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Haffner DN, Bauer Huang SL. Using Telemedicine to Overcome Barriers to Neurodevelopmental Care from the Neonatal Intensive Care Unit to School Entry. Clin Perinatol 2023; 50:253-268. [PMID: 36868709 DOI: 10.1016/j.clp.2022.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Dedicated Neonatal Intensive Care Unit (NICU) follow-up programs are recommended for ongoing surveillance for infants at high-risk for future neurodevelopmental impairment (NDI). Systemic, socioeconomic, and psychosocial barriers remain for referrals and the continued neurodevelopmental follow-up of high-risk infants. Telemedicine can help overcome these barriers. Telemedicine allows standardization of evaluations, increased referral rates, and reduced time to follow-up as well as increased therapy engagement. Telemedicine can expand neurodevelopmental surveillance and support all NICU graduates, facilitating the early identification of NDI. However, with the recent expansion of telemedicine during the COVID-19 pandemic, new barriers related to access and technological support have arisen.
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Affiliation(s)
- Darrah N Haffner
- Division of Pediatric Neurology, Department of Pediatrics, Nationwide Children's Hospital and the Ohio State University, 700 Children's Dr, Columbus, OH 43205, USA.
| | - Sarah L Bauer Huang
- Department of Pediatric and Developmental Neurology, Department of Neurology, Washington University in Saint Louis School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA
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2
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Chen D, Wu Y, Li H, Pan X, Zhou J. Treatment on patients with spastic cerebral palsy in the past 30 years: A systematic review and bibliometric analysis. Medicine (Baltimore) 2022; 101:e30535. [PMID: 36397367 PMCID: PMC9666139 DOI: 10.1097/md.0000000000030535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Over the past 30 years, treatments from different disciplines have been applied to spastic cerebral palsy (SCP). However, few bibliometric studies have been conducted to date. This study explored the knowledge base, emerging hotspots, and future trends related to SCP treatment research using bibliometric analysis. METHODS Publications on SCP treatment included in the Web of Science Core Collection database between 1990 and 2020 were retrieved, and Medical Subject Headings terms were extracted from PubMed. Online bibliometric analysis website (http://bibliometric.com/), 2 pieces of software called "CiteSpace" and "VOSViewer" were used for quantitative analysis and knowledge map establishment. RESULTS A total of 1668 papers were retrieved from 1990 to 2020. The number of publications has increased annually. Developmental Medicine and Child Neurology is the most productive and the highest co-cited journal. The United States has been the largest contributor. Vrije Universiteit Amsterdam ranked first in the number of papers published among institutions that have conducted correlational research. Becher JG and Graham HK should be considered scholars who have made outstanding contributions. The knowledge base of the SCP treatment research field is thoughtfully constructed to promote understanding of the field. CONCLUSION This bibliometric study identified global achievements, research hotspots, and trends of SCP treatment. They provide insights into the research field and valuable information for future scientific research and clinical treatment.
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Affiliation(s)
- Dingfang Chen
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Yuefeng Wu
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - HaiYing Li
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Xue Pan
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Jin Zhou
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
- *Correspondence: Jin Zhou, School of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, China (e-mail: )
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Sher-Censor E, Shahar-Lahav R. Parents' resolution of their child's diagnosis: A scoping review. Attach Hum Dev 2022; 24:580-604. [PMID: 35156548 DOI: 10.1080/14616734.2022.2034899] [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: 11/02/2022]
Abstract
This scoping review focused on parents' resolution of their reactions to receiving a diagnosis for their child, based on Marvin and Pianta's model and Reaction to Diagnosis Interview (RDI). We aimed to map the populations examined, the prevalence of parents' narrated resolution, and what is known about its outcomes and determinants. A structured search identified 47 peer-reviewed papers published between 1992-2021. All employed the RDI and most had a cross-sectional design. Studies focused on a wide range of children's health and mental health diagnoses. Days to years after receiving the diagnosis, RDI narratives of 18.43% to 72.49% of the parents (44% on average) indicated lack of resolution. Studies reported associations between unresolved narratives and children's insecure attachment, higher parenting stress, and poorer parental health. However, findings on the associations of narrated resolution with parents' representations of their child, sensitivity, and psychological symptoms were equivocal, and findings on factors that may shape narrated resolution were limited. To advance the understanding of parents' narrated resolution and its effects, we recommend researchers employ prospective and longitudinal designs, evaluate narrated resolution as a continuous phenomenon, focus on outcomes derived from attachment theory, and systematically sample families from heterogenous cultures.
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Affiliation(s)
- Efrat Sher-Censor
- The Interdisciplinarity MA and PhD programs in Child Development, School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Ravit Shahar-Lahav
- The Interdisciplinarity MA and PhD programs in Child Development, School of Psychological Sciences, University of Haifa, Haifa, Israel
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4
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Sheng Q, Cai C, Li P, Chen L, Zhang X, Wang X, Gong Y. Development and Validation of a Nomogram for Predicting the Unresolved Risk of Parents of Adolescents With Psychiatric Diagnoses. Front Psychiatry 2022; 13:796384. [PMID: 35432017 PMCID: PMC9010732 DOI: 10.3389/fpsyt.2022.796384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/01/2022] [Indexed: 12/29/2022] Open
Abstract
Evaluating the resolution of parents of ill children can help in taking measures to alleviate their distress in a timely manner and promote children's rehabilitation. This study aims to develop and validate a nomogram for predicting the unresolved risk of parents of adolescents with psychiatric diagnoses. The data for 130 parents (modeling dataset = 90; validation dataset = 40) were collected. A nomogram was first developed to predict the unresolved risk for parents based on the logistic regression analysis in the modeling dataset. The internal and external validation then were conducted through quantifying the performance of the nomogram with respect to discrimination and calibration, respectively, in the modeling and validation datasets. Finally, the clinical use was evaluated through decision curve analyses (DCA) in the overall dataset. In the results, the nomogram consisted of six risk factors and provided a good discrimination with areas under the curve of 0.920 (95% CI, 0.862-0.978) in internal validation and 0.886 (95% CI, 0.786-0.986) in external validation. The calibration with good consistency between the observed probability and predicted probability was also found in both internal and external validation. DCA showed that the nomogram had a good clinical utility. In conclusion, the proposed nomogram exhibited a favorable performance with regard to its predictive accuracy, discrimination capability, and clinical utility, and, thus, can be used as a convenient and reliable tool for predicting the unresolved risk of parents of children with psychiatric diagnoses.
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Affiliation(s)
- Qingqing Sheng
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunfeng Cai
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Pingdong Li
- Nursing Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lihua Chen
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xi Zhang
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Xinyu Wang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yucui Gong
- Nursing Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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DORNER REBECCAA, BOSS RENEED, BURTON VERAJOANNA, RAJA KATHERINE, LEMMON MONICAE. Parent preferences for neurodevelopmental screening in the neonatal intensive care unit. Dev Med Child Neurol 2020; 62:500-505. [PMID: 31909496 PMCID: PMC7056590 DOI: 10.1111/dmcn.14457] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 12/24/2022]
Abstract
AIM To determine whether, and how, neonatal intensive care unit (NICU) parents want to receive early neurodevelopmental screening information about their child's future risk of cerebral palsy and other disabilities. METHOD This was a qualitative interview study. Parents of hospitalized infants born preterm completed semi-structured interviews. Data were analysed using a directed content analysis approach. RESULTS Thematic saturation was achieved after 19 interviews. Four themes characterized parent perceptions of early neurodevelopmental screening: (1) acceptability: most parents were in favour of neurodevelopmental screening if parents could refuse; (2) disclosure of results: parents want emotional preparation for results, especially false positives; (3) emotional burden of uncertainty: parents of children in the NICU balance taking their infant's illness 'day by day' and preparing for an uncertain future. Parents expressed distress with screening that increased uncertainty about the future; and (4) disability: prior experience with disability informs parent concerns. INTERPRETATION Parents interpret the risks and benefits of NICU developmental screening through the lens of prior experiences with disability. Most expressed interest in screening and emphasized a desire for autonomy, pretest counselling, and emotional preparation. WHAT THIS PAPER ADDS Most parents with infants in the neonatal intensive care unit expressed interest in early screening for developmental disability. Prior experience with disability informed concerns about specific deficits. Parents emphasized a desire for autonomy, pretest counselling, and emotional preparation.
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Affiliation(s)
- REBECCA A DORNER
- Division of Perinatal-Neonatal Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - RENEE D BOSS
- Division of Perinatal-Neonatal Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD;,Johns Hopkins Berman Institute of Bioethics, Baltimore, MD
| | - VERA JOANNA BURTON
- Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD;,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - MONICA E LEMMON
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD;,Department of Pediatrics, Division of Pediatric Neurology, Duke University School of Medicine, Durham, NC;,Duke-Margolis Center for Health Policy, Durham, NC, USA
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6
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Reed P, Giles A, White S, Osborne LA. Actual and perceived speedy diagnoses are associated with mothers' unresolved reactions to a diagnosis of autism spectrum disorder for a child. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1843-1852. [PMID: 30859844 DOI: 10.1177/1362361319833676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reaction to a child's diagnosis can strongly affect the parent, but little is known about the aspects of the diagnostic process associated with such reactions. The pre-diagnostic levels of anxiety, depression, and parenting stress of 67 volunteer mothers of children subsequently diagnosed with autism spectrum disorder were assessed, along with the children's functioning. The speed and number of professionals involved in the diagnosis were recorded, and mothers completed a post-diagnosis assessment of their perceptions of the process. Longer actual and perceived diagnosis speeds predicted resolved reactions to diagnosis. Mothers' psychological states pre-diagnosis did not predict reactions to diagnosis. Providing a measured diagnostic process, and strong relationship with mothers, rather than aiming for speed alone, may well be more productive for the parent and child.
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Leblond M, Achille M, Béliveau MJ, Clermont MJ, Blydt-Hansen T. Resolution of diagnosis and parental attitudes among parents of adolescent kidney recipients. Pediatr Transplant 2019; 23:e13472. [PMID: 31081267 DOI: 10.1111/petr.13472] [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: 05/28/2018] [Revised: 03/20/2019] [Accepted: 04/12/2019] [Indexed: 11/29/2022]
Abstract
The diagnosis of a chronic illness is described as an upsetting event that implies an emotional crisis for parents. Some are able to come to terms with their child's chronic condition and feel a sense of resolution, but for others, strong negative emotions persist through time. The present study examines diagnostic resolution among parents of teenagers with a transplant. The design was qualitative and involved individual interviews with nine parents. Five were donor to their child. Data were analyzed according to the principles of IPA. Early reactions to the diagnosis suggest that parents with an unresolved status experienced trauma. Many factors seem to contribute to diagnostic resolution such as good communication between spouses, positive relationship with the medical staff, and being the parent donor. For all parents, concerns over adherence are central to their relationship with their youth. Results call attention to the support needs of all parents and particularly those with an unresolved status.
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Affiliation(s)
- Marie Leblond
- Department of Psychology, Arts and Sciences Faculty, Université de Montréal, Montréal, QC, Canada
| | - Marie Achille
- Department of Psychology, Arts and Sciences Faculty, Université de Montréal, Montréal, QC, Canada
| | - Marie-Julie Béliveau
- Department of Psychology, Arts and Sciences Faculty, Université de Montréal, Montréal, QC, Canada
| | - Marie-José Clermont
- Department of Pediatric Nephrology, CHU Sainte-Justine, Montréal, QC, Canada
| | - Tom Blydt-Hansen
- BC Children's Hospital, Pediatric Multi Organ Transplant Program, BC Children Research Institute, Vancouver, BC, Canada
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Sher-Censor E, Dan Ram-On T, Rudstein-Sabbag L, Watemberg M, Oppenheim D. The reaction to diagnosis questionnaire: a preliminary validation of a new self-report measure to assess parents' resolution of their child's diagnosis. Attach Hum Dev 2019; 22:409-424. [PMID: 31184278 DOI: 10.1080/14616734.2019.1628081] [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
Parents' resolution of their child's diagnosis is associated with parental sensitivity and secure child attachment. The Reaction to Diagnosis Interview (RDI) is the accepted measure for assessing resolution, but its administration and coding are time and labor intensive. This study examined the psychometric properties of the Reaction to Diagnosis Questionnaire (RDQ), a new self-report measure that assesses resolution. 75 mothers of children diagnosed with Cerebral Palsy or Developmental Delay completed the RDI and the RDQ and reported on family characteristics. The RDQ showed good internal consistency. Mothers who were classified as resolved using the RDI had higher RDQ scores compared with mothers who were classified as unresolved. The networks of associations of the RDI and the RDQ with family characteristics were similar, although formal equivalence testing could not be performed. The RDQ may be a promising time- and cost-effective tool. Nevertheless, more research is needed to further establish its validity.
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Affiliation(s)
- Efrat Sher-Censor
- The Center for the Study of Child Development, The University of Haifa , Haifa, Israel
| | - Tali Dan Ram-On
- The Center for the Study of Child Development, The University of Haifa , Haifa, Israel
| | - Liron Rudstein-Sabbag
- The Center for the Study of Child Development, The University of Haifa , Haifa, Israel
| | - Merav Watemberg
- The Center for the Study of Child Development, The University of Haifa , Haifa, Israel
| | - David Oppenheim
- The Center for the Study of Child Development, The University of Haifa , Haifa, Israel
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Yaari M, Millo I, Harel-Gadassi A, Friedlander E, Bar-Oz B, Eventov-Friedman S, Mankuta D, Yirmiya N. Maternal resolution of preterm birth from 1 to 18 months. Attach Hum Dev 2017; 19:487-503. [PMID: 28504008 DOI: 10.1080/14616734.2017.1324499] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Preterm birth can be traumatic for some mothers, involving feelings of grief over the hoped-for full-term pregnancy. In this longitudinal study, we interviewed 50 mothers of preterm infants, using the reaction to diagnosis interview when their child was 1 month and 18 months old. We examined change and stability in resolution status over time. Additionally, we explored possible predictors of resolution trajectories between 1 and 18 months. Findings indicated that resolution at 1 month was not yet common. The rate of resolution at 18 months was 62.6%, compared with 38.2% at 1 month. Prenatal precursors of preterm birth, lower medical neonatal risk, and lower maternal stress at 1 month significantly differentiated mothers who attained resolution as early as at 1 month from those who were unresolved at 1 and 18 months. Lower maternal stress at 1 month was the only predictor that significantly differentiated initially unresolved mothers who later attained resolution from those who remained unresolved at 18 months. Discussion focuses on maternal stress, which may mark a subgroup of mothers of preterm infants who are at risk of being unresolved through the first 18 months, and who may benefit from resolution-focused intervention.
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Affiliation(s)
- Maya Yaari
- a Department of Psychology , the Hebrew University of Jerusalem , Jerusalem , Israel
| | - Inbal Millo
- a Department of Psychology , the Hebrew University of Jerusalem , Jerusalem , Israel
| | - Ayelet Harel-Gadassi
- a Department of Psychology , the Hebrew University of Jerusalem , Jerusalem , Israel
| | - Edwa Friedlander
- a Department of Psychology , the Hebrew University of Jerusalem , Jerusalem , Israel
| | - Benjamin Bar-Oz
- b Department of Neonatology , Hadassah University Hospital , Jerusalem , Israel
| | | | - David Mankuta
- c Department of Obstetrics & Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - Nurit Yirmiya
- a Department of Psychology , the Hebrew University of Jerusalem , Jerusalem , Israel
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10
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Stability and change in resolution of diagnosis among parents of children with autism spectrum disorder: Child and parental contributions. Dev Psychopathol 2015; 27:1045-57. [DOI: 10.1017/s095457941500067x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe contribution of change over time in parent and child characteristics to parents’ resolution of child's diagnosis was examined among 78 mothers and fathers of children with autism spectrum disorder. Children's characteristics (e.g., mental age and severity of symptoms), parental characteristics (e.g., attachment-related anxiety and stress level), and parents’ resolution of their child's diagnosis (resolved vs. unresolved) were examined at Time 1, and reassessed 3 years later at Time 2. Results indicated a deferential contribution of change in parent and child characteristics among mothers and fathers. An increase in child symptom severity and in maternal attachment-related anxiety, as well as longer durations of time since receiving the diagnosis, significantly predicted maternal resolved status at Time 2. Conversely, none of the changes in children's or paternal characteristics predicted paternal resolved status at Time 2. Results are discussed in relation to child and parental contributions to resolution, the differences in the adjustment and well-being of mothers and fathers of children with autism spectrum disorder, parental growth following receiving the diagnosis, and the need for intervention components specific to parental resolution and attachment-related anxiety.
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Yaari M, Millo I, Harel A, Friedlander E, Bar-Oz B, Eventov-Friedman S, Mankuta D, Yirmiya N. Predicting Maternal Resolution of Preterm Birth at One Month Corrected Age. INFANCY 2015. [DOI: 10.1111/infa.12089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Maya Yaari
- Department of Psychology; the Hebrew University of Jerusalem
| | - Inbal Millo
- Department of Psychology; the Hebrew University of Jerusalem
| | - Ayelet Harel
- Department of Psychology; the Hebrew University of Jerusalem
| | | | | | | | - David Mankuta
- Department of Obstetrics & Gynecology; Hadassah University Hospital
| | - Nurit Yirmiya
- Department of Psychology; the Hebrew University of Jerusalem
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Kruijsen-Terpstra AJA, Ketelaar M, Verschuren O, Smits DW, Jongmans MJ, Gorter JW. Determinants of Developmental Gain in Daily Activities in Young Children with Cerebral Palsy. Phys Occup Ther Pediatr 2014; 35:265-279. [PMID: 25232647 DOI: 10.3109/01942638.2014.957429] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACT The aim of this study was to examine which child and family characteristics at the child's age of 2 years are determinants of development of self-care and mobility activities over a period of 2 years in young children with cerebral palsy (CP). Longitudinal data of 92 children, representing all levels of the Gross Motor Function Classification System (GMFCS), were analyzed. Children's self-care and mobility activities were assessed with the Functional Skills Scale of the Pediatric Evaluation of Disability Inventory. Development of self-care and mobility activities was related to several child determinants but no family determinants. GMFCS, type of CP, intellectual capacity, and epilepsy were related to the development of self-care and mobility activities, while manual ability and spasticity were related to development of mobility activities. Multivariate analysis indicated that GMFCS and intellectual capacity were the strongest determinants of development of self-care activities, and GMFCS was the strongest determinant of development of mobility activities. The change in self-care and mobility activities was less favorable in severely affected children with severe disability. Knowledge of GMFCS level and intellectual capacity is important in anticipating change over time and goal setting in young children with CP.
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Affiliation(s)
- Anne J A Kruijsen-Terpstra
- 1Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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13
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Abstract
Background Perinatal stroke is a leading cause of early brain injury, cerebral palsy, and lifelong neurological morbidity. No study to date has examined the impact of raising a child with perinatal stroke on parents and families. However, a large breadth of research suggests that parents, especially mothers, may be at increased risk for psychological concerns. The primary aim of this study was to examine the impact of raising a child with perinatal stroke on mothers’ wellbeing. A secondary aim was to examine how caring for a child with perinatal stroke differentially affects mothers and fathers. Methods In Study I, a matched case-control design was used to compare the wellbeing of mothers of children with perinatal stroke and mothers of children with typical development. In Study II, a matched case-control design was used to compare mother-father dyads. Participants completed validated measures of anxiety and depression, stress, quality of life and family functioning, marital satisfaction, and marital distress. Parents of children with perinatal stroke also completed a recently validated measure of the psychosocial impact of perinatal stroke including guilt and blame outcomes. Disease severity was categorized by parents, validated by the Pediatric Stroke Outcome Measure (PSOM), and compared across the above outcomes in Study I. Results A total of 112 mothers participated in Study I (n = 56 per group; mean child age = 7.42 years), and 56 parents participated in Study II (n = 28 per group; mean child age = 8.25 years). In Study I, parent assessment of disease severity was correlated with PSOM scores (γ = 0.75, p < .001) and associated with parent outcomes. Mothers of children with mild conditions were indistinguishable from controls on the outcome measures. However, mothers of children with moderate/severe conditions had poorer outcomes on measures of depression, marital satisfaction, quality of life, and family functioning. In Study II, mothers and fathers had similar outcomes except mothers demonstrated a greater burden of guilt and higher levels of anxiety. Conclusions Although most mothers of children with perinatal stroke adapt well, mothers of children with moderate/severe conditions appear to be at higher risk for psychological concerns.
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Bemister TB, Brooks BL, Kirton A. Development, reliability, and validity of the Alberta Perinatal Stroke Project Parental Outcome Measure. Pediatr Neurol 2014; 51:43-52. [PMID: 24938139 DOI: 10.1016/j.pediatrneurol.2014.01.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 01/22/2014] [Accepted: 01/28/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Perinatal stroke is a leading cause of cerebral palsy and lifelong disability, although parent and family outcomes have not yet been studied in this specific population. The Alberta Perinatal Stroke Project Parental Outcome Measure was developed as a 26-item questionnaire on the impact of perinatal stroke on parents and families. METHODS The items were derived from expert opinion and scientific literature on issues salient to parents of children with perinatal stroke, including guilt and blame, which are not well captured in existing measures of family impact. Data were collected from 82 mothers and 28 fathers who completed the Parental Outcome Measure and related questionnaires (mean age, 39.5 years; mean child age, 7.4 years). Analyses examined the Parental Outcome Measure's internal consistency, test-retest reliability, validity, and factor structure. RESULTS The Parental Outcome Measure demonstrated three unique theoretical constructs: Psychosocial Impact, Guilt, and Blame. The Parental Outcome Measure has excellent internal consistency (Cronbach α = 0.91) and very good test-retest reliability more than 2-5 weeks (r = 0.87). Regarding validity, the Parental Outcome Measure is sensitive to condition severity, accounts for additional variance in parent outcomes, and strongly correlates with measures of anxiety, depression, stress, quality of life, family functioning, and parent adjustment. CONCLUSIONS The Parental Outcome Measure contributes to the literature as the first brief measure of family impact designed for parents of children with perinatal stroke.
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Affiliation(s)
- Taryn B Bemister
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Brian L Brooks
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Neurosciences (Brain Injury and Rehabilitation Programs), Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Adam Kirton
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Calgary Pediatric Stroke Program, Calgary, Alberta, Canada.
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15
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Parental reaction to early diagnosis of their children's autism spectrum disorder: an exploratory study. Child Psychiatry Hum Dev 2014; 45:294-305. [PMID: 23959534 DOI: 10.1007/s10578-013-0400-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study explores parental reactions subsequent to receiving their child’s autism spectrum disorder (ASD)-diagnosis. Seventy seven parents of recently diagnosed children participated in the Reaction to Diagnosis Interview. Within this group, associations between parental reaction to diagnosis, parental and child characteristics and prediagnostic circumstances were analysed. In a sub-sample, the stability of reaction to diagnosis was examined. The majority of parents were classified as ‘resolved’ regarding their child’s diagnosis. Conversely, parents of children with more severe ASD symptoms or non-Dutch parents were more likely to be classified as ‘unresolved’. Sub-sample analysis revealed stability of reaction to ASD-diagnosis. The majority of parents adapted well to the circumstances and the care for their child. Autism severity and parental nationality were significant factors affecting parental reactions. Thus, early identification of parental reaction to children’s ASD-diagnosis may aid in providing more tailored parental support programs.
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16
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Popp JM, Robinson JL, Britner PA, Blank TO. Parent adaptation and family functioning in relation to narratives of children with chronic illness. J Pediatr Nurs 2014; 29:58-64. [PMID: 23973569 DOI: 10.1016/j.pedn.2013.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 07/18/2013] [Accepted: 07/23/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study assessed the experience of parents who have a child diagnosed with chronic illness and whether children's narratives mirror these experiences. METHOD A total of 66 parents completed assessments about adaptation and family functioning. Children with type 1 diabetes or asthma participated in a story-stem narrative task. RESULTS Forty-one percent of parents were unresolved about their child's diagnosis, regardless of time since diagnosis. Unresolved parents reported lower family functioning, and children in these families had more family conflict themes. CONCLUSIONS Parental/Child narratives may provide unique insights into family adjustment. Future work may consider interventions related to family communication and expression of emotion.
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Affiliation(s)
- Jill M Popp
- Connecticut Children's Medical Center, Hartford CT; Department of Pediatrics, University of Connecticut, Farmington, CT.
| | - JoAnn L Robinson
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT
| | - Preston A Britner
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT
| | - Thomas O Blank
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT
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