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Wu C, Chu X, Tang K, Cheng D, Ren L. Caregiving experiences of caregivers of children with rare diseases: A qualitative meta-synthesis. J Pediatr Nurs 2024; 75:31-40. [PMID: 38101309 DOI: 10.1016/j.pedn.2023.12.003] [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: 07/06/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
PROBLEM Most rare diseases occur in childhood and are difficult to diagnose and treat. The caregivers are faced with the challenge of providing care to the children afflicted with these rare diseases, resulting in a significant burden of care and an altered family dynamic. ELIGIBILITY CRITERIA A meta-synthesis review was conducted to explore the caregivers' experience of children with rare diseases using eight electronic databases PubMed, Web of Science, the Cochrane Library, EMBASE, VIP database, Wan Fang, Chinese BioMedical Literature Database, and China National Knowledge Infrastructure from each database's inception to October 5, 2023. SAMPLE 4207 records were identified and 20 eligible studies were included. RESULTS Three themes emerged: (1) Life is changed by "rare"; (2) many unmet needs; (3) Strive to adapt and grow. CONCLUSIONS Caregivers of children with rare diseases are full of stress and challenges in the process of caring for them, and their lives have changed greatly due to "rare". Appropriate measures need to be taken to reduce the burden on caregivers. IMPLICATIONS According to the findings, both the medical and health systems, as well as society, should pay attention to the care load and unmet requirements of carers of children with rare diseases, and offer them with practical supportive services. Finally, it can improve the quality of life for caregivers and families of children with rare diseases, as well as stimulate the development of rare diseases.
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Affiliation(s)
- Chenxi Wu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Chu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Kexin Tang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongmei Cheng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liangjuan Ren
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Freda MF, Scandurra C, Auriemma E, Guarino A, Lemmo D, Martino ML, Nunziata F, Maldonato NM, Continisio GI. Long-COVID in children: An exploratory case-control study from a bio-psycho-social perspective. J Psychosom Res 2024; 176:111564. [PMID: 38100898 DOI: 10.1016/j.jpsychores.2023.111564] [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: 06/01/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE This study aimed to determine psychosocial differences between children with Long-COVID Syndrome (LCS) and two control groups (i.e., children who did not have COVID-19 and children who had previously had COVID-19 but did not develop LCS) from a bio-psycho-social and psychosomatic perspective. To classify children in these three groups, we examined the percentage of children meeting criteria for LCS, the type, frequency, perceived severity of symptoms, and their prevalence compared with children who never had SARS-CoV-2 infection. METHODS Data were collected from 198 Italian mothers of children aged 4 to 13 years using a cross-sectional web-based case-control survey. Of these, 105 were mothers of children who had contracted SARS-CoV-2 and 94 were mothers of children who had previously had COVID-19. Information was collected on the type and frequency of symptoms commonly referred to as "Long-COVID symptoms" and psychosocial dimensions (i.e., maternal and child health anxiety, COVID-19 anxiety, adjustment, and child deprivation). Descriptive analyses, chi-square tests, Student's T-Test, and analyses of variance were performed. RESULTS 29 children (15% of the total sample) developed LCS, mostly in the neurological/neuropsychiatric domain (59%), and of mild intensity. Regarding psychosocial and psychological dimensions, maternal health anxiety, child deprivation, and fear of SARS-CoV-2 infection differed between groups, with the first two dimensions higher in children with LCS than in controls and the latter lower in children with LCS than in controls. CONCLUSION This study sheds light on the need of integrating a psychosocial approach into the medical care of children with LCS and their caregivers.
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Affiliation(s)
- Maria Francesca Freda
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Cristiano Scandurra
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Ersilia Auriemma
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy.
| | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Maria Luisa Martino
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Francesco Nunziata
- Department of Translational Medical Sciences, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy.
| | - Grazia Isabella Continisio
- Department of Translational Medical Sciences, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy.
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Hakim Zada F, Ahmad Azahari AHS, Wong SW, Ali A, Ismail NAS. Understanding Challenges of Genetic Testing on Neuromuscular Disorders from the Parental Lens. J Pers Med 2023; 13:1652. [PMID: 38138879 PMCID: PMC10744978 DOI: 10.3390/jpm13121652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/14/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
Neuromuscular disorders, characterized by progressive muscle degeneration and weakness, present substantial challenges to both affected individuals and their families. Genetic testing assumes a pivotal role in facilitating early diagnosis, intervention, treatment, and informed family planning for these conditions. The objective of this qualitative study is to delve into the knowledge, awareness, and perceptions surrounding genetic testing within the cohort of parents caring for individuals with neuromuscular disorders in Malaysia. A semi-structured interview approach was employed to elicit data from parents of individuals diagnosed with neuromuscular disorders, encompassing those with clinical diagnoses and those diagnosed through genetic testing. Examination of the interview responses yielded nine overarching themes, which furnish invaluable insights into the perspectives of Malaysian parents concerning genetic testing. The study discerned several challenges associated with genetic testing, notably encompassing the limited awareness among parents, the financial constraints associated with genetic testing, and the perceived significance of genetic testing in the context of neuromuscular disorders. The findings suggest that the level of knowledge and awareness pertaining to genetic testing for neuromuscular disorders among parents in Malaysia varies, with initial levels of awareness ranging from relatively low to reasonably sufficient prior to and following the birth of an affected child. However, the investigation revealed that parents tended to cultivate more favorable perceptions regarding genetic testing subsequent to their experience with genetic counseling. This underscores the potential for heightened awareness and comprehension as a consequence of the personal experience of parenting an affected child confirmed through genetic testing and genetic counseling, ultimately influencing parental awareness.
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Affiliation(s)
- Farheen Hakim Zada
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (F.H.Z.); (A.H.S.A.A.); (S.W.W.); (A.A.)
| | - Ahmad Hazim Syakir Ahmad Azahari
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (F.H.Z.); (A.H.S.A.A.); (S.W.W.); (A.A.)
| | - Sau Wei Wong
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (F.H.Z.); (A.H.S.A.A.); (S.W.W.); (A.A.)
| | - Adli Ali
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (F.H.Z.); (A.H.S.A.A.); (S.W.W.); (A.A.)
- Research Centre, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia
| | - Noor Akmal Shareela Ismail
- Research Centre, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia
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Aim M, Rousseau M, Hamouda I, Anzola AB, de Villemeur TB, Milh M, Maincent K, Lind K, Auquier P, Baumstarck K, Dany L. Parents' experiences of parenting a child with profound intellectual and multiple disabilities in France: A qualitative study. Health Expect 2023; 27:e13910. [PMID: 37932892 PMCID: PMC10757136 DOI: 10.1111/hex.13910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023] Open
Abstract
INTRODUCTION Parents of persons with profound intellectual and multiple disabilities (PIMD) play a major and often lifelong role in the care and support of their child. A better understanding of parents' perspectives regarding their experiences of parenting their child with PIMD is essential to support them more effectively. Although this topic has been explored extensively in Anglo-Saxon and Northern European countries, little is known about the experience of these parents in a highly institutionalized context such as that in France. OBJECTIVE We explored parents' experiences of the activities they performed to care for their child with PIMD (namely, the 'parenting work') in the French context. METHOD Qualitative semistructured interviews were conducted by telephone with 34 parents of persons with PIMD aged 8-35. The resulting data were analyzed using thematic analysis. RESULTS The analysis highlighted the diversity of activities performed by parents as well as the influence of context on the forms of this parenting work. Five themes were developed: (1) navigating the challenges of obtaining medical recognition; (2) negotiating a concealed domain and becoming an expert; (3) unfolding medical and medicosocial care management; (4) navigating the challenges of daily living and (5) shaping one's child's possibilities. CONCLUSION This study offers a better understanding of the challenges, levers and expectations of parents of children with PIMD in France. Contextual factors such as the lack of knowledge of PIMD among health professionals, access to knowledge and know-how associated with care management, the administrative complexity of access to care and equipment, institutional issues (e.g., professional turnover) and societal ableism (e.g., access to infrastructures, interpersonal discrimination) shape the work parents perform to support their child's needs. It is necessary to consider contextual aspects to better support these parents and their children. Suggestions for applications are provided in the discussion. PATIENT OR PUBLIC CONTRIBUTION One of the researchers, a parent of a child with PIMD, supported the research design and provided feedback on the study's procedures and manuscript.
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Affiliation(s)
- Marie‐Anastasie Aim
- LPS, Social Psychology LaboratoryAix‐Marseille UniversityAix‐en‐ProvenceFrance
- Department of Epidemiology and Health EconomicsAP‐HMMarseilleFrance
| | - Marie‐Christine Rousseau
- CEReSS, Research Centre on Health Services and Quality of LifeAix‐Marseille UniversityMarseilleFrance
- Polyhandicap FederationSan Salvadour APHP HospitalHyèresFrance
| | - Ilyes Hamouda
- CEReSS, Research Centre on Health Services and Quality of LifeAix‐Marseille UniversityMarseilleFrance
- Methodological Support Unit for Clinical, Epidemiological and Economic ResearchAP‐HMMarseilleFrance
| | - Any Beltran Anzola
- Department of Epidemiology and Health EconomicsAP‐HMMarseilleFrance
- CEReSS, Research Centre on Health Services and Quality of LifeAix‐Marseille UniversityMarseilleFrance
| | | | - Mathieu Milh
- Department of Pediatric NeurologyAP‐HM, TimoneMarseilleFrance
| | - Kim Maincent
- Committee for StudiesEducation and Care for People with Polyhandicap (CESAP)ParisFrance
| | - Katia Lind
- Alice Blum‐Ribes Pediatric SpaceEstablishment of the Unions for the Management of Health Insurance Fund Establishments (UGECAM) Ile de France GroupMontreuilFrance
| | - Pascal Auquier
- CEReSS, Research Centre on Health Services and Quality of LifeAix‐Marseille UniversityMarseilleFrance
| | - Karine Baumstarck
- CEReSS, Research Centre on Health Services and Quality of LifeAix‐Marseille UniversityMarseilleFrance
- Methodological Support Unit for Clinical, Epidemiological and Economic ResearchAP‐HMMarseilleFrance
| | - Lionel Dany
- LPS, Social Psychology LaboratoryAix‐Marseille UniversityAix‐en‐ProvenceFrance
- Department of Medical OncologyAP‐HM, TimoneMarseilleFrance
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Yagi N, Toda A, Mitani K, Kotobuki Y, Ogawa W. A Qualitative Research Study of Experiences and Perceptions of People Living with Insulin Resistance Syndrome or Lipoatrophic Diabetes in Japan. Diabetes Ther 2023:10.1007/s13300-023-01412-6. [PMID: 37289357 PMCID: PMC10299960 DOI: 10.1007/s13300-023-01412-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/17/2023] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION There are few reports on the experiences and perceptions of people living with the rare diseases of insulin resistance syndrome or lipodystrophy. This study was designed to identify treatment experiences and perceptions of disease-related burdens among affected people, as well as their needs and priorities. We discussed how to meet identified needs and expectations, in addition to the types of therapeutic drugs and support required. METHODS Qualitative data regarding participants' experiences and perceptions of the diseases were collected through individual interviews, advisory board meetings, and individual follow-up activities. Verbatim transcripts from recorded participants' statements were qualitatively analysed. RESULTS Four women aged 30-41 years participated in the study, two with insulin resistance syndrome and two with lipoatrophic diabetes. The diseases not only took a heavy physical toll on these women, but they and their families were also affected psychologically, with some experiencing stigmatisation. There was a lack of information for participants about their disease and little public awareness of the disease. The needs identified include initiatives to promote an accurate understanding of these diseases, information booklets, consultation service for those affected by the diseases, less burdensome treatment options, and opportunities for peer communication. CONCLUSION People living with insulin resistance syndrome or lipoatrophic diabetes have significant physical/psychological burdens and unmet needs. The following are highly desirable to alleviate the burdens: promoting proper understanding of the diseases; establishing a framework for dissemination of disease and treatment information to those living with the diseases; development of therapeutic drugs for these diseases; educational materials that raise public awareness; and opportunities for peer communication. TRIAL REGISTRATION UMIN Clinical Trials Registry (UMIN000043693). A Japanese translation is available for this article.
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Affiliation(s)
- Nobutaka Yagi
- Patient Engagement, Nippon Boehringer Ingelheim Co., Ltd., 2-1-1 Osaki, Shinagawa-ku, Tokyo, 141-6017, Japan.
| | | | - Kimiko Mitani
- Medicine Division, Nippon Boehringer Ingelheim Co., Ltd., Tokyo, 141-6017, Japan
| | - Yutaro Kotobuki
- Medicine Division, Nippon Boehringer Ingelheim Co., Ltd., Tokyo, 141-6017, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan
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Pediatric acute liver failure in Saudi Arabia: prognostic indicators, outcomes and the role of genetic testing. Eur J Gastroenterol Hepatol 2023; 35:420-430. [PMID: 36574286 DOI: 10.1097/meg.0000000000002499] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE The objective of this study was to determine the etiologies, outcomes, prognostic indicators and the role of genetic testing in children with acute liver failure (ALF). METHODS This retrospective study included 46 patients with pediatric acute liver failure (PALF) according to the PALF study group definition, admitted to King Fahad Specialist Hospital-Dammam, Saudi Arabia, between January 2014 and December 2021. Patients who survived with supportive therapy were designated as the recovery group, whereas those who died or underwent liver transplantation were designated as the death/transplant group. RESULTS There were 26 (56.5%) patients in the recovery group and 20 (43.5%) patients in the death/transplant group. Four patients (8.7%) underwent liver transplantation. After indeterminate causes (45.6%), genetic-metabolic diseases and drug-induced liver injury (DILI) were the most common cause with 15.2 and 13%, respectively. Genetic testing had a high yield of (6/31) in identifying monogenic disease associated with ALF. Younger age, lower Glasgow Coma Scale and higher international normalized ratio (INR) on admission were predictors for poor prognosis. The death/transplant group had longer intensive care unit stay ( P < 0.001), and on admission they had more advanced hepatic encephalopathy ( P < 0.005), more prolonged prothrombin time ( P < 0.001), higher lactate ( P < 0.006), higher total and direct bilirubin ( P < 0.008) and ( P < 0.001), respectively. CONCLUSION Genetic, metabolic and DILI causes constituted the most common cause of PALF after indeterminate causes. The use of genetic testing can improve diagnostic rates in special cases, but we could not assess the effect of genetic testing on prognosis. The overall survival rate in our study was 65.2%. Younger age, higher admission INR and lower Glasgow coma scale were indicators of poor prognosis.
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Milde N, Rasmussen A, Nissen K, Kessel L. Support needs around the time of diagnosis of parents caring for an infant with visual impairment or blindness in Denmark: a qualitative study. BMJ Open 2023; 13:e067805. [PMID: 36810175 PMCID: PMC9945031 DOI: 10.1136/bmjopen-2022-067805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE The whole family is affected when an infant is diagnosed with visual impairment or blindness. We aimed to describe the support needs of parents around the time of diagnosis. DESIGN We used a descriptive qualitative method based on the theory of critical psychology and conducted five semistructured interviews with a total of eight parents of children under the age of 2 years who had been diagnosed with blindness or visual impairment before the age of 1 year. Thematic analysis was used to extract primary themes. SETTING The study was initiated by a tertiary hospital centre specialised in the ophthalmic management of children and adults with visual impairment. PARTICIPANTS Eight parents representing five families caring for a child under the age of 2 years with visual impairment or blindness participated in the study. The parents were recruited from the Department of Ophthalmology at Rigshospitalet, Denmark in relation to appointments in the clinic or by phone or email. RESULTS We identified three themes: (1) recognition and reactions during the time of diagnosis; (2) family, network and struggles; and (3) interaction with healthcare professionals. CONCLUSION The main lesson for healthcare professionals is to bring hope at a time when all hope may seem to be lost. Second, a need to direct attention to families with no or sparse supportive networks. Third, coordinating appointments between hospital departments and at-home therapies and reducing the number of appointments to allow parents time to establish a family relation with their child. Parents respond well to competent healthcare professionals who keep them informed and who see their child as an individual rather than as a diagnosis.
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Affiliation(s)
- Nina Milde
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Annette Rasmussen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Kamilla Nissen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet - KennedyCenter, Glostrup, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Du N, Wu Y, Xiong S, Ji H, Huang L, Guo W, Zeng C. Current situation and influencing factors of disease uncertainty in parents of children with Sturge‒Weber syndrome: a retrospective study. BMC Pediatr 2023; 23:64. [PMID: 36750798 PMCID: PMC9903547 DOI: 10.1186/s12887-023-03857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Sturge Weber syndrome (SWS), can cause extensive capillary malformations on the face, head, trunk, and other parts of the body, and the eyes can also suffer optic nerve injury. Secondary glaucoma can cause blindness, which has the characteristics of a relatively hidden onset and unclear pathogenesis. The treatment of SWS secondary glaucoma has always been difficult, and due to the characteristics of the disease, there is uncertainty about the long-term efficacy and safety of various treatment methods for such patients. METHODS A total of 105 parents of children with SWS completed a self-designed general information questionnaire, a generalized anxiety questionnaire (GAD-7), a patient health questionnaire (PHQ-2), a stress perception scale (PSS-4), a simple coping scale (SCSQ) and a disease-uncertainty scale (PPUS). RESULTS The total uncertainty score of parents of children with SWS was 79.07 ± 13.24, and the average item score was 2.82 ± 0.47. Multiple linear regression analysis revealed that anxiety and simple coping were the main influencing factors of disease uncertainty among parents of children with SWS (P < 0.05). CONCLUSIONS Parents of children with SWS exhibit a high level of disease uncertainty. Medical staff should pay attention to the source of parents' disease uncertainty and provide targeted interventions, which are of great importance in reducing parents' disease uncertainty.
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Affiliation(s)
- Na Du
- Department of Nursing, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
| | - Yue Wu
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
| | - Shanshan Xiong
- Department of Nursing, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
| | - Hong Ji
- Department of Nursing, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
| | - Lulu Huang
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
| | - Wenyi Guo
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
| | - Changjuan Zeng
- Department of Nursing, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011 China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011 China
- Shanghai JiaoTong University School of Nursing, Shanghai, 200025 China
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Hatirnaz Ng O, Sahin I, Erbilgin Y, Ozdemir O, Yucesan E, Erturk N, Yemenici M, Akgun Dogan O, Ugur Iseri SA, Satman I, Alanay Y, Ozbek U. Obstacles and expectations of rare disease patients and their families in Türkiye: ISTisNA project survey results. Front Public Health 2023; 10:1049349. [PMID: 36684907 PMCID: PMC9846031 DOI: 10.3389/fpubh.2022.1049349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023] Open
Abstract
Rare disease patients constitute a significant part of the healthcare system of all countries. However, the information on the experiences during disease processes and daily life of rare disease patients is still limited. So far, there is a small number of studies conducted in Türkiye, and they mainly cover specific issues like education or anxiety. Here we present a comprehensive survey analysis conducted among the patients and their families within the scope of the Istanbul Solution Platform for Undiagnosed and Rare Diseases-ISTisNA project. A total of 498 individuals responded to the survey, and 58% of the participants answered all questions. The majority of the patients were in the age range of 1-10 years (44.7%), and 91% of all the patients had a precise diagnosis. The diagnosis rate in the first 6 months was 69%, and almost 10% of the patients remained undiagnosed. The mothers were the primary caregivers (72%). Nearly 30% of the caregivers had to quit their jobs and 25% of the patients (0-18 years) had to leave school. Accessing physicians with relevant specialization and reaching treatments/medications/supplements were the two main obstacles the participants mentioned, with a frequency of 81% and 73%, respectively. Around 50% of participants noted that they commonly faced difficulties at work/school and in their social lives. The highest expectation or priority was the establishment of rare disease-specific diagnosis and treatment centers, accurate and detailed information on diseases in the Turkish language, and easy access to physicians, treatments, and supportive therapies. To the best of our knowledge, this is the most comprehensive survey conducted on the rare disease community in Türkiye. These results show that regardless of the country, the individuals affected by rare diseases and their families have similar problems and expectations. On the other hand, regional and country-specific issues are still in the line to be solved. These studies can provide a deeper insight into rare diseases and guide the activities of Türkiye's national rare disease action plan.
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Affiliation(s)
- Ozden Hatirnaz Ng
- Department of Medical Biology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
- Acibadem Mehmet Ali Aydinlar University Rare Diseases and Orphan Drugs Application and Research Center (ACURARE), Istanbul, Türkiye
- Department of Medical Genetics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
| | - Ilayda Sahin
- Department of Medical Biotechnology, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye
| | - Yucel Erbilgin
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Türkiye
| | - Ozkan Ozdemir
- Acibadem Mehmet Ali Aydinlar University Rare Diseases and Orphan Drugs Application and Research Center (ACURARE), Istanbul, Türkiye
- Department of Genome Studies, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye
| | - Emrah Yucesan
- Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Nazli Erturk
- Turkish Public Health and Chronic Disease Institute, Health Institutes of Türkiye, Istanbul, Türkiye
| | - Merve Yemenici
- Turkish Public Health and Chronic Disease Institute, Health Institutes of Türkiye, Istanbul, Türkiye
| | - Ozlem Akgun Dogan
- Department of Medical Genetics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
- Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
| | - Sibel Aylin Ugur Iseri
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Türkiye
| | - Ilhan Satman
- Turkish Public Health and Chronic Disease Institute, Health Institutes of Türkiye, Istanbul, Türkiye
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Yasemin Alanay
- Acibadem Mehmet Ali Aydinlar University Rare Diseases and Orphan Drugs Application and Research Center (ACURARE), Istanbul, Türkiye
- Department of Medical Genetics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
- Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
| | - Ugur Ozbek
- Acibadem Mehmet Ali Aydinlar University Rare Diseases and Orphan Drugs Application and Research Center (ACURARE), Istanbul, Türkiye
- Department of Medical Genetics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Türkiye
- Department of Genome Studies, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye
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10
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Participant experiences of genome sequencing for rare diseases in the 100,000 Genomes Project: a mixed methods study. Eur J Hum Genet 2022; 30:604-610. [PMID: 35264738 PMCID: PMC9091267 DOI: 10.1038/s41431-022-01065-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 01/30/2023] Open
Abstract
In this mixed methods study, a survey and in-depth interviews were used to explore whether decision regret and the psychological impact of receiving genome sequencing (GS) results differed between parents and patients, and between those who received a genetic diagnosis and those who did not. Participants (n = 77) completed a survey that included the Decisional Regret Scale (DRS) and an adaptation of the Multidimensional Impact of Cancer Risk Assessment (MICRA) at least 12 months after consenting for GS for rare disease diagnosis in the 100,000 Genomes Project. Survey participants were invited to take part in an interview and 39 agreed; 12 with a diagnosis, 5 with variants of uncertain significance, and 19 with no pathogenic findings identified. Both survey and interview findings indicated that decision regret was low. DRS scores revealed no differences in levels of regret between parents and patients, or between those with a diagnosis and those without. Though MICRA scores indicated minimal evidence of negative psychological impacts of receiving GS results, subscale analysis revealed greater distress and uncertainty for parents compared to patients. Receiving a diagnosis was found not to influence MICRA scores, supporting interview findings of both positive and negative emotional and psychological impacts irrespective of a genetic diagnosis. Our findings have implications for policy and practice as GS is integrated into the UK and worldwide; notably, that expectation-setting is critical when offering GS, and that post-test counselling is important regardless of the GS result received, with parents perhaps needing additional emotional support.
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11
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Holzinger D, Hofer J, Dall M, Fellinger J. Multidimensional Family-Centred Early Intervention in Children with Hearing Loss: A Conceptual Model. J Clin Med 2022; 11:jcm11061548. [PMID: 35329873 PMCID: PMC8949393 DOI: 10.3390/jcm11061548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
At least two per thousand newborns are affected by hearing loss, with up to 40% with an additional disability. Early identification by universal newborn hearing screening and early intervention services are available in many countries around the world, with limited data on their effectiveness and a lack of knowledge about specific intervention-related determinants of child and family outcomes. This concept paper aimed to better understand the mechanisms by which multi-dimensional family-centred early intervention influences child outcomes, through parent behaviour, targeted by intervention by a review of the literature, primarily in the field of childhood hearing loss, supplemented by research findings on physiological and atypical child development. We present a conceptual model of influences of multi-disciplinary family-centred early intervention on family coping/functioning and parent–child interaction, with effects on child psycho-social and cognitive outcomes. Social communication and language skills are postulated as mediators between parent–child interaction and non-verbal child outcomes. Multi-disciplinary networks of professionals trained in family-centred practice and the evaluation of existing services, with respect to best practice guidelines for family-centred early intervention, are recommended. There is a need for longitudinal epidemiological studies, including specific intervention measures, family behaviours and multidimensional child outcomes.
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Affiliation(s)
- Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Institute of Linguistics, University of Graz, 8010 Graz, Austria
- Correspondence: or
| | - Johannes Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Department of Paediatrics I, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Magdalena Dall
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
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