobility challenges) and social (bullying and harmful friendships, secrecy about the condition, social isolation and unhappiness) hindrances to well-being. CONCLUSION Acknowledging the contributors and hindrances to the well-being of adolescents with spina bifida myelomeningocele is crucial for guiding informed positive interventions and preventing blind spots. Given the limited number of positive contexts, concentrated effort is required to facilitate opportunities for growth in a range of environments. Primary caregivers lack insight into the positive and negative aspects of the adolescents' lives. We suggest families prioritize bonding time and open communication.Implications for rehabilitationExploring the perspectives of adolescents living with spina bifida and their parents regarding well-being is important to develop appropriate interventions.Adolescents living with spina bifida value social support and social interaction as ways to maintain well-being.Special needs education institutions with curriculums tailored to adolescents with spina bifida promote comfort, acceptance, and personal excellence.Sport contributes to the mental, social and physical well-being of adolescents with spina bifida. Sport inspires and offers opportunities for success, it improves school attendance, increases positive affect, and provides opportunities for close relationships with friends and family.Finding ways to mitigate the stigma around spina bifida is necessary to improve adolescents' well-being within South Africa.
Collapse
Affiliation(s)
- Daniel T Page
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Bronwyne J Coetzee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
25
|
Bakaniene I, Prasauskiene A. Patterns and predictors of participation in children and adolescents with spina bifida. Disabil Rehabil 2019; 42:3771-3779. [PMID: 31050564 DOI: 10.1080/09638288.2019.1610510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Participation is defined as involvement and engagement in all life situations and is seen as an essential condition for children's development. Here, we analyzed the patterns and predictors of participation for Lithuanian children and adolescents with spina bifida (SB).Material and methods: A cross-sectional design was employed. Parents of children aged 5-18 years with SB (n = 99) completed the Participation and Environment Measure for Children and Youth. Information about children's health conditions and functional issues was also collected. Descriptive statistics were used to analyze participation patterns, and multiple linear regression analyses were employed to identify the significant explanatory factors in each setting.Results: Participation restriction was mainly observed in preschool/school and the community settings. The environmental factors consistently explained at least one dimension of participation across all settings. Intellectual abilities had a substantial effect on participation in the home and preschool/school setting, whereas the contribution of bowel incontinence was observed in the preschool/school setting.Conclusions: Our findings highlight the role of intellectual functioning, bowel continence, and the environmental factors in explaining participation of children with SB across different settings and, therefore, demonstrate the need for more supports and environmental modifications (especially for those who have lower level of cognitive abilities), as well as interventions targeting improved bowel continence.Implications for rehabilitationChildren with spina bifida had low levels of participation in the community and preschool/school settings.The most important predictors for participation were intellectual abilities, bowel continence, and the environmental factors.Practitioners should pay more attention to environmental modifications (especially for children who have lower level of cognitive abilities) as primary targets of interventions aimed at promoting participation.Strategies to improve bowel continence could improve participation in the preschool/school setting.
Collapse
Affiliation(s)
- Indre Bakaniene
- Department of Children's Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Audrone Prasauskiene
- Department of Children's Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
26
|
Abstract
PURPOSE The purpose of this study, which was guided by the Family Resilience Model, was twofold: (1) to assess the risk and protective factors related to adaptation and resilience in families of children with spina bifida (SB) in South Korea and (2) to examine predictors of family adaptation and resilience. DESIGN This is a descriptive study using survey methodology. METHODS Data were collected from 203 parents of children with SB between June 2013 and February 2014 at the SB clinic in South Korea and analyzed using stepwise linear regression. FINDINGS The best predictors of family adaptation and resilience in children with SB included one risk factor (parental depression) and four protective factors (parental health, family cohesion, family communication skills, and supportive friends/relatives). These five factors explained 39.7% of the total variance in family functioning (an indicator of family adaptation and resilience; F = 26.43, p < .001). CONCLUSION AND CLINICAL RELEVANCE Findings suggest that nursing interventions designed to strengthen protective factors and reduce risk factors are likely to promote adaptation and resilience in families of children with SB.
Collapse
|
27
|
Vu Minh Arnell M, Abrahamsson K. Urinary continence appears to enhance social participation and intimate relations in adolescents with myelomeningocele. J Pediatr Urol 2019; 15:33.e1-33.e6. [PMID: 30228091 DOI: 10.1016/j.jpurol.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 08/06/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The majority of adults with myelomeningocele (MMC) in Western Sweden use incontinence pads. There is an ongoing discussion as to whether continence improves the quality of life (QoL) in individuals with MMC as it has been hard to establish that an increase in QoL measured by generic health-related quality of life (HRQoL) instruments is achieved by continence surgery. OBJECTIVE The hypotheses are that patients who are actively involved in a urotherapy/urology program are more continent than patients who are not and that urinary continence is one of the conditions required to enable social participation and physical intimacy. STUDY DESIGN All 25 individuals in Western Sweden with MMC (15 males) aged 16-18 years were involved in this cross-sectional, prospectively designed study of urinary and fecal continence. During interviews, questions were asked about the following: clean intermittent catheterization (CIC) and bowel regimens, the need for reminders or help from an assistant, social participation, and physical intimacy with a partner. RESULTS In the group, overall 17 of 25 (68%) had achieved urinary continence, 19 of 25 (76%) had a medical history of fecal continence, and 14 of 25 (56%) had no prescription for incontinence pads. Those who were urinary continent (17) included all nine patients who had received continence surgery in addition to six patients taking anticholinergics and two following the CIC procedure only. Urinary incontinence due to sphincter insufficiency was found in eight individuals, all of whom declined surgical treatment. All individuals (25/25) physically catheterized themselves, and 15/25 (60%) performed the fecal elimination regimen independently. Twelve individuals participated actively in social life, and eight of them had, or had had, a partner. All these 12 were urinary continent, and all but one were able to follow a fecal elimination regimen independently. Three of the 12 said they were fecal incontinent but knew how to become continent by following the prescribed fecal elimination regimen. DISCUSSION Studies in this patient group have shown that incontinence means that it's harder to live a healthy adult life. Children too worry about incontinence episodes at school, and 70% consider urinary incontinence a problem. A limitation in the study is the small population, something often seen in rare diseases. CONCLUSIONS With standardized follow-up, active treatment strategy and uro/bowel therapy, the urinary continence rate in adolescents with MMC at the study center is high compared with adults with MMC in Sweden. It appears that urinary continence is important in enabling successful participation in social life and in intimate physical relations with others.
Collapse
Affiliation(s)
- M Vu Minh Arnell
- The Pediatric Surgery Department, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - K Abrahamsson
- The Pediatric Surgery Department, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
28
|
McPherson AC, Oake M, Stinson J. "Don't sweat it buddy, it's OK": an exploration of the needs of adolescents with disabilities when designing a mobile application for weight management and healthy lifestyles. Disabil Rehabil 2019; 42:1569-1577. [PMID: 30689451 DOI: 10.1080/09638288.2018.1530804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Adolescents with disabilities often demonstrate higher sedentary behaviours, lower physical activity levels, poorer quality diets, and higher rates of overweight and obesity than typically developing youth. This study had two objectives: 1) To understand the needs and priorities of adolescents with disabilities, parents, and the healthcare professionals who work with them around healthy lifestyles and weight management; and 2) To explore whether and how a mobile application could address these needs.Methods: Multiple perspectives were gathered through separate qualitative focus groups with adolescents with disabilities (12-17 years), parents, and rehabilitation healthcare professionals. Data were analysed using descriptive thematic analysis.Results: Parents (n = 6) and healthcare professionals (n = 9) described the complex needs of adolescents with disabilities around weight management and healthy lifestyles, including balancing differing priorities and a lack of appropriate resources. Adolescents (n = 7) endorsed the potential for technology to enhance their health through empowerment and having a virtual support system. All stakeholder groups endorsed taking a holistic, wellness approach.Conclusions: Adolescents with disabilities have a complex lifestyle and weight management needs, but mobile applications have the potential to provide individualized support. It is critical that anyone developing mobile applications engage a range of stakeholders as co-designers.Implications for rehabilitationAdolescents with disabilities have complex support needs and priorities around weight management and healthy lifestyles.Existing resources do not take into account the wide-ranging abilities of adolescents with disabilities.Mobile applications have the potential to empower adolescents and provide tailored support around healthy lifestyles.Including user input when designing technologies is critical.
Collapse
Affiliation(s)
- Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Michelle Oake
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Jennifer Stinson
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| |
Collapse
|
29
|
Favoretto N, Faleiros F, Lopes F, Freitas G, Käppler C. ONLINE HEALTH FORUM AS A SUPPORT FOR PEOPLE WHO PERFORM INTERMITTENT VESICAL CATHETERIZATION. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-2018-0263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to evaluate the use of an online forum for people with myelomeningocele and their families and the profile of the users, based on intermittent catheterization. Method: a quantitative, cross-sectional, descriptive and exploratory study. Data was collected from users of the online forum, based on an online questionnaire available from March 20 to April 20, 2015. Sample consisted of 30 users. Descriptive statistical data analyses and chi-square test were performed. Results: among users, 27% were people with myelomeningocele and 73% were family members. Age, considering the total sample, ranged from 22 to 58 years old. Women represented 67% of the sample. Most users considered the language used in the forum understandable, and also thought the forum had a proper layout and was easy to navigate. It was noted that the mother and the person with myelomeningocele are the main responsible people for intermittent catheterization; 86% use a simple plastic catheter and 14% use a hydrophilic catheter; 81% do not reuse the catheter, 10% use the same catheter for one day and 9% for up to one week. The main place chosen to perform intermittent catheterization was the bed, followed by the toilet and wheelchairs. Conclusion: the use of the online forum was well evaluated by the users. It can be considered a means to obtain information, create a support network and clarify any doubts, empowering users and contributing to adherence to intermittent catheterization, which is one of the treatments for neurogenic bladder.
Collapse
Affiliation(s)
| | | | - Filipe Lopes
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, BraSil
| | | | | |
Collapse
|
30
|
Nahal MS, Axelsson ÅB, Imam A, Wigert H. Palestinian children's narratives about living with spina bifida: Stigma, vulnerability, and social exclusion. Child Care Health Dev 2019; 45:54-62. [PMID: 30335194 DOI: 10.1111/cch.12625] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Living with spina bifida in Palestine is a critical issue that might influence various aspects of the individual's life. It is a challenge for children, their families, and health care providers because it requires lifelong treatment and follow-up of care provision. However, little focus has been placed on these children's perceptions about their daily life experiences with spina bifida. PURPOSE To illuminate the lived experience of children with spina bifida in the West Bank, Palestine. METHODS A qualitative study was conducted using the phenomenological hermeneutical method to interpret the meaning of being a child with spina bifida in Palestine. Ten children with spina bifida, aged 7-18 years, were interviewed. The two local authors independently analyzed the Arabic transcriptions, whereas the two Swedish authors analyzed the transcriptions after translation to English. Finally, the four authors discussed their analysis and reached agreement about the themes. RESULTS Studying the children's experience with spina bifida helped us highlight their feelings, needs, and challenges. The findings were formulated into one main theme, Vulnerability and suffering due to social exclusion and stigma, which was grounded in three themes: Experiencing negative self-concept, Experiencing vulnerability, and Obtaining a sense of security. These three themes were in turn derived from subthemes. CONCLUSION The Palestinian children in this study faced physical, emotional, and psychosocial challenges, which negatively influenced their health and development. They were vulnerable and stigmatized, and they lived with a negative self-concept. The findings could help health professionals, families, and caregivers to achieve a deeper understanding of what being a child with disabilities entails, and the findings may also serve as a platform for interventions that seek to promote these children's development and to enable them to experience childhood as a meaningful and positive process.
Collapse
Affiliation(s)
- Maha Sudki Nahal
- Faculty of Health Professions, Department of Nursing, Al-Quds University, Abu Dis Campus, Jerusalem, Palestine
| | - Åsa B Axelsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Asma Imam
- School of Public Health, Al-Quds University, Abu Dies Campus, Jerusalem, Palestine
| | - Helena Wigert
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
31
|
Abstract
The field of transitional urology has taken on an increasing importance in recent years as more individuals with congenital urologic issues are living and thriving into adulthood. This article reviews the transitional process itself including barriers to successful transition and the consequences of failing to properly transition. Also provided is a broad overview of the urologic issues faced by patients who may benefit from lifelong care and the providers who will be helping them with transition and assuming their care.
Collapse
Affiliation(s)
- Robert C Kovell
- Division of Urology, Department of Surgery, University of Pennsylvania Health System, Children's Hospital of Philadelphia, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, 3 West, Philadelphia, PA 19104, USA.
| | - Alexander J Skokan
- Division of Urology, Department of Surgery, University of Pennsylvania Health System, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, 3 West, Philadelphia, PA 19104, USA
| | - Dan N Wood
- Department of Urology, University College London Hospitals, 16-18 Westmoreland Street, London W1H 6PL, UK
| |
Collapse
|
32
|
|
33
|
Continence technologies whitepaper: Informing new engineering science research. Proc Inst Mech Eng H 2018; 233:138-153. [DOI: 10.1177/0954411918784073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
34
|
Participation of Children with Spina Bifida: A Scoping Review Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Reference Framework. ACTA ACUST UNITED AC 2018; 54:medicina54030040. [PMID: 30344271 PMCID: PMC6122101 DOI: 10.3390/medicina54030040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 12/13/2022]
Abstract
Background and objectives. Participation is a fundamental right of the child, regardless of his health status. Assessing and supporting the participation of children with spina bifida (SB) presents a significant challenge for practitioners. The purpose of this study was to examine what is known about the participation of children with SB. Materials and Methods. The framework for scoping reviews from Arksey & O’Malley was used. A literature search in Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (Medline), PsychINFO and the Education Resources Information Centre (ERIC) databases retrieved 136 papers, 10 of which met the criteria for inclusion and were selected for analysis. Synthesis of the results on participation within occupational domains of leisure, school and community, and factors influencing participation of children with SB was performed. Results. All the included studies were non-experimental and used cross-sectional, population-based or qualitative design. Most studies analysed social participation or participation in physical activities, except one that focused on school participation. Data from these studies have shown that children with SB experience greater participation restrictions compared to their typical peers or children with other chronic diseases. The participation was mainly affected by contextual factors. Relationships between pathology and participation were not sufficiently validated. Conclusions. There is little research on the participation of children with SB. Future studies must consider contextual factors and interventions facilitating or impeding participation.
Collapse
|
35
|
Liu T, Ouyang L, Thibadeau J, Wiener JS, Routh JC, Castillo H, Castillo J, Freeman KA, Sawin KJ, Smith K, Van Speybroeck A, Valdez R. Longitudinal Study of Bladder Continence in Patients with Spina Bifida in the National Spina Bifida Patient Registry. J Urol 2018; 199:837-843. [PMID: 29132982 PMCID: PMC5948157 DOI: 10.1016/j.juro.2017.11.048] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Achieving bladder continence in individuals with spina bifida is a lifetime management goal. We investigated bladder continence status through time and factors associated with this status in patients with spina bifida. MATERIALS AND METHODS We used National Spina Bifida Patient Registry data collected from 2009 through 2015 and applied generalized estimating equation models to analyze factors associated with bladder continence status. RESULTS This analysis included 5,250 participants with spina bifida in a large, multi-institutional patient registry who accounted for 12,740 annual clinic visit records during the study period. At last followup mean age was 16.6 years, 22.4% of participants had undergone bladder continence surgery, 92.6% used some form of bladder management and 45.8% reported bladder continence. In a multivariable regression model the likelihood of bladder continence was significantly greater in those who were older, were female, were nonHispanic white, had a nonmyelomeningocele diagnosis, had a lower level of lesion, had a higher mobility level and had private insurance. Continence surgery history and current management were also associated with continence independent of all other factors (adjusted OR and 95% CI 1.9, 1.7-2.1 and 3.8, 3.2-4.6, respectively). The association between bladder management and continence was stronger for those with a myelomeningocele diagnosis (adjusted OR 4.6) than with nonmyelomeningocele (adjusted OR 2.8). CONCLUSIONS In addition to demographic, social and clinical factors, surgical intervention and bladder management are significantly and independently associated with bladder continence status in individuals with spina bifida. The association between bladder management and continence is stronger in those with myelomeningocele.
Collapse
Affiliation(s)
- Tiebin Liu
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lijing Ouyang
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Judy Thibadeau
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John S Wiener
- Duke University Medical Center, Durham, North Carolina
| | | | | | | | | | - Kathleen J Sawin
- Children's Hospital of Wisconsin and University of Wisconsin, Milwaukee, Wisconsin
| | - Kathryn Smith
- Children's Hospital Los Angeles, Los Angeles, California
| | | | - Rodolfo Valdez
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
36
|
McPherson AC, McAdam L, Keenan S, Schwellnus H, Biddiss E, DeFinney A, English K. A feasibility study using solution-focused coaching for health promotion in children and young people with Duchenne muscular dystrophy. Dev Neurorehabil 2018; 21:121-130. [PMID: 28272972 DOI: 10.1080/17518423.2017.1289271] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the feasibility and acceptability of a coaching intervention (Solution-Focused Coaching in pediatric rehabilitation [SFC-Peds]) related to physical activity and diet in males with Duchenne muscular dystrophy. METHODS A pre-post design was employed. Participants had five coaching sessions over 8 weeks. The first session was face-to-face, followed by four virtual sessions. Feasibility criteria included recruitment rates, attrition, and intervention fidelity. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were employed to look at outcome trends. The acceptability was assessed using a survey. RESULTS Five males (11-19 years) participated. All feasibility criteria were met. Clinically significant increases were observed for GAS and COPM scores. Participants reported SFC-Peds to be acceptable. Broad barriers and facilitators to coaching success were identified. CONCLUSIONS A SFC-Peds intervention for health promotion is feasible and acceptable in children with DMD and their families. A rigorous efficacy study assessing SFC-Peds intervention is warranted.
Collapse
Affiliation(s)
- Amy C McPherson
- a Bloorview Research Institute , Toronto , Ontario , Canada.,b Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto , Toronto , Ontario , Canada
| | - Laura McAdam
- a Bloorview Research Institute , Toronto , Ontario , Canada.,c Department of Paediatrics , University of Toronto , Toronto, Ontario , Canada
| | - Sarah Keenan
- a Bloorview Research Institute , Toronto , Ontario , Canada.,d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Heidi Schwellnus
- a Bloorview Research Institute , Toronto , Ontario , Canada.,d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Elaine Biddiss
- a Bloorview Research Institute , Toronto , Ontario , Canada.,e The Institute of Biomaterials & Biomedical Engineering and Rehabilitation Sciences Institute, University of Toronto , Toronto , Ontario , Canada
| | - Andrea DeFinney
- d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Kirsten English
- d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| |
Collapse
|
37
|
Saarikoski A, Koppeli R, Salanterä S, Taskinen S, Axelin A. Voiding school as a treatment of daytime incontinence or enuresis: Children's experiences of the intervention. J Pediatr Urol 2018; 14:56.e1-56.e7. [PMID: 29037865 DOI: 10.1016/j.jpurol.2017.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 09/10/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Daytime incontinence and enuresis are common problems in otherwise healthy children, and negatively influence their social lives and self-esteem. Motivation for treatment is often a real clinical problem. Children's experiences of their incontinence treatments have not been previously described. OBJECTIVE The aim of this study was to describe children's experiences of the Voiding School intervention as a treatment for their incontinence. STUDY DESIGN A qualitative, descriptive focus-group study with a purposive sample was conducted at a Finish university hospital in 2014. Children aged 6-12 years participated in the Voiding School at an outpatient clinic. The intervention included two 1-day group visits 2 months apart. The educational content was based on the International Children Continence Society's standards for urotherapy. The education was delivered with child-oriented teaching methods. At the end of the second visit, 19 children were interviewed in five groups. Data were analysed with inductive content analysis. RESULTS The children described incontinence as an embarrassing problem, which they had to hide at any cost. They had experienced bullying and social isolation because of it. Normal outpatient visits emphasized adult-to-adult communication, which made the children feel like outsiders. The children perceived the Voiding School as a nice and child-oriented experience. Making new friends was especially important to younger boys who felt that the Voiding School day was too long and issue-oriented. In the Voiding School, videos and 'learning by doing' helped the children to understand the basis of given advice, and they were able to learn new habits, which gave them control over the incontinence; this helped them to become 'the boss of the bladder'. Sharing experiences and improvements in their incontinence with their peers supported the children's self-esteem and encouraged them to do new things, such as staying overnight with friends. These experiences helped them to acquire control over the problem (Summary Figure). DISCUSSION According to the children's experiences, normal outpatient visits were only appointments for adults, and not very useful for children. In the Voiding School, they were respected as being the main person, and their views were listened to. The results underlined the importance of a child-oriented approach to patient education with regard to children, and provided encouragement to further develop the intervention. CONCLUSION Child orientation, peer support, learning by doing, and understanding the cause and effect helped children to gain control over their bladders. Based on the children's experiences, this could be achieved by a voiding school.
Collapse
Affiliation(s)
- A Saarikoski
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland; Department of Nursing Science, University of Turku, Turku, Finland.
| | - R Koppeli
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - S Salanterä
- Department of Nursing Science, University of Turku, Turku, Finland
| | - S Taskinen
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - A Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| |
Collapse
|
38
|
Blencowe H, Kancherla V, Moorthie S, Darlison MW, Modell B. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Ann N Y Acad Sci 2018; 1414:31-46. [PMID: 29363759 DOI: 10.1111/nyas.13548] [Citation(s) in RCA: 163] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 10/10/2017] [Accepted: 10/15/2017] [Indexed: 12/19/2022]
Abstract
Neural tube defects (NTDs) are associated with substantial mortality, morbidity, disability, and psychological and economic costs. Many are preventable with folic acid, and access to appropriate services for those affected can improve survival and quality of life. We used a compartmental model to estimate global and regional birth prevalence of NTDs (live births, stillbirths, and elective terminations of pregnancy) and subsequent under-5 mortality. Data were identified through web-based reviews of birth defect registry databases and systematic literature reviews. Meta-analyses were undertaken where appropriate. For 2015, our model estimated 260,100 (uncertainty interval (UI): 213,800-322,000) NTD-affected birth outcomes worldwide (prevalence 18.6 (15.3-23.0)/10,000 live births). Approximately 50% of cases were elective terminations of pregnancy for fetal anomalies (UI: 59,300 (47,900-74,500)) or stillbirths (57,800 (UI: 35,000-88,600)). Of NTD-affected live births, 117,900 (∼75%) (UI: 105,500-186,600) resulted in under-5 deaths. Our systematic review showed a paucity of high-quality data in the regions of the world with the highest burden. Despite knowledge about prevention, NTDs remain highly prevalent worldwide. Lack of surveillance and incomplete ascertainment of affected pregnancies make NTDs invisible to policy makers. Improved surveillance of all adverse outcomes is needed to improve the robustness of total NTD prevalence estimation, evaluate effectiveness of prevention through folic acid fortification, and improve outcomes through care and rehabilitation.
Collapse
Affiliation(s)
- Hannah Blencowe
- Centre for Maternal, Adolescent, Reproductive, and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | | | - Matthew W Darlison
- World Health Organization Collaborating Centre for Community Genetics, UCL Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK
| | - Bernadette Modell
- World Health Organization Collaborating Centre for Community Genetics, UCL Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK
| |
Collapse
|
39
|
Mohd-Zin SW, Marwan AI, Abou Chaar MK, Ahmad-Annuar A, Abdul-Aziz NM. Spina Bifida: Pathogenesis, Mechanisms, and Genes in Mice and Humans. SCIENTIFICA 2017; 2017:5364827. [PMID: 28286691 PMCID: PMC5327787 DOI: 10.1155/2017/5364827] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 11/14/2016] [Accepted: 12/01/2016] [Indexed: 05/26/2023]
Abstract
Spina bifida is among the phenotypes of the larger condition known as neural tube defects (NTDs). It is the most common central nervous system malformation compatible with life and the second leading cause of birth defects after congenital heart defects. In this review paper, we define spina bifida and discuss the phenotypes seen in humans as described by both surgeons and embryologists in order to compare and ultimately contrast it to the leading animal model, the mouse. Our understanding of spina bifida is currently limited to the observations we make in mouse models, which reflect complete or targeted knockouts of genes, which perturb the whole gene(s) without taking into account the issue of haploinsufficiency, which is most prominent in the human spina bifida condition. We thus conclude that the need to study spina bifida in all its forms, both aperta and occulta, is more indicative of the spina bifida in surviving humans and that the measure of deterioration arising from caudal neural tube defects, more commonly known as spina bifida, must be determined by the level of the lesion both in mouse and in man.
Collapse
Affiliation(s)
- Siti W. Mohd-Zin
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ahmed I. Marwan
- Laboratory for Fetal and Regenerative Biology, Colorado Fetal Care Center, Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, 12700 E 17th Ave, Aurora, CO 80045, USA
| | | | - Azlina Ahmad-Annuar
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Noraishah M. Abdul-Aziz
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| |
Collapse
|
40
|
Lim SW, Yi M. Mothers’ Perceived Difficulties in the Management of Chronic Conditions of Children with Spina Bifida: A Qualitative Descriptive Approach. CHILD HEALTH NURSING RESEARCH 2016. [DOI: 10.4094/chnr.2016.22.4.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
41
|
Vilaysack B, Cordier R, Doma K, Chen YW. Capturing everyday experiences of typically developing children aged five to seven years: A feasibility study of experience sampling methodology. Aust Occup Ther J 2016; 63:424-433. [DOI: 10.1111/1440-1630.12336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Brandon Vilaysack
- College of Healthcare Sciences; James Cook University; Townsville Queensland Australia
| | - Reinie Cordier
- School of Occupational Therapy and Social Work; Curtin University; Perth Western Australia Australia
| | - Kenji Doma
- College of Healthcare Sciences; James Cook University; Townsville Queensland Australia
| | - Yu-Wei Chen
- Faculty of Health Sciences; University of Sydney; Sydney New South Wales Australia
| |
Collapse
|
42
|
Abstract
Neurogenic bladder is a heterogeneous entity that may result from a variety of conditions affecting the central or peripheral nervous systems. Regardless of etiology, the overall goals of management are primarily twofold. As a neurogenic bladder may affect the ability to store urine safely and to empty the bladder efficiently, early management is focused on optimization of bladder storage function to prevent irreversible injury to either the upper or lower urinary tracts. In older children, this goal is added to the challenge of maximizing quality of life through achievement of urinary continence and independence in bladder management that continues into the transition to adulthood. In this review, we seek to bring the reader up-to-date regarding management of the pediatric neurogenic bladder with a focus on literature published in the past year. We discuss key contributions related to fetal intervention for myelomeningocele, monitoring and medical management of the neurogenic bladder and prediction of postoperative outcomes. Put together, these studies highlight the continued need for further research to improve evidence-based medical and surgical decision-making strategies for children affected by neurogenic bladder.
Collapse
Affiliation(s)
- Renea M. Sturm
- Division of Urology, Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Box 24, Chicago, IL 60611 USA
- Department of Urology, Feinberg School of Medicine at Northwestern University, 303 E. Chicago Ave, Chicago, IL 60611 USA
| | - Earl Y. Cheng
- Division of Urology, Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Box 24, Chicago, IL 60611 USA
- Department of Urology, Feinberg School of Medicine at Northwestern University, 303 E. Chicago Ave, Chicago, IL 60611 USA
| |
Collapse
|
43
|
Lindsay S, McPherson AC, Maxwell J. Perspectives of school-work transitions among youth with spina bifida, their parents and health care providers. Disabil Rehabil 2016; 39:641-652. [DOI: 10.3109/09638288.2016.1153161] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Amy C. McPherson
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Joanne Maxwell
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
44
|
de Freitas GL, de Sena RR, e Silva JCF, Faleiros F. The Reality of Children and Adolescents with Meningomyelocele and Their Families, in the City of Belo Horizonte and Its Metropolitan Area, Brazil. Health (London) 2016. [DOI: 10.4236/health.2016.86059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|