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Marshall KH, d'Udekem Y, Winlaw DS, Zannino D, Celermajer DS, Justo R, Iyengar A, Cordina R, Sholler GF, Woolfenden SR, Kasparian NA. Quality of Life and Well-Being in Adults With Fontan Physiology: Findings From the Australian and New Zealand Fontan Registry Quality of Life Study. J Am Heart Assoc 2024; 13:e033818. [PMID: 39011952 DOI: 10.1161/jaha.123.033818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/29/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND To characterize global and health-related quality of life (QOL) among adults with Fontan physiology enrolled in the Australian and New Zealand Fontan Registry (ANZFR), and identify sociodemographic, clinical, psychological, and relational factors associated with outcomes. METHODS AND RESULTS Using a cross-sectional survey design, 66 adults with Fontan physiology (58% women; mean age, 29.6±7.7 years; range, 18-50 years) completed validated self-report measures. Health-related QOL was assessed using the Pediatric Quality of Life Inventory, and global QOL was assessed using a visual analog scale (0-10). Participants reported lower total health-related QOL (P<0.001), as well as lower physical (P<0.001) and social (P=0.002) functioning compared with normative data. Median global QOL was 7.0 (interquartile range: 5.0-8.0) and most participants (71%) rated their QOL ≥6. For health-related QOL, age, sex, university education, and length of hospital stay in the past 12 months explained 27% of the variance in scores, while general psychological stress, medical traumatic stress, communication problems, and access to emotional support explained a further 44% of variance (final model: 71% of variance explained). For global QOL, sociodemographic and clinical factors explained 20% of the variance in scores, while psychological stress and sense of coherence explained a further 24% (final model: 44% of variance explained). CONCLUSIONS Adults with Fontan physiology reported lower overall health-related QOL compared with community-based norms. Variance in QOL outcomes were predominantly attributable to psychological and relational factors. Tailored screening and assessment to identify Fontan patients at greatest risk of lower QOL, and a proactive approach to supportive care, are needed.
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Affiliation(s)
- Kate H Marshall
- Heart Centre for Children The Sydney Children's Hospitals Network Sydney NSW Australia
- School of Clinical Medicine University of New South Wales Sydney NSW Australia
| | - Yves d'Udekem
- Division of Cardiac Surgery Children's National Hospital Washington DC United States
| | - David S Winlaw
- Heart Center, Ann & Robert H. Lurie Children's Hospital Chicago IL United States
| | - Diana Zannino
- Clinical Epidemiology and Biostatistics Unit Murdoch Children's Research Institute Melbourne VIC Australia
| | - David S Celermajer
- Sydney Medical School The University of Sydney NSW Australia
- Department of Cardiology Royal Prince Alfred Hospital Sydney NSW Australia
| | - Robert Justo
- Queensland Pediatric Cardiac Service Queensland Children's Hospital Brisbane QLD Australia
- Faculty of Medicine The University of Queensland Brisbane QLD Australia
| | - Ajay Iyengar
- Pediatric and Congenital Cardiac Service Starship Children's Hospital Auckland New Zealand
- Department of Surgery The University of Auckland New Zealand
| | - Rachael Cordina
- Sydney Medical School The University of Sydney NSW Australia
- Department of Cardiology Royal Prince Alfred Hospital Sydney NSW Australia
| | - Gary F Sholler
- Heart Centre for Children The Sydney Children's Hospitals Network Sydney NSW Australia
- Sydney Medical School The University of Sydney NSW Australia
| | - Susan R Woolfenden
- Sydney Medical School The University of Sydney NSW Australia
- Institute for Women, Children and their Families Sydney Local Health District Sydney NSW Australia
| | - Nadine A Kasparian
- Heart and Mind Wellbeing Center Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine Cincinnati OH United States
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Allonsius F, de Kloet AJ, van Markus-Doornbosch F, Vliet Vlieland TPM, van der Holst M. A longitudinal follow-up study of parent-reported family impact and quality of life in young patients with traumatic and non-traumatic brain injury. Disabil Rehabil 2024; 46:2240-2250. [PMID: 37295937 DOI: 10.1080/09638288.2023.2218657] [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: 11/29/2022] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Brain injuries (traumatic-/nontraumatic, TBI/nTBI) in young patients may lead to problems e.g., decreased health-related quality of life (HRQoL), and causes family impact. Knowledge regarding the family impact and the relationship with patients' HRQoL over time is scarce. This follow-up study describes family impact/HRQoL and their mutual relationship in young patients (5-24 years) after TBI/nTBI. MATERIALS AND METHODS Parents of patients that were referred to outpatient rehabilitation completed the PedsQL™Family-Impact-Module questionnaire to assess the family impact and the parent-reported PedsQL™Generic-core-set-4.0 to assess patients' HRQoL (lower scores: more family impact/worse HRQoL). Questionnaires were completed at the time of referral to rehabilitation (baseline) and one/two years later (T1/T2). Linear-mixed models were used to examine family impact/HRQoL change scores, and repeated-measure correlations (r) to determine longitudinal relationships. RESULTS Two-hundred-forty-six parents participated at baseline, 72 (at T2), median patient's age at baseline was 14 years (IQR:11-16), and 181 (74%) had TBI. Mean (SD) PedsQL™Family-Impact-Module score at baseline was 71.7 (SD:16.4) and PedsQL™Generic-core-set-4.0: 61.4 (SD:17.0). Over time, PedsQL™Family-Impact-Module scores remained stable, while PedsQL™Generic-core-set-4.0 scores improved significantly(p < 0.05). A moderately strong longitudinal correlation was found between family impact&HRQoL (r = 0.51). CONCLUSIONS Family impact does not tend to decrease over time but remained a considerable problem, although patients' HRQoL improved. Next to focusing on patients' HRQoL, it remains important to consider family impact and offer family support throughout rehabilitation.IMPLICATIONS FOR REHABILITATIONThis longitudinal study found that in young patients with traumatic brain injury (TBI) or non-traumatic brain injury (nTBI) referred for rehabilitation there is a considerable impact on the family until two years after referral, whereas the patients' health-related quality of life (HRQoL) improved significantly.Improvements in patients' quality of life status may not automatically lead to a decrease of family impact.Rehabilitation clinicians should monitor the impact on the family over time and provide long-term family support with special attention to parental worrying when needed.Clinicians should be aware that, despite significant differences between the clinical characteristics of patients with TBI and nTBI, the courses of family impact are very similar.
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Affiliation(s)
- F Allonsius
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands
- Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - A J de Kloet
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands
| | - F van Markus-Doornbosch
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands
| | - T P M Vliet Vlieland
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands
- Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - M van der Holst
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands
- Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
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3
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MacMullen LE, George-Sankoh I, Stanley K, McCormick EM, Muraresku CC, Goldstein A, Zolkipli-Cunningham Z, Falk MJ. Bridging the clinical-research gap: Harnessing an electronic data capture, integration, and visualization platform to systematically assess prospective patient-reported outcomes in mitochondrial medicine. Mol Genet Metab 2024; 142:108348. [PMID: 38387305 DOI: 10.1016/j.ymgme.2024.108348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/04/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE Optimizing individualized clinical care in heterogeneous rare disorders, such as primary mitochondrial disease (PMD), will require gaining more comprehensive and objective understanding of the patient experience by longitudinally tracking quantifiable patient-specific outcomes and integrating subjective data with clinical data to monitor disease progression and targeted therapeutic effects. METHODS Electronic surveys of patient (and caregiver) reported outcome (PRO) measures were administered in REDCap within clinical domains commonly impaired in patients with PMD in the context of their ongoing routine care, including quality of life, fatigue, and functional performance. Descriptive statistics, group comparisons, and inter-measure correlations were used to evaluate system feasibility, utility of PRO results, and consistency across outcome measure domains. Real-time tracking and visualization of longitudinal individual-level and cohort-level data were facilitated by a customized data integration and visualization system, MMFP-Tableau. RESULTS An efficient PRO electronic capture and analysis system was successfully implemented within a clinically and genetically heterogeneous rare disease clinical population spanning all ages. Preliminary data analyses demonstrated the flexibility of this approach for a range of PROs, as well as the value of selected PRO scales to objectively capture qualitative functional impairment in four key clinical domains. High inter-measure reliability and correlation were observed. Between-group analyses revealed that adults with PMD reported significantly worse quality of life and greater fatigue than did affected children, while PMD patients with nuclear gene disorders reported lower functioning relative to those with an mtDNA gene disorder in several clinical domains. CONCLUSION Incorporation of routine electronic data collection, integration, visualization, and analysis of relevant PROs for rare disease patients seen in the clinical setting was demonstrated to be feasible, providing prospective and quantitative data on key clinical domains relevant to the patient experience. Further work is needed to validate specific PROs in diverse PMD patients and cohorts, and to formally evaluate the clinical impact and utility of harnessing integrated data systems to objectively track and integrate quantifiable PROs in the context of rare disease patient clinical care.
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Affiliation(s)
- Laura E MacMullen
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America
| | - Ibrahim George-Sankoh
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America; Department of Bioinformatics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America
| | - Katelynn Stanley
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America
| | - Elizabeth M McCormick
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America
| | - Colleen C Muraresku
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America
| | - Amy Goldstein
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America
| | - Zarazuela Zolkipli-Cunningham
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America
| | - Marni J Falk
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States of America; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America.
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4
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Kallio M, Tornivuori A, Miettinen PJ, Kolho KL, Relas H, Culnane E, Loftus H, Sawyer SM, Kosola S. Health-related quality of life and self-reported health status in adolescents with chronic health conditions before transfer of care to adult health care: an international cohort study. BMC Pediatr 2024; 24:163. [PMID: 38459510 PMCID: PMC10921592 DOI: 10.1186/s12887-024-04629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 02/07/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Heath-related quality of life (HRQoL) is lower in adolescents with chronic health conditions compared to healthy peers. While there is evidence of some differences according to the underlying condition and gender, differences by measure and country are poorly understood. In this study we focus on the differences in HRQoL in adolescents with various chronic medical conditions in the year before transfer of care to adult health services. We also study the associations of two different HRQoL measurements to each other and to self-reported health. METHODS We recruited 538 adolescents from New Children`s Hospital, Helsinki, Finland, and the Royal Children`s Hospital, Melbourne, Australia in 2017-2020. We used two validated HRQoL measurement instruments, Pediatric Quality of Life Inventory (PedsQL) and 16D, and a visual analog scale (VAS) for self-reported health status. RESULTS In total, 512 adolescents (50.4% female, mean age 17.8 [SD 1.2] years), completed the survey measures. Higher HRQoL was reported in males than females in both countries (PedsQL 79.4 vs. 74.1; 16D 0.888 vs. 0.846), and in adolescents from Finland than Australia (80.6 vs. 72.2 and 0.905 vs. 0.825, p < 0.001 for all). Adolescents with diabetes, rheumatological, nephrological conditions and/or organ transplants had higher HRQoL than adolescents with neurological conditions or other disease syndromes (p < 0.001). PedsQL and 16D scores showed a strong correlation to each other (Spearman correlation coefficient r = 0.81). Using the 7-point VAS (1-7), 52% (248 of 479) considered their health status to be good (6-7) and 10% (48 of 479) rated it poor (1-2). Better self-reported health was associated with higher HRQoL. CONCLUSIONS The HRQoL of transition aged adolescents varies between genders, diagnostic groups, and countries of residence. The association between self-reported health and HRQoL suggests that brief assessment using the VAS could identify adolescents who may benefit from in-depth HRQoL evaluation. TRIAL REGISTRATION Trial registration name The Bridge and registration number NCT04631965 ( https://clinicaltrials.gov/ct2/show/NCT04631965 ).
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Affiliation(s)
- Mira Kallio
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Anna Tornivuori
- Department of Nursing Science, University of Turku, Turku, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Päivi J Miettinen
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaija-Leena Kolho
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heikki Relas
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Evelyn Culnane
- Transition Support Service, The Royal Children's Hospital, Melbourne, Australia
| | - Hayley Loftus
- Transition Support Service, The Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Silja Kosola
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Espoo, Finland
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5
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Maas A, Maurice-Stam H, van den Heuvel MH, Koopman MMW, den Hartogh JG, Kremer LCM, Grootenhuis M. Monitoring health related quality of life in survivorship care of young adult survivors of childhood cancer using web-based patient-reported outcome measures: survivors' and health care practitioners' perspectives on the KLIK method. Qual Life Res 2024; 33:145-156. [PMID: 37615734 PMCID: PMC10784327 DOI: 10.1007/s11136-023-03504-z] [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] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The KLIK method is a tool to systematically monitor and discuss Health Related Quality of Life (HRQOL) in clinical practice. It has been successfully used in clinical practice in The Netherlands, and has recently been implemented in survivorship care for young adult childhood cancer survivors (CCSs). This study evaluates implementation fidelity and satisfaction of CCSs and healthcare practitioners (HCPs) with the KLIK method in survivorship care. METHODS CCSs' HRQOL was monitored using the KLIK questionnaire (PedsQL generic 18-30 years). In a mixed-methods design, implementation fidelity was based on registrations, and user satisfaction was assessed with evaluation surveys (CCSs) and semi-structured interviews (CCSs, HCPs). Descriptive statistics and qualitative analysis methods were used. RESULTS A total of 245 CCSs were eligible for the study. Fidelity was 79.2% (194/245) for registration in the KLIK PROM portal, 89.7% (174/194) for completed KLIK questionnaires, 74.7% (130/174) for its discussion during consultation. Of the eligible CCSs, 17.6% (43/245) completed the study evaluation survey. Five CCSs and HCPs were invited for an interview and participated. CCSs (7.7/10) and HCPs (7.5/10) were satisfied with the KLIK method. Reported facilitators included increased insight into CCSs' functioning, improved preparation before, and communication during consultation, without lengthening consultation duration. Barriers included CCSs not always completing KLIK questionnaires, incomplete content of the KLIK questionnaire, and the need for customization for CCSs with cognitive disabilities. CONCLUSION The KLIK method is a feasible and valuable tool to systematically monitor and discuss HRQOL in survivorship care. Integration of the KLIK method within the organization is essential, with structural support in reminding CCSs to complete questionnaires.
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Affiliation(s)
- Anne Maas
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - Heleen Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Marloes H van den Heuvel
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Maria M W Koopman
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Jaap G den Hartogh
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Vereniging Kinderkanker Nederland, De Bilt, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Martha Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
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Matalon N, Shani S, Weinberger R, Serur Y, Somech R, Givon U, Katz U, Levy-Shraga Y, Carmel E, Weiss B, Ben-Zeev B, Hochberg Y, Gur RE, Gothelf D. The contribution of medical burden to 22q11.2 deletion syndrome quality of life and functioning. Genet Med 2023; 25:100924. [PMID: 37422717 DOI: 10.1016/j.gim.2023.100924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/10/2023] Open
Abstract
PURPOSE To date, there is no systematic method to quantify the medical burden of individuals with 22q11.2 deletion syndrome (22q11.2DS). This study aimed to design a Medical Burden Scale for 22q11.2DS to evaluate the effect of medical symptoms severity on quality of life (QoL) and functioning in individuals with this syndrome. METHODS Individuals with 22q11.2DS (n = 76) were included in the study. A multidisciplinary group of physicians determined the severity of symptoms (on a scale of 0 to 4) of 8 major medical systems affected in 22q11.2DS, as well as the level of cognitive deficits and psychiatric morbidity. Regression models were used to evaluate the impact of medical, cognitive, and psychiatric symptoms' severity on global assessment of functioning (GAF) and QoL. RESULTS The total Medical Burden Scale score was significantly associated with both QoL and GAF scores, beyond the effect of the psychiatric and cognitive deficits. We also found that QoL and GAF scores were associated with the severity scores of specific medical systems, particularly neurological symptoms, but also cardiovascular, ear-nose-throat, endocrinology, and orthopedics. CONCLUSION Quantifying the medical burden of 22q11.2DS individuals is feasible and indicates the overall and specific contribution of medical symptoms to QoL and functioning of 22q11.2DS individuals.
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Affiliation(s)
- Noam Matalon
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shachar Shani
- Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Ronnie Weinberger
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaffa Serur
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Raz Somech
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Givon
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uriel Katz
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Levy-Shraga
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eldar Carmel
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Batia Weiss
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bruria Ben-Zeev
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Doron Gothelf
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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7
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DiVito D, Wellik A, Burfield J, Peterson J, Flickinger J, Tindall A, Albanowski K, Vishnubhatt S, MacMullen L, Martin I, Muraresku C, McCormick E, George-Sankoh I, McCormack S, Goldstein A, Ganetzky R, Yudkoff M, Xiao R, Falk MJ, R Mascarenhas M, Zolkipli-Cunningham Z. Optimized Nutrition in Mitochondrial Disease Correlates to Improved Muscle Fatigue, Strength, and Quality of Life. Neurotherapeutics 2023; 20:1723-1745. [PMID: 37723406 PMCID: PMC10684455 DOI: 10.1007/s13311-023-01418-9] [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] [Accepted: 07/26/2023] [Indexed: 09/20/2023] Open
Abstract
We sought to prospectively characterize the nutritional status of adults ≥ 19 years (n = 22, 27% males) and children (n = 38, 61% male) with genetically-confirmed primary mitochondrial disease (PMD) to guide development of precision nutritional support strategies to be tested in future clinical trials. We excluded subjects who were exclusively tube-fed. Daily caloric requirements were estimated using World Health Organization (WHO) equations to predict resting energy expenditure (REE) multiplied by an activity factor (AF) based on individual activity levels. We developed a Mitochondrial Disease Activity Factors (MOTIVATOR) score to encompass the impact of muscle fatigue typical of PMD on physical activity levels. PMD cohort daily diet intake was estimated to be 1,143 ± 104.1 kcal in adults (mean ± SEM, 76.2% of WHO-MOTIVATOR predicted requirement), and 1,114 ± 62.3 kcal in children (86.4% predicted). A total of 11/22 (50%) adults and 18/38 (47.4%) children with PMD consumed ≤ 75% predicted daily Kcal needs. Malnutrition was identified in 16/60 (26.7%) PMD subjects. Increased protein and fat intake correlated with improved muscle strength in those with insufficient daily Kcal intake (≤ 75% predicted); higher protein and fat intake correlated with decreased muscle fatigue; and higher protein, fat, and carbohydrate intake correlated with improved quality of life (QoL). These data demonstrate the frequent occurrence of malnutrition in PMD and emphasize the critical need to devise nutritional interventions to optimize clinical outcomes.
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Affiliation(s)
- Donna DiVito
- Clinical Nutrition Department, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amanda Wellik
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jessica Burfield
- Clinical Nutrition Department, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - James Peterson
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jean Flickinger
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alyssa Tindall
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kimberly Albanowski
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shailee Vishnubhatt
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Laura MacMullen
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Isaac Martin
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colleen Muraresku
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth McCormick
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ibrahim George-Sankoh
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shana McCormack
- Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Amy Goldstein
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca Ganetzky
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marc Yudkoff
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rui Xiao
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marni J Falk
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Maria R Mascarenhas
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zarazuela Zolkipli-Cunningham
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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8
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van Gorp M, Irestorm E, Twisk JWR, Dors N, Mavinkurve-Groothuis A, Meeteren AYNSV, de Bont J, van den Bergh EMM, van der Meer WVDP, Beek LR, Aarsen FK, Streefkerk N, van Litsenburg RRL, Grootenhuis MA. The course of health-related quality of life after the diagnosis of childhood cancer: a national cohort study. BMC Cancer 2023; 23:855. [PMID: 37697253 PMCID: PMC10496372 DOI: 10.1186/s12885-023-11379-z] [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: 06/05/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Comprehensive insight in the longitudinal development of health-related quality of life (HRQOL) after childhood cancer diagnosis could improve quality of care. Thus, we aimed to study the course and biopsychosocial determinants of HRQOL in a unique national cohort of children with cancer. METHODS HRQOL of 2154 children with cancer was longitudinally reported (median: 3 reports) between diagnosis and 5 years after, using the pediatric quality of life inventory generic core scales (PedsQL). HRQOL was modelled over time since diagnosis using mixed model analysis for children 2-7 years (caregiver-reports) and ≥ 8 years (self-reports). Differences in the course between hematological, solid and central nervous system malignancies were studied. Additional associations of demographics, disease characteristics (age at diagnosis, relapse, diagnosis after the national centralization of childhood cancer care and treatment components) and caregiver distress (Distress thermometer) were studied. RESULTS Overall, HRQOL improved with time since diagnosis, mostly in the first years. The course of HRQOL differed between diagnostic groups. In children aged 2-7 years, children with a solid tumor had most favorable HRQOL. In children aged ≥ 8 years, those with a hematological malignancy had lower HRQOL around diagnosis, but stronger improvement over time than the other diagnostic groups. In both age-groups, the course of HRQOL of children with a CNS tumor showed little or no improvement. Small to moderate associations (β: 0.18 to 0.67, p < 0.05) with disease characteristics were found. Centralized care related to better HRQOL (β: 0.25 to 0.44, p < 0.05). Caregiver distress was most consistently associated with worse HRQOL (β: - 0.13 to - 0.48, p < 0.01). CONCLUSIONS The HRQOL course presented can aid in identifying children who have not fully recovered their HRQOL following cancer diagnosis, enabling early recognition of the issue. Future research should focus on ways to support children, especially those with a CNS tumor, for example by decreasing distress in their caregivers.
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Affiliation(s)
- Marloes van Gorp
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | - Elin Irestorm
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
- Faculty of Medicine, Department of Paediatrics, Lund University, Lund, Sweden
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Location VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Natasja Dors
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | | | | | - Judith de Bont
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | | | | | - Laura R Beek
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | - Femke K Aarsen
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | - Nienke Streefkerk
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
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9
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Bense JE, Haverman L, von Asmuth EGJ, Louwerens M, Luijten MAJ, Stiggelbout AM, Lankester AC, de Pagter APJ. Late Effects in Pediatric Allogeneic Hematopoietic Stem Cell Transplantation for Nonmalignant Diseases: Proxy- and Patient-Reported Outcomes. Transplant Cell Ther 2023; 29:186.e1-186.e10. [PMID: 36587742 DOI: 10.1016/j.jtct.2022.12.024] [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: 10/12/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023]
Abstract
Survival rates in pediatric hematopoietic stem cell transplantation (HSCT) for nonmalignant diseases have improved due to advances in conditioning regimens, donor selection, and prophylaxis and treatment of infections and graft-versus-host disease. Insight into the long-term patient-reported outcomes (PROs) after pediatric HSCT for nonmalignant disease is lacking but essential for optimal shared decision making, counseling, and quality of care. The purpose of this research was to determine long-term patient-reported outcomes in allogeneic pediatric HSCT for nonmalignant diseases and to compare these results with Dutch reference data. This single-center cohort study evaluated PROs (PedsQL 4.0, PROMIS item banks), self- or proxy-reported, among patients at ≥2 years after pediatric allogeneic HSCT for nonmalignant disease. Mean scores were compared with those of the Dutch general population. Of 171 eligible patients, 119 participated, for a 70% response rate. The median patient age was 15.8 years (range, 2 to 49 years), and the median duration of follow-up was 8.7 years (range, 2 to 34 years). Indications for HSCT included inborn errors of immunity (n = 41), hemoglobinopathies (n = 37), and bone marrow failure (n = 41). Compared with reference data, significantly lower scores were found in adolescents (age 13 to 17 years) on the Total, Physical Health, and School Functioning PedsQL subscales. Significantly more Sleep Disturbance was reported in children (age 8 to 18 years). On the other hand, significantly better scores were seen on PROMIS Fatigue (age 5 to 7 years) and Pain Interference (age 8 to 18 years) and, in adults (age 19 to 30 years), on Depressive Symptoms and Sleep Disturbance. This study showed better or comparable very long-term PROs in patients after pediatric HSCT for nonmalignant diseases compared with the reference population. Children and adolescents seem to be the most affected, indicating the need for supportive care to prevent impaired quality of life and, more importantly, to amplify their long-term well-being.
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Affiliation(s)
- Joëll E Bense
- Division of Stem cell Transplantation, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands.
| | - Lotte Haverman
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Erik G J von Asmuth
- Division of Stem cell Transplantation, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Marloes Louwerens
- Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Michiel A J Luijten
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Anne M Stiggelbout
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands; Erasmus School of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
| | - Arjan C Lankester
- Division of Stem cell Transplantation, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Anne P J de Pagter
- Division of Stem cell Transplantation, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands.
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10
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van Erp LME, Maurice-Stam H, Beek LR, Kremer LCM, den Hartogh JG, van Gorp M, Huizinga GA, Grootenhuis MA. Online cognitive-behavioral group intervention for young adult survivors of childhood cancer: a pilot study. J Psychosoc Oncol 2022; 41:518-538. [PMID: 36537338 DOI: 10.1080/07347332.2022.2150110] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND Young adult childhood cancer survivors (YACCS) are a vulnerable group in need of psychosocial support, but tailored interventions are lacking. AIM To examine feasibility and satisfaction, and to explore preliminary effectiveness of an online group intervention (Op Koers Online for YACCS) aimed at teaching active coping skills and providing peer-contact, thereby reducing and preventing psychosocial problems in YACCS. The intervention is based on psycho-education, cognitive behavioral therapy, and aspects of acceptance and commitment therapy. METHODS YACCS completed questionnaires pre- and post-intervention. Feasibility was based on attendance, drop-out, and an evaluation questionnaire was administered to assess satisfaction. Preliminary effectiveness was evaluated with the Mastery Scale, Illness Cognition Questionnaire, Distress Thermometer, Impact of Cancer - Childhood Survivors, and Pediatric Quality of Life Inventory. Preliminary effectiveness was investigated by testing differences on the psychosocial outcomes (coping and psychosocial wellbeing) between T0 and T1 within respondents, using paired samples t tests and Cohen's d. RESULTS 10 YACCS participated in the intervention and completed all questionnaires. There was no drop-out; 90% of participants attended five out of six sessions. Overall, participants were satisfied with the intervention; 7.6 on a 0-10 scale. Distress (Cohen's d=-.6, p=.030) and feelings of helplessness (Cohen's d=-.8, p=.001) reduced from T0 to T1, while self-efficacy (Cohen's d=.8, p=.013,) improved. Other outcomes displayed small effects, but did not change significantly. CONCLUSIONS This first, small pilot study showed short-term decrease in distress and feelings of helplessness and improvement of self-efficacy. Op Koers Online was positively evaluated by YACCS and course leaders, filling a gap in psychosocial services for YACCS.
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Affiliation(s)
- Loes M E van Erp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Laura R Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap G den Hartogh
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Vereniging Kinderkanker Nederland, De Bilt, The Netherlands
| | - Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Gea A Huizinga
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Beatrix Children's Hospital, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
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11
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Yu L, Du M. Social networking use, mental health, and quality of life of Hong Kong adolescents during the COVID-19 pandemic. Front Public Health 2022; 10:1040169. [PMID: 36388293 PMCID: PMC9659958 DOI: 10.3389/fpubh.2022.1040169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/10/2022] [Indexed: 01/29/2023] Open
Abstract
Background During the COVID-19 pandemic, adolescents' use of social networking sites/apps has surged, and their mental health and quality of life have also been significantly affected by the pandemic and its associated social-protection measures. The present study first examined the prevalence of social networking sites/apps use and social networking addiction, the mental health status, and the health-related quality of life among Hong Kong adolescent students. We further investigated the associations of the youths' daily use of social networking sites/apps and their social networking addiction with their mental health and quality of life during the pandemic. Methods A total of 1,147 students (age = 15.20 ± 0.53 years) recruited from 12 randomly selected local secondary schools in Hong Kong participated in a questionnaire survey in classroom settings between January and June, 2020, right after the COVID-19 outbreak. The questionnaire includes demographic characteristics and scales that measure social networking sites/apps use and social networking addiction, mental health, and quality of life. Results Approximately 46.4% of the participants reported using social networking sites/apps often or very often, and 7.8% met the criteria for social networking addiction using Bergen's Social Media Addiction Scale. The prevalence of mild to extremely severe depression, anxiety, and stress among the adolescents stood at 39.6, 37.5, 48.8%, respectively, and the participants' physical, social, and school functioning were lower than the norms of healthy adolescents before the pandemic. Participants who used social networking sites/apps but for <3 h per day (excluding students who never used social networking sites/apps) showed significantly fewer problems of depression, anxiety, and stress than did those who spent more than 3 h per day on social networking sites/apps. Social networking addiction was found to be consistently associated with poor mental health and health-related quality of life. Conclusion This study provides important evidence supporting the potential protective effect of guiding adolescents to use social networking sites/apps appropriately in order to mitigate their negative emotions during contexts such as that of the pandemic; it further points to the need to provide extra support to promote the well-being of young people, especially those in disadvantaged situations (e.g., non-intact family) during and after the pandemic.
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12
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Masnari O, Neuhaus K, Schiestl C, Landolt MA. Psychosocial health and psychological adjustment in adolescents and young adults with congenital melanocytic nevi: Analysis of self-reports. Front Psychol 2022; 13:911830. [PMID: 36160549 PMCID: PMC9497455 DOI: 10.3389/fpsyg.2022.911830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
This study assessed self-reported health-related quality of life and psychological adjustment in 43 adolescents and young adults (ages in years: 14–24, M = 17.6, SD = 2.2) with congenital melanocytic nevi (CMN) and examined associations with sociodemographic variables, characteristics of the CMN, perceived social reactions, and cognitive emotion regulation strategies. Outcome measures included the Pediatric Quality of Life Inventory™ 4.0 and the Strengths and Difficulties Questionnaire. Findings suggest impaired psychosocial health and psychological adjustment in youth with CMN compared to community norms. Impairments were associated with higher age of participants, lower socioeconomic status, visibility of the skin lesion, perceived stigmatization, poorer perceived social support, and maladaptive cognitive emotion regulation strategies (self-blame, rumination, and catastrophizing), but not with sex of participants, extent of the skin lesion, and surgical removal of the nevus. Implications for clinical practice and future research are discussed.
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Affiliation(s)
- Ornella Masnari
- Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- *Correspondence: Ornella Masnari,
| | - Kathrin Neuhaus
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Clemens Schiestl
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Markus A. Landolt
- Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
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13
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Maurice-Stam H, van Erp LME, Maas A, van Oers HA, Kremer LCM, van Dulmen-den Broeder E, Tissing WJE, Loonen JJ, van der Pal HJH, Beek LR, de Vries ACH, van den Heuvel-Eibrink MM, Ronckers CM, Bresters D, Louwerens M, van der Heiden-van der Loo M, Huizinga GA, Grootenhuis MA. Psychosocial developmental milestones of young adult survivors of childhood cancer. Support Care Cancer 2022; 30:6839-6849. [PMID: 35538326 PMCID: PMC9213344 DOI: 10.1007/s00520-022-07113-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The study aimed to compare the psychosocial development of young adult survivors of childhood cancer (YACCS) with a norm group of young adults from the general population. METHODS From 2017 to 2020, 558 YACCS (18-30 years, 51% female, 10.9% CNS cancer) who participated in the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort (diagnosed 1963-2001) part 2 completed the Course of Life Questionnaire (CoLQ), assessing the achievement of milestones. Items were grouped into the scales autonomy, psychosexual, and social development. Differences between YACCS and norm group were examined with ANOVA and Cohen's d (CoLQ scales) and with logistic regression analysis and odds ratio (OR) (CoLQ items), for the total group and YACCS of CNS cancer. RESULTS The total group of YACCS did not report a less favorable psychosocial development than the norm group. YACCS of CNS cancer scored lower than the norm group (p < 0.001) on the scales autonomy (d = - 0.36) and psychosexual (d = - 0.46). Additionally, on half of the items of autonomy (0.25 ≤ OR ≤ 0.34), psychosexual (0.30 ≤ OR ≤ 0.48), and social (0.23 ≤ OR ≤ 0.47) development, YACCS of CNS cancer were less likely (p < 0.01) than the norm group to have achieved the milestones. CONCLUSION Overall, psychosocial development of YACCS was as favorable as the norm, but YACCS of CNS cancer were at risk of an unfavorable psychosocial development in all domains. Monitoring psychosocial development should be included in the standards of psychosocial care, especially for CNS cancer patients and survivors, to be able to trace delay. Personalized interventions should be offered to improve the psychosocial development in an early stage.
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Affiliation(s)
- Heleen Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - Loes M E van Erp
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Anne Maas
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Hedy A van Oers
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | | | - Helena J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Laura R Beek
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Willem Alexander Children's Hospital/Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Gea A Huizinga
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
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14
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Support needs of Dutch young adult childhood cancer survivors. Support Care Cancer 2022; 30:3291-3302. [PMID: 34981198 PMCID: PMC8723798 DOI: 10.1007/s00520-021-06723-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/26/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Studies about support needs of young adult childhood cancer survivors (YACCS) previously focused mainly on information needs. This study assessed support needs and associated factors (sociodemographic, medical, and psychosocial functioning) in Dutch YACCS. METHODS YACCS (aged 18-30, diagnosed ≤ 18 years, time since diagnosis ≥ 5 years) cross-sectionally filled out a questionnaire regarding their need for various types of support (concrete information, personal counseling, and peer contact) in eight domains (physical consequences of childhood cancer, social-emotional consequences, relationships and sexuality, fertility, lifestyle, school and work, future perspective, insurance and mortgage), and questionnaires assessing health-related quality of life (PedsQL-YA), anxiety and depression (HADS), and fatigue (CIS-20R). Descriptive statistics were used to describe support needs. Linear regression was used to identify characteristics associated with support needs. RESULTS One hundred fifty-one YACCS participated (response = 40%). Most YACCS reported a need for support in one or more domains (88.0%, N = 133). More than half of the participants reported a need for concrete information in the domains lifestyle, fertility, and physical consequences of childhood cancer and 25-50% in the domains insurance and mortgages, future perspective, and social-emotional consequences of childhood cancer. In the domains lifestyle and physical as well as emotional consequences of childhood cancer, 25-50% reported a need for counseling. Overall need for support was positively associated with middle (β = 0.26, p = 0.024) and high (β = 0.35, p = 0.014) compared to low educational attainment and (sub)clinical anxiety (β = 0.22, p = 0.017), and negatively associated with social functioning (β = - 0.37, p = 0.002) in multivariate analyses. CONCLUSION YACCS report the strongest need for support, for concrete information, in the domains lifestyle, fertility, and physical consequences of childhood cancer. Associated factors were mostly socioeconomic and psychosocial in nature. Psychosocial care should be an integral part of survivorship care for YACCS, with screening for psychosocial problems, information provision including associated emotional consequences and support if necessary (psycho-education) and tailored interventions, and adequate referrals to more specialized care if necessary.
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15
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Heesterbeek MR, Luijten MAJ, Gouw SC, Limperg PF, Fijnvandraat K, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Flens G, Terwee CB, Peters M, Haverman L. Measuring anxiety and depression in young adult men with haemophilia using PROMIS. Haemophilia 2022; 28:e79-e82. [PMID: 35305286 DOI: 10.1111/hae.14534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M R Heesterbeek
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - M A J Luijten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands.,Amsterdam UMC, Epidemiology and Data Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - S C Gouw
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - P F Limperg
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - K Fijnvandraat
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - M J H A Kruip
- Erasmus MC, Department of Haematology Rotterdam, Erasmus University Medical Centre, The Netherlands
| | - J Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands
| | - G Flens
- Alliance for Quality in Mental Health Care, Utrecht, The Netherlands
| | - C B Terwee
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Peters
- Amsterdam UMC, Epidemiology and Data Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - L Haverman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
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16
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Alexandrou E, Dauber A, Tyzinski L, Hwa V, Andrew M, Kim H, Elangovan S, Gubanich P, Taylor-Haas JA, Paterno M, Backeljauw P. Clinical phenotype and musculoskeletal characteristics of patients with aggrecan deficiency. Am J Med Genet A 2022; 188:1193-1203. [PMID: 35001504 DOI: 10.1002/ajmg.a.62639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/21/2021] [Accepted: 11/28/2021] [Indexed: 11/10/2022]
Abstract
Aggrecan is a proteoglycan within the physeal and articular cartilage. Aggrecan deficiency, due to heterozygous mutations in the ACAN gene, causes dominantly inherited short stature and, in many patients, early-onset osteoarthritis and degenerative disc disease. We aimed to further characterize this phenotypic spectrum with an emphasis on musculoskeletal health. Twenty-two individuals from nine families were enrolled. Histories and examinations focused on joint health, gait analysis, joint specific patient reported outcomes, and imaging studies were performed. All patients had dominantly inherited short stature, with the exception of a de novo mutation. Short stature was worse in adults versus children (median height -3.05 SD vs. -2.25 SD). ACAN mutations were not always associated with bone age advancement (median advancement +1.1 years, range 0 to +2 years). Children had subtle disproportionality and clinically silent joint disease-25% with osteochondritis dissecans (OD). Adults had a high prevalence of joint symptomatology-decline in knee function, disability from spinal complaints, and lower physical activity on outcome measures. Osteoarthritis (OA) and OD was detected in 90% of adults, and orthopedic surgeries were reported in 60%. Aggrecan deficiency leads to short stature with progressive decline in height SD, mild skeletal dysplasia, and increasing prevalence of joint pathology over time. Optimal musculoskeletal health and quality of life can be attained with timely identification of pathology and intervention.
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Affiliation(s)
- Eirene Alexandrou
- Division of Endocrinology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.,Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA
| | - Andrew Dauber
- Division of Endocrinology, Children's National Hospital, Washington, District of Columbia, USA.,Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Leah Tyzinski
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Vivian Hwa
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Melissa Andrew
- Division of Endocrinology, Children's National Hospital, Washington, District of Columbia, USA
| | - Hee Kim
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Stacey Elangovan
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Paul Gubanich
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Mark Paterno
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Philippe Backeljauw
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
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17
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The added value of transition programs in Dutch diabetes care: A controlled evaluation study. J Pediatr Nurs 2022; 62:155-163. [PMID: 34419327 DOI: 10.1016/j.pedn.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE The desirability of evaluating transition programs is widely acknowledged. This study aimed to explore the added value of transitional care investments for young adults with type 1 diabetes mellitus. DESIGN AND METHODS Based on qualitative data, two groups of diabetes teams were created through cluster analysis: paying more (HI-ATT) versus less attention (LO-ATT) to transitional care. Retrospective controlled evaluation included chart reviews on healthcare use and clinical outcomes; and a survey on young adults' experiences, satisfaction with care, and self-management skills. RESULTS Data from 320 patients in fifteen diabetes teams were collected; 123 young adults (38.4%) completed a questionnaire. Self-reported outcomes showed that young adults treated by a HI-ATT team felt better prepared for transfer (p < .05). Self-management outcomes did not differ between groups. HI-ATT teams had more scheduled consultations in the year after transfer (p < .05); only 10.6% of all measurements had reached targeted HbA1c scores. CONCLUSIONS Current transitional care investments in Dutch diabetes care did not lead to notable improvements in experiences and outcomes, except for preparation for transfer. The period after transfer, however, is just as important. Attention is required for parent involvement. PRACTICE IMPLICATIONS Transitional care investments should extend beyond the transfer. By educating young adults about the importance of regular clinic attendance and introducing additional person-centered consultations in adult care, nurses may help ensure continuity of care. Nurses could also introduce support programs for parents to prepare for the transition and their change in role, taking into account their continuing partnership.
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18
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Hijkoop A, Ten Kate CA, Madderom MJ, IJsselstijn H, Reuser JA, Koopman H, van Rosmalen J, Rietman AB. Sex differences in children's health status as measured by the Pediatric Quality of Life Inventory (PedsQL)™: cross-sectional findings from a large school-based sample in the Netherlands. BMC Pediatr 2021; 21:580. [PMID: 34922476 PMCID: PMC8683815 DOI: 10.1186/s12887-021-03059-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 12/01/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Previous research has shown that female adolescents and adults report lower health status than their male peers. Possibly, this discrepancy already develops during childhood. We collected sex-specific data with the Pediatric Quality of Life Inventory (PedsQL) in a large school-based sample. METHODS The online version of the PedsQL was administered to healthy Dutch children aged 5-7 years (parent proxy-report), 8-12 years (parent proxy-report and child self-report), and 13-17 years (parent proxy-report and child self-report), recruited through regular primary and secondary schools. Sex differences were assessed using t-tests or Mann-Whitney U-tests. Wilcoxon signed-rank tests and intraclass correlation coefficients served to compare parent proxy-reports with child self-reports. Multivariable linear regression analyses were used to assess the associations of sex of the child, age, and parental educational level with PedsQL scores. RESULTS Eight hundred eighty-two parents and five hundred eighty one children were recruited from 15 different schools in the Netherlands. Parents of 8-to-12-year-olds reported higher scores on School Functioning for girls than for boys (mean difference [MD]: 6.56, p < 0.001). Parents of 13-to-17-year-olds reported lower scores on Physical and Emotional Functioning for girls than for boys (MDs: 2.14 and 5.79, p = 0.014 and p < 0.001, respectively). Girls aged 8-12 years reported lower scores than boys in this age group on Physical Functioning (MD: 3.09, p = 0.005). Girls aged 13-17 years reported lower scores than boys in this age group on Physical Functioning (MD: 3.67, p < 0.001), Emotional Functioning (MD: 8.11, p < 0.001), and the Total Score (MD 3.26, p = 0.004). No sex differences were found in children aged 5-7 years. Agreement between child self-reports and parent proxy-reports was poor to moderate. CONCLUSIONS Girls generally had lower PedsQL scores than boys, both in parent proxy-reports and in child self-reports. We recommend to apply sex-specific data when assessing health status using the PedsQL.
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Affiliation(s)
- Annelieke Hijkoop
- Department of Paediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Chantal A Ten Kate
- Department of Paediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Marlous J Madderom
- Department of Paediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Hanneke IJsselstijn
- Department of Paediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Julie A Reuser
- Department of Developmental and Educational Psychology, Faculty of Social Sciences, Leiden University, Leiden, the Netherlands
| | - Hendrik Koopman
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - André B Rietman
- Department of Paediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
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19
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Egset KS, Weider S, Stubberud J, Hjemdal O, Ruud E, Hjort MA, Eilertsen MEB, Sund AM, Røkke ME, Reinfjell T. Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study. Front Psychol 2021; 12:724960. [PMID: 34777103 PMCID: PMC8581253 DOI: 10.3389/fpsyg.2021.724960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
Neurocognitive late effects following the diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) commonly include impaired executive functions (EFs), with negative consequences for one's health-related quality of life and mental health. However, interventions for EF impairments are scarce. Thus, the aims of this study were to (1) explore the feasibility and acceptability of the cognitive rehabilitation program Goal Management Training (GMT) and (2) examine whether GMT is associated with positive outcomes across cases of ALL survivors with EF complaints. Four participants (median age 31.5 years) underwent nine GMT modules in a total of five group sessions. Rehabilitation was focused on compensatory strategies to improve real-life EFs. Participants were evaluated at 2-week and 6-month follow-ups. Evaluation of feasibility and acceptability included adherence, a semi structured interview, self-reports, and safety. Additionally, therapists' experience with implementation was evaluated. Outcome measures included self-reports and neurocognitive tests of attention, EF, and processing speed. All participants completed GMT and rated the intervention as useful, suitable, and satisfactory. The reliable change index showed improved daily life EFs (two participants) and neurocognitive performance (three participants) at 6-month follow-up. Additionally, all participants improved on a "real-life" task involving EF. A future randomized controlled trial is recommended.
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Affiliation(s)
- Kaja Solland Egset
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Siri Weider
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Stubberud
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ellen Ruud
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Magnus Aassved Hjort
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Mary-Elizabeth Bradley Eilertsen
- Department of Public Health and Nursing, Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Magnhild Eitrem Røkke
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trude Reinfjell
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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20
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Naafs JC, Marchal JP, Verkerk PH, Fliers E, van Trotsenburg ASP, Zwaveling-Soonawala N. Health-Related Quality of Life in Patients With Early-Detected Central Congenital Hypothyroidism. J Clin Endocrinol Metab 2021; 106:e4231-e4241. [PMID: 33780546 PMCID: PMC8475203 DOI: 10.1210/clinem/dgab209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Indexed: 12/18/2022]
Abstract
CONTEXT Central congenital hypothyroidism (CH) requires lifelong medical treatment. The majority of children with central CH have multiple pituitary hormone deficiencies (MPHD), but in some cases central CH is isolated. Most pituitary hormone deficiencies are associated with impaired health-related quality of life (HRQoL). However, studies on HRQoL in central CH are lacking. OBJECTIVE To evaluate HRQoL and fatigue in children and young adults with central CH, as well as parent perspectives. DESIGN Nationwide cross-sectional study comparing HRQoL between early-detected central CH patients and unaffected siblings with the Pediatric Quality of Life inventory (PedsQL™) and PedsQL Multidimensional Fatigue Scale. Participants ≥ 8 years old filled in self-reports; parents of participants aged 3 to 18 years filled in parent reports. Isolated central CH patients, MPHD patients, and siblings were compared using a linear mixed model and Tukey's post hoc test. RESULTS Eighty-eight patients and 52 siblings participated, yielding 98 self-reports and 115 parent reports. Isolated central CH patients (n = 35) and siblings showed similar scores on all subscales, both in the self-reports and parent reports. For MPHD patients (n = 53), self-reported scores were similar to those of siblings. Parent reported total HRQoL and fatigue scores were significantly poorer in MPHD patients compared with siblings (mean differences -10.2 and -9.4 points; P < 0.01), as were scores for physical functioning, social functioning and general fatigue. CONCLUSION Self-reported HRQoL scores in isolated central CH and MPHD patients were similar to siblings. However, parents reported significantly lower HRQoL and fatigue scores for MPHD patients, suggesting a difference in perceived limitations between MPHD patients and their parents.
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Affiliation(s)
- Jolanda C Naafs
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, department of Pediatric Endocrinology, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Jan Pieter Marchal
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Psychosocial department, Amsterdam, the Netherlands
| | - Paul H Verkerk
- TNO, Department of Child Health, Leiden, The Netherlands
| | - Eric Fliers
- Amsterdam UMC, University of Amsterdam, department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - A S Paul van Trotsenburg
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, department of Pediatric Endocrinology, Amsterdam, the Netherlands
| | - Nitash Zwaveling-Soonawala
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, department of Pediatric Endocrinology, Amsterdam, the Netherlands
- Correspondence: Nitash Zwaveling-Soonawala, MD, PhD, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatric Endocrinology, Amsterdam, the Netherlands.
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21
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van Erp LME, Maurice-Stam H, Kremer LCM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Versluys BAB, Loonen JJ, Bresters D, Louwerens M, van der Heiden-van der Loo M, van den Berg MH, Ronckers CM, van der Kooi ALLF, van Gorp M, van Dulmen-den Broeder E, Grootenhuis MA. Health-related quality of life in Dutch adult survivors of childhood cancer: A nation-wide cohort study. Eur J Cancer 2021; 152:204-214. [PMID: 34119924 DOI: 10.1016/j.ejca.2021.04.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 01/16/2023]
Abstract
AIM To investigate the health-related quality of life (HRQOL) of Dutch adult childhood cancer survivors (CCS) and to identify risk factors of impaired HRQOL. METHODS Adult CCS (age >18, diagnosed <18, ≥5 years since diagnosis) from the Dutch LATER registry completed the Medical Outcome Study Short Form 36 (SF-36) to measure HRQOL and provided sociodemographic characteristics. Age-adjusted mean SF-36 scale scores of CCS were compared to the Dutch general population for men and women separately using t-tests, with effect size d. Multivariate logistic regression models were built to identify sociodemographic and cancer-related risk factors for impaired physical and mental HRQOL. RESULTS Both male and female CCS (N = 2301, mean age = 35.4 years, 49.6% female) reported significantly (p ≤ .005) worse HRQOL than the general population on almost all scales of the SF-36 (-.11 ≤ d ≤ -.56). Largest differences were found on vitality and general health perceptions. Significant risk factors (p ≤ .05) for impaired physical HRQOL were female sex, older age at diagnosis, not having a partner, low educational attainment, disease recurrence and exposure to radiotherapy, specifically to lower extremity radiation. Odds ratios (ORs) ranged from 1.6 to 3.7. Significant risk factors for impaired mental HRQOL were age 26-35 years, male sex, not having a partner and low educational attainment. ORs ranged from 1.3 to 2.0. CONCLUSION Adult CCS had worse HRQOL than the general population. CCS most at risk were those with low educational attainment and without a partner. Adult CCS could benefit from routine surveillance of their HRQOL. Special attention for CCS' vitality and health perceptions and beliefs is warranted.
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Affiliation(s)
- L M E van Erp
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - L C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - W J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
| | - H J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - A C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, the Netherlands
| | - M M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, the Netherlands
| | - B A B Versluys
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - J J Loonen
- Radboud University Medical Center, Nijmegen, the Netherlands
| | - D Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - M Louwerens
- Leiden University Medical Center, Leiden, the Netherlands
| | | | - M H van den Berg
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Paediatrics, Amsterdam, the Netherlands
| | - C M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany
| | - A L L F van der Kooi
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Erasmus MC, University Medical Centre, Rotterdam, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology
| | - M van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - E van Dulmen-den Broeder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Amsterdam UMC/location VUmc, Amsterdam, the Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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22
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Peersmann SHM, van Straten A, Kaspers GJL, Thano A, van den Bergh E, Grootenhuis MA, van Litsenburg RRL. Does the guided online cognitive behavioral therapy for insomnia "i-Sleep youth" improve sleep of adolescents and young adults with insomnia after childhood cancer? (MICADO-study): study protocol of a randomized controlled trial. Trials 2021; 22:307. [PMID: 33902701 PMCID: PMC8077706 DOI: 10.1186/s13063-021-05263-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents and young adults who had childhood cancer are at increased risk for insomnia, due to being critically ill during an important phase of their life for the development of good sleep habits. Insomnia is disabling and prevalent after childhood cancer (26-29%) and negatively impacts quality of life, fatigue, pain, and general functioning and is often associated with other (mental) health problems. Insomnia and a history of childhood cancer both increase the risk of adverse health outcomes, posing a double burden for adolescents who had childhood cancer. The first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I). However, access to this type of care is often limited. The guided online CBT-I treatment "i-Sleep" has been developed to facilitate access via online care. i-Sleep is shown effective in adult (breast cancer) patients, but it is unknown if iCBT-I is effective in pediatric oncology. METHODS/DESIGN We developed a youth version of i-Sleep. Our aim is to evaluate its effectiveness in a national randomized-controlled clinical trial comparing iCBT-I to a waiting-list control condition at 3 and 6 months (n = 70). The intervention group will be also assessed at 12 months to see whether the post-test effects are maintained. Adolescents and young adults aged 12-30 years with insomnia, diagnosed with (childhood) cancer, currently at least 6 months since their last cancer treatment will be eligible. Outcomes include sleep efficiency (actigraphic), insomnia severity (self-report), sleep and circadian activity rhythm parameters, fatigue, health-related quality of life, perceived cognitive functioning, chronic distress, depressive and anxiety symptoms, and intervention acceptability. DISCUSSION Insomnia is prevalent in the pediatric oncology population posing a double health burden for adolescents and young adults who had childhood cancer. If guided iCBT-I is effective, guidelines for insomnia can be installed to treat insomnia and potentially improve quality of life and the health of adolescents and young adults who had childhood cancer. TRIAL REGISTRATION NL7220 (NTR7419; Netherlands Trial register). Registered on 2 August 2018.
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Affiliation(s)
- Shosha H M Peersmann
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht, 3584 CS, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro, and Developmental Psychology, Faculty of Behavioural and Movement Science & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Gertjan J L Kaspers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht, 3584 CS, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Adriana Thano
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht, 3584 CS, The Netherlands
| | - Esther van den Bergh
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht, 3584 CS, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht, 3584 CS, The Netherlands
| | - Raphaële R L van Litsenburg
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht, 3584 CS, The Netherlands. .,Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.
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23
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Ter Haar AM, Van den Hof M, Scherpbier HJ, Oostrom KJ, Haverman L, Pajkrt D. Health-related quality of life of perinatally HIV-infected young people: a longitudinal study. AIDS Care 2021; 34:263-271. [PMID: 33793369 DOI: 10.1080/09540121.2021.1909695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Young people perinatally infected with HIV (pHIV) are at risk of a lowered health-related quality of life (HRQOL). Previous evaluation of the NeurOlogical, VIsual and Cognitive performance in HIV-infected Children (NOVICE)-cohort showed no difference in HRQOL between pHIV and matched HIV-uninfected controls (HIV-), yet a higher percentage of pHIV had impaired HRQOL. The aim of this study is to compare the change over time in HRQOL of pHIV to HIV- over a 5-year period. We used the Pediatric Quality of Life Inventory (PedsQL)™ 4.0 to repeat HRQOL assessment. High PedsQL scores indicate good HRQOL. Fifteen/33 (45.5%) pHIV and 17/37 (45.9%) HIV- completed both assessments. At the first assessment, the mean age was 13.1 years (range 8.0-18.4). PHIV scored higher than HIV- on Emotional functioning and on Total scale score. After five years, the mean age was 17.6 years (range 12.1-22.8). PHIV scored higher than HIV- on all scales, except Social functioning. PHIV did not differ significantly from the Dutch norm on either time-point. LMEM showed no difference in change over time for any of the PedsQL scales. In this study, young people with pHIV receiving high-quality health care, including monitoring of HRQOL, remain to experience a good HRQOL.
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Affiliation(s)
- A M Ter Haar
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
| | - M Van den Hof
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
| | - H J Scherpbier
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
| | - K J Oostrom
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, Department of Child and Adolescent Psychiatry, Pediatric Psychology and Psychosocial Care, University of Amsterdam, Amsterdam, Netherlands
| | - L Haverman
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, Department of Child and Adolescent Psychiatry, Pediatric Psychology and Psychosocial Care, University of Amsterdam, Amsterdam, Netherlands
| | - D Pajkrt
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
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24
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Allonsius F, de Kloet A, Bedell G, van Markus-Doornbosch F, Rosema S, Meesters J, Vliet Vlieland T, van der Holst M. Participation Restrictions among Children and Young Adults with Acquired Brain Injury in a Pediatric Outpatient Rehabilitation Cohort: The Patients' and Parents' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041625. [PMID: 33567741 PMCID: PMC7914578 DOI: 10.3390/ijerph18041625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022]
Abstract
Improving participation is an important aim in outpatient rehabilitation treatment. Knowledge regarding participation restrictions in children and young adults with acquired brain injury (ABI) is scarce and little is known regarding the differences in perspectives between patients and parents in the outpatient rehabilitation setting. The aims are to describe participation restrictions among children/young adults (5–24 years) with ABI and investigating differences between patients’ and parents’ perspectives. At admission in 10 rehabilitation centers, patients and parents were asked to complete the Child and Adolescent Scale of Participation (CASP; score 0–100; lower score = more restrictions) and injury/patient/family-related questions. CASP scores were categorized (full/somewhat-limited/limited/very-limited participation). Patient/parent-reported outcomes were compared using the Wilcoxon signed-rank test. 223 patients and 245 parents participated (209 paired-samples). Median patients’ age was 14 years (IQR; 11–16), 135 were female (52%), 195 had traumatic brain injury (75%). The median CASP score reported by patients was 82.5 (IQR: 67.5–90) and by parents 91.3 (IQR: 80.0–97.5) (difference = p < 0.05). The score of 58 patients (26%) and 25 parents (10%) was classified as ‘very-limited’. Twenty-six percent of children and young adults referred for rehabilitation after ABI had “very-limited” participation. Overall, parents rated their child’s participation better than patients themselves. Quantifying participation restrictions after ABI and considering both perspectives is important for outpatient rehabilitation treatment.
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Affiliation(s)
- Florian Allonsius
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Correspondence: (F.A.); (M.v.d.H.)
| | - Arend de Kloet
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA;
| | - Frederike van Markus-Doornbosch
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Stefanie Rosema
- National Department Level, Specialists in Youth and Families, 1105 AZ Amsterdam, The Netherlands;
| | - Jorit Meesters
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Centre of Expertsie in Health Innovations, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands
| | - Thea Vliet Vlieland
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Menno van der Holst
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence: (F.A.); (M.v.d.H.)
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van Erp LME, Maurice-Stam H, Kremer LCM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Versluys BAB, van der Heiden-van der Loo M, Huizinga GA, Grootenhuis MA. A vulnerable age group: the impact of cancer on the psychosocial well-being of young adult childhood cancer survivors. Support Care Cancer 2021; 29:4751-4761. [PMID: 33527229 PMCID: PMC8236461 DOI: 10.1007/s00520-021-06009-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/19/2021] [Indexed: 02/04/2023]
Abstract
Purpose This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer. Methods YACCS (aged 18–30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the “Pediatric Quality of Life Inventory Young Adults” (PedsQL-YA), “Hospital Anxiety and Depression Scale” (HADS), and “Checklist Individual Strengths” (CIS-20R) to measure fatigue and survivor-specific “Impact of Cancer - Childhood Survivors” (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses. Results YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (− .4 ≤ d ≤ − .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially “Life Challenges” (HRQOL β = − .18, anxiety β = .36, depression β = .29) and “Body & Health” (HRQOL β = .27, anxiety β = − .25, depression β = − .26, fatigue β = − .47). Conclusion YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.
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Affiliation(s)
- L M E van Erp
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.
| | - L C M Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - W J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - H J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands
| | - A C H de Vries
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - M M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - B A B Versluys
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - G A Huizinga
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands
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Limperg PF, Maurice-Stam H, Heesterbeek MR, Peters M, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Haverman L. Illness cognitions associated with health-related quality of life in young adult men with haemophilia. Haemophilia 2020; 26:793-799. [PMID: 32842171 DOI: 10.1111/hae.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 07/01/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIM Knowledge on patterns of beliefs about the illness (illness cognitions) can provide insight into individual differences in adjustment to haemophilia. The current study aimed to identify (a) which sociodemographic and disease characteristics were associated with illness cognitions and (b) which illness cognitions were associated with health-related quality of life (HRQOL) in young adult men with haemophilia, besides sociodemographic and disease characteristics. METHODS Young adult men (18-30 years) with haemophilia in the Netherlands participated in an online multicentre cross-sectional study. Participants completed the Pediatric Quality of Life Inventory Young Adult version (PedsQL_YA). Potential sociodemographic determinants were assessed with the Course of Life Questionnaire (CoLQ) and illness cognitions with the Illness Cognition Questionnaire (ICQ). Multiple linear regression analyses were performed to assess potential determinants of illness cognitions and HRQOL. RESULTS Seventy young adult men with haemophilia (mean age 24.7 years, SD 3.5) participated. Born outside the Netherlands (β -0.24) and >1 bleed past 6 months (β -0.32) were associated with less acceptance of the disease. More acceptance was associated with better HRQOL in all domains: β 0.23-0.39. More helplessness was associated with worse total (β -0.30) and physical (β -0.42) HRQOL. Disease benefits, sociodemographic and disease characteristics were not associated with HRQOL. CONCLUSION Illness cognitions are associated with HRQOL in young adult men with haemophilia. Early recognition and identification of illness cognitions are important to facilitate support and psychosocial treatment to optimize young adults' well-being. Extra attention is needed for young adult men with frequent bleeds because they are at risk of lowered levels of acceptance of the disease.
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Affiliation(s)
- Perrine F Limperg
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Madelief R Heesterbeek
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Peters
- Department of Pediatric-Hematology, Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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van Markus-Doornbosch F, van der Holst M, de Kloet AJ, Vliet Vlieland TPM, Meesters JJL. Fatigue, Participation and Quality of Life in Adolescents and Young Adults with Acquired Brain Injury in an Outpatient Rehabilitation Cohort. Dev Neurorehabil 2020; 23:328-335. [PMID: 31746261 DOI: 10.1080/17518423.2019.1692948] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE To study the association between fatigue and participation and QoL after acquired brain injury (ABI) in adolescents and young adults (AYAs). MATERIALS & METHODS Cross-sectional study with AYAs aged 14-25 years, diagnosed with ABI. The PedsQL™ Multidimensional Fatigue Scale, Child & Adolescent Scale of Participation, and PedsQL™4.0 Generic Core Scales were administered. RESULTS Sixty-four AYAs participated in the study, 47 with traumatic brain injury (TBI). Median age at admission was 17.6 yrs, 0.8 yrs since injury. High levels of fatigue (median 44.4 (IQR 34.7, 59.7)), limited participation (median 82.5 (IQR 68.8, 92.3)), and diminished QoL (median 63.0 (IQR 47.8, 78.3)) were reported. More fatigue was significantly associated with more participation restrictions (β 0.64, 95%CI 0.44, 0.85) and diminished QoL (β 0.87, 95%CI 0.72, 1.02). CONCLUSIONS AYAs with ABI reported high levels of fatigue, limited participation and diminished quality of life with a significant association between fatigue and both participation and QoL. Targeting fatigue in rehabilitation treatment could potentially improve participation and QoL.
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Affiliation(s)
| | - Menno van der Holst
- Basalt Rehabilitation , The Hague, The Netherlands.,Leiden University Medical Center , Leiden, The Netherlands
| | - Arend J de Kloet
- Basalt Rehabilitation , The Hague, The Netherlands.,The Hague University of Applied Sciences , The Hague, The Netherlands
| | - Thea P M Vliet Vlieland
- Basalt Rehabilitation , The Hague, The Netherlands.,Leiden University Medical Center , Leiden, The Netherlands
| | - Jorit J L Meesters
- Basalt Rehabilitation , The Hague, The Netherlands.,Leiden University Medical Center , Leiden, The Netherlands.,The Hague University of Applied Sciences , The Hague, The Netherlands
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Bronner MB, Peeters MAC, Sattoe JNT, van Staa A. The impact of type 1 diabetes on young adults' health-related quality of life. Health Qual Life Outcomes 2020; 18:137. [PMID: 32398086 PMCID: PMC7218580 DOI: 10.1186/s12955-020-01370-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/17/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Young adulthood is a challenging period for people with diabetes mellitus type 1 (T1DM) as they are facing multiple life transitions while managing a demanding disease. This poses a risk for impaired health-related quality of life (HRQOL). We assessed HRQOL in a cohort of young adults with T1DM in the Netherlands, and compared outcomes with those of Dutch norm groups of healthy young adults and young adults with a chronic disease. METHODS We analyzed data collected in a larger evaluation study on transitional care for young adults with T1DM in a nationwide sample in the Netherlands, including twelve participating hospitals. These data had been obtained from online questionnaires completed by young adults with T1DM after they had transferred to adult care. HRQOL was self-reported with the Pediatric Quality of Life Inventory for young adults (PedsQL-YA). RESULTS One hundred and sixty-five young adults with T1DM participated (44.2% response); and they scored significantly worse than did healthy peers on all domains of HRQOL, except social functioning. Particularly, functioning at school or work was worse than that of the norm group. The study group's HRQOL-scores were comparable to norm scores of young adults with chronic diseases, although the physical and social functioning of young people with T1DM was better. One quarter (26.1%) of all young adults with T1DM reported fatigue. CONCLUSIONS During transition to adulthood, young adults with T1DM struggle to maintain a balance between the demands of managing a disease and their life. Many of them encounter problems at work or school, and suffer from fatigue. These findings underscore the need to regularly assess HRQOL, and to discuss work- and education-related issues in clinical practice.
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Affiliation(s)
- Madelon B Bronner
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Mariëlle A C Peeters
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jane N T Sattoe
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands. .,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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Options for the Interpretation of and Recommendations for Acting on Different PROMs in Daily Clinical Practice Using KLIK. Med Care 2020; 57 Suppl 5 Suppl 1:S52-S58. [PMID: 30985597 DOI: 10.1097/mlr.0000000000001061] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This paper describes the different ways in which information is being fed back to health care providers (HCPs) using the Dutch evidence-based KLIK Patient-Reported Outcome Measures (PROMs) portal (www.hetklikt.nu). KLIK was initially developed for children with a chronic illness and their parents, and recently expanded for use in adult health care. Patients complete online PROMs at home about their health-related quality of life (HRQOL), symptoms and/or psychosocial functioning before an outpatient consultation with their HCP. PROMs are subsequently converted into an individual KLIK electronic (e)PROfile and discussed during the consultation to facilitate systematic attention for HRQOL. METHODS FOR PRO SCORE INTERPRETATION KLIK includes a variety of different PROMs. The KLIK ePROfile initially consisted of literal representations of the individual PROM items in the European traffic light colors (red, orange, green) and only one graph. Over the years, the KLIK ePROfile evolved into a broader spectrum of feedback options; (1) literal representation of individual items, (2) summary scores, and (3) graphic representations (4 options). DEVELOPING RECOMMENDATIONS FOR ACTING ON PRO RESULTS The primary goal of KLIK is to longitudinally monitor patient and parent self-reported or proxy-reported health outcomes, which means that the focus of KLIK is not mainly on recommending actions for PRO results. However, there are several aids that help interpretation of the KLIK ePROfile and recommendations are given for actions based on PROM scores. The main aid is the KLIK training, which includes a theoretical and a practical part. In the training, 2 tools-a decision tree and a summary of information about the KLIK ePROfile-are given to the HCPs to assist them in using KLIK. DISCUSSION Customization of a PROM portal is needed for each different patient group and clinical setting. Because the KLIK website is flexible, every PROM (with good psychometric qualities and permission of the publisher) can be built in. However, implementing and feeding back PROMs in pediatric health care encompasses different challenges, because different versions of the same PROM are needed for children of different ages, as well as proxy and self-report versions.
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van Gulik EC, Verkuil F, Barendregt AM, Schonenberg-Meinema D, Rashid ANS, Kuijpers TW, van den Berg JM, Hoving JL. Experiences, perspectives and expectations of adolescents with juvenile idiopathic arthritis regarding future work participation; a qualitative study. Pediatr Rheumatol Online J 2020; 18:33. [PMID: 32293467 PMCID: PMC7158382 DOI: 10.1186/s12969-020-00429-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/03/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Having Juvenile idiopathic Arthritis (JIA) has widespread implications for a person's life. Patients have to deal with recurring arthritis, characterized by pain often accompanied by a loss of energy. Since JIA often persists into adulthood, patients with JIA are likely to encounter difficulties in their working life. We expect that the experiences in school life may be comparable to the barriers and opportunities which patients affected by JIA encounter in adult working life. Therefore, the aim of this study was to elicit the experiences during school life and the perspectives and expectations regarding future work participation of adolescents with JIA. METHODS This study used individual, semi-structured interviews and followed a predefined interview guide. Participants between 14 and 18 years of age (n = 22) were purposively selected to achieve a broad range of participant characteristics. Open coding was performed, followed by axial coding and selective coding. RESULTS Great differences were seen in the support and understanding that adolescents received in dealing with JIA at school, leisure activities and work. Varying approaches were mentioned on how to pursue a desired vocation. Perspectives regarding disclosure varied. Participants wished to be approached like any other healthy adolescent. Expectations regarding work participation were positively expressed. CONCLUSION This study showed that participants often disregarded having JIA when making plans for their future career. Facilitating an open discussion about the possible limitations accompanying JIA with educators and employers might prevent overburden and increase the chance of starting a career which would accommodate the patient with JIA in the near and distant future.
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Affiliation(s)
- E. Charlotte van Gulik
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Floris Verkuil
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Anouk M. Barendregt
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Dieneke Schonenberg-Meinema
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Amara Nassar-Sheikh Rashid
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Taco W. Kuijpers
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - J. Merlijn van den Berg
- grid.7177.60000000084992262Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Immunology Rheumatology and Infectious diseases, Location AMC
- G1-215
- Meibergdreef 9, Amsterdam, 1105AZ The Netherlands
| | - Jan L. Hoving
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Department Coronel Institute of Occupational Health. Amsterdam Public Health research institute, P.O. Box 22700, Amsterdam, DE NL-1100 The Netherlands ,Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
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Gastro-intestinal function and quality of life are favorable in adolescent and adult gastroschisis patients. Early Hum Dev 2020; 141:104936. [PMID: 31874371 DOI: 10.1016/j.earlhumdev.2019.104936] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/20/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Studies on long-term sequelae of gastroschisis are scarce. The limited data suggest increased abdominal complaints in young children. To provide proper counseling for both parents and patients, more information on long-term outcome is needed. This study aims to evaluate long-term outcome regarding GI function, gastroesophageal reflux (GER), health-related quality of life (HRQoL) and cosmetic satisfaction. METHODS An observational longitudinal cohort study was performed. All patients (N = 43) born between 1982 and 2008 with gastroschisis that were admitted to the University Medical Centre Utrecht, Wilhelmina Children's Hospital were invited to fill in a survey. Data of included patients were compared to validated Dutch reference standards. RESULTS Fourteen patients responded to the survey. The median follow-up was 18 years. Abdominal pain on weekly basis was present in two patients (14%) and feeding difficulties were present in one patient. Presence of a complication during gastroschisis treatment led to more GI symptoms (80% versus 22%). One patient experienced moderate complaints of regurgitation or dyspepsia. Although the overall HRQoL was lower in teenage gastroschisis patients as compared to healthy controls (73/100 versus 83/100, respectively), we found no relevant difference in overall HRQoL in the other age groups. Seven patients (50%) were satisfied with the cosmetic result of the scar. CONCLUSIONS GI function and HRQoL in gastroschisis patients seem similar to healthy controls at adolescent and adult age. Complications during gastroschisis treatment led to an increase of abdominal complaints later in life. The surgical technique had no significant effect on the cosmetic results.
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Sattoe JNT, Peeters MAC, Haitsma J, van Staa A, Wolters VM, Escher JC. Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation. BMJ Open 2020; 10:e033535. [PMID: 31911522 PMCID: PMC6955474 DOI: 10.1136/bmjopen-2019-033535] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Developing and evaluating effective transition interventions for young people (16-25 years) with inflammatory bowel disease (IBD) is a high priority. While transition clinics (TCs) have been recommended, little is known about their operating structures and outcomes. This study aimed to gain insight into the value of a TC compared with direct handover care. DESIGN Controlled mixed-methods evaluation of process outcomes, clinical outcomes and patient-reported outcomes. SETTING Two outpatient IBD clinics in the Netherlands. PARTICIPANTS Data collection included: semistructured interviews with professionals (n=8), observations during consultations with young people (5×4 hours), medical chart reviews of patients transferred 2 to 4 years prior to data collection (n=56 in TC group; n=54 in control group) and patient questionnaires (n=14 in TC group; n=19 in control group). OUTCOMES Data were collected on service structures and daily routines of the TC, experienced barriers, facilitators and benefits, healthcare use, clinical outcomes, self-management outcomes and experiences and satisfaction of young people with IBD. RESULTS At the TC, multidisciplinary team meetings and alignment of care between paediatric and adult care providers were standard practice. Non-medical topics received more attention during consultations with young people at the TC. Barriers experienced by professionals were time restrictions, planning difficulties, limited involvement of adult care providers and insufficient financial coverage. Facilitators experienced were high professional motivation and a high case load. Over the year before transfer, young people at the TC had more planned consultations (p=0.015, Cohen's d=0.47). They showed a positive trend in better transfer experiences and more satisfaction. Those in direct handover care more often experienced a relapse before transfer (p=0.003) and had more missed consultations (p=0.034, Cohen's d=-0.43) after transfer. CONCLUSION A TC offer opportunities to improve transitional care, but organisational and financial barriers need to be addressed before guidelines and consensus statements in healthcare policy and daily practice can be effectively implemented.
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Affiliation(s)
- Jane N T Sattoe
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Mariëlle A C Peeters
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jannie Haitsma
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Victorien M Wolters
- Department of Pediatric Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna C Escher
- Department of Pediatric Gastroenterology, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
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Peeters MAC, Sattoe JNT, van Staa A, Versteeg SE, Heeres I, Rutjes NW, Janssens HM. Controlled evaluation of a transition clinic for Dutch young people with cystic fibrosis. Pediatr Pulmonol 2019; 54:1811-1820. [PMID: 31424181 PMCID: PMC6852263 DOI: 10.1002/ppul.24476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Transition clinics (TCs) are advocated as best practice to support young people with cystic fibrosis (CF) during transition to adulthood and adult care. We aimed to research the functioning of a TC for young people with CF compared with direct hand-over care and to evaluate whether those treated at the TC have better transfer experiences and outcomes compared with the control group. METHODS Mixed-methods retrospective controlled design, including interviews with professionals, observations of clinics, chart reviews (at four measurement moments), and patient surveys. Qualitative data analysis focused on organization and daily routines, and barriers and facilitators experienced. Young people's transfer experiences, self-management, health care use, and clinical outcomes were assessed quantitatively. RESULTS The most notable feature distinguishing the TC and direct hand-over care comprised joint consultations between pediatric and adult care professionals in the former. A transition coordinator was considered essential for the success of the TC. The main barriers were lack of time, planning, and reimbursement issues. Young people treated at the TC tended to have better transfer experiences and were more satisfied. They reported significantly more trust in their adult care professionals. Their self-management-related outcomes were less favorable. CONCLUSIONS The TC had several perceived benefits and showed positive trends in transfer experiences and satisfaction, but no differences in health-related outcomes. Structured preparation of young people, joint consultations with pediatric and adult care professionals, and better coordination were perceived as facilitating elements. Further improvement demands solutions for organizational and financial barriers, and better embedding of self-management interventions in CF care.
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Affiliation(s)
- Mariëlle A C Peeters
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jane N T Sattoe
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Simone E Versteeg
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Inge Heeres
- Department of Pediatrics, Division Respiratory Medicine and Allergology, Erasmus MC/Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Niels W Rutjes
- Department of Pediatric Pulmonology, Amsterdam UMC/Emma Children's Hospital, Amsterdam, The Netherlands
| | - Hettie M Janssens
- Department of Pediatrics, Division Respiratory Medicine and Allergology, Erasmus MC/Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
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Langeland IO, Sollesnes R, Nilsen RM, Almenning G, Langeland E. Examining boys' and girls' health-related quality of life from the first to the third year of upper secondary school: A prospective longitudinal study. Nurs Open 2019; 6:1606-1614. [PMID: 31660189 PMCID: PMC6805264 DOI: 10.1002/nop2.366] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/12/2019] [Indexed: 02/06/2023] Open
Abstract
AIM To examine differences in health-related quality of life between boys and girls in the first and third years of upper secondary school. DESIGN Prospective longitudinal study. METHODS The KIDSCREEN-10 was used to assess health-related quality of life. Differences in health-related quality of life over time were estimated using a linear mixed-effects model for correlated measurements. RESULTS In the first-year boys (N = 168) and girls (N = 228) reported a mean health-related quality of life score of 76.3 (SD 10.7) and 69.8 (SD 11.5), respectively. In the third year, the mean health-related quality of life score for boys and girls was 73.5 (SD 12.4) and 65.7 (SD 13.3), respectively. Boys had a significant decrease in health-related quality of life mean score of -2.6 and girls a significant decrease of -3.8 (p < .001) over the 3-year period. There was no significant difference between boys' and girls' health-related quality of life changes (p = .39).
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Affiliation(s)
- Ingrid Oma Langeland
- Department of Health and Caring Science, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Ragnhild Sollesnes
- Department of Health and Caring Science, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Roy Miodini Nilsen
- Department of Health and Functioning, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Grethe Almenning
- Section for Innovation, Health, Children and Youth, Department of Health and CareBergen MunicipalityBergenNorway
| | - Eva Langeland
- Department of Health and Caring Science, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
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Longitudinal functional health status in young adults with repaired dextro-transposition of the great arteries: A Congenital Heart Surgeons' Society study. J Thorac Cardiovasc Surg 2019; 159:604-614.e3. [PMID: 31677883 DOI: 10.1016/j.jtcvs.2019.07.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/02/2019] [Accepted: 07/23/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Improved survival has led to interest in functional health status (FHS) as patients with dextro-transposition of the great arteries (d-TGA) transition to adulthood. Our primary objectives were (1) evaluation of The Medical Outcomes Study Short Form-36 Health Survey (SF-36) results; (2) comparison with results of patients who completed the Child Health Questionnaire-Child Form 87 (CHQ-CF87) previously, or the PedsQL Generic Core Scales (PedsQL) survey subsequently; and (3) determination of factors associated with SF-36 domains. METHODS Survivors from the d-TGA Congenital Heart Surgeons' Society cohort (1985-1989) completed the SF-36 (2010) as a measure of FHS (n = 210; age 21-26 years). Patient characteristics, medical history, psychosocial factors, and previous adolescent CHQ-CF87 FHS assessment (2000) were explored for association with SF-36 domains, along with comparison with recent PedsQL data (2017). RESULTS Patients scored themselves the same/higher than published normative data in 10 of 10 SF-36 summary scores/domains and similar in 5 of 6 PedsQL summary scores/domains. Factors commonly associated with lower summary scores/domains of the SF-36 were presence of cardiac symptoms, heart condition impacting physical activity/overall health/quality of life, unemployment, and lack of postsecondary education. Less commonly associated factors were lower birth weight, greater total medication number, female sex, shorter procedure-free interval, poor health knowledge, lower family income, younger age at SF-36, living with parents, and being married. These factors accounted for 17% to 47% of the variation in FHS summary scores/domains. FHS was minimally related to d-TGA morphology and repair type. CONCLUSIONS Patients with d-TGA surviving into adulthood, regardless of morphology or repair type, can primarily expect normal FHS. Addressing the challenges of patients with d-TGA entering adulthood requires consideration of psychosocial factors and clinical management.
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Devlin PJ, Jegatheeswaran A, Williams WG, Blackstone EH, DeCampli WM, Lambert LM, Mussatto KA, Prospero CJ, Bondarenko I, McCrindle BW. Late Survival and Patient-Perceived Health Status of the Congenital Heart Surgeons' Society dextro-Transposition of the Great Arteries Cohort. Ann Thorac Surg 2019; 108:1447-1455. [PMID: 31348901 DOI: 10.1016/j.athoracsur.2019.05.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/17/2019] [Accepted: 05/21/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Improved survival for patients with dextro-transposition of the great arteries (d-TGA) has led to an increased focus on functional health status (FHS). We assessed late survival and patient-perceived FHS for repaired TGA patients. METHODS From 1985-1990, 830 neonates admitted to 24 Congenital Heart Surgeons' Society (CHSS) institutions with d-TGA underwent repair, including 516 arterial switch, 110 Mustard, 175 Senning, and 29 Rastelli operations. Median follow-up was 24.0 years (range, 0-32.7 years). We performed multiphase parametric hazard analysis for death after repair. Patients completed Pediatric Quality of Life Inventory (PedsQL) Core Scales and Cardiac Module Adult Forms. Patient and operative factors and CHSS General Questionnaire responses were analyzed for association with FHS using multiple linear regression. RESULTS Survival at 30 years after repair was arterial switch, 80% ± 2%; Mustard, 81% ± 5%; Senning, 70% ± 4%; and Rastelli, 86% ± 8%. The arterial switch had the lowest hazard for late death. TGA patients reported FHS similar to a healthy population in all domains except physical health (lower scores). Symptoms, including chest pain and fainting, and having a pacemaker were associated with lower, and being employed with higher, self-reported physical health. Arterial switch patients reported higher FHS than the atrial switch patients in all domains. CONCLUSIONS Arterial switch patients have a lower risk of premature death and better FHS than those with an atrial switch. Increased surveillance in atrial switch patients is warranted because of their increased risk of late death. Presence of symptoms, pacemaker, and lack of employment are associated with reduced FHS.
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Affiliation(s)
- Paul J Devlin
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Anusha Jegatheeswaran
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - William G Williams
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eugene H Blackstone
- Division of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - William M DeCampli
- Division of Pediatric Cardiac Surgery, Arnold Palmer Hospital for Children, Orlando, Florida
| | - Linda M Lambert
- Department of Pediatrics, Primary Children's Hospital, Salt Lake City, Utah
| | - Kathleen A Mussatto
- Herma Heart Institute, Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Carol J Prospero
- Nemours Cardiac Center, Alfred I. DuPont Hospital for Children, Wilmington, Delaware
| | - Igor Bondarenko
- Department of Cardiovascular Surgery, Children's Hospital of Michigan, Detroit, Michigan
| | - Brian W McCrindle
- Division of Pediatric Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada
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Limperg PF, Maurice-Stam H, Haverman L, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Peters M. Professional functioning of young adults with congenital coagulation disorders in the Netherlands. Haemophilia 2019; 25:e138-e145. [PMID: 30859671 PMCID: PMC6850762 DOI: 10.1111/hae.13698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2019] [Indexed: 01/17/2023]
Abstract
Introduction and Aim Suboptimal health‐related quality of life and lowered employment rates found in a previous study in young adults (YA) with congenital coagulation disorders (CCD) in the Netherlands underline the need for more insight into professional functioning of YA with CCD and into determinants of professional functioning. Methods Young adults (18‐30 years) with CCD participated in a cross‐sectional study. Professional functioning was assessed with the Work Productivity and Activity Impairment questionnaire (WPAI). Potential determinants were assessed with the Course of Life Questionnaire (CoLQ), Pediatric Quality of Life Inventory Young Adult version (PedsQL_YA), Illness Cognition Questionnaire (ICQ) and Haemophilia Activities List (HAL). Logistic regression analyses were performed in the complete sample of YA with CCD, and in YA men with haemophilia separately, to examine determinants of WPAI outcomes. Results Ninety‐four YA (77 men; mean age 24.1 years, SD 3.5 and 17 women; mean age 24.5 years, SD 3.8) with CCD (74% haemophilia A/B) participated. 74.5% of YA were paid employed for on average 30 hours per week. Of these, more than a quarter reported work impairment. Older age and a non‐severe type of haemophilia (in the sample of YA men with haemophilia) were associated with successful (paid) employment. No variables were associated with professional functioning (expressed as Presenteeism and Overall work impairment) in patients with CCD or haemophilia. Conclusion Three‐quarters of YA with CCD were successful in finding paid employment. Though absenteeism was low, YA with paid employment needs attention as a considerable part experienced work impairment.
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Affiliation(s)
- Perrine F Limperg
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Section Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Peters
- Department of Pediatric-Hematology and Hemophilia Comprehensive Care Treatment Center, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Vaarwerk B, Schoot RA, Maurice-Stam H, Slater O, Hartley B, Saeed P, Gajdosova E, van den Brekel MW, Balm AJM, Hol MLF, van Jaarsveld S, Kremer LCM, Ronckers CM, Mandeville HC, Pieters BR, Gaze MN, Davila Fajardo R, Strackee SD, Dunaway D, Smeele LE, Chisholm JC, Caron HN, Grootenhuis MA, Merks JHM. Psychosocial well-being of long-term survivors of pediatric head-neck rhabdomyosarcoma. Pediatr Blood Cancer 2019; 66:e27498. [PMID: 30318743 DOI: 10.1002/pbc.27498] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Head and neck rhabdomyosarcoma (HNRMS) survivors are at risk to develop adverse events (AEs). The impact of these AEs on psychosocial well-being is unclear. We aimed to assess psychosocial well-being of HNRMS survivors and examine whether psychosocial outcomes were associated with burden of therapy. PROCEDURE Sixty-five HNRMS survivors (median follow-up: 11.5 years), treated in the Netherlands and the United Kingdom between 1990 and 2010 and alive ≥2 years after treatment visited the outpatient multidisciplinary follow-up clinic once, in which AEs were scored based on a predefined list according to the Common Terminology Criteria for Adverse Events. Survivors were asked to complete questionnaires on health-related quality of life (HRQoL; PedsQL and YQOL-FD), self-perception (KIDSCREEN), and satisfaction with appearances (SWA). HRQoL and self-perception scores were compared with reference values, and the correlation between physician-assessed AEs and psychosocial well-being was assessed. RESULTS HNRMS survivors showed significantly lower scores on PedsQL school/work domain (P ≤ 0.01, P = 0.02, respectively), YQOL-FD domains negative self-image and positive consequences (P ≤ 0.01, P = 0.04, respectively) compared with norm data; scores on negative consequences domain were significantly higher (P = 0.03). Over 50% of survivors negatively rated their appearances on three or more items. Burden of AEs was not associated with generic HRQoL and self-perception scores, but was associated with disease-specific QoL (YQOL-FD). CONCLUSION In general, HRQoL in HNRMS survivors was comparable to reference groups; however, survivors did report disease-specific consequences. We therefore recommend including specific questionnaires related to difficulties with facial appearance in a systematic monitoring program to determine the necessity for tailored care.
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Affiliation(s)
- Bas Vaarwerk
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Reineke A Schoot
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Paediatric Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Olga Slater
- Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Benjamin Hartley
- Department of Otorhinolaryngology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Peerooz Saeed
- Orbital Centre, Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Gajdosova
- Department of Ophthalmology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Michiel W van den Brekel
- Department of Oral and Maxillofacial surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Alfons J M Balm
- Department of Oral and Maxillofacial surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marinka L F Hol
- Department of Oral and Maxillofacial surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Stefanie van Jaarsveld
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leontien C M Kremer
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Cecile M Ronckers
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Henry C Mandeville
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Bradley R Pieters
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mark N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Raquel Davila Fajardo
- Department of Radiation Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands
| | - Simon D Strackee
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - David Dunaway
- Craniofacial Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Ludi E Smeele
- Department of Oral and Maxillofacial surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Julia C Chisholm
- Children and Young People's Department, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Huib N Caron
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Paediatric Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H M Merks
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Jović D, Petrović-Tepić S, Knežević D. Assessment of the quality of life in children and adolescents with asthma. OBZORNIK ZDRAVSTVENE NEGE 2018. [DOI: 10.14528/snr.2018.52.2.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Asthma is a global health problem that negatively affects various aspects of the quality of a person's life. The aim of the study was to examine the quality of life in children and adolescents with asthma and the correlation between the degree of asthma control and the quality of life.Methods: The cross-sectional study included 100 children and adolescents with asthma over a six-month period in 2015. The study used: Standardized Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)) for the assessment quality of life and the questionnaires for the assessment of asthma control for two age groups: Asthma Control Test (ACT) for adolescents and Childhood Asthma Control Test (C-ACT).Results: 62 boys and 38 girls aged 7−17, whose average age was 11.2 (s = 2.7) years were included in the study. The overall PAQLQ(S) score ranged between 3.30 and 7.00 with an average mean value of 5.95. The findings have showed that most children with asthma estimated their overall PAQLQ(S) on the positive end of the scale. The children reported more impairment in the domain of 'Emotion' (x = 5.84) than in 'Activities' and 'Symptoms'. The percentage of adolescents in the category of poor control (12.5 %) was significantly lower than in the group of children (25.0 %). In both groups of children, the sub-scale 'Symptoms' was in highest correlation with the degree of asthma control (r = 0.915, p < 0.01).Discussion and conclusion: In this study the children and adolescents with asthma showed an overall good quality of life. Control of asthma symptoms in children and adolescents positively influenced their quality of life.
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Shahabeddin Parizi A, Krabbe PFM, Verschuuren EAM, Hoek RAS, Kwakkel‐van Erp JM, Erasmus ME, van der Bij W, Vermeulen KM. Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study. Am J Transplant 2018; 18:684-695. [PMID: 28889654 PMCID: PMC5836864 DOI: 10.1111/ajt.14492] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 08/23/2017] [Accepted: 08/30/2017] [Indexed: 01/25/2023]
Abstract
During the last three decades lung transplantation (LTx) has become a proven modality for increasing both survival and health-related quality of life (HRQoL) in patients with various end-stage lung diseases. Most previous studies have reported improved HRQoL shortly after LTx. With regard to long-term effects on HRQoL, however, the evidence is less solid. This prospective cohort study was started with 828 patients who were on the waiting list for LTx. Then, in a longitudinal follow-up, 370 post-LTx patients were evaluated annually for up to 15 years. For all wait-listed and follow-up patients, the following four HRQoL instruments were administered: State-Trait Anxiety Inventory, Zung Self-rating Depression Scale, Nottingham Health Profile, and a visual analogue scale. Cross-sectional and generalized estimating equation (GEE) analysis for repeated measures were performed to assess changes in HRQoL during follow-up. After LTx, patients showed improvement in all HRQoL domains except pain, which remained steady throughout the long-term follow-up. The level of anxiety and depressive symptoms decreased significantly and remained constant. In conclusion, this study showed that HRQoL improves after LTx and tends to remain relatively constant for the entire life span.
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Affiliation(s)
- A. Shahabeddin Parizi
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - P. F. M. Krabbe
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - E. A. M. Verschuuren
- Department of Pulmonology and TuberculosisUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - R. A. S. Hoek
- Department of PulmonologyErasmus MC‐University Medical CenterRotterdamThe Netherlands
| | | | - M. E. Erasmus
- Department of Cardiothoracic SurgeryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - W. van der Bij
- Department of Pulmonology and TuberculosisUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - K. M. Vermeulen
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
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Thijssen MA, de Boo GM, Plötz FB. Single episode of alcohol intoxication in adolescents has no long-term psychosocial effects. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1430198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Maartje A. Thijssen
- Department of Medical Psychology, Tergooi Hospitals, Blaricum, the Netherlands
| | - Gerly M. de Boo
- Department of Medical Psychology, Tergooi Hospitals, Blaricum, the Netherlands
| | - Frans B. Plötz
- Department of Paediatrics, Tergooi Hospitals, Blaricum, the Netherlands
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Ahmadi M, Noudehi M, Esmaeili M, Sadrollahi A. Comparing the Quality of Life Between Active and Non-Active Elderly Women With an Emphasis on Physical Activity. SALMAND 2017. [DOI: 10.21859/sija.12.3.262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Limperg PF, Haverman L, Maurice-Stam H, Coppens M, Valk C, Kruip MJHA, Eikenboom J, Peters M, Grootenhuis MA. Health-related quality of life, developmental milestones, and self-esteem in young adults with bleeding disorders. Qual Life Res 2017; 27:159-171. [PMID: 28900823 PMCID: PMC5770500 DOI: 10.1007/s11136-017-1696-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 11/26/2022]
Abstract
Background The treatment of bleeding disorders improved in the last decades. However, the effect of growing up with bleeding disorders on developmental, emotional, and social aspects is understudied. Therefore, this study assesses HRQOL, developmental milestones, and self-esteem in Dutch young adults (YA) with bleeding disorders compared to peers. Methods Ninety-five YA (18–30 years) with bleeding disorders (78 men; mean 24.7 years, SD 3.5) and 17 women (mean 25.1 years, SD 3.8) participated and completed the Pediatric Quality of Life Inventory Young Adult version, the Course of Life Questionnaire, and the Rosenberg Self-Esteem Scale. Differences between patients with bleeding disorders and their peers, and between hemophilia severity groups, were tested using Mann–Whitney U tests. Results YA men with bleeding disorders report a slightly lower HRQOL on the total scale, physical functioning, and school/work functioning in comparison to healthy peers (small effect sizes). YA men with severe hemophilia report more problems on the physical functioning scale than non-severe hemophilia. YA men with bleeding disorders achieved more psychosexual developmental milestones than peers, but show a delay in ‘paid jobs, during middle and/or high school.’ A somewhat lower self-esteem was found in YA men with bleeding disorders in comparison to peers (small effect size). For YA women with bleeding disorders, no differences were found on any of the outcomes in comparison to peers. Conclusion This study demonstrates some impairments in HRQOL and self-esteem in YA men with bleeding disorders. By monitoring HRQOL, problems can be identified early, especially with regard to their physical and professional/school functioning.
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Affiliation(s)
- P F Limperg
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - L Haverman
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - H Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M Coppens
- Department of Vascular Medicine, Hemophilia Comprehensive Care Treatment Center, AMC, Amsterdam, The Netherlands
| | - C Valk
- Department of Vascular Medicine, Hemophilia Comprehensive Care Treatment Center, AMC, Amsterdam, The Netherlands
| | - M J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Eikenboom
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - M Peters
- Department of Pediatric-Hematology, Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center, AMC, Amsterdam, The Netherlands
| | - M A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
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Nowak-Göttl U, Clausnizer H, Kowalski D, Limperger V, Krümpel A, Shneyder M, Reinke S, Rocke A, Juhl D, Steppat D, Krause M. Health-related quality of life in children, adolescents and adults with hereditary and acquired bleeding disorders. Blood Cells Mol Dis 2017; 67:96-101. [DOI: 10.1016/j.bcmd.2016.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/11/2016] [Indexed: 11/16/2022]
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Schepers SA, van Oers HA, Maurice-Stam H, Huisman J, Verhaak CM, Grootenhuis MA, Haverman L. Health related quality of life in Dutch infants, toddlers, and young children. Health Qual Life Outcomes 2017; 15:81. [PMID: 28438198 PMCID: PMC5404665 DOI: 10.1186/s12955-017-0654-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 04/12/2017] [Indexed: 12/12/2022] Open
Abstract
Background The purpose of this study is to provide Dutch normative data and to assess internal consistency and known-groups validity for the TNO AZL Preschool Children Quality of Life (TAPQOL) and the acute version of the generic Pediatric Quality of Life Inventory (PedsQL 4.0) in Dutch young children aged 0–7 years. Methods Participants were selected from a panel of a large Dutch market research agency. A sample of 794 parents (response rate 61%, 39% fathers) of children (53% boys) from the general Dutch population, completed an electronic version of the TAPQOL (N = 227 infants aged 0–1 years) or PedsQL 4.0 (N = 293 toddlers aged 2–4 years and N = 274 young children aged 5–7 years). Results Except for the ‘stomach’ scale (α = .39), the TAPQOL showed acceptable to excellent internal consistency (α = .60-.88). The PedsQL 4.0 showed acceptable to excellent reliability in children aged 2–4 years (α = .60–.88) and in children aged 5–7 years (α = .76–.90). Children with a chronic health condition had lower scores than healthy children on 3 out of 12 domains of the TAPQOL (p = .001–.013) and on 2 out of 6 domains of the PedsQL 4.0 for children aged 2–4 years (p = .016–.04). The PedsQL 4.0 differentiated on all domains (p < .05) between children aged 5–7 years with and without a chronic health condition. Conclusion In Dutch children aged 0–7 years old, HRQoL can be relialy measured with the TAPQOL and the PedsQL 4.0. However, it remains unclear whether these HRQoL instruments can distinguish between healthy children and children with a chronic health condition under the age of 5.
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Affiliation(s)
- S A Schepers
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, USA.,Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.,Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
| | - H A van Oers
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - H Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - J Huisman
- Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands.,Department of Medical Psychology & Social Work, University Medical Center, Utrecht, The Netherlands
| | - C M Verhaak
- Department of Medical Psychology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.,Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
| | - L Haverman
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
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46
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Sattoe JNT, Peeters MAC, Hilberink SR, Ista E, van Staa A. Evaluating outpatient transition clinics: a mixed-methods study protocol. BMJ Open 2016; 6:e011926. [PMID: 27566639 PMCID: PMC5013382 DOI: 10.1136/bmjopen-2016-011926] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/13/2016] [Accepted: 07/26/2016] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION To support young people in their transition to adulthood and transfer to adult care, a number of interventions have been developed. One particularly important intervention is the transition clinic (TC), where paediatric and adult providers collaborate. TCs are often advocated as best practices in transition care for young people with chronic conditions, but little is known about TC models and effects. The proposed study aims to gain insight into the added value of a TC compared with usual care (without a TC). METHODS AND ANALYSIS We propose a mixed-methods study with a retrospective controlled design consisting of semistructured interviews among healthcare professionals, observations of consultations with young people, chart reviews of young people transferred 2-4 years prior to data collection and questionnaires among the young people included in the chart reviews. Qualitative data will be analysed through thematic analysis and results will provide insights into structures and daily routines of TCs, and experienced barriers and facilitators in transitional care. Quantitatively, within-group differences on clinical outcomes and healthcare use will be studied over the four measurement moments. Subsequently, comparisons will be made between intervention and control groups on all outcomes at all measurement moments. Primary outcomes are 'no-show after transfer' (process outcome) and 'experiences and satisfaction with the transfer' (patient-reported outcome). Secondary outcomes consider clinical outcomes, healthcare usage, self-management outcomes and perceived quality of care. ETHICS The Medical Ethical Committee of the Erasmus Medical Centre approved the study protocol (MEC-2014-246). DISSEMINATION Study results will be disseminated through peer-reviewed journals and conferences. The study started in September 2014 and will continue until December 2016. The same study design will be used in a national study in 20 diabetes settings (2016-2018).
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Affiliation(s)
- Jane N T Sattoe
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Mariëlle A C Peeters
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Sander R Hilberink
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Erwin Ista
- Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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47
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de Boo GM, Thijssen MA, Lasham C, Plötz FB. Short- and long-term psychosocial of a single episode of alcoholic intoxication: a cohort study among Dutch adolescents. Eur J Pediatr 2016; 175:895-901. [PMID: 27048504 DOI: 10.1007/s00431-016-2721-y] [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: 07/17/2015] [Revised: 02/16/2016] [Accepted: 03/27/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED The short- and long-term psychological consequences of a single episode of alcohol intoxication in adolescents are unknown. Twenty-four adolescents (12 M, 12 F), mean age 18.3 ± 1.1 years, who had been admitted to the pediatric ward with alcohol intoxication (mean age at admission 15.6 ± 1.1) and thirty-two parents were interviewed on the intoxication episode and the subsequent consequences. This interview took place 2-3 years after the alcohol intoxication. At the same time, all participants completed questionnaires, assessing general and demographic information, detailed information about current alcohol use, present-day health-related quality of life, and psychological well-being. We observed that short-term (<6 months) psychosocial consequences on family life, family rules, friendships, and school were retrospectively judged more neutral and even more positive than negative by adolescents and their parents. Eighty-six percent of all reported changes by adolescents and parents, directly after the intoxication, lasted 6 months or less. At follow-up present-day quality of life was comparable to the norm, social functioning was significantly better and their mental health proved to be within the normal range (no emotional and behavioral problems). Since the intoxication, none of the participants had dropped out of school and their present-day alcohol use was comparable to estimated averages for their age. CONCLUSION Short- and long-term psychosocial consequences of a single episode of alcohol intoxication were positively judged by adolescents and their parents. WHAT IS KNOWN • Alcohol abuse among adolescents is a growing concern both in society and pediatrics. What is new: • This manuscript describes short and long term psychological consequences of a single episode of alcohol intoxication in adolescents.
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Affiliation(s)
- Gerly M de Boo
- Department of Medical Psychology, Tergooi Hospitals, Blaricum, The Netherlands
| | - Maartje A Thijssen
- Department of Medical Psychology, Tergooi Hospitals, Blaricum, The Netherlands
| | - Carole Lasham
- Department of Pediatrics, Tergooi Hospitals, Rijksstraatweg 1, 1261, AN, Blaricum, The Netherlands
| | - Frans B Plötz
- Department of Pediatrics, Tergooi Hospitals, Rijksstraatweg 1, 1261, AN, Blaricum, The Netherlands.
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48
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Uzark K, Zak V, Shrader P, McCrindle BW, Radojewski E, Varni JW, Daniels K, Handisides J, Hill KD, Lambert LM, Margossian R, Pemberton VL, Lai WW, Atz AM. Assessment of Quality of Life in Young Patients with Single Ventricle after the Fontan Operation. J Pediatr 2016; 170:166-72.e1. [PMID: 26685073 PMCID: PMC4769899 DOI: 10.1016/j.jpeds.2015.11.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/12/2015] [Accepted: 11/05/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To assess self-reported quality of life (QOL) in a large multicenter cohort of adolescent and young adults surviving Fontan. STUDY DESIGN Cross-sectional. The Pediatric Quality of Life Inventory (PedsQL) was administered to 408 survivors of Fontan ages 13-25 years enrolled in the Pediatric Heart Network Fontan Follow-up Study. Subjects also completed either the Child Health Questionnaire (age <19 years) or Short Form Health Survey (age ≥ 19 years). PedsQL data were compared with matched controls without a chronic health condition. Correlations between the measures were examined. RESULTS Mean PedsQL scores for subjects receiving Fontan were significantly lower than those for the control group for physical and psychosocial QOL (P < .001). Overall, 45% of subjects receiving Fontan had scores in the clinically significant impaired range for physical QOL with 30% in the impaired range for psychosocial QOL. For each 1 year increase in age, the physical functioning score decreased by an average of 0.76 points (P = .004) and the emotional functioning score decreased by an average of 0.64 points (P = .03). Among subjects ≥19 years of age, the physical functioning score decreased by an average of 2 points for each year increase in age (P = .02). PedsQL scale scores were significantly correlated with conceptually related Child Health Questionnaire (P < .001) and Short Form Health Survey scores (P < .001). CONCLUSIONS Survivors of Fontan are at risk for significantly impaired QOL which may decline with advancing age. Routine assessment of QOL is essential to inform interventions to improve health outcomes. The PedsQL allowed QOL assessment from pediatrics to young adulthood. TRIAL REGISTRATION ClinicalTrials.gov: NCT00132782.
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Affiliation(s)
- Karen Uzark
- University of Michigan Mott Children's Hospital, Ann Arbor, MI.
| | - Victor Zak
- New England Research Institutes, Watertown, MA
| | | | - Brian W McCrindle
- University of Toronto Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | | | - Wyman W Lai
- Columbia University Medical Center, New York, NY
| | - Andrew M Atz
- Medical University of South Carolina, Charleston, SC
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Adverse events of local treatment in long-term head and neck rhabdomyosarcoma survivors after external beam radiotherapy or AMORE treatment. Eur J Cancer 2015; 51:1424-34. [DOI: 10.1016/j.ejca.2015.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 02/10/2015] [Accepted: 02/21/2015] [Indexed: 11/22/2022]
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50
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Psychometric properties and Dutch norm data of the PedsQL Multidimensional Fatigue Scale for Young Adults. Qual Life Res 2014; 23:2841-7. [DOI: 10.1007/s11136-014-0734-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 11/26/2022]
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