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Alonso Rubio P, Bahíllo Curieses MP, Prieto Matos P, Bertholt Zuber ML, Martín Alonso MM, Murillo Vallés M, Chueca Guindulain MJ, Berrade Zubiri S, Huidobro Fernández B, Prado Carro AM, Rodríguez Estévez A, Rica Echevarría I, Grau Bolado G, Díez López I, Fernández Ramos MC, Rodríguez Dehli C, Riaño-Galán I. Adaptation, reliability and validity of health-related quality of life questionnaires: Disabkids chronic and specific diabetes disease in children and adolescents with diabetes mellitus type 1. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 3:18-26. [PMID: 37598007 DOI: 10.1016/j.endien.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/30/2022] [Indexed: 08/21/2023]
Abstract
INTRODUCTION It is recommended to periodically evaluate the health-related quality of life (HRQoL) in children and adolescents with type 1 diabetes mellitus (DM1). Despite this, no specific paediatric HRQoL instrument for DM1 has been validated in Spanish. OBJECTIVES Multicentre, prospective descriptive study in children and adolescents with DM1 with the aim of carrying out cross-cultural adaptation to Spanish and evaluating the reliability and validity of the DISABKIDS chronic disease and diabetes-specific HRQoL questionnaires, using reverse translation. MATERIAL AND METHODS Sociodemographic variables were compiled together with the most recent capillary glycated haemoglobin (HbA1c) value and HRQoL questionnaires were handed out to 200 Spanish children and adolescents with DM1 aged between 8 and 18 years of age under evaluation in 12 different hospitals. RESULTS The mean score on the HRQoL questionnaire (patient version) for chronic disease was 80.32 (13.66), being significantly lower (P = .04) in patients with a shorter duration of the disease (≤5 years): 78.34 (13.70) vs. 82.60 (13.36). The mean score of the DM1-specific modules was: 60.81 (16.23) for disease impact and 65.59 (26.19) for treatment impact. The mean HbA1c value was 7.08 (0.79), with no differences (P > .05) noted in the mean score of the HRQoL instruments in patients with HbA1c ≤7% vs. HbA1c >7%. The Cronbach α value varied between 0.72 and 0.90. CONCLUSIONS The Spanish versions of the DISABKIDS HRQoL instruments meet the proposed objectives of semantic equivalence and internal consistency, making it possible to periodically assess HRQoL in these patients. The good average glycaemic control presented by the patients may explain why no difference was found in the HRQoL instruments based on the HbA1c value.
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Affiliation(s)
- Pablo Alonso Rubio
- Unidad de Endocrinología Pediátrica, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | | | - Pablo Prieto Matos
- Unidad de Endocrinología Pediátrica, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | - Marta Murillo Vallés
- Unidad de Endocrinología Pediátrica, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - Sara Berrade Zubiri
- Unidad de Endocrinología Pediátrica, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Ana María Prado Carro
- Unidad de Endocrinología Pediátrica, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Amaia Rodríguez Estévez
- Unidad de Endocrinología Pediátrica, Hospital Universitario Cruces, Barakaldo, Spain; BIOCRUCES, Barakaldo, Bizkaia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Itxaso Rica Echevarría
- Unidad de Endocrinología Pediátrica, Hospital Universitario Cruces, Barakaldo, Spain; BIOCRUCES, Barakaldo, Bizkaia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Gema Grau Bolado
- Unidad de Endocrinología Pediátrica, Hospital Universitario Cruces, Barakaldo, Spain; BIOCRUCES, Barakaldo, Bizkaia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Ignacio Díez López
- Unidad de Endocrinología Pediátrica, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | | | | | - Isolina Riaño-Galán
- AGC de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Biosanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
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Hov B, Andersen T, Toussaint M, Mikalsen IB, Vollsaeter M, Markussen H, Indrekvam S, Hovland V. User-perceived impact of long-term mechanical assisted cough in paediatric neurodisability. Dev Med Child Neurol 2023; 65:655-663. [PMID: 36787316 DOI: 10.1111/dmcn.15543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 02/15/2023]
Abstract
AIM To (1) compare the perceived benefit of long-term mechanical insufflation-exsufflation (MI-E) of children with neuromuscular disorders (NMDs) and central nervous system (CNS) disorders, including health care needs and treatment routines and (2) describe the children's health-related quality of life (HRQoL). METHOD This cross-sectional study used a questionnaire and memory card data to assess the perceived benefit of MI-E via the Visual Analogue Scale (VAS; 10 maximum), willingness to pause treatment, level of health care needs before and after MI-E initiation, and the children's treatment routines. A DISABKIDS questionnaire assessed HRQoL (100 maximum). RESULTS Seventy-three children using MI-E participated (42 males, median [interquartile range {IQR}] age 10 years 2 months [6 years 3 months-14 years 1 month]), 47 with NMDs (such as spinal muscular atrophy and Duchenne muscular dystrophy) and 26 with CNS disorders (such as cerebral palsy, encephalitis, neurometabolic and other diseases). The median (IQR) VAS score for the perceived benefit of MI-E therapy at stable state and respiratory tract infection were 9 (6-10) and 10 (8.5-10) respectively. Sixty-two per cent were reluctant or unwilling to pause MI-E therapy, with no NMD versus CNS disorder group difference. After MI-E initiation, fewer physician consultations and hospitalizations were reported by the group with NMDs. The MI-E routine was similar in both groups. The mean (SD) HRQoL score for 26 of 51 eligible children was 71 (16.7). INTERPRETATION MI-E treatment was generally perceived as beneficial and performed equally in both diagnostic groups. HRQoL was in line with children with a moderate-to-severe chronic condition.
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Affiliation(s)
- Brit Hov
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tiina Andersen
- Norwegian Advisory Unit on Long-term Mechanical Ventilation, Thoracic Department, Haukeland University Hospital, Bergen, Norway.,Faculty of Health and Social Sciences, Western Norway University of Applied Science, Bergen, Norway
| | - Michel Toussaint
- Centre de Référence Neuromusculaire, Département de Neurologie, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Ingvild B Mikalsen
- Department of Paediatrics, Stavanger University Hospital HF, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Maria Vollsaeter
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Heidi Markussen
- Norwegian Advisory Unit on Long-term Mechanical Ventilation, Thoracic Department, Haukeland University Hospital, Bergen, Norway.,Faculty of Health and Social Sciences, Western Norway University of Applied Science, Bergen, Norway
| | - Solfrid Indrekvam
- Norwegian Advisory Unit on Long-term Mechanical Ventilation, Thoracic Department, Haukeland University Hospital, Bergen, Norway.,Norwegian National Register for Long-Term Mechanical Ventilation, Thoracic Department, Haukeland University Hospital, Bergen, Norway
| | - Vegard Hovland
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Martens SA, Tuberty S, James MA. Self-concept development in children with limb differences: A scoping review. Int J Orthop Trauma Nurs 2023; 49:100997. [PMID: 36773469 DOI: 10.1016/j.ijotn.2023.100997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
Having a visible physical difference, such as a limb difference, can have a significant impact on a child's psychosocial development, as children with limb differences may experience negative psychosocial sequelae. The aim of this scoping review was to investigate the findings of literature pertaining to self-concept of children with limb differences. Using the PRISMA ScR guidelines, a literature search was conducted in Embase, CINAHL, PsycINFO and PubMed databases. Nine articles met the inclusion criteria and were included in this review. Two studies focused on evaluating self-concept, whereas the remaining seven studies focused on associated constructs of self-concept (i.e., self-perception and self-esteem). The findings of these studies indicated that the social environment directly impacted the development of psychopathology and self-concept in children with limb differences. This review demonstrated a need for a gold standard instrument with which to assess children's self-concept. CLINICAL RELEVANCE: Level IV: Evidence derived from guidelines developed from a systematic review of existing qualitative, quantitative, and mixed methods research studies.
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Affiliation(s)
- Sally Ann Martens
- University of Louisville, School of Nursing, 555 S. Floyd St, Louisville, KY, 40059, USA.
| | - Sarah Tuberty
- Shriners Hospital for Children, Philadelphia, 3551 N Broad St, Philadelphia, PA, 19140, USA
| | - Michelle A James
- Shriners Hospital for Children, Northern California, 2425 Stockton Blvd, Sacramento, CA, 95817, USA
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Adaptación, fiabilidad y validez de los cuestionarios de calidad de vida relacionada con la salud: DISABKIDS, enfermedad crónica y específico de diabetes, en niños y adolescentes con diabetes mellitus tipo 1. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bratke H, Biringer E, Margeirsdottir HD, Njølstad PR, Skrivarhaug T. Relation of Health-Related Quality of Life with Glycemic Control and Use of Diabetes Technology in Children and Adolescents with Type 1 Diabetes: Results from a National Population Based Study. J Diabetes Res 2022; 2022:8401328. [PMID: 36387938 PMCID: PMC9649325 DOI: 10.1155/2022/8401328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The primary aim was to analyse the association between diabetes-specific health-related quality of life (HRQOL) and HbA1c in children and adolescents with type 1 diabetes. The secondary aims were to evaluate the associations between diabetes-specific HRQOL and age, sex, diabetes duration, and the use of diabetes technology in diabetes treatment. Research Design and Methods. Children with type 1 diabetes (10-17 years, N = 1,019) and parents (children <10 years, N = 371; 10-17 years, N = 1,070) completed the DISABKIDS diabetes-specific questionnaire (DDM-10) as part of the 2017 data collection for the Norwegian Childhood Diabetes Registry. The DDM-10 consists of two subscales-'impact' and 'treatment'-with six and four items, respectively. In the linear regression models, the items and subscales were outcome variables, while HbA1c, age, sex, diabetes duration, insulin pump use, and continuous glucose monitoring (CGM) system use were predictor variables. RESULTS Lower HbA1c measurements and male sex were associated with higher HRQOL scores on both DDM-10 scales in the age group 10-17 years, but not in children under 10 years. Parents gave lower HRQOL scores than children in the 10-17 age group. Insulin pump and CGM use were not significantly associated with HRQOL on the impact and treatment scale. CONCLUSIONS Low HbA1c and male sex are significantly associated with high HRQOL in children aged 10-17 with type 1 diabetes, but the use of diabetes technology is not positively associated with HRQOL. Differences in child- and parent-reported scores imply that parents might both over- and underestimate their child's HRQOL.
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Affiliation(s)
- Heiko Bratke
- Department of Pediatrics, Haugesund Hospital, Fonna Health Trust, Haugesund, Norway
- Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Oslo Diabetes Research Centre, Oslo, Norway
- Department of Research and Innovation, Fonna Health Trust, Haugesund, Norway
| | - Eva Biringer
- Department of Research and Innovation, Fonna Health Trust, Haugesund, Norway
| | - Hanna D. Margeirsdottir
- Oslo Diabetes Research Centre, Oslo, Norway
- Division of Childhood and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Pål R. Njølstad
- Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Child and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Torild Skrivarhaug
- Oslo Diabetes Research Centre, Oslo, Norway
- Division of Childhood and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo, Norway
- The Norwegian Childhood Diabetes Registry, Division of Childhood and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Singh A, Dasgupta M, Retherford D, Fiallo-Scharer R, Simpson PM, Panepinto JA. Measurement properties of Patient Reported Outcomes Measurement Information System domains for children with type 1 diabetes. Pediatr Diabetes 2021; 22:335-344. [PMID: 33026680 PMCID: PMC8185634 DOI: 10.1111/pedi.13134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/02/2020] [Accepted: 10/04/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Patient Reported Outcomes Measurement Information System (PROMIS) includes numerous domains to assess functioning among the pediatric population. These domains, however, have not been evaluated for use in children with type 1 diabetes (T1D). The objective of this study was to determine the measurement properties of PROMIS domains (pain behavior, pain quality, physical stress experience, physical activity, strength impact, and profile-25) in children with T1D. METHODS This is a cross-sectional study of children with T1Drecruited from tertiary care facilities. To determine construct validity, we compared PROMIS T-scores between known-groups based on (a) glycemic control, hemoglobin A1c (HbA1c%) and (b) self-reported general health, using t test or analysis of variance. Reliability was determined using Cronbach's alpha and item response theory reliability. We also determined agreement between parent-proxy and child self-report PROMIS scores. RESULTS Our study included 192 children, mean age 12.7 (SD = 2.9) years, eligible to self-report PROMIS surveys. There were significant differences in physical stress experience and pain intensity between children with HbA1c < 10% and those with HbA1c ≥ 10%. There also were significant differences in T-scores for all domains except physical function mobility and strength impact among children with poor/fair, good, very good/excellent general health. All valid domains had reliability >0.70. More than 40% of child-parent pairs were in agreement, with intraclass correlations coefficients (ICC) ranging between 0.41 and 0.63 for all domains, except pain behavior (%agreement = 23%; ICC = 0.29). CONCLUSIONS Most of the PROMIS domains tested are valid, reliable, and able to differentiate children with T1D who report different general health states. There is moderate agreement between child-parent pairs for all domains except pain behavior.
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Affiliation(s)
- Ashima Singh
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mahua Dasgupta
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Dawn Retherford
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rosanna Fiallo-Scharer
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Pippa M. Simpson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Julie A. Panepinto
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
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Alelayan H, Liang L, Ye R, Meng J, Liao X. Assessing health-related quality of life in Chinese children and adolescents with cancer: validation of the DISABKIDS chronic generic module (DCGM-37). BMC Cancer 2021; 21:204. [PMID: 33639887 PMCID: PMC7913225 DOI: 10.1186/s12885-021-07910-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background With increasing cancer incidence and decreasing cancer mortality, there is a growing need for a valid and culturally adapted tool to measure health-related quality of life in children with cancer. This study validated the DISABKIDS Chronic Generic Module (DCGM-37) in Chinese children and adolescents with cancer. Methods The DCGM-37 was translated and adapted for use in China following the guidelines from its copyright holders. In total, 140 children and adolescents with cancer and their guardians were included in this cross-sectional study. Internal consistency and test-retest reliability were evaluated. Convergent validity was examined using Pearson correlation between the DCGM-37 and the PedsQL 4.0 Generic Core Scale. Dimensionality was clarified using exploratory factor analysis. Discriminant validity was evaluated by comparing DCGM-37 scores by sex, age, family income, and clinical characteristics. Results Internal consistency (Cronbach’s alpha 0.91) and test–retest reliability were good (intraclass correlation coefficient 0.87, 95% confidence interval 0.73–0.94). Strong correlations between the DCGM-37 and the PedsQL 4.0 (r = 0.83) suggest good convergent validity. Six factors explained 51.94% of the total variance. Children with leukemia scored higher than those with sarcoma in all subscales (effect size ranged from 0.39 to 0.83), especially the “social exclusion” subscales (effect size 0.83). Small to moderate differences (effect size ranged from 0.38 to 0.58) were observed by sex, age, and family income. Neither floor nor ceiling effects were observed. Conclusion The DCGM-37 is reliable and valid for measuring health-related quality of life in Chinese children and adolescents with cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-07910-9.
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Affiliation(s)
- Hasan Alelayan
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, No. 28 Innovation Avenue, Zengcheng, Guangzhou, 511300, China.,School of Nursing, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou , 510515, China
| | - Lizhu Liang
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, No. 28 Innovation Avenue, Zengcheng, Guangzhou, 511300, China.,School of Nursing, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou , 510515, China
| | - Rui Ye
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, No. 28 Innovation Avenue, Zengcheng, Guangzhou, 511300, China.,School of Nursing, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou , 510515, China
| | - Jiangnan Meng
- Pediatric Department, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Xiaoyan Liao
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, No. 28 Innovation Avenue, Zengcheng, Guangzhou, 511300, China.
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Svensson J, Sildorf SM, Bøjstrup J, Kreiner S, Skrivarhaug T, Hanberger L, Petersson C, Åkesson K, Frøisland DH, Chaplin J. The DISABKIDS generic and diabetes-specific modules are valid but not directly comparable between Denmark, Sweden, and Norway. Pediatr Diabetes 2020; 21:900-908. [PMID: 32333631 DOI: 10.1111/pedi.13036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 03/31/2020] [Accepted: 04/06/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/OBJECTIVES Government guidance promote benchmarking comparing quality of care including both clinical values and patient reported outcome measures in young persons with type 1 diabetes. The aim was to test if the Nordic DISABKIDS health-related quality of life (HrQoL) modules were construct valid and measurement comparable within the three Nordic countries. METHODS Data from three DISABKIDS validation studies in Sweden, Denmark, and Norway were compared using Rasch and the graphical log-linear Rasch modeling. Monte Carlo methods were used to estimate reliability coefficient and target was defined as the point with the lowest SE of the mean. Self-report data were available from 99 Danish (8-18 years), 103 Norwegian (7-19 years), and 131 Swedish (8-18 years) young people. RESULTS For the DISABKIDS higher scores on most subscales were noted in the Norwegian population. The Swedish sample had a significantly higher score on the "Diabetes treatment" subscale and scores closer to optimal target than the other countries. For each country, construct validity and sensitivity were acceptable when accounting for differential item function (DIF) and local dependency (LD). Less LD and DIF were found if only Denmark and Norway were included. The combined model was reliable; however, some differences were noted in the scale translations relating to the stem and response alternatives, which could explain the discrepancies. CONCLUSION The Nordic versions of the DISABKIDS questionnaires measures valid and reliable HrQoL both within and between countries when adjusted for DIF and LD. Adjusting the Likert scales to the same respond categories may improve comparability.
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Affiliation(s)
- Jannet Svensson
- Pediatric Department, Herlev University Hospital, Herlev, Denmark
| | | | - Julie Bøjstrup
- Pediatric Department, Herlev University Hospital, Herlev, Denmark
| | - Svend Kreiner
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences , University of Copenhagen, Copenhagen, Denmark
| | - Torild Skrivarhaug
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, The Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lena Hanberger
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Christina Petersson
- Department of Nursing Sciences, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Karin Åkesson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Pediatrics, Ryhov County Hospital, Jønkøping, Sweden
| | | | - John Chaplin
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Health related quality of life associated with extreme obesity in adolescents - results from the baseline evaluation of the YES-study. Health Qual Life Outcomes 2020; 18:58. [PMID: 32138734 PMCID: PMC7059717 DOI: 10.1186/s12955-020-01309-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 02/26/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity can significantly reduce health-related quality of life (HRQoL) and may lead to numerous health problems even in youths. This study aimed to investigate whether HRQoL varies among youths with obesity depending on grade of obesity and other factors. METHODS For the Youths with Extreme obesity Study (YES) (2012-2014), a prospective multicenter cohort study, a baseline sample of 431 obese and extremely obese adolescents and young adults (age 14 to 24 years, BMI ≥30 kg/m2) was recruited at four German university medical centers and one job center. Obesity grade groups (OGG) were defined according to BMI (OGG I: 30-34.9 kg/m2, OGG II: 35-39.9 kg/m2, OGG III (extreme obesity): ≥40 kg/m2). HRQoL was measured with the Euroqol-5D-3 L (EQ-5D-3 L), DISABKIDS chronic generic (DCGM-31) and the KINDLR obesity module. Differences between OGGs were assessed with logistic and linear regression models, adjusting for age, sex, and study center in the base model. In a second regression analysis, we included other characteristics to identify possible determinants of HRQoL. RESULTS Three hundred fifty-two adolescents (mean age: 16.6 (±2.4), mean BMI: 39.1 (±7.5) kg/ m2) with available HRQoL data were analysed. HRQoL of youths in all OGGs was markedly lower than reference values of non-obese adolescents. Adjusting for age and sex, HRQoL of youths in OGG III significantly impaired compared to OGG I. Youths in OGG III were 2.15 times more likely to report problems with mobility in the EQ-5D-3 L than youths in OGG I. A mean difference of 9.7 and 6.6 points between OGG III and I were found for DCGM-31 and KINDL respectively and 5.1 points between OGG II and I for DCGM-31. Including further variables into the regression models, showed that HRQoL measured by DCGM-31 was significantly different between OGGs. Otherwise, female sex and having more than 4 h of daily screen time were also associated with lower HRQoL measured by DCGM-31 and KINDL. CONCLUSION HRQoL of adolescents with obesity is reduced, but HRQoL of adolescents with extreme obesity is particularly affected. Larger and longitudinal studies are necessary to understand the relation of extreme obesity and HRQoL, and the impact of other lifestyle or socioeconomic factors. TRIAL REGISTRATION Clinicaltrials.gov NCT01625325; German Clinical Trials Register (DRKS) DRKS00004172.
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Tönnies T, Stahl-Pehe A, Baechle C, Castillo K, Yossa R, Holl RW, Rosenbauer J. Diabetic nephropathy and quality of life among youths with long-duration type 1 diabetes: A population-based cross-sectional study. Pediatr Diabetes 2019; 20:613-621. [PMID: 30806008 DOI: 10.1111/pedi.12837] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/24/2019] [Accepted: 02/19/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To investigate whether diabetic nephropathy (DN) is associated with lower quality of life (QOL) in youths with long-duration type 1 diabetes and whether associations differ by diabetes duration. METHODS Overall, 1,462 youths aged 11 to 17 years with diabetes onset between 0 and 4 years of age and at least 10 years diabetes duration completed questionnaires on QOL between 2009 and 2016. Chronic generic and diabetes-specific QOL (diabetes impact and treatment scale) were assessed with three scales of the DISABKIDS instruments. Information on DN was obtained from the diabetes patient follow-up registry ("Diabetes-Patienten-Verlaufsdokumentation") with DN defined as micro- or macroalbuminuria. Linear regression analyses were used to evaluate the association between QOL and DN. To adjust for potential confounders, we applied inverse probability of treatment weighting for the linear regression. RESULTS In adjusted analysis, DN was associated with lower QOL in the chronic generic and the two diabetes-specific DISABKIDS scales. Overall, the observed effects were not clinically relevant but increased consistently with longer diabetes duration. Among those with at least 16 years diabetes duration, differences in QOL between patients with vs without DN were clinically relevant on the chronic generic scale (β = -10.3 [-21.0;0.7]). CONCLUSION The results suggest that long-term microvascular complications can impair chronic generic QOL already in youths with type 1 diabetes. Differences in QOL between patients with and without DN seem to increase with diabetes duration.
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Affiliation(s)
- Thaddäus Tönnies
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Christina Baechle
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Rhuphine Yossa
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Neuherberg, Germany.,Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
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11
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Te Velde SJ, Lankhorst K, Zwinkels M, Verschuren O, Takken T, de Groot J. Associations of sport participation with self-perception, exercise self-efficacy and quality of life among children and adolescents with a physical disability or chronic disease-a cross-sectional study. SPORTS MEDICINE-OPEN 2018; 4:38. [PMID: 30112621 PMCID: PMC6093823 DOI: 10.1186/s40798-018-0152-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 07/27/2018] [Indexed: 12/13/2022]
Abstract
Background Little evidence is available about how sports participation influences psychosocial health and quality of life in children and adolescents with a disability or chronic disease. Therefore, the aim of the current study is to assess the association of sports participation with psychosocial health and with quality of life, among children and adolescents with a disability. Methods In a cross-sectional study, 195 children and adolescents with physical disabilities or chronic diseases (11% cardiovascular, 5% pulmonary, 8% metabolic, 8% musculoskeletal/orthopaedic, 52% neuromuscular and 9% immunological diseases and 1% with cancer), aged 10–19 years, completed questionnaires to assess sports participation, health-related quality of life (DCGM-37), self-perceptions and global self-worth (SPPC or SPPA) and exercise self-efficacy. Results Regression analyses showed that those who reported to participate in sports at least twice a week had more beneficial scores on the various indicators compared to their peers who did not participate in sport or less than twice a week. Those participating in sports scored better on all scales of the DCGM-37 scale, on the scales for feelings of athletic competence and children but not adolescents participating in sports reported greater social acceptance. Finally, we found a strong association between sport participation and exercise self-efficacy. Conclusions This study provides the first indications that participating in sports is beneficial for psychosocial health among children and adolescents with a disability. However, more insight is needed in the direction of the relationships.
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Affiliation(s)
| | | | - Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janke de Groot
- University of Applied Sciences, Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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12
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Nielsen JB, Kyvsgaard JN, Sildorf SM, Kreiner S, Svensson J. Item analysis using Rasch models confirms that the Danish versions of the DISABKIDS® chronic-generic and diabetes-specific modules are valid and reliable. Health Qual Life Outcomes 2017; 15:44. [PMID: 28249622 PMCID: PMC5333394 DOI: 10.1186/s12955-017-0618-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 02/16/2017] [Indexed: 01/09/2023] Open
Abstract
Background Type 1 Diabetes (T1D) has a negative impact on psychological and overall well-being. Screening for Health-related Quality of Life (HrQoL) and addressing HrQoL issues in the clinic leads to improved well-being and metabolic outcomes. The aim of this study was to translate the generic and diabetes-specific validated multinational DISABKIDS® questionnaires into Danish, and then determine their validity and reliability. Methods The questionnaires were translated using a validated translation procedure and completed by 99 children and adolescents from our diabetes-department; all diagnosed with T1D and were aged between 8 and 18 years old. The Rasch and the graphical log linear Rasch model (GLLRM) were used to determine validity. Monte Carlo methods and Cronbach’s α were used to confirm reliability. Results The data did not fit a pure Rasch model but did fit a GLLRM when item six in the independence scale is excluded. The six subscales measure different aspects of HrQoL indicating that all the subscales are necessary. The questionnaire shows local dependency between items and differential item functioning (DIF). Therefore age, gender, and glycated hemoglobin (HbA1c) levels must be taken into account when comparing HrQoL between groups. Conclusions The Danish versions of the DISABKIDS® chronic-generic and diabetes-specific modules provide valid and objective measurements with adequate reliability. These Danish versions are useful tools for evaluating HrQoL in Danish patients with T1D. However, guidelines on how to manage DIF and local independence will be required, and item six should be rephrased. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0618-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julie Bøjstrup Nielsen
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev University Hospital, Herlev Ringvej 75, Herlev, 2730, Denmark.
| | - Julie Nyholm Kyvsgaard
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev University Hospital, Herlev Ringvej 75, Herlev, 2730, Denmark
| | - Stine Møller Sildorf
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev University Hospital, Herlev Ringvej 75, Herlev, 2730, Denmark
| | - Svend Kreiner
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1014, Denmark
| | - Jannet Svensson
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev University Hospital, Herlev Ringvej 75, Herlev, 2730, Denmark
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13
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Brorsson AL, Lindholm Olinder A, Wikblad K, Viklund G. Parent's perception of their children's health, quality of life and burden of diabetes: testing reliability and validity of 'Check your Health' by proxy. Scand J Caring Sci 2016; 31:497-504. [PMID: 27440173 DOI: 10.1111/scs.12362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 04/27/2016] [Indexed: 01/09/2023]
Abstract
AIM To test the validity and reliability of the 'Check your Health by proxy' instrument in parents to children with diabetes aged 8-17 years. METHODS One hundred and ninety-one caregivers and their children, aged 8-17 years, were included. All completed the 'Check your Health' questionnaire measuring quality of life and burden of diabetes, DISABKIDS self- or proxy version, and 45 completed the same questionnaires 2 weeks later. RESULTS Test-retest reliability on the 'Check your Health' questionnaire by proxy was moderate to strong (r = 0.48-0.74), p < 0.002). Convergent validity was weak to moderate (r = 0.15-0.49, p < 0.05). The instrument showed acceptable discriminant validity. Parents reported lower scores than the children on emotional health and social relations and higher scores on physical and emotional burden and higher burden on quality of life. Poorer social relationships and quality of life were associated with higher reported disease severity. The diabetes burden domain of the questionnaire correlated to perceived severity of diabetes and to perceived health. Discriminant validity showed that poorer social relationships and quality of life were associated with higher severity of the disease. The diabetes burden domain of 'Check your Health' by proxy showed discriminant validity on perceived severity of diabetes. CONCLUSIONS The instrument 'Check your Health' by proxy showed acceptable psychometric characteristics in parents to young people (8-17 years of age) with diabetes. We also concluded that parents reported that their children had lower health and higher burden of diabetes than the children did, and it correlated to reported disease severity.
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Affiliation(s)
- Anna Lena Brorsson
- Department of Women's and Children's Health, Karolinska Institute and Hospital, Stockholm, Sweden
| | - Anna Lindholm Olinder
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Karin Wikblad
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunnel Viklund
- Department of Women's and Children's Health, Karolinska Institute and Hospital, Stockholm, Sweden
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14
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Frøisland DH, Graue M, Markestad T, Skrivarhaug T, Wentzel-Larsen T, Dahl-Jørgensen K. Health-related quality of life among Norwegian children and adolescents with type 1 diabetes on intensive insulin treatment: a population-based study. Acta Paediatr 2013; 102:889-95. [PMID: 23738648 DOI: 10.1111/apa.12312] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/04/2013] [Indexed: 12/21/2022]
Abstract
AIM To examine health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes on intensive insulin treatment. METHODS All children and adolescents with type 1 diabetes above 8 years of age scheduled for follow-up at 21 paediatric departments in Norway, and one of their parents was invited to describe HRQOL by completing DISABKIDS questionnaires. HRQOL was related to sociodemographic factors (i.e. parental economy, education, marital status and to level of physical activity and disease characteristics, obtained from the Norwegian Childhood Diabetes Registry). RESULTS Nine hundred and thirty seven (48%) and one of their parents responded. Mean duration of diabetes was 4.9 years (SD 3.3), 51% were girls, 56% used insulin pumps, and 44% used multiple insulin injections, predominantly of long-acting and rapid insulin analogues. Mean HbA1c was 8.5% (SD 1.3). Lower HRQOL scores were significantly associated with higher HbA1c, being a girl and experience of diabetes ketoacidosis. Mothers scored lower than fathers on total score and most subscales. No significant differences in scores were found between users of an insulin pump and multi-injection treatment. CONCLUSIONS Health-related quality of life was related to metabolic control and gender, but not to mode of intensified insulin treatment.
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Affiliation(s)
- Dag Helge Frøisland
- Research Center for Child and Youth Competence Development; Lillehammer University College; Lillehammer Norway
- Department of Paediatrics; Innlandet Hospital Trust; Lillehammer Norway
| | - Marit Graue
- Department of Clinical Medicine; University of Bergen; Bergen Norway
- Center for Evidence-Based Practice; Bergen University College; Bergen Norway
| | - Trond Markestad
- Department of Clinical Medicine; University of Bergen; Bergen Norway
- Department of Research; Innlandet Hospital Trust; Lillehammer Norway
| | - Torild Skrivarhaug
- Department of Paediatrics; Oslo University Hospital; Oslo Norway
- The Norwegian Childhood Diabetes Registry; Oslo University Hospital; Oslo Norway
- Oslo Diabetes Research Centre; Oslo Norway
| | - Tore Wentzel-Larsen
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway; Oslo Norway
- Norwegian Centre for Violence and Traumatic Stress Studies; Oslo Norway
| | - Knut Dahl-Jørgensen
- Department of Paediatrics; Oslo University Hospital; Oslo Norway
- The Norwegian Childhood Diabetes Registry; Oslo University Hospital; Oslo Norway
- Oslo Diabetes Research Centre; Oslo Norway
- Faculty of Medicine; University of Oslo; Oslo Norway
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15
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Maas-van Schaaijk NM, Roeleveld-Versteegh ABC, van Baar AL. The Interrelationships Among Paternal and Maternal Parenting Stress, Metabolic Control, and Depressive Symptoms in Adolescents With Type 1 Diabetes Mellitus. J Pediatr Psychol 2012; 38:30-40. [DOI: 10.1093/jpepsy/jss096] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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