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Arai Y, Kadekaru R, Okanishi T, Tamasaki A, Maegaki Y. Assessing the Subjective Happiness of Parents of Children With Severe Motor and Intellectual Disabilities Receiving Home Care. Cureus 2024; 16:e64562. [PMID: 39144842 PMCID: PMC11323715 DOI: 10.7759/cureus.64562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Home care for children with severe motor and intellectual disabilities (SMID) is challenging for parents because it is highly intensive and long-lasting. The pursuit of happiness is an essential goal for everyone. However, only a few studies have focused on the happiness of families with such children. OBJECTIVE The study aimed to examine the subjective happiness of parents of children with SMID receiving home care and identify the factors associated with their happiness. METHODS We conducted a cross-sectional online questionnaire-based survey of 23 parents of children with SMID and nurses with children without disabilities as controls at Tottori University Hospital, Yonago, Japan from July 1 to August 31, 2023. We set the subjective happiness scale (SHS) scores as the outcomes. We used the Mann-Whitney U test to compare the SHS scores between the two groups. Moreover, we extracted the clinical and demographic factors affecting the SHS scores of parents of children with SMID using univariate linear regression analysis. RESULTS We obtained responses from 12 parents with SMID and 105 controls. The average SHS scores of parents with SMID and controls were 4.8 and 4.7, respectively, and both groups did not differ significantly. Univariate analysis showed that parental male sex and the presence of a tracheostomy were negatively associated with the SHS scores of parents. CONCLUSIONS The SHS scores did not differ significantly between parents with SMID and controls. However, more attention seemed necessary for fathers and parents of children who have undergone tracheostomies. Given the exploratory nature of this study and its small sample size, larger-scale investigations are warranted. Additionally, qualitative research conducted after establishing trustful relationships could provide further insights.
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Affiliation(s)
- Yuto Arai
- Child Neurology, Tottori University Hospital, Yonago, JPN
| | - Ryuki Kadekaru
- Psychology, Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Yonago, JPN
| | - Tohru Okanishi
- Child Neurology, Tottori University Hospital, Yonago, JPN
| | | | - Yoshihiro Maegaki
- Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Tottori, JPN
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Nevin SM, Le Marne FA, Beavis E, Macintosh R, Palmer EE, Sachdev R, Nunn K, Bye A. Psychosocial experiences of clinicians providing care for children with severe neurological impairment. Dev Med Child Neurol 2024. [PMID: 38837791 DOI: 10.1111/dmcn.15987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate clinicians' psychosocial experiences navigating interdisciplinary care for children with severe neurological impairment (SNI), for example children with a developmental epileptic encephalopathy; secondarily, to identify preferences for future interventions to support clinicians caring for children with SNI. METHOD We conducted a qualitative descriptive study with interdisciplinary clinicians by using a purposeful sampling recruitment strategy. Twenty-four participants with expertise caring for children with SNI completed in-depth, semi-structured interviews. We transcribed the interviews, de-identified them, and performed inductive thematic analysis. RESULTS Thematic analysis elicited interrelated themes. Clinicians experienced immense professional barriers providing patient-centred care across fragmented healthcare contexts. Physical, emotional, and psychological impacts were attributed to inadequate reflective practice training and a paucity of integrated resources to support clinicians over time. Multipronged strategies were prioritized by clinicians, incorporating psychoeducation, interdisciplinary peer mentorship, and psychological resources to build reflective practice skills for clinicians providing complex care in an advancing era of medicine. INTERPRETATION This study provides novel and in-depth insight into clinicians' experiences navigating care for children with SNI. The results will be used to inform future integrated and multipronged co-developed resources tailored for clinicians, on the basis of their recommendations.
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Affiliation(s)
- Suzanne M Nevin
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Fleur A Le Marne
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Erin Beavis
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rebecca Macintosh
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Elizabeth E Palmer
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rani Sachdev
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine Sydney, Children's Hospital Network, Sydney, NSW, Australia
| | - Ann Bye
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
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Rousseau MC, Winance M, Baumstarck K. Polyhandicap, profound intellectual multiple disabilities : Concept and definition of a highly specific public health issue. Rev Epidemiol Sante Publique 2023; 71:102184. [PMID: 37918043 DOI: 10.1016/j.respe.2023.102184] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES The concept of polyhandicap first emerged in the late '60s in France, with actually a consensus on its definition. This consensus has yet to be reached internationally. The absence of an international consensus on a definition and name for persons with polyhandicap limits progress in research and health planning for these people. METHODS This article describes the history of the emergence of the concept of polyhandicap in France and internationally. RESULTS The emergence of the concept and definition of polyhandicap is part of the history of the development of special education and care for children with disabilities started at the end of the 19th century and during the first half of the 20th century. In France, between 1970 and 2002, working groups composed of professionals and family associations gradually developed and refined the definition of polyhandicap, differentiating it from other clinical entities such as cerebral palsy. Internationally, the term polyhandicap is used in 4 European countries: in France where it first appeared, in Italy, in French-speaking Belgium, and in French-speaking Switzerland but also outside the EU. Various terms may be used around the world to describe clinical entities similar to polyhandicap; the most frequently used in the literature is the term Profound Intellectual and Multiple Disabilities (PIMD) or PIMD Spectrum which does not systematically refer to an early brain injury. DISCUSSION We are currently in the process of internationalizing the concept and definition of polyhandicap, and hopefully, as was the case for cerebral palsy in the 2000s, the various research teams working on this subject around the world will create collaborations and research networks targeting this specific population. CONCLUSION A consensus around a precise definition of polyhandicap is important to ensure that these people are recognized for their uniqueness and specific qualities and to provide them adapted care.
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Affiliation(s)
- Marie-Christine Rousseau
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27 boulevard Jean-Moulin, 13385 Marseille, France; Hôpital San Salvadour, Hospital Fédération des Hôpitaux de Polyhandicap et Multihandicap, University Hospital of Paris, 4312 Rte de l'Almanarre, 83400 Hyères, France.
| | - Myriam Winance
- CERMES3, INSERM, Université Paris Cité, CNRS, EHESS, France
| | - Karine Baumstarck
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27 boulevard Jean-Moulin, 13385 Marseille, France; Epidemiology and Health Economy Department, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille, France
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4
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Nevin SM, McGill BC, Kelada L, Hilton G, Maack M, Elvidge KL, Farrar MA, Baynam G, Katz NT, Donovan L, Grattan S, Signorelli C, Bhattacharya K, Nunn K, Wakefield CE. The psychosocial impact of childhood dementia on children and their parents: a systematic review. Orphanet J Rare Dis 2023; 18:277. [PMID: 37679855 PMCID: PMC10486052 DOI: 10.1186/s13023-023-02859-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Childhood dementias are a group of rare and ultra-rare paediatric conditions clinically characterised by enduring global decline in central nervous system function, associated with a progressive loss of developmentally acquired skills, quality of life and shortened life expectancy. Traditional research, service development and advocacy efforts have been fragmented due to a focus on individual disorders, or groups classified by specific mechanisms or molecular pathogenesis. There are significant knowledge and clinician skill gaps regarding the shared psychosocial impacts of childhood dementia conditions. This systematic review integrates the existing international evidence of the collective psychosocial experiences of parents of children living with dementia. METHODS We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched four databases to identify original, peer-reviewed research reporting on the psychosocial impacts of childhood dementia, from the parent perspective. We synthesised the data into three thematic categories: parents' healthcare experiences, psychosocial impacts, and information and support needs. RESULTS Nineteen articles met review criteria, representing 1856 parents. Parents highlighted extensive difficulties connecting with an engaged clinical team and navigating their child's rare, life-limiting, and progressive condition. Psychosocial challenges were manifold and encompassed physical, economic, social, emotional and psychological implications. Access to coordinated healthcare and community-based psychosocial supports was associated with improved parent coping, psychological resilience and reduced psychological isolation. Analysis identified a critical need to prioritize access to integrated family-centred psychosocial supports throughout distinct stages of their child's condition trajectory. CONCLUSION This review will encourage and guide the development of evidence-based and integrated psychosocial resources to optimise quality of life outcomes for of children with dementia and their families.
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Affiliation(s)
- Suzanne M Nevin
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia.
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.
| | - Brittany C McGill
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Lauren Kelada
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Gail Hilton
- Childhood Dementia Initiative, Sydney, NSW, Australia
| | - Megan Maack
- Childhood Dementia Initiative, Sydney, NSW, Australia
| | | | - Michelle A Farrar
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
- Department of Neurology, Sydney Children's Hospital, Randwick, Australia
| | - Gareth Baynam
- Faculty of Health and Medical Sciences, Division of Paediatrics, University of Western Australia, Western Australia, Australia
- Rare Care Centre, Perth Children's Hospital, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Naomi T Katz
- Victorian Paediatric Palliative Care Program, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Leigh Donovan
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Sarah Grattan
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
| | - Christina Signorelli
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Kaustuv Bhattacharya
- Genetic Metabolic Disorders Service, Sydney Children's Hospitals' Network, Randwick and Westmead, Australia
- Faculty of Medicine and Health, Discipline of Genomics, Sydney University, Westmead, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Claire E Wakefield
- School of Clinical Medicine, UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Sydney, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
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Nazari-Shirkouhi S, Badizadeh A, Dashtpeyma M, Ghodsi R. A model to improve user acceptance of e-services in healthcare systems based on technology acceptance model: an empirical study. JOURNAL OF AMBIENT INTELLIGENCE AND HUMANIZED COMPUTING 2023; 14:7919-7935. [PMID: 37228695 PMCID: PMC10080501 DOI: 10.1007/s12652-023-04601-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/29/2023] [Indexed: 05/27/2023]
Abstract
Improving the quality of electronic services (e-services) is essential when dealing with unforeseen factors and uncertainties in healthcare, such as the outbreak of coronavirus (COVID-19) and changes in the needs and expectations of patients. This paper presents a comprehensive conceptual model in healthcare systems for improving the user acceptance of e-services. A model referred to as the technology acceptance model (TAM) is considered that includes several factors. The factors are computer literacy, website quality, service quality, user attitude, perceived enjoyment, and user satisfaction. According to the collected data and the performed analysis, the fit indices of this survey reveal that the conceptual model has an acceptable fit. The findings are as follows. Computer literacy has positive effects on perceived enjoyment and ease of use. Website quality has positive effects on perceived enjoyment, ease of use, and user satisfaction. Perceived enjoyment has a positive effect on perceived usefulness. Ease of use has positive effects on the usefulness, willingness to use e-services, and user attitude. User satisfaction has a positive effect on user attitude. Perceived usefulness has a positive effect on the willingness to use e-services. Finally, among these variables, only the user attitude has no significant effect on the willingness to use e-services in the healthcare system. Therefore, to promote performance quality and to motivate people to use e-services, healthcare managers should improve these factors.
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Affiliation(s)
- Salman Nazari-Shirkouhi
- School of Industrial Engineering, Fouman Faculty of Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Ali Badizadeh
- Faculty of Management and Accounting, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Mosayeb Dashtpeyma
- School of Industrial Engineering, Fouman Faculty of Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Reza Ghodsi
- Engineering Department, Central Connecticut State University, New Britain, USA
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Hamouda I, Rousseau MC, Aim MA, Anzola AB, Loundou A, De Villemeur TB, Auquier P, Baumstarck K. Development and initial validation of the quality of life questionnaire for persons with polyhandicap (PolyQoL). Ann Phys Rehabil Med 2023; 66:101672. [PMID: 35490967 DOI: 10.1016/j.rehab.2022.101672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/11/2022] [Accepted: 03/31/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Ilyes Hamouda
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France.
| | - Marie-Christine Rousseau
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France; Fédération des Hôpitaux de Polyhandicap et Multihandicap, San Salvadour Hospital, University Hospital of Paris, 4312 Rte de l'Almanarre, 83400 Hyères, France
| | - Marie-Anastasie Aim
- UR 849, LPS, Social Psychology Laboratory, Aix-Marseille University, 29 Av. Robert Schuman, 13621 Aix-en-Provence, France; University Hospital of Marseille, Direction of Clinical Research and Innovation, Marseille, France
| | - Any Beltran Anzola
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France
| | - Anderson Loundou
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France
| | - Thierry Billette De Villemeur
- Clinical research group GRC ConCer-LD, Sorbonne University & Pierre-et-Marie-Curie University, 4, place Jussieu, 75005 Paris, France; Department of Neuropediatrics Armand-Trousseau Hospital, 26 Av. du Dr Arnold Netter, 75012 Paris, France
| | - Pascal Auquier
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France
| | - Karine Baumstarck
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France
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Hamouda I, Rousseau MC, Beltran Anzola A, Aim MA, de Villemeur TB, Auquier P, Baumstarck K, de Villemeur TB, Rousseau MC, Khaldi-Cherif S, Maincent K, Felce A, Baumstarck K, Auquier P, Dany L, Beltran A, Hamouda I, Aim MA, Boutalbi N, Kemlin I, Roger J, Julien P, Heng P, Willocq D, Valkov M, Pietra S, Lenormand S, Lind K. The French EVAL-PLH cohort of persons with polyhandicap. Sci Rep 2022; 12:12512. [PMID: 35869128 PMCID: PMC9305042 DOI: 10.1038/s41598-022-16596-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/12/2022] [Indexed: 12/02/2022] Open
Abstract
Polyhandicap is characterized by a combination of profound intellectual disability and serious motor deficit, resulting in the extreme restriction of autonomy and communication. The aim of the EVAL-PLH (EVALuation PoLyHandicap) study is to identify the impact of socioeconomic, environmental, and epidemiological determinants on the health status of the persons with polyhandicap and the daily lives of their caregivers. EVAL-PLH is a prospective cohort study. The study involved persons with severe polyhandicap (who were cared for at reeducation centers, residential facilities, and one specialized pediatric/neurological department of a university hospital), their familial caregivers and the institutional caregivers. Data collection included sociodemographics, heath status, and psychocomportemental information. Data have been collected at 2 points (2015-2016 and 2020-2021). The French EVAL-PLH cohort is the first cohort study focusing on persons with polyhandicap, their families, and the health care workers caring for them. The sustainability of the device is essential to assist patients, families, clinicians, and health decision-making authorities in the optimization of care management.
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Impact of an intensive multimodal educative program on behavioral disorders of multihandicapped patients: A randomized controlled trial. Arch Pediatr 2022; 29:292-299. [DOI: 10.1016/j.arcped.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/17/2021] [Accepted: 01/30/2022] [Indexed: 11/22/2022]
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Rousseau M, Dagois J, Lausecker C, Humbertclaude E, Dominique A, Hamouda I, Auquier P, Billette de Villemeur T, Baumstarck K. Healthcare of Persons With Complex Developmental Disabilities From Three European Experiences: France, Italy, and Norway. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marie‐Christine Rousseau
- Fédération des Hôpitaux de Polyhandicap et Multihandicap Hôpital San Salvadour Assistance Publique Hôpitaux de Paris France
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
| | - Jean‐Francois Dagois
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées Paris France
| | - Claire Lausecker
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées Paris France
| | - Eric Humbertclaude
- Fédération du polyhandicap de l'Assistance Publique des Hôpitaux de Paris France
| | - Alain Dominique
- Fédération des Hôpitaux de Polyhandicap et Multihandicap Hôpital San Salvadour Assistance Publique Hôpitaux de Paris France
| | - Ilyes Hamouda
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
| | - Pascal Auquier
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
| | - Thierry Billette de Villemeur
- UPMC, GRC ConCer‐LD and AP‐HP, Hôpital Trousseau, Service de Neuropédiatrie ‐ Pathologie du développement Sorbonne Université Paris France
- Centre de référence des déficits intellectuels de causes rares, Inserm U 1141 France
- Hôpital de La Roche Guyon, Service de Polyhandicap Pédiatrique Assistance Publique Hôpitaux de Paris France
| | - Karine Baumstarck
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
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Rousseau MC, Hully M, Milh M, Juzeau D, Pollez B, Peudenier S, Bahi Buisson N, Gautheron V, Chabrol B, Billette de Villemeur T. Clinical characteristics of COVID-19 infection in polyhandicapped persons in France. Arch Pediatr 2021; 28:374-380. [PMID: 33994267 PMCID: PMC8064873 DOI: 10.1016/j.arcped.2021.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 01/02/2023]
Abstract
Aim Little is known about the clinical profile of COVID-19 infection in polyhandicapped persons. This study aimed to describe the characteristics of this infection among individuals with polyhandicap. Method This was a retrospective observational study. Polyhandicap was defined by the combination of motor deficiency, profound mental retardation, and age at onset of cerebral lesion younger than 6 years. A positive COVID-19 status was considered for patients with a positive COVID-19 laboratory test result, or patients presenting with compatible symptoms and living in an institution or at home with other patients or relatives who had laboratory-confirmed COVID-19 infection. Data collection included sociodemographic data, clinical and paraclinical characteristics, as well as the management and treatment for COVID-19 infection. Results We collected 98 cases, with a sex ratio of 0.98 and a mean age of 38.5 years (3 months to 73 years). COVID-19 infection was paucisymptomatic in 46% of patients, 20.6% of patients presented with dyspnea, while the most frequent extra-respiratory symptoms were digestive (26.5%) and neurological changes (24.5%); 18 patients required hospital admission, four adults died. The mean duration of infection was longer for adults than for children, and the proportion of taste and smell disorders was higher in older patients. Conclusion These findings suggest that PLH persons often develop paucisymptomatic forms of COVID-19 infection, although they may also experience severe outcomes, including death. Clinicians should be aware that COVID-19 symptoms in PLH persons are often extra-respiratory signs, mostly digestive and neurologic, which may help in the earlier identification of COVID-19 infection in this particular population of patients.
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Affiliation(s)
- M-C Rousseau
- Service polyhandicap adultes, Hôpital San Salvadour (Assistance Publique Hôpitaux de Paris), BP 30 080, 83407 Hyères cedex, France.
| | - M Hully
- MD, Services de Neurologie et Rééducation Pédiatriques, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France
| | - M Milh
- Service de Neuropédiatrie, Hôpital d'Enfants CHU Timone, 13005 Marseille, France
| | - D Juzeau
- Santé Publique, Co Fondatrice du réseau NeurodeV, 59000 Lille, France
| | | | - S Peudenier
- CRDI, Hôpital Morvan, CHRU Brest, 29200 Brest, France
| | - N Bahi Buisson
- Pediatric Neurology, Necker Enfants Malades University Hospital, Université de Paris, 75015 Paris, France; Institut Imagine, INSERM U 1163, Université de Paris, Paris, France
| | - V Gautheron
- Physical and Rehabilitation Medicine, Bellevue University Hospital, 42100 Saint-Étienne, France
| | | | - B Chabrol
- Service de Neuropédiatrie, Hôpital d'Enfants CHU Timone, 13005 Marseille, France
| | - T Billette de Villemeur
- Service de Neuropédiatrie, Pathologie du développement, hôpital Trousseau-La Roche Guyon, 95780 La Roche-Guyon, France
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Nothelle S, Wolff J, Nkodo A, Litman J, Dunbar L, Boyd C. "It's Tricky": Care Managers' Perspectives on Interacting with Primary Care Clinicians. Popul Health Manag 2020; 24:338-344. [PMID: 32758066 DOI: 10.1089/pop.2020.0082] [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: 11/12/2022] Open
Abstract
Care management programs that facilitate collaboration between care managers and primary care clinicians are more likely to be successful in improving chronic disease metrics than programs that do not facilitate such collaboration. The authors sought to understand care managers' perspectives on interacting with primary care clinicians. Semi-structured qualitative interviews were conducted with care managers (n = 29) from 3 health systems in and around a large, urban academic center. Interviews were audio recorded, transcribed verbatim, and iteratively analyzed using a grounded theory approach. Care managers worked for health plans (14%), outpatient specialty clinics (31%), hospitals and emergency departments (24%), and primary care offices (14%). Care managers identified the primary care clinician as leading patients' care and as essential to avoiding unnecessary utilization. Care managers described variability in and barriers to interacting with primary care clinicians. When possible, care managers use the electronic medical record to facilitate interaction rather than communicating directly (eg, phone call) with primary care clinicians. The role of the care manager varied across programs, contributing to primary care clinicians' poor understanding of what the care manager could provide. Consequently, primary care clinicians asked the care manager for help with tasks beyond his/her role. Care managers felt inferior to primary care clinicians, a potential result of the traditional medical hierarchy, which also hindered interactions. Although care managers view interactions with the primary care clinician as essential to the health of the patient, communication challenges, variability of the care manager's role, and medical hierarchy limit collaboration.
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Affiliation(s)
- Stephanie Nothelle
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amelie Nkodo
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jessica Litman
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Linda Dunbar
- Johns Hopkins HealthCare, Baltimore, Maryland, USA
| | - Cynthia Boyd
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Health issues in polyhandicapped patients according to age: Results of a large French cross-sectional study. Rev Neurol (Paris) 2020; 176:370-379. [DOI: 10.1016/j.neurol.2019.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/24/2019] [Indexed: 11/20/2022]
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Rousseau MC, Baumstarck K, Valkov M, Felce A, Brisse C, Khaldi-Cherif S, Loundou A, Auquier P, Billette de Villemeur T. Impact of severe polyhandicap cared for at home on French informal caregivers' burden: a cross-sectional study. BMJ Open 2020; 10:e032257. [PMID: 32014871 PMCID: PMC7045096 DOI: 10.1136/bmjopen-2019-032257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Polyhandicap (PLH), defined by a combination of profound intellectual impairment and serious motor deficits, is a severe condition with complex disabilities. In France, care of the large majority of PLH individuals is managed in specialised rehabilitation centres or residential facilities, but some of PLH individuals are cared for at home. The aims of this study were to assess the self-perceived burden among informal caregivers of PLH individuals and to identify potential determinants of this burden. DESIGN Cross-sectional study (Neuropaediatric Department, Trousseau Hospital, Paris, France). SETTINGS PLH children were recruited from a specialised paediatric/neurological department. PARTICIPANTS The selection criteria of caregivers were age above 18 years and being the PLH individual's next of kin. OUTCOMES MEASURES From March 2015 to December 2016, data were collected from the caregivers, including sociodemographical data, health status, psycho-behavioural data (quality of life, mood disorders and coping) and self-perceived burden. In addition, the health status of the PLH individual was collected. Relationships between the burden scores and potential determinants were tested (correlations coefficients, Mann-Whitney tests, generalised estimating equations models). RESULTS Eighty-four children were eligible; 77 families returned their questionnaire. The informal caregivers of PLH children experienced a high level of perceived burden (scores ranged from 55±20 to 81±12). Eighty per cent of them had more than 5 hours of daily caregiving and 51% of them had to get up more than twice during the night. The main factors associated with caregiver burden were age, financial issues, health status, daily care and coping strategies. The patients' health status was not associated with caregiver burden. CONCLUSIONS Some of the caregiver burden determinants might be modifiable. These findings should help healthcare workers and health-decision makers implement specific and appropriate interventions. TRIAL REGISTRATION NUMBER NCT02400528.
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Affiliation(s)
- Marie-Christine Rousseau
- Hôpital San Salvadour, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Karine Baumstarck
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Maria Valkov
- Hôpital San Salvadour, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Agnés Felce
- Hôpital Marin d'Hendaye, Assistance Publique Hopitaux de Paris, Paris, Île-de-France, France
| | - Catherine Brisse
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées, Paris, France
| | | | - Anderson Loundou
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Pascal Auquier
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Thierry Billette de Villemeur
- Hôpital de La Roche Guyon, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, France
- Pathologie du développement, Sorbonne Université, UPMC, GRC ConCer-LD, Paris, France
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Polyhandicap and aging. Disabil Health J 2019; 12:657-664. [DOI: 10.1016/j.dhjo.2019.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/20/2018] [Accepted: 01/18/2019] [Indexed: 02/04/2023]
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Rousseau MC, Baumstarck K, Khaldi-Cherif S, Brisse C, Felce A, Moheng B, Loundou A, Billette de Villemeur T, Auquier P. Impact of severe polyhandicap on parents' quality of life: A large French cross-sectional study. PLoS One 2019; 14:e0211640. [PMID: 30716093 PMCID: PMC6361449 DOI: 10.1371/journal.pone.0211640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/17/2019] [Indexed: 02/02/2023] Open
Abstract
Background Polyhandicap (PLH) is a condition of severe and complex disabilities and is defined by a combination of profound intellectual impairment and serious motor deficits. Parents of PLH individuals are chronically confronted with stressful situations. The aims of this study are i) to assess and compare the quality of life (QoL) of a large panel of parents of PLH individuals with age- and gender-matched controls and ii) to identify potential determinants of parents’ QoL. Method We conducted a cross-sectional study. Parents were recruited from 4 specialized rehabilitation centres, 9 residential facilities, and a specialized paediatric/neurological department. The selection criteria were age above 18 years and being the mother/father of a PLH individual. The data collected from the parents included sociodemographic, health status, and psycho-behavioural data (including QoL); additionally, the health status of the PLH individuals was collected. Results The QoL scores of all dimensions were significantly lower for parents than for controls. The main factors modulating parents’ QoL were financial issues, health status, and coping strategies. The PLH individuals’ health status was not associated with parents’ QoL. Conclusions Some QoL determinants might be amenable. These findings should help health care workers and health decision makers to implement specific and appropriate interventions.
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Affiliation(s)
- Marie-Christine Rousseau
- Fédération des Hôpitaux de Polyhandicap et Multihandicap, Hôpital San Salvadour, Assistance Publique Hôpitaux de Paris, Hyères, France.,EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, Marseille, France
| | - Karine Baumstarck
- EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, Marseille, France
| | | | - Catherine Brisse
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées, Paris, France
| | - Agnès Felce
- Hôpital d'Hendaye, Assistance Publique Hôpitaux de Paris, Hendaye, France
| | - Benjamin Moheng
- EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, Marseille, France
| | - Anderson Loundou
- EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, Marseille, France
| | - Thierry Billette de Villemeur
- Sorbonne Université, UPMC, GRC ConCer-LD, Paris, France.,Service de Neuropédiatrie-Pathologie du développement, Centre de référence des déficits intellectuels de causes rares, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France.,Service de Polyhandicap Pédiatrique, Assistance Publique Hôpitaux de Paris, Hôpital de La Roche Guyon, La Roche Guyon, France
| | - Pascal Auquier
- EA 3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, Marseille, France
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Nowrouzi-Kia B. The impact of workplace violence on health care workers' quality of life. Dev Med Child Neurol 2017; 59:675. [PMID: 28464247 DOI: 10.1111/dmcn.13466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Behdin Nowrouzi-Kia
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada
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