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Cheok FE, Tan NRX, Chan YY, Wong BWZ, Kong G, Amin Z, Ng YPM. Quality of life of family caregivers of children and young adults with Down syndrome: A systematic review and meta-analysis. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2024; 53:490-501. [PMID: 39230317 DOI: 10.47102/annals-acadmedsg.202420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Introduction The aims of this systematic review and meta-analysis are to synthesise quality of life (QOL) of family caregivers of children and young adults with Down syndrome (DS) and determine factors affecting their QOL. Method This review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Key search terms were "quality of life", "down syndrome" and "trisomy 21". Meta-analysis using random effect model was conducted where feasible. All studies underwent qualitative synthesis. The study protocol was registered with PROSPERO (CRD42023413532). Results Eighteen studies with 1956 caregivers were included. Of the 10 studies utilising the World Health Organization Quality of Life Instrument-Brief Version, 5 were included in the meta-analysis. Psychosocial domain had the highest score with mean (95% confidence interval [CI]) of 63.18 (39.10-87.25). Scores were poorer in physical, environmental and social domains: 59.36 (28.24-90.48), 59.82 (19.57-100.07) and 59.83 (44.24-75.41), respectively. Studies were heterogenous with I2 values ranging from 99-100% (P<0.01). The remaining 8 studies used 6 other instruments. Qualitative synthesis revealed that caregivers' QOL was adversely affected by child-related factors, such as level of functional independence, developmental delay, presence of multiple comorbidities, impaired activities of daily living and poor sleep quality. Environmental factors that adversely affected caregivers' QOL included number of children, housing and support from the family. Personal factors that affected caregivers' QOL included age, being a single mother, low education and low income. Conclusion QOL of caregivers of children with DS was lower than population reference data. Understand-ing the factors that influence family caregivers' QOL is an essential step towards improving the QOL of caregivers and their children with DS.
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Affiliation(s)
| | | | - Yu Yi Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Zubair Amin
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | - Yvonne Peng Mei Ng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
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Van Riper M, Knafl GJ, Knafl KA, do Céu Barbieri-Figueiredo M, Barnoy S, Caples M, Choi H, Cosgrove B, Duarte ED, Honda J, Marta E, Phetrasuwan S, Alfieri S, Angelo M, Deoisres W, Fleming L, Dos Santos AS, da Silva MJR. Family adaptation in families of individuals with Down syndrome from 12 countries. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2024; 196:e32075. [PMID: 37929633 DOI: 10.1002/ajmg.c.32075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/11/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
Our current understanding of adaptation in families of individuals with Down syndrome (DS) is based primarily on findings from studies focused on participants from a single country. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, the purpose of this cross-country investigation, which is part of a larger, mixed methods study, was twofold: (1) to compare family adaptation in 12 countries, and (2) to examine the relationships between family variables and family adaptation. The focus of this study is data collected in the 12 countries where at least 30 parents completed the survey. Descriptive statistics were generated, and mean family adaptation was modeled in terms of each predictor independently, controlling for an effect on covariates. A parsimonious composite model for mean family adaptation was adaptively generated. While there were cross-country differences, standardized family adaptation mean scores fell within the average range for all 12 countries. Key components of the guiding framework (i.e., family demands, family appraisal, family resources, and family problem-solving communication) were important predictors of family adaptation. More cross-country studies, as well as longitudinal studies, are needed to fully understand how culture and social determinants of health influence family adaptation in families of individuals with DS.
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Affiliation(s)
- Marcia Van Riper
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - George J Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathleen A Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | - Maria Caples
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Beth Cosgrove
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | - Elena Marta
- Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Sara Alfieri
- Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Louise Fleming
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Quality of life of parents with children with congenital abnormalities: a systematic review with meta-analysis of assessment methods and levels of quality of life. Qual Life Res 2021; 31:991-1011. [PMID: 34482484 DOI: 10.1007/s11136-021-02986-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] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To quantify and understand how to assess the quality of life and health-related QoL of parents with children with congenital abnormalities. METHODS We conducted a systematic review with meta-analysis. The search was carried out in 5 bibliographic databases and in ClinicalTrials.gov. No restriction on language or date of publication was applied. This was complemented by references of the studies found and studies of evidence synthesis, manual search of abstracts of relevant congresses/scientific meetings and contact with experts. We included primary studies (observational, quasi-experimental and experimental studies) on parents of children with CA reporting the outcome quality of life (primary outcome) of parents, independently of the intervention/exposure studied. RESULTS We included 75 studies (35 observational non-comparatives, 31 observational comparatives, 4 quasi-experimental and 5 experimental studies). We identified 27 different QoL instruments. The two most frequently used individual QoL instruments were WHOQOL-Bref and SF-36. Relatively to family QoL tools identified, we emphasized PedsQL FIM, IOFS and FQOL. Non-syndromic congenital heart defects were the CA most frequently studied. Through the analysis of comparative studies, we verified that parental and familial QoL were impaired in this population. CONCLUSIONS This review highlights the relevance of assessing QoL in parents with children with CA and explores the diverse QoL assessment tools described in the literature. Additionally, results indicate a knowledge gap that can help to draw new paths to future research. It is essential to assess QoL as a routine in healthcare providing and to implement strategies that improve it.
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Van Riper M, Knafl GJ, Barbieri-Figueiredo MDC, Caples M, Choi H, de Graaf G, Duarte ED, Honda J, Marta E, Phetrasuwan S, Alfieri S, Angelo M, Deoisres W, Fleming L, dos Santos AS, Rocha da Silva MJ, Skelton B, van der Veek S, Knafl KA. Measurement of Family Management in Families of Individuals With Down Syndrome: A Cross-Cultural Investigation. JOURNAL OF FAMILY NURSING 2021; 27:8-22. [PMID: 33272069 PMCID: PMC7897787 DOI: 10.1177/1074840720975167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Down syndrome (DS) is the most common genetic cause of intellectual disability worldwide. The purpose of this analysis was to determine the internal consistency reliability of eight language versions of the Family Management Measure (FaMM) and compare family management of DS across cultures. A total of 2,740 parents of individuals with DS from 11 countries completed the FaMM. The analysis provided evidence of internal consistency reliability exceeding .70 for four of six FaMM scales for the entire sample. Across countries, there was a pattern of positive family management. Cross-cultural comparisons revealed parents from Brazil, Spain, and the United States had the most positive family management and respondents from Ireland, Italy, Japan, and Korea had the least positive. The rankings were mixed for the four remaining countries. These findings provide evidence of overall strong internal consistency reliability of the FaMM. More cross-cultural research is needed to understand how social determinants of health influence family management in families of individuals with DS.
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Affiliation(s)
- Marcia Van Riper
- University of North Carolina at Chapel Hill, USA
- Marcia Van Riper, School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, Room 433, Campus Box 7460, 120 N. Medical Drive, Chapel Hill, NC 27599, USA.
| | | | | | | | | | - Gert de Graaf
- Dutch Down Syndrome Foundation, Meppel, The Netherlands
| | | | | | - Elena Marta
- Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Sara Alfieri
- Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | | | | | | | - Beth Skelton
- University of North Carolina at Chapel Hill, USA
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Darla S, Bhat D. Health-related quality of life and coping strategies among families with Down syndrome children in South India. Med J Armed Forces India 2020; 77:187-193. [PMID: 33867636 DOI: 10.1016/j.mjafi.2020.07.010] [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: 04/28/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022] Open
Abstract
Background Down Syndrome (DS) is the most common chromosomal disorder associated with intellectual disability. Besides clinical management, additional support to cope with the demands of life is also necessary. These parents are frequently unstable and forego their Quality of Life (QoL), suffer additional economic difficulties, ill health and have lower well-being than families without disabilities. Hence, the study intends to evaluate the Health-Related QoL (HR-QoL) and coping strategies among families of DS children. Methods This explorative, cross-sectional study was conducted among parents/caregivers of DS children (n = 51). Socio-demographic details, HR-QoL, coping strategies and perspectives on having a child with disability were obtained through a standard questionnaire. Results Most DS children were upper and upper-middle class of urban background. The mean score of the QoL of the families was found to be 68.98%. The least and the most affected domains were cognitive functioning (71.67%) and worry (57.33%), respectively. Maximum coping was through the instrumental social support, active coping and religious coping. Though 27.45% were upset with the diagnosis, most had a "feeling of love" towards the child (72.55%). 50.98% had limited knowledge about DS and lacked organizational support (60.78%). Conclusion With increasing life expectancy, the gap continues concerning the assessment of needs beyond medical aid among DS children. Better HR-QoL and coping with the stress could be ensured by the provision of comprehensive health policies inclusive of training programs, stress management, as well as psychosocial and organizational support across any socio-economic strata.
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Affiliation(s)
- Shreyans Darla
- MBBS Phase III Part 2, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Deepa Bhat
- Associate Professor (Anatomy), JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Choi H, Van Riper M. mHealth Family Adaptation Intervention for Families of Young Children with Down Syndrome: A Feasibility Study. J Pediatr Nurs 2020; 50:e69-e76. [PMID: 30928311 DOI: 10.1016/j.pedn.2019.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this study was to explore the feasibility of using the mHealth Family Adaptation Intervention (FamilyAdapt-DS), with families of young children with Down syndrome (DS), and to assess the effect of participating in this mHealth intervention on family adaptation. DESIGN AND METHODS A one-group pre-test post-test design was employed. Sixteen parents from eight families of young children with DS (under the age of three years) participated in this study between September 2015 and September 2016. A Wilcoxon signed rank test was used to identify the difference between the pre-test and post-test scores. RESULTS All parents perceived that the program was feasible to use and they were willing to recommend the intervention to other families. Improvements were noted between pre-test and post-test scores. For fathers, views of their child's daily life became more positive, their child's condition became more manageable, their problem-solving communication became more affirming and their family functioning scores improved. Mothers reported less difficulty managing their child's condition. CONCLUSIONS These findings suggest that FamilyAdapt-DS is a feasible m-Health intervention for families of young children with DS; however, scaling up of this program with larger and more diverse samples is needed to test its effectiveness. PRACTICE IMPLICATIONS Nurses and other healthcare providers may find it helpful to use therapeutic conversations and mHealth interventions such as the one described in this paper to tailor the care they provide to families of young children with DS.
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Affiliation(s)
- Hyunkyung Choi
- College of Nursing & Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
| | - Marcia Van Riper
- The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, United States of America
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Choi EK, Jung E, Van Riper M, Lee YJ. Sleep problems in Korean children with Down syndrome and parental quality of life. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1346-1358. [PMID: 31353681 DOI: 10.1111/jir.12675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 06/28/2019] [Accepted: 07/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Sleep problems are common among children with Down syndrome (DS), and they can have a serious impact on children with DS as well as their parents and other family members. Specific aims of this study were to evaluate parent-reported sleep problems in children with DS and to examine the relationship between the sleep behaviour of children with DS and their parents' quality of life (QOL). METHOD A cross-sectional survey was conducted in September and October of 2017. Parents of children with DS were recruited from an online self-support community for parents of children with DS in South Korea. The mean age of the parents and children with DS was 40.40 years (SD = 5.09) and 7.89 years (SD = 3.03), respectively. Children's sleep problems and parents' QOL were assessed using the Children's Sleep Habits Questionnaire and the abbreviated version of the World Health Organization Quality of Life scale, respectively. RESULTS Results revealed that 83% of the parents reported that their child with DS experienced sleep problems. Children with DS had significantly more bedtime resistance, night waking, parasomnias and sleep-disordered breathing than did typically developing children. In addition, their Children's Sleep Habits Questionnaire scores were higher than those of typically developing children. Moreover, being older, being male and having more severe developmental delays were significant risk factors for sleep problems among children with DS. Furthermore, sleep problems in children with DS negatively affected parents' QOL. CONCLUSIONS Sleep problems negatively affect children with DS as well as their parents; therefore, health care providers should be aware of these issues and help parents manage sleep problems proactively.
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Affiliation(s)
- E K Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - E Jung
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - M Van Riper
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Y J Lee
- Department of Pediatrics, Hallym University, Kangnam Sacred Heart Hospital, Seoul, South Korea
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Senses Dinc G, Cop E, Tos T, Sari E, Senel S. Mothers of 0-3-year-old children with Down syndrome: Effects on quality of life. Pediatr Int 2019; 61:865-871. [PMID: 31267616 DOI: 10.1111/ped.13936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/24/2019] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to assess the quality of life (QoL) of mothers of children with Down syndrome (DS) and the factors related to it. METHODS Seventy-five DS child-mother diads and 54 healthy child-mother diads were included in this study. The brief World Health Organization Quality of Life scale - Turkish version (WHOQOL-BREF-TR), Symptom Check List-90-Revised (SCL-90-TR), Beck Depression Inventory, Beck Anxiety Inventory and Maslach Burnout Inventory (MBI) were completed by mothers to assess maternal QoL, burnout, anxiety, depression and general psychiatric symptoms. RESULTS Mothers of DS children had significantly higher SCL-90 general symptom index scores, Beck depressive symptom scores and higher scores in all domains of the brief World Health Organization Quality of Life scale - (WHOQOL-BREF-TR) except the WHOQOL-BREF-TR-psychological health domain. MBI personal achievement scores were weakly correlated with psychological health in mothers of DS children. There was a reverse correlation between comorbid disorders and the WHOQOL-BREF-TR psychological health domain, and a weak correlation between sex (having a baby girl with DS) and increased WHOQOL-BREF-TR physical health domain score. Number of offspring was negatively correlated with maternal social quality of life. CONCLUSION Mothers of children with DS are negatively affected in terms of QoL and mental health, even in the early period. It would be useful to systematically screen these mothers and to refer them for appropriate intervention at an early stage.
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Affiliation(s)
- Gulser Senses Dinc
- Department of Child Psychiatry, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Esra Cop
- Department of Child Psychiatry, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tulay Tos
- Department of Genetics, Ankara Etlik Zubeyde Hanim Obstetrics Training and Research Hospital, Ankara, Turkey
| | - Eyup Sari
- Department of Pediatrics, Sami Ulus Children Hospital, Ankara, Turkey
| | - Saliha Senel
- Department of Pediatrics, Medical School, Yıldırım Beyazıt University, Ankara, Turkey
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Barros ALO, de Gutierrez GM, Barros AO, Santos MTBR. Quality of life and burden of caregivers of children and adolescents with disabilities. SPECIAL CARE IN DENTISTRY 2019; 39:380-388. [PMID: 31172548 DOI: 10.1111/scd.12400] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the quality of life (QoL) and burden of primary caregivers of children and young adults (PCCYAs) with and without disabilities. METHODS A cross-sectional study was carried out with sample composed of 336 PCCYAs with cerebral palsy (CP; n = 84), Down syndrome (DS; n = 84), autism spectrum disorder (ASD; n = 84), and without disabilities (control group: CG n = 84), matched by gender and age. The burden of caregivers was assessed with the Zarit Burden Interview (ZBI), whereas QoL was assessed using the WHOQOL-BREF instrument. RESULTS QoL and burden of CG presented better results compared to groups with disabilities, with the lowest environmental domain of all study groups (P <.001). The prevalence of burden was moderate for PCCAs of groups with disabilities. There was association between all WHOQOL-BREF and ZBI domains and variables age, schooling, occupation and per capita income (Spearman's correlation coefficient, P <.05). There is a negative impact on WHOQOL-BREF, with an increase in the level of burden of PCCAs with disabilities. CONCLUSION The majority of PCCYAs were unemployed married mothers, with low schooling and health problems. Older caregivers experience even higher burden and greater impact on QoL.
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Sutan R, Al-Saidi NA, Latiff ZA, Ibrahim HM. Coping Strategies among Parents of Children with Acute Lymphoblastic Leukemia. Health (London) 2017. [DOI: 10.4236/health.2017.97071] [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]
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