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Moka E, Ntova Z, Gavriilaki E, Kotsiou N, Chissan S, Papadopoulou T, Vakalopoulou S. A Retrospective Observational Study of Quality of Life in a Northern Greece Population of People with Haemophilia. Life (Basel) 2024; 14:697. [PMID: 38929680 PMCID: PMC11205034 DOI: 10.3390/life14060697] [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: 04/12/2024] [Revised: 05/15/2024] [Accepted: 05/25/2024] [Indexed: 06/28/2024] Open
Abstract
Haemophilia presents a significant challenge to the quality of life of affected individuals. Evaluating the health-related quality of life (HRQoL) of people with haemophilia (PwH) provides a valuable mean of assessing their perception of overall care outcomes, while also identifying influential factors across various age and condition severity demographics. This observational retrospective study determined the HRQoL of 100 adult PwH in Northern Greece through comprehensive analysis and interpretation of their HRQoL levels, particularly in domains concerning their physical, emotional, and mental well-being, obtained through the Haem-A-QoL index questionnaire. Disease severity and young age were significantly associated with the administration of prophylactic treatment (84.2% of patients with severe haemophilia and 65.2% of patients aged 18-30). The mean Haem-A-QoL score was 40.11 ± 17.38, with the lowest HRQoL observed in the 46-60 age group (46.16), and the highest in the ≥61 age groups (35.16). Notably, the 'Sports/Leisure' and 'Physical Health' domains exhibited the highest scores, in contrast to 'Family Planning' and 'Relationships/Sexuality'. Individuals with mild haemophilia recorded the lowest mean score (39.38), while those with a severe condition exhibited the highest (41.23). Age, disease severity, and physical activity emerged as primary determinants significantly affecting HRQoL outcomes.
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Affiliation(s)
| | | | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, 54642 Thessaloniki, Greece; (E.M.); (Z.N.); (N.K.); (S.C.); (T.P.); (S.V.)
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Iyar S, Gebremariam GT, Beyene DA, Gebremedhin A, Tadesse TA. Health-related quality of life and its associated factors among hemophilia patients: experience from Ethiopian Hemophilia Treatment Centre. J Pharm Health Care Sci 2024; 10:3. [PMID: 38167221 PMCID: PMC10762823 DOI: 10.1186/s40780-023-00326-6] [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: 09/08/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Hemophilia is a rare genetic condition that is often overlooked and underdiagnosed, particularly in low-income countries. Long-term spontaneous joint bleeding and soft tissues can have a significant negative impact on a patient's health-related quality of life (HRQoL). The objective of this study was to assess HRQoL and its associated factors in Ethiopian patients with hemophilia. METHODS A cross-sectional survey was conducted among patients with hemophilia at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Patients were recruited consecutively during follow-up visits. The European Quality of Life Group's 5-Domain Questionnaires at five levels (EQ-5D-5L) and Euro Quality of Life Group's Visual Analog Scale (EQ-VAS) instruments were used to assess HRQoL. The EQ-5D-5L utility score was computed using the disutility coefficients. We applied the Krukal-Wallis and Mann-Whitney U tests to determine the differences in EQ-5D-5L and EQ-VAS utility scores between patient groups. A multivariate Tobit regression model was used to identify factors associated with HRQoL. Statistical analyses were performed using STATA version 14 and statistical significance was determined at p < 0.05. RESULTS A total of 105 patients with hemophilia participated in the study, with a mean (standard deviation (SD) age of 21.09 (± 7.37] years. The median (IQR) EQ-5D-5L utility and EQ-VAS scores were 0.86 (0.59-0.91) and 75 (60.0-80.0), respectively. Age was significantly negatively associated with the EQ-5D-5L utility index and EQ-VAS (β = -0.020, 95 CI = -0.034, -0.007) and β = -0.974, 95% CI = -1.72, 0.225), respectively. The duration since hemophilia diagnosis (β-0.011, 95% CI, 0.001-0.023) and living out of Addis Ababa (β = -0.128, 95% CI, -0.248-, -0.007) were also significantly negatively associated with the EQ-5D-5L utility index.. CONCLUSION The median EQ-5D-5L utility and EQ-VAS scores of patients with hemophilia were 0.86 (0.59-0.91) and 75 (60.0-80.0), respectively. Older age, living far from the Hemophilia Treatment Center (HTC), and longer duration since diagnosis were significantly negatively associated with HRQoL. HRQoL may be improved by providing factor concentrates, decentralizing HTCs in different parts of the country, increasing awareness of bleeding disorders among health professionals, and providing psychosocial support to affected patients.
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Affiliation(s)
- Sitina Iyar
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girma Tekle Gebremariam
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dessale Abate Beyene
- Department of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Amha Gebremedhin
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa, University, Addis Ababa, Ethiopia
| | - Tamrat Assefa Tadesse
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
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Koseoglu FD, Zuhal D, Onen-Sertoz O, Fahri S. Depression and anxiety in patients with hemophilia A and B. Int J Psychiatry Med 2024; 59:20-33. [PMID: 37565475 DOI: 10.1177/00912174231196343] [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: 08/12/2023]
Abstract
OBJECTIVE This study described the prevalence of and correlates of depression and anxiety in adult patients with hemophilia A and B. METHODS In this cross-sectional study, we investigated patients with hemophilia who were being seen at an adult hemophilia center in Turkey. Participants were screened for depression and anxiety during their annual clinic visit, which included administration of the Beck Depression Inventory and State-Trait Anxiety Scale. RESULTS Of the 90 patients, 22 (24.4%) met criteria for significant depressive symptoms and 67 (74.4%) met criteria for significant anxiety symptoms. There were no significant associations between depression and any psychosocial or clinical characteristics or adherence to hemophilia prophylaxis, except for educational status. No association was found between state and trait anxiety scores and psychosocial and clinical characteristics other than hemophilia type. After adjusting for confounding factors, multivariable analysis showed that high school education level was associated with depression (OR: 1.87, CI: 1.31-2.36, P = .010) and type B hemophilia was associated with anxiety (OR: 1.32, CI: 1.09-1.75, P = .042). CONCLUSION Depression and anxiety are major psychiatric comorbidities in patients with hemophilia in Turkey. Routine evaluation for mood and anxiety disorders are important in the routine care of patients with haemophilia.
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Affiliation(s)
- Fatos D Koseoglu
- Department of Hematology, Faculty of Medicine, İzmir Bakırçay University, Izmir, Turkey
| | - Demirci Zuhal
- Department of Hematology, Adult Hemophilia Center, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ozen Onen-Sertoz
- Department of Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sahin Fahri
- Department of Hematology, Adult Hemophilia Center, Faculty of Medicine, Ege University, Izmir, Turkey
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Soares BMD, Imoto AM, Ribeiro AJT, Simeoni LA, de Almeida KJQ, Bezerra LB, Braverman MS, Fernandes SES, Costa AM, Amorim FF. Evaluation of Functional and Joint Health and Associated Factors in Adults With Hemophilia From a Developing Country With Government-Backed Efforts to Improve Hemophilia Care. Perm J 2023; 27:68-78. [PMID: 37417806 PMCID: PMC10502392 DOI: 10.7812/tpp/23.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Introduction Hemophilic arthropathy affects people with hemophilia (PwH) and causes joint dysfunction and disability. Brazil has a unique situation and implemented policies to improve health care for PwH. The aim of this study was to evaluate the Functional Independence Score in Hemophilia (FISH), Hemophilia Joint Health Score (HJHS), and associated factors among adult PwH attending a Hemophilia Comprehensive Care Center in Brazil. Methods A post hoc analysis was conducted, including 31 patients who had submitted to a physical evaluation during a previously published cross-sectional study performed from June 2015 to May 2016 at the Brasília Blood Center Foundation, Brazil. Results The mean age was 30.8±9.4 years, and 80.6% had severe hemophilia. FISH was 27.0±3.8, and HJHS 18.0±10.8. The ankle was the most often affected joint (25/31, 80.6%). There were significant correlations between FISH and HJHS scores and the Hemophilia Quality of Life Questionnaire for Adults. Patients with severe hemophilia (P = 0.029) and PwH aged ≥ 30 years (P = 0.049) had lower FISH scores. Monthly household income > 2 Brazilian minimum wages was independently associated with improved HJHS (P = 0.033). The factors simultaneously associated with better HJHS and FISH were age < 30 years (P = 0.021) and monthly household income < 2 minimum wages (P = 0.013). Conclusion FISH and HJHS showed favorable scores despite being performed in a country with unfavorable socioeconomic conditions. In addition to hemophilia severity and age, monthly household income was independently associated with functional and articular state of PwH. The results highlight the importance of the free provision of coagulation factors in Brazil.
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Affiliation(s)
- Beatriz Mac Dowell Soares
- School of Medicine, Higher Education School of Health Sciences, Brasília, Federal District, Brazil
- Graduate Program in Health Sciences, University of Brasilia, Brasília, Federal District, Brazil
| | - Aline Mizusaki Imoto
- School of Medicine, Higher Education School of Health Sciences, Brasília, Federal District, Brazil
- Brasília Hemocentro Foundation, Federal District, Brazil
| | - Alexandre Jorge Teixeira Ribeiro
- School of Medicine, Higher Education School of Health Sciences, Brasília, Federal District, Brazil
- Brasília Hemocentro Foundation, Federal District, Brazil
| | - Luiz Alberto Simeoni
- Graduate Program in Health Sciences, University of Brasilia, Brasília, Federal District, Brazil
| | | | - Lucas Barbosa Bezerra
- School of Medicine, Higher Education School of Health Sciences, Brasília, Federal District, Brazil
| | | | | | - Ana Maria Costa
- School of Medicine, Higher Education School of Health Sciences, Brasília, Federal District, Brazil
| | - Fábio Ferreira Amorim
- School of Medicine, Higher Education School of Health Sciences, Brasília, Federal District, Brazil
- Graduate Program in Health Sciences, University of Brasilia, Brasília, Federal District, Brazil
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Liang H, Zheng J, Sun Y. Prevalence and predictive risk factors of self-stigmatization in patients with rare diseases: Based on health ecology model. Int J Soc Psychiatry 2023; 69:1541-1545. [PMID: 37092767 DOI: 10.1177/00207640231168023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND AND AIMS Given the cause of self-stigmatization of patients with rare diseases is complicated, and the self-stigmatization can be prevented by managing the related risk factors. This study aimed to report the prevalence as well as influencing factors associated with self-stigmatization in patients with rare diseases. METHODS From January to April 2022, the respondent-driven sampling (RDS) method was used to select patients with rare diseases through the Chinese Organization for Rare Disorders as the subjects. Based on the theoretical model of health ecology, logistic regression analysis was used to explore the association between self-stigmatization level and sample characteristics of patients with rare diseases. RESULTS A total of 530 patients were included, 50.2% of whom were male, and most of them are under 45 years old (86.5%). The prevalence of self-stigmatization in patients with rare diseases was 85.7%. Logistic regression analysis indicated that age (OR: 0.624, 95% CI: [0.399, 0.976]), mental health status (OR: 0.184, 95% CI: [0.076, 0.445]), family relations (OR: 0.180, 95% CI: [0.074, 0.434]), full time work (OR: 2.835, 95% CI: [1.024, 7.849]) and medical insurance (OR: 0.296, 95% CI: [0.105, 0.835]) were risk factors for self-stigmatization of patients with rare diseases. CONCLUSIONS Chinese patients with rare diseases have a high level of self-stigmatization, and the potential risk factors are multi-level and multi-dimensional.
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Affiliation(s)
- Haixu Liang
- School of Public Health, Xiamen University, China
| | - Jiaqi Zheng
- School of Public Health, Shenyang Medical College, China
| | - Yongkang Sun
- Traditional Chinese Medicine Department, Baodi Clinical College of Medical University of Tianjin, China
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Haghpanah S, Naderi M, Kamalian S, Tavoosi H, Parand S, Javanmardi N, Karimi M. The impact of inhibitors on the quality of life in patients with hemophilia. SAGE Open Med 2023; 11:20503121231182284. [PMID: 37456083 PMCID: PMC10338721 DOI: 10.1177/20503121231182284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To investigate the association of health-related quality of life in hemophilia patients with inhibitor and clinical and demographic characteristics. Methods In this multi-center cross-sectional study, 41 male patients with hemophilia A were investigated from May to October 2021. All patients were registered at the Hemophilia Clinic affiliated with Shiraz and Zahedan Universities of Medical Sciences in Iran. Health-related quality of life of the patients was evaluated by the Short Form-36 questionnaire. Results The patients' mean ± SD of age was 36.9 ± 13.2 (range: 18-76) years. Eleven patients (26.8%) were inhibitor positive. In univariate analysis, physical function, mental health dimension, and total Short Form-36 scores were significantly lower in the inhibitor-positive patients (p < 0.001, p = 0.045, and p = 0.035, respectively). Moreover, patients with severe disease showed significantly lower scores in physical function (p < 0.001), physical health dimension (p = 0.018), and total Short Form-36 (p = 0.031) than those with mild and moderate hemophilia. Also, blood-borne infections showed a significant association with lower score in physical health dimension (p = 0.038). In addition, annual bleeding rate showed significant negative correlations with physical health dimension (rs = -0.609, p < 0.001), mental health dimension (r = -0.317, p = 0.044), and total Short Form-36 (r = -0.455, p = 0.003) scores. In multiple linear regression analysis, disease severity revealed a significant negative relationship with scores in physical function (p = 0.001), role physical (RP) (p = 0.015), general health (GH) (p = 0.006), physical health dimension (p = 0.006), and marginally in total Short Form-36 score (p = 0.054). Also, age of the patients showed a significant negative association with physical function and GH scores (p < 0.001 and p = 0.015, respectively). Conclusion Disease severity and age were shown as independent factors affecting health-related quality of life, but inhibitor alone was not an independent influencing factor. Reduced health-related quality of life was also observed in hemophilia patients with higher annual bleeding rate and blood-borne infections. Therefore, it is necessary to pay more attention to these subgroups. Further studies with larger sample size are needed for more accurate results.
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Affiliation(s)
- Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Naderi
- Department of Pediatrics, School of medicine, Genetics of Non-Communicable Disease Research Center, Ali Ibne Abitaleb Hospital Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sepideh Kamalian
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hakimeh Tavoosi
- Shiraz Hemophilia Comprehensive Center, Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shirin Parand
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Javanmardi
- Student Research committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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von Mackensen S, Santaella ME, Nichols CD, Khair K, Lambing AY, Witkop ML. Cross-cultural assessment of the influence of the COVID-19 pandemic on the perceived mental health and medical experiences of persons with inherited bleeding disorders and their parents/guardians. Expert Rev Hematol 2023; 16:1107-1123. [PMID: 38099480 DOI: 10.1080/17474086.2023.2277323] [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: 04/30/2023] [Accepted: 10/19/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Objectives were to 1) assess COVID-19-associated medical and psychological challenges facing persons with inherited bleeding disorders (PIBD) and their parents/guardians (PG) in Germany, the US, and the UK; 2) describe similarities and differences among these countries; 3) identify needs and opportunities for intervention by patient advocacy organizations (PAGs). RESEARCH DESIGN & METHODS A cross-sectional, international survey was conducted in three countries using validated psychometric instruments and investigator-developed items. RESULTS Five hundred and four surveys were included. Significant differences between countries were found including experiences with medical care, specific thoughts, and concerns about COVID-19, anxiety, and other mental health measures, as well as resources used to cope with stress. Age, education, income, race, IBD diagnosis, PIBD vs. BD group, and gender had moderating effects on resources used. Communication with friends/relatives and use of PAG and HTCs as resources for information/coping decreased in all countries during the pandemic. CONCLUSIONS There were similarities and differences between respondents across the country in the perceived impact of the pandemic, mental health scores, and strategies used to cope with stress. Recommendations: strategies to increase PAG access for PIBD and their PG during pandemics and natural disasters, ongoing assessment and adaptation to provide supportive resources to specific patient subgroups.
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Affiliation(s)
- Sylvia von Mackensen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Cynthia D Nichols
- Munson Medical Center, Quality & Safety Department, Traverse City, MI and National Bleeding Disorders Foundation, consultant to the Research Department, New York, NY, USA
| | | | | | - Michelle L Witkop
- National Bleeding Disorders Foundation at time of research, consultant at time of publication, Traverse City, MI, USA
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Asad F, Jahangarad S, Dorgalaleh A. Psychological complications among patients with congenital bleeding disorders. Blood Coagul Fibrinolysis 2023; 34:138-143. [PMID: 36719804 DOI: 10.1097/mbc.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Congenital bleeding disorders (CBDs), including inherited platelet function disorders and rare and common bleeding disorders, are a heterogeneous group of bleeding disorders with a wide range of clinical presentations, including psychological complications. Due to the chronic nature of CBDs, psychological complications are relatively common in these patients, which can affect treatment adherence, quality of life, and even the frequency of bleeding episodes. Chronic pain causes many psychological problems in CBDs, disrupting their social interactions, affecting all aspects of their lives, including their emotional functioning and behavior, and eventually leading to social exclusion. About one-third of patients with severe hemophilia A suffer from anxiety, 64% from depression, and 60% from other minor psychological complications such as withdrawal/depression, anxiety/depression, attention problems, and emotional problems. Anxiety, depression, and uncontrolled pain interfere with treatment adherence. For this reason, psychological interventions are needed in people with CBDs. Psychological interventions increase quality of life and treatment adherence. Therefore, early recognition of psychological complications in CBD patients may increase treatment adherence, leading to a reduction in bleeding episodes and thus an improvement in quality of life.
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Affiliation(s)
- Fatemeh Asad
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Sara Jahangarad
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Akbar Dorgalaleh
- Hematology and Blood Transfusion, Hamin Tis Research Institute, Tehran, Iran
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Okwuosa LN, Onu DU, Onyedibe MCC. Perceived stress and health-related quality of life in cancer patients: the mediating role of religious coping. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04510-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Feng C, Geng BF, Liu SG, Jiang ZL, Lin F. Activity and participation in haemophiliacs: Item response modelling based on international classification of functioning, disability and health. Haemophilia 2023; 29:308-316. [PMID: 36424822 DOI: 10.1111/hae.14702] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES There is scant research investigating the user-friendly functional assessment tool conceptualized by the International Classification of Functioning, Disability and Health (ICF) among persons with haemophilia (PWH). This study aims to accomplish two goals: (1) quantifying comprehensive functioning measures of haemophilia through Item Response Theory (IRT); (2) discussing patient-centred care based on the Wright map of personal ability and item difficulty. METHODS A cross-sectional study was carried out in 70 PWH (mean age, 33.09 ± 11.04) via convenience sampling. All patients completed the 45 ICF categories of haemophilic-specific activity and participation. Psychometric properties of the categories were examined using Mokken scale analysis and parametric item response modelling. RESULTS We extracted a unidimensional scale with 31 categories, and constructed a Rasch model with good fitness. The Cronbach's α of the scale was .9713, with the Guttman's λ2 = .9730, Molenaar Sijtsma ρ = .9802, and latent class reliability coefficient = .9769, indicating great internal reliability. The estimated individual social competence by the Rasch model was highly related to the index score of the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L) (p < .001, r = .62), and had a moderate correlation (p < .001, r = .54) with the score of Haemophilia Activities List (HAL). CONCLUSIONS The ICF scale of haemophilic activity and participation with 31 categories (HAPPY-ICF) has good construct validity and internal consistency. The person-item threshold distribution map might be helpful in research and clinical practices for patient-oriented care.
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Affiliation(s)
- Chun Feng
- The Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Rehabilitation Hospital Affiliated to Tongji University, Shanghai, China
| | - Bao-Feng Geng
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shou-Guo Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhong-Li Jiang
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Parviniannasab AM, Rakhshan M, Momennasab M, Soltanian M, Rambod M, Akbarzadeh M. The mediating role of Courageous coping in the relations between spirituality and social support with resilience among adolescents with hemophilia. Clin Child Psychol Psychiatry 2022; 27:1141-1154. [PMID: 35037784 DOI: 10.1177/13591045211055081] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In addition to physical disorders, people with hemophilia face complex psychological problems. Hence, protective factors such as coping strategies, social support, and spirituality to improve psychological health should be determined. This study examined the role of courageous coping as a mediator in the interrelationships between spirituality as well as social support and resilience among adolescents with hemophilia. In this descriptive-analytical study, the participants were 372 adolescents with hemophilia aged 11-21 years. Connor-Davidson resilience scale, Jalowiec Coping scale, Perceived Social Support Scale, and spirituality scale were the instruments used in this study. The analysis results of Pearson correlation revealed a significant positive relationship between spirituality as well as social support and resilience. Also, it was determined that courageous coping is a thorough mediator between spirituality and resilience. The mediating role of courageous coping did not reach meaningful levels between social support and resilience, meaning that zero was included in bootstrap interval, CI 95% (β =.026, CI [-.002, .089]). Social support, adopting a spiritual strategy, and using coping strategies played a crucial role among the adolescents to promote their level of resilience to cope with hemophilia.
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Affiliation(s)
| | - Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Associate Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Soltanian
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Akbarzadeh
- PhD of Biostatistics, Assistant Professor, Researcher in Statistical Genetics, Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Soares BMD, Imoto AM, Simeoni LA, de Almeida KJQ, Braverman MS, Bezerra LB, de Souza JL, Ribeiro AJT, Costa AM, Amorim FF. Health‐related quality of life and associated factors: Results from the haemophilia QOL questionnaire for adults (Haem‐A‐QOL) in a low‐income country with public policies to improve haemophilia care. Haemophilia 2022; 28:e125-e128. [DOI: 10.1111/hae.14618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/09/2022] [Accepted: 06/18/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Beatriz Mac Dowell Soares
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
- Brasília Hemocentro Foundation Brasília Federal District Brazil
| | - Aline Mizusaki Imoto
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
- Brasília Hemocentro Foundation Brasília Federal District Brazil
| | - Luiz Alberto Simeoni
- Graduate Program in Health Sciences University of Brasilia (UnB) Brasília Federal District Brazil
| | | | | | - Lucas Barbosa Bezerra
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
| | - Jaqueline Lima de Souza
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
| | - Alexandre Jorge Teixeira Ribeiro
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
- Brasília Hemocentro Foundation Brasília Federal District Brazil
| | - Ana Maria Costa
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
| | - Fábio Ferreira Amorim
- Graduate Program in Health Sciences Higher Education School of Health Sciences (ESCS) Brasília Federal District Brazil
- Graduate Program in Health Sciences University of Brasilia (UnB) Brasília Federal District Brazil
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Pain in Hemophilia: Unexplored Role of Oxidative Stress. Antioxidants (Basel) 2022; 11:antiox11061113. [PMID: 35740010 PMCID: PMC9220316 DOI: 10.3390/antiox11061113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 02/04/2023] Open
Abstract
Hemophilia is the most common X-linked bleeding diathesis caused by the genetic deficiency of coagulation factors VIII or IX. Despite treatment advances and improvements in clinical management to prevent bleeding, management of acute and chronic pain remains to be established. Repeated bleeding of the joints leads to arthropathy, causing pain in hemophilia. However, mechanisms underlying the pathogenesis of pain in hemophilia remain underexamined. Herein, we describe the novel perspectives on the role for oxidative stress in the periphery and the central nervous system that may contribute to pain in hemophilia. Specifically, we cross examine preclinical and clinical studies that address the contribution of oxidative stress in hemophilia and related diseases that affect synovial tissue to induce acute and potentially chronic pain. This understanding would help provide potential treatable targets using antioxidants to ameliorate pain in hemophilia.
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Elsakka EE, Azouz HG, Hassab HA, Abdelfattah ME, Abdel Ghany HM. Screening of behavioral disorders in children with hemophilia. Int J Rheum Dis 2022; 25:803-810. [DOI: 10.1111/1756-185x.14352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/25/2022] [Accepted: 05/08/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Elham E. Elsakka
- Pediatrics Department, Faculty of Medicine Alexandria University Alexandria Egypt
| | - Hanan G. Azouz
- Pediatrics Department, Faculty of Medicine Alexandria University Alexandria Egypt
| | - Hoda A. Hassab
- Pediatrics Department, Faculty of Medicine Alexandria University Alexandria Egypt
| | | | - Hayam M. Abdel Ghany
- Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine Alexandria University Alexandria Egypt
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Liu M, Zhao S, Zhu X, Chen Y. Research on the Impact of Home Nursing Based on Intelligent Medical Internet of Things on the Quality of Life of Patients with Hemophilia. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4976303. [PMID: 35572828 PMCID: PMC9095391 DOI: 10.1155/2022/4976303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/27/2022] [Accepted: 04/02/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this paper is to study the feasibility and economic benefits of intelligent medical Internet of Things (IOT) systems for improving the quality of life of hemophilia patients, thereby reducing the risk of teratogenicity and disability for patients. This article selects 60 severe hemophilia patients who were followed up in our hospital from 2018 to 2019 as the research object. In the intelligent medical system, the Gaussian mixture model discretization algorithm is used to preprocess patient data collection. The observation group uses the intelligent medical system to implement home nursing for the patients, and the control group uses ordinary home nursing. This paper evaluates the quality of life of the two groups of patients 6 months after the intervention, including self-care ability, transfer function, and home nursing cognitive ability. The research results show that the home nursing based on smart medical IOT proposed in this paper is feasible and effective for improving the quality of life of patients. It can effectively improve the patient's self-care ability and joint functions and has important reference value for the development of intelligent medical IOT equipment.
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Affiliation(s)
- Mengyan Liu
- Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Sufang Zhao
- Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Xiaming Zhu
- Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Ying Chen
- Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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Deniz V, Guzel NA, Lobet S, Antmen AB, Sasmaz HI, Kilci A, Boyraz OC, Gunaştı O, Kurdak SS. Effects of a supervised therapeutic exercise program on musculoskeletal health and gait in patients with haemophilia: A pilot study. Haemophilia 2021; 28:166-175. [PMID: 34687122 DOI: 10.1111/hae.14444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Episodes of bleeding in patients with haemophilia (PwH) are associated with haemophilic arthropathy, limitations in physical performance, reduced quality of life (QoL), and gait disorders. AIM This non-randomized, controlled, interventional, prospective, single-centre pilot study aimed to assess the effects of an 8-week supervised therapeutic exercise program on musculoskeletal health, gait kinematic parameters (GKP), functional capacity, and QoL in adult PwH. METHODS Nineteen PwH were allocated to an exercise group (n = 10) or a control group (n = 9). The patients in the exercise group followed an 8-week supervised therapeutic exercise program. The Haemophilia Joint Health Score (HJHS), a two-dimensional video-based gait kinematic analysis (2D-GKA), the 6-min walking test (6MWT), and the Haemophilia Quality of Life Questionnaire for Adults (Haem-A-Qol) were used as the outcome measures at baseline, after the exercise program (at the 8th week), and at the 6th-month follow-up. RESULTS A significant improvement was observed in the exercise group in the HJHS-Total and Haem-A-Qol Total scores and the 6MWT value after the exercise program. Moreover, the 2D-GKA revealed improvement in most of the GKP (knee extension during the midstance and late swing phases, ankle dorsiflexion during the midstance phase, and ankle plantar flexion during the preswing phase). However, the gain obtained by the exercise program was not maintained at the 6th-month follow-up for the HJHS-Total and Hem-A-QoL-Total scores and GKP. CONCLUSION The 8-week supervised therapeutic exercise program was successful in achieving improvement in joint health, GKP, functional capacity, and QoL in PwH.
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Affiliation(s)
- Volkan Deniz
- Department of Physiotherapy and Rehabilitation, Gazi University Faculty of Health Sciences, Ankara, Turkey
| | - Nevin Atalay Guzel
- Department of Physiotherapy and Rehabilitation, Gazi University Faculty of Health Sciences, Ankara, Turkey
| | - Sébastien Lobet
- Service d'hématologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.,Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal Lab (NMSK), Brussels, Belgium.,Cliniques universitaires Saint-Luc, Secteur de kinésithérapie, Brussels, Belgium
| | - Ali Bülent Antmen
- Department of Pediatric Hematology and Oncology, Acıbadem Hospital, Adana, Turkey
| | - Hatice Ilgen Sasmaz
- Department of Pediatric Hematology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Abdullah Kilci
- Faculty of Sport Sciences, Çukurova University, Adana, Turkey
| | | | - Ozgür Gunaştı
- Division of Sport Physiology, Department of Physiology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Sanli Sadi Kurdak
- Division of Sport Physiology, Department of Physiology, Faculty of Medicine, Çukurova University, Adana, Turkey
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Witkop M, Santaella M, Nichols CD, Lambing AY, Baumann K, Curtis RG, Humphrey C, Humphries TJ, Newman J, Fritz R, Mauer K, Thibodeaux CB, Wheat E, Buckner T. Understanding the Pain Management Landscape within the US Bleeding Disorder Community: A Multi-Center Survey. PAIN MEDICINE 2021; 23:269-279. [PMID: 34185087 PMCID: PMC8807078 DOI: 10.1093/pm/pnab196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives Pain is a known complication in persons with hemophilia (PWH) as a result of muscle and joint bleeding. Little is known regarding national Hemophilia Treatment Center (HTC) practice patterns related to pain management. The aim of this study was to: 1) Describe pain management practice patterns of HTC providers, 2) Identify gaps and areas of alignment with the CDC pain guidelines, and 3) Address educational opportunities for pain management. This survey is the first extensive description of multidisciplinary practice patterns of pain management for PWH. Methods This descriptive study involved physicians, nurse practitioners, nurses, physical therapists, and social workers from federally funded Hemophilia Treatment Centers (HTC) eligible to complete an online survey exploring pain management practice patterns within the CDC pain guidelines. Results Results of this survey shed light on areas of strength and cohesiveness between HTC providers, including the following: dedication to effective pain management, utilization of non-pharmacological pain options, trial of non-opioid medications first before opioids, maintaining follow-up with patients after opioid prescription initiation, recognizing and utilizing clinically important findings before prescribing opioids, and counseling their patients regarding potential risk factors. Conclusions There remain opportunities to incorporate into clinical practice consistent use of tools such as formal screening questionnaires, opioid use agreements, written measurable goals, ongoing prescription monitoring, and written plans for discontinuation of opioid therapy. These results provide opportunities for improvement in education of HTC team members thus optimizing pain management in persons with bleeding disorders.
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Affiliation(s)
| | | | | | | | - Kimberly Baumann
- University of Minnesota Health-Center for Bleeding and Clotting Disorders
| | | | | | | | | | | | | | | | - Emily Wheat
- University of Colorado Anshultz Medical Campus
| | - Tyler Buckner
- University of Colorado School of Medicine, Hemophilia and Thrombosis Center
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Xu RH, Dong D, Luo N, Wong ELY, Wu Y, Yu S, Yang R, Liu J, Yuan H, Zhang S. Evaluating the psychometric properties of the EQ-5D-5L and SF-6D among patients with haemophilia. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:547-557. [PMID: 33761029 DOI: 10.1007/s10198-021-01273-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the psychometric properties of the EQ-5D-5L and SF-6D, and to compare their performance among patients living with haemophilia in China. METHODS A total of 875 Chinese patients completed the EQ-5D-5L, SF-6D, and Haem-A-QoL questionnaires. Construct validity of the EQ-5D-5L and SF-6D dimensions and indices was assessed by testing hypotheses relating these measures to Haem-A-QoL and clinical measures. The Spearman correlation coefficient was used to assess convergent validity, and one-way analysis of variance (F statistic) was used to assess the known-groups validity (discriminatory power). The agreement between EQ-5D-5L and SF-6D indices was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. RESULTS Both the EQ-5D-5L and SF-6D indices showed acceptable ceiling and floor effects. As hypothesised, both EQ-5D-5L and SF-6D were significantly correlated with Haem-A-QoL (both dimensions and overall score). EQ-5D-5L and SF-6D indices as well as EQ-VAS differentiated patients are known to differ in severity of haemophilia, bleeding status, disabling levels, and comorbidity. The F statistics in the known-groups comparisons suggested that the EQ-5D-5L was slightly more discriminative than the SF-6D. ICC (0.41) and Bland-Altman plot confirmed that the agreement between the EQ-5D-5L and SF-6D indices was poor. CONCLUSION Both EQ-5D-5L and SF-6D showed satisfactory construct validity in the measurement of the HRQoL among patients with haemophilia. However, the two instruments may not be used interchangeably in this patient population due to their poor agreement and differing discriminatory power.
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Affiliation(s)
- Richard Huan Xu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yushan Wu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Siyue Yu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Renchi Yang
- Thrombosis and Hemostasis Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Junshuai Liu
- Beijing Society of Rare Disease Clinical Care and Accessibility, Beijing, China
| | - Huiqin Yuan
- Beijing Society of Rare Disease Clinical Care and Accessibility, Beijing, China
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Arbab Siyar N, Amiri Majd M, Baghdassarians A. The effectiveness of cognitive-behavioural therapy on emotional regulation and quality of life in children with Haemophilia. Haemophilia 2021; 27:599-605. [PMID: 33993585 DOI: 10.1111/hae.14155] [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: 02/10/2020] [Revised: 08/07/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
AND BACKGROUND DATA Haemophilia has known as an inherited bleeding disorder accompanied by remarkable pain, emotional distress, and impaired quality of life (QoL) and emotional regulation. Psychological interventions, such as cognitive-behavioural therapy (CBT), have cost-effectiveness to promote emotional well-being, QoL and emotional regulation; however, they have been scarcely used in the treatment of haemophilia. OBJECTIVES OF THE STUDY This research aimed at examining the effect of CBT on emotional regulation and QoL in children with haemophilia using quasi-experimental research with pretest and post-test design and a control group. METHOD 30 subjects were selected using convenient sampling and divided into two groups (n = 15). Both groups responded to the QoL questionnaire, the Persian version of the Pediatric Quality of Life Inventory (PedsQL) developed and the Cognitive Emotion Regulation Questionnaire (CERQ-k) in the pretest. The experimental group was then subjected to the CBT intervention through 9 sessions. The analysis of covariance was used for data analysis. RESULTS There was a significant increase in the QoL and emotion regulation in the experimental group than the control group. CONCLUSION The CBT training was effective to stop negative thinking and control their anger at school and also to adopt more appropriate strategies to deal efficaciously with concerns in social situations. Awareness about the thoughts, feelings and behaviours and being able to solve problems enables children to have better social relations and friendships with peers and also in other social situations. It also can increase the QoL and emotion regulation.
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Affiliation(s)
- Nikoo Arbab Siyar
- Department of General Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mojtaba Amiri Majd
- Department of Psychology, Faculty of Humanities Abhar Branch, Islamic Azad University, Abhar, Iran
| | - Anita Baghdassarians
- Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
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Parviniannasab AM, Rakhshan M, Momennasab M, Soltanian M, Rambod M, Akbarzadeh M. Haemophiliac adolescents' perspectives of resilience: A qualitative study based on the resilience in illness model. Clin Child Psychol Psychiatry 2020; 25:346-358. [PMID: 31814433 DOI: 10.1177/1359104519890905] [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] [Indexed: 12/18/2022]
Abstract
A qualitative study was conducted to investigate the concept of resilience among Iranian haemophilic adolescents based on the Haase's Resilience in Illness Model (RIM). Purposive sampling was used to recruit 15 participants comprising haemophilic adolescents and their parents in the study. The data were collected through in-depth semi-structured interviews and analysed using direct content analysis. The themes and categories were defensive coping (emotive coping, evasive coping), courageous coping (optimism, constructive approach, seeking support), derived meaning (spiritual strategy, hope) and social support (support from family, friends and treatment teams). Social support, adopting a spiritual strategy and self-management behaviours played an important role among the adolescents in improving their level of resilience and skills to cope with haemophilia.
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Affiliation(s)
- Ali Mohammad Parviniannasab
- PhD candidate in Nursing, Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Community-based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Soltanian
- Community-based Psychiatric Care Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community-based Psychiatric Care Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Assessment of Self-Image With the Offer Self-Image Questionnaire in Adolescents With Hemophilia: A Single-Center Experience. J Pediatr Hematol Oncol 2020; 42:e159-e163. [PMID: 31725545 DOI: 10.1097/mph.0000000000001664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hemophilia, which is a chronic illness associated with recurrent bleeding, may occur with psychosocial and behavioral problems. AIM The aim of this study was to evaluate the clinical characteristics and demographic features and changes in the self-image of adolescents with hemophilia. MATERIALS AND METHODS Data about hemophilia type, the severity of hemophilia, secondary prophylaxis received, and annual bleeding rate (ABR) were recorded from patient files. Hemophilia Joint Health Score (HJHS) and the Offer Self-Image Questionnaire (OSIQ) (as a measure of self-esteem) were applied to hemophilia patients and a healthy control group. RESULTS Thirty-two hemophilia patients (mean age=16.2±3.06 y) and 35 healthy male individuals (mean age=16.02±1.4 y) were enrolled in the study. Hemophilia patients had lower total OSIQ score than their peers (P=0.007). There was no difference between patients who received and who did not receive secondary prophylaxis (P=0.408) in terms of total OSIQ score. The median total OSIQ score of patients with pathologic HJHS (>0 points) was lower than that of patients with normal HJHS (0 points) (P=0.010). The median of ABR was 6 (range: 0 to 20) in the whole hemophilia group. There were no differences between hemophilia patients with ABR≤4 and >4 (P=0.084). All of the subscale parameters of the OSIQ were lower for hemophilia patients compared with their peers, besides one. The subscale of sexuality attitudes was better for hemophilia patients than for the healthy control group (P=0.028). CONCLUSIONS Low self-esteem in hemophilia patients indicates the importance of lifelong psychosocial support. Patients with pathologic HJHS are at risk of low-esteem. Using OSIQ with HJHS during follow-up of hemophilia patients may be useful for management.
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