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Akça Sümengen A, İsmailoğlu AV, İsmailoğlu P, Gümüş T, Çeliker A, Namlısesli D, Poyraz E, Özçevik Subaşı D, Zeren Erdem C, Çakır GN. The effect of 3D modeling on family quality of life, surgical success, and patient outcomes in congenital heart diseases: objectives and design of a randomized controlled trial. Turk J Pediatr 2024; 66:237-250. [PMID: 38814302 DOI: 10.24953/turkjpediatr.2024.4574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Understanding the severity of the disease from the parents' perspective can lead to better patient outcomes, improving both the child's health-related quality of life and the family's quality of life. The implementation of 3-dimensional (3D) modeling technology in care is critical from a translational science perspective. AIM The purpose of this study is to determine the effect of 3D modeling on family quality of life, surgical success, and patient outcomes in congenital heart diseases. Additionally, we aim to identify challenges and potential solutions related to this innovative technology. METHODS The study is a two-group pretest-posttest randomized controlled trial protocol. The sample size is 15 in the experimental group and 15 in the control group. The experimental group's heart models will be made from their own computed tomography (CT) images and printed using a 3D printer. The experimental group will receive surgical simulation and preoperative parent education with their 3D heart model. The control group will receive the same parent education using the standard anatomical model. Both groups will complete the Sociodemographic Information Form, the Surgical Simulation Evaluation Form - Part I-II, and the Pediatric Quality of Life Inventory (PedsQL) Family Impacts Module. The primary outcome of the research is the average PedsQL Family Impacts Module score. Secondary outcome measurement includes surgical success and patient outcomes. Separate analyses will be conducted for each outcome and compared between the intervention and control groups. CONCLUSIONS Anomalies that can be clearly understood by parents according to the actual size and dimensions of the child's heart will affect the preoperative preparation of the surgical procedure and the recovery rate in the postoperative period.
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Affiliation(s)
- Aylin Akça Sümengen
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, İstanbul, Türkiye
- Capstone College of Nursing, The University of Alabama, Alabama, United States of America
| | - Abdul Veli İsmailoğlu
- Department of Anatomy, School of Medicine, Acıbadem University, İstanbul, Türkiye
- Department of Anatomy, School of Medicine, Marmara University, İstanbul, Türkiye
| | - Pelin İsmailoğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Fenerbahce University, İstanbul, Türkiye
- Department of Anatomy, School of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Terman Gümüş
- Department of Radiology, School of Medicine, Koç University Research and Training Hospital, İstanbul, Türkiye
| | - Alpay Çeliker
- Pediatric Cardiology Department, American Hospital, İstanbul, Türkiye
| | - Deniz Namlısesli
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Yeditepe University, İstanbul, Türkiye
| | - Ezgi Poyraz
- Pediatric Cardiology Department, American Hospital, İstanbul, Türkiye
| | | | - Ceren Zeren Erdem
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, İstanbul, Türkiye
| | - Gökçe Naz Çakır
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, İstanbul, Türkiye
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Schnellmann AS, Balmer C, Lehmann P, Werner H. Cardiac rhythm devices in pediatric patients: Impact on family functioning and parent's health-related quality of life. J Child Health Care 2024; 28:37-52. [PMID: 35549925 DOI: 10.1177/13674935221085388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study compares the impact of children's cardiac rhythm devices and health status on their parents with that of healthy controls. Furthermore, it aims to ascertain whether sociodemographic characteristics and medical data are associated with parent-reported impacts. This cross-sectional study is part of a comprehensive single-center study of long-term psychosocial outcomes in pediatric patients with pacemakers and implantable cardioverter defibrillators. The study includes 69 patients with their parents: 69 mothers and 57 fathers. Parents responded to the Pediatric Quality of Life Inventory Family Impact Module and to open-ended questions assessing impact on family life and treatment satisfaction. Parents reported more negative impact on family life than healthy controls in all three summary scores. Among fathers, presence of a child's congenital heart disease and female sex is associated with lower family function. No group differences emerged regarding device type. Positive and negative cognitive aspects predominated for patients' mothers and fathers. However, one substantial difference is that mothers reported more positive and negative emotional impact than fathers. We conclude that parents' well-being should be addressed in clinical contexts, especially through emotional and practical support and open communication focused on parents' worries and concerns.
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Affiliation(s)
- Anne-Sophie Schnellmann
- Department of Cardiology, Pediatric Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Christian Balmer
- Department of Cardiology, Pediatric Heart Centre, University Children's Hospital, Zurich, Switzerland
- Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Phaedra Lehmann
- Children's Research Center, University Children's Hospital, Zurich, Switzerland
- Department of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Helene Werner
- Children's Research Center, University Children's Hospital, Zurich, Switzerland
- Department of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland
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Demirbağ S, Ergin D. Hospital quality of life for children: development of a new measurement tool for hospitalised children. J Res Nurs 2024; 29:32-42. [PMID: 38495322 PMCID: PMC10939021 DOI: 10.1177/17449871231222158] [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: 03/19/2024] Open
Abstract
Background Hospitalisation affects children's quality of life (QoL) regardless of illness, treatment and care. Aims The objective of this study was to create an instrument for evaluating QoL of hospitalised children aged 7 to 18 years. Methods Initially, 46 items for the preliminary Hospital Quality of Life for Children Scale (HQL-children) were developed through a combination of literature reviews and individual interviews. The study was conducted with 230 participants from a general paediatric ward of a hospital. Exploratory and confirmatory factor analyses were conducted to examine the construct, convergent and discriminant validities of the measure. Criterion validity was assessed by confirming split-half reliability, whereas reliability was established using Cronbach's alpha coefficient. Results The HQL-child scale consists of 17 items and the total variance is 51.14%. The scale is categorised into five sub-dimensions: illness, fear, activity, hospital and perception. The scale demonstrated construct, convergent and divergent validity, discriminant and split-half reliability, with Cronbach's alpha coefficient 0.75. Conclusions The scale is a promising instrument to determine children's perception by capturing their experiences on hospitalisation. Assessing the QoL in hospitalised children is crucial for enhancing patient satisfaction and facilitating the development of health policies based on patient self-reporting in Turkey.
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Affiliation(s)
- Selin Demirbağ
- Research Assistant, Department of Child Health and Disease Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Dilek Ergin
- Professor, Department of Child Health and Disease Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
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Dardas LA, Pan W, Hamdan AI, Abu Jabeh RAH, Eid Ashakhanba A, Sami Abdelhai O, Naim Abid M, Ahmad Mohammad H, Al-Ammouri I. Quality of life in Arab children with congenital heart disease. PLoS One 2024; 19:e0290306. [PMID: 38236921 PMCID: PMC10796050 DOI: 10.1371/journal.pone.0290306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/06/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND AND PURPOSE Management strategies for children with congenital health diseases (CHDs) should encompass more than just the medical aspect of the disease and consider how heart diseases affect their everyday activities and, subsequently, their quality of life (QoL). Global studies witnessed a greater emphasis on studying the QoL associated with CHD. However, there is still a great lag in such data in the Arab region. The purpose of this study was to evaluate QoL in children with CHD using an Arab sample from Jordan. The specific objectives were twofold: (1) to contrast the assessments of children's QoL reported by their parents with those reported by the children themselves, and (2) to assess the factors that influence the QoL of children with CHD. METHODS A total of 79 children aged 2-18 with a confirmed diagnosis of CHD were included in the study, along with their mothers. Of them, 38.0% were girls, 67.1% were diagnosed with non-cyanotic CHD, 58.2% had a severe CHD, 92.4% had undergone at least one operation, 81.0% had repaired defects, 13.9% underwent palliated procedures, and 24.1% were admitted to a neonatal intensive care unit after delivery. The Pediatric Quality of Life Inventory was used to assess QoL of children with CHD. Both children's and parents' reports of QoL were analyzed using paired-sample t-tests, ANOVAs, and multiple linear regression. RESULTS Older children reported significantly lower QoL scores, whereas there were no differences in parents-reported QoL scores across different children age groups. There was a divergence in perceptions of QoL between parents-reported and children-reported scores with parents reporting significantly lower scores. The children-reported QoL in this study seemed to be significantly associated with their gender, age, and the presence of learning difficulties, whereas the parent-reported QoL was only associated with the presence of learning difficulties. CONCLUSIONS Responses from both children and parents need to be considered to understand the similarities and differences between them and to provide further insight into the optimal way to help children with CHD effectively navigate the transition into adulthood. Future research studies of outcomes for survivors of children with CHD are needed to identify high-risk survivors for worse psychosocial functioning and assess prevention measures and treatment interventions to improve their QoL.
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Affiliation(s)
| | - Wei Pan
- Duke University School of Nursing, Durham, North Carolina, United States of America
| | | | | | | | | | | | | | - Iyad Al-Ammouri
- Pediatric Cardiology School of Medicine, The University of Jordan, Amman, Jordan
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Mamasoula C, Pennington L, Adesanya AM, Rankin J. A systematic review and meta-analysis of school and cognitive function domains of health-related quality of life measures for children and young adults with congenital heart disease. Birth Defects Res 2024; 116:e2275. [PMID: 38014517 DOI: 10.1002/bdr2.2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/31/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Research on cognitive and school functioning domains of health-related quality of life (HRQOL) for children and adolescents with congenital heart disease (CHD) presents inconsistencies. OBJECTIVES To summarize and synthesize data on school and cognitive function domains of HRQOL for children and young people (CYP) with CHD. METHODS Five electronic databases MEDLINE, Scopus, PsycINFO, EMBASE, ERI, and citations were systematically searched. We included original-research articles reporting the cognitive and school function domains of HRQOL for children and young people with CHD (child and parent reports included). Both fixed and random-effects meta-analyses were performed to estimate pooled mean test scores for cognitive and school function. A total of 34 studies met our inclusion criteria and were synthesized narratively, 17 studies were included in formal meta-analyses. RESULTS Self-reported cognitive function was lower for children and young people with CHD than healthy controls (SMD -0.28 (-0.42, -0.15)). Parental reports demonstrated similar results to self-reports (SMD -0.54 (-0.91, -0.18)). School function was lower in children and young people with CHD compared with healthy controls in self-reported (SMD -0.30 (-0.48, -0.13)) and parent reported HRQOL (SMD -0.49 (0.64, -0.36)). Self-reported school function domain scores were lower for young (<8 years) (SMD -0.65 (-1.32, 0.03)) and older children (8-18 years) (SMD -0.25 (-0.47, -0.03)) with CHD than their peers. Similarly, parents reported lower school function domain scores for young (<8 years) (SMD -0.68 (-1.29, -0.07)) and older (8-18 years) (SMD -0.46 (-068, -0.25)) children with CHD than typically developing peers. CONCLUSION Children born with CHD may experience lower cognitive and school function HRQOL scores than healthy controls (self and proxy-report). This is consistent with a subgroup meta-analysis of young (<8 years) and older (8 years old or more) children with CHD reporting lower school function scores compared to controls.
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Affiliation(s)
| | - Lindsay Pennington
- Population Health Science Institute, Newcastle University, Newcastle, UK
| | | | - Judith Rankin
- Population Health Science Institute, Newcastle University, Newcastle, UK
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Vostrikova SA, Penkina NI, Ivanova MA. Quality of life in children with atopic dermatitis aged 13–17 years. ROSSIYSKIY VESTNIK PERINATOLOGII I PEDIATRII (RUSSIAN BULLETIN OF PERINATOLOGY AND PEDIATRICS) 2023. [DOI: 10.21508/1027-4065-2022-67-6-83-87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose. To study the quality of life of children aged 13–17 years with atopic dermatitis, depending on the sex of the child, the severity of the disease.Material and methods. 350 children aged 13–17 with atopic dermatitis (observation group) and 350 children of the same age of I– II health groups, without allergic diseases (comparison group) were examined. The quality of life of children and their parents was studied using a general questionnaire, Pediatric Quality of Life Inventory — PedsQL™4.0 (Varni J. et al., USA, 2001).Results. The quality of life of children with atopic dermatitis aged 13–17 years is reduced in all respects in comparison with their healthy peers. Atopic dermatitis had the greatest negative impact on such areas of the child’s life as emotional, school, and social functioning. The quality of life in children aged 13–17 years with severe cases of atopic dermatitis was significantly more impaired in girls, compared with boys. Parents rated the quality of life of their children higher than the children themselves.Conclusion. A significant decrease in emotional, school, and social functioning in the structure of the components of the quality of life of children aged 13–17 years with atopic dermatitis indicates the need for timely diagnosis of these disorders and their correction.
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Affiliation(s)
- S. A. Vostrikova
- Republican Medical College named after the Hero of the Soviet Union F.A. Pushina
| | | | - M. A. Ivanova
- Central Research Institute for the Organization and Informatization of Healthcare
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Zhu JH, Jin CD, Tang XM. Psychological needs of parents of children with complicated congenital heart disease after admitting to pediatric intensive care unit: A questionnaire study. World J Clin Cases 2022; 10:8578-8586. [PMID: 36157802 PMCID: PMC9453356 DOI: 10.12998/wjcc.v10.i24.8578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/22/2022] [Accepted: 07/06/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Parents of children with complicated congenital heart disease (CHD) have different needs after surgery. Little literature reports the impact factors for psychological needs of parents of children with complicated CHD.
AIM To investigate the status quo of the needs of parents of children after surgery for complex CHD, and analyze the influencing factors, in order to provide a theoretical basis for formulating corresponding nursing countermeasures.
METHODS A modified Chinese version of the Critical Care Family Needs Inventory (M-CCFNI) was used to select 200 parents of children with complex CHD after surgery within 72 h after admission to the intensive care unit in our hospital to conduct an online questionnaire survey. The aim was to understand the needs of parents in relation to the following five aspects: The support from medical staff, comfort of the parents themselves, the acquisition of information, their closeness to the children, and assurance of the child’s condition.
RESULTS Parents of children with complex CHD had a higher degree of demand, especially in terms of condition assurance, acquisition of information, and closeness to the children. The age, education level, and residence of the parents were related to the five dimensions of the needs of parents of children with complex CHD who had undergone surgery.
CONCLUSION In practice, nurses should formulate corresponding nursing strategies based on the different cultural and social backgrounds of parents of children after complex CHD surgery to meet their different needs, and improve satisfaction. These findings provide a theoretical basis for constructing a family participatory nursing model for children in the intensive care unit in the future.
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Affiliation(s)
- Ji-Hua Zhu
- Department of Nursing, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, Zhejiang Province, China
| | - Chen-Di Jin
- Department of Nursing, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, Zhejiang Province, China
| | - Xiao-Min Tang
- Department of Nursing, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, Zhejiang Province, China
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Simeone S, Rea T, Platone N, Guillari A, Lanzuise A, Assanta N, Da Valle P, Baratta S, Pucciarelli G. Quality of Life of Families with Children Presenting Congenital Heart Disease:Longitudinal Study Protocol. Healthcare (Basel) 2022; 10:healthcare10071273. [PMID: 35885800 PMCID: PMC9317531 DOI: 10.3390/healthcare10071273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Advances in medicine have caused a notable increase in the survival rates of children born with congenital heart disease, even in the most complicated cases, almost mitigating the disease’s pathology from lethal to chronic. The quality of life perceived by such children is influenced by the perceptions of their parents. However, the international literature has rarely considered the entire family nucleus. AIMS: This study aims to study the temporal trend of quality of life of families with children with congenital heart disease, particularly with respect to parents following a child’s hospitalization for an invasive procedure. DESIGN: A longitudinal study. METHOD: A sample of families (that is, those including a child with congenital heart disease and their parents) will be enrolled following the patient’s discharge from the hospital and examined every 3 months for 1 year. The study’s adopted hypothesis is that there is an interdependence between the subjects of the study that is capable of influencing individual perceptions of quality of life. RESULTS: This study will attempt to identify variables (and their temporal trend) that can be attributed to the family unit and—together with physical and clinical variables—that may influence the quality of life of children with congenital heart disease. CONCLUSION: Examining family quality of life with the longitudinal method will allow us to identify the predictors and interdependence of this factor with respect to children and their parents. This will help to correct and elaborate upon care guidelines, providing better assistance to patients and their caregivers.
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Affiliation(s)
- Silvio Simeone
- Clinical and Experimental Medicine Department, “Magna Graecia” University, 88100 Catanzaro, Italy;
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy;
| | - Nicol Platone
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Assunta Guillari
- Department of Public Health, University Federico II of Naples, 80145 Napoli, Italy
- Correspondence:
| | | | - Nadia Assanta
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Paola Da Valle
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Stefania Baratta
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevenion, University of Rome Tor Vergata, 00133 Rome, Italy;
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Bösch F, Landolt MA, Baumgartner MR, Fernandez S, Forny P, Gautschi M, Grünert SC, Häberle J, Horvath C, Karall D, Lampis D, Rohrbach M, Scholl-Bürgi S, Szinnai G, Huemer M. Caregiver burden, and parents' perception of disease severity determine health-related quality of life in paediatric patients with intoxication-type inborn errors of metabolism. Mol Genet Metab Rep 2022; 31:100876. [PMID: 35762020 PMCID: PMC9233158 DOI: 10.1016/j.ymgmr.2022.100876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background Living with a non-acute (phenylketonuria) or acute (e.g. urea cycle disorders, organic acidurias) intoxication-type inborn error of metabolism (IT-IEM) can have a substantial impact on health-related quality of life (HrQoL) of paediatric patients and their families. Parents take primary responsibility for treatment monitoring and experience worry and fear about their child's health status. Quantitative evidence on parental psychological factors which may influence the HrQoL of patients with IT-IEM are sparse to non-existent. Methods In this multicenter survey study 50 parents of IT-IEM patients (ages 5–19) assessed the severity of their child's disease, reported on caregiver burden, and proxy-rated their child's HrQoL. Additionally, 35 patient self-reports on HrQoL were obtained (n = 16 female patients, n = 19 male patients). Multiple linear regressions were conducted to examine the predictive power of child age, sex, medical diagnosis type (acute / non-acute), parental perceived disease severity and caregiver burden on patients' HrQoL. Mediation analyses were used to investigate the relation of caregiver burden and parental ratings of disease severity with patients' HrQoL. Results Significant regression models for self-reported [F(5,34) = 10.752, p < .001, R2 adj.. = 0.59] and parent proxy reported HrQoL [F(5,49) = 20.513, p < .001, R2 adj.. = 0.67] emerged. High caregiver burden and perceived disease severity predicted significantly lower patient self- and proxy-reported HrQoL while type of diagnosis (acute versus non-acute) did not. Female sex predicted significantly lower self-reported HrQoL. High caregiver burden was the mediating factor between high perceived severity of the child's disease and lower proxy- by parent rated HrQoL. Conclusion Detecting elevated burden of care and providing support for parents seems crucial to prevent adverse consequences for their children's HrQoL. Intervention studies are needed, to assess which support programs are most efficient. Caregiver burden enforced by high parent-perceived disease severity is a considerable risk factor for low HrQoL in paediatric patients with IT-IEM. The parent perspective was a better estimator for the impact of disease than the mere medical type of diagnosis. Female sex predicted lower self-reported HrQoL
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Amodeo G, Ragni B, Calcagni G, Piga S, Giannico S, Yammine ML, Drago F, Ciofi degli Atti ML, Rossi A, De Stasio S, Grimaldi Capitello T. Health-related quality of life in Italian children and adolescents with congenital heart diseases. BMC Cardiovasc Disord 2022; 22:173. [PMID: 35428190 PMCID: PMC9013137 DOI: 10.1186/s12872-022-02611-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Congenital heart disease (CHD) is the most common congenital anomaly at birth, affecting approximately 1% of live births. In recent decades great medical and surgical advances have significantly increased life expectancy, shifting healthcare professionals' and researchers’ interests in patients' Quality of Life (QoL). The main aims of our study were to evaluate generic and condition-specific QoL in a group of Italian children and adolescents with CHD and their parents and examine the level of agreement and directional disagreement between child/adolescent and parents reports on generic and condition-specific QoL.
Methods A cross-sectional study was designed with CHD children and adolescents and their parents referred to the Cardiology Department of “Bambino Gesù” Children’s Hospital. The PedsQL scale was used, including generic (PedsQL 4.0) and cardiac-specific modules (PedsQL 3.0) were administered to patients and caregivers. A Kruskal–Wallis test was used to compare generic and cardiac module scores between patients with different ages, CHD diagnoses, and between patients who underwent surgery interventions and/or are currently taking cardiac medications.
Results 498 families were enrolled in this study. On average, patients reported a good level of generic and condition-specific QoL, as well as their mothers and fathers. Children aged between 5–7 years old reported lower generic and cardiac-specific total QoL levels than children aged 8–12 years and adolescents (13–18 years). With regard to the agreement, patient-parent agreement on condition-specific QoL ranged from 25 to 75% while on generic QoL, it ranged from 19 to 76%. The highest percentage of disagreement between parents and children was found in patients aged 5–7 years old, both for condition-specific and generic QoL rates. Conclusions Our study contributed to the growing body of knowledge on QoL in CHD, emphasizing the need for these families to receive support from multidisciplinary standardized care, including psychological consultations and support. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02611-y.
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Knobbe K, Partha M, Seckeler MD, Klewer S, Hsu CH, Edgin J, Morgan WJ, Provencio-Dean N, Lopez S, Parthasarathy S, Combs D. Association Between Sleep Disturbances With Neurodevelopmental Problems and Decreased Health-Related Quality of Life in Children With Fontan Circulation. J Am Heart Assoc 2021; 10:e021749. [PMID: 34668394 PMCID: PMC8751823 DOI: 10.1161/jaha.121.021749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background Children with Fontan circulation are known to be at increased risk for neurodevelopmental problems and decreased health-related quality of life (HRQOL), but many factors that may contribute to this risk are unknown. Sleep disturbances may be one previously unidentified factor that contributes to this risk. Methods and Results We analyzed data from the Pediatric Heart Network Fontan cross-sectional study to evaluate associations between a parent or child report of sleep disturbance with reported neurodevelopmental concerns and HRQOL in 558 children with Fontan circulation. Parent-reported sleep disturbance was present in 11% of participants and child-reported sleep disturbance was present in 15%. Parent-reported sleep disturbance was associated with a significantly higher risk of attention problems, anxiety, depression, behavioral problems, and developmental delay (P<0.001 for all). Similarly, parent-reported disturbance was associated with decreased HRQOL on both parent and child-reported HRQOL (P<0.001 for most domains). Child-reported sleep disturbances were associated with increased odds of anxiety, depression, and attention problems as well as worse HRQOL. These associations were present even after adjustment for cardiac, demographic, and socioeconomic factors that may affect HRQOL and neurodevelopmental status. Conclusions Sleep disturbances in children with Fontan circulation are associated with an increased risk of neurodevelopmental problems as well as reduced HRQOL compared with those without sleep disturbance. Better understanding of sleep disturbances is needed in children with Fontan circulation, as sleep disturbances may represent a reversible cause of neurodevelopmental problems and decreased HRQOL in this population.
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Affiliation(s)
- Kirstin Knobbe
- UAHS Center for Sleep & Circadian Sciences University of Arizona Tucson AZ
| | - Meghana Partha
- UAHS Center for Sleep & Circadian Sciences University of Arizona Tucson AZ
| | | | - Scott Klewer
- Department of Pediatrics University of Arizona Tucson AZ
| | - Chiu-Hsieh Hsu
- Mel and Enid Zuckerman College of Public Health University of Arizona Tucson AZ
| | - Jamie Edgin
- Department of Psychology University of Arizona Tucson AZ.,Sonoran University Center for Excellence in Developmental DisabilitiesUniversity of Arizona Tucson AZ
| | - Wayne J Morgan
- Department of Pediatrics University of Arizona Tucson AZ
| | | | - Silvia Lopez
- UAHS Center for Sleep & Circadian Sciences University of Arizona Tucson AZ
| | | | - Daniel Combs
- UAHS Center for Sleep & Circadian Sciences University of Arizona Tucson AZ.,Department of Pediatrics University of Arizona Tucson AZ
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Ma J, Gong G, Zhang T, Zhang Y. Influence of transition readiness from paediatric to adult health care on quality of life in child-parent dyads with long-term conditions. J Adv Nurs 2021; 77:2340-2352. [PMID: 33426728 DOI: 10.1111/jan.14758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 11/07/2020] [Accepted: 12/14/2020] [Indexed: 11/27/2022]
Abstract
AIM To delineate the impact of perspective of children's transition readiness from paediatric to adult health care on quality of life in child-parent dyads with long-term conditions. We used Actor-Partner Interdependence Model to identify actor effects (effect of one's own transition readiness on one's own quality of life) and partner effects (effect of one's own transition readiness on the partner's quality of life). DESIGN A multi-centre cross-sectional survey. METHODS The study was conducted in two paediatric hospitals in China from October 2018-August 2019. We used a researcher-designed questionnaire to collect demographic and clinical characteristics. Furthermore, we used four questionnaires assessing transition readiness and quality of life in child and parent respectively to collect data from 370 child-parent dyads. Structural equation modelling was applied to estimate the effect of actor-partner interdependence models. RESULTS The total score of transition readiness had two actor effects on total child and parent quality of life controlling for age (βchildren = 3.335, p = .032 and βparents = 8.952, p < .001), while only one actor effect controlling for gender (βparents = 8.891, p < .001). Specific transition readiness dimensions had different partner effects on different domains of children and parents' quality of life. Moreover, younger children and fathers had a better quality of life. CONCLUSION Our study verified inherently interpersonal relationship that transition readiness appeared to influence quality of life in child-parent dyads with long-term conditions. IMPACT This study was the first to verify mutual influence of transition readiness and quality of life in child-parent dyad using actor-partner interdependence model. Nurses who design the transition promoting programs should consider the effective communication between healthcare provider and child-parent dyads and support parents' involvement to improve shared understanding about managing child's condition, especially for older children and mothers.
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Affiliation(s)
- Jiali Ma
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Geyan Gong
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Taomei Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Ying Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
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13
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Ladak LA, Gallagher R, Hasan BS, Awais K, Abdullah A, Gullick J. Exploring the influence of socio-cultural factors and environmental resources on the health related quality of life of children and adolescents after congenital heart disease surgery: parental perspectives from a low middle income country. J Patient Rep Outcomes 2020; 4:72. [PMID: 32857277 PMCID: PMC7455647 DOI: 10.1186/s41687-020-00239-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health related quality of life (HRQOL) is an important indicator of long-term well-being, influenced by environmental factors such as family, culture, societal norms and available resources. This study aimed to explore parental perspectives on the influence of socio-cultural factors and environmental resources on the HRQOL of children and adolescents after congenital heart disease (CHD) surgery. METHODS Using a descriptive, qualitative design, semi-structured interviews of children/adolescents who had CHD surgery in this low-middle income country (LMIC) were collected between July to December 2017. There were 20 families enrolled, which included 18 parent dyads (mother and father) and two single mothers, making a total of 38 participants. Initial inductive analysis was further refined using the Social Ecological Model as an analytic lens. RESULTS At the intrapersonal level, unrealistic expectations of surgery, residual CHD symptoms and difficulty maintaining educational progress were of great concern. There were low levels of health literacy and understanding about CHD among family and friends, however, strong kinship ties were an important resource at the interpersonal level. These families lived in poverty and mothers often carried the sole burden of care for their sick children. At the institutional level, there were unclear expectations of the child's needs at school, and parents had poor access to psychological, family-planning and genetic counselling, and poor access to CHD education resources. At a sociocultural level, religion and trust in God were important coping factors, however, CHD was a gendered experience with particular concerns around scarring and the marriageability of girls. Parents noted the deficit of antenatal and specialist CHD services and felt the consequence of a lack of a universal health care system at the public policy level. CONCLUSION Socio-ecological factors have the potential to explain the issues and challenges that children living in LMIC experience with CHD after surgery. The study findings will help to inform future interventions to be implemented in countries like Pakistan.
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Affiliation(s)
- Laila A Ladak
- Department of Paediatrics and Child Health, School of Nursing and Midwifery, The Aga Khan University, Karachi, Pakistan. .,Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia.
| | - Robyn Gallagher
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia.,Charles Perkins Centre, Sydney Nursing School Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Babar S Hasan
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Khadija Awais
- Medical College, The Aga Khan University, Karachi, Pakistan
| | - Ahmed Abdullah
- Medical College, The Aga Khan University, Karachi, Pakistan
| | - Janice Gullick
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
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14
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Gaydos LM, Sommerhalter K, Raskind-Hood C, Fapo O, Lui G, Hsu D, Van Zutphen A, Glidewell J, Farr S, Rodriguez FH, Hoffman T, Book W. Health Care Transition Perceptions Among Parents of Adolescents with Congenital Heart Defects in Georgia and New York. Pediatr Cardiol 2020; 41:1220-1230. [PMID: 32500288 PMCID: PMC9109153 DOI: 10.1007/s00246-020-02378-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/22/2020] [Indexed: 11/30/2022]
Abstract
With increasing survival trends for children and adolescents with congenital heart defects (CHD), there is a growing need to focus on transition from pediatric to adult specialty cardiac care. To better understand parental perspectives on the transition process, a survey was distributed to 451 parents of adolescents with CHD who had recent contact with the healthcare system in Georgia (GA) and New York (NY). Among respondents, 90.7% reported excellent, very good or good health-related quality of life (HRQoL) for their adolescent. While the majority of parents (77.8%) had been told by a provider about their adolescent's need to transition to adult specialty cardiac care, most reported concerns about transitioning to adult care. Parents were most commonly concerned with replacing the strong relationship with pediatric providers (60.7%), locating an appropriate adult provider (48.7%), and accessing adult health insurance coverage (43.6%). These findings may offer insights into transition planning for adolescents with CHD.
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Affiliation(s)
- Laura M Gaydos
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | | | | | - Olushola Fapo
- New York State Department of Health, Albany, NY, USA
| | - George Lui
- Division of Cardiovascular Medicine and Pediatric Cardiology, Stanford School of Medicine, Stanford, CA, USA
| | - Daphne Hsu
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Alissa Van Zutphen
- New York State Department of Health, Albany, NY, USA
- University at Albany School of Public Health, Rensselaer, NY, USA
| | - Jill Glidewell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sherry Farr
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Trenton Hoffman
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Wendy Book
- Emory University School of Medicine, Atlanta, GA, USA
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15
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Bektas İ, Kır M, Yıldız K, Genç Z, Bektas M, Ünal N. Symptom Frequency in Children with Congenital Heart Disease and Parental Care Burden in Predicting the Quality of Life of Parents in Turkey. J Pediatr Nurs 2020; 53:e211-e216. [PMID: 32354457 DOI: 10.1016/j.pedn.2020.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE This study was conducted to investigate the symptom frequency and parental care burden of the children with congenital heart disease in predicting the quality of life of parents in Turkey. DESIGN AND METHOD The study subjects for the present study included 124 parents whose children were suffering from heart disease. The data for the study were collected from these parents using parent information form, the questionnaire of the frequency of heart disease-related symptoms of the child, the caregiver burden scale, and the quality of life scale. The level by which the heart disease-related symptoms of the child and caregiver burden predicted the quality of life was analyzed using the regression analysis. RESULTS The most common symptoms in children were found to be anorexia, difficulty in activities, palpitations, shortness of breath, weakness, and fatigue. The number of symptoms observed in children and the care burden of the parents were determined to explain 27.1% of the psychological health sub-dimension, 14.4% of the social relations sub-dimension, and 34.9% of the environment sub-dimension. When the variables were examined separately, the number of symptoms was found to significantly predict only social relations sub-dimensions. CONCLUSION Increased number of symptoms increased parental care burden. Increased number of symptoms and care burden of parents reduced the quality of life of parents. PRACTICE IMPLICATIONS Symptom management is one of the important responsibilities of nurses in improving care burden and quality of life for parents of children with heart disease.
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Affiliation(s)
- İlknur Bektas
- Dokuz Eylul University, Faculty of Nursing, Inciraltı, Izmir, Turkey.
| | - Mustafa Kır
- Department of Pediatric Cardiology, Faculty of Medicine, Dokuz Eylül University, Balcova, Turkey.
| | - Kaan Yıldız
- Department of Pediatric Cardiology, Faculty of Medicine, Dokuz Eylül University, Balcova, Turkey
| | - Zeynep Genç
- Department of Pediatric Cardiology, Faculty of Medicine, Dokuz Eylül University, Balcova, Turkey
| | - Murat Bektas
- Dokuz Eylul University, Faculty of Nursing, Inciraltı, Izmir, Turkey
| | - Nurettin Ünal
- Department of Pediatric Cardiology, Faculty of Medicine, Dokuz Eylül University, Balcova, Turkey.
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16
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Quality of life in children with infrequent congenital heart defects: cohort study with one-year of follow-up. Health Qual Life Outcomes 2020; 18:5. [PMID: 31907046 PMCID: PMC6945590 DOI: 10.1186/s12955-019-1265-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 12/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background The evidence regarding patient related outcomes in children with infrequent congenital heart defects (I-CHD) is very limited. We sought to measure quality of life (QoL) in children with I-CHD, and secondarily, to describe QoL changes after one-year of follow-up, self-reported by children and through their caregivers’ perspective. Methods We assembled a cohort of children diagnosed with an I-CHD in a cardiovascular referral center in Colombia, between August 2016 and September 2018. At baseline and at one-year follow-up, a clinical psychology assessment was performed to establish perception of QoL. The Pediatric Quality of Life Inventory (PedsQL) 4.0 scale was used in both general and cardiac modules for patients and for their caregivers. We used a Mann-Whitney U test to compare scores for general and cardiac modules between patients and caregivers, while a Wilcoxon test was used to compared patients’ and caregivers’ baseline and follow-up scores. Results are presented as median and interquartile range. Results To date, QoL evaluation at one-year follow-up has been achieved in 112/157 patients (71%). Self-reported scores in general and cardiac modules were higher than the QoL perceived through their caregivers, both at baseline and after one-year of follow-up. When compared, there was no statistically significant difference in general module scores at baseline between patients (median = 74.4, IQR = 64.1–80.4) and caregivers scores (median = 68.4, IQR = 59.6–83.7), p = 0.296. On the contrary, there was a statistical difference in baseline scores in the cardiac module between patients (median = 79.6, IQR = 69.7–87.4) and caregivers (median = 73.6, IQR = 62.6–84.3), p = 0.019. At one-year of follow-up, scores for the general module between patients (median = 72.8, IQR = 59.2–85.9) and caregivers (median = 69.9, IQR = 58.1–83.7) were not statistically different (p = 0.332). Finally, a significant difference was found for cardiac module scores between patient (median = 75.0, IQR = 67.1–87.1) and caregivers (median = 73.1, IQR = 59.5–83.8), p = 0.034. Conclusions QoL in children with I-CHD can be compromised. However, children have a better perception of their QoL when compared with their caregivers’ assessments. To provide high-quality care, besides a thorough clinical evaluation, QoL directly elicited by the child should be an essential aspect in the integral management of I-CHD.
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Lee JS, Cinanni N, Di Cristofaro N, Lee S, Dillenburg R, Adamo KB, Mondal T, Barrowman N, Shanmugam G, Timmons BW, Longmuir PW. Parents of Very Young Children with Congenital Heart Defects Report Good Quality of Life for Their Children and Families Regardless of Defect Severity. Pediatr Cardiol 2020; 41:46-53. [PMID: 31701166 DOI: 10.1007/s00246-019-02220-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to investigate parent reports of quality of life for their very young children with congenital heart defects (CHD) and to compare their scores to previously published data. Parents of children 1-3 years old with CHD or innocent heart murmurs completed the Pediatric Quality of Life Inventory (PedsQL) core, cardiac, and family impact modules. Multivariable regression analyses assessed the impact of age, sex, family income, and CHD treatment history (study group) on PedsQL scores. Correlations between family impact and core/cardiac modules were examined. PedsQL scores were compared to healthy norms. 140 parents of young children participated within four study groups: CHD no treatment (n = 44), CHD treatment without bypass (n = 26), CHD treatment with bypass (n = 42) ,and innocent heart murmurs (n = 28). Male sex was associated with higher core (F = 4.16, p = 0.04, σ2 = .03) and cardiac quality of life (F = 4.41, p = .04, σ2 = 0.04). Higher family income was associated with higher family quality of life (F = 8.89, p < .01, σ2 = 0.13). Parents of children with innocent heart murmurs and children with CHD not requiring treatment had higher core quality of life compared to young healthy children. Cardiac-related quality of life scores were associated with family impact (r = 0.68) and core module (r = 0.63) quality of life scores. Parents of very young children with CHD report good quality of life for their children and families. Quality of life exceeds in children with innocent murmurs or CHD not requiring repair. Parents report a lower quality of life among girls, and lower family quality of life is associated with lower family income.
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Affiliation(s)
- J S Lee
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, RI#1-214, Ottawa, ON, K1H 8L1, Canada. .,Faculty of Health Science, University of Ottawa, Ottawa, Canada.
| | - N Cinanni
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, RI#1-214, Ottawa, ON, K1H 8L1, Canada
| | | | - S Lee
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, RI#1-214, Ottawa, ON, K1H 8L1, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - R Dillenburg
- McMaster University, Hamilton, Canada.,McMaster Children's Hospital, Hamilton, Canada
| | - K B Adamo
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, RI#1-214, Ottawa, ON, K1H 8L1, Canada.,Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - T Mondal
- McMaster University, Hamilton, Canada.,McMaster Children's Hospital, Hamilton, Canada
| | - N Barrowman
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, RI#1-214, Ottawa, ON, K1H 8L1, Canada
| | - G Shanmugam
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - B W Timmons
- McMaster University, Hamilton, Canada.,McMaster Children's Hospital, Hamilton, Canada
| | - P W Longmuir
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, RI#1-214, Ottawa, ON, K1H 8L1, Canada.,Faculty of Health Science, University of Ottawa, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
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