1
|
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.
Collapse
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
| |
Collapse
|
2
|
Cortés-Martín J, Piqueras-Sola B, Sánchez-García JC, Reinoso-Cobo A, Ramos-Petersen L, Díaz-Rodríguez L, Rodríguez-Blanque R. Nursing Care Plan for Patients with Tay-Sachs-A Rare Paediatric Disease. J Pers Med 2023; 13:1222. [PMID: 37623472 PMCID: PMC10455330 DOI: 10.3390/jpm13081222] [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: 06/28/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Tay-Sachs disease is classified as a rare paediatric disease of metabolic origin. It is an autosomal recessive inherited disease. The gene responsible for the disease is known as HEXA, and it is located on chromosome 15(15q23). There is currently no effective treatment for Tay-Sachs disease; hence, it is an incurable disease in which patients do not live for more than five years, meaning that nursing care takes on greater importance to maintain quality of life. The main objective of this work is to develop a specific standard nursing care plan by applying an inductive research method supported by nursing methodology using the NANDA-NIC-NOC taxonomy and validated by the Delphi method. This care plan will improve the knowledge of health professionals on this topic and support future studies on the disease. Following its implementation, the care plan proposed in this study aims to increase the quality of life of patients diagnosed with this disease.
Collapse
Affiliation(s)
- Jonathan Cortés-Martín
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Nursing Department, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (L.D.-R.); (R.R.-B.)
| | | | - Juan Carlos Sánchez-García
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Nursing Department, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (L.D.-R.); (R.R.-B.)
| | - Andrés Reinoso-Cobo
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain; (A.R.-C.); (L.R.-P.)
| | - Laura Ramos-Petersen
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain; (A.R.-C.); (L.R.-P.)
| | - Lourdes Díaz-Rodríguez
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Nursing Department, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (L.D.-R.); (R.R.-B.)
| | - Raquel Rodríguez-Blanque
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Nursing Department, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (L.D.-R.); (R.R.-B.)
- Hospital-Universitariy Clínico San Cecilio, 18016 Granada, Spain
| |
Collapse
|
3
|
Cortés-Martín J, Sánchez-García JC, Rodríguez-Blanque R. Health Care on Rare Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:395. [PMID: 36612717 PMCID: PMC9819633 DOI: 10.3390/ijerph20010395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Rare diseases are a subject of great scientific and health interest that has been on the rise in recent years [...].
Collapse
Affiliation(s)
- Jonathan Cortés-Martín
- Andalusia Research Plan, Junta de Andalucía, Research Group CTS1068, School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
| | - Juan Carlos Sánchez-García
- Andalusia Research Plan, Junta de Andalucía, Research Group CTS1068, School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
| | - Raquel Rodríguez-Blanque
- Andalusia Research Plan, Junta de Andalucía, Research Group CTS1068, School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain
- Hospital Universitario Clínico San Cecilio, 18071 Granada, Spain
| |
Collapse
|
4
|
Vale AR, de Avó LRDS, Pilotto RF, Germano CMR, Melo DG. Quality of life of Brazilian families who have children with Rubinstein-Taybi syndrome: An exploratory cross-sectional study. Am J Med Genet A 2022; 188:3294-3305. [PMID: 35913016 DOI: 10.1002/ajmg.a.62914] [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: 01/28/2022] [Revised: 06/03/2022] [Accepted: 07/10/2022] [Indexed: 01/31/2023]
Abstract
This exploratory cross-sectional study aimed to examine the family quality of life (FQoL) among 51 Brazilian families who have children with Rubinstein-Taybi syndrome, a rare genetic disorder. Data were collected using sociodemographic and clinical data forms, as well as the Beach Center FQoL Scale, a 5-point Likert scale ranging from "very dissatisfied" (1) to "very satisfied" (5). The average score of the overall FQoL was 3.93 ± 0.64. Families' scores were higher for family interaction (4.17 ± 0.76), parenting (4.13 ± 0.61), and disability-related support (4.08 ± 0.76) domains, and lower for the family's emotional well-being (3.31 ± 0.96) and physical/material well-being (3.76 ± 0.82) domains. Family income, attendance at religious services, presence of ocular abnormalities, and aggressive behavior explained 46.2% of the variance in the overall FQoL. In summary, FQoL seems to be anchored in aspects such as family interaction and the care of parents, and be negatively affected by emotional issues, physical, and material limitations. In this context, psychological assistance should be provided to both parents and siblings whenever indicated, for improving emotional well-being and increasing family resilience. Additionally, investments in social policies, services, and human and material resources are needed to improve the physical and material conditions of families, promote better health care, and therefore reduce the family burden.
Collapse
Affiliation(s)
- Amanda Rodrigues Vale
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Lucimar Retto da Silva de Avó
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rui Fernando Pilotto
- Department of Genetics, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Carla Maria Ramos Germano
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| | - Débora Gusmão Melo
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
5
|
Doyle C. Mothers' experiences of giving medicines to children with severe and profound intellectual disabilities-The impact on time. Child Care Health Dev 2022; 48:558-568. [PMID: 35001409 PMCID: PMC9306770 DOI: 10.1111/cch.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 12/21/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic health conditions experienced by children with severe and profound intellectual disabilities are accompanied by numerous challenges because of the prolonged period over which children take medication and the large number of drugs they take. Mothers experience many challenges in giving medicines, from difficulties in physical administration to manipulation of medication, covert administration and alternative formulations. The aim of this study was to explore mothers' lived experience of giving medicines to children with severe and profound intellectual disabilities. METHODS A hermeneutic phenomenological approach was used. Semistructured face-to-face interviews and participant diaries were adopted for data collection, resulting in 28 interviews undertaken and 7 diaries completed with mothers of children with severe and profound intellectual disabilities. Van Manen's method for thematic analysis was used for data analysis. RESULTS The concept of time and the impact of giving medicines were apparent, mothers being 'always on call' and the constant full-time pace of their caring role evident. There was little spontaneity in their lives, dampened by the routine of giving medicines and their caregiving role. The necessity to be prepared and organized was highlighted as important in ensuring children got their medications on time and safely. CONCLUSIONS This study provides insight into the phenomenon of mothers' lived experience of giving medicines to children with severe and profound intellectual disabilities. It has enabled exploration and familiarity with the lifeworld of mothers and offers meaning on the phenomena of giving medicines. It was concluded that this experience is a relentless and challenging one, yet appears invisible as an element of care in professional discourse. Through addressing the gap in understanding and exploring the meaning of this phenomenon, it may be useful in developing care for mothers and children with severe and profound intellectual disabilities.
Collapse
Affiliation(s)
- Carmel Doyle
- School of Nursing & MidwiferyTrinity College DublinDublinIreland
| |
Collapse
|
6
|
Pélissier A, Wallut L, Giot G, Domenighetti L, Demougeot L, Faivre L. Access to social services for undiagnosed rare disease patients in France: A pilot study. Eur J Med Genet 2022; 65:104494. [DOI: 10.1016/j.ejmg.2022.104494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/29/2022]
|
7
|
Dunst CJ. Family Hardiness and Parent and Family Functioning in Households with Children Experiencing Adverse Life Conditions: a Meta-Analysis. Int J Psychol Res (Medellin) 2021; 14:93-118. [PMID: 35096359 PMCID: PMC8794328 DOI: 10.21500/20112084.5236] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/08/2021] [Accepted: 07/16/2021] [Indexed: 11/09/2022] Open
Abstract
Objective: The purposes of the meta-analysis were to evaluate the relationship between family hardiness and different dimensions of parent and family functioning in households experiencing adverse child or family life events and circumstances and determine if family hardiness had either or both stress-buffering and healthenhancing effects on parent and family functioning. Method: Studies were included if the correlations between family hardiness and different dimensions of parental or family functioning were reported. The synthesis included 53 studies (N = 4418 participants) conducted in nine countries between 1992 and 2017. Results: showed that family hardiness was related to less parental stress, anxiety/depression, and parenting burden/demands and positively related to parental global health, well-being, and parenting practices. Results also showed that family hardiness was negatively related to family stress and positively related to family life satisfaction, adaptation, and cohesion. The effects sizes between family hardiness and positive parent and family functioning indicators were larger than those for stress-buffering indicators. Child and family life events and child age moderated the relationship between family hardiness and family but not parental functioning. Conclusion: The results are consistent with the hypothesis that family hardiness is an internal resource that simultaneously has stress-buffering and health-enhancing effects on parent and family functioning.
Collapse
Affiliation(s)
- Carl J Dunst
- Orelena Hawks Puckett Institute, Asheville, North Carolina, USA. Orelena Hawks Puckett Institute USA
| |
Collapse
|
8
|
Moretti A, Cianci P, De Paoli A, Meroni F, Tajè S, Mariani M, Selicorni A. Burden of care in families of patients with rare genetic diseases: analysis of a large Italian cohort. Eur J Med Genet 2021; 64:104230. [PMID: 33910094 DOI: 10.1016/j.ejmg.2021.104230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/03/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022]
Abstract
In the last decade, the number of children and youth with special health care needs (CYSHCN) is increased as a result of the improvement of neonatal and pediatric assistance. The aim of our study was to describe the burden of care of the families caring a CYSHCN in our country, evaluating their living condition in order to explore socio-economic characteristics, health problems, needs and their adaptation processes trying to reach a balance between the needs of the disabled child and those of the other family members. We administered a questionnaire to the parents of CYSHCN during a routine clinical evaluation. From the analyses of questionnaires obtained, parents were the main caregiver of the children and 43,8% of them reported that they were not getting enough support. Burden of care fell on parents and indeed compilers reported an average level of stress of 3,2 (0-5) and more important, the main reported sources of stress were the concern about the future and health of their children. From the analyses of our population emerged unsatisfied needs of these families and their necessity to be effectively supported and integrated into the social fabric of the community. Social supporting is essential to help managing family stress and is evident the needed of these parents for interventions to directly target caregiver needs through the provision of tailored services, such as respite care opportunity, peer support, financial aid and medical home technologies to improve their quality of life.
Collapse
Affiliation(s)
- Alex Moretti
- Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Italy
| | - Paola Cianci
- Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy
| | - Anita De Paoli
- Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy
| | - Francesca Meroni
- Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy
| | - Silvia Tajè
- Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy
| | - Milena Mariani
- Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy
| | - Angelo Selicorni
- Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy.
| |
Collapse
|
9
|
Sánchez-García JC, Cortés-Martín J, Rodríguez-Blanque R, Marín-Jiménez AE, Montiel-Troya M, Díaz-Rodríguez L. Depression and Anxiety in Patients with Rare Diseases during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063234. [PMID: 33800980 PMCID: PMC8003983 DOI: 10.3390/ijerph18063234] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
Scientific knowledge on depression and anxiety in patients with rare diseases during the COVID-19 pandemic is scarce; however, it is essential to perform comprehensive management of these patients. The aim of this study was to research how the situation caused by the SARS-CoV-2 pandemic has influenced the lives of patients with rare diseases regarding depression and anxiety. This Spanish study considered a heterogeneous population sample of 86 patients with confirmed diagnosis of different rare diseases. Participants took part in a cross-sectional online study by completing specific questionnaires on the study topic. Depression was measured using the Patient Health Questionnaire (PHQ-9), and the General Anxiety Disorder Scale (GAD-7) was used for evaluating anxiety. Data collection through an online questionnaire allowed for a greater population scope and therefore the inclusion patients of other nationalities in the study sample. Finally, as a general result, this study found that, in the face of the pandemic, anxiety and depression remained at a higher level in this group than in the general population, making these patients a vulnerable population group.
Collapse
Affiliation(s)
- Juan Carlos Sánchez-García
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, JMADOC, School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Jonathan Cortés-Martín
- Research Group CTS 1068, Andalusia Research Plan, Junta de Andalucía, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | - Raquel Rodríguez-Blanque
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Distrito Sanitario Granada-Metropolitano, 18013 Granada, Spain
- Correspondence:
| | - Ana Eugenia Marín-Jiménez
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, Quantitative Methods for the Economics and Enterprise, Faculty of Economics and Business Sciences, University of Granada, 18071 Granada, Spain;
| | - Maria Montiel-Troya
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing Ceuta Campus, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain;
| | - Lourdes Díaz-Rodríguez
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| |
Collapse
|
10
|
|
11
|
Cheng D, Yuan S, Hu L, Yi D, Luo K, Gong F, Lu C, Lu G, Lin G, Tan YQ. The genetic cause of intellectual deficiency and/or congenital malformations in two parental reciprocal translocation carriers and implications for assisted reproduction. J Assist Reprod Genet 2020; 38:243-250. [PMID: 33094427 DOI: 10.1007/s10815-020-01986-1] [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: 08/27/2020] [Accepted: 10/15/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To elucidate the genetic cause of intellectual deficiency and/or congenital malformations in two parental reciprocal translocation carriers and provide appropriate strategies of assisted reproductive therapy (ART). MATERIALS AND METHODS Two similar couples having a child with global developmental delay/intellectual disability symptoms attended the Reproductive and Genetic Hospital of CITIC-Xiangya (Changsha, China) in 2017 and 2019, respectively, in order to determine the cause(s) of the conditions affecting their child and to seek ART to have a healthy baby. Both of the healthy couples were not of consanguineous marriage, denied exposure to toxicants, and had no adverse life history. This study was approved by the Institutional Ethics Committee of the Reproductive & Genetic Hospital of CITIC-Xiangya, and written informed consent was obtained from the parents. Genetic diagnoses were performed by karyotype analysis, breakpoint mapping analysis of chromosomal translocation(s), single-nucleotide polymorphism (SNP) microarray analysis, and whole-exome sequencing (WES) for the two children and different appropriate reproductive strategies were performed in the two families. RESULTS Karyotype analysis revealed that both patients carried parental reciprocal translocations [46,XY,t(7;16)(p13;q24)pat and 46,XY,t(13;17)(q12.3;p11.2)pat, respectively]. Follow-up breakpoint mapping analysis showed no interruption of associated genes, and SNP microarray analysis identified no significant copy number variations (CNVs) in the two patients. Moreover, WES results revealed that patients 1 and 2 harbored candidate compound heterozygous mutations of MCOLN1 [c.195G>C (p.K65N) and c.1061G>A (p.W354*)] and MCPH1 [c.877A>G (p.S293G) and c.1869_1870delAT (p.C624*)], respectively, that were inherited from their parents and not previously reported. Furthermore, the parents of patient 1 obtained 10 embryos during ART cycle, and an embryo of normal karyotype and non-carrier of observed MCOLN1 mutations according to preimplantation genetic testing for structural rearrangement and monogenic defect was successfully transferred, resulting in the birth of a healthy boy. The parents of patient 2 chose to undergo ART with donor sperm to reduce the risk of recurrence. CONCLUSIONS Systematic genetic diagnosis of two carriers of inherited chromosomal translocations accompanied by clinical phenotypes revealed their cause of disease, which was critical for genetic counseling and further ART for these families.
Collapse
Affiliation(s)
- Dehua Cheng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Shimin Yuan
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Liang Hu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Duo Yi
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Keli Luo
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Changfu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Guangxiu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Ge Lin
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China
- National Engineering and Research Center of Human Stem Cells, Changsha, 410013, China
| | - Yue-Qiu Tan
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, China.
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, 410013, Hunan, People's Republic of China.
- Institute of Reproduction and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, 410078, Hunan, China.
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Central South University, Changsha, 410008, China.
| |
Collapse
|
12
|
DE Stefano S, Grassi FS, Lalatta F, Scuvera G, Brena M, Grillo P, Peves Rios WE, Guez S. Family burden of children suffering from epidermolysis bullosa. Ital J Dermatol Venerol 2020; 156:580-587. [PMID: 33034432 DOI: 10.23736/s2784-8671.20.06613-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Living with a rare disease has profound effects on the patient's life and that of their entire family, with practical and psychosocial consequences. This is particularly true when the patient is a child. The principal aim of this study was to measure the family burden in Epidermolysis Bullosa (EB). The secondary endpoint was to evaluate the possible correlation between family burden and the severity of EB. METHODS A sample of 50 families with one or two children affected by EB were recruited between January 2016 and February 2017 to answer a 20-item questionnaire - the EB Burden of Disease (EB-BoD) - developed and validated to assess the family burden of children with EB. RESULTS The presence of a child with EB may have profound negative implications on several different areas of daily life. In particular, the results demonstrate important differences between the different subtypes of epidermolysis bullosa regarding most of the categories considered by the questionnaire. For three categories out of four (family life, child's life, economic and social impact), a higher score is observed for children with the more debilitating forms of EB: recessive dystrophic EB (RDEB) and junctional EB (JEB). CONCLUSIONS It is important to work with patients and their families to identify and strengthen adaptive and coping behaviors. That is possible only through the synergistic working of a multidisciplinary team made up of experienced doctors, psychologists, and social workers while in contact with patient Associations.
Collapse
Affiliation(s)
- Santa DE Stefano
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
| | | | - Faustina Lalatta
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulietta Scuvera
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Brena
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Grillo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Sophie Guez
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
13
|
Darla S, Bhat D. Health-related quality of life and coping strategies among families with Down syndrome children in South India. Med J Armed Forces India 2020; 77:187-193. [PMID: 33867636 DOI: 10.1016/j.mjafi.2020.07.010] [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: 04/28/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022] Open
Abstract
Background Down Syndrome (DS) is the most common chromosomal disorder associated with intellectual disability. Besides clinical management, additional support to cope with the demands of life is also necessary. These parents are frequently unstable and forego their Quality of Life (QoL), suffer additional economic difficulties, ill health and have lower well-being than families without disabilities. Hence, the study intends to evaluate the Health-Related QoL (HR-QoL) and coping strategies among families of DS children. Methods This explorative, cross-sectional study was conducted among parents/caregivers of DS children (n = 51). Socio-demographic details, HR-QoL, coping strategies and perspectives on having a child with disability were obtained through a standard questionnaire. Results Most DS children were upper and upper-middle class of urban background. The mean score of the QoL of the families was found to be 68.98%. The least and the most affected domains were cognitive functioning (71.67%) and worry (57.33%), respectively. Maximum coping was through the instrumental social support, active coping and religious coping. Though 27.45% were upset with the diagnosis, most had a "feeling of love" towards the child (72.55%). 50.98% had limited knowledge about DS and lacked organizational support (60.78%). Conclusion With increasing life expectancy, the gap continues concerning the assessment of needs beyond medical aid among DS children. Better HR-QoL and coping with the stress could be ensured by the provision of comprehensive health policies inclusive of training programs, stress management, as well as psychosocial and organizational support across any socio-economic strata.
Collapse
Affiliation(s)
- Shreyans Darla
- MBBS Phase III Part 2, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Deepa Bhat
- Associate Professor (Anatomy), JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| |
Collapse
|
14
|
Hong YD, Villalonga-Olives E, Perfetto EM. Patient-Reported Outcomes in Orphan Drug Labels Approved by the US Food and Drug Administration. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:925-930. [PMID: 31426934 DOI: 10.1016/j.jval.2019.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/20/2019] [Accepted: 03/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES In recent years, there has been increasing recognition of the need to assess treatment benefit from the patient's perspective. The extent of patient-reported outcome (PRO) data included in labeling for rare disease treatment is largely unknown. The objective of this study was to review trends over time for PRO-based labeling granted by the US Food and Drug Administration (FDA) for orphan drugs. STUDY DESIGN Review of FDA package inserts. METHODS Products included in this analysis were all new molecular entities (NMEs) and biologic license applications (BLAs) with orphan designations approved by the FDA from 2002 through 2017. For identified products, package inserts were reviewed to determine the number and type of PRO claim(s) granted, endpoint status, and PRO measure named. Two trends were analyzed: (1) over all years 2002 to 2017 and (2) 2002 to 2017 stratified into 3 periods (before draft FDA PRO guidance [2006], between draft and final guidance release, and after final guidance [2009] release. RESULTS A total of 156 NMEs and BLAs with orphan designations were approved between 2002 and 2017. Of these, 13 products (8.3%) had PRO-based labeling, and 7 of 13 were symptom-related. The percent of orphan drugs approved with PRO-based labeling between 2002 and 2005, 2006 and 2008, and 2009 and 2017 was 0, 10.5, and 9.9, respectively. CONCLUSIONS In FDA-approved labeling for orphan therapies, PRO measures used as primary and secondary endpoints increased after draft FDA PRO guidance release but remained relatively low thereafter. It is important to understand barriers to PRO measure use to ensure that treatments capture perspectives of patients with rare diseases.
Collapse
Affiliation(s)
- Yoon Duk Hong
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
| | - Ester Villalonga-Olives
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Eleanor M Perfetto
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA; National Health Council, Washington, DC, USA
| |
Collapse
|
15
|
Hong S, Wang L, Zhao D, Zhang Y, Chen Y, Tan J, Liang L, Zhu T. Clinical utility in infants with suspected monogenic conditions through next-generation sequencing. Mol Genet Genomic Med 2019; 7:e684. [PMID: 30968598 PMCID: PMC6565546 DOI: 10.1002/mgg3.684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/06/2019] [Accepted: 03/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background Rare diseases are complex disorders with huge variability in clinical manifestations. Decreasing cost of next‐generation sequencing (NGS) tests in recent years made it affordable. We witnessed the diagnostic yield and clinical use of different NGS strategies on a myriad of monogenic disorders in a pediatric setting. Methods Next‐generation sequencing tests are performed for 98 unrelated Chinese patients within their first year of life, who were admitted to Xin Hua Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, during a 2‐year period. Results Clinical indications for NGS tests included a range of medical concerns. The mean age was 4.4 ± 4.2 months of age for infants undergoing targeting specific (known) disease‐causing genes (TRS) analysis, and 4.4 ± 4.3 months of age for whole‐exome sequencing (WES) (p > 0.05). A molecular diagnosis is done in 72 infants (73.47%), which finds a relatively high yield with phenotypes of metabolism/homeostasis abnormality (HP: 0001939) (odds ratio, 1.83; 95% CI, 0.56–6.04; p = 0.32) and a significantly low yield with atypical symptoms (without a definite HPO term) (odds ratio, 0.08; 95% CI, 0.01–0.73; p = 0.03). TRS analysis provides molecular yields higher than WES (p = 0.01). Ninety‐eight different mutations are discovered in 72 patients. Twenty‐seven of them have not been reported previously. Nearly half (43.06%, 31/72) of the patients are found to carry 11 common disorders, mostly being inborn errors of metabolism (IEM) and neurogenetic disorders and all of them are observed through TRS analysis. Eight positive cases are identified through WES, and all of them are sporadic, of highly variable phenotypes and severity. There are 26 patients with negative findings in this study. Conclusion This study provides evidence that NGS can yield high success rates in a tertiary pediatric setting, but suggests that the scope of known Mendelian conditions may be considerably broader than currently recognized.
Collapse
Affiliation(s)
- Sha Hong
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wang
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongying Zhao
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yonghong Zhang
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Chen
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jintong Tan
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lili Liang
- Department of Endocrinology and Genetic Metabolism, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianwen Zhu
- Department of Neonatal Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
16
|
Granero-Molina J, Sánchez-Hernández F, Fernández-Sola C, Jiménez-Lasserrotte MDM, Antequera-Raynal LH, Hernández-Padilla JM. The Diagnosis of Hereditary Angioedema: Family Caregivers' Experiences. Clin Nurs Res 2018; 29:117-126. [PMID: 29862835 DOI: 10.1177/1054773818780102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to understand the experiences of family caregivers in the process of diagnosing hereditary angioedema. An interpretive and qualitative research methodology based on Gadamer's philosophical hermeneutics was carried out. Data collection took place between May 2015 and August 2016 and included a focus group and in-depth interviews with 16 family caregivers. Two themes define the experiences of family caregivers: "Family life focuses on identifying the problem" and "Discovering and coping with a complex diagnosis." The process of diagnosis generates fear, anxiety, uncertainty, and incomprehension. Family caregivers are the main support for patients diagnosed with hereditary angioedema. As they share in the patients' suffering, they need a diagnosis to be established to be able to cope with the disease and offer support. Family health nurses can contribute to improving the coping process in this phase of the disease.
Collapse
|
17
|
Slade A, Isa F, Kyte D, Pankhurst T, Kerecuk L, Ferguson J, Lipkin G, Calvert M. Patient reported outcome measures in rare diseases: a narrative review. Orphanet J Rare Dis 2018; 13:61. [PMID: 29688860 PMCID: PMC5914068 DOI: 10.1186/s13023-018-0810-x] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/16/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Rare diseases can lead to a significant reduction in quality of life for patients and their families. Ensuring the patients voice is central to clinical decision making is key to delivering, evaluating and understanding the efficacy of therapeutic interventions. Patient reported outcome measures (PROMs) are used to capture the patient's views about their health status and facilitate our understanding of the impact of these diseases and their treatments on patient's quality of life and symptoms. MAIN TEXT This review explores some of the current issues around the utilisation of PROMs in rare diseases, including small patient populations and dearth of valid PROMs. Difficulties in validating new or current PROMs for use in clinical trials and research are discussed. The review highlights potential solutions for some of the issues outlined in the review and the implementation of PROMs in research and clinical practice are discussed. CONCLUSION Patient input throughout the development of PROMs including qualitative research is essential to ensure that outcomes that matter to people living with rare disease are appropriately captured. Given the large number of rare diseases, small numbers of patients living with each condition and the cost of instrument development, creative and pragmatic solutions to PROM development and use may be necessary. Solutions include qualitative interviews, modern psychometrics and resources such as item banking and computer adaptive testing. Use of PROMs in rare disease research and clinical practice offers the potential to improve patient care and clinical outcomes.
Collapse
Affiliation(s)
- Anita Slade
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK.
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
- Birmingham Health Partners, Birmingham, UK.
| | | | - Derek Kyte
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tanya Pankhurst
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- University Hospital Birmingham, Birmingham, UK
| | - Larissa Kerecuk
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- Birmingham Childrens and Womens Hospital, Birmingham NHS Foundation Trust, Birmingham, UK
| | - James Ferguson
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- University Hospital Birmingham, Birmingham, UK
| | - Graham Lipkin
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- University Hospital Birmingham, Birmingham, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcome Research, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|