1
|
Rudra S, Ali A, Powell JM, Hastings RP, Totsika V. Psychological distress and convergence of own and proxy health-related quality of life in carers of adults with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:74-83. [PMID: 37698226 DOI: 10.1111/jir.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 06/11/2023] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND In adults with an intellectual disability, health-related quality of life (HRQoL) is often measured by proxy report. This cross-sectional study investigated whether the mental health of proxy raters impacts the way they rate HRQoL. METHODS In this study, 110 carers of adults with an intellectual disability completed measures of psychological distress (Kessler-6) and HRQoL (EQ-5D-3L) about their own HRQoL and that of the care recipient. Differences between HRQoL scores as rated by the carer about themselves and the care recipient were calculated (convergence scores) and multiple regression models were fitted to estimate the association between proxy psychological distress and convergence scores for subjective/objective HRQoL controlling for support needs of the care recipient, carer age and gender of care recipient. RESULTS There was a significant association between psychological distress and subjective HRQoL convergence scores (r = .92; P = 0.03; 95%; CI: -1.76 to -0.09). There was no association between psychological distress and objective HRQoL convergence scores (r = .01; CI -0.02 to 0.001; P = 0.08). The association between psychological distress and HRQoL scores was no longer present when models did not include convergence scores. CONCLUSIONS Carers experiencing more psychological distress tended to rate their own and the care recipients' subjective HRQoL more similarly. Objective HRQoL measures did not show this convergence in scores with increasing carer psychological distress. Findings differed when the analysis approach was changed, suggesting the results above require replication in future studies.
Collapse
Affiliation(s)
- S Rudra
- Division of Psychiatry, University College London, London, UK
| | - A Ali
- Luton and Bedford Disability Service, East London NHS Foundation Trust, London, UK
- Wolfson Institute for Population Health, Queen Mary University, London, UK
| | - J M Powell
- Centre for Research in Health and Social Care, School for Policy Studies, University of Bristol, Bristol, UK
| | - R P Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - V Totsika
- Division of Psychiatry, University College London, London, UK
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| |
Collapse
|
2
|
Papp ZK, Török S, Szentes A, Hosszú D, Kökönyei G. Parent-child agreement on health-related quality of life: the role of perceived consequences of the child's chronic illness. Psychol Health 2024; 39:233-251. [PMID: 35350930 DOI: 10.1080/08870446.2022.2057496] [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: 07/26/2021] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aimed to assess the parent-child agreement on various domains of health-related quality of life (HRQoL) in a Hungarian pediatric sample. We examined the associations of demographic, illness-specific factors and the perceived consequences of the illness with the parent-child disagreement. DESIGN A cross-sectional study was carried out with child-parent pairs in a heterogeneous pediatric sample (n = 259). OUTCOME MEASURES Child and parent versions of Kidscreen-52 and the consequences scale of the Revised Illness Perception Questionnaire (IPQ-R) were applied. We used intraclass correlation coefficients to measure agreement. We computed directional discrepancies as dyadic indexes and applied them in multinomial regression analysis to identify factors influencing agreement. RESULTS Agreement between children and parents on the KIDSCREEN-52 instrument was moderate to good (ICC = 0.41 to 0.66). Significant (p < 0.005) parent-child disagreement was observed on 6 out of 10 dimensions of HRQoL: Parents rated their children's well-being lower on Physical Well-being, Psychological Well-being, Parent Relations and Home Life, Social Support and Peers, and Financial Resources scales and rated higher on Moods and Emotions compared to child-reported HRQoL. Both parent's and child's higher perceived illness consequences made disagreement significantly more likely on various domains. CONCLUSIONS Direction of disagreement may draw attention to potentially vulnerable domains of the child's well-being, like moods and emotions and self-perception.
Collapse
Affiliation(s)
| | - Szabolcs Török
- Institute of Mental Health, Semmelweis University, Budapest, Hungary
| | - Annamária Szentes
- 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Dalma Hosszú
- Doctoral School of Psychology, University of Pécs, Budapest, Hungary
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| |
Collapse
|
3
|
Lykke C, Ekholm O, Olsen M, Sjøgren P. Paediatric end-of-life care - symptoms and problems: parent assessment. BMJ Support Palliat Care 2023; 13:e327-e333. [PMID: 33707300 DOI: 10.1136/bmjspcare-2021-002891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Symptoms and problems (S&P) are under-reported in children in end-of-life care.To target future interventions, the primary aim was to examine S&P in children in end-of-life care. METHODS All parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012-2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents' assessments of S&P during the last month of life were restricted to children aged 3-18 years. Data were analyses by means of descriptive statistics. RESULTS Children ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced 'mess-ups' or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death. CONCLUSION According to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.
Collapse
Affiliation(s)
- Camilla Lykke
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
- Department of Oncology and Palliative Care, Nordsjællands Hospital, Hillerod, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
4
|
Ferro MA, Basque D, Elgie M, Dol M. Agreement of the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in parents and youth with physical illness living in Canada. Disabil Rehabil 2023; 45:3125-3134. [PMID: 36066067 DOI: 10.1080/09638288.2022.2120095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study modelled the factor structure and tested for measurement invariance between youth and parent reports on the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0; estimated agreement between informants; and, examined moderators of youth-parent discrepancies. MATERIALS AND METHODS Data come from the baseline wave of the Multimorbidity in Youth across the Life-course study (n = 117). Multiple-group confirmatory factor analysis was used to test for measurement invariance and Wilcoxon signed-rank tests compared informant scores. Intraclass correlation coefficient (ICC) and Bland-Altman limits of agreement plots were used to examine the youth-parent agreement. RESULTS The WHODAS 2.0 demonstrated measurement invariance [χ2 = 221.8(136), p < 0.01; RMSEA = 0.073 (0.055, 0.091); CFI = 0.962; and, SRMR = 0.078]. Youth typically reported more disability compared to parent proxies, with the exception of item Q5 (emotional). The agreement was low (ICC = 0.08-0.53). Youth sex moderated informant agreement such that more consistent agreement was seen for female youth (β = 0.54, p < .01) compared to male youth (β = 0.11, p = .29). CONCLUSIONS Youth and their parents interpret the construct of disability, as measured by the 12-item WHODAS 2.0, similarly. Thus, informant differences represent real differences that are not a consequence of error. Low parent-youth agreement reinforces the need for collecting multiple perspectives in the pediatric setting, especially for male youth.Implications for rehabilitationThe WHODAS 2.0 is one of the most widely used measures of disability and functioning.Measurement invariance of the WHODAS 2.0 suggests that youth and parents interpret the construct of disability similarly.Parent-youth agreement was low and youth typically report more disability compared to parent proxies.More consistent agreement with parents was found for female youth compared to male youth.
Collapse
Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Dominique Basque
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Melissa Elgie
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Megan Dol
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| |
Collapse
|
5
|
Friedel M, Aujoulat I, Brichard B, Fonteyne C, Renard M, Degryse JM. The Quality of Life of Children Facing Life-Limiting Conditions and That of Their Parents in Belgium: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1167. [PMID: 37508664 PMCID: PMC10378398 DOI: 10.3390/children10071167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Paediatric palliative care (PPC) aims to improve children's quality of life, but this outcome is rarely measured in clinical care. PPC is provided in Belgium through six transmural paediatric liaison teams (PLTs) ensuring continuity of care for children with life-limiting or life-threatening conditions (LLC/LTC). This study aims to measure the quality of life (QoL) of children with LLC/LTC followed-up by PLTs and the QoL of their parents. METHODS During interviews, an original socio demographic questionnaire, the Children palliative outcome scale-version 2 (CPOS-2), the Fragebogen für Kinder und Jugendliche zur Erfassung der gesundheitsbezogenen Lebensqualität (KINDL) and the Quality of life in life-threatening Illness-Family caregiver (QOLLTI-F) were filled in by PLT members. Statistics were used to investigate significant differences between scores. Results were discussed and interpreted with six PLTs. RESULTS 73 children aged 1-18 were included in the study. Especially for items focusing on emotional items, children reported their QoL as higher than their parents did. The QoL scores were not significantly associated with the child's condition's severity. CONCLUSIONS This study provides, for the first time, an overview of the QoL of children and parents followed-up by PLTs in Belgium.
Collapse
Affiliation(s)
- Marie Friedel
- Department of Life Sciences and Medicine (DLSM), Faculty of Sciences, Technology and Medicine (FSTM), University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
- Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Isabelle Aujoulat
- Faculty of Public Health, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Bénédicte Brichard
- Interface Pédiatrique, Department of Paediatric Oncology and Haematology, Cliniques Universitaires St Luc, 1200 Brussels, Belgium
| | - Christine Fonteyne
- Globul'home, Hôpital Universitaire des Enfants Reine Fabiola, 1020 Brussels, Belgium
| | - Marleen Renard
- Kites, Department of Paediatric Oncology and Haematology, Universitair Ziekenhuis Leuven, 3000 Leuven, Belgium
| | - Jean-Marie Degryse
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| |
Collapse
|
6
|
Ahmed Meelad R, Abd Hamid IJ, Zainudeen ZT, Hashim IF, Azizuddin MNA, Mangantig E, Taib F, Mohamad N, Ismail IH, Abdul Latiff AH, Mohd Noh L. Health-Related Quality of Life of Patients and Families with Primary Immunodeficiency in Malaysia: a Cross-Sectional Study. J Clin Immunol 2023; 43:999-1006. [PMID: 36882668 PMCID: PMC9990971 DOI: 10.1007/s10875-023-01463-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 03/01/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE Primary immunodeficiency disease (PID) affects various aspects of a patient's life. However, the health-related quality of life (HRQOL) of PID among Malaysian patients is poorly described. This study aimed to determine the quality of life of PID patients and their respective parents. METHOD This cross-sectional study was performed from August 2020 to November 2020. Patients with PID and their families were invited to answer the PedsQL Malay version (4.0) questionnaire, the tool used to assess the HRQOL. A total of 41 families and 33 patients with PID answered the questionnaire. A comparison was performed with the previously published value of healthy Malaysian children. RESULT Parents of respondents recorded a lower mean of total score than the parents of healthy children (67.26 ± 16.73 vs. 79.51 ± 11.90, p-value = 0.001, respectively). PID patients reported lower mean total score to healthy children (73.68 ± 16.38 vs. 79.51 ± 11.90, p-value = 0.04), including the psychosocial domain (71.67 ± 16.82 vs. 77.58 ± 12.63, p-value = 0.05) and school functioning (63.94 ± 20.87 vs. 80.00 ± 14.40, p-value = 0.007). No significant difference of reported HRQOL when comparing between subgroup of PID on immunoglobulin replacement therapy and those without immunoglobulin replacement (56.96 ± 23.58 vs. 65.83 ± 23.82, p-value 0.28). Socioeconomic status was found to be predictive of the lower total score of PedsQL in both parent and children reports. CONCLUSION Parents and children with PID, especially those from middle socioeconomic status, have lower HRQOL and school function impairment than healthy children.
Collapse
Affiliation(s)
- Ruwaydah Ahmed Meelad
- Primary Immunodeficiency Diseases Group, Department of Clinical Medicine, Institut Perubatan & Pergigian Termaju, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia
| | - Intan Juliana Abd Hamid
- Primary Immunodeficiency Diseases Group, Department of Clinical Medicine, Institut Perubatan & Pergigian Termaju, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia.
| | - Zarina Thasneem Zainudeen
- Primary Immunodeficiency Diseases Group, Department of Clinical Medicine, Institut Perubatan & Pergigian Termaju, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia
| | - Ilie Fadzilah Hashim
- Primary Immunodeficiency Diseases Group, Department of Clinical Medicine, Institut Perubatan & Pergigian Termaju, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia
| | - Muhd Nur Akmal Azizuddin
- Primary Immunodeficiency Diseases Group, Department of Clinical Medicine, Institut Perubatan & Pergigian Termaju, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia
| | - Ernest Mangantig
- Primary Immunodeficiency Diseases Group, Department of Clinical Medicine, Institut Perubatan & Pergigian Termaju, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia
| | - Fahisham Taib
- Paediatric Department, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Norsarwany Mohamad
- Paediatric Department, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Intan Hakimah Ismail
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | | | - Lokman Mohd Noh
- Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
7
|
Wu TT, Finkel RS, Siskind CE, Feely SM, Burns J, Reilly MM, Muntoni F, Estilow T, Shy ME, Ramchandren S. Validation of the parent-proxy pediatric Charcot-Marie-Tooth disease quality of life outcome measure. J Peripher Nerv Syst 2023; 28:237-251. [PMID: 36748295 PMCID: PMC10521146 DOI: 10.1111/jns.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/16/2023] [Accepted: 01/28/2023] [Indexed: 02/08/2023]
Abstract
Charcot-Marie-Tooth disease (CMT) reduces health-related quality of life (QOL) in children. We have previously developed and validated the English and Italian versions of the pediatric CMT-specific QOL outcome measure (pCMT-QOL) for children aged 8 to 18. There is currently no parent-proxy CMT QOL outcome measure for use in clinical trials, which could provide complementary information in these children and adolescents. This study describes the validation studies conducted to develop the parent-proxy version of the pCMT-QOL outcome measure for children aged 8 to 18 years old. Development and validation of the parent-proxy version of the pCMT-QOL outcome measure for children aged 8 to 18 years old was iterative, involving identifying relevant domains, item pool generation, prospective pilot testing and clinical assessments, structured focus-group interviews, and psychometric testing, conducted on parents of children with CMT seen at participating sites from the USA, United Kingdom, and Australia. We utilized previously described methods to develop a working parent-proxy version of the pCMT-QOL measure. From 2010 to 2016, the parent-proxy pCMT-QOL working version was administered to 358 parents of children with CMT aged 8 to 18, seen at the participating study sites of the Inherited Neuropathies Consortium. The resulting data underwent rigorous psychometric analysis, including factor analysis, test-retest reliability, internal consistency, convergent validity, IRT analysis, and longitudinal analysis, to develop the final parent-proxy version of the pCMT-QOL outcome measure for children aged 8 to 18 years old. The parent-proxy version of the pCMT-QOL outcome measure is a reliable, valid, and sensitive proxy measure of health-related QOL for children aged 8 to 18 with CMT.
Collapse
Affiliation(s)
- Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA
| | - Richard S. Finkel
- Center for Experimental Neurotherapeutics, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Shawna M.E. Feely
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Joshua Burns
- University of Sydney School of Health Sciences, Faculty of Medicine and Health; Pediatric Gait Analysis Service of New South Wales, Sydney Children’s Hospitals Network, Sydney, Australia
| | - Mary M. Reilly
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Francesco Muntoni
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
- Dubowitz Neuromuscular Centre, NIHR Great Ormond Street Hospital Biomedical Research Centre UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Timothy Estilow
- Department of Pediatrics, Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael E. Shy
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Sindhu Ramchandren
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Department of Neurology, Wayne State University, Detroit, MI, USA
- The Janssen Pharmaceutical Companies of Johnson & Johnson, NJ, USA
| | | |
Collapse
|
8
|
McDonald EJ, Bedard C, Kirkpatrick SI, Perlman CM, Ferro MA. Psychometric properties and informant agreement of the WHODAS 2.0 in youth with mental disorder. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2023; 32:38-49. [PMID: 36776927 PMCID: PMC9879036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 12/03/2022] [Indexed: 02/14/2023]
Abstract
Objective This study examined psychometric properties, parent-youth agreement, and factors associated with agreement on the 12-item and 36-item versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Methods Data come from a clinical sample of 56 youth, aged 14-17 years, receiving mental health care at a pediatric hospital. Correlations between the WHODAS 2.0, KIDSCREEN-27, and demographic variables were used to assess validity. Internal consistency was measured using ordinal alpha. The Bland-Altman method and intraclass correlation coefficients (ICC) were used to assess parent-youth agreement. Logistic regression examined factors associated with disagreement > 0.5 standard deviation. Results For both parent and youth, correlations were low to moderate in exploring convergent (τ= -0.42 to 0.01) and divergent validity (τ/r = -0.12 to 0.32). Internal consistency was adequate (α > 0.7). Parent WHODAS 2.0 scores were significantly lower than youth scores and Bland-Altman plots revealed poor parent-youth agreement (ICC = -0.04 to 0.33). Lower household income was associated with lower odds of disagreement on the 35-item WHODAS 2.0 (OR= 0.28, 95% CI= 0.08-0.99), and older youth age was associated with lower odds of disagreement on the 12-item WHODAS 2.0 (OR= 0.40, 95% CI= 0.19-0.84). Conclusion The psychometric properties of both WHODAS 2.0 versions were similar, so the abbreviated version may be sufficient to measure functional impairment in a clinical context. Additional research is needed to better understand the factors that influence discrepancies between informants and the implications for care. However, reports from both youth and parents appear valuable in understanding functional impairment.
Collapse
Affiliation(s)
- Erica J. McDonald
- University of Waterloo, School of Public Health Sciences, Waterloo, Ontario
| | - Chloe Bedard
- University of Waterloo, School of Public Health Sciences, Waterloo, Ontario
| | | | | | - Mark A. Ferro
- University of Waterloo, School of Public Health Sciences, Waterloo, Ontario
| |
Collapse
|
9
|
Rihm L, Dreier M, Rezvani F, Wiegand-Grefe S, Dirmaier J. The psychosocial situation of families caring for children with rare diseases during the COVID-19 pandemic: results of a cross-sectional online survey. Orphanet J Rare Dis 2022; 17:449. [PMID: 36572906 PMCID: PMC9791975 DOI: 10.1186/s13023-022-02595-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is affecting many areas of life and has posed additional strains on the highly vulnerable group of caregivers of children with rare diseases (RDs). The psychosocial situation of the family caregivers deserves more attention, both in research and practice. The current study explores the distress level of caregivers of children with RDs, their psychosocial information needs, and caregiver-reported health-related quality of life (HRQoL) of children with RDs in times of the COVID-19 pandemic. METHODS Data from a cross-sectional online survey conducted within the German CARE-FAM-NET project (children affected by rare diseases and their families-network) between March and August 2020 were examined. The study sample included 149 family caregivers, mostly mothers (83.2%) of 167 children with RDs. The survey assessed demographic and disease-related characteristics, distress and everyday problems of caregivers (Distress Thermometer for Parents; scale 0-10), psychosocial information needs (self-developed items; scale 0-100), and caregiver-reported HRQoL of the children with RDs (DISABKIDS Chronic Generic Measure, short-form; scale 0-100). Using descriptive statistics, we analyzed the psychosocial situation of families during the COVID-19 pandemic. We further conducted correlation analysis to investigate interrelations. RESULTS The distress level among caregivers was high (M = 6.84, SD = 2.43); 89.6% reported clinical distress (≥ 4). Everyday problems (e.g., sleep problems, fatigue, being out of shape, fears, feeling tense or nervous, and worry) were frequent. Caregivers reported a wide range of psychosocial information needs. In about half of the children (49.5%), caregiver-reported HRQoL was low, while average HRQoL (M = 58.7, SD = 19.5) was comparable to parent-reported norm data of children with severe clinical conditions. Distress correlated positively with psychosocial information needs (r = 0.40), and negatively with the caregiver-reported HRQoL of the children (r = - 0.46). CONCLUSIONS This study indicates a high psychosocial burden on family caregivers of children with RDs during the early COVID-19 pandemic, characterized by high distress levels and wide-ranging everyday problems, unmet psychosocial information needs, and reduced caregiver-reported HRQoL in children with RDs. The findings highlight the ongoing need for target group-specific, low-threshold support services (e.g., websites) during and after the pandemic.
Collapse
Affiliation(s)
- Lydia Rihm
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Mareike Dreier
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Farhad Rezvani
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Wiegand-Grefe
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Dirmaier
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
10
|
Jeanbert E, Baumann C, Todorović A, Tarquinio C, Rousseau H, Bourion-Bédès S. Factors Associated with Discrepancy of Child-Adolescent/Parent Reported Quality of Life in the Era of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14359. [PMID: 36361238 PMCID: PMC9654617 DOI: 10.3390/ijerph192114359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Billions of children/adolescents experienced unprecedented changes in their daily lives that impacted their health-related quality of life (HRQoL) during the first wave of the coronavirus disease 2019. The purpose of this study was to describe child-parent discrepancies in reporting on HRQoL and explore factors associated with such discrepancies at the end of the first lockdown in France. A cross-sectional study was conducted among French school-aged children from 8 to 18 years and their parents living in the Grand Est region in France during the first wave of the epidemic. The impact of individual, self-reported health status and environmental data on discrepant parent-child reports of HRQoL was assessed by multinomial multivariable logistic regression models. A total of 471 parent-child pairs were included. Among 50% of the discordant pairs, parents underestimated HRQoL more frequently than they overestimated it. Home location, social support score, children's education level, parents' education level, tensions and conflicts with neighbors reported by children, whether they had access to a garden, and parents' professional activity were significantly associated with parental overestimation (adjustedOR from 2.08 to 11.61; p < 0.05). Factors associated with parental underestimation were children's education level, SF12 score, home location, the child's gender, parent's level of education, the presence of noise in the residence reported by children, whether a household member was infected with COVID-19, whether they had access to a garden, and family structure (adjustedOR from 1.60 to 4.0; p < 0.05). This study revealed differences between child-reported and parent-reported HRQoL. The COVID-19 pandemic accentuated the discrepancies in observable dimensions and attenuated them in unobservable dimensions of HRQoL but did not impact the directional discrepancy; parents underestimated their child's HRQoL more. These discrepancies appear to be explained by parent and child sociodemographic factors.
Collapse
Affiliation(s)
- Elodie Jeanbert
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
- Methodology, Data Management and Statistics Unit, University Hospital of Nancy, 54000 Nancy, France
| | - Cédric Baumann
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
- Methodology, Data Management and Statistics Unit, University Hospital of Nancy, 54000 Nancy, France
| | - Anja Todorović
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
| | - Cyril Tarquinio
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
| | - Hélène Rousseau
- Methodology, Data Management and Statistics Unit, University Hospital of Nancy, 54000 Nancy, France
| | - Stéphanie Bourion-Bédès
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
- Versailles Hospital, University Department of Child and Adolescent Psychiatry, 78157 Versailles-Le-Chesnay, France
| |
Collapse
|
11
|
Wieringa WG, van Berkel RJ, Los LI, Lelieveld OTHM, Armbrust W. Physical and Psychosocial Health in Pediatric Uveitis Patients. Ocul Immunol Inflamm 2022; 30:1692-1700. [PMID: 34228595 DOI: 10.1080/09273948.2021.1934484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND To investigate the possible associations between childhood noninfectious uveitis and cardio-respiratory fitness, physical activity, health related quality of life and fatigue. METHODS Cross-sectional analysis of 23 patients with noninfectious uveitis, aged 8-18 years. BMI, exercise capacity, muscle strength and physical activity were measured. Health-related quality of life and fatigue were assessed. The results were compared to standardized values for age matched healthy children. RESULTS Twenty-three patients were included. Children with uveitis had a higher bodyweight and body mass index. Children with uveitis had lower cardio-respiratory fitness and they were less physically active, but they experienced a normal quality of life and normal fatigue. Parents of children with uveitis reported a lower quality of life and more fatigue for their children than parents of healthy children. CONCLUSION Our study indicates that children with noninfectious uveitis are at risk of developing lower physical and psychosocial health.
Collapse
Affiliation(s)
- Wietse G Wieringa
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Rosanne J van Berkel
- Department of Children's Rheumatology and Immunology, Beatrix Children's Hospital, Groningen, RB, The Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, AV, The Netherlands
| | - Otto T H M Lelieveld
- Center of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Wineke Armbrust
- Department of Children's Rheumatology and Immunology, Beatrix Children's Hospital, Groningen, RB, The Netherlands
| |
Collapse
|
12
|
Ardelean VP, Andrei VL, Miuţa CC, Boros-Balint I, Deak GF, Molnar A, Berki T, Győri F, Geantă VA, Dehelean CA, Borcan F. The KIDSCREEN-27 Quality of Life Measure for Romanian Children Aged 6: Reliability and Validity of the Romanian Version. Healthcare (Basel) 2022; 10:healthcare10071198. [PMID: 35885725 PMCID: PMC9319028 DOI: 10.3390/healthcare10071198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
The KIDSCREEN-27 represents a standardized, worldwide instrument, employed to assess the health-related quality of life in children. The purpose of the present study is to validate the KIDSCREEN-27 questionnaire for 6-year-old preparatory school children and verify its reliability, as well as to perform a comparison regarding the quality of children’s lives living in two cities in Romania: Arad, a provincial city, versus the second most developed city in the country, Cluj-Napoca. A total of 256 children of 6 years of age, who come from families with both parents, with a medium to high socioeconomic status and a good health status, were included in the analysis, using the KIDSCREEN-27 questionnaire at three assessment time points with a re-test period of two weeks. Results indicated that the KIDSCREEN-27 turned out to be suitable for use in 6-year-old Romanian children. Analysis regarding the psychometric properties showed that the Cronbach’s alpha ranged from 0.554 to 0.661 at the end of the study. The Pearson correlation coefficients showed statistically significant differences between the items of each area investigated. In conclusion, there is a growing need to periodically monitor the health status of children to avoid possible problems which may occur.
Collapse
Affiliation(s)
- Viorel Petru Ardelean
- Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, 2-4, Elena Dragoi, 310330 Arad, Romania; (V.L.A.); (C.C.M.)
- Correspondence: ; Tel.: +40-743-107182
| | - Vasile Liviu Andrei
- Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, 2-4, Elena Dragoi, 310330 Arad, Romania; (V.L.A.); (C.C.M.)
| | - Caius Călin Miuţa
- Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, 2-4, Elena Dragoi, 310330 Arad, Romania; (V.L.A.); (C.C.M.)
| | - Iuliana Boros-Balint
- Faculty of Physical Education and Sport, Babeș-Bolyai University of Cluj-Napoca, 7 Pandurilor Str., 400376 Cluj-Napoca, Romania; (I.B.-B.); (G.-F.D.)
| | - Grațiela-Flavia Deak
- Faculty of Physical Education and Sport, Babeș-Bolyai University of Cluj-Napoca, 7 Pandurilor Str., 400376 Cluj-Napoca, Romania; (I.B.-B.); (G.-F.D.)
| | - Andor Molnar
- Institute of Physical Education and Sport Sciences, Faculty of Education, University of Szeged, Hattyas u. 10, H-6725 Szeged, Hungary; (A.M.); (T.B.)
| | - Tamás Berki
- Institute of Physical Education and Sport Sciences, Faculty of Education, University of Szeged, Hattyas u. 10, H-6725 Szeged, Hungary; (A.M.); (T.B.)
| | - Ferenc Győri
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, 4 Vörösmarty u., H-7621 Pécs, Hungary;
| | - Vlad Adrian Geantă
- Faculty of Science, Physical Education and Informatics, University of Piteşti, 7 Normal School Alley, 110254 Piteşti, Romania;
| | - Cristina Adriana Dehelean
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (C.A.D.); (F.B.)
| | - Florin Borcan
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (C.A.D.); (F.B.)
| |
Collapse
|
13
|
Uhac M, Zibar Belasic T, Perkovic V, Matijevic M, Spalj S. Orthodontic treatment demand in young adolescents - Are parents familiar with their children's desires and reasons? Int J Paediatr Dent 2022; 32:383-391. [PMID: 34402117 DOI: 10.1111/ipd.12893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/18/2021] [Accepted: 07/09/2021] [Indexed: 12/01/2022]
Abstract
AIM To assess the levels of agreement between parents and adolescents about young adolescents' orthodontic treatment demand and to what extent is treatment demand conditioned by family and psychosocial impacts and oral function. DESIGN This cross-sectional study included 221 adolescents (11-14 years, 54% female) and their parents. A 5-point scale was used to assess orthodontic treatment demand. Adolescents self-administered the Child Perceptions Questionnaire, and parents self-administered the Parental-Caregivers Perceptions Questionnaire and Family Impact Scale. The Index of Orthodontic Treatment Need Dental Health Component (IOTN DHC) was used for determining malocclusion severity. Intraclass correlation coefficient and Cohen's kappa coefficient were used for the assessment of agreement between two informants. RESULTS The parent-child agreement on children's orthodontic treatment demand was weak, concording in 67.4% of cases. The most common reasons for seeking orthodontic treatment derive from the emotional (EW) and social well-being domains for both informants. In linear regression, the adolescent's reporting of impaired EW and IOTN DHC was the only significant linear predictor of orthodontic treatment demand. CONCLUSION Parents cannot correctly assess the orthodontic treatment demand of their children. Impaired EW is the most significant self-reported determinant of adolescents' demand for orthodontic treatment. Family relationships and parental perspective have a low influence.
Collapse
Affiliation(s)
- Mia Uhac
- Department of Orthodontics, Clinical Hospital Center Rijeka, Dental Clinic, Rijeka, Croatia.,Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | | | - Vjera Perkovic
- Department of Orthodontics, Clinical Hospital Center Rijeka, Dental Clinic, Rijeka, Croatia.,Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Marko Matijevic
- Department of Dental Medicine, Faculty of Dental Medicine and Health, J. J, Strossmayer University of Osijek, Osijek, Croatia
| | - Stjepan Spalj
- Department of Orthodontics, Clinical Hospital Center Rijeka, Dental Clinic, Rijeka, Croatia.,Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Dental Medicine, Faculty of Dental Medicine and Health, J. J, Strossmayer University of Osijek, Osijek, Croatia
| |
Collapse
|
14
|
Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Overestimation and underestimation of youths' health-related quality of life are associated with youth and caregiver positive screens for depression: results of a population-based study among youths with longstanding type 1 diabetes. Diabetol Metab Syndr 2022; 14:40. [PMID: 35264222 PMCID: PMC8905804 DOI: 10.1186/s13098-022-00809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to analyze the extent and direction of disagreement between self- and proxy-reported quality of life (QoL) and the factors associated with QoL overestimation and underestimation by caregivers compared with self-reports. METHODS This study used data from population-based questionnaire surveys conducted in 2012-2013 and 2015-2016 with 11- to 17-year-olds with a duration of type 1 diabetes of 10 years or longer and their caregivers (n = 1058). QoL in youth was assessed via 10-item KIDSCREEN (KIDSCREEN-10) self- and proxy-reported questionnaires. The scores ranged from 0 to 100, with higher scores indicating better QoL. Depression screening was performed via the Center for Epidemiological Studies Depression Scale for Children for youths (CES-DC screen positive: score > 15) and WHO-5 Well-being Index for parents/caregivers (WHO-5 screen positive: score ≤ 50). RESULTS The mean self- and proxy-reported normalized KIDSCREEN-10 scores were 64.2 (standard deviation [SD] 11.4) and 66.1 (11.5), respectively. More caregivers overestimated (self-reported minus proxy-reported score < - 0.5*SD self-reported score) than underestimated (self-reported minus proxy-reported score > 0.5*SD self-reported score) youths' QoL (37% versus 23%, p < 0.001). Youths who screened positive for depression (18%) were at higher risk of their QoL being overestimated and lower risk of their QoL being underestimated by caregivers than youths who screened negative for depression (RROverestimation 1.30 [95% CI 1.10-1.52], RRUnderestimation 0.27 [0.15-0.50]). Caregivers who screened positive for depression (28%) overestimated the QoL of their children less often and underestimated the QoL of their children more often than caregivers who screened negative for depression (RROverestimation 0.73 [0.60-0.89], RRUnderestimation 1.41 [1.14-1.75]). CONCLUSIONS Caregivers often over- or underestimated their children's QoL. Positive screens for depression among both youths and caregivers contributed to the observed differences between self- and caregiver-reported QoL.
Collapse
Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| |
Collapse
|
15
|
Nikitina IL, Kelmanson IA. Health-related quality of life in 4-to-6-year-old children with type 1 diabetes mellitus estimated by children and their mothers. Eur J Pediatr 2022; 181:549-560. [PMID: 34424400 PMCID: PMC8380516 DOI: 10.1007/s00431-021-04239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/29/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
Administration of pediatric Health Related Quality of Life (HRQoL) inventories frequently assesses both the child and parent perspectives in young children with type 1 diabetes mellitus (T1DM), but parent-proxy and child self-reports may differ, and little is known on these discrepancies. The aim is to evaluate HRQoL estimated by young children with T1DM and by their mothers, potential discrepancies in the children-maternal estimates and the factors influencing these discrepancies. Thirty-five 4-to-6-year-old children (19 boys) with T1DM admitted to the Pediatric Endocrinology Department were approached with the self-report KINDL questionnaire for children aged 4-6 years (Kiddy-KINDL for children). Their mothers were approached with the parental version (Kiddy-KINDL for parents). Both versions enable measuring child HRQoL in physical, emotional wellbeing, self-esteem, family, friends, everyday functioning, and the disease dimensions, as well as KINDL total on a 0-100 scale. Statistically significant differences were found between children's and maternal estimates on the KINDL total and "Disease" scales, in that the maternal proxy-reports produced lower values. A statistically significant difference between self- and proxy-reports was found for the KINDL "Emotional wellbeing" scale values, and the maternal proxy-reports yielded higher estimates compared with children's self-reports. These associations remained significant after adjustment for major potential confounders. Maternal education, maternal marital status, insulin regimen, and achievement of glycemic control modified the effect of child-maternal discrepancies.Conclusion: Attempts should be made to improve parental understanding of child problems related to his/her disease with due account to individual family social and demographic characteristics. What is Known: • HRQoL in children with T1DM has been advocated as an important complementary outcome to clinical and laboratory markers. • Self-and parental proxy-reports on HRQoL may differ, but little is known on these discrepancies and on the factors influencing them in young children with T1DM. What is New: • Mothers tend to underestimate general and disease-related components of HRQoL but likely to overestimate psychological wellbeing of their ill young children with T1DM. • Maternal education, marital status, insulin regimen, and achievement of glycemic control modify estimations of HRQoL and child-maternal discrepancies.
Collapse
Affiliation(s)
- Irina L. Nikitina
- Department of Children’s Diseases, Institute for Medical Education of the V.A.Almazov National Medical Research Centre, Akkuratova Str., 2, 197341 St. Petersburg, Russia
| | - Igor A. Kelmanson
- Department of Children’s Diseases, Institute for Medical Education of the V.A.Almazov National Medical Research Centre, Akkuratova Str., 2, 197341 St. Petersburg, Russia
| |
Collapse
|
16
|
Grant A, Ng VL, Nicholas D, Dhawan A, Yazigi N, Ee LC, Stormon MO, Gilmour SM, Schreiber RA, Carmody E, Otley AR. The effects of child anxiety and depression on concordance between parent-proxy and self-reported health-related quality of life for pediatric liver transplant patients. Pediatr Transplant 2021; 25:e14072. [PMID: 34245065 DOI: 10.1111/petr.14072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND HRQOL is a key outcome following pediatric LT. Parent-proxy reports may substitute for patients unable to report their own HRQOL. This study compared parent-proxy and self-reported HRQOL in children who have undergone LT. METHODS Pediatric LT recipients between the ages of 8 and 18 years, and a parent, completed self and proxy versions of the PeLTQL questionnaire, PedsQL Generic and Transplant modules, and standardized measures of depression and anxiety. RESULTS Data from 129 parent-patient dyads were included. Median parent age was 44 years, and most (89%) were mothers. Median patient age was 2.5 years at LT and 13.6 years at the time of study participation. Parents had significantly lower scores than patients on PedsQL total generic (70.8 ± 18.5 and 74.3 ± 19.0, p = .01), PeLTQL coping and adjustment (63.0 ± 15.6 and 67.3 ± 16.2, p < .01), and social-emotional (66.3 ± 14.9 and 71.9 ± 15.6, p < .001) domains. Higher patient anxiety and depression were related to larger absolute differences between parent-proxy and self-reported scores on all HRQOL measures (all p < .05). In this disparity, parents reported higher HRQOL scores than their child as self-reported anxiety and depression scores increased. CONCLUSIONS Differences in concordance between parent-proxy and self-reported HRQOL scores can be more prominent when children have more symptoms of anxiety and depression. Children's mental health symptoms should be queried, if feasible, when interpreting differences in parent and child reports of HRQOL.
Collapse
Affiliation(s)
- Amy Grant
- Maritime Intestinal Research Alliance, IWK Health Centre, Halifax, NS, Canada
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | | | - Nada Yazigi
- MedStar Georgetown Transplant Institute, Washington, DC, USA
| | - Looi C Ee
- Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, QLD, Australia
| | | | | | | | - Erin Carmody
- Maritime Intestinal Research Alliance, IWK Health Centre, Halifax, NS, Canada
| | - Anthony R Otley
- Maritime Intestinal Research Alliance, Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | | |
Collapse
|
17
|
Robertson AO, Tadić V, Horvat-Gitsels LA, Cortina-Borja M, Rahi JS. Differences in Self-Rated Versus Parent Proxy-Rated Vision-Related Quality of Life and Functional Vision of Visually Impaired Children. Am J Ophthalmol 2021; 230:167-177. [PMID: 34097897 DOI: 10.1016/j.ajo.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate disagreement between children's self-reported vision-related quality of life (VQoL) and functional vision (FV) and their parents' proxy-reports. DESIGN Cross-sectional study. METHODS A total of 152 children aged 7-18 years with visual impairment (VI) (defined by the World Health Organization), and their parents, were recruited from 22 National Health Service (NHS) ophthalmology departments in the United Kingdom. Age-appropriate versions of 2 vision-specific instruments, capturing VQoL and FV, were administered to children alongside modified versions for completion by parents on behalf of their child (ie, parent proxy-report). Disagreement between self-report and parent proxy-report was examined using the Bland-Altman (BA) method and a threshold of disagreement based on 0.5 standard deviation. Disagreement was analyzed according to participants' age, sex, and clinical characteristics, using logistic regression analyses. RESULTS Children rated themselves as having better outcomes than their parents did, although parents both under- and overestimated their child's VQoL (mean score difference = 7.7). With each year of increasing age, there was a 1.18 (1.04-1.35) higher odds of children self-rating their VQoL better than their parents (P = .013). Although parents consistently underestimated their child's FV (mean score difference = -4.7), no characteristics were significantly associated with differences in disagreement. CONCLUSIONS Disagreement between child self-report on the impact of VI and their parents' proxy-reports varies by age. This implies that self-report from children must remain the gold standard. Where self-reporting is not possible, parent proxy-reports may provide useful insights, but they must be interpreted with caution.
Collapse
Affiliation(s)
- Alexandra O Robertson
- From the UCL Great Ormond Street Institute of Child Health, London, United Kingdom (A.O.R., V.T., L.A.H.G., M.C.B., J.S.R.)
| | - Valerija Tadić
- From the UCL Great Ormond Street Institute of Child Health, London, United Kingdom (A.O.R., V.T., L.A.H.G., M.C.B., J.S.R.); School of Human Sciences/Institute for Lifecourse Development, University of Greenwich, London, United Kingdom (V.T.)
| | - Lisanne A Horvat-Gitsels
- From the UCL Great Ormond Street Institute of Child Health, London, United Kingdom (A.O.R., V.T., L.A.H.G., M.C.B., J.S.R.); Ulverscroft Vision Research Group, London, United Kingdom (L.A.H.G., J.S.R.)
| | - Mario Cortina-Borja
- From the UCL Great Ormond Street Institute of Child Health, London, United Kingdom (A.O.R., V.T., L.A.H.G., M.C.B., J.S.R.)
| | - Jugnoo S Rahi
- From the UCL Great Ormond Street Institute of Child Health, London, United Kingdom (A.O.R., V.T., L.A.H.G., M.C.B., J.S.R.); Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom (J.S.R.); National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom (J.S.R.); Ulverscroft Vision Research Group, London, United Kingdom (L.A.H.G., J.S.R.).
| |
Collapse
|
18
|
Mozzillo E, Zito E, Calcaterra V, Corciulo N, Di Pietro M, Di Sessa A, Franceschi R, Licenziati MR, Maltoni G, Morino G, Predieri B, Street ME, Trifirò G, Gallè F, Franzese A, Valerio G. Poor Health Related Quality of Life and Unhealthy Lifestyle Habits in Weight-Loss Treatment-Seeking Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179355. [PMID: 34501945 PMCID: PMC8431705 DOI: 10.3390/ijerph18179355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022]
Abstract
Obesity is associated with unhealthy lifestyle behaviors and poor Health Related Quality of Life (HRQOL). The cumulative effect of lifestyle behaviors on HRQOL has been demonstrated in chronically ill adolescents, but not in adolescents with obesity. The present study aimed to assess the association between HRQOL and adherence to the Mediterranean Diet (MD) and/or low levels of physical activity (PA) in a large sample of outpatient adolescents with overweight or obesity seeking weight loss treatment. Four-hundred-twenty participants were enrolled from 10 Italian outpatient clinics. The demographics and anthropometric features, KIDMED scores, and exercise levels of the participants were collected, together with parental features. The HRQOL was assessed by the Pediatric Quality of Life Inventory (PedsQL™), Adolescents Version 4.0. PedsQL total score and functioning subscales were lower in adolescents who reported one or two unhealthy habits. Compared with the high/intermediate groups, the risk of low HRQOL was twice as high for each unit increase in BMI SDS, while the percentage was reduced by 12.2% for every unit increase in the KIDMED score and by 32.3% for each hour increase of exercise. The clustering of these two unhealthy behaviors conferred a 120% higher risk of low HRQOL. Similarly, adolescents displaying better diet quality and/or a physically more active lifestyle have better physical and psychological functioning. Further studies are needed to disclose whether these characteristics may be predictive of better adherence to weight loss treatment.
Collapse
Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Eugenio Zito
- Department of Social Sciences, University of Naples Federico II, 80138 Naples, Italy;
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Nicola Corciulo
- Unit of Auxology and Pediatric Endocrinology, Sacred Heart of Jesus Hospital, Gallipoli, 73014 Lecce, Italy;
| | | | - Anna Di Sessa
- Department of Woman, Child, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy;
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Giuseppe Morino
- Research Unit for Multifactorial Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy;
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults—Pediatric Unit University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Maria Elisabeth Street
- Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giuliana Trifirò
- Endocrinology and Metabolism Division, IRCCS Policlinico San Donato, 20097 Milan, Italy;
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
- Correspondence:
| |
Collapse
|
19
|
Chen G, DunnGalvin A, Campbell DE. Impact of COVID-19 pandemic on quality of life for children and adolescents with food allergy. Clin Exp Allergy 2021; 52:162-166. [PMID: 34157164 PMCID: PMC8444946 DOI: 10.1111/cea.13973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, Vic., Australia
| | - Audrey DunnGalvin
- Paediatrics and Child Health, INFANT Centre, HRB-CRF, University College Cork, Cork, Ireland.,Paediatrics and Child Health, Royal College of Surgeons in Ireland, Children's Health Ireland, Dublin, Ireland
| | - Dianne E Campbell
- The Children's Hospital at Westmead, Sydney, NSW, Australia.,Department of Paediatrics & Child Health, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
20
|
Kallander EK, Weimand BM, Hanssen-Bauer K, Van Roy B, Ruud T. Factors associated with quality of life for children affected by parental illness or substance abuse. Scand J Caring Sci 2021; 35:405-419. [PMID: 32383213 DOI: 10.1111/scs.12868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/05/2020] [Accepted: 04/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness. AIM The aim of this study was to explore factors associated with self-reported QoL in children affected by parental illness or parental substance abuse. DESIGN A cross-sectional multicentre study. METHODS The sample included 246 families with children 8-18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self-reported QoL. MAIN OUTCOME MEASURE KIDSCREEN-27. RESULTS The children's self-reported QoL was positively associated with the ill parent's self-reported physical health, the children's self-reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self-reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2 ) in children's total QoL. STUDY LIMITATIONS Sampling bias may have occurred during recruitment. CONCLUSIONS The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self-reported QoL to identify children who are most negatively affected.
Collapse
Affiliation(s)
- Ellen Katrine Kallander
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Fafo Research Foundation, Oslo, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Betty Van Roy
- Department of CAMHS, Clinic of Children and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
21
|
Gray A, Pickering M, Sturman S. Absence of monitoring in withdrawal of clinically-assisted nutrition and hydration (CANH) and other treatments: a cause for concern? Clin Med (Lond) 2021; 21:235-237. [PMID: 34001577 DOI: 10.7861/clinmed.2020-0673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Since 2018, there has been no requirement to bring decisions about the withdrawal of clinically-assisted nutrition and hydration (CANH) in patients with persistent disorders of consciousness before the courts, providing that the requirements of the Mental Capacity Act 2005 (MCA) are fulfilled. Subsequent British Medical Association and Royal College of Physicians guidance on CANH withdrawal recommended standards of record keeping and internal and external audit to ensure local decision making was compliant with the MCA to safeguard patients. The scope of the guidance also included patients with stroke and neurodegenerative disorders.Freedom of Information requests made 2 years after the introduction of this guidance have shown that none of the NHS trusts or clinical commissioning groups who responded were undertaking any systematic monitoring of these decisions. Neither is the Care Quality Commission reviewing these decisions, as there is 'no statutory requirement' to do so. It appears there is a lack of organised scrutiny of these highly complex life-ending treatment decisions. This omission must surely be a cause for concern.
Collapse
Affiliation(s)
- Alice Gray
- Christian Medical Fellowship, London, UK and specialist registrar in palliative medicine, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Mark Pickering
- Christian Medical Fellowship, London, UK and prison general practitioner, London, UK
| | - Stephen Sturman
- Christian Medical Fellowship, London, UK and consultant neurologist (neurorehabilitation), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
22
|
Sentenac M, Rapp M, Ehlinger V, Colver A, Thyen U, Arnaud C. Disparity of child/parent-reported quality of life in cerebral palsy persists into adolescence. Dev Med Child Neurol 2021; 63:68-74. [PMID: 32710687 DOI: 10.1111/dmcn.14638] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2020] [Indexed: 01/10/2023]
Abstract
AIM To examine the evolution of child-parent discrepancy in reporting quality of life (QoL) between childhood and adolescence in children with cerebral palsy (CP) and to investigate potential factors associated with such a discrepancy. METHOD We used data from the SPARCLE (Study of PARticipation of Children with CP Living in Europe) study, a population-based cohort study of children with CP, aged 8 to 12 years at baseline (in 2004-2005), in nine European centres, who were followed up at the age of 13 to 17 years. The KIDSCREEN-52 Quality of Life measure was used at baseline and follow-up; 354 child-parent dyads out of 500 eligible dyads were followed up (201 males, 153 females). We used intraclass correlation coefficients (ICCs) to examine agreement between parent proxy-reports and self-reported QoL. We used linear regression to examine factors associated with child-parent discrepancy in QoL reporting. RESULTS Agreement was low to moderate (ICC=0.16-0.48) in childhood and in adolescence across all QoL domains. In four domains (moods and emotions, self-perception, relationship with parents and home life, and social support and peers), the extent of the discrepancy increased significantly between childhood and adolescence. Parenting stress, child pain, and child behaviour problems influenced parent proxy-reports during both childhood and adolescence. INTERPRETATION The points of view of the child and their parents should be treated as complementary to obtain better knowledge regarding the QoL of children and adolescents with CP.
Collapse
Affiliation(s)
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | | | - Allan Colver
- Institute of Health and Society, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
| | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Catherine Arnaud
- Inserm U1027, Université Paul Sabatier, Toulouse, France.,Clinical Epidemiology Unit, CHU Purpan, Toulouse, France
| |
Collapse
|
23
|
Rensen N, Steur LMH, Schepers SA, Merks JHM, Moll AC, Kaspers GJL, Van Litsenburg RRL, Grootenhuis MA. Determinants of health-related quality of life proxy rating disagreement between caregivers of children with cancer. Qual Life Res 2020; 29:901-912. [PMID: 31820207 PMCID: PMC7142061 DOI: 10.1007/s11136-019-02365-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Proxy reports of health-related quality of life (HRQoL) are commonly used in pediatric oncology. However, it is not known if caregivers' reports differ. This study therefore aims to compare paternal and maternal proxy reports, and explore determinants of couple disagreement (sociodemographic and medical characteristics, and parental QoL and distress). METHODS Both parents completed the PedsQL generic (child's HRQoL), Short Form-12 (own QoL) and Distress Thermometer for Parents. To assess agreement in child HRQoL, intra-class correlation coefficients (ICCs) were calculated. Differences between fathers/mothers were assessed with paired t tests. Systematic disagreement patterns were visualized with Bland-Altman plots. Characteristics of parental couples with a mean proxy difference in the highest quartile (highest proxy score minus lowest proxy score) were explored with multiple logistic regression analysis. RESULTS Parents of 120 children with cancer (87% post-treatment, mean age 11.0 ± 5.7 years) participated. No significant differences were found between paternal and maternal proxy scores, and agreement was good on all scales (ICCs 0.65-0.83). Bland-Altman plots revealed no systematic disagreement patterns, but there was a wide range in magnitude of the differences, and differences went in both directions. Couples with a mean proxy difference (irrespective of which direction) in the highest quartile (± 20 points) were more likely to have a child in active treatment, with retinoblastoma or relapsed disease, and to diverge in their own QoL. CONCLUSIONS If proxy reports of only one parent are available, clinicians may reasonably assume that paternal and maternal reports are interchangeable. However, if in doubt, respondent's sex is not of major importance, but clinicians should be aware of patient's and family's characteristics.
Collapse
Affiliation(s)
- Niki Rensen
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M H Steur
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
| | - Gertjan J L Kaspers
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Raphaële R L Van Litsenburg
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
24
|
Russo S, Wakefield CE, Fardell JE, Cohn RJ. Summer sun-exposure in Australian childhood cancer survivors and community reference groups. Semin Oncol 2020; 47:48-55. [PMID: 32145971 DOI: 10.1053/j.seminoncol.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/11/2022]
Abstract
PURPOSE Sun-exposure can cause health problems, including melanoma and nonmelanoma skin cancer, especially in Australia where the incidence of skin cancer is particularly high. Childhood cancer survivors (CCSs) have an augmented risk due to previous cancer history and treatment. Despite recommendations advising sun protection, CCSs may be placing themselves at risk. We considered daily summer sun-exposure in an Australian cohort of CCSs and in community reference groups, and identified factors associated with sun-exposure in these populations. METHODS Summer sun-exposure data were collected on 471 CCSs (119 parents of survivors aged <16, and 352 survivors aged ≥16) and a reference group of 470 participants from the community (155 parents of children aged <16, and 355 adults aged ≥16). Survivors completed paper questionnaires and the reference groups completed an online survey. Medical records confirmed survivors' clinical information. Ordinal logistic regressions identified factors associated with daily summer sun-exposure. RESULTS More daily summer sun-exposure was reported by both parents reporting for the young survivors (U = 5,522.5, P < .001; U = 31,412, P < .001) and by older survivors (U = 5,039.5, P < .001; U = 29,913, P < .001). Among younger participants greater sun-exposure was associated with being a CCS, while in older participants, greater sun-exposure was associated with being a CCS, a male, smoker/ex-smoker and was also increased in those with more sensitive skin reaction to sunlight. Focusing only on the CCSs, when treatments were considered, none statistically predicted sun-exposure in young CCSs while older CCSs who received radiotherapy were less likely to spend excess time in the sun. CONCLUSION CCSs have sun-exposure at times of day when sun-related skin damage is highest, despite advice to avoid highest risk times. This data can inform sun-protection programs and lifestyle advice aimed at ameliorating the potential increased risk of skin cancer in CCSs.
Collapse
Affiliation(s)
- Selena Russo
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.
| | - Claire E Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Joanna E Fardell
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Richard J Cohn
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia
| |
Collapse
|
25
|
Emotional/Behavioral Indicators in Children and Adolescents With and Without Vocal Problems: Self-Evaluation and Parental Evaluation. J Voice 2020; 35:664.e1-664.e9. [PMID: 31980293 DOI: 10.1016/j.jvoice.2019.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To verify the relationships between voice, behavior, and social skills in children and adolescents with and without voice disorders based on their self-reports and their parents/guardians' reports. METHODS The study comprised 575 individuals, with 347 parents/guardians of children and adolescents aged 6-18 years who responded the parent version of the Strengths and Difficulties Questionnaire and 228 children and adolescents aged 11-18 years, who responded its report version. RESULTS Children and adolescents with vocal problem scored higher on hyperactivity/inattention, emotional symptoms, peer relationship, and conduct problems domains; and in the internalization, externalization, and difficulties scales. Children with vocal problem scored lower on the skills scale in the self-report. Parents/guardians in the group with vocal problem reported peer relationship problems not perceived by their children. Parents/guardians in the group without vocal problem did not perceive the signs of hyperactivity/inattention reported in their children and adolescents' self-reports. CONCLUSIONS The presence of vocal problems in the pediatric and adolescent population may be a risk factor for mental health due to the higher scores on behavior problems scales, both in their internalization and externalization aspects.
Collapse
|
26
|
Tory H, Zurakowski D, Kim S. Patient and physician discordance of global disease assessment in juvenile dermatomyositis: findings from the Childhood Arthritis & Rheumatology Research Alliance Legacy Registry. Pediatr Rheumatol Online J 2020; 18:5. [PMID: 31941511 PMCID: PMC6964044 DOI: 10.1186/s12969-020-0402-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Global disease activity scores (gVAS) capture patient or family (PF) and physician (MD) assessments of disease. This study sought to measure discordance between PF and MD global activity scores in juvenile dermatomyositis (JDM), and determine factors associated with discordance. METHODS Patients with JDM were included from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry (N = 563). PF and MD gVAS were assessed for discordance, defined as a ≥ 2-point difference. Factors associated with discordant gVAS were compared in univariate analysis. Multivariable regression analysis was used to identify predictors of discordance. RESULTS Almost 40% (N = 219) of PF and MD gVAS were discordant. Among discordant scores, 68% of PF rated gVAS ≥2-points above MD, which was associated with calcinosis and lower quality of life and functional scores (p < 0.01). MD gVAS rated ≥2-points above PF in 32%, which was associated with abnormal laboratory results, weakness, arthritis, rash and other skin changes, and current intravenous steroid treatment (p < 0.01). In multivariate analysis, predictors for higher PF rating included calcinosis, lower quality of life and functional scores, while predictors for higher MD rating included rash, calcinosis, nailfold capillaroscopy changes, and current intravenous steroid treatment. CONCLUSIONS Discordance between PF and MD gVAS was common in this JDM cohort. Overall, higher PF rating was associated with poorer patient reported outcome (PRO) scores, while higher MD rating was associated with poorer objective measures. This suggests PF and MD assessments of gVAS may be measuring different aspects of disease, highlighting the importance of integrating PROs into clinical practice and research.
Collapse
Affiliation(s)
- Heather Tory
- Division of Pediatric Rheumatology, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT, 06106, USA. .,Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - David Zurakowski
- Departments of Anesthesiology and Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Susan Kim
- Pediatric Rheumatology, Benioff Children’s Hospital and University of San Francisco Medical Center, San Francisco, CA USA
| | | |
Collapse
|
27
|
Moola FJ, Neville AR, Huynh E, Moothathamby N, Naganathan M. Ensuring long-term benefits of camp for children with chronic illnesses? Dev Med Child Neurol 2019; 61:1355. [PMID: 31090918 DOI: 10.1111/dmcn.14259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Fiona J Moola
- The HEART Lab, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Alyssa R Neville
- The HEART Lab, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Ontario, Canada
| | - Elizabeth Huynh
- The HEART Lab, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Ontario, Canada
| | - Nivatha Moothathamby
- The HEART Lab, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Ontario, Canada.,Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Methuna Naganathan
- The HEART Lab, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Ontario, Canada.,School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
28
|
Children and adolescents with VACTERL association: health-related quality of life and psychological well-being in children and adolescents and their parents. Qual Life Res 2019; 29:913-924. [PMID: 31741214 PMCID: PMC7142056 DOI: 10.1007/s11136-019-02364-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2019] [Indexed: 12/15/2022]
Abstract
Purpose VACTERL association is a rare and complex condition of congenital malformations, often requiring repeated surgery and entailing various physical sequelae. Due to scarcity of knowledge, the study aim was to investigate self-reported health-related quality of life (HRQoL), anxiety, depression and self-concept in children and adolescents with VACTERL association and self-reported anxiety and depression in their parents. Methods Patients aged 8–17 years with VACTERL association and their parents were recruited from three of four Swedish paediatric surgical centres during 2015–2019. The well-established validated questionnaires DISABKIDS, Beck Youth Inventories, Beck Anxiety Inventory and Beck Depression Inventory were sent to the families. Data were analysed using descriptives, t tests and multivariable analysis. Results were compared with norm groups and reference samples. Results The questionnaires were returned by 40 patients, 38 mothers and 33 fathers. The mean HRQoL was M = 80.4, comparable to children with asthma (M = 80.2) and diabetes (M = 79.5). Self-reported psychological well-being was comparable to the norm group of Swedish school children, and was significantly higher than a clinical sample. Factors negatively influencing children’s HRQoL and psychological well-being were identified. The parents’ self-reports of anxiety and depression were comparable to non-clinical samples. Conclusions Although children and adolescents with VACTERL association reported similar HRQoL to those of European children with chronic conditions, their psychological well-being was comparable to Swedish school children in general. Nevertheless, some individuals among both children and parents were in need of extra support. This attained knowledge is valuable when counselling parents regarding the prognosis for children with VACTERL association.
Collapse
|
29
|
Oppong R, Kodabuckus S. Cost-effectiveness of outpatient parenteral antibiotic therapy for children with cellulitis. THE LANCET. INFECTIOUS DISEASES 2019; 19:1041-1042. [PMID: 31420293 DOI: 10.1016/s1473-3099(19)30413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Raymond Oppong
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK.
| | | |
Collapse
|
30
|
Livermore P, Gray S, Mulligan K, Stinson JN, Wedderburn LR, Gibson F. Being on the juvenile dermatomyositis rollercoaster: a qualitative study. Pediatr Rheumatol Online J 2019; 17:30. [PMID: 31215480 PMCID: PMC6582587 DOI: 10.1186/s12969-019-0332-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/22/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Juvenile Dermatomyositis is a rare, potentially life-threatening condition with no known cure. There is no published literature capturing how children and young people feel about their condition, from their perspective. This study was therefore unique in that it asked children and young people what is it like to live with Juvenile Dermatomyositis. METHODS Data were obtained from fifteen young people with Juvenile Dermatomyositis, between eight and nineteen years of age from one Paediatric Rheumatology department using audio-recorded interpretive phenomenology interviews. Data were analyzed phenomenologically, using a process that derives narratives from transcripts resulting in a collective composite of participants shared experiences, called a 'phenomenon'. RESULTS The overarching metaphor of a rollercoaster captures the phenomenon of living with Juvenile Dermatomyositis as a young person, with the ups and downs at different time points clearly described by those interviewed. The five themes plotted on the rollercoaster, began with confusion; followed by feeling different, being sick, steroidal and scared from the medications; uncertainty; and then ended with acceptance of the disease over time. CONCLUSION Young people were able to talk about their experiences about having Juvenile Dermatomyositis. Our findings will aid clinicians in their practice by gaining a deeper understanding of what daily life is like and highlighting ways to enhance psychosocial functioning. Hopefully, this study and any further resulting studies, will raise understanding of Juvenile Dermatomyositis worldwide and will encourage health care professionals to better assess psychosocial needs in the future.
Collapse
Affiliation(s)
- Polly Livermore
- University College London Great Ormond Street Institute of Child Health, London, UK. .,Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. .,Centre for Adolescent Rheumatology Versus Arthritis at UCL UCLH and GOSH, London, UK. .,NIHR Clinical Doctoral Research Nursing Fellow, Infection, Immunity and Inflammation, 6th Floor, Institute of Child Health, University College London Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | - Suzanne Gray
- 0000 0004 5345 7223grid.483570.dEvelina London Children’s Hospital, GSTT NHS Foundation Trust, London, UK
| | - Kathleen Mulligan
- 0000 0004 1936 8497grid.28577.3fCity, University of London, London, UK ,0000 0004 0426 7183grid.450709.fEast London NHS Foundation Trust, London, UK
| | - Jennifer N. Stinson
- 0000 0004 0473 9646grid.42327.30Hospital for Sick Children, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Lucy R. Wedderburn
- 0000000121901201grid.83440.3bUniversity College London Great Ormond Street Institute of Child Health, London, UK ,0000 0001 2116 3923grid.451056.3NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, UK ,0000000121901201grid.83440.3bCentre for Adolescent Rheumatology Versus Arthritis at UCL UCLH and GOSH, London, UK
| | - Faith Gibson
- 0000 0004 5902 9895grid.424537.3Centre for Outcomes and Experience Research in Children’s Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,0000 0004 0407 4824grid.5475.3School of Health Sciences, University of Surrey, Surrey, UK
| |
Collapse
|
31
|
Silva N, Pereira M, Otto C, Ravens-Sieberer U, Canavarro MC, Bullinger M. Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires. Qual Life Res 2019; 28:1725-1750. [PMID: 31055778 DOI: 10.1007/s11136-019-02189-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This meta-analytic review aimed to estimate the magnitude of health-related quality of life (HrQoL) impairments, as assessed by the KIDSCREEN questionnaires, both self- and parent-reported, in 8- to 18-years-old children/adolescents with chronic health conditions. METHODS To identify studies using the KIDSCREEN questionnaires, three electronic databases (PubMed, PsycINFO, EBSCOhost Psychology & Behavioral Sciences) were searched. The final search (February 14-15, 2018) revealed 528 non-duplicated articles, of which 23 papers (21 studies) directly compared the HrQoL of pediatric patients to community/healthy controls and were included in the meta-analysis. Pooled mean differences (MD) with 95% CIs were estimated using the inverse-variance random-effects method. RESULTS Of the 21 studies, 16 used self-reports, one used parent-reports and four adopted a multi-informant approach. Self-reported data were retrieved from 20 studies (4852 cases/28,578 controls), and parent-reported data were retrieved from four studies (511 cases/433 controls). Pediatric patients presented significant HrQoL impairments in the domains of physical well-being (MD = - 4.84, 95% CI - 6.44/- 3.24 for self-reports; MD = - 6.86, 95% CI - 10.42/- 3.29 for parent-reports) and peers and social support (MD = - 1.29, 95% CI - 2.25/- 0.34 for self-reports; MD = - 3.90, 95% CI - 5.28/- 2.52 for parent-reports), compared to community/healthy peers. Between-studies heterogeneity was explained by diagnostic categories, instrument version and informants. CONCLUSIONS The identification of significant HrQoL impairments among pediatric patients, specifically in the physical and social domains, highlights the importance of routine psychosocial assessment and intervention in primary pediatric healthcare services. Specific recommendations include the use of profile measures, both self- and parent-reports, and the prioritization of oncology, endocrinology and neurology services.
Collapse
Affiliation(s)
- Neuza Silva
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal. .,Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany.
| | - Marco Pereira
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany
| | - Maria Cristina Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany
| |
Collapse
|
32
|
Rasmussen GS, Kragballe K, Maindal HT, Lomborg K. Caring for young people with moderate to severe psoriasis: an interpretive description of parental perspectives. J DERMATOL TREAT 2019; 31:227-234. [PMID: 30835580 DOI: 10.1080/09546634.2019.1590523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Psoriasis often sets on during childhood or adolescence, when parents have great importance for the young people's self-management, well-being, and quality of life. The aim of this study was to understand parents' perspectives on young people's daily life with psoriasis in order to improve adolescents' self-management.Method: Adopting interpretive, description methodology (ID), focus group discussion, and interviews were conducted with eight parents of adolescents with psoriasis. The analysis was inductive with an iterative comparative approach. Main themes conveying participants' perceptions were identified for constructing a coherent narrative of parents' perspectives on their young people's transition with psoriasis through adolescence.Results: Parents initially perceived psoriasis mainly a physical and treatment-related burden and not until late realized its socio-emotional impact. They eventually found themselves balancing between declining treatment due to fear of side effects and acknowledging the impact on their young people's quality of life and their desire for effective treatment.Conclusions: Caring for young people with psoriasis is a stressful process involving experimental learning to understand and manage the complexity of psoriasis and its impact on adolescents' emotional and social life. Future research should consider integration of shared decision-making and self-management support interventions in routine daily care as focus points.
Collapse
Affiliation(s)
| | - Knud Kragballe
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Kirsten Lomborg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
33
|
Friedel M, Aujoulat I, Dubois AC, Degryse JM. Instruments to Measure Outcomes in Pediatric Palliative Care: A Systematic Review. Pediatrics 2019; 143:peds.2018-2379. [PMID: 30530504 DOI: 10.1542/peds.2018-2379] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Pediatric palliative care (PPC) is intended to promote children's quality of life by using a family-centered approach. However, the measurement of this multidimensional outcome remains challenging. OBJECTIVE To review the instruments used to assess the impact of PPC interventions. DATA SOURCES Five databases (Embase, Scopus, The Cochrane Library, PsychInfo, Medline) were searched. STUDY SELECTION Inclusion criteria were as follows: definition of PPC used; patients aged 0 to 18 years; diseases listed in the directory of life-limiting diseases; results based on empirical data; and combined descriptions of a PPC intervention, its outcomes, and a measurement instrument. DATA EXTRACTION Full-text articles were assessed and data were extracted by 2 independent researchers, and each discrepancy was resolved through consensus. The quality of the studies was assessed by using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers From a Variety of Fields checklist. RESULTS Nineteen of 2150 articles met the eligibility criteria. Researchers in 15 used quantitative methods, and 9 were of moderate quality. Multidimensional outcomes included health-related quality of life, spiritual well-being, satisfaction with care and/or communication, perceived social support, and family involvement in treatment or place-of-care preferences. PPC interventions ranged from home-based to hospital and respite care. Only 15 instruments (of 23 reported) revealed some psychometric properties, and only 5 included patient-reported (child) outcome measures. LIMITATIONS We had no access to the developmental process of the instruments used to present the underlying concepts that were underpinning the constructs. CONCLUSIONS Data on the psychometric properties of instruments used to assess the impact of PPC interventions were scarce. Children are not systematically involved in reporting outcomes.
Collapse
Affiliation(s)
- Marie Friedel
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium; .,Institut Parnasse-Institut Supérieur d'Enseignement Infirmier, Haute Ecole Léonard de Vinci, Brussels, Belgium; and
| | - Isabelle Aujoulat
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Anne-Catherine Dubois
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Marie Degryse
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.,Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
| |
Collapse
|
34
|
Ferrand A, Gorgos A, Ali N, Payot A. Resilience Rather than Medical Factors: How Parents Predict Quality of Life of Their Sick Newborn. J Pediatr 2018; 200:64-70.e5. [PMID: 29958673 DOI: 10.1016/j.jpeds.2018.05.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/16/2018] [Accepted: 05/15/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess the influence of resiliency and stress on parental perspectives of the future quality of life (QOL) of neonatal intensive care unit (NICU) newborns at high risk of neurodevelopmental disability. STUDY DESIGN We conducted a prospective multicenter questionnaire study. Perspectives from parents of newborns at high risk of disability as per neonatal follow-up criteria were compared with a low-risk group consisting of parents of all other NICU newborns. Parental anxiety and resiliency, measured using Brief Symptom Inventory and Sense of Coherence scales, respectively, were associated with QOL projections. RESULTS Parents returned 129 (81%) questionnaires. Parents considering their newborn as currently sicker were more stressed (P = .011) and worried about future physical (P < .001) and mental (P < .001) health, QOL (P < .001), coping (P = .019), and financial (P < .001) and emotional (P = .002) impact on the family. Ooverall, there was no difference between parents of high-risk and low-risk newborns on QOL projections. Almost all parents projected a good future QOL. Less resilient parents projected more pain (P = .04), more financial (P = .019), and emotional (P = .031) impact on their family, and were 10 times more likely to predict that their newborn would remain chronically ill. CONCLUSIONS Parental projection of future QOL of NICU newborns is not associated with risk of disability. Most parents predict overall a good future QOL and focus more on familial impact. The Sense of Coherence scale may be used in clinical settings to identify less resilient parents.
Collapse
Affiliation(s)
- Amaryllis Ferrand
- Division of Neonatology, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Québec, Canada
| | - Andreea Gorgos
- Division of Neonatology, Department of Pediatrics, McGill University Health Center, McGill University, Montreal, Québec, Canada
| | - Nabeel Ali
- Division of Neonatology, Department of Pediatrics, Hôpital Maisonneuve-Rosemont, University of Montreal, Montreal, Québec, Canada
| | - Antoine Payot
- Division of Neonatology, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Québec, Canada; Clinical Ethics Unit, CHU Sainte-Justine, University of Montreal, Montreal, Québec, Canada; CHU Sainte-Justine Research Center, Department of Pediatrics, University of Montreal, Montreal, Québec, Canada; Palliative Care Unit, CHU Sainte-Justine, Montreal, Québec, Canada.
| |
Collapse
|
35
|
Naros A, Brocks A, Kluba S, Reinert S, Krimmel M. Health-related quality of life in cleft lip and/or palate patients - A cross-sectional study from preschool age until adolescence. J Craniomaxillofac Surg 2018; 46:1758-1763. [PMID: 30054220 DOI: 10.1016/j.jcms.2018.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/01/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Cleft lip and/or palate (CLP) is the most common congenital craniofacial anomaly. Multiple operations, long-lasting supplementary treatments, as well as impaired functional and esthetic outcome might have a negative impact on patients' social-emotional functioning and self-esteem, resulting in a lower health-related quality of life (HRQoL). PATIENTS AND METHODS This cross-sectional study aimed to evaluated CLP patients' HRQoL from preschool age (4 years) until adolescence (18 years) using the age-specific German KINDLR questionnaire. We compared self-reports and parent proxy-reports, as well as reference values from an age-matched German norm population. Multivariate analysis was applied to identify mediating factors, e.g. cleft type, age, and gender. Additionally, a KINDSCREEN-10 questionnaire was used to implement a screening tool in the clinical routine. RESULTS In total, 134 participants (average age 9.0 ± 3.8 years; 47.8% female) were included. Compared with German normative data, the evaluation revealed a significantly higher 'total QoL' in all self-report groups (Kiddy-, Kid-, Kiddo-KINDLR) and a significantly higher proxy rating for children aged 7-13 years. Multivariate analysis verified a significant disparity between self-reports and parents' conceptions of HRQoL, as well as a deterioration of the ratings with increasing age. No significant effects of other contributing factors, e.g. cleft type and gender, were found. The KIDSCREEN-10 questionnaire successfully confirmed these findings. CONCLUSIONS Surprisingly, our survey revealed a higher HRQoL in cleft patients compared with normative data from healthy controls. But because the return rate of the forwarded questionnaire was low, this may have contributed to bias. Keeping this in mind, we may conclude at least that the HRQoL in our cleft patients was not significantly lower than in healthy children. On the other hand, it can be assumed that the special attention of the parents and the support from speech therapy and other medical professionals may have contributed to a positive effect on family interaction, communication skills, and self-esteem.
Collapse
Affiliation(s)
- Andreas Naros
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany.
| | - Annekathrin Brocks
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| | - Susanne Kluba
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| | - Siegmar Reinert
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| | - Michael Krimmel
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| |
Collapse
|
36
|
Kim SK, Jo MW, Kim SH. Health-related quality of life by allergy symptoms in elementary school students. Health Qual Life Outcomes 2018; 16:93. [PMID: 29764459 PMCID: PMC5952875 DOI: 10.1186/s12955-018-0922-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/30/2018] [Indexed: 12/31/2022] Open
Abstract
Background Globally, allergic diseases are very common in childhood and may affect children’s quality of life. This study aimed to explore health-related quality of life of elementary school students with allergy symptoms using the EQ-5D-Y and to examine the validity and feasibility of the EQ-5D-Y. Methods The study subjects were the students within 50 elementary schools which voluntarily participated in research project. In this sample population, the EQ-5D-Y questionnaire was self-administered by the students, and demographic and health information were collected from the student’s parents. The parents’ information was used to investigate the proportion of students with allergic symptoms (wheezing, runny or blocked nose, and itchy rash) in the past 12 months. In addition, we analyzed the correlation of symptom reporting and EQ-5D-Y including EQ-VAS. Results The overall return was 9117 responses, of which 198 (2.2%) lacked responses on the EQ-5D-Y dimension and 1258 (13.8%) on the VAS score. There were significant differences in symptom reporting in all EQ-5D-Y dimensions between groups with or without allergic symptoms. Particularly, there was a large difference in reporting rates in ‘having pain or discomfort’ and ‘feeling worried, sad or unhappy’ dimensions. As the number of allergic symptoms increased, in all dimensions also the problem reporting rate tended to increase. Conclusions As expected, the presence of allergic symptoms is inversely correlated with the quality of life of children. The EQ-5D-Y instrument proved to be useful in terms of feasibility and construct validity in assessing the quality of life of Korean elementary school students.
Collapse
Affiliation(s)
- Sang-Kyu Kim
- Department of Preventive Medicine, Dongguk University College of Medicine, 123, Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 38066, Republic of Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Seon-Ha Kim
- Department of Nursing, Dankook University College of Nursing, 119, Dandaero, Dongam-gu, Cheonan, Chungnam, 31116, Republic of Korea.
| |
Collapse
|
37
|
Dittrich K, Fuchs A, Bermpohl F, Meyer J, Führer D, Reichl C, Reck C, Kluczniok D, Kaess M, Hindi Attar C, Möhler E, Bierbaum AL, Zietlow AL, Jaite C, Winter SM, Herpertz SC, Brunner R, Bödeker K, Resch F. Effects of maternal history of depression and early life maltreatment on children's health-related quality of life. J Affect Disord 2018; 225:280-288. [PMID: 28843077 DOI: 10.1016/j.jad.2017.08.053] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/27/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is a well-established link between maternal depression and child mental health. Similar effects have been found for maternal history of early life maltreatment (ELM). However, studies investigating the relationship of children's quality of life and maternal depression are scarce and none have been conducted for the association with maternal ELM. The aim of the present study was to investigate the effects of maternal history of ELM and depression on children's health-related quality of life and to identify mediating factors accounting for these effects. METHODS Our study involved 194 mothers with and without history of depression and/or ELM and their children between five and 12 years. Children's health-related quality of life was assessed by maternal proxy- and child self-ratings using the KIDSCREEN. We considered maternal sensitivity and maternal parenting stress as potential mediators. RESULTS We found an effect of maternal history of depression but not of maternal history of ELM on health-related quality of life. Maternal stress and sensitivity mediated the effects of maternal depression on child global health-related quality of life, as well as on the dimensions Autonomy & Parent Relation, School Environment (maternal and child rating), and Physical Wellbeing (child rating). LIMITATION Due to the cross-sectional design of the study, causal interpretations must be made with caution. Some scales yielded low internal consistency. CONCLUSIONS Maternal impairments in areas of parenting which possibly developed during acute depression persist even after remission of acute affective symptoms. Interventions should target parenting stress and sensitivity in parents with prior depression.
Collapse
Affiliation(s)
- Katja Dittrich
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany.
| | - Anna Fuchs
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany
| | - Felix Bermpohl
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Justus Meyer
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany; Vivantes Clinical Centre Spandau, Department of Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany
| | - Daniel Führer
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
| | - Corinna Reichl
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany
| | - Corinna Reck
- Ludwig-Maximilians-University Munich, Department of Child and Adolescent Clinical Psychology and Counseling Psychology, Munich, Germany
| | - Dorothea Kluczniok
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Michael Kaess
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, Bern, Switzerland
| | - Catherine Hindi Attar
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Eva Möhler
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany
| | - Anna-Lena Bierbaum
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
| | - Anna-Lena Zietlow
- University Hospital Heidelberg, Center for Psychosocial Medicine, Institute of Medical Psychology, Germany
| | - Charlotte Jaite
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
| | - Sibylle Maria Winter
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
| | - Sabine C Herpertz
- University Hospital Heidelberg, Center for Psychosocial Medicine, General Psychiatry, Germany
| | - Romuald Brunner
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany
| | - Katja Bödeker
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
| | - Franz Resch
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany
| |
Collapse
|
38
|
Longo E, Badia M, Begoña Orgaz M, Gómez-Vela M. Comparing parent and child reports of health-related quality of life and their relationship with leisure participation in children and adolescents with Cerebral Palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:214-222. [PMID: 29055241 DOI: 10.1016/j.ridd.2017.09.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 08/10/2017] [Accepted: 09/28/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to examine the level of agreement between reports of health-related quality of life (HR-QoL) obtained from children and adolescents with cerebral palsy (CP) and their parents. We also examined the relationships between child and parent perception of the different domains of HR-QoL and participation dimensions. Sixty-nine children and adolescents with CP and their parents separately completed parallel forms of the KIDSCREEN questionnaire. The Spanish version of the Children's Assessment of Participation and Enjoyment (CAPE) was completed by the child/adolescent. Concordance between the children's and the parents' HR-QoL scores was analyzed via Pearson and intraclass correlations. Differences in means were tested using paired Student's t-tests. Chi-square tests were using to assess the incidence of personal variables in the agreement and disagreement of children-parents' responses. The relationships between HR-QoL and leisure participation was confirmed with Pearson's correlation coefficients. Correlations between child and parent HR-QoL scores were small in 7 domains, medium in 2 and large in the Social Support & Peers domain. Children reported significantly better HR-QoL than their parents did. Participation was positively associated with specific domains of HR-QoL, but only weakly, and there were discrepancies between parent and child reports of HR-QoL. These findings provide interesting information about the importance of hearing the voices of children and adolescents with CP to promote HR-QoL and leisure participation.
Collapse
Affiliation(s)
- Egmar Longo
- Federal University of Rio Grande do Norte/FACISA, Brazil.
| | - Marta Badia
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - M Begoña Orgaz
- Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - María Gómez-Vela
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| |
Collapse
|
39
|
Knight A, Kogon AJ, Matheson MB, Warady BA, Furth SL, Hooper SR. Cognitive Function in Children with Lupus Nephritis: A Cross-Sectional Comparison with Children with Other Glomerular Chronic Kidney Diseases. J Pediatr 2017; 189:181-188.e1. [PMID: 28734655 PMCID: PMC5614831 DOI: 10.1016/j.jpeds.2017.06.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 05/10/2017] [Accepted: 06/19/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To identify factors contributing to cognitive impairment in children with lupus nephritis. STUDY DESIGN A cross-sectional analysis of a large multicenter national cohort of children with chronic kidney disease (CKD) using standardized measures to determine baseline neuropsychiatric function and health-related quality of life (HRQoL) in children with lupus nephritis (n = 34), and to compare baseline function with that in children with other forms of glomerular CKD (gCKD; n = 171). We used inverse probability weighting via a logistic model for propensity score analysis to achieve balance between children with lupus nephritis and those with other glomerular causes of CKD, adjusting for known confounders. We used linear regression models to compare neurocognitive outcomes between exposure groups, adjusting for current prednisone use and testing for an interaction between current prednisone use and lupus nephritis, and to test for an association between cognitive function and HRQoL. RESULTS Current prednisone use was independently associated with worse attention (P < .01) and better adaptive skills (P = .04), and there was a significant interaction between current prednisone use and lupus nephritis for internalizing problems, with worse parent-reported internalizing problems in children with lupus nephritis on prednisone (P = .047). Better parent-reported HRQoL was associated with better visual memory (P = .01), and better child-reported HRQoL was associated with better attention (P < .01) and inhibitory control (P < .01). Both parent and child HRQoL were associated with better measures of executive function (P = .02 and < .001, respectively). CONCLUSION Children with lupus nephritis have comparable or better cognitive function than their peers with other gCKDs, which is reassuring given the multiorgan and lifelong complications associated with lupus.
Collapse
Affiliation(s)
- Andrea Knight
- Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Amy J. Kogon
- Division of Nephrology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Matthew B. Matheson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Susan L. Furth
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA and
| | - Stephen R. Hooper
- Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC
| |
Collapse
|
40
|
Cohen-Holzer M, Sorek G, Kerem J, Katz-Leurer M. The impact of combined constraint-induced and bimanual arm training program on the perceived hand-use experience of children with unilateral cerebral palsy. Dev Neurorehabil 2017; 20:355-360. [PMID: 27739919 DOI: 10.1080/17518423.2016.1238017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess change in perceived hand-use experience following a combined bimanual with constraint intervention and to examine its relationship regarding objective hand-function among children with unilateral cerebral palsy (UCP). METHODS Twenty-six children with UCP received 6 hours of combined intervention daily for 10 days. The Children's Hand-use Experience Questionnaire (CHEQ), Assisting Hand Assessment (AHA), and the Jebsen-Taylor Test of Hand Function (JTTHF) assessed independence and experience, bimanual and unimanual function at baseline and 3-months post-intervention. RESULTS Significant improvement over time was noted in AHA and in JTTHF scores. No significant difference was noted on the CHEQ. Although significant associations were noted between JTTHF and AHA results and CHEQ at 3-months post-intervention, no significant associations were noted between changed scores over time. CONCLUSIONS Although measured hand-function and performance improved, this may not be reflected in the hand-use experience during bimanual performance following a combined program. Children's experience merits treatment strategy implementation and investigation.
Collapse
Affiliation(s)
- Marilyn Cohen-Holzer
- a Department of Occupational Therapy , Alyn Hospital, Pediatric and Adolescent Rehabilitation Center , Jerusalem , Israel
| | - Gilad Sorek
- a Department of Occupational Therapy , Alyn Hospital, Pediatric and Adolescent Rehabilitation Center , Jerusalem , Israel
| | - Julie Kerem
- a Department of Occupational Therapy , Alyn Hospital, Pediatric and Adolescent Rehabilitation Center , Jerusalem , Israel
| | - Michal Katz-Leurer
- a Department of Occupational Therapy , Alyn Hospital, Pediatric and Adolescent Rehabilitation Center , Jerusalem , Israel.,b Physical Therapy Department, School of Health Professions, Faculty of Medicine , Tel Aviv University , Ramat Aviv , Israel
| |
Collapse
|
41
|
Adaptación transcultural del cuestionario PedsQL Cancer Module version 3.0 para su uso en Colombia. ACTA ACUST UNITED AC 2017; 46:161-167. [DOI: 10.1016/j.rcp.2016.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/23/2016] [Accepted: 07/19/2016] [Indexed: 11/19/2022]
|
42
|
Qadeer RA, Ferro MA. Child–parent agreement on health-related quality of life in children with newly diagnosed chronic health conditions: a longitudinal study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2017. [DOI: 10.1080/02673843.2017.1297242] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Rana A. Qadeer
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Mark A. Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| |
Collapse
|
43
|
Scott D, Ferguson GD, Jelsma J. The use of the EQ-5D-Y health related quality of life outcome measure in children in the Western Cape, South Africa: psychometric properties, feasibility and usefulness - a longitudinal, analytical study. Health Qual Life Outcomes 2017; 15:12. [PMID: 28103872 PMCID: PMC5248508 DOI: 10.1186/s12955-017-0590-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The EQ-5D-Y, an outcome measure of Health Related Quality of Life (HRQoL) in children, was developed by an international task team in 2010. The multinational feasibility, reliability and validity study which followed was undertaken with mainly healthy children. The aim of this study was to investigate the psychometric properties of the EQ-5D-Y when used to assess the HRQoL of children with different health states. METHOD A sample of 224 children between eight and twelve years were grouped according to their health state. The groups included 52 acutely ill children, 67 children with either a chronic health condition or disability and 105 mostly healthy, mainstream school children as a comparator. They were assessed at baseline, at three months and at six months. An analysis of the psychometric properties was performed to assess the reliability, validity and responsiveness of the EQ-5D-Y in the different groups of children. Cohen's kappa, the intraclass correlation coefficient, Pearson Chi-square, Kruskal-Wallis ANOVA and effect size of Wilcoxon Signed-rank test were used to determine the reliability, validity and responsiveness of the instrument. RESULTS The EQ-5D-Y dimensions were found to be reliable on test-retest (kappa varying from 0.365 to 0.653), except for the Usual Activities dimension (kappa 0.199). The Visual Analogue Scale (VAS) was also reliable (ICC = 0.77). Post-hoc analysis indicated that dimensions were able to discriminate between acutely ill and healthy children (all differences p < 0.001). The acutely ill children had the lowest ranked VAS (median 50, range 0-100), indicating worst HRQoL and was the only group significantly different from the other three groups (p < 0.001 in all cases). Convergent validity between all similar EQ-5D-Y and PedsQL, WeeFIM and Faces Pain Scale dimensions was only evident in the acutely ill children. As expected the largest treatment effect was also observed in these children (Wilcoxon Signed-rank test for VAS was 0.43). Six of the nine therapists who took part in the study, found the measure quick and easy to apply, used the information in the management of the child and would continue to use it in future. CONCLUSIONS The EQ-5D-Y could be used with confidence as an outcome measure for acutely-ill children, but demonstrated poorer psychometric properties in children with no health condition or chronic conditions. It appears to be feasible and useful to include the EQ-5D-Y in routine assessments of children.
Collapse
Affiliation(s)
- Des Scott
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Observatory 7925, Cape Town, South Africa.
| | - Gillian D Ferguson
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Observatory 7925, Cape Town, South Africa
| | - Jennifer Jelsma
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Observatory 7925, Cape Town, South Africa
| |
Collapse
|
44
|
Williams VK, Antoniou G, Jackson A, Atkins A. Parents' perception of quality of life in their sons with haemophilia. J Paediatr Child Health 2016; 52:1095-1098. [PMID: 27566422 DOI: 10.1111/jpc.13340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/29/2016] [Accepted: 06/09/2016] [Indexed: 11/27/2022]
Abstract
AIM Quality of life (QOL) in haemophilia involves both physical and psychological issues. This study was performed to determine parents' perceptions of the QOL of their sons with haemophilia and compare this to their children's own assessment. METHODS In this study, we used the Haemo-QoL questionnaire for haemophilia, to compare the responses of 22 parents to the responses of their children within the age groups 4-7, 8-12 and 13-16 and also for the severity groups mild versus moderate-severe. RESULTS In the 4-7 age group, the children considered their QOL to be less than that estimated by their parents for a number of areas, while in the 8-12 age group the parents considered the QOL for their children to be lower than that estimated by the children themselves. In the 13-16 age group, there was almost universal agreement on QOL between the children and their parents apart from the subscale of school and sport (P = 0.04). Within the severity groupings, there was much more concordance between the parents and children. The only significant difference between parents and children was for physical health in the mild group (P = 0.03). In the moderate-severe groups, no results were significant, however, five of the subscales showed borderline significant (P < 0.1) results. CONCLUSIONS Parental perceptions of QOL of their sons changes with the age of the child and the severity of the haemophilia. These perceptions need to be taken into account when developing an overall care strategy involving both the child and parent.
Collapse
Affiliation(s)
- Vaughan K Williams
- SA Pathology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Georgia Antoniou
- Department of Orthopaedic Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Anne Jackson
- Haemophilia Treatment Centre, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Andrew Atkins
- Haemophilia Centre, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| |
Collapse
|
45
|
Quitmann J, Rohenkohl A, Sommer R, Bullinger M, Silva N. Explaining parent-child (dis)agreement in generic and short stature-specific health-related quality of life reports: do family and social relationships matter? Health Qual Life Outcomes 2016; 14:150. [PMID: 27769269 PMCID: PMC5075198 DOI: 10.1186/s12955-016-0553-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the context of health-related quality of life (HrQoL) assessment in pediatric short stature, the present study aimed to examine the levels of agreement/disagreement between parents' and children's reports of generic and condition-specific HrQoL, and to identify socio-demographic, clinical and psychosocial variables associated with the extent and direction of parent-child discrepancies. METHODS This study was part of the retest phase of the QoLISSY project, which was a multicenter study conducted simultaneously in France, Germany, Spain, Sweden and UK. The sample comprised 137 dyads of children/adolescents between 8 and 18 years of age, diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS), and one of their parents. The participants completed child- and parent-reported questionnaires on generic (KIDSCREEN-10 Index) and condition-specific HrQoL (QoLISSY Core Module). Children/adolescents also reported on social support (Oslo 3-items Social Support Scale) and parents assessed the parent-child relationships (Parental Role subscale of the Social Adjustment Scale) and burden of short stature on parents (QoLISSY- additional module). RESULTS The parent-child agreement on reported HrQoL was strong (intraclass correlation coefficients between .59 and .80). The rates of parent-child discrepancies were 61.5 % for generic and 35.2 % for condition-specific HrQoL, with the parents being more prone to report lower generic (42.3 %) and condition-specific HrQoL (23.7 %) than their children. The extent of discrepancies was better explained by family and social relationships than by clinical and socio-demographic variables: poorer parent-child relationships and better children's social support were associated with larger discrepancies in generic HrQoL, while more parental burden was associated with larger discrepancies in condition-specific HrQoL reports. Regarding the direction of discrepancies, higher parental burden was significantly associated with parents' underrating, and better children's social support was significantly associated with parents' overrating of condition-specific HrQoL. CONCLUSIONS Routine assessment of pediatric HrQoL in healthcare and research contexts should include child- and parent-reported data as complementary sources of information, and also consider the family and social context.
Collapse
Affiliation(s)
- Julia Quitmann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany.
| | - Anja Rohenkohl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany
| | - Rachel Sommer
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany
| | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany
| | - Neuza Silva
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany.,Cognitive and Behavioural Center for Research and Intervention, Faculty of Psychology and Educational Sciences of the University of Coimbra, Rua do Colégio Novo, 3001-802, Coimbra, Portugal
| |
Collapse
|
46
|
Minooei MS, Ghazavi Z, Abdeyazdan Z, Gheissari A, Hemati Z. The Effect of the Family Empowerment Model on Quality of Life in Children with Chronic Renal Failure: Children's and Parents' Views. Nephrourol Mon 2016; 8:e36854. [PMID: 27713868 PMCID: PMC5045527 DOI: 10.5812/numonthly.36854] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/26/2016] [Accepted: 06/11/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic renal failure (CRF) causes a gradual decline in kidney function to the extent that CRF patients need long-term clinical care, which affects the patients' family function and quality of life (QoL). OBJECTIVES The present study was conducted to study the effects of the family-centered empowerment model on QoL in children with CRF during 2012-2013. PATIENTS AND METHODS In this quasi-experimental study, 68 children with CRF and their parents were randomly assigned to two groups, intervention and control, via a random numbers table. An empowerment program was then conducted over the course of seven 45-minute sessions, and a questionnaire to ascertain demographic characteristics and the core pediatric QoL Inventory (version 4) were administered to both groups before the sessions and one month after the last training session. The data were analyzed using SPSS 20. RESULTS The mean age of the children was 10.2 and 10.5 years in the intervention and control groups, respectively. The duration of the disease was five years in both groups. Furthermore, a significant difference was seen in the mean score of the children's QoL from their own perspectives in the physical and psychosocial domains and the total QoL score in the intervention group before and after the training (P < 0.05). CONCLUSIONS Since family-centered empowerment interventions can determine the training- and treatment-related needs of patients and are low cost and effective, they may help parents promote their children's self-efficacy and QoL.
Collapse
Affiliation(s)
- Marzieh Sadat Minooei
- Department of Nursing, Faculty of Nursing and Midwifery, Najafabad Branch, Islamic Azad University, Najafabad, IR Iran
| | - Zohreh Ghazavi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Zahra Abdeyazdan
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Alaleh Gheissari
- Isfahan Kidney Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Zeinab Hemati
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| |
Collapse
|
47
|
Conway L, Smith ML, Ferro MA, Speechley KN, Connoly MB, Snead OC, Widjaja E. Correlates of health-related quality of life in children with drug resistant epilepsy. Epilepsia 2016; 57:1256-64. [PMID: 27350597 DOI: 10.1111/epi.13441] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Health-related quality of life (HRQL) is compromised in children with epilepsy. The current study aimed to identify correlates of HRQL in children with drug resistant epilepsy. METHODS Data came from 115 children enrolled in the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PEPSQOL), a multicenter prospective cohort study. Individual, clinical, and family factors were evaluated. HRQL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE), a parent-rated epilepsy-specific instrument, with composite scores ranging from 0 to 100. A series of univariable linear regression analyses were conducted to identify significant associations with HRQL, followed by a multivariable regression analysis. RESULTS Children had a mean age of 11.85 ± 3.81 years and 65 (56.5%) were male. The mean composite QOLCE score was 60.18 ± 16.69. Child age, sex, age at seizure onset, duration of epilepsy, caregiver age, caregiver education, and income were not significantly associated with HRQL. Univariable regression analyses revealed that a higher number of anti-seizure medications (p = 0.020), lower IQ (p = 0.002), greater seizure frequency (p = 0.048), caregiver unemployment (p = 0.010), higher caregiver depressive and anxiety symptoms (p < 0.001 for both), poorer family adaptation, fewer family resources, and a greater number of family demands (p < 0.001 for all) were associated with lower HRQL. Multivariable regression analysis showed that lower child IQ (β = 0.20, p = 0.004), fewer family resources (β = 0.43, p = 0.012), and caregiver unemployment (β = 6.53, p = 0.018) were associated with diminished HRQL in children. SIGNIFICANCE The results emphasize the importance of child cognition and family variables in the HRQL of children with drug-resistant epilepsy. The findings speak to the importance of offering comprehensive care to children and their families to address the nonmedical features that impact on HRQL.
Collapse
Affiliation(s)
- Lauryn Conway
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Mary Lou Smith
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Mark A Ferro
- Departments of Psychiatry and Behavioural Neurosciences and Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Kathy N Speechley
- Departments of Paediatrics, Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Mary B Connoly
- Division of Neurology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - O Carter Snead
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elysa Widjaja
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada
| | | |
Collapse
|
48
|
Yi-Frazier JP, Hilliard ME, Fino NF, Naughton MJ, Liese AD, Hockett CW, Hood KK, Pihoker C, Seid M, Lang W, Lawrence JM. Whose quality of life is it anyway? Discrepancies between youth and parent health-related quality of life ratings in type 1 and type 2 diabetes. Qual Life Res 2016; 25:1113-21. [PMID: 26466834 PMCID: PMC4936832 DOI: 10.1007/s11136-015-1158-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Health-related quality of life (HRQOL) is a critical diabetes outcome, yet differences between youth and parent-proxy ratings can make interpretation difficult. This study aims to explore potential differences between self- and parent-reports of Pediatric Quality of Life Inventory (PedsQL) scores from youth with type 1 (T1D) or type 2 diabetes (T2D) and to evaluate associations between discrepancies, PedsQL scores, and glycemic control (HbA1c). METHODS Youth and parents in the SEARCH for Diabetes in Youth Study (T1D: age 5-18, n = 3402; T2D: age 8-18, n = 353) completed the PedsQL Generic and Diabetes Modules, and youth provided a blood sample to assess HbA1c. Discrepancies (youth minus parent PedsQL ratings) were calculated and examined by age and diabetes type, and associations with youth PedsQL scores and HbA1c were evaluated. RESULTS Discrepancies existed between youth and parent-proxy reports of generic and diabetes PedsQL scores in T1D and T2D (all p values < 0.01). Higher (more favorable) ratings were reported by youth except for those 5-7-years old, where parents' scores were higher. When parent-proxy scores were higher, discrepancies were largest when the child reported low PedsQL scores. Higher HbA1c was associated with larger discrepancies (youth scores higher) for adolescents with T1D. CONCLUSIONS Discrepant PedsQL ratings suggest that parents may often underestimate youths' HRQOL except in the youngest children. Although examining both reports is optimal, the youth report should be prioritized, particularly for young children with T1D and for adolescents with either T1D or T2D.
Collapse
Affiliation(s)
- Joyce P Yi-Frazier
- Department of Endocrinology, Seattle Children's Research Institute, Seattle, WA, 98101, USA.
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Nora F Fino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michelle J Naughton
- Division of Population Sciences, The Ohio State University, Columbus, OH, 43201, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Christine W Hockett
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, 80045, USA
| | - Korey K Hood
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94305, USA
| | - Catherine Pihoker
- Department of Endocrinology, Seattle Children's Research Institute, Seattle, WA, 98101, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, 98105, USA
| | - Michael Seid
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Wei Lang
- Division of Population Sciences, The Ohio State University, Columbus, OH, 43201, USA
| | - Jean M Lawrence
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA
| |
Collapse
|
49
|
Schei J, Jozefiak T, Nøvik TS, Lydersen S, Indredavik MS. The Impact of Coexisting Emotional and Conduct Problems on Family Functioning and Quality of Life Among Adolescents With ADHD. J Atten Disord 2016; 20:424-33. [PMID: 24141100 DOI: 10.1177/1087054713507976] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to assess the impact of self-reported emotional and conduct problems on family functioning and quality of life (QoL) among adolescents with ADHD. METHOD The ADHD group (N = 194) was divided into the following groups: without additional emotional or conduct problems, with emotional problems, with conduct problems, and with both problem types. The cross-sectional study included parent and adolescent reports. RESULTS Adolescents with ADHD and both problem types reported significantly lower QoL and family functioning than all other ADHD groups. Parents reported better QoL for the ADHD group without additional problems, but similar family functioning for all groups. CONCLUSION A higher level of coexisting psychiatric problems had a significant impact on adolescents' reports of family functioning and QoL. However, coexisting problems showed no association with parent reports of family functioning. Adolescents with ADHD might add important information in clinical assessment.
Collapse
Affiliation(s)
- Jorun Schei
- NTNU, Trondheim, Norway St. Olavs University Hospital, Trondheim, Norway
| | - Thomas Jozefiak
- NTNU, Trondheim, Norway St. Olavs University Hospital, Trondheim, Norway
| | | | | | - Marit S Indredavik
- NTNU, Trondheim, Norway St. Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
50
|
de Ruiter MA, Schouten-van Meeteren AYN, van Vuurden DG, Maurice-Stam H, Gidding C, Beek LR, Granzen B, Oosterlaan J, Grootenhuis MA. Psychosocial profile of pediatric brain tumor survivors with neurocognitive complaints. Qual Life Res 2016; 25:435-446. [PMID: 26289022 PMCID: PMC4722086 DOI: 10.1007/s11136-015-1091-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 10/25/2022]
Abstract
PURPOSE With more children surviving a brain tumor, neurocognitive consequences of the tumor and its treatment become apparent, which could affect psychosocial functioning. The present study therefore aimed to assess psychosocial functioning of pediatric brain tumor survivors (PBTS) in detail. METHODS Psychosocial functioning of PBTS (8-18 years) with parent-reported neurocognitive complaints was compared to normative data on health-related quality of life (HRQOL), self-esteem, psychosocial adjustment, and executive functioning (one-sample t tests) and to a sibling control group on fatigue (independent-samples t test). Self-, parent-, and teacher-report questionnaires were included, where appropriate, providing complementary information. RESULTS Eighty-two PBTS (mean age 13.4 years, SD 3.2, 49 % males) and 43 healthy siblings (mean age 14.3, SD 2.4, 40 % males) were included. As compared to the normative population, PBTS themselves reported decreased physical, psychological, and generic HRQOL (d = 0.39-0.62, p < 0.008). Compared to siblings, increased fatigue-related concentration problems (d = 0.57, p < 0.01) were reported, although self-reported self-esteem and psychosocial adjustment seemed not to be affected. Parents of PBTS reported more psychosocial (d = 0.81, p < 0.000) and executive problems (d = 0.35-0.43, p < 0.016) in their child than parents of children in the normative population. Teachers indicated more psychosocial adjustment problems for female PBTS aged 8-11 years than for the female normative population (d = 0.69, p < 0.025), but they reported no more executive problems. CONCLUSIONS PBTS with parent-reported neurocognitive complaints showed increased psychosocial problems, as reported by PBTS, parents, and teachers. IMPLICATIONS FOR CANCER SURVIVORS Systematic screening of psychosocial functioning is necessary so that tailored support from professionals can be offered to PBTS with neurocognitive complaints.
Collapse
Affiliation(s)
- Marieke Anna de Ruiter
- />Pediatric Psychosocial Department, Emma Children’s Hospital AMC, Meibergdreef 9, Room A3-241, 1105 AZ Amsterdam, The Netherlands
| | | | | | - Heleen Maurice-Stam
- />Pediatric Psychosocial Department, Emma Children’s Hospital AMC, Meibergdreef 9, Room A3-241, 1105 AZ Amsterdam, The Netherlands
| | - Corrie Gidding
- />Department of Pediatric Oncology/Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Laura Rachel Beek
- />Department of Medical Psychology, Wilhelmina Children’s Hospital UMC, Utrecht, The Netherlands
| | - Bernd Granzen
- />Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jaap Oosterlaan
- />Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Martha Alexandra Grootenhuis
- />Pediatric Psychosocial Department, Emma Children’s Hospital AMC, Meibergdreef 9, Room A3-241, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|