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Pedersen MJ, Høst C, Hansen SN, Klotsche J, Minden K, Deleuran BW, Bech BH. School Well-Being and Academic Performance of Children With Juvenile Idiopathic Arthritis: A National Register-Based Study. J Rheumatol 2024; 51:804-810. [PMID: 38561185 DOI: 10.3899/jrheum.2023-1197] [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] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE We aimed to investigate how school well-being (SWB) and academic performance of children with juvenile idiopathic arthritis (JIA) compare to their peers on a national level using the Danish national registers. Further, we investigated the potential influence of socioeconomic status (SES). METHODS A population-wide, register-based, cross-sectional study was performed. We compared the results of children with and without JIA in the Danish National Well-Being Questionnaire (DNWQ), the National Danish School Testing (NDST), and their ninth grade (aged approximately 16 yrs) final school marks in Danish and mathematics. The results were analyzed using adjusted ordinal logistic regression (SWB) and linear regression (tests and marks). RESULTS In separate cohorts, we included a total of 505,340 children answering the DNWQ, 812,461 children with NDST results, and the ninth-grade final marks of 581,804 children. Of these children, 1042, 1541, and 1410, respectively, fulfilled the criteria of JIA. Children with JIA reported SWB comparable to their peers, except for the question "Do you perform well in school?" (odds ratio 0.89, 95% CI 0.81-0.99). In the NDST, the children with JIA in general did just as well as their peers. We found no differences in the ninth-grade final marks in either Danish or mathematics. Stratifying the analyses on SES showed no significant differences in the associations. CONCLUSION Overall, children with JIA report SWB comparable to that of children without JIA and perform equally well in school as children without JIA.
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Affiliation(s)
- Malthe J Pedersen
- M.J. Pedersen, MD, S.N. Hansen, PhD, Department of Public Health, Aarhus University, Aarhus, Denmark;
| | - Christian Høst
- C. Høst, MD, PhD, Department of Paediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Stefan Nygaard Hansen
- M.J. Pedersen, MD, S.N. Hansen, PhD, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jens Klotsche
- J. Klotsche, PhD, Epidemiology Unit, Deutsches Rheuma-Forschungszentrum, Berlin, Germany
| | - Kirsten Minden
- K. Minden, MD, Epidemiology Unit, Deutsches Rheuma-Forschungszentrum, and Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bent W Deleuran
- B.W. Deleuran, MD, Department of Rheumatology, and Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bodil H Bech
- B.H. Bech, MD, PhD, Department of Public Health, Aarhus University, Aarhus, Denmark
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Fardell JE, Hu N, Wakefield CE, Marshall G, Bell J, Lingam R, Nassar N. Impact of Hospitalizations due to Chronic Health Conditions on Early Child Development. J Pediatr Psychol 2023; 48:799-811. [PMID: 37105227 DOI: 10.1093/jpepsy/jsad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE To assess the impact of hospitalization for chronic health conditions on early child development and wellbeing at school start. METHODS We conducted a longitudinal cohort study of children starting school using population-based record linkage of routinely collected admitted hospital data and standardized assessment of early childhood development (Australian Early Developmental Census: AEDC). Developmental vulnerability (DV) was defined as children scoring <10th centile in any one of five developmental domains. Children scoring <10th centile on two or more domains were considered developmentally high-risk (DHR). Children hospitalized with chronic health conditions were compared to children without hospitalizations prior to school start. RESULTS Among 152,851 children with an AEDC record, 22,271 (14·6%) were hospitalized with a chronic condition. Children hospitalized with chronic health conditions were more likely to be DHR (adjusted odds ratio 1.25, 95% CI: 1.18-1.31) compared to children without hospitalizations. Children hospitalized more frequently (>7 times) or with longer duration (>2 weeks) had a 40% increased risk of being DHR (1.40, 95% CI: 1.05-1.88 and 1.40, 95% CI: 1.13-1.74, respectively). Children hospitalized with mental health/behavioral/developmental conditions had the highest risk of DHR (2.23, 95% CI: 1.72-2.90). Developmental vulnerability was increased for physical health (1.37, 95% CI: 1.30-1.45), language (1.28, 95% CI: 1.19-1.38), social competence (1.22, 95% CI: 1.16-1.29), communication (1.17, 95% CI: 1.10-1.23), and emotional maturity (1.16, 95% CI: 1.09-1.23). CONCLUSIONS Frequent and longer duration hospitalizations for chronic health conditions can impact early childhood development. Research and interventions are required to support future development and well-being of children with chronic health conditions who are hospitalized.
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Affiliation(s)
- Joanna E Fardell
- Behavioural Sciences Unit, School of Women's and Children's Health, UNSW Sydney, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Nan Hu
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Australia
| | - Claire E Wakefield
- Behavioural Sciences Unit, School of Women's and Children's Health, UNSW Sydney, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Glenn Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Jane Bell
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, University of Sydney, Australia
| | - Raghu Lingam
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, University of Sydney, Australia
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Yang Y, Reyes BL, Jacob E. Health status, healthcare, and access in children with long-term medication use and difficulties with emotion, concentration, and behavior. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2022; 35:240-249. [PMID: 35368132 DOI: 10.1111/jcap.12371] [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: 11/06/2020] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/26/2022]
Abstract
PROBLEM Children with chronic conditions often have difficulties with emotions, concentration, and behaviors (ECB) and are not recognized and treated adequately. In this paper, long-term medication use (LTM) was adopted as a proxy for chronic illness due to the lack of consistent and standardized diagnostic criteria for chronic illnesses in children. METHODS Children (8-12 years) were selected from the California Health Interview Survey (2017) based on: (1) households with children (<12 years), (2) parent/adult caregivers report about child's health indicating "yes" to, (3) "does your child require prescription medicine for a health condition that has lasted or is expected to last at least 12 months or more," and (4) "difficulties with ECB in past 6 months." FINDINGS A total of 1600 children were included by the CHIS data set, and children whose parental report had met the selection criteria were children with LTM (n = 144; 7.4 ± 2.9 years), ECB (n = 233; 8.16 ± 2.14), and both LTM + ECB (n = 62; 8.61 ± 1.81). Children with LTM+ ECB were Caucasian (56.4%), Hispanic (19.3%), and males (64.5%). Children with both LTM + ECB had two to three (33.87%) or at least four (53.2%) physician visits, and/or receiving special therapy (45.1%). Children with LTM had prescription delays (n = 144; 5.6%) and were not able to get medical care due to lack of insurance (n = 144; 6.9%). The majority of the children with LTM (54.2%) and LTM + ECB (43.5%) had parental employment-based insurance. More children that have both LTM and ECB (48.4%) than children with LTM, No ECB (32.9%) were on Medi-Cal/Medicaid. CONCLUSION Children with LTM need further evaluation for difficulties with ECB. Future studies are required to examine health status, healthcare use, and access for children with LTM and ECB.
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Affiliation(s)
- Yuyin Yang
- UCLA Department of Psychology, Los Angeles, California, USA
| | - Beck L Reyes
- UCLA Adolescent Epilepsy Center, Los Angeles, California, USA
| | - Eufemia Jacob
- UCLA School of Nursing, Los Angeles, California, USA
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Thomas S, White V, Ryan N, Byrne L. Effectiveness of play therapy in enhancing psychosocial outcomes in children with chronic illness: A systematic review. J Pediatr Nurs 2022; 63:e72-e81. [PMID: 34776315 DOI: 10.1016/j.pedn.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/16/2021] [Accepted: 10/13/2021] [Indexed: 12/25/2022]
Abstract
PROBLEM To examine the nature, quality, and effectiveness of Play Therapy (PT) interventions in children with chronic health conditions (CHC) and to identify the measures used to evaluate psychosocial outcomes. ELIGIBILITY CRITERIA Systematic searches of the databases: Medline complete, PsycINFO, CINHAL, Embase and Sport Discuss were conducted to identify peer reviewed papers reporting original studies published in English between January1990 - April 2020. Studies testing any type of PT or Filial Therapy (FT) with children with CHC aged between 3 and 11 years, or their parents if FT, where outcomes were primarily psychosocial were eligible. SAMPLE AND RESULTS The title and abstract search identified 6742 papers and six studies (three each for PT and FT) including two randomized control trials were identified as eligible for review. All FT interventions involved group-based training, while only one PT study used a group format. Outcomes for children included emotional and behavioural issues including anxiety, depression, and self-concept and while constructs were broadly comparable across studies, the measures used differed. Sample size ranged between 4 and 58. Two studies suggested positive impact of PT on depression, with one finding improvements in self-concept. Three studies with sample sizes less than 30 found no effect. CONCLUSION With varied study designs, and small sample sizes, current evidence regarding the effectiveness of PT in improving psychosocial outcomes for children with chronic illnesses is inconclusive. IMPLICATIONS The field should move from small underpowered studies to randomized trials with comprehensive protocols and larger sample sizes.
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Affiliation(s)
- Sangeetha Thomas
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - Victoria White
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Nicholas Ryan
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Linda Byrne
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
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Kim S, Van Zwieten A, Lorenzo J, Khalid R, Lah S, Chen K, Didsbury M, Francis A, Mctaggart S, Walker A, Mackie FE, Prestidge C, Teixeira-Pinto A, Tong A, Blazek K, Barton B, Craig JC, Wong G. Cognitive and academic outcomes in children with chronic kidney disease. Pediatr Nephrol 2022; 37:2715-2724. [PMID: 35243536 PMCID: PMC9489550 DOI: 10.1007/s00467-022-05499-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Few data exist on the cognitive and academic functioning of children with chronic kidney disease (CKD) over the trajectory of their illness. We aimed to determine the association between CKD stages and cognitive and academic performance in children over time. METHODS We included 53 participants (aged 6-18 years) with CKD stages 1-5 (n = 37), on dialysis (n = 3), or with functioning kidney transplant (n = 22) from three units in Australia from 2015 to 2019. Participants undertook a series of psychometric tests and were invited for repeated assessments annually. We used linear regression and linear mixed models to investigate the effect of CKD stage, adjusted for socioeconomic status. RESULTS At baseline, full-scale intelligence quotient (FSIQ) (95%CI) of children on kidney replacement therapy (KRT) was in the low average range (87: 78, 96) and average (101: 95, 108) for children with CKD 1-5. Mean (95%CI) FSIQ, word reading, numerical operations, and spelling scores for children on KRT were 14.3 (- 25.3, - 3.3), 11 (- 18.5, - 3.6), 8.5 (- 17.6, 0.76), and 10 (- 18.6, - 1.3) points lower than children with CKD Stages 1-5. Spelling and numerical operations scores declined by 0.7 (- 1.4, - 0.1) and 1.0 (- 2.0, 0.2) units per year increase in age, regardless of CKD stage. CONCLUSIONS Children treated with KRT have low average cognitive abilities and lower academic performance for numeracy and literacy compared to both children with CKD 1-5 and to the general population. However, the rate of decline in academic performance over time is similar for children across the full spectrum of CKD. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. .,Sydney School of Public Health, The University of Sydney, Sydney, Australia.
| | - Anita Van Zwieten
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Jennifer Lorenzo
- grid.413973.b0000 0000 9690 854XKids Neuroscience Centre, The Children’s Hospital at Westmead, Sydney, Australia
| | - Rabia Khalid
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Suncica Lah
- grid.1013.30000 0004 1936 834XSchool of Psychology, The University of Sydney, Sydney, Australia
| | - Kerry Chen
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Madeleine Didsbury
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anna Francis
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia ,grid.240562.7Child & Adolescent Renal Service, Queensland Children’s Hospital, Brisbane, Australia
| | - Steven Mctaggart
- grid.240562.7Child & Adolescent Renal Service, Queensland Children’s Hospital, Brisbane, Australia
| | - Amanda Walker
- grid.416107.50000 0004 0614 0346Department of Renal Medicine, The Royal Children’s Hospital, Melbourne, Australia
| | - Fiona E. Mackie
- grid.414009.80000 0001 1282 788XDepartment of Nephrology, Sydney Children’s Hospital at Randwick, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Women’s and Child Health, University of New South Wales, Sydney, Australia
| | - Chanel Prestidge
- grid.414054.00000 0000 9567 6206Department of Nephrology, Starship Children’s Hospital, Auckland, New Zealand
| | - Armando Teixeira-Pinto
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Allison Tong
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Katrina Blazek
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Belinda Barton
- grid.413973.b0000 0000 9690 854XChildren’s Hospital Education Research Institute, The Children’s Hospital at Westmead, Sydney, Australia
| | - Jonathan C. Craig
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Germaine Wong
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia ,grid.413252.30000 0001 0180 6477Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
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Barnett T, Goldfeld S, Kelaher M. Evaluating the Effectiveness of Education Support Programs for Hospitalized Students With Chronic Health Conditions: Protocol for a Feasibility Study of a Controlled Trial. CONTINUITY IN EDUCATION 2020; 1:126-135. [PMID: 38774528 PMCID: PMC11104333 DOI: 10.5334/cie.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 02/20/2020] [Indexed: 05/24/2024]
Abstract
Chronic health conditions in children and young people can have a significant impact on their ability to maintain engagement in school, education, and learning. While this functional limitation affects only about 1.6% of all children and young people, the absolute number is not inconsequential. In Australia, for example, the number is in the order of 67,000 children and young people. Furthermore, research has shown that this group of young learners are at increased risk of lower academic, social, and emotional and quality of life outcomes than their healthy peers, both in the short and the longer term. For this reason, most pediatric hospitals in western developed countries have hospital-based schools that aim to prevent children and young people with a chronic health condition from disengaging from school, education, and learning. However, there is a lack of robust evidence of the effectiveness of these education support programs. This protocol for a feasibility study of the effectiveness of evaluating an education support program in Australia aims to identify a priori the methodological key features of a robust trial, including developing an answerable research question, choosing a controlled study design that compares the outcomes of both an intervention group and a well-matched non-intervention or control group, eligibility criteria, important and validated outcome measures such as quality of life, and how statistical data should be analyzed and reported. Lessons learned from the proposed feasibility study will be used to inform a larger-scale study.
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