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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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A Machine Learning Approach to Assess Differential Item Functioning of the KINDL Quality of Life Questionnaire Across Children with and Without ADHD. Child Psychiatry Hum Dev 2022; 53:980-991. [PMID: 33963488 DOI: 10.1007/s10578-021-01179-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to investigate differential item functioning (DIF) of the child and parent reports of the KINDL measure across children with and without Attention-deficit/hyperactivity disorder (ADHD). The sample included 122 children with ADHD and 1086 healthy peers, alongside 127 and 1061 of their parents, respectively. The generalized partial credit model with lasso penalization, as a machine learning method, was used to assess DIF of the KINDL across the two groups. The findings showed that three out of 24 items of the child reports and seven out of 24 items of the parent reports of the KINDL exhibited DIF between children with and without ADHD. Accordingly, Iranian children with and without ADHD along with their parents perceive almost all items in the KINDL similarly. Hence, the observed difference in quality of life scores between children with and without ADHD is a real difference and not a reflection of measurement bias.
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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.
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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.)
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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.
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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
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Ueda R, Okada T, Kita Y, Ozawa Y, Inoue H, Shioda M, Kono Y, Kono C, Nakamura Y, Amemiya K, Ito A, Sugiura N, Matsuoka Y, Kaiga C, Kubota M, Ozawa H. Psychological Status Associated With Low Quality of Life in School-Age Children With Neurodevelopmental Disorders During COVID-19 Stay-At-Home Period. Front Psychiatry 2021; 12:676493. [PMID: 34733180 PMCID: PMC8558384 DOI: 10.3389/fpsyt.2021.676493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/23/2021] [Indexed: 12/05/2022] Open
Abstract
Background: This study seeks to ascertain how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders (NDDs) who had experienced sleep schedules alteration and clarify what psychological status predicted low QOL in children with and without altered sleep patterns. Materials and Methods: Study participants were 86 children between 8 and 17 years of age (mean age, 11.7 years; 70 boys, 16 girls; mean intellectual quotient, 83.6). QOL was evaluated using the self-assessment KINDLR. Participants answered questions regarding depression and anxiety on a visual analog scale (VAS) for temporary mood. Their parents answered questionnaires regarding their maladaptive behaviors and differences in sleep patterns before and during the COVID-19 pandemic. The student's t-test was performed to examine the presence or absence of sleep changes in the children, which affected QOL, temporary mood, and maladaptive behaviors. Multiple or simple linear regression analyses were also performed to identify the psychogenic factors that significantly affected decreased QOL for each group with and without changes in sleep schedule. Results: During the COVID-19 stay-at-home period, 46.5% of participants experienced changes in sleep patterns. These changes were associated with decreased QOL as well as internalized symptoms. The decreased QOL of children with sleep patterns changed was predicted by a high level of depression. In addition, low QOL in children with unchanged sleep patterns was predicted by a high level of depression and low current mood status. Conclusions: Almost half of the participants experienced a poor sleep schedule during the stay-at-home period. These alterations in sleep patterns were associated with a low QOL. The QOL of children with a stable life schedule was affected not only by depressive tendencies but also temporary moods. Therefore, they need to live a fulfilling life to maintain their QOL. However, the QOL of children with poor sleep patterns was affected only by depressive tendencies. Hence, clinicians need to ensure that children with NDDs are well-diagnosed with depression and treated for sleep problems.
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Affiliation(s)
- Riyo Ueda
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yosuke Kita
- Mori Arinori Center for Higher Education and Global Mobility, Hitotsubashi University, Kunitachi, Japan.,Cognitive Brain Research Unit (CBRU), Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yuri Ozawa
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Hisami Inoue
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Mutsuki Shioda
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Yoshimi Kono
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Chika Kono
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Yukiko Nakamura
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Kaoru Amemiya
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Ai Ito
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Nobuko Sugiura
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Yuichiro Matsuoka
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Chinami Kaiga
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Masaya Kubota
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Hiroshi Ozawa
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
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