1
|
Adedeji A, Witt S, Innig F, Quitmann J. A comprehensive systematic review of health-related quality of life measures in short stature paediatric patients. Endocrine 2024:10.1007/s12020-024-03938-6. [PMID: 39017834 DOI: 10.1007/s12020-024-03938-6] [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: 04/30/2024] [Accepted: 06/20/2024] [Indexed: 07/18/2024]
Abstract
This systematic review investigates Patient-reported Outcome Measures (PROMs) and Observed Reported Outcome Measures (ObsROMs) pertinent to assessing Health-Related Quality of Life (HRQoL) in short-stature paediatric patients, focusing on Achondroplasia (ACH), Growth Hormone Deficiency (GHD), Isolated Growth Hormone Deficiency (IGHD), and Small-for-Gestational-Age (SGA) diagnoses. Utilising rigorous selection criteria, 53 studies published from 1998 to 2023 were analysed, revealing a predominance of European-based research. Notably, the review elucidated the utilisation of disease-specific and generic HRQoL measures, showcasing the multifaceted nature of short-stature conditions and their impact across physical, emotional, and social domains. The Quality of Life in Short Stature Youth (QoLISSY), Paediatric Quality of Life Inventory (PedsQL), and KIDSCREEN emerged as frequently employed instruments, offering nuanced insights into HRQoL perceptions across diverse age demographics. Additionally, the review highlighted the adaptation of adult HRQoL measures for adolescent populations, signalling a need for age-appropriate assessment tools. Furthermore, integrating PROMs and ObsROMs in HRQoL assessment underscored a comprehensive approach, considering both subjective patient perspectives and observed outcomes. Future research directions encompass comprehensive search strategies, longitudinal studies with diverse populations, and the development of age-appropriate HRQoL assessment tools. In conclusion, this review emphasises the importance of comprehensive HRQoL assessment to address the diverse needs of short-stature paediatric patients effectively.
Collapse
Affiliation(s)
- Adekunle Adedeji
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Witt
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Innig
- BKMF Federal Association for People of Short Stature and their Families (Bundesverband Kleinwüchsige Menschen und ihre Familien e.V.), BKMF, Hamburg, Germany
| | - Julia Quitmann
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany.
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
| |
Collapse
|
2
|
欧阳 力, 杨 凡. [Pay attention to the mental health of children with short stature]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:331-336. [PMID: 38660895 PMCID: PMC11057308 DOI: 10.7499/j.issn.1008-8830.2309056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/23/2024] [Indexed: 04/26/2024]
Abstract
In the clinical diagnosis and treatment of children with short stature, mental health issues merit special attention. It is widely acknowledged that the psychological well-being of children with short stature is lower than that of their peers with normal height. Therefore, during the diagnosis, treatment, and care of short stature, it is crucial to actively monitor the mental health of these children, promptly identify potential psychological and behavioral issues, and intervene accordingly. Such measures play a positive role in enhancing the quality of life of these children and improving their physical and mental health. This article analyses and discusses the current state of psychological assessment and psycho-behavioral interventions for children with short stature, aiming to provide insights for improving their mental health.
Collapse
|
3
|
Grimberg A, Friedrich EA, Faig W, Kamoun C, Fremont ER, Xiao R, Miller VA. Patient and Parent Characteristics Related to Quality of Life and Self-Esteem in Healthy Youth Undergoing Provocative Growth Hormone Testing. J Pediatr 2023; 260:113460. [PMID: 37172805 DOI: 10.1016/j.jpeds.2023.113460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/24/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To examine how height and youth as well as parenting characteristics associate with quality of life (QoL) and self-esteem among healthy youth undergoing growth evaluation with growth hormone (GH) testing. STUDY DESIGN Healthy youth, aged 8-14 years, undergoing provocative GH testing, and a parent completed surveys at or around the time of testing. Surveys collected demographic data; youth and parent reports of youth health-related QoL; youth reports of self-esteem, coping skills, social support, and parental autonomy support; and parent reports of perceived environmental threats and achievement goals for their child. Clinical data were extracted from electronic health records. Univariate models and multivariable linear regressions were used to identify factors associated with QoL and self-esteem. RESULTS Sixty youth (mean height z score -2.18 ± 0.61) and their parents participated. On multivariable modeling, youth perceptions of their physical QoL associated with higher grade in school, greater friend and classmate support, and older parent age; youth psychosocial QoL with greater friend and classmate support, and with less disengaged coping; and youth height-related QoL and parental perceptions of youth psychosocial QoL with greater classmate support. Youth self-esteem associated with greater classmate support and taller mid-parental height. Youth height was not associated with QoL or self-esteem outcomes in multivariable regression. CONCLUSIONS Perceived social support and coping skills, rather than height, were related to QoL and self-esteem in healthy short youth and may serve as an important potential area for clinical intervention.
Collapse
Affiliation(s)
- Adda Grimberg
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA.
| | - Elizabeth A Friedrich
- Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Walter Faig
- Department of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Camilia Kamoun
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA; Division of Endocrinology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Ettya R Fremont
- Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Rui Xiao
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Victoria A Miller
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| |
Collapse
|
4
|
Reis CT, Macedo MC, Morcillo AM, Guerra G, de Lemos-Marini SHV. Anthropometry and physical appearance can be associated with quality of life in Brazilian women with Turner syndrome. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:126-135. [PMID: 36468921 PMCID: PMC9983798 DOI: 10.20945/2359-3997000000535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective This study aimed to analyze if anthropometric factors and physical appearance are associated to QoL in Turner syndrome (TS). Materials and methods Observational, analytical, and cross-sectional study. The SF-36 was applied along with an additional questionnaire regarding specific characteristics of TS. Results There were no differences in quality of life (QoL) in TS women regarding median height and appropriate height according to parental target height, however, participants satisfied and who did not desire to change their height had better scores in the mental health and role emotional domains than those not satisfied and desired to change it. When comparing participants who were or were not bothered by physical appearance, the results showed that those not bothered by physical appearance had a better score in the vitality and social function domains. Considering patients who did or did not desire to change physical appearance, those who did not want to change their physical appearance had higher scores in the mental component and in the social function and mental health domains of the SF-36. Conclusion This study indicated that anthropometric factors and physical appearance may possibly be associated to QoL in TS, and also emphasizes the need to develop and validate an official questionnaire regarding specific TS characteristics in order to assess in more detail how specific characteristics of TS interfere with their QoL.
Collapse
Affiliation(s)
| | | | | | - Gil Guerra
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | | |
Collapse
|
5
|
Ardelean VP, Andrei VL, Miuţa CC, Boros-Balint I, Deak GF, Molnar A, Berki T, Győri F, Geantă VA, Dehelean CA, Borcan F. The KIDSCREEN-27 Quality of Life Measure for Romanian Children Aged 6: Reliability and Validity of the Romanian Version. Healthcare (Basel) 2022; 10:healthcare10071198. [PMID: 35885725 PMCID: PMC9319028 DOI: 10.3390/healthcare10071198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
The KIDSCREEN-27 represents a standardized, worldwide instrument, employed to assess the health-related quality of life in children. The purpose of the present study is to validate the KIDSCREEN-27 questionnaire for 6-year-old preparatory school children and verify its reliability, as well as to perform a comparison regarding the quality of children’s lives living in two cities in Romania: Arad, a provincial city, versus the second most developed city in the country, Cluj-Napoca. A total of 256 children of 6 years of age, who come from families with both parents, with a medium to high socioeconomic status and a good health status, were included in the analysis, using the KIDSCREEN-27 questionnaire at three assessment time points with a re-test period of two weeks. Results indicated that the KIDSCREEN-27 turned out to be suitable for use in 6-year-old Romanian children. Analysis regarding the psychometric properties showed that the Cronbach’s alpha ranged from 0.554 to 0.661 at the end of the study. The Pearson correlation coefficients showed statistically significant differences between the items of each area investigated. In conclusion, there is a growing need to periodically monitor the health status of children to avoid possible problems which may occur.
Collapse
Affiliation(s)
- Viorel Petru Ardelean
- Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, 2-4, Elena Dragoi, 310330 Arad, Romania; (V.L.A.); (C.C.M.)
- Correspondence: ; Tel.: +40-743-107182
| | - Vasile Liviu Andrei
- Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, 2-4, Elena Dragoi, 310330 Arad, Romania; (V.L.A.); (C.C.M.)
| | - Caius Călin Miuţa
- Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, 2-4, Elena Dragoi, 310330 Arad, Romania; (V.L.A.); (C.C.M.)
| | - Iuliana Boros-Balint
- Faculty of Physical Education and Sport, Babeș-Bolyai University of Cluj-Napoca, 7 Pandurilor Str., 400376 Cluj-Napoca, Romania; (I.B.-B.); (G.-F.D.)
| | - Grațiela-Flavia Deak
- Faculty of Physical Education and Sport, Babeș-Bolyai University of Cluj-Napoca, 7 Pandurilor Str., 400376 Cluj-Napoca, Romania; (I.B.-B.); (G.-F.D.)
| | - Andor Molnar
- Institute of Physical Education and Sport Sciences, Faculty of Education, University of Szeged, Hattyas u. 10, H-6725 Szeged, Hungary; (A.M.); (T.B.)
| | - Tamás Berki
- Institute of Physical Education and Sport Sciences, Faculty of Education, University of Szeged, Hattyas u. 10, H-6725 Szeged, Hungary; (A.M.); (T.B.)
| | - Ferenc Győri
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, 4 Vörösmarty u., H-7621 Pécs, Hungary;
| | - Vlad Adrian Geantă
- Faculty of Science, Physical Education and Informatics, University of Piteşti, 7 Normal School Alley, 110254 Piteşti, Romania;
| | - Cristina Adriana Dehelean
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (C.A.D.); (F.B.)
| | - Florin Borcan
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (C.A.D.); (F.B.)
| |
Collapse
|
6
|
Gong Z, Xue J, Han Z, Li Y. Validation of the Chinese Version of KIDSCREEN-10 Quality of Life Questionnaire: A Rasch Model Estimation. Front Psychol 2021; 12:647692. [PMID: 34484023 PMCID: PMC8415151 DOI: 10.3389/fpsyg.2021.647692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/20/2021] [Indexed: 01/28/2023] Open
Abstract
The KIDSCREEN-10 was deemed as a cross-national instrument for measuring Health-Related Quality of Life (HRQoL). However, no empirical endeavor has explored its reliability and validity in the context of China. This study aims to translate and validate the Chinese version of the KIDSCREEN-10 questionnaire. The KIDSCREEN-10 was translated into Chinese (Mandarin) using a blindly bilingual forward–backward–forward technique. A cross-sectional survey, including 1,830 students aged from 8 to 18 years, was conducted in a county located in Gansu province, China. Psychometric properties were evaluated using the Rasch partial credit model, ANOVA, and the correlation analysis. Results indicated that the KIDSCREEN-10 performed good internal consistency, known-group validity, and concurrent validity, but there were still some deficiencies in psychometrics: first, disordered response categories were found between category 2 (seldom) and category 3 (sometimes); second, item 3 (“Have you felt sad?”), item 4 (“Have you felt lonely?”), and item 5 (“Have enough time for self?”) demonstrated misfit to the Rasch model; third, items 3 and 4 exhibited differential item functioning. After collapsing the disordered response categories and removing the three misfit items, the seven-item questionnaire performed good psychometric properties. However, the seven-item version does not cover the psychological well-being dimension of HRQoL, and that may lead to inappropriate measures of HRQoL. Therefore, this paper suggested to use classical test theory to investigate the psychological properties of the KIDSCREEN-10.
Collapse
Affiliation(s)
- Zepeng Gong
- School of Public Affairs and Administration & Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China, Chengdu, China
| | - Jia Xue
- Factor-Inwentash Faculty of Social Work & Faculty of Information, University of Toronto, Toronto, ON, Canada
| | - Ziqiang Han
- School of Political Science and Public Administration, Shandong University, Qingdao, China
| | - Yuhuan Li
- School of Government, Central University of Finance and Economics, Beijing, China
| |
Collapse
|
7
|
Constantinides C, Landis SH, Jarrett J, Quinn J, Ireland PJ. Quality of life, physical functioning, and psychosocial function among patients with achondroplasia : a targeted literature review. Disabil Rehabil 2021; 44:6166-6178. [PMID: 34403286 DOI: 10.1080/09638288.2021.1963853] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Achondroplasia (ACH) is the most common form of skeletal dysplasia, resulting in disproportionate short stature and medical complications. We review the literature on physical functioning, psychosocial function, and quality of life (QoL) in ACH individuals compared to average stature individuals or other short stature conditions. Studies that assess the association between these outcomes and height, limb length/lengthening surgery in ACH patients are also summarized. MATERIALS AND METHODS PubMed/MEDLINE and Embase were searched through April 2021. Study inclusion criteria were: (1) quantitative design; (2) study population consisting solely/mainly of ACH patients; (3) reports of physical functioning, psychosocial functioning, and/or QoL. Included studies were summarized separately for pediatric and adult populations. RESULTS Of 1664 records identified, 23 primary studies (sample size 8-437 participants) were included. Multiple tools were used across studies, including the generic PedsQL and SF-36 and height-specific QoLISSY. CONCLUSIONS The literature demonstrates that ACH patients experience limitations in physical functioning and poorer QoL outcomes compared to average stature people across the life span. This appeared to be at least in part due to disproportionate short stature. Future research to better characterize QoL in ACH patients will assist clinicians to better evaluate the effectiveness of management programs including novel interventions.IMPLICATIONS FOR REHABILITATIONPatients with achondroplasia experience limitations in physical functioning and poorer quality of life throughout their life course when compared to average statured individuals.Psychosocial issues are also heightened in adults with achondroplasia compared to average statured peers but are observed less frequently in children and adolescents with achondroplasia.The overall impact that limb lengthening has on physical functioning and QoL remains unclear, although there is some evidence that greater height or upper limb length may lead to an improvement in these parameters.Rehabilitation professionals should regularly assess physical functioning, psychosocial wellbeing, and quality of life in individuals with achondroplasia using condition-specific tools.
Collapse
Affiliation(s)
| | | | | | | | - Penelope J Ireland
- Children's Health Queensland Hospital & Health Service, Brisbane, Australia
| |
Collapse
|
8
|
Halas JG, Grimberg A. Dilemmas of growth hormone treatment for GH deficiency and idiopathic short stature: defining, distinguishing, and deciding. Minerva Pediatr 2020; 72:206-225. [PMID: 32274914 DOI: 10.23736/s0026-4946.20.05821-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Worrisome growth can be a sign of underlying pathology but usually reflects healthy variation. It is often recognized through short stature, which is defined by arbitrarily separating height, a physical trait on a continuum, into "normal" and "abnormal." In some cases of worrisome growth, recombinant human growth hormone (rhGH) treatment is indicated to hasten growth/increase height. This review addresses the two most frequently treated indications for rhGH, growth hormone deficiency (GHD) and idiopathic short stature (ISS). A review of worrisome growth itself, of the history of GH treatment, of the blurry line between partial GHD and ISS, of the GH stakeholders, and of the outside pressures involved in these cases demonstrates the ambiguous platform upon which treatment decisions are made. The rhGH treatment decision process can be examined further by considering the three most impactful factors on parental height-related medical decision-making: treatment characteristics, child health, and psychosocial function. While it is important to note that treatment for classical GHD is uncontroversial and supported, treatment decisions for partial GHD and ISS are more complicated and require careful evaluation of both patient needs and the supporting evidence. As the rhGH community grows, physicians, parents, and patients are encouraged to engage in a shared decision-making process to navigate the many challenges facing the GH field. Although this review addresses GHD and ISS specifically, the issues discussed are often applicable to pediatrics as a whole.
Collapse
Affiliation(s)
- Julia G Halas
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Adda Grimberg
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA -
| |
Collapse
|
9
|
Murano MC, Slatman J, Zeiler K. How sociophenomenology of the body problematises the 'problem-oriented approach' to growth hormone treatment. MEDICAL HUMANITIES 2020; 46:2-11. [PMID: 30478090 DOI: 10.1136/medhum-2018-011548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 06/09/2023]
Abstract
This article examines how people who are shorter than average make sense of their lived experience of embodiment. It offers a sociophenomenological analysis of 10 semistructured interviews conducted in the Netherlands, focusing on if, how, and why height matters to them. It draws theoretically on phenomenological discussions of lived and objective space, intercorporeality and norms about bodies. The analysis shows that height as a lived phenomenon (1) is active engagement in space, (2) coshapes habituated ways of behaving and (3) is shaped by gendered norms and beliefs about height. Based on this analysis, the article challenges what we label as the 'problem-oriented approach' to discussions about growth hormone treatment for children with idiopathic short stature. In this approach, possible psychosocial disadvantages or problems of short stature and quantifiable height become central to the ethical evaluation of growth hormone treatment at the expense of first-hand lived experiences of short stature and height as a lived phenomenon. Based on our sociophenomenological analysis, this paper argues that the rationale for giving growth hormone treatment should combine medical and psychological assessments with investigations of lived experiences of the child. Such an approach would allow considerations not only of possible risks or disadvantages of short stature but also of the actual ways in which the child makes sense of her or his height.
Collapse
Affiliation(s)
- Maria Cristina Murano
- Department of Culture and Communication, Linköping University, Linköping, Sweden
- Medicine, Science, Health and Society (Cermes3), School for Advanced Studies in the Social Sciences (EHESS), Paris, France
- Center for Bioethics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Jenny Slatman
- Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
| | - Kristin Zeiler
- Department of Thematic Studies: Technology and Social Change, Linköping University, Linköping, Sweden
| |
Collapse
|
10
|
Bloemeke J, Balacano Valdez R, Mauras N, Mericq V, Ross J, Permuy J, Quitmann J, Bullinger M. Psychometric performance of the Quality of Life in Short Stature Youth (QoLISSY) questionnaire in a randomized open-label comparator trial in idiopathic short stature. J Pediatr Endocrinol Metab 2019; 32:1089-1101. [PMID: 31557127 DOI: 10.1515/jpem-2019-0137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/09/2019] [Indexed: 11/15/2022]
Abstract
Background In addition to increasing linear growth, improvement in health-related quality of life (HRQOL) is an important endpoint in the treatment of short statured youth. Hence, condition-specific psychometric valid instruments that adequately assess HRQOL are needed. We aimed to confirmatorily examine the psychometric performance of the Quality of Life in Short Stature Youth (QoLISSY) questionnaire used in a previously reported prospective randomized open-label trial. Methods This trial compared treatment of idiopathic short stature (ISS) in 76 adolescent males with either oral aromatase inhibitors (AIs), subcutaneous daily growth hormone (GH) or a combination treatment (AI/GH) for at least 2 years, demonstrating improvements in HRQOL with the GH and AI/GH interventions. HRQOL was assessed from the child's and parent's perspectives with the short stature-specific QoLISSY and the generic KIDSCREEN questionnaires before and 24 months into treatment. Scale scores and psychometric properties were examined regarding reliability and validity of the QoLISSY questionnaire using the dataset from the published trial. Results The QoLISSY questionnaire showed high internal consistency and satisfactory criterion, convergent and known-groups validity. Scale scores were evenly distributed with no major floor or ceiling effects. Responsiveness analyses suggest that the QoLISSY questionnaire detects significant changes in HRQOL after 2 years of treatment with growth-promoting therapies in children with short stature from both the child's and parent's perspectives. Conclusions The QoLISSY questionnaire is a psychometrically sound, reliable and valid instrument that can explore the experiences associated with short stature, track HRQOL changes over time and in response to treatment, and highlight HRQOL domains that can be improved through intervention.
Collapse
Affiliation(s)
- Janika Bloemeke
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Institute for Medical Psychology, Martinistraße 52, 20246 Hamburg, Germany
| | - Richelle Balacano Valdez
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Institute for Medical Psychology, Hamburg, Germany.,Center for Dental and Oral Medicine Polyclinic of Prosthetic Dentistry, University Clinic Hamburg Eppendorf, Hamburg, Germany
| | - Nelly Mauras
- Divisions of Endocrinology at Nemours Children's Health System, Jacksonville, FL, USA
| | - Veronica Mericq
- Division of Endocrinology at University of Santiago, Santiago, Chile
| | - Judith Ross
- Divisions of Endocrinology at Nemours Children's Health System, Philadelphia, PA, USA
| | - Joseph Permuy
- Divisions of Endocrinology at Nemours Children's Health System, Jacksonville, FL, USA
| | - Julia Quitmann
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Institute for Medical Psychology, Hamburg, Germany
| | - Monika Bullinger
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Institute for Medical Psychology, Hamburg, Germany
| |
Collapse
|
11
|
Quitmann J, Bloemeke J, Dörr HG, Bullinger M, Witt S, Silva N. First-year predictors of health-related quality of life changes in short-statured children treated with human growth hormone. J Endocrinol Invest 2019; 42:1067-1076. [PMID: 30840207 DOI: 10.1007/s40618-019-01027-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 02/20/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE Little attention has been directed towards examining the impact of predictors on change in health-related quality of life (HRQOL) within the course of growth hormone (GH) treatment in pediatric short stature. We aimed to assess changes in HRQOL and its sociodemographic, clinical and psychosocial predictors in children and adolescents diagnosed with growth hormone deficiency (GHD), and born short for gestational age (SGA) before and 12-month after start of GH treatment from the parents' perspective. Results were compared with an untreated group with idiopathic short stature (ISS). In this prospective multicenter study, 152 parents of children/adolescents (aged 4-18 years) provided data on their children's HRQOL at baseline and at 12-month follow-up. METHOD Repeated-measures multivariate analyses of covariance were performed to examine parent-reported HRQOL changes from baseline to 1-year after treatment and hierarchical linear regressions to identify the predictors of HRQOL changes. RESULTS Results showed that parents of children that were treated with GH report an increase in their children's HRQOL after 1 year. Changes in HRQOL were mostly explained by psychosocial predictors followed by sociodemographic and clinical variables. Specifically, the diagnosis SGA significantly predicted a greater increase in parent-reported HRQOL. Furthermore, a lower caregiving burden significantly predicted a decrease in parent-reported HRQOL. CONCLUSION In conclusion, a substantial percentage of explained variance in HRQOL relates to psychosocial and sociodemographic predictors. However, there appears to be other important factors that are predictors of HRQOL, which need to be determined in large, population-based samples.
Collapse
Affiliation(s)
- J Quitmann
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - J Bloemeke
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - H-G Dörr
- Division Paediatric Endocrinology, Hospital for Children and Adolescents, University Erlangen-Nürnberg, Erlangen, Germany
| | - M Bullinger
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - S Witt
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - N Silva
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Faculty of Psychology and Education Sciences, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
12
|
Bullinger M, Bloemeke J, Mericq V, Sommer R, Gaete X, Ross JL, Yu YM, Permuy J, Gagliardi P, Damaso YL, Mauras N. Quality of Life in Adolescent Boys with Idiopathic Short Stature: Positive Impact of Growth Hormone and Aromatase Inhibitors. Horm Res Paediatr 2019; 90:381-392. [PMID: 30820008 DOI: 10.1159/000496353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/18/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The combination of growth hormone (GH) and aromatase inhibitors (AI) improves linear growth in severely short adolescent boys; however, the effects of this intervention on quality of life (QoL) are unknown. This study assesses whether GH, AI, or their combination impacts the QoL of adolescent males with idiopathic short stature (ISS) from both the adolescent and the parent perspective. METHOD A randomized open-label comparator trial was conducted in 76 pubertal males with ISS who received AI, GH, or AI/GH for 24 months. The condition-specific Quality of Life in Short Stature Youth questionnaire was used to assess QoL. RESULTS QoL scores were low at baseline in the children's and parents' reports. Within-group testing showed that total QoL scores increased significantly at 24 months in the GH and AI/GH group but not the AI group in the children's report, whereas it increased in all of the groups in the parents' report. Increases in QoL scores were associated with an increase in height SDS. CONCLUSIONS Treatment with GH and AI/GH was associated with improved QoL scores as measured from both the patients' and the parents' perspectives, suggesting that the improved growth resulting from the use of these growth-promoting therapies has beneficial psychosocial effects in adolescent males with ISS followed for 24 months.
Collapse
Affiliation(s)
| | | | - Veronica Mericq
- Division of Endocrinology, University of Santiago, Santiago, Chile
| | - Rachel Sommer
- University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Xiemena Gaete
- Division of Endocrinology, University of Santiago, Santiago, Chile
| | - Judith L Ross
- Division of Endocrinology, Nemours Children's Health System, Philadelphia, Pennsylvania, USA
| | - Y Miles Yu
- Division of Endocrinology, Nemours Children's Health System, Orlando, Florida, USA
| | - Joseph Permuy
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Priscila Gagliardi
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Y Ligeia Damaso
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Nelly Mauras
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| |
Collapse
|
13
|
Drosatou C, Vlachopapadopoulou EA, Bullinger M, Quitmann J, Silva N, Salemi G, Pavlopoulou I, Michalacos S, Tsoumakas K. Validation of the Greek version of the Quality of Life in Short Stature Youth (QoLISSY) questionnaire. J Pediatr Endocrinol Metab 2019; 32:215-224. [PMID: 30735483 DOI: 10.1515/jpem-2018-0403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/16/2018] [Indexed: 11/15/2022]
Abstract
Background The Quality of Life in Short Stature Youth (QoLISSY) questionnaire is a condition-specific instrument for measuring the health-related quality of life (HRQoL) in short statured children/adolescents from patients' and parents' perspectives. The aim of this study was to investigate the psychometric properties of the Greek version of the QoLISSY questionnaire. Methods The original European QoLISSY scales were translated into Greek following the guidelines for linguistic validation and applied to 184 dyads of children 8-18 years old and their parents, as well as to 14 parents of children 4-7 years old in Greece. The field testing responses to the Greek version of QoLISSY were analyzed. Results The qualitative analysis of the Greek data provided results consistent with the European sample. The subsequent field test showed acceptable internal consistency (Cronbach α between 0.67-0.93) and high test-retest reliability (intraclass correlation coefficients [ICC] ≥0.70). Correlations with the generic KIDSCREEN questionnaire indicated good convergent validity. Confirmatory factor analysis (CFA) also yielded acceptable results. Higher HRQoL for taller children suggests that QoLISSY was able to detect significant height-related differences. Conclusions The Greek version of the QoLISSY questionnaire is psychometrically sound and its use is recommended in further clinical research to ascertain the impact of short stature (SS) and treatments in Greek children/adolescents and families.
Collapse
Affiliation(s)
- Chrysoula Drosatou
- Department of Endocrinology-Growth and Development, Athens General Children's Hospital "P. & A. Kyriakou", Thivon & Levadeias str., Athens 11527, Greece.,Nursing Department, National and Kapodistrian University of Athens, Athens, Greece, Phone: +302132009527
| | | | - Monika Bullinger
- Department of Medical Psychology, University Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Quitmann
- Department of Medical Psychology, University Hamburg-Eppendorf, Hamburg, Germany
| | - Neuza Silva
- Department of Medical Psychology, University Hamburg-Eppendorf, Hamburg, Germany.,Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Georgia Salemi
- Department of Nursing Administration, Athens General Children's Hospital "P. & A. Kyriakou", Athens, Greece
| | - Ioanna Pavlopoulou
- Nursing Department, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefanos Michalacos
- Department of Endocrinology-Growth and Development, Athens General Children's Hospital "P. & A. Kyriakou", Athens, Greece
| | | |
Collapse
|
14
|
Bloemeke J, Silva N, Bullinger M, Witt S, Dörr HG, Quitmann J. Psychometric properties of the quality of life in short statured youth (QoLISSY) questionnaire within the course of growth hormone treatment. Health Qual Life Outcomes 2019; 17:49. [PMID: 30885197 PMCID: PMC6423839 DOI: 10.1186/s12955-019-1118-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/07/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The Quality of Life of Short Stature Youth (QoLISSY) questionnaire is a patient- and parent-reported outcome measure assessing health-related quality of life (HRQOL) in short stature youth. This study evaluates the psychometric properties of the QoLISSY questionnaire within a German prospective trial of short statured children treated with human growth hormone (hGH). METHOD The instrument was administered to children with idiopathic growth hormone Deficiency (IGHD) and small for gestational age (SGA) before and after 12 month of hGH treatment. Children with idiopathic short stature (ISS) served as a reference group receiving no treatment. Psychometric testing included scale distribution characteristics, reliability (internal consistency), criterion-and convergent validity (correlations with the generic KIDSCREEN-Index, inter-correlations among QOLISSY subscales), known-group validity (treatment status, height SDS), and responsiveness analysis (ability to detect change). RESULTS One hundred fifty-two parents and 66 children/adolescents completed both HRQOL assessments. The QoLISSY demonstrated good reliability with Cronbach's alpha > .70. Moderate significant correlations between QoLISSY domains and the KIDSCREEN-10 Index supported criterion validity. Statistically significant differences in HRQOL were observed between treatment groups at baseline with children who were about to start treatment reporting a significantly lower HRQOL compared to the children who will not receive treatment. No significant differences were found between the level of short stature based on height SDS scores (≤ - 2 SDS, > - 2 SDS). Furthermore, the instrument detected significant changes in HRQOL between the treated and the untreated group in patient-reports. CONCLUSIONS In conclusion, the scales showed satisfactory reliability, adequate validity and ability to detect change in self-reported HRQOL within GH treatment. Findings support QoLISSY's further use in clinical trials, offering the opportunity to adequately assess HRQOL from the patients' and caregivers' perspective to improve patient-centered care.
Collapse
Affiliation(s)
- Janika Bloemeke
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf in Hamburg, Hamburg, Germany
| | - Neuza Silva
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf in Hamburg, Hamburg, Germany
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Monika Bullinger
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf in Hamburg, Hamburg, Germany
| | - Stefanie Witt
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf in Hamburg, Hamburg, Germany
| | - Helmuth-Günther Dörr
- Clinic for Children and Adolescents, University Hospital Erlangen-Nurnberg, Erlangen, Germany
| | - Julia Quitmann
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf in Hamburg, Hamburg, Germany
| |
Collapse
|
15
|
Using structural equation modeling to detect response shift in quality of life in patients with Alzheimer's disease. Int Psychogeriatr 2019; 31:123-132. [PMID: 29720293 DOI: 10.1017/s1041610218000595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
UNLABELLED ABSTRACTBackground:Our study aims to detect different types of response shifts (RS) and true changes of quality of life (QOL) measurement in patients with Alzheimer's disease (AD) using structural equation modeling (SEM) in domain level. METHODS Patients with AD aged over 60 years old were collected from the Department of Neurology and Geriatrics in Taiyuan Central Hospital, China. The 12-item Short Form (SF-12) Health Survey was measured in 238 patients with AD prior to hospitalization and one month following discharge. RS was detected by SEM approach. The statistical process consisted of four steps and fitted four models. We interpreted changes of parameters in models to detect RS and to assess true change. RESULTS The results showed reprioritization of social functioning (SF) (χ2 = 4.13, p < 0.05), reconceptualization of role limitations due to emotional problems (RE) (χ2 = 17.03, p < 0.001), uniform recalibration of bodily pain (BP) (χ2 = 12.24, p < 0.001), and non-uniform recalibration of mental health (MH) (χ2 = 4.41, p < 0.05), respectively. The true changes of common factors were deteriorated in general physical health (PHYS) (-0.10, χ2 = 8.30, p < 0.005) and improved in general mental health (MENT) (+0.29, χ2 = 20.95, p < 0.001). The effect-sizes of RS were only small. CONCLUSION This study showed that patients with AD occurred three types of RS and true changes one month following discharge. RS had effects on the QOL of patients. Better understanding of potential changes in QOL in patients with AD is crucial.
Collapse
|
16
|
Collins L, Athale U, Cranston A, Barr R. Impact of short stature on health-related quality of life in long-term survivors of acute lymphoblastic leukemia in childhood and adolescence. J Patient Rep Outcomes 2018; 2:59. [PMID: 30535818 PMCID: PMC6286289 DOI: 10.1186/s41687-018-0084-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/06/2018] [Indexed: 02/08/2023] Open
Abstract
Purpose Some survivors of acute lymphoblastic leukemia (ALL) in childhood and adolescence exhibit short stature, especially if their treatment included cranial irradiation. The impact of this outcome on health-related quality of life (HRQL) is uncertain and so formed the basis for the investigation reported here. Methods This study examined the association between self-reported HRQL and measured height in a cohort (n = 75) of survivors of ALL more than 10 years from diagnosis. HRQL was expressed as utility scores generated from a multi-attribute preference-based measure, the Health Utilities Index (HUI) which includes the complementary systems HUI2 and HUI3. For single attributes the range is from 1.00 (no limitations) to 0.00 (lowest level of function). For overall HRQL the range is 1.00 (perfect health) to 0.00 (equivalent to being dead). A negative score is associated with states of health worse than being dead. Results There were no statistically significant differences in overall HRQL between subjects <25th (n = 16, 21%), 15th (n = 11, 15%) and 10th (n = 10, 13%) centiles. A greater amount of emotional morbidity, focused on anger and depression, was manifest in those <25th and 15th centiles, with clinically important differences of 0.07 (p = 0.03) and 0.077 (p = 0.016) respectively, but not in the shortest group who were < 10th centile. Conclusions Studies in large cohorts of young adults in the general population has reported an inconsistent relationship between height and HRQL. Results from the current study suggest that no such relationship exists in long-term survivors of ALL in childhood and adolescence.
Collapse
Affiliation(s)
- Laura Collins
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Uma Athale
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Room 3N27, Health Sciences Centre, 1200 Main Street West, Hamilton, Ontario, L8S 4J9, Canada
| | - Amy Cranston
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ronald Barr
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada. .,Department of Pediatrics, McMaster University, Room 3N27, Health Sciences Centre, 1200 Main Street West, Hamilton, Ontario, L8S 4J9, Canada.
| |
Collapse
|
17
|
Quitmann J, Giammarco A, Maghnie M, Napoli F, Di Giovanni I, Carducci C, Mohn A, Bullinger M, Sommer R. Validation of the Italian Quality of Life in Short Stature Youth (QoLISSY) questionnaire. J Endocrinol Invest 2017; 40:1077-1084. [PMID: 28397185 DOI: 10.1007/s40618-017-0667-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/25/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The Quality of Life in Short Stature Youth (QoLISSY) questionnaire is a disease-specific instrument developed to assess health-related quality of life (HrQoL) in children with short stature. While the original instrument was simultaneously developed in five European countries, this study describes the results of the Italian QoLISSY translation, cultural adaptation, and validation. METHODS Focus group discussions and a cognitive debriefing process with children (N = 12) diagnosed with growth hormone deficiency or idiopathic short stature and one parent each, as well as parents of younger children (N = 20) were conducted to examine the linguistic and content validity of the Italian version. Psychometric testing was performed using data from the subsequent field- and re-test (N = 32). RESULTS The results of the qualitative testing of the Italian sample revealed comparability of content to data of the original five European countries. The following field- and re-test results were psychometrically satisfactory including good item and scale operating characteristics, sufficient evidence of reliability, and acceptable evidence of construct validity. CONCLUSION In conclusion, the Italian QoLISSY HrQoL-dimensions are comparable to other European countries. The psychometric quality of the Italian QoLISSY version is satisfactory and the instrument is ready for use in Italian patients and their parents.
Collapse
Affiliation(s)
- J Quitmann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - A Giammarco
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - M Maghnie
- Istituto Giannina Gaslini, Genova, Italy
| | - F Napoli
- Istituto Giannina Gaslini, Genova, Italy
| | | | - C Carducci
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - A Mohn
- Fondazione Università "G.d'Annunzio", Chieti, Italy
| | - M Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - R Sommer
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| |
Collapse
|
18
|
Development and Psychometric Evaluation of the MetabQoL 1.0: A Quality of Life Questionnaire for Paediatric Patients with Intoxication-Type Inborn Errors of Metabolism. JIMD Rep 2017; 37:27-35. [PMID: 28247338 DOI: 10.1007/8904_2017_11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/01/2017] [Accepted: 02/03/2017] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION This study is part of the "European network and registry for intoxication type metabolic diseases" (E-IMD) project. Intoxication-type inborn errors of metabolism (IT-IEM) such as urea cycle disorders (UCD) and organic acidurias (OA) have a major impact on patients' lives. Patients have to adhere to strict diet and medication and may suffer from metabolic crises and neurocognitive impairment. Disease-specific health-related quality of life (HrQoL) assessment questionnaires are the method of choice to estimate the subjective burden of a disease. To date, no such instrument is available for IT-IEM. METHODS Disease-specific patient- and parent-reported HrQoL questions were constructed in German based on focus group interviews with patients and parents. Questionnaires for patients from 8 to 18 years were piloted with 14 participants (n = 9 children and adolescents, n = 5 parents) by cognitive debriefing and tested psychometrically with 80 participants (n = 38 patients, n = 42 parents) for item characteristics, validity, and reliability to construct the first version of a disease-specific HrQoL questionnaire. RESULTS Twenty-eight questions were selected based on item descriptives. Scales of self- and proxy questionnaires demonstrated acceptable to excellent reliability in terms of internal consistency (Cronbach's α = 0.70-0.93). Scales and total scores correlated with those of generic HrQoL questionnaires, showing convergent validity. DISCUSSION The MetabQoL 1.0 questionnaire exhibits sound psychometric properties and is a promising step towards assessing patient-reported outcomes in research and clinical practice. It provides a solid basis for translation into other languages and further elaboration and psychometric exploration in larger populations.
Collapse
|
19
|
The impact of depressive symptoms on health-related quality of life in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease. Int Psychogeriatr 2016; 28:2045-2054. [PMID: 27576786 DOI: 10.1017/s1041610216001289] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is an important issue in the context of dementia care. The purpose of this study was to investigate the association between HRQOL and depressive symptoms in patients with subjective cognitive decline (SCD) and subtypes of mild cognitive impairment (MCI) and Alzheimer´s disease (AD). METHODS In this cross-sectional, observational study, a control group and four experimental groups (SCD, non-amnestic MCI, amnesticMCI, AD) were compared. Neuropsychological measurers (NTBV) and psychological questionnaires were used for data collection. RESULTS The control group scored higher than patients with SCD, naMCI, aMCI, or AD for the Mental Health Component Score (MHCS) of the Short Form of the Health Survey (SF-36). The Physical Health Component Score (PHCS) of the SF-36 differed only between some groups. Furthermore, cognitive variables were more strongly associated with the physical aspects of HRQOL, whereas depressive symptoms were more strongly related with the mental aspects of HRQOL. CONCLUSIONS HRQOL and depressive symptoms are closely related in patients with cognitive impairments. Therefore, it is of great importance to assess patients with subjective impairment carefully in terms of depressive symptoms.
Collapse
|
20
|
Quitmann JH, Bullinger M, Sommer R, Rohenkohl AC, Bernardino Da Silva NM. Associations between Psychological Problems and Quality of Life in Pediatric Short Stature from Patients' and Parents' Perspectives. PLoS One 2016; 11:e0153953. [PMID: 27097033 PMCID: PMC4838264 DOI: 10.1371/journal.pone.0153953] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/06/2016] [Indexed: 11/19/2022] Open
Abstract
Short stature has been associated with psychosocial impairments, but whether treatments and achieved height impact on health-related quality of life (HrQoL) and psychological functioning of children/adolescents is still controversial. This study aimed to examine the effects of height deviation and treatment status on psychosocial adaptation outcomes and to identify clinical and psychosocial determinants of internalizing/externalizing problems in a large cohort of short statured children/adolescents from seven European countries. Participants were 345 children aged 8–18 years with a clinical diagnosis of short stature and 421 parents of 4–18 year-old patients. Children and parents reported on psychological problems (Strengths and Difficulties Questionnaire), generic (KIDSCREEN) and condition-specific HrQoL (QoLISSY). According to analyses of covariance, children/adolescents with current short stature presented more parent-reported internalizing problems and lower self- and parent-reported condition-specific HrQoL, compared to patients with an achieved height above -2SD. Treated children self-reported better HrQoL than the untreated group. Hierarchical regression analysis showed that, rather than height–related clinical variables, children’s sex, younger age and poorer HrQoL were the best predictors of psychological problems, explaining 39% of the variance in patient- and 42% in parent-reported internalizing problems, and 22% of the variance in patient- and 24% in parent-reported externalizing problems. Treatment status also moderated the negative links between patient-reported HrQoL and internalizing problems, explaining 2% of additional variance. These results suggest that children with current short stature are at greater risk for internalizing problems. Routine assessment of HrQoL in pediatric healthcare may help identify children for referral to specialized psychological assessment and intervention.
Collapse
Affiliation(s)
- Julia Hannah Quitmann
- University Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
- * E-mail:
| | - Monika Bullinger
- University Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
| | - Rachel Sommer
- University Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
| | | | - Neuza Maria Bernardino Da Silva
- University Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
- University of Coimbra, Cognitive and Behavioral Center for Research and Intervention, Coimbra, Portugal
| |
Collapse
|