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Rattay P, Öztürk Y, Geene R, Blume M, Allen J, Poethko-Müller C, Mauz E, Manz K, Wieland C, Hövener C. [Social situation, health, and health behavior of children and adolescents in one-parent households at the end of the COVID-19 pandemic: Results of the KIDA study 2022-2023]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:983-997. [PMID: 38995360 PMCID: PMC11349779 DOI: 10.1007/s00103-024-03910-9] [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] [Received: 01/20/2024] [Accepted: 06/03/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION During the COVID-19 pandemic, single parents and their children were particularly exposed to stress due to the containment measures and to limited resources. We analyzed differences in the social and health situation of children and adolescents in one-parent households and two-parent households at the end of the pandemic. METHODS The analysis is based on data from the KIDA study, in which parents of 3‑ to 15-year-old children as well as 16- to 17-year-old adolescents were surveyed in 2022/2023 (telephone: n = 6992; online: n = 2896). Prevalences stratified by family type were calculated for the indicators psychosocial stress, social support, health, and health behavior. Poisson regressions were adjusted for gender, age, level of education, and household income. RESULTS Children and adolescents from one-parent households are more likely to be burdened by financial restrictions, family conflicts, and poor living conditions and receive less school support than peers from two-parent households. They are more likely to have impairments in health as well as increased healthcare needs, and they use psychosocial services more frequently. Furthermore, they are less likely to be active in sports clubs, but they take part in sporting activities at schools as often as minors from two-parent households. The differences are also evident when controlling for income and education. DISCUSSION Children and adolescents from one-parent households can be reached well through exercise programs in a school setting. Low-threshold offers in daycare centers, schools, and the community should therefore be further expanded. Furthermore, interventions are needed to improve the socioeconomic situation of single parents and their children.
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Affiliation(s)
- Petra Rattay
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
- Institut für Medizinische Soziologie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
| | - Yasmin Öztürk
- Abteilung Familie und Familienpolitik, Deutsches Jugendinstitut, München, Deutschland
| | - Raimund Geene
- Berlin School of Public Health, Alice Salomon Hochschule, Berlin, Deutschland
- Berliner Institut für Gesundheits- und Sozialwissenschaften, Europa-Institut für Sozial- und Gesundheitsforschung, Berlin School of Public Health, Berlin, Deutschland
| | - Miriam Blume
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Jennifer Allen
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christina Poethko-Müller
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Elvira Mauz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Kristin Manz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Catherine Wieland
- Berliner Institut für Gesundheits- und Sozialwissenschaften, Europa-Institut für Sozial- und Gesundheitsforschung, Berlin School of Public Health, Berlin, Deutschland
| | - Claudia Hövener
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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Fasshauer M, Schuermann G, Gebert N, Bernuth HV, Bullinger M, Goldacker S, Krueger R, Manzey P, Messner S, Renner ED, Ritterbusch H, Schauer U, Schulze I, Umlauf V, Widmann S, Baumann U. A patient empowerment program for primary immunodeficiency improves quality of life in children and adolescents. Immunotherapy 2024:1-7. [PMID: 39073437 DOI: 10.1080/1750743x.2024.2367924] [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: 03/22/2024] [Accepted: 06/11/2024] [Indexed: 07/30/2024] Open
Abstract
Aim: To assess a patient empowerment program (PEP) for children/adolescents with primary immunodeficiency (PID) on IgG replacement therapy regarding quality of life (QoL) in patients and proxy. Patients & methods: Health-related QoL was assessed using KIDSCREEN-27 and DISABKIDS-37 before and 6 months after PID-PEP kids in 19 children/adolescents and their parents. Results: The following three dimensions of the KIDSCREEN-27 significantly increased in children/adolescents after PID-PEP kids as compared with baseline: Psychological Well-Being, Parents & Autonomy and School Environment. Total DISABKIDS-37 index, as well as 5 of the 6 DISABKIDS-37 dimensions, significantly increased, in other words, Independence, Emotion, Social Inclusion, Social Exclusion and Physical. Evaluation of proxy instruments showed comparable results. Conclusion: PID-PEP kids significantly improved QoL in patients with PID.
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Affiliation(s)
- Maria Fasshauer
- Klinikum St. Georg, Klinik für Kinder- und Jugendmedizin - ImmunDefektCentrum Leipzig IDCL, Leipzig, Germany
| | - Gesine Schuermann
- Medizinische Hochschule Hannover, Arbeitsbereich Immunologie, Klinik für Pädiatrische Pneumologie, Allergologie und Neonatologie, Hannover, Germany
| | | | - Horst von Bernuth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin & Berlin Institute of Health (BIH), Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Berlin, Germany
- Labor Berlin Charité-Vivantes, Fachbereich Immunologie, Berlin, Germany
- Berlin Institute of Health at Charité (BIH) - UniversitätsmedizinBerlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin & Berlin Institute of Health (BIH), Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Monika Bullinger
- Universitätsklinikum Eppendorf, Zentrum für Psychosoziale Medizin, Institut und Poliklinik für Medizinische Psychologie, Hamburg, Germany
| | - Sigune Goldacker
- Universitätsklinikum Freiburg, Centrum für Chronische Immundefizienz (CCI), Freiburg, Germany
| | - Renate Krueger
- Charité- Universitätsmedizin Berlin, ImmunDefektCentrum Berlin, Berlin, Germany
| | - Petra Manzey
- Ludwig-Maximilian-Universität München, Dr. von Haunersches Kinderspital, Immundefektambulanz, München, Germany
| | - Stefanie Messner
- Universitätsklinikum Freiburg, Centrum für Chronische Immundefizienz (CCI), Freiburg, Germany
| | - Ellen D Renner
- Universität Augsburg, Medizinische Fakultät, Translationale Immunologie, Augsburg, Germany
- Technische Universität München, Klinikum rechts der Isar, Kinderpoliklinik Schwabing, München, Germany
| | - Henrike Ritterbusch
- Universitätsklinikum Freiburg, Centrum für Chronische Immundefizienz (CCI), Freiburg, Germany
| | - Uwe Schauer
- Ruhr-Universität Bochum im St. Josef Hospital, Klinik für Kinder- und Jugendmedizin, Bochum, Germany
| | - Ilka Schulze
- KiJuMed-Gemeinschaftspraxis für Kinder- und Jugendmedizin sowie Kinder- und Jugendpsychotherapie, Bern, Switzerland
| | | | - Steffi Widmann
- Ludwig-Maximilian-Universität München, Dr. von Haunersches Kinderspital, Immundefektambulanz, München, Germany
| | - Ulrich Baumann
- Medizinische Hochschule Hannover, Arbeitsbereich Immunologie, Klinik für Pädiatrische Pneumologie, Allergologie und Neonatologie, Hannover, Germany
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Darkhawaja R, Hänggi J, Bringolf-Isler B, Kayser B, Suggs LS, Kwiatkowski M, Probst-Hensch N. Weekend physical activity profiles and their relationship with quality of life: The SOPHYA cohort of Swiss children and adolescents. PLoS One 2024; 19:e0298890. [PMID: 38820541 PMCID: PMC11142694 DOI: 10.1371/journal.pone.0298890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/31/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Quality of life (QoL) is an important health indicator among children and adolescents. Evidence on the effect of physical activity (PA)-related behaviors on QoL among youth remains inconsistent. Conventional accelerometer-derived PA metrics and guidelines with a focus on whole weeks may not adequately characterize QoL relevant PA behavior. OBJECTIVE This study aims to a) identify clusters of accelerometer-derived PA profiles during weekend days among children and adolescents living in Switzerland, b) assess their cross-sectional and predictive association with overall QoL and its dimensions, and c) investigate whether the associations of QoL with the newly identified clusters persist upon adjustment for the commonly used PA metrics moderate-to-vigorous physical activity (MVPA) and time spent in sedentary behavior (SB). METHODS The population-based Swiss children's Objectively measured PHYsical Activity (SOPHYA) cohort among children and adolescents aged 6 to 16 years was initiated at baseline in 2013. PA and QoL information was obtained twice over a five-year follow-up period. The primary endpoint is the overall QoL score and its six dimension scores obtained by KINDL® questionnaire. The primary predictor is the cluster membership of accelerometer-derived weekend PA profile. Clusters were obtained by applying the k-medoid algorithm to the distance matrix of profiles obtained by pairwise alignments of PA time series using the Dynamic Time Warping (DTW) algorithm. Secondary predictors are accelerometer-derived conventional PA metrics MVPA and SB from two combined weekend days. Linear regression models were applied to assess a) the cross-sectional association between PA cluster membership and QoL at baseline and b) the predictive association between PA cluster membership at baseline and QoL at follow-up, adjusting for baseline QoL. RESULTS The study sample for deriving PA profile clusters consisted of 51.4% girls and had an average age of 10.9 [SD 2.5] years). The elbow and silhouette methods indicated that weekend PA profiles are best classified in two or four clusters. The most differentiating characteristic for the two-clusters classification ("lower activity" and "high activity"), and the four-clusters classification ("inactive", "low activity", "medium activity", and "high activity"), respectively was the participant's mean counts per 15-seconds epoch. Participants assigned to high activity clusters were younger and more often male. Neither the clustered PA profiles nor MVPA or SB were cross-sectionally or predictively associated with overall QoL. The only association of a conventional PA metrics with QoL while adjusting for cluster membership was observed between MVPA during the weekend days and social well-being with a mean score difference of 2.4 (95%CI: 0.3 to 4.5; p = 0.025). CONCLUSION The absence of strong associations of PA metrics for the weekend with QoL, except for the positive association between MVPA during the weekend days and social well-being, is in line with results from two randomized studies not showing efficacy of PA interventions on youth QoL. But because PA decreases with age, its promotion and relevance to QoL remain important research topics. Larger longitudinal study samples with more than two follow-up time points of children and adolescents are needed to derive new novel accelerometer-derived PA profiles and to associate them with QoL dimensions.
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Affiliation(s)
- Ranin Darkhawaja
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Johanna Hänggi
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bettina Bringolf-Isler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - L. Suzanne Suggs
- Institute for Public Health and Institute of Communication and Public Policy, Università della SvizzeraItaliana, Lugano, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Inhestern L, Nasse ML, Krauth KA, Kandels D, Rutkowski S, Escherich G, Bergelt C. Reintegration into school, kindergarten and work in families of childhood cancer survivors after a family-oriented rehabilitation program. Front Pediatr 2024; 12:1288567. [PMID: 38516352 PMCID: PMC10954838 DOI: 10.3389/fped.2024.1288567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Objective To describe the situation of childhood cancer survivors and their parents before and one year after a family-oriented rehabilitation program (FOR) and to identify factors influencing reintegration. Methods We included parents of children diagnosed with leukemia or central nervous system tumor. We assessed parental functioning using the functioning subscale of the Ulm Quality of Life Inventory for Parents (ULQIE) and children's school/kindergarten related quality of life (parental assessment, subscale KINDL-R). Descriptive analyses, group comparisons and multiple regression analyses on data of 285 parents of 174 children diagnosed with leukemia or central nervous system tumor. Results Parents reported changes in their work situation (e.g., reduction of working hours) due to their child's diagnosis. Parental functioning increased significantly over time. Children's leukemia diagnosis and shorter time since the end of treatment were associated with higher functioning in parents one year after FOR. Parents reported difficulties in the child's work pace, concentration, stress resilience and empathy. The school/kindergarten-related quality of life (QoL) of the children was lower than in the general population. One year after FOR, most children reintegrated fully in school/kindergarten, partly with support (e.g., integration assistant). No significant predictors for children's reintegration were identified. Discussion Parents and children experience major changes in their work/school/kindergarten life. One year after FOR most parents reported a reintegration of their children, however the children's school/kindergarten-related QoL remained below average compared to norm values. Even after rehabilitation families of childhood cancer survivors might benefit from psychosocial and practical support offers to support families with the reintegration into work/school/kindergarten.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mona L. Nasse
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Konstantin A. Krauth
- Department of Pediatrics, Pediatric Hematology & Oncology, Klinik Bad Oexen, Bad Oeynhausen, Germany
| | - Daniela Kandels
- Swabian Children’s Cancer Center, University Hospital Augsburg, Augsburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Winzig J, Inhestern L, Paul V, Nasse ML, Krauth KA, Kandels D, Rutkowski S, Escherich G, Bergelt C. Parent-reported health-related quality of life in pediatric childhood cancer survivors and factors associated with poor health-related quality of life in aftercare. Qual Life Res 2023; 32:2965-2974. [PMID: 37204653 PMCID: PMC10474174 DOI: 10.1007/s11136-023-03436-8] [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: 05/05/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Despite advances in cancer treatment, there is a prevalence of pediatric childhood cancer survivors still at risk of developing adverse disease and treatment outcomes, even after the end of treatment. The present study aimed to (1) explore how mothers and fathers assess the health-related quality of life (HRQoL) of their surviving child and (2) evaluate risk factors for poor parent-reported HRQoL in childhood cancer survivors about 2.5 years after diagnosis. METHODS We assessed parent-reported HRQoL of 305 child and adolescent survivors < 18 years diagnosed with leukemia or tumors of central nervous system (CNS) with the KINDL-R questionnaire in a prospective observational study with a longitudinal mixed-methods design. RESULTS In agreement with our hypotheses, our results show that fathers rate their children's HRQoL total score as well as the condition-specific domains family (p = .013, d = 0.3), friends (p = .027, d = 0.27), and disease (p = .035, d = 0.26) higher than mothers about 2.5 years after diagnosis. Taking variance of inter-individual differences due to family affiliation into account, the mixed model regression revealed significant associations between the diagnosis of CNS tumors (p = .018, 95% CI [- 7.78, - 0.75]), an older age at diagnosis, (p = .011, 95% CI [- 0.96, - 0.12]), and non-participation in rehabilitation (p = .013, 95% CI [- 10.85, - 1.28]) with poor HRQoL in children more than 2 years after being diagnosed with cancer. CONCLUSION Based on the results, it is necessary for health care professionals to consider the differences in parental perceptions regarding children's aftercare after surviving childhood cancer. High risk patients for poor HRQoL should be detected early, and families should be offered support post-cancer diagnosis to protect survivors' HRQoL during aftercare. Further research should focus on characteristics of pediatric childhood cancer survivors and families with low participation in rehabilitation programs.
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Affiliation(s)
- Jana Winzig
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Verena Paul
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Mona L Nasse
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany
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Loidl V, Hamacher K, Lang M, Laub O, Schwettmann L, Grill E. Impact of a pediatric primary care health-coaching program on change in health-related quality of life in children with mental health problems: results of the PrimA-QuO cohort study. BMC PRIMARY CARE 2023; 24:182. [PMID: 37684633 PMCID: PMC10486116 DOI: 10.1186/s12875-023-02119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/31/2023] [Indexed: 09/10/2023]
Abstract
Mental health problems (MHP) have a considerable negative impact on health-related quality of life (HRQoL) in children and their families. A low threshold Health Coaching (HC) program has been introduced to bring MH services to primary care and strengthen the role of pediatricians. It comprised training concepts as a hands-on approach for pediatricians, standardization of diagnosis and treatment, and extended consultations. The aim of this study was to evaluate the potential effects of the HC on HRQoL in children with MHP and their parents.We used data from the PrimA-QuO cohort study conducted in Bavaria, Germany from November 2018 until November 2019, with two assessments one year apart. We included children aged 17 years or younger with developmental disorder of speech and language, non-organic enuresis, head and abdominal pain, and conduct disorder. All included children were already part of the Starke Kids (SK) program, a more general preventive care program, which includes additional developmental check-ups for children enrolled in the program. In addition, treatment according to the HC guidelines can be offered to children and adolescents with mental health problems, who are already enrolled in the SK program. These children form the intervention group; while all others (members of BKK and SK but not HC) served as controls. HRQoL in children was assessed using the KINDL questionnaire. Parental HRQoL was measured by the visual analogue scale. To analyze the effects of the intervention on children´s HRQoL over the 1-year follow-up period, we used linear mixed effects models.We compared 342 children receiving HC with 767 control patients. We could not detect any effects of the HC on HRQoL in children and their parents. This may be attributed to the relatively high levels of children´s HRQoL at baseline, or because of highly motivated pediatricians for the controls because of the selection of only participant within the Starke Kids program. Generally, HRQoL was lower in older children (-0.42 points; 95% CI [-0.73; -0.11]) and in boys (-1.73 points; 95% CI [-3.11; -0.36]) when reported by proxy. Parental HRQoL improved significantly over time (2.59 points; 95% CI [1.29; 3.88]).Although this study was not able to quantitatively verify the positive impact of this HC that had been reported by a qualitative study with parents and other stakeholders, and a cost-effectiveness study, the approach of the HC may still be valid and improve health care of children with MHP and should be evaluated in a more general population.
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Affiliation(s)
- Verena Loidl
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | | | - Martin Lang
- PaedNetz Bayern e.V., Munich, Germany
- Berufsverband der Kinder- und Jugendärzte (BVKJ) e.V., Cologne, Germany
| | - Otto Laub
- Berufsverband der Kinder- und Jugendärzte (BVKJ) e.V., Cologne, Germany
| | - Lars Schwettmann
- Helmholtz Zentrum München (GmbH) - German Research Center for Environmental Health, Institute of Health Economics and Health Care Management (IGM), Neuherberg, Germany
- Department of Economics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- German Centre for Vertigo and Balance Disorders, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
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Ferro MA, Elgie M, Dol M, Basque D. Measurement invariance of the 12-item self-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 across early and late adolescents in Canada. Disabil Rehabil 2023; 45:3118-3124. [PMID: 36082846 DOI: 10.1080/09638288.2022.2118867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/11/2022] [Accepted: 08/25/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study examined whether the 12-item self-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 demonstrated measurement invariance between young adolescents aged 10-16 years with a physical illness and older adolescents aged 15-19 years from the general population. MATERIALS AND METHODS Young adolescent data come from the baseline wave of the Multimorbidity in Youth across the Life-course study (n = 117) and older adolescent data come from the Canadian Community Health Survey-Mental Health (n = 1851). Multiple-group confirmatory factor analysis was used to test measurement invariance. WHODAS 2.0 scores were compared across morbidity subgroups using multiple regression. RESULTS Measurement invariance of the WHODAS 2.0 was demonstrated: (χ2=635.2(144), p<.001; RMSEA = 0.059 (0.054, 0.064); CFI = 0.967; TLI = 0.970; and, SRMR = 0.068). Adjusting for data source, sex, race, immigrant status, and household income, WHODAS 2.0 scores were associated with morbidity status in a dose-response manner: physical illness only (B = 1.50, p<.001), mental illness only (B = 2.92, p<.001), and physical-mental comorbidity (B = 4.44, p<.001). CONCLUSIONS Measurement invariance of the WHODAS 2.0 suggests that young adolescents interpret the items and disability construct similarly to older adolescents - a group that previously demonstrated measurement invariance with an adult sample. The 12-item self-administered WHODAS 2.0 may be used to measure disability across the life-course. IMPLICATIONS FOR REHABILITATIONThe 12-item self-administered WHODAS 2.0 is one of the most widely used measures of disability and functioning.Measurement invariance of the WHODAS 2.0 suggests that young adolescents interpret the items and disability construct similarly to older adolescents and adults in Canada.Researchers and health professionals can be confident that differences in 12-item self-administered WHODAS 2.0 scores are real and meaningful.The 12-item self-administered WHODAS 2.0 may be used to measure disability across the life-course.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Melissa Elgie
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Megan Dol
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Dominique Basque
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Willinger L, Oberhoffer-Fritz R, Ewert P, Müller J. Digital Health Nudging to increase physical activity in pediatric patients with congenital heart disease: A randomized controlled trial. Am Heart J 2023; 262:1-9. [PMID: 37030491 DOI: 10.1016/j.ahj.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Digital nudging is a modern e-health approach to increase physical activity (PA) in younger age groups. As activity promotion is particularly important in adolescents with congenital heart disease (CHD) this randomized-controlled trail examines if Digital Health Nudging via daily smartphone messages increases PA, activity-related self-efficacy (ArSE) and health-related quality of life (HrQoL) in adolescents with CHD. METHODS From May 2021 to April 2022, 97 patients (15.1 ± 2.0 years, 50% girls) with moderate or severe CHD were randomly allocated 1:1 to intervention (IG) or control group (CG). Daily PA was objectively assessed in minutes of moderate-to-vigorous PA (MVPA) by the wearable "Garmin Vivofit jr. 2" over the entire study period. The IG received daily smartphone messages based on Bandura's social cognitive theory on the subject of PA over a period of 12-weeks. RESULTS According to the linear mixed model, the change of MVPA over the study period did not significantly differ between IG and CG when taking baseline MVPA into account (b = 0.136, 95%-CI [-0.355; 0.627], P = .587). Activity level was comparably high and showed only minor variability in both groups with 73.7 [62.3; 78.8] min/day in IG and 78.4 [66.6; 93.9] min/d in CG throughout the whole 12-weeks. Emotional well-being significantly increased over the study period in the IG (IG: Δ1.60 [-0.2; 6.3] vs CG: Δ0.0 [-12.5; 6.3], P = .043), but not total HrQoL (P = .518) and ArSE (P = .305). CONCLUSIONS 12-weeks, of Digital Health Nudging did not increase PA, but improved feelings of emotional well-being in adolescents with CHD. TRIAL REGISTRATION Clinical Trials Identifier NCT04933786.
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Affiliation(s)
- Laura Willinger
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany.
| | - Renate Oberhoffer-Fritz
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Jan Müller
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
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Kutlay S, Sonel Tur B, Sezgin M, Elhan AH, Gökmen D, Tennant A, Küçükdeveci AA. Validation of the Pediatric Quality of Life Inventory 3.0 Cerebral Palsy Module (Parent Form) for use in Türkiye. Turk J Phys Med Rehabil 2023; 69:52-60. [PMID: 37201004 PMCID: PMC10186021 DOI: 10.5606/tftrd.2023.11462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/18/2022] [Indexed: 05/20/2023] Open
Abstract
Objectives This study was planned to test the reliability and validity of the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 cerebral palsy (CP) module (parent form) in children with CP. Patients and methods In the validation study conducted between June 2007 and June 2009, 511 children (299 normal children, 212 children with CP) were assessed by the seven scales of PedsQL [daily activities (DA), school activities (SA), movement and balance (MB), pain and hurt (PH), fatigue (F), eating activities (EA), and speech and communication (SC)]. Reliability was tested by internal consistency and person separation index (PSI); internal construct validity by Rasch analysis and external construct validity by correlation with the Gross Motor Function Classification System (GMFCS) and Functional Independence Measure for Children (WeeFIM). Results Only 13 children with CP completed the inventory by themselves and thus were excluded. Consequently, 199 children with CP (113 males, 86 females; mean age: 7.3±4.2 years; range, 2 to 18 years) and 299 normal children (169 males, 130 females; mean age: 9.4±4.0 years; range, 2 to 17 years) were included in the final analysis. Reliabilities of the seven scales of the PedsQL 3.0 CP module were adequate, with Cronbach's alphas between 0.66 and 0.96 and the PSI between 0.672 and 0.943 for the CP group. In Rasch analysis, for each scale, items showing disordered thresholds were rescored; then testlets were created to overcome local dependency. Internal construct validity of the unidimensional seven scales was good with the mean item fit of -0.107±1.149, 0.119±0.818, 0.232±1.069, -0.442±0.672, 0.221±0.554, -0.091±0.606, and -0.333±1.476 for DA, SA, MB, PH, F, EA, and SC, respectively. There was no differential item functioning. External construct validity of the instrument was confirmed by expected moderate to high correlations with WeeFIM and GMFCS (Spearman's r=0.35-0.89). Conclusion Turkish version of the PedsQL 3.0 CP module is reliable, valid, and available for use in clinical setting to evaluate health-related quality of life of children with CP.
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Affiliation(s)
- Sehim Kutlay
- Department of Physical Medicine and Rehabilitation, Ankara Universityy Faculty of Medicine, Ankara, Türkiye
| | - Birkan Sonel Tur
- Department of Physical Medicine and Rehabilitation, Ankara Universityy Faculty of Medicine, Ankara, Türkiye
| | - Melek Sezgin
- Department of Physical Medicine and Rehabilitation, Mersin University Faculty of Medicine, Mersin, Türkiye
| | - Atilla Halil Elhan
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Derya Gökmen
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Türkiye
| | | | - Ayşe Adile Küçükdeveci
- Department of Physical Medicine and Rehabilitation, Ankara Universityy Faculty of Medicine, Ankara, Türkiye
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Singh I, Asnani MR, Harrison A. Health-Related Quality of Life in Adolescents With Chronic Illness in Jamaica: Adolescent and Parent Reports. J Adolesc Health 2023; 72:12-20. [PMID: 36202679 DOI: 10.1016/j.jadohealth.2022.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study is to assess the level of agreement between adolescents' self-assessment and parent-proxy reports on health-related quality of life (HRQOL) in Jamaican adolescents with chronic illness. METHODS A cross-sectional study was conducted, recruiting adolescents living with a chronic illness (ALCIs)-asthma, human immunodeficiency virus, insulin-dependent diabetes mellitus, or sickle cell disease and age/sex-matched healthy adolescents. Data were collected on HRQOL from adolescents and parents using the Pediatric Quality of Life Scale. Parent-adolescent agreement was determined at group level (Wilcoxon signed-rank test) and individual level (intraclass correlation coefficient). RESULTS Two hundred twenty-six (226) parent/adolescent pairs participated: 130 ALCIs and 96 healthy peers; mean age 14.9 ± 2.8 years; 58% females. Adolescents with and without chronic illness reported similar HRQOL; parent-proxies reported better HRQOL for healthy adolescents compared to ALCIs. Intraclass correlation demonstrated higher levels of parent-adolescent correlation for ALCIs than healthy adolescents (ALCIs: 0.11-0.34; healthy adolescents: 0.01-0.10). At group level, analyses demonstrated better parent-proxy rating of QOL in all of the scores with the exception of the general health score. Parent-proxies overestimated QOL for asthma and insulin-dependent diabetes mellitus but not for sickle cell disease and human immunodeficiency virus. Linear regression modeling revealed that female sex and living with chronic illness were significant predictors of agreement. DISCUSSION Parent-proxies overestimated adolescents' QOL compared to adolescents' report regardless of whether the adolescent was living with a chronic illness or not. As such, health care providers should elicit feedback from the adolescent wherever possible and proxy reports should be used as complementary information rather than primary source.
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Affiliation(s)
- Indira Singh
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Kingston, Jamaica
| | - Monika Rani Asnani
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Mona, Kingston, Jamaica
| | - Abigail Harrison
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Kingston, Jamaica.
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Rojc M, Sršen KG, Mohar J, Vidmar G. Slovenian version of the scoliosis research society instrument-22 revised (SRS-22r) in adolescents and adults: Psychometric properties and some implications. J Pediatr Rehabil Med 2023; 16:351-359. [PMID: 36847023 DOI: 10.3233/prm-210127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
PURPOSE This study aimed to provide a reliable and valid translation of the Scoliosis Research Society-22 (SRS-22r) questionnaire, compare it with the EQ-5D-5 L questionnaire, and analyse health-related quality of life (HRQoL) of patients with idiopathic scoliosis (IS) in Slovenia in order to potentially improve their rehabilitation processes. METHODS A matched-case-control study was performed to assess internal consistency reliability, test-retest reliability, concurrent validity, and discriminative validity. The questionnaire was returned by 25 adolescent IS patients, 25 adult IS patients, and 25 healthy controls (87%, 71%, and 100% response rate, respectively). RESULTS Internal consistency was high for all four scales in the adult IS group, but lower among the adolescent patients. Test-retest reliability of the SRS-22r was high to very high in both patient groups. Correlations between SRS-22r and EQ-5D-5 L were low or close to zero among adolescent patients and moderate or high among adult IS patients. SRS-22r domain scores were statistically significantly different between adult patients and healthy controls. CONCLUSION The study proved that the Slovenian version of SRS-22r has the psychometric properties needed to measure HRQoL, whereby it appears to be more reliable for adults than adolescents. When used with IS adolescents, SRS-22r is affected by a severe ceiling effect. It could be used for longitudinal follow-up of adult patients after rehabilitation treatment. Additionally, some important issues that adolescents and adults with IS are faced with were identified.
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Affiliation(s)
- Marina Rojc
- Valdoltra Orthopaedic Hospital, Anakaran, Slovenia
| | | | - Janez Mohar
- Valdoltra Orthopaedic Hospital, Anakaran, Slovenia
| | - Gaj Vidmar
- University Rehabilitation Institute, Ljubljana, Slovenia
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Huber M. Cochlear implant-specific risks should be considered, when assessing the quality of life of children and adolescents with hearing loss and cochlear implants-not just cochlear implant-specific benefits-Perspective. Front Neurosci 2022; 16:985230. [PMID: 36425475 PMCID: PMC9679369 DOI: 10.3389/fnins.2022.985230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/14/2022] [Indexed: 09/09/2024] Open
Abstract
Cochlear implants (CIs) are electronic medical devices that enable hearing in cases where traditional hearing aids are of minimal or no use. Quality of life (QoL) studies of children and adolescents with a CI have so far focused on the CI-specific benefits. However, the CI-specific risks listed by the U.S. Food and Drug Administration have not yet been considered. From this list, medical and device-related complications, lifelong dependency on the implanted device, and neurosecurity risks (CI technology is an interface technology) may be particularly relevant for young CI users. Medical and device-related complications can cause physical discomfort (e.g., fever, pain), as well as functioning problems (e.g., in speech discrimination, social behavior, and mood). In the worst case, reimplantation is required. Clinical experience shows that these complications are perceived as a burden for young CI users. Furthermore, many young patients are worried about possible complications. Additionally, CIs can be at least a temporary burden when children, typically at the age of 8-9 years, realize that they need the CI for life, or when they become peer victims because of their CI. Concerning neurosecurity risks, it is still unknown how young CI recipients perceive them. In summary, CI-specific risks can be perceived as a burden by young CI users that impairs their QoL. Therefore, they should not be ignored. There is an urgent need for studies on this topic, which would not only be important for professionals and parents, but also for the design of CI-specific QoL instruments.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, Salzburg, Austria
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13
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Mpundu-Kaambwa C, Bulamu N, Lines L, Chen G, Dalziel K, Devlin N, Ratcliffe J. A Systematic Review of International Guidance for Self-Report and Proxy Completion of Child-Specific Utility Instruments. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1791-1804. [PMID: 35667950 DOI: 10.1016/j.jval.2022.04.1723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/04/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to identify and summarize published guidance and recommendations for child self- and proxy assessment of existing child-specific instruments of health-related quality of life (HRQoL) that are accompanied by utilities. METHODS A total of 9 databases plus websites of (1) health technology assessment and health economics outcomes research organizations and (2) instrument developers were systematically searched. Studies were included if they reported guidance for child self- and proxy assessment for child populations (0-18 years old). Three reviewers independently screened titles, abstracts, and full-text reviews against the inclusion criteria. Key features of the guidance identified were summarized. RESULTS A total of 19 studies met the inclusion criteria. In general, journal articles provided little guidance on child self- and proxy assessment, with the majority focused on instrument development and psychometric performance more broadly. Instrument developers' websites provided more guidance for child self- and proxy reports with specific guidance found for the EQ-5D-Y and the Pediatric Quality of Life Inventory. This guidance included the minimum age for self-report and mode of administration; recommended proxy types, age range of child for whom proxy report can be completed, and target population; and recall period. Websites of leading organizations provided general guidance on HRQoL evaluation in children but lacked specific guidance about self- and proxy completion. CONCLUSIONS EQ-5D-Y and Pediatric Quality of Life Inventory developers' websites provided the most comprehensive guidance for self-report and proxy report of their respective instruments. More evidence is required for developing best practice guidance on why, when, and how to use self- and proxy reports in assessing HRQoL in child populations.
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Affiliation(s)
| | - Norma Bulamu
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Lauren Lines
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
| | - Kim Dalziel
- Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nancy Devlin
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
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Remmele J, Willinger L, Oberhofer-Fritz R, Ewert P, Müller J. Increased carotid intima-media thickness and reduced health-related physical fitness in children and adolescents with coarctation of the aorta. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2022. [DOI: 10.1016/j.ijcchd.2022.100390] [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
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15
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Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Overestimation and underestimation of youths' health-related quality of life are associated with youth and caregiver positive screens for depression: results of a population-based study among youths with longstanding type 1 diabetes. Diabetol Metab Syndr 2022; 14:40. [PMID: 35264222 PMCID: PMC8905804 DOI: 10.1186/s13098-022-00809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to analyze the extent and direction of disagreement between self- and proxy-reported quality of life (QoL) and the factors associated with QoL overestimation and underestimation by caregivers compared with self-reports. METHODS This study used data from population-based questionnaire surveys conducted in 2012-2013 and 2015-2016 with 11- to 17-year-olds with a duration of type 1 diabetes of 10 years or longer and their caregivers (n = 1058). QoL in youth was assessed via 10-item KIDSCREEN (KIDSCREEN-10) self- and proxy-reported questionnaires. The scores ranged from 0 to 100, with higher scores indicating better QoL. Depression screening was performed via the Center for Epidemiological Studies Depression Scale for Children for youths (CES-DC screen positive: score > 15) and WHO-5 Well-being Index for parents/caregivers (WHO-5 screen positive: score ≤ 50). RESULTS The mean self- and proxy-reported normalized KIDSCREEN-10 scores were 64.2 (standard deviation [SD] 11.4) and 66.1 (11.5), respectively. More caregivers overestimated (self-reported minus proxy-reported score < - 0.5*SD self-reported score) than underestimated (self-reported minus proxy-reported score > 0.5*SD self-reported score) youths' QoL (37% versus 23%, p < 0.001). Youths who screened positive for depression (18%) were at higher risk of their QoL being overestimated and lower risk of their QoL being underestimated by caregivers than youths who screened negative for depression (RROverestimation 1.30 [95% CI 1.10-1.52], RRUnderestimation 0.27 [0.15-0.50]). Caregivers who screened positive for depression (28%) overestimated the QoL of their children less often and underestimated the QoL of their children more often than caregivers who screened negative for depression (RROverestimation 0.73 [0.60-0.89], RRUnderestimation 1.41 [1.14-1.75]). CONCLUSIONS Caregivers often over- or underestimated their children's QoL. Positive screens for depression among both youths and caregivers contributed to the observed differences between self- and caregiver-reported QoL.
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Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
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Health-Related Quality of Life and Frequency of Physical Activity in Spanish Students Aged 8-14. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179418. [PMID: 34502002 PMCID: PMC8430964 DOI: 10.3390/ijerph18179418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 12/22/2022]
Abstract
The study of health-related quality of life (HRQoL) in children and adolescents has important implications in terms of policy, education, and health. Data on the time spent in physical activity (PA) and in sedentary activities in this population are worrying. We aim to analyze possible differences in HRQoL and PA levels between sexes and age groups in Spanish students aged between 8 and 14 years, as well as to assess the relationship between HRQoL and the frequency of PA in this population. A total of 3197 participants (1610 boys and 1587 girls) from 8 to 14 years old were recruited. Mquality and Mapping Child Health Utility instrument (Chu9d) were used as HRQoL indicators. A medium positive association between PA and HRQoL concerning the Spanish school population was found. HRQoL was higher among students aged 8 to 12 than 13 to 14. Moreover, when children start secondary education, both sexes seem to lose the quality of life. Similarly, PA decreases among girls over the years, although it seems to increase among boys. Thus, PA levels and HRQoL are directly associated in Spanish schoolchildren aged between 8 and 14 years. However, this HRQoL decreases in children over the years. Practical implications include the need to support education and physical activity programs to improve HRQoL in children and adolescents.
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Schiekiera LJ, Bergelt C. Fear of progression in parents of childhood cancer survivors: prevalence and associated factors. J Cancer Surviv 2021; 16:823-833. [PMID: 34302272 PMCID: PMC9300493 DOI: 10.1007/s11764-021-01076-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Recent research demonstrated that fear of progression (FoP) is a major burden for adult cancer survivors. However, knowledge on FoP in parents of childhood cancer survivors is scarce. This study aimed to determine the proportion of parents who show dysfunctional levels of FoP, to investigate gender differences, and to examine factors associated with FoP in mothers and fathers. METHODS Five hundred sixteen parents of pediatric cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system (CNS) tumor) were consecutively recruited after the end of intensive cancer treatment. We conducted hierarchical multiple regression analyses for mothers and fathers and integrated parent-, patient-, and family-related factors in the models. RESULTS Significantly more mothers (54%) than fathers (41%) suffered from dysfunctional levels of FoP. Maternal FoP was significantly associated with depression, a medical coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and lower family functioning (adjusted R2 = .30, p < .001). Paternal FoP was significantly associated with a lower level of education, depression, a family coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and fewer siblings (adjusted R2 = .48, p < .001). CONCLUSIONS FoP represents a great burden for parents of pediatric cancer survivors. We identified associated factors of parental FoP. Some of these factors can be targeted by health care professionals within psychosocial interventions and others can provide an indication for an increased risk for higher levels of FoP. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial support targeting FoP in parents of childhood cancer survivors is highly indicated.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Louis J Schiekiera
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Balcerek M, Sommerhäuser G, Schilling R, Hölling H, Klco-Brosius S, Borgmann-Staudt A. Health-related quality of life of children born to childhood cancer survivors in Germany. Psychooncology 2021; 30:1866-1875. [PMID: 34156134 DOI: 10.1002/pon.5752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/17/2021] [Accepted: 06/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Rising childhood cancer survival rates have increased the importance of health-related quality of life (HRQL) assessment. While survivors show comparable HRQL to peers, concerns that cancer treatment could impact the health of prospective children were reported. No previous publications address HRQL of childhood cancer survivor offspring. METHODS We assessed survivor offspring HRQL using the parental KINDL questionnaire. Matched-pair analysis was conducted with data from the general population (KiGGS study) using age, gender and education (1:1, n = 1206 cases). Multivariate analyses were conducted to detect the influence of parental diagnose and treatment on offspring HRQL. RESULTS Overall, within KINDL dimensions, survivors reported comparable to higher HRQL for their children than the general population. Survivor parents reported significantly (p < 0.001) higher psychological (86.7% vs. 83.0%, Cohen's d = 0.3) and self-esteem (79.1% vs. 73.3%, Cohen's d = 0.5) well-being scores for younger children (3-6-year-olds). As time since diagnosis increased, parents reported higher well-being scores. Accordingly, recently diagnosed survivors reported significantly lower psychological well-being scores (p = 0.28; OR = 0.457; 95% CI = 0.228-0.918) for their children. With increasing age, average HRQL scores decreased in both cohorts; yet, this drop was less pronounced for survivor offspring. The biggest difference between age groups (7-10- vs. 14-17-year-olds) was found for school-specific well-being (6.2-point drop in survivor offspring vs. 18.2-point drop in KiGGS offspring). CONCLUSION Comparable to higher parentally assessed HRQL was reported for survivor offspring compared to peers. These findings are reassuring and consistent with self-reported HRQL in childhood cancer survivors. Type of parental cancer diagnosis and treatment showed no negative impact on offspring HRQL.
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Affiliation(s)
- Magdalena Balcerek
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Greta Sommerhäuser
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ralph Schilling
- Institute of Biometry and Clinical Epidemiology, Charité-Univseristätsmedzin Berlin, Berlin, Germany.,Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heike Hölling
- Division of Epidemiology and Health Monitoring, Robert Koch-Institute Berlin, Berlin, Germany
| | - Stephanie Klco-Brosius
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anja Borgmann-Staudt
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Peikert ML, Inhestern L, Krauth KA, Bergelt C. [Childhood Cancer Patients in a Family-Oriented Rehabilitation Program: Goals and Change in Physical Functioning]. REHABILITATION 2021; 60:124-131. [PMID: 33858021 DOI: 10.1055/a-1361-4970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Childhood cancer often leads to physical and psychosocial burdens that can persist beyond the end of treatment. Family-oriented rehabilitation programs (FOR) focus on long-term consequences and support families in returning to daily life. The objectives of this study were to describe rehabilitation goals and goal attainment, to analyze the relationship between physical functioning and physical well-being and to examine predictors of changes in physical functioning during the FOR. METHODS In a prospective observational study, statements of physicians regarding rehabilitation goals, goal achievement and physical functioning of 175 children (<18 years of age at the time of diagnosis of leukemia or central nervous system tumor) at the beginning and the end of a FOR were analyzed. The physical well-being of the patients was assessed from a parent and child perspective. Correlation coefficients were calculated to analyze the relation between physical functioning and physical well-being. Predictors of changes in physical functioning were examined with a multiple regression analysis. RESULTS The most frequently mentioned rehabilitation goals were the increase of physical functioning and the integration into the peer group. Overall, the goal achievement ranged from 82 to 100%. Physical functioning improved significantly during the FOR. A significant positive correlation between the physician's assessment of physical functioning and the parental assessment of physical well-being could be found at the beginning of the FOR. According to the regression model, female gender of the child and a longer time since diagnosis were associated with a lower change in physical functioning. Furthermore, a higher degree of physical consequential damages was associated with a larger change. CONCLUSIONS The 4-week multimodal rehabilitation program of the FOR addressed various physical and psychosocial burdens and was accompanied by a significant improvement of the physical functioning of childhood cancer patients. The change in physical functioning was associated with different sociodemographic and medical factors (eg, sex). The consideration of these factors could help with optimizing the program.
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Affiliation(s)
- Mona L Peikert
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Laura Inhestern
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | | | - Corinna Bergelt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
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20
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Headache Is Associated with Low Systolic Blood Pressure and Psychosocial Problems in German Adolescents: Results from the Population-Based German KiGGS Study. J Clin Med 2021; 10:jcm10071492. [PMID: 33916726 PMCID: PMC8038357 DOI: 10.3390/jcm10071492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
Studies have reported controversial results on the relationship between headache and blood pressure. The aim of this post hoc study was twofold: first, to further investigate this relationship and, second, to assess the impact of psychosocial factors on this association in a population-based study of German children and adolescents. The analysis was conducted on study participants aged between 11 and 17 years (n = 5221, weighted from the total study cohort) from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Health-related quality of life was assessed by self- and parent-rated German-language KINDL-R questionnaires (Children’s Quality of Life Questionnaire), while mental problems were analyzed using the Strengths and Difficulties Questionnaire (SDQ). Our findings confirmed that blood pressure was significantly lower in adolescents reporting episodes of headache than in those without headache (114.0 ± 10.2 mmHg vs. 115.5 ± 11.0 mmHg, p < 0.001). Logistic regression models adjusted to sex, age, body mass index, contraceptive use, and serum magnesium concentration demonstrated that headache was significantly associated with self-rated KINDL-R (Exp(B) = 0.96, 95% confidence interval (95% Cl) = 0.96–0.97, p < 0.001), parent-rated KINDL-R (Exp(B) = 0.97, 95% CI = 0.96–0.98, p < 0.001), as well as self-rated SDQ (Exp(B) = 1.08, 95% CI = 1.07–1.10, p < 0.001), and parent-rated SDQ (Exp(B) = 1.05, 95% CI = 1.04–1.06, p < 0.001). There was evidence that quality of life and mental problems mediated the effect of blood pressure on headache, as revealed by mediation models. Our results from the nationwide, representative KiGGS survey showed that low blood pressure is a significant predictor of headache, independent of quality of life and mental problems. However, these psychosocial factors may mediate the effect of blood pressure on headache in a still unknown manner.
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Plass-Christl A, Ravens-Sieberer U, Hölling H, Otto C. Trajectories of health-related quality of life in children of parents with mental health problems: results of the BELLA study. Qual Life Res 2021; 30:1841-1852. [PMID: 33651276 DOI: 10.1007/s11136-021-02783-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Children of parents with mental health problems (CPM) have an increased risk for impaired health-related quality of life (HRQoL). This study aims at investigating the age- and gender-specific course of HRQoL and at exploring predictors of HRQoL in CPM based on longitudinal data (baseline, 1-year and 2-year follow-up) of a German population-based sample. METHODS Longitudinal data from the German BELLA study was analyzed (n = 1429; aged 11 to 17 years at baseline). The SCL-S-9 in combination with the cutoff for the General Severity Index (GSI) from the longer SCL-90-R served to identify CPM (n = 312). At first, we compared domain-specific HRQoL according to the KIDSCREEN-27 in CPM versus Non-CPM. Focusing on CPM, we used individual growth modeling to investigate the age and gender-specific course, and to explore effects of risk and (personal, familial and social) resource factors on self-reported HRQoL in CPM. RESULTS Self-reported HRQoL was reduced in CPM compared to Non-CPM in all domains, but in social support & peers. However, a minimal important difference was only reached in girls for the domain autonomy & parent relation. Internalizing and externalizing mental health problems were associated with impaired HRQoL in CPM. Self-efficacy, social support and family climate were identified as significant resources, but parental mental health problems over time were not associated with any investigated domain of HRQoL in CPM. CONCLUSIONS Adolescent female CPM may be especially at risk for reduced HRQoL. When developing support programs for CPM, self-efficacy, social support and family climate should be considered, HRQoL and mental health problems in CPM should be addressed.
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Affiliation(s)
- Angela Plass-Christl
- Evangelical Hospital Alsterdorf Hamburg, Hamburg, Germany.
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany.
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany.
| | - Heike Hölling
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
| | - Christiane Otto
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany
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22
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Perazzo MF, Martins-Júnior PA, Abreu LG, Mattos FF, Pordeus IA, Paiva SM. Oral Health-Related Quality Of Life of Pre-School Children: Review and Perspectives for New Instruments. Braz Dent J 2020; 31:568-581. [PMID: 33237227 DOI: 10.1590/0103-6440202003871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 11/21/2022] Open
Abstract
This study aimed to describe different approaches for the evaluation of the Oral health-related quality of life (OHRQoL) of preschool children and to discuss perspectives for future instruments. The OHRQoL is a concept that surpasses an exclusively clinical perception and includes functional, social, emotional, and environmental issues. The measure of OHRQoL represents a holistic approach for researchers and clinicians extending their visions beyond the mouth and understanding the entire context of the patient. Negative impacts of oral conditions on OHRQoL in childhood can reflect on health development, especially in a life stage marked by social and cognitive maturation. Instruments have been developed and cross-culturally adapted to evaluate the impact of oral conditions on the OHRQoL of preschool children and their families. Some features distinguish these instruments and influence their selection, such as: self- or proxy-report; generic- or specific-condition; long- or short-form, and less or more established used in literature. Moreover, theoretical framework, construct validation and availability should also be considered. Nine OHRQoL instruments for preschool children were included in the present literature review. They were created between 2003 and 2017 by developed countries in most cases. The shorter instrument has five items, and the larger has 31 items. Most of them are proxy-reported, generic-condition, and have been relatively well established in the literature. The diversity of instruments indicates the evolution of OHRQoL studies, but there are methodological issues still in need to be improved in future developments or cross-cultural adaptations, according to current psychometric evidence.
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Affiliation(s)
- Matheus França Perazzo
- Department of Paediatric Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Lucas Guimarães Abreu
- Department of Paediatric Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Flávio Freitas Mattos
- Department of Social and Preventive Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Isabela Almeida Pordeus
- Department of Paediatric Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Saul Martins Paiva
- Department of Paediatric Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Ernst G, Klein L, Kowalewski K, Szczepanski R. [I'm still here - Training for the Siblings of Chronically Ill or Handicapped Children]. KLINISCHE PADIATRIE 2020; 232:300-306. [PMID: 32767293 DOI: 10.1055/a-1214-6624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Siblings of chronically ill or handicapped children are exposed to increased stress as a result of their special life situation. This can lead to psychological abnormalities. International studies show that programs for siblings can reduce this risk. In Germany, there is a lack of compact educational programs for siblings. Such an offer was tested with this workshop. In the one-day group training, coping strategies were developed and disease knowledge conveyed in order to reduce fears. The parents receive parallel training. METHODS Altogether 19 sibling workshops were held. Before and six weeks after the training, standardized questionnaires were used to record sibling distress, mental health problems, and their health-related quality of life as well as family burden. T-tests for dependent samples were used to check the changes before and after training. RESULTS Ninety-two children (average age 9.6 years; 54% female) and their parents took part in the training. From the parents' point of view, 32.5% of the children initially had an increased risk of psychological distress because of the family situation. After the training, this was reduced to 25.3%. The mental health problems were significantly reduced, as was the overall family burden. According to the self-assessment, the quality of life of the children improved. DISCUSSION The families seem to benefit from the compact training. The workshop was applicable for families of children with different diseases and in different settings.
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Affiliation(s)
- Gundula Ernst
- Medical Psychology, Hannover Medical School, Hannover
| | - Luisa Klein
- Pediatric Nephrology, University of Cologne, Cologne
| | - Kerstin Kowalewski
- Sibling research, Institute of Social Medicine in Pediatrics Augsburg, Augsburg
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Fainardi V, Fasola S, Mastrorilli C, Volta E, La Grutta S, Vanelli M. A two-week summer program promoting physical activity: quality of life assessment in Italian children. PSYCHOL HEALTH MED 2020; 26:444-456. [PMID: 32393066 DOI: 10.1080/13548506.2020.1761552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Physical activity (PA) can be associated with better health-related quality of life (HRQoL). This study aimed to assess HRQoL before and after a two-week summer program promoting PA in Italian school-aged children. Participants were recruited during the Giocampus summer2017 (Parma, Italy), from June to July. Before (T0) and after (T1) the program, children and one of their parents answered the Kindl questionnaire. For each domain, least-square mean changes (LSmc) at T1 were derived from linear regression models stratified by responder and adjusted for child gender, age group, time spent in PAs and HRQoL score of the responder at T0. 350 children (7-13 years, 52% males) and 342 parents answered the questionnaire at both T0 and T1. At T1, the HRQoL score of the children significantly improved in the emotional (LSmc 2.9, p<0.001), self-esteem (LSmc 3.3, p<0.001), family (LSmc 4.2, p<0.001) and friend (LSmc 3.1, p<0.001) domains. Parents reported significantly more improvement in self-esteem than children (LSmc 6.7 vs 3.3, p=0.012). Children spending more time in PA reported significantly more improvement in self-esteem than those doing less PA (LSmc 4.4 [p<0.001] vs 2.2 [p=0.181]). A short summer program promoting PA may improve HRQoL in the general population of school-aged children.
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Affiliation(s)
- Valentina Fainardi
- Department of Medicine and Surgery, Children's Hospital, Parma University Hospital, Parma, Italy
| | - Salvatore Fasola
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Palermo, Italy
| | - Carla Mastrorilli
- Department of Medicine and Surgery, Children's Hospital, Parma University Hospital, Parma, Italy
| | - Elio Volta
- Giocampus Steering Committee, Parma, Italy
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Palermo, Italy
| | - Maurizio Vanelli
- Department of Medicine and Surgery, Children's Hospital, Parma University Hospital, Parma, Italy
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25
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Quality of Life in Pediatric Neurosurgery: Comparing Parent and Patient Perceptions. World Neurosurg 2020; 134:e306-e310. [DOI: 10.1016/j.wneu.2019.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
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26
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Schwörer MC, Reinelt T, Petermann F, Petermann U. Influence of executive functions on the self-reported health-related quality of life of children with ADHD. Qual Life Res 2020; 29:1183-1192. [DOI: 10.1007/s11136-019-02394-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
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27
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Hirtz R, Keesen A, Hölling H, Hauffa BP, Hinney A, Grasemann C. No Effect of Thyroid Dysfunction and Autoimmunity on Health-Related Quality of Life and Mental Health in Children and Adolescents: Results From a Nationwide Cross-Sectional Study. Front Endocrinol (Lausanne) 2020; 11:454. [PMID: 32982959 PMCID: PMC7492205 DOI: 10.3389/fendo.2020.00454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022] Open
Abstract
Background: In adults, a significant impact of thyroid dysfunction and autoimmunity on health-related quality of life (HRQoL) and mental health is described. However, studies in children and adolescents are sparse, underpowered, and findings are ambiguous. Methods: Data from 759 German children and adolescents affected by thyroid disease [subclinical hypothyroidism: 331; subclinical hyperthyroidism: 276; overt hypothyroidism: 20; overt hyperthyroidism: 28; Hashimoto's thyroiditis (HT): 68; thyroid-peroxidase antibody (TPO)-AB positivity without apparent thyroid dysfunction: 61] and 7,293 healthy controls from a nationwide cross-sectional study ("The German Health Interview and Examination Survey for Children and Adolescents") were available. Self-assessed HRQoL (KINDL-R) and mental health (SDQ) were compared for each subgroup with healthy controls by analysis of covariance considering questionnaire-specific confounding factors. Thyroid parameters (TSH, fT4, fT3, TPO-AB levels, thyroid volume as well as urinary iodine excretion) were correlated with KINDL-R and SDQ scores employing multiple regression, likewise accounting for confounding factors. Results: The subsample of participants affected by overt hypothyroidism evidenced impaired mental health in comparison to healthy controls, but SDQ scores were within the normal range of normative data. Moreover, in no other subgroup, HRQoL or mental health were affected by thyroid disorders. Also, there was neither a significant relationship between any single biochemical parameter of thyroid function and HRQoL or mental health, nor did the combined thyroid parameters account for a significant proportion of variance in either outcome measure. Importantly, the present study was sufficiently powered to identify even small effects in children and adolescents affected by HT, subclinical hypothyroidism, and hyperthyroidism. Conclusions: In contrast to findings in adults, and especially in HT, there was no significant impairment of HRQoL or mental health in children and adolescents from the general pediatric population affected by thyroid disease. Moreover, mechanisms proposed to explain impaired mental health in thyroid dysfunction in adults do not pertain to children and adolescents in the present study.
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Affiliation(s)
- Raphael Hirtz
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Raphael Hirtz
| | - Anne Keesen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Berthold P. Hauffa
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Corinna Grasemann
- Department of Pediatrics and Center for Rare Diseases Ruhr CeSER, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
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Supke M, Hahlweg K, Schulz W. Kompetente Eltern – Glückliche Kinder? ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2020. [DOI: 10.1026/1616-3443/a000572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund. Im internationalen Vergleich befinden sich deutsche Kinder hinsichtlich ihrer gesundheitsbezogenen Lebensqualität (gLQ) im Mittelfeld, wobei psychische Auffälligkeiten die kindliche gLQ am stärksten einschränken. Fragestellung. Ziel war es zu untersuchen, ob Kindergartenkinder von Eltern, die am Positive Parenting Program (Triple P) teilgenommen haben, kurz- (1/2/3 Jahres-FU) und langfristige (10 Jahres-FU) positive Effekte in ihrer gLQ, gemessen mit dem KINDLR ( Ravens-Sieberer & Bullinger, 2000 ), zeigen. Methode. N = 219 Familien mit Kindergartenkindern aus dem Projekt Zukunft Familie wurden analysiert. Ergebnisse. Es konnten weder quer- noch längsschnittlich Effekte des Triple P aus Sicht der Kinder, Mütter und Väter auf die gLQ nachgewiesen werden. Sowohl Mütter als auch Väter überschätzen im Vergleich mit ihren Kindern die gLQ. Schlussfolgerungen. Das Triple P hat keinen signifikanten Einfluss auf den Verlauf der gLQ. In der zukünftigen Forschung sollten die Perspektiven von Kindern und Eltern berücksichtigt werden, da sie sich ergänzen könnten. Ein Modul in Elterntrainings, welches die gLQ fokussiert, könnte langfristige positive Effekte erzielen. Zukünftige Forschung zur positiven Beeinflussung der kindlichen gLQ ist notwendig.
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Affiliation(s)
- Max Supke
- Abteilung für Klinische Psychologie, Psychotherapie und Diagnostik, Institut für Psychologie, Technische Universität Braunschweig
| | - Kurt Hahlweg
- Abteilung für Klinische Psychologie, Psychotherapie und Diagnostik, Institut für Psychologie, Technische Universität Braunschweig
| | - Wolfgang Schulz
- Abteilung für Klinische Psychologie, Psychotherapie und Diagnostik, Institut für Psychologie, Technische Universität Braunschweig
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Huber M, Havas C. Restricted Speech Recognition in Noise and Quality of Life of Hearing-Impaired Children and Adolescents With Cochlear Implants - Need for Studies Addressing This Topic With Valid Pediatric Quality of Life Instruments. Front Psychol 2019; 10:2085. [PMID: 31572268 PMCID: PMC6751251 DOI: 10.3389/fpsyg.2019.02085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/27/2019] [Indexed: 11/27/2022] Open
Abstract
Cochlear implants (CI) support the development of oral language in hearing-impaired children. However, even with CI, speech recognition in noise (SRiN) is limited. This raised the question, whether these restrictions are related to the quality of life (QoL) of children and adolescents with CI and how SRiN and QoL are related to each other. As a result of a systematic literature research only three studies were found, indicating positive moderating effects between SRiN and QoL of young CI users. Thirty studies addressed the quality of life of children and adolescents with CI. Following the criteria of the World Health Organization (WHO) for pediatric health related quality of life HRQoL (1994) only a minority used validated child centered and age appropriate QoL instruments. Moreover, despite the consensus that usually children and adolescents are the most prominent informants of their own QoL (parent-reports complement the information of the children) only a minority of investigators used self-reports. Restricted SRiN may be a burden for the QoL of children and adolescents with CI. Up to now the CI community does not seem to have focused on a possible impairment of QoL in young CI users. Further studies addressing this topic are urgently needed, which is also relevant for parents, clinicians, therapists, teachers, and policy makers. Additionally investigators should use valid pediatric QoL instruments. Most of the young CI users are able to inform about their quality of life themselves.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Clara Havas
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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30
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Reiner B, Oberhoffer R, Ewert P, Müller J. Quality of life in young people with congenital heart disease is better than expected. Arch Dis Child 2019; 104:124-128. [PMID: 29599167 DOI: 10.1136/archdischild-2017-314211] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/07/2018] [Accepted: 03/10/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Improved treatments for patients with congenital heart disease (CHD) have led to a growing interest in long-term functional outcomes such as health-related quality of life (HRQoL). Studies on HRQoL in children with CHD have contradicting results. Therefore, we compared HRQoL of children with CHD with that of current healthy peers and stratify CHD cases by severity and diagnostic subgroups. METHODS We included 514 patients (191 girls) aged 7-17 (12.9±3.1) years who were recruited at our institution between July 2014 and May 2017. The self-reported and age-adapted KINDL questionnaire was used to assess HRQoL. Patient data were compared with that of a recent control group of 734 healthy children (346 girls, 13.4±2.1 years). RESULTS Patients with CHD scored at least as high as healthy peers in HRQoL (CHD: 78.6±9.8; healthy: 75.6±10.1; P<0.001). After correction for sex and age, patients with CHD presented a 2.3-point higher HRQoL (P<0.001). The sex-specific and age-specific analyses showed that there were no differences between boys with and without CHD in childhood (P=0.255), but in adolescence, boys with CHD had on average 3.9-point higher scores (P=0.001), whereas girls with CHD had statistically higher HRQoL perception than healthy girls in childhood (4.2 points; P=0.003) and adolescence (4.2 points; P=0.005). There were no differences between the severity classes or diagnostic subgroups in the total HRQoL score or in the six subdomains. CONCLUSION The high HRQoL in young patients with CHD suggests that they can cope well with their disease burden. This holds true for all severity classes and diagnostic subgroups.
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Affiliation(s)
- Barbara Reiner
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jan Müller
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
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Menrath I, Ernst G, Lange K, Eisemann N, Szczepanski R, Staab D, Degner M, Thyen U. Evaluation of a generic patient education program in children with different chronic conditions. HEALTH EDUCATION RESEARCH 2019; 34:50-61. [PMID: 30535075 DOI: 10.1093/her/cyy045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/13/2018] [Indexed: 06/09/2023]
Abstract
For frequent pediatric chronic conditions, especially less common chronic conditions patient education programs are missing. A recently developed modular patient education approach (ModuS) combines disease-specific modules with generic psychosocial topics. ModuS was associated with increased disease-specific knowledge and improvements in families' well-being in children with asthma. In this study we tested if new developed ModuS programs for seven, mostly less common, chronic conditions show comparable program-associated effects. ModuS education programs were offered to the affected child and its parents. Disease-specific knowledge, children's health-related quality of life, life satisfaction and condition-specific burden were measured before, directly following and 6 weeks after participation in the program. The results were compared with families who received a ModuS asthma program. One hundred and sixty-eight children participated. Families were highly satisfied with the programs. Program participation was associated with increased families' knowledge, children`s self-reported health-related quality of life and reduced condition-specific burden. The results were comparable with the results of 230 families who participated in a ModuS asthma program. The ModuS approach allowed the development of patient education programs for children with a variety of chronic conditions. Therefore, ModuS closed an important healthcare gap.
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Affiliation(s)
- Ingo Menrath
- Department of Pediatrics, Luebeck University, Luebeck, Germany
| | - Gundula Ernst
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Karin Lange
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, Luebeck University, Luebeck, Germany
| | | | - Doris Staab
- Department of Pediatric Pulmonology and Immunology, Charité, Berlin, Germany
| | - Mareike Degner
- Department of Pediatrics, Luebeck University, Luebeck, Germany
| | - Ute Thyen
- Department of Pediatrics, Luebeck University, Luebeck, Germany
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Paakkonen T, Paakkonen H. Finnish schoolchildren's perceived health-related quality of life deteriorates remarkably with age. Scand J Child Adolesc Psychiatr Psychol 2019; 6:152-158. [PMID: 33907691 PMCID: PMC7852350 DOI: 10.21307/sjcapp-2018-014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 09/14/2018] [Indexed: 11/11/2022] Open
Abstract
Background Information on individuals' functioning and disability is needed for numerous purposes in social and health care. Objective The purpose of the study was to assess the perceived health-related quality of life of Finnish schoolchildren aged from 7 to 17 years. We were interested to ascertain if changes of health-related quality of life with age could be discovered. Method The quality of life data (N = 4,776) were collected using Revidierter KINDer Lebensqualitätsfragebogen (KINDL-R). The survey was conducted in several comprehensive schools using tablet computers. The response rate was 95%. The quality of life data are presented as means and standard deviations. The rating scale was 0 to 100 points. Results The mean of respondents' (N = 4,776) health-related quality of life points was 72.1 (SD 11.0). Family as a factor impacting on the quality of life scored the highest points 78.2 (SD 16.1), while self-esteem got the lowest points 62.5 (SD 17.9). Adolescent girls' school-related quality of life points were 60.2 (SD 15.0) and adolescent boys' points were 61.7 (SD 14.4). Lower graders' and upper graders' quality of life differed very significantly so that the ratings of the lower graders were higher than the ratings of the upper graders. Finnish girls' quality of life as a whole was poorer than that of Finnish boys. The physical and emotional welfare as well as the self-esteem of young Finnish girls were poorer than those of their male peers. Conclusions The poor well-being of adolescents is recognized and accepted as a development-related phenomenon. Poor health-related quality of life experienced by adolescents may be interpreted as a symptom of a disease. Deterioration in health-related quality of life among adolescents should not be accepted as a development-related factor; that phenomenon should be further investigated and necessary measures taken to improve the quality of adolescent's life.
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Affiliation(s)
- Tarja Paakkonen
- Niuvanniemi Hospital, The National Institute for Health and Welfare, Kuopio, Finland
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Kreimeier S, Greiner W. EQ-5D-Y as a Health-Related Quality of Life Instrument for Children and Adolescents: The Instrument's Characteristics, Development, Current Use, and Challenges of Developing Its Value Set. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:31-37. [PMID: 30661631 DOI: 10.1016/j.jval.2018.11.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 10/24/2018] [Accepted: 11/02/2018] [Indexed: 05/18/2023]
Abstract
OBJECTIVES Interest in the measurement of health-related quality of life (HRQoL) in children and adolescents has been increasing, and appropriate instruments are required for this target group. This article focuses on the EQ-5D-Y instrument, presenting an overview of its characteristics, development, and current use, and includes a discussion of methodological and conceptual issues related to the valuation of child health and the development of an EQ-5D-Y value set. METHODS This article brings together the experiences of the research team that developed and validated the EQ-5D-Y, supplemented by information derived from EQ-5D-Y study registrations on the EuroQol Group's website. RESULTS EQ-5D-Y is a child-specific and age-appropriate measure of HRQoL. Study registration data show that the instrument's use has steadily increased since its first publication. It has been used in various types of studies and in different disease areas. Currently there is no value set for EQ-5D-Y, and so its use in cost-utility analysis (CUA) is limited. There are methodological and conceptual issues that affect the design of valuation studies for child health. Issues that are discussed include the need for separate value sets for children and adolescents, the choice of appropriate reference samples and valuation techniques, and the framing of the tasks. CONCLUSIONS Research on EQ-5D-Y and its use has increased in the last years. Further research is required to clarify methodological issues regarding health state valuation in children and adolescents. This will support the development of a value set for EQ-5D-Y and the use of EQ-5D-Y in CUA.
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Affiliation(s)
- Simone Kreimeier
- Department of Health Economics and Health Care Management, Faculty of Health Science, Bielefeld University, Bielefeld, Germany.
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, Faculty of Health Science, Bielefeld University, Bielefeld, Germany
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Pollatos O, Georgiou E, Kobel S, Schreiber A, Dreyhaupt J, Steinacker JM. Trait-Based Emotional Intelligence, Body Image Dissatisfaction, and HRQoL in Children. Front Psychiatry 2019; 10:973. [PMID: 32038322 PMCID: PMC6990369 DOI: 10.3389/fpsyt.2019.00973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/09/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Body image dissatisfaction (BID) is related to an increased risk for various health issues including descreased health-related quality of life (HRQoL), the development of problematic eating behaviors and obesity. Previous research indicates that emotional intelligence is one important factor related to BID in adults. Whether this is the case in children, remains yet unknown. Taking this into consideration, the aim of this study was to explore the relationship between BID and trait-based emotion intelligence (TEI) as well as HRQoL in female and male primary school children. MATERIALS AND METHODS TEI and BID were assessed via self-reports as well as HRQoL via parental reports in a large sample of 991 primary school children (429 girls) within the "Baden Württemberg Study", which evaluated the effectiveness of the health prevention programm "Join the Healthy Boat" in Southwestern Germany. RESULTS Our findings demonstrated the interrelation between higher levels of TEI and lower levels of BID among girls and boys. Positive associations were found between better HRQoL, better intrapersonal and stress management abilites (subscales of TEI) and lower BID, as reflected by parental and self-reports. CONCLUSIONS Our results reveal an interconnectivity between TEI, BID, and better HRQoL in female and male primary school children. Although the observed correlations were rather small, they nervertheless support the idea that TEI consists a key-factor for the self-regulation of health-related behavior. Prevention programs could benefit from including processes, that sough to improve aspects of emotional intelligence such as intrapersonal, interpersonal abilities, and adaptability, as an effort of preventing problematic habits or lifestyles that could lead to disordered eating behaviors as well as to obesity in middle childhood.
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Affiliation(s)
- Olga Pollatos
- Clinical & Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Eleana Georgiou
- Clinical & Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Susanne Kobel
- Division Sports and Rehabilitation Medicine, Research Group "Join the Healthy Boat-Primary School", Ulm University, Ulm, Germany
| | - Anja Schreiber
- Division Sports and Rehabilitation Medicine, Research Group "Join the Healthy Boat-Primary School", Ulm University, Ulm, Germany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jürgen M Steinacker
- Division Sports and Rehabilitation Medicine, Research Group "Join the Healthy Boat-Primary School", Ulm University, Ulm, Germany
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Naros A, Brocks A, Kluba S, Reinert S, Krimmel M. Health-related quality of life in cleft lip and/or palate patients - A cross-sectional study from preschool age until adolescence. J Craniomaxillofac Surg 2018; 46:1758-1763. [PMID: 30054220 DOI: 10.1016/j.jcms.2018.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/01/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Cleft lip and/or palate (CLP) is the most common congenital craniofacial anomaly. Multiple operations, long-lasting supplementary treatments, as well as impaired functional and esthetic outcome might have a negative impact on patients' social-emotional functioning and self-esteem, resulting in a lower health-related quality of life (HRQoL). PATIENTS AND METHODS This cross-sectional study aimed to evaluated CLP patients' HRQoL from preschool age (4 years) until adolescence (18 years) using the age-specific German KINDLR questionnaire. We compared self-reports and parent proxy-reports, as well as reference values from an age-matched German norm population. Multivariate analysis was applied to identify mediating factors, e.g. cleft type, age, and gender. Additionally, a KINDSCREEN-10 questionnaire was used to implement a screening tool in the clinical routine. RESULTS In total, 134 participants (average age 9.0 ± 3.8 years; 47.8% female) were included. Compared with German normative data, the evaluation revealed a significantly higher 'total QoL' in all self-report groups (Kiddy-, Kid-, Kiddo-KINDLR) and a significantly higher proxy rating for children aged 7-13 years. Multivariate analysis verified a significant disparity between self-reports and parents' conceptions of HRQoL, as well as a deterioration of the ratings with increasing age. No significant effects of other contributing factors, e.g. cleft type and gender, were found. The KIDSCREEN-10 questionnaire successfully confirmed these findings. CONCLUSIONS Surprisingly, our survey revealed a higher HRQoL in cleft patients compared with normative data from healthy controls. But because the return rate of the forwarded questionnaire was low, this may have contributed to bias. Keeping this in mind, we may conclude at least that the HRQoL in our cleft patients was not significantly lower than in healthy children. On the other hand, it can be assumed that the special attention of the parents and the support from speech therapy and other medical professionals may have contributed to a positive effect on family interaction, communication skills, and self-esteem.
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Affiliation(s)
- Andreas Naros
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany.
| | - Annekathrin Brocks
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| | - Susanne Kluba
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| | - Siegmar Reinert
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
| | - Michael Krimmel
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert), University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany
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Meyer M, Hreinsdottir A, Häcker AL, Brudy L, Oberhoffer R, Ewert P, Müller J. Web-Based Motor Intervention to Increase Health-Related Physical Fitness in Children With Congenital Heart Disease: A Study Protocol. Front Pediatr 2018; 6:224. [PMID: 30211141 PMCID: PMC6120348 DOI: 10.3389/fped.2018.00224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/20/2018] [Indexed: 01/08/2023] Open
Abstract
Objective: Exercise interventions are underutilized in children with congenital heart disease (CHD) especially when the primary outcome is not peak oxygen uptake. Most of the studies are restricted to a low sample size and proximity of the patients to the study centers. Now eHealth approaches bear a promising but also challenging opportunity to transmit such intervention programs to participants, and check progress and compliance from remote. This study will aim to improve health-related physical fitness (HRPF) with a 24 weeks web-based exercise intervention. Methods and Design: The current study is planned as a randomized control trial (RCT) with a crossover design and the aim to improve functional outcome measures. It also estimates adherence and feasibility in patients with CHD in this web-based exercise/motor intervention over 24 weeks. Primary outcome will be the improvement of HRPF. Secondary outcomes are, functional and structural arterial stiffness measures and health-related quality of life. Thus, 70 children from 10 to 18 years with CHD of moderate and complex severity will be recruited and allocated randomly 1:1 in two study arms after baseline testing for their HRPF, arterial stiffness measures and health-related quality of life. For 24 weeks, participants in the intervention arm will receive three weekly exercise video clips of 20 min each. Every video clip comprises 20 child-oriented exercises which have to be executed for 30 s followed by a recovery period of 30 s. Each session will start with 3-4 warming-up exercises, followed by 10-12 strength and flexibility exercises, and ending with 3-4 min of cool down or stretching tasks. Continuous video clips will be streamed from a web-based e-Learning platform. The participant simply has to imitate the execution and follow some short advices. After each session, a brief online survey will be conducted to assess perceived exertion and feasibility. Discussion: The study will help to determine the efficacy and applicability of a web-based exercise intervention in children with CHD in regard to functional outcome measures. In addition, it will outline the effectiveness of remote monitoring, which provides a cost effective approach to reach patients with CHD that are low in prevalence and often do not live in close proximity to their tertiary center. Trial Registration: https://ClinicalTrials.gov Identifier: NCT03488797.
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Affiliation(s)
- Michael Meyer
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | | | - Anna-Luisa Häcker
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Leon Brudy
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Renate Oberhoffer
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jan Müller
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
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Peikert ML, Inhestern L, Bergelt C. The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol. BMJ Open 2017; 7:e014505. [PMID: 28801389 PMCID: PMC5724106 DOI: 10.1136/bmjopen-2016-014505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 05/24/2017] [Accepted: 05/25/2017] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION For ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment. METHODS AND ANALYSIS This prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4-6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis. ETHICS AND DISSEMINATION This study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences.
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Affiliation(s)
- Mona Leandra Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract
OBJECTIVE To summarize the epidemiology and outcomes of children with multiple organ dysfunction syndrome as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development multiple organ dysfunction syndrome workshop (March 26-27, 2015). DATA SOURCES Literature review, research data, and expert opinion. STUDY SELECTION Not applicable. DATA EXTRACTION Moderated by an experienced expert from the field, issues relevant to the epidemiology and outcomes of children with multiple organ dysfunction syndrome were presented, discussed, and debated with a focus on identifying knowledge gaps and research priorities. DATA SYNTHESIS Summary of presentations and discussion supported and supplemented by the relevant literature. CONCLUSIONS A full understanding the epidemiology and outcome of multiple organ dysfunction syndrome in children is limited by inconsistent definitions and populations studied. Nonetheless, pediatric multiple organ dysfunction syndrome is common among PICU patients, occurring in up to 57% depending on the population studied; sepsis remains its leading cause. Pediatric multiple organ dysfunction syndrome leads to considerable short-term morbidity and mortality. Long-term outcomes of multiple organ dysfunction syndrome in children have not been well studied; however, studies of adults and children with other critical illnesses suggest that the risk of long-term adverse sequelae is high. Characterization of the long-term outcomes of pediatric multiple organ dysfunction syndrome is crucial to identify opportunities for improved treatment and recovery strategies that will improve the quality of life of critically ill children and their families. The workshop identified important knowledge gaps and research priorities intended to promote the development of standard definitions and the identification of modifiable factors related to its occurrence and outcome.
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Becker-Grünig T, Schneider S, Sonntag D, Jarczok MN, Philippi H, De Bock F. [Parental Social Status and other determinants of quality of life and behavioral problems: An analysis of German preterm births between 1987-2004]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:166-80. [PMID: 26637387 DOI: 10.1007/s00103-015-2276-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Knowledge of the factors affecting the development of preterm children in Germany is limited. We analysed the prevalence of preterm birth in Germany using the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 and assessed factors associated with quality of life (QOL) and behavioural development in preterm children (< 37 weeks' gestational age). METHODS Data were weighted and preterm prevalence was calculated by socioeconomic status (SES) and year of birth for 1,106 preterm children. Using linear regression models, the relationship between sociodemographic, pre- and perinatal, lifestyle, and contextual determinants on the one hand, and the QOL (KINDL® parent questionnaire) and behavioural problems (the total problem behaviour scale, the Strengths and Difficulties Questionnaire [SDQ]) on the other was calculated. RESULTS Prevalence of preterm birth (mean 7.5 %) was higher in families with low compared with high SES (8.4 versus 7.0 %). In the final regression models, preterm children with high SES had higher QOL scores (+ 3.3 KINDL points, p = 0.024) compared with children with low SES, and adolescents (aged 14-17 years) had a higher QOL than children aged 7-13 years. All other variables (contextual, pre- and perinatal) were not related to QOL. In contrast, there were many determinants of behavioural development in preterms: the SDQ total score was lower in girls, children with older mothers, those from high SES and those with a high level of physical activity. However, both very low birth weight (< 1,500 g) and birth at > 34 weeks' gestation were associated with a higher SDQ total score. CONCLUSION Given its high prevalence, preterm birth is a relevant public health issue in Germany. While SES may be the most important determinant of QOL in preterms, determinants of behavioural problems are the same as those in term children and also encompass perinatal factors.
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Affiliation(s)
- Tabea Becker-Grünig
- Klinik für Kinder- und Jugendmedizin, Universitätsklinik Mannheim, Mannheim, Deutschland
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Sven Schneider
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Diana Sonntag
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Marc N Jarczok
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Heike Philippi
- Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Deutschland
| | - Freia De Bock
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland.
- Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Deutschland.
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Schäfer TK, Herrmann-Lingen C, Meyer T. Association of circulating 25-hydroxyvitamin D with mental well-being in a population-based, nationally representative sample of German adolescents. Qual Life Res 2016; 25:3077-3086. [PMID: 27342235 DOI: 10.1007/s11136-016-1334-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Numerous studies have linked vitamin D to health-related quality of life (hrQoL) in chronically ill adults or elderly subjects. The aim of this study was to evaluate the association between 25-hydroxyvitamin D (25(OH)D) and hrQoL in a population-based sample of German adolescents. METHODS A total of n = 5066 study participants from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (Kinder- und Jugendgesundheitssurvey) aged 11-17 years were included in this post hoc analysis. HrQoL was measured using the well-validated self- and parent-rated Children's Quality of Life questionnaires (KINDL-R), while the level of distress was assessed using the self- and proxy version of the Strengths and Difficulties Questionnaire (SDQ). Serum 25(OH)D concentrations were determined using a commercially available chemiluminescence immunoassay. RESULTS Bivariate analyses demonstrated a significant positive association between 25(OH)D and hrQoL for both self- [estimate (E) = 0.82, 95 % confidence interval (95 % CI) 0.35-1.30, p = 0.001] and parent ratings (E = 1.33, 95 % CI 0.83-1.83, p < 0.001). In addition, we found negative correlations between 25(OH)D and self- (E = -0.34, 95 % CI -0.58 to -0.11, p = 0.005) and parent-reported total SDQ scores (E = -0.70, 95 % CI -1.03 to -0.37, p < 0.001). Generalized linear models adjusted for age, sex, body mass index, systolic blood pressure, migration background, socio-economic status, and sedentary screen time confirmed that 25(OH)D independently and significantly predicted better hrQoL (p ≤ 0.004). CONCLUSIONS These findings linking 25(OH)D to better well-being in a nationally representative sample of German children and adolescents suggest beneficial effects of vitamin D on mental health. However, recommendations for vitamin supplementation in healthy children and adolescents are not warranted from our data.
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Affiliation(s)
- Theresa Katharina Schäfer
- Department of Psychosomatic Medicine and Psychotherapy, German Centre for Cardiovascular Research, University of Göttingen Medical Centre, University of Göttingen, Waldweg 33, 37073, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, German Centre for Cardiovascular Research, University of Göttingen Medical Centre, University of Göttingen, Waldweg 33, 37073, Göttingen, Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, German Centre for Cardiovascular Research, University of Göttingen Medical Centre, University of Göttingen, Waldweg 33, 37073, Göttingen, Germany.
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Hemmingsson H, Ólafsdóttir LB, Egilson ST. Agreements and disagreements between children and their parents in health-related assessments. Disabil Rehabil 2016; 39:1059-1072. [PMID: 27291406 DOI: 10.1080/09638288.2016.1189603] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings. METHOD The Uni-Search and five additional databases were searched. Children's health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life. RESULTS Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their children's difficulties in emotional functioning and pain. There were no consistencies in differences between children's and parent's ratings on levels of agreement with respect to the children's health issue, age or gender. CONCLUSIONS Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. Implications for Rehabilitation In general, parents consider their children to have more difficulties - or more extensive difficulties - than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the child´s health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the children's emotional functioning and pain. Clinicians should prioritize obtaining children's views on subjective aspects such as emotional issues as well as on pain.
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Affiliation(s)
- Helena Hemmingsson
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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Meyer M, Oberhoffer R, Hock J, Giegerich T, Müller J. Health-related quality of life in children and adolescents: Current normative data, determinants and reliability on proxy-report. J Paediatr Child Health 2016; 52:628-31. [PMID: 27144733 DOI: 10.1111/jpc.13166] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 11/28/2022]
Abstract
AIM Health-related quality of life (HrQoL) is a multidimensional concept including self-reported measures of physical and mental health. Throughout the last decades, HrQoL has become a more and more important outcome measure not only in clinical conditions. This study evaluates current HrQoL of healthy children and adolescents, determinants of HrQoL, and the agreement between self- and proxy-report. METHODS From April 2012 to July 2013, we prospectively examined 530 healthy children (13.2 ± 2.1 years, 236 girls) and their parents on their childrens HrQoL using the KINDL-R self-report questionnaire and the parent's proxy-report. Data was compared to the established reference value from 2007 and the agreement of self- and parent's proxy-report was assessed by calculation of intraclass correlation coefficient (ICC). RESULTS In general, the HrQoL improved compared to references in both children's (104.5 ± 12.6 % of predicted reference value, P < .001) and parent's proxy-report (104.3 ± 12.3 % of predicted reference value, P < .001). HrQoL declined with proceeding age (r = -.247, P < .001) but was not associated with BMI (r = -.035, P = .420). There was good accordance between children's reported HrQoL and the parent's proxy-report (ICC: .774). Only in the domains 'self-esteem' (ICC: .558) and 'Emotional well-being' (ICC: .612) the agreements were moderate. CONCLUSIONS HrQoL perception has increased throughout the past 10 years and worsens with increasing age. Moreover, the parent's proxy-report of the KINDL-R questionnaire is a good supplementary method to provide additional information regarding to children's HrQoL.
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Affiliation(s)
- Michael Meyer
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Julia Hock
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Tobias Giegerich
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Jan Müller
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
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Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children. J Clin Epidemiol 2016; 69:61-9. [DOI: 10.1016/j.jclinepi.2015.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/26/2015] [Accepted: 05/06/2015] [Indexed: 11/20/2022]
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Abreu LG, Melgaço CA, Abreu MHNG, Lages EMB, Paiva SM. Agreement between adolescents and parents or caregivers in rating adolescents' quality of life during orthodontic treatment. Am J Orthod Dentofacial Orthop 2015; 148:1036-42. [PMID: 26672710 DOI: 10.1016/j.ajodo.2015.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 11/27/2022]
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45
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Pardo-Guijarro MJ, Martínez-Andrés M, Notario-Pacheco B, Solera-Martínez M, Sánchez-López M, Martínez-Vizcaíno V. Self-reports versus parental perceptions of health-related quality of life among deaf children and adolescents. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2015; 20:275-82. [PMID: 25986604 DOI: 10.1093/deafed/env018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/20/2015] [Indexed: 05/15/2023]
Abstract
The aim of this study was to assess the agreement between deaf children's and adolescents' self-ratings of health-related quality of life (HRQoL) and their parents' proxy reports. This observational cross-sectional study included 114 deaf 8- to 18-years-old students and proxy family members. HRQoL was measured using the KIDSCREEN-27 questionnaire, which was adapted to Spanish sign language for children, with a written version for parents. Respondents completed a self-administered paper questionnaire. Parents' and children's mean scores differences were not significant, except for the "Autonomy and Parents" and "Peers and Social Support" dimensions. Children aged 8-11 years scored higher in some domains of QoL compared to those aged 12-18 years. The level of agreement between children/adolescents' and parents/proxies' responses was acceptable, except for the dimension "Autonomy and Parents." Overall, deaf children/adolescents' self-ratings of HRQoL did not differ from their parents' proxy reports; however, differences were found in the dimensions that explored the quality of the interaction of children/adolescents and parents, the perceived level of autonomy, and social relations and support.
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Ravens-Sieberer U, Karow A, Barthel D, Klasen F. How to assess quality of life in child and adolescent psychiatry. DIALOGUES IN CLINICAL NEUROSCIENCE 2015. [PMID: 25152654 PMCID: PMC4140509 DOI: 10.31887/dcns.2014.16.2/usieberer] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article provides an overview of the conceptual foundations of measuring health-related quality of life (HRQoL) in children and adolescents in child and adolescent psychiatry, and of the current state of research in this field. The available procedures for determining quality of life are presented according to their areas of use and their psychometric characteristics. The internationally available generic instruments for measuring HRQoL in children are identified and assessed in terms of their strengths and weaknesses with regard to selected criteria. As a result, seven generic HRQoL instruments and two utility procedures have been identified which satísfy the following criteria: (i) psychometric qualíty; (ii) age-appropriate measurement; (iii) versions for self-reporting and external rating; and (iv) cross-cultural measurement. The identified instruments satisfy the individual criteria to different degrees. They are increasingly being used in health services research, treatment studies, and epidemiological research; however, they are not yet widely used as part of the clinical routine in child and adolescent psychiatrics.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Child Public Health Research Unit, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Karow
- Psychiatric Clinic, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Dana Barthel
- Child Public Health Research Unit, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Fionna Klasen
- Child Public Health Research Unit, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Kennedy-Behr A, Rodger S, Mickan S. Play or hard work: unpacking well-being at preschool. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:30-38. [PMID: 25546295 DOI: 10.1016/j.ridd.2014.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/30/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
Well-being or quality of life is thought to give a more accurate picture of the impact a condition has on day-to-day functioning than traditional outcome measures. This study sought to examine the relationship between engagement in play and well-being for preschool children with and without developmental coordination disorder (DCD). A quasi-experimental design was used with two independent groups of preschool children aged 4-6 years with (n=32) and without (n=31) probable DCD. Play skills were assessed using the Play Observation Scale based on 30min of videotape of free-play at preschool. Well-being was assessed using a parent-proxy version of the Revised Children Quality of Life Questionnaire (KINDL(R)). Spearman rho correlations were performed to examine the relationship between play and well-being. Well-being at preschool was significantly lower for the children in the DCD group however overall well-being was not significantly different. Engagement in type of social play (solitary, parallel or group) was found to predict well-being for the typically developing children. For the children with DCD, engagement in group play was not associated with well-being. An explanation for this difference may be that children with DCD may not experience free-play at preschool as "play" but rather as hard work. Further research is needed to determine why children with DCD experience lower well-being at preschool than their peers and to investigate children's perceptions of free-play. This may enable teachers and therapists to better support children with DCD in the preschool environment.
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Affiliation(s)
- A Kennedy-Behr
- School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC 4558, QLD, Australia.
| | - S Rodger
- Autism CRC Ltd, Cooperative Research Centre for Living with Autism Spectrum Disorders, The University of Queensland, St Lucia 4072, QLD, Australia; Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia 4072, QLD, Australia.
| | - S Mickan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, Kellogg College, University of Oxford, Oxford, United Kingdom.
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Rank M, Wilks DC, Foley L, Jiang Y, Langhof H, Siegrist M, Halle M. Health-related quality of life and physical activity in children and adolescents 2 years after an inpatient weight-loss program. J Pediatr 2014; 165:732-7.e2. [PMID: 25039048 DOI: 10.1016/j.jpeds.2014.05.045] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 04/22/2014] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate changes in health-related quality of life (HRQOL), body mass index (BMI), physical activity, and sedentary behavior at 24 months after an inpatient weight-loss program and to examine correlations between changes in HRQOL and BMI or physical activity. STUDY DESIGN This prospective study included 707 overweight and obese individuals (mean age, 14 ± 2 years; 57% girls) participating in a 4- to 6-week inpatient weight-loss program, 381 of whom completed a 24-month follow-up. HRQOL, physical activity, sedentary behavior, and BMI were assessed at baseline, at discharge, and at 6, 12, and 24 months after starting therapy. Longitudinal analyses were conducted using repeated-measures mixed models, adjusted for age, sex, and baseline outcome and accounting for attrition over time. RESULTS All variables improved over treatment and 6-month follow-up (P < .05). At 24 months, overall HRQOL indicated improvements relative to baseline (3 points on a scale of 0-100; 95% CI, 1.68-4.47; P < .001). Of the 6 HRQOL domains, the greatest improvement was observed for self-esteem (11 points; 95% CI, 8.40-13.14; P < .001). BMI was 0.5 kg/m(2) lower than at baseline (95% CI, -0.92 to -0.02; P = .04). Long-term changes in physical activity explained 30% of the variation in overall HRQOL (P = .01), and change in BMI was not associated with a change in HRQOL. CONCLUSIONS This inpatient weight-loss program was associated with positive changes in HRQOL over the long term, with particular improvements in self-esteem. The results indicate the potential role of physical activity in improving HRQOL without a substantial change in body composition.
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Affiliation(s)
- Melanie Rank
- Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany.
| | - Desiree C Wilks
- Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany; Sports Center, University of Passau, Germany
| | - Louise Foley
- National Institute for Health Innovation, University of Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, New Zealand
| | - Helmut Langhof
- Rehabilitation Clinic Schoensicht, Berchtesgaden, Germany
| | - Monika Siegrist
- Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Martin Halle
- Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; Else-Kröner-Fresenius-Zentrum, Klinikum rechts der Isar, Munich, Germany
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Vescovelli F, Albieri E, Ruini C. Self-rated and observer-rated measures of well-being and distress in adolescence: an exploratory study. SPRINGERPLUS 2014; 3:490. [PMID: 25221741 PMCID: PMC4161734 DOI: 10.1186/2193-1801-3-490] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 08/19/2014] [Indexed: 01/31/2023]
Abstract
The evaluation of eudaimonic well-being in adolescence is hampered by the lack of specific assessment tools. Moreover, with younger populations, the assessment of positive functioning may be biased by self-report data only, and may be more accurate by adding significant adults' evaluations. The objective of this research was to measure adolescents' well-being and prosocial behaviours using self-rated and observer-rated instruments, and their pattern of associations. The sample included 150 Italian high school adolescents. Observed-evaluation was performed by their school teachers using the Strengths and Difficulties Questionnaire. Adolescents completed Ryff's Psychological Well-being Scales and Symptom Questionnaire. Pearson' r correlations and Linear regression were performed. Self-rated dimensions of psychological well-being significantly correlated with all observer-rated dimensions, but Strengths and Difficulties Emotional symptom scale. Multiple linear regression showed that the self-rated dimensions Environmental Mastery and Personal Growth, and surprisingly not Positive Relations, are related to the observer-rated dimension Prosocial Behaviour. Adolescents with higher levels of well-being in specific dimensions tend to be perceived as less problematic by their teachers. However, some dimensions of positive functioning present discrepancies between self and observer-rated instruments. Thus, the conjunct use of self-reports and observer-rated tools for a more comprehensive assessment of students' eudaimonic well-being is recommended.
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Affiliation(s)
- Francesca Vescovelli
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, Bologna, 40127 Italy
| | - Elisa Albieri
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, Bologna, 40127 Italy
| | - Chiara Ruini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, Bologna, 40127 Italy
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50
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Sommer R, Bullinger M, Rohenkohl A, Quitmann J, Brütt AL. Linking a short-stature specific health-related quality of life measure (QoLISSY) to the International Classification of Functioning – Children and Youth (ICF-CY). Disabil Rehabil 2014; 37:439-46. [DOI: 10.3109/09638288.2014.923528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Rachel Sommer
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Bullinger
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja Rohenkohl
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Quitmann
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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