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Gowda NC, Chatterjee R, Balakrishnan A, Lawrence A, Aggarwal A. Caregiver burden in families of children with juvenile idiopathic arthritis in India. Clin Rheumatol 2024; 43:2009-2019. [PMID: 38662098 DOI: 10.1007/s10067-024-06975-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
Juvenile Idiopathic Arthritis (JIA) causes caregiver burden on families with children affected with it. Our study aimed to explore this multifaceted burden in the Indian context. In this cross-sectional study, we administered the Hindi translated CAREGIVER questionnaire to adult caregivers in the families of JIA patients ≤ 18 years. The responses to the 28 items were used to calculate the burden scores in various dimensions. The relationship of the global burden scores with demographic and socioeconomic factors were analysed. Non parametric tests were used. Two hundred twenty-one caregivers participated with a median age of 39 years (IQR 32-45). This included 116 fathers, 50 mothers, 32 brothers, 18 uncles, three grandfathers, one sister, and one grandmother. The JIA patients had a median age of 15 (12-17) years, and the male-to-female ratio was 3.2:1. Enthesitis-related arthritis was the predominant subtype (72.4%). Most caregivers (70.6%) expressed sadness at diagnosis, and 29.9% continued to express sadness. Nearly two-thirds (65.6%) had to borrow money from others. More than half (59.3%) of the caregivers neglected their health, and 9.0% became sick. Male gender of the child, systemic JIA subtype, low socioeconomic status, high disease activity, extra-articular damage, high parent-reported disease activity and poor quality of life were associated with higher global caregiver burden. JIA has a significant emotional, social, economic, and labour impact on caregivers. Economic and psychosocial support needs to be given to family caregivers caring for children with JIA.
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Affiliation(s)
- Nikhil C Gowda
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Rudrarpan Chatterjee
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Anu Balakrishnan
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Able Lawrence
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Amita Aggarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014.
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Livermore P, Ainsworth S, Beesley R, Douglas S, Earle E, Wilson D, Woolley L, Clinch J. 'The current mental health status of children and young people with JIA, and their wider family': a charity partner collaboration survey. Pediatr Rheumatol Online J 2023; 21:111. [PMID: 37798784 PMCID: PMC10557198 DOI: 10.1186/s12969-023-00898-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND This paper presents insight into the scale of mental health concerns for families who have a child or young person with a diagnosis of Juvenile Idiopathic Arthritis (JIA) living in any of the four nations of the United Kingdom (UK). The study's objective is to share the current experiences of those that responded to a charity survey and consider future work to improve mental health support. METHODS This work was initiated and led by five UK charity partner organisations working with families affected by JIA. Parents/carers of a child or young person with JIA, and young people with JIA, submitted self-completion online questionnaires. The questionnaire asked 19 core questions, with a focus on the mental health impact of having and living with a JIA diagnosis. Questionnaires were delivered via charity partner UK-wide mailing lists and social media. RESULTS Questionnaire were completed by 291 participants over a 3-week period in February 2022. The majority of respondents were parents (229, 79%), 103 children had been diagnosed for over six years (35%), and 131 (45%) received shared care between paediatric rheumatology centres. In total, 168 (59%) children and young people with JIA had received, were currently receiving or were waiting for mental health support. Parents reported that their child's diagnosis impacted their own mental health (218, 82%). Children and young people reported never being offered mental health support during appointments for JIA (157, 54%), and 71 (50%) of these had never received support. CONCLUSION Children and young people with JIA have significant mental health sequelae from their diagnosis. Our findings found that nearly 60% of our respondents have had or are requiring mental health support, with significant numbers of parents/carers reporting difficulties in accessing care for their child's mental health or their own mental health, due to their child's diagnosis. This unique collaborative charity-led study, illustrates the importance of timely and accessible mental health support. Further work is needed to understand why best practice guidance for mental health support is not being met consistently and to identify how to embed it into standard rheumatology care.
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Affiliation(s)
- Polly Livermore
- NIHR Advanced Clinical Academic Nursing Fellow, Infection, Immunity and Inflammation, Institute of Child Health, University College London Great Ormond Street Institute of Child Health, 6th Floor, 30 Guilford Street, WC1N 1EH, London, UK.
| | | | - R Beesley
- Juvenile Arthritis Research (JAR), Tonbridge, UK
| | - S Douglas
- Scottish Network for Arthritis in Children (SNAC), Edinburgh, Scotland
| | - E Earle
- Children's Chronic Arthritis Association (CCAA), Nuneaton, UK
| | - D Wilson
- National Rheumatoid Arthritis Society (NRAS), Berkshire, UK
| | - L Woolley
- Young People and Families, Versus Arthritis (VA), London, UK
| | - J Clinch
- Bristol Royal Hospital for Children, Bristol, UK
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Bramanti SM, Manippa V, Babore A, Dilillo A, Marcellino A, Martucci V, Mallardo S, Isoldi S, Bloise S, Sanseviero M, Iorfida D, De Luca E, Trumello C, D’Alleva F, Ventriglia F, Lubrano R, Del Giudice E. Comparing parental distress and children's difficulties between parents of children with rheumatic diseases and parents of healthy children in families facing the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022; 42:1-10. [PMID: 35967493 PMCID: PMC9361970 DOI: 10.1007/s12144-022-03589-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 11/03/2022]
Abstract
The COVID-19 pandemic could be a threat for the health status of children with a chronic condition. The present study aimed to explore parents' and children's psychological adjustment during the current pandemic, pursuing a triple objective: to compare the psychological adjustment of parents of children with pediatric rheumatic diseases (PRDs) and parents of healthy children; to analyze children's psychological symptoms (emotional problems and hyperactivity) before and during the COVID-19 pandemic, and with or without a PRDs diagnosis; to explore the associations of children's emotional problems and hyperactivity with parents' psychological adjustment, parent-child interactions and belonging or not to families with PRDs. This cross-sectional study involved 56 parents of children with PRDs and 53 parents of healthy children. Self-report questionnaires about parents' depression, anxiety, parenting stress, and children's emotional symptoms and hyperactivity-inattention were administered. No differences were detected on psychological adjustment between parents of children with PRDs and parents of healthy children. Parents of children with PRDs reported statistically significant higher levels of children's emotional problems and hyperactivity before the pandemic, compared to parents of healthy children; during COVID-19 pandemic, emotional symptoms increased for both groups, while hyperactivity-inattention symptoms increased only in the group of healthy children. Children's emotional difficulties were associated with higher levels of parental anxiety, worse parent-child interaction and having PRDs; children's hyperactivity symptoms were related to parent-child difficult interaction and higher levels of parental depression. Findings suggest the importance to target the children in relation to their parents, when approaching the psychological aspects of PRDs.
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Affiliation(s)
- Sonia M. Bramanti
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Valerio Manippa
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
- Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Alessandra Babore
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Anna Dilillo
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Alessia Marcellino
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Vanessa Martucci
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Saverio Mallardo
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Sara Isoldi
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Silvia Bloise
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Mariateresa Sanseviero
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Donatella Iorfida
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Enrica De Luca
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Carmen Trumello
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Francesca D’Alleva
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Flavia Ventriglia
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Riccardo Lubrano
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Emanuela Del Giudice
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
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Mental Health in Pediatric Rheumatology: An Opportunity to Improve Outcomes. Rheum Dis Clin North Am 2021; 48:67-90. [PMID: 34798960 DOI: 10.1016/j.rdc.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Mental health problems are more common in children with pediatric rheumatologic diseases (PRDs) than healthy peers. Mental health problems affect disease-related outcomes and health-related quality of life (HRQOL), so addressing these problems can improve clinical and psychosocial outcomes. Mental health screening tools are available, and there are resources available to aid in integrating mental health care into the clinical setting. By implementing these tools, mental health problems can be recognized and addressed.
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Min M, Hancock DG, Aromataris E, Crotti T, Boros C. Experiences of living with Juvenile Idiopathic Arthritis: a qualitative systematic review. JBI Evid Synth 2021; 20:60-120. [PMID: 34669687 DOI: 10.11124/jbies-21-00139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to investigate the available qualitative evidence to enhance understanding of the experiences of children, young adults, and their carers living with Juvenile Idiopathic Arthritis in any setting. INTRODUCTION Juvenile Idiopathic Arthritis is the most common chronic rheumatic disease in childhood. Despite the availability of effective treatments, persistent pain, growth retardation, physical disability, and psychological problems can occur. This may reduce the quality of life for Juvenile Idiopathic Arthritis patients by negatively affecting their family, educational, and social well-being. Patient-centered management and care for Juvenile Idiopathic Arthritis patients requires increasing attention to their self-reported quality of life and experiences, in addition to clinically measured disease activity. Furthermore, taking care of children with Juvenile Idiopathic Arthritis may have negative impacts on the lives of their carers and families. The experiences of carers have been poorly understood and studied. This review describes experiences and perspectives from patients and carers in order to inform the needs of families throughout their Juvenile Idiopathic Arthritis journey. INCLUSION CRITERIA Studies describing the experiences of patients aged <21 years who have been diagnosed with Juvenile Idiopathic Arthritis according to the International League of Associations for Rheumatology criteria, as well as the experiences of their carers, have been considered. METHODS A comprehensive search using PubMed, CINAHL, Embase, PsycINFO, Web of Science, and Google Scholar, as well as relevant conference proceedings of the American College of Rheumatology (ACR; 2018-2019), the European Pediatric Rheumatology Congress (PReS) 2018, the European League Against Rheumatism (EULAR; 2018-2019), and the Asia Pacific League of Associations for Rheumatology (APLAR; 2018-2019), was undertaken in December 2020 to identify pertinent published and unpublished studies. Studies published in English from 2001 to 2020 were included. The JBI approach to study selection, critical appraisal, data extraction, and data synthesis was used. RESULTS Ten studies were included in this review. A total of 61 findings were extracted and aggregated to form 12 categories. From the 12 categories, five synthesized findings were developed: i) Self-management of Juvenile Idiopathic Arthritis requires pain management, medication management, and the acquisition of knowledge and professional support; ii) A promising relationship with health care professionals but unbalanced access to services; iii) Parental financial burden and their adjustment to maintain family happiness; iv) Patients and parents support the web-based approach to communicate and develop self-management skills and acknowledge the importance of clinical trials; v) Desire to live a normal life without prejudice from school, social settings, and the workplace. CONCLUSIONS This review has provided a comprehensive overview of experiences and perceptions of Juvenile Idiopathic Arthritis patients and their parents. It is important to understand what they need to know and understand about the disease. This review also highlights the importance of appropriate web-based programs, career counseling, infrastructures, and school facilities. Findings in this review can guide future policy and practice in order to improve care for families and children with Juvenile Idiopathic Arthritis. Further research is required to develop management strategies for medication intolerance and evaluate the longitudinal benefits of relevant Juvenile Idiopathic Arthritis programs. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42019133165).
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Affiliation(s)
- Ming Min
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia University of Adelaide Discipline of Paediatrics, Women's and Children's Hospital, Adelaide, SA, Australia Women's and Children's Hospital Department of Rheumatology, Adelaide, SA, Australia JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Talarico R, Marinello D, Manzo A, Cannizzo S, Palla I, Ticciati S, Gaglioti A, Trieste L, Pisa L, Badalamenti L, Randisi G, Del Bianco A, Lorenzoni V, Turchetti G, Mosca M. Being a caregiver of a Behçet's syndrome patient: challenges and perspectives during a complex journey. Orphanet J Rare Dis 2021. [PMID: 34663419 DOI: 10.1186/s13023-021-02070-2.pmid:34663419;pmcid:pmc8524918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND As often seen in many chronic diseases, the disease impact on patients also induces a significant impact on the quality of life (QoL) of caregivers. Caregivers are the ones who are really willing to offer care in the general approach of many aspects of the disease, including the awareness of the diseases itself, the daily management of therapy, and all the potential challenges that living with a chronic disease can include. The main objectives of the study were to explore the perspectives and views of caregivers of Behçet's syndrome (BS) patients, to study their level of awareness on the disease and the impact that BS may have on their lives by means of a survey co-designed with caregivers and patients with this purpose. A survey was entirely co-designed with a panel of caregivers of patients living with BS patients. RESULTS Results show that BS caregivers organise their life according to the needs of the patient, that they (79%) considered themselves as helpful for the patient and 53% of them replied that they can freely express their emotions. Notably, 70% and 68% of the respondents reported they renounced with a variable frequency to sexual relationships due to concerns regarding the health of the partner or to the partner's illness, respectively. The majority (79%) of respondents indicated that they are familiar with the treatment taken by the patients and that 68% deal with the administration of some medicines. In terms of awareness, a good percentage (64%) of respondents reported to understand the illness and, in terms of education, 68% of participants are willing to take part in training programmes dedicated to BS. CONCLUSIONS The results of this survey contribute to provide new information on BS caregivers and on their important role, and to identify areas in which new initiatives could provide BS caregivers (and therefore patients) with tools and knowledge that can empower them in reducing the burden of the disease on their lives, on families, and on the patient.
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Affiliation(s)
- Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy.
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | | | - Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Simone Ticciati
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | - Andrea Gaglioti
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Lorenzo Pisa
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | - Luciano Badalamenti
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | - Girolamo Randisi
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | - Alessandra Del Bianco
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | | | | | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
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Talarico R, Marinello D, Manzo A, Cannizzo S, Palla I, Ticciati S, Gaglioti A, Trieste L, Pisa L, Badalamenti L, Randisi G, Del Bianco A, Lorenzoni V, Turchetti G, Mosca M. Being a caregiver of a Behçet's syndrome patient: challenges and perspectives during a complex journey. Orphanet J Rare Dis 2021; 16:436. [PMID: 34663419 PMCID: PMC8524918 DOI: 10.1186/s13023-021-02070-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background As often seen in many chronic diseases, the disease impact on patients also induces a significant impact on the quality of life (QoL) of caregivers. Caregivers are the ones who are really willing to offer care in the general approach of many aspects of the disease, including the awareness of the diseases itself, the daily management of therapy, and all the potential challenges that living with a chronic disease can include. The main objectives of the study were to explore the perspectives and views of caregivers of Behçet’s syndrome (BS) patients, to study their level of awareness on the disease and the impact that BS may have on their lives by means of a survey co-designed with caregivers and patients with this purpose. A survey was entirely co-designed with a panel of caregivers of patients living with BS patients. Results Results show that BS caregivers organise their life according to the needs of the patient, that they (79%) considered themselves as helpful for the patient and 53% of them replied that they can freely express their emotions. Notably, 70% and 68% of the respondents reported they renounced with a variable frequency to sexual relationships due to concerns regarding the health of the partner or to the partner’s illness, respectively. The majority (79%) of respondents indicated that they are familiar with the treatment taken by the patients and that 68% deal with the administration of some medicines. In terms of awareness, a good percentage (64%) of respondents reported to understand the illness and, in terms of education, 68% of participants are willing to take part in training programmes dedicated to BS. Conclusions The results of this survey contribute to provide new information on BS caregivers and on their important role, and to identify areas in which new initiatives could provide BS caregivers (and therefore patients) with tools and knowledge that can empower them in reducing the burden of the disease on their lives, on families, and on the patient.
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Affiliation(s)
- Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy.
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | | | - Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Simone Ticciati
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | - Andrea Gaglioti
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Lorenzo Pisa
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | - Luciano Badalamenti
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | - Girolamo Randisi
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | - Alessandra Del Bianco
- Associazione S.I.M.B.A (Associazione Italiana Sindrome E Malattia Di Behçet), Pontedera, Italy
| | | | | | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
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Shah R, Ali FM, Finlay AY, Salek MS. Family reported outcomes, an unmet need in the management of a patient's disease: appraisal of the literature. Health Qual Life Outcomes 2021; 19:194. [PMID: 34353345 PMCID: PMC8339395 DOI: 10.1186/s12955-021-01819-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A person's chronic health condition or disability can have a huge impact on the quality of life (QoL) of the whole family, but this important impact is often ignored. This literature review aims to understand the impact of patients' disease on family members across all medical specialities, and appraise existing generic and disease-specific family quality of life (QoL) measures. METHODS The databases Medline, EMBASE, CINHAL, ASSIA, PsycINFO and Scopus were searched for original articles in English measuring the impact of health conditions on patients' family members/partner using a valid instrument. RESULTS Of 114 articles screened, 86 met the inclusion criteria. They explored the impact of a relative's disease on 14,661 family members, mostly 'parents' or 'mothers', using 50 different instruments across 18 specialities including neurology, oncology and dermatology, in 33 countries including the USA, China and Australia. These studies revealed a huge impact of patients' illness on family members. An appraisal of family QoL instruments identified 48 instruments, 42 disease/speciality specific and six generic measures. Five of the six generics are aimed at carers of children, people with disability or restricted to chronic disease. The only generic instrument that measures the impact of any condition on family members across all specialities is the Family Reported Outcome Measure (FROM-16). Although most instruments demonstrated good reliability and validity, only 11 reported responsiveness and only one reported the minimal clinically important difference. CONCLUSIONS Family members' QoL is greatly impacted by a relative's condition. To support family members, there is a need for a generic tool that offers flexibility and brevity for use in clinical settings across all areas of medicine. FROM-16 could be the tool of choice, provided its robustness is demonstrated with further validation of its psychometric properties.
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Affiliation(s)
- R. Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F. M. Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A. Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M. S. Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Fortuna-Reyna BDJ, Peláez-Ballestas I, García-Rodríguez F, Faugier-Fuentes E, Mendieta-Zerón S, Villarreal-Treviño AV, Rosiles-De la Garza SG, Reyes-Cordero G, Jiménez-Hernández S, Guadarrama-Orozco JH, de la O-Cavazos ME, Rubio-Pérez N. Psychosocial and economic impact of rheumatic diseases on caregivers of Mexican children. Pediatr Rheumatol Online J 2021; 19:30. [PMID: 33731150 PMCID: PMC7967951 DOI: 10.1186/s12969-021-00524-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 03/04/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pediatric rheumatic disease (PRD) patients and their caregivers face a number of challenges, including the consequences of the PRD in patients and the impact on multiple dimensions of the caregivers' daily lives. The objective of this study is to measure the economic, psychological and social impact that PRD has on the caregivers of Mexican children. METHODS This is a multicenter, cross-sectional study including primary caregivers of children and adolescents with PRD (JIA, JDM and JSLE) during April and November, 2019. A trained interviewer conducted the CAREGIVERS questionnaire, a specific, 28-item multidimensional tool validated to measure the impact on different dimensions of the lives of caregivers. Sociodemographic, clinical, and healthcare system data were collected for further analysis. RESULTS Two hundred participants were recruited (women 169, 84.5%, aged 38 [IQR 33-44] years); 109 (54.5%) cared for patients with JIA, 28 (14%) JDM and 63 (31.5%) JSLE. The healthcare system was found to be determinant on the impact of the disease. The emotional impact was higher in all the participants, regardless of the specific diagnoses. The social dimension showed significant differences regarding PRD, healthcare system, time to reach the center, presence of disability, active disease, cutaneous and systemic manifestations, treatment and partner. Financial and work impacts were more frequent in those caring for JSLE and less so in those with a partner. Family relationships changed in 81 caregivers (25 [12.5%] worsened and 56 [28%] improved). No variables affecting spirituality were found. For caregivers without a partner, the social networks impact increased. CONCLUSION The influence of sociodemographic factors can be devastating on families with children with a PRD. These data will help physicians to identify the areas with the greatest need for intervention to achieve comprehensive care for caregivers and their patients.
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Affiliation(s)
- Brenda de Jesús Fortuna-Reyna
- grid.464574.00000 0004 1760 058XDepartment of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460 Monterrey, Mexico
| | - Ingris Peláez-Ballestas
- grid.414716.10000 0001 2221 3638Rheumatology Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Fernando García-Rodríguez
- grid.464574.00000 0004 1760 058XDepartment of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460 Monterrey, Mexico
| | - Enrique Faugier-Fuentes
- grid.414757.40000 0004 0633 3412Hospital Infantil de México Federico Gómez, Servicio de Reumatología, Mexico City, Mexico
| | - Samara Mendieta-Zerón
- Instituto de Seguridad Social del Estado de México y Municipios, Hospital Regional Toluca, Toluca, Mexico
| | - Ana Victoria Villarreal-Treviño
- grid.464574.00000 0004 1760 058XDepartment of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460 Monterrey, Mexico
| | - Sara Georgina Rosiles-De la Garza
- grid.464574.00000 0004 1760 058XDepartment of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460 Monterrey, Mexico
| | - Greta Reyes-Cordero
- grid.440441.10000 0001 0695 3281Hospital Infantil de Especialidades del Estado de Chihuahua, Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Mexico
| | - Sol Jiménez-Hernández
- grid.464574.00000 0004 1760 058XDepartment of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460 Monterrey, Mexico
| | - Jessica Haydee Guadarrama-Orozco
- grid.414757.40000 0004 0633 3412Departamento de Cuidados Paliativos y Calidad de Vida, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Manuel Enrique de la O-Cavazos
- grid.464574.00000 0004 1760 058XDepartment of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460 Monterrey, Mexico
| | - Nadina Rubio-Pérez
- Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Madero y Gonzalitos SN, Col. Mitras Centro, C.P, 64460, Monterrey, Mexico.
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Cunningham N, Reid M, Fabricius J, Danguecan A, Ardalan K, Knight A. Anxiety and depression in childhood rheumatologic conditions: A topical review. INDIAN JOURNAL OF RHEUMATOLOGY 2021. [DOI: 10.4103/injr.injr_127_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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