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Dave S, Kim SC, Beaver S, Hasimoglu YG, Katz I, Luedke H, Yandulskaya AS, Sharma N. Peer support in adolescents and young adults with chronic or rare conditions in northern America and Europe: Targeted literature review. J Pediatr Nurs 2024:S0882-5963(24)00221-5. [PMID: 38964964 DOI: 10.1016/j.pedn.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 07/06/2024]
Abstract
PROBLEM Adolescents and young adults with chronic or rare conditions face unique risks to their physical, social and emotional development. Research suggests that peer support improves their quality of life and reduces social isolation. However, there is a paucity of current information considering multiple intervention formats. ELIGIBILITY CRITERIA A targeted literature review was conducted to identify peer support interventions and assess their feasibility, acceptability and efficacy for this population. Searches were conducted in MEDLINE, Embase and American Psychological Association PsycINFO for records reporting peer support interventions in young adults with chronic or rare conditions. Data were extracted from relevant publications and qualitatively evaluated. SAMPLE Thirty studies were included, which assessed the use of peer support for young adults (aged 13-30 years) with chronic or rare conditions in Europe or North America. RESULTS Peer support interventions had positive effects on social positivity, psychosocial development and medical outcomes, though significance was not always demonstrated. CONCLUSIONS Peer support can enhance care for young adults with chronic or rare conditions. Current literature suggests that once-weekly virtual interventions are the most feasible and acceptable for patients, leading to multifaceted improvements in their well-being. IMPLICATIONS This study is one of the first to discuss in-person, virtual and hybrid peer-based interventions for young adults with chronic and rare conditions. While all formats improved social, psychological and medical outcomes, virtual formats may be most accessible to participants. Interventions should be made available to this population, and guidelines for optimal implementation of peer support are needed.
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Affiliation(s)
| | - Sandra C Kim
- Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Children's Hospital, 8950 Euclid Ave R3, Cleveland, OH 44195, United States
| | - Steph Beaver
- Costello Medical (UK), 55 Old Broad Street, London EC2M 1RX, United Kingdom
| | - Yasemin G Hasimoglu
- Costello Medical (US), 175 Federal St Floor 16, Boston, MA 02110, United States
| | - Isabel Katz
- Costello Medical (US), 175 Federal St Floor 16, Boston, MA 02110, United States
| | - Hannah Luedke
- Costello Medical (UK), 55 Old Broad Street, London EC2M 1RX, United Kingdom
| | | | - Niraj Sharma
- Department of Internal Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States; Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States
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Poku BA, Atkin KM, Kirk S. Self-management interventions for children and young people with sickle cell disease: A systematic review. Health Expect 2023; 26:579-612. [PMID: 36597596 PMCID: PMC10010100 DOI: 10.1111/hex.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Increasing numbers of interventions are being developed to support self-management for children and young people (CYP) with sickle cell disease (SCD), but no systematic review has systematically synthesized this evidence regarding their characteristics, effectiveness, acceptability and feasibility for all published intervention types. METHODS The Joanna Briggs Institute guidelines for mixed-method reviews were followed. A systematic search of eight databases and key journals was conducted from their inception to November 2021. Primary research of self-management interventions targeting CYP with SCD aged 8-24 years and reporting any health/social outcome and acceptability data were included. Design-specific standardized critical appraisal instruments were used. Two independent reviewers screened and appraised the articles. A third reviewer resolved disagreements. RESULTS Of 1654 articles identified, 38 studies were included. Methodological quality was moderate. Most studies evaluated SCD education, psycho-behavioural, psychosocial and skills training and/or social support interventions. They appear to demonstrate short-term improvements in knowledge, social functioning and medical adherence outcomes. Interventions that were multifaceted in content, combined technological platforms and in-person group-based formats and involved peers, family and care providers were more acceptable and effective. The long-term impact of interventions was limited, including CYP's involvement in the intervention development and implementation. CONCLUSIONS There is inconclusive evidence for any self-management programme. Nonetheless, support from family, peers and care providers appears to be important for self-management interventions' effectiveness and acceptability. Future research needs to prioritize CYP involvement in both intervention design and delivery, their wider social context and include CYP with SCD from non-Black backgrounds. PATIENT AND PUBLIC CONTRIBUTION Three young people with SCD recruited acted as the review advisors. They were formally trained in the review process and involved in every aspect of the review: the design, conduct and interpretation of the findings. CYP involvement in the interventions' development and implementation was analysed as part of the review. This systematic review was conducted as part of a wider research project titled: Understanding fatigue experiences of CYP with SCD to guide the co-development of a fatigue self-management intervention. Two of the young advisors involved in the review were also involved in the development of the project funding application.
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Affiliation(s)
- Brenda A Poku
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Sue Kirk
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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3
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Hoyt CR, Hurwitz S, Varughese TE, Yaeger LH, King AA. Individual-level behavioral interventions to support optimal development of children with sickle cell disease: A systematic review. Pediatr Blood Cancer 2023; 70:e30178. [PMID: 36583467 PMCID: PMC10416609 DOI: 10.1002/pbc.30178] [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: 09/07/2022] [Revised: 11/15/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022]
Abstract
This review aimed to identify and describe individual-level behavioral interventions for children 0-18 years of age with sickle cell disease (SCD). PRISMA guidelines were followed at each stage of this review. Twenty-seven studies were included, representing six intervention types: disease knowledge (n = 7), self-management (n = 7), pain management (n = 4), school functioning (n = 4), cognitive health (n = 4), and mental health (n = 2). Most interventions targeted older children (5+ years), while only two examined interventions for children 0-3 years. This review suggests that offering education about disease knowledge, self-management, and pain management interventions can be beneficial for this population. Future research is needed to understand interventions to support young children and the impact of SCD on development.
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Affiliation(s)
- Catherine R Hoyt
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sadie Hurwitz
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Taniya E Varughese
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lauren H Yaeger
- Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Allison A King
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Education, Washington University School of Medicine, St. Louis, Missouri, USA
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4
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Ouyang A, Gadiraju M, Gadiraju V, Power L, Gadiraju V, Liu G, Guilliams KP, Binkley MM, Badawy SM, Fields ME. GRAPES: Trivia game increases sickle cell disease knowledge in patients and providers and mitigates healthcare biases. Pediatr Blood Cancer 2022; 69:e29717. [PMID: 35441455 DOI: 10.1002/pbc.29717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients with sickle cell disease (SCD) endure healthcare biases that are partially due to a lack of disease-specific education among healthcare providers. Furthermore, there is a paucity of age-appropriate health education materials for patients with SCD. To address this gap, we created the GRAPES tool (Game to Raise Awareness for Patient/Provider/Public Education of SCD; www.tinyurl.com/GRAPESgame) and hypothesized that utilization of the GRAPES tool will improve patient and provider SCD knowledge and mitigate healthcare bias. PROCEDURE The GRAPES tool is an online, single-player trivia game. A feasibility study was conducted in pediatric patients with SCD at age 10 years or older and registered nurses. All participants were assessed for change in SCD-relevant knowledge and satisfaction post-gameplay. Providers were assessed for change in attitudes toward patients with SCD post-gameplay. RESULTS Twenty-five patients and 25 providers were enrolled. All participants (P < 0.001), and specifically within the patient (P = 0.019) and provider (P < 0.001) cohorts, showed increased SCD knowledge post-gameplay. Both patients and providers reported high satisfaction with GRAPES. Provider negative attitudes were reduced (P = 0.007) post-gameplay without change in positive attitudes (P = 0.959). Providers demonstrated post-gameplay reduced (P = 0.001) belief that patients' changing behavior around providers indicates inappropriate drug-seeking behavior. CONCLUSIONS This study demonstrates the feasibility and acceptability of the GRAPES tool as a potential digital, behavioral intervention to provide educational materials for patients and their providers in different clinical settings, improve knowledge about SCD, and decrease stigma against patients with SCD in the healthcare setting.
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Affiliation(s)
- Amy Ouyang
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Manasa Gadiraju
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Veda Gadiraju
- University of Washington School of Medicine, Seattle, Washington
| | - Landon Power
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | | | - Gloria Liu
- Rutgers University, New Brunswick, New Jersey
| | - Kristin P Guilliams
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Michael M Binkley
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Melanie E Fields
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
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Sawyer JL, Mishna F, Bouffet E, Saini M, Zlotnik-Shaul R. Bridging the Gap: Exploring the Impact of Hospital Isolation on Peer Relationships Among Children and Adolescents with a Malignant Brain Tumor. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2021; 40:91-105. [PMID: 34025015 PMCID: PMC8130807 DOI: 10.1007/s10560-021-00764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2021] [Indexed: 06/12/2023]
Abstract
Children and adolescents with complex medical conditions are often uprooted from their environments and isolated in hospital while undergoing treatment. Little is known about how they perceive this isolation and its subsequent impact on their relationships with peers, both during and after isolation for treatment. This study describes the experience of hospital isolation from the perspectives of children and adolescents with a malignant brain tumor. The use and impact of information and communication technologies (ICT) as a possible bridge for contact is also explored. Following a qualitative approach utilizing interpretive phenomenological analysis, in-depth interviews were conducted with eight youth participants who had undergone treatment for medulloblastoma. Data analysis generated three main themes: (1) transforming children and relationships, (2) hospitalization in a digital world, and (3) ICTs as a promising bridge back to school. Study findings provide insight into the experience of hospital isolation for children and adolescents, while highlighting the positive social as well as academic outcomes of frequent, open ended ICT use throughout hospital isolation. This is timely, given the context of the COVID-19 pandemic and its resulting isolation. Considerations for hospital social workers to promote relationships and connection, while facilitating a smooth transition as these children return to school are included.
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Affiliation(s)
- Jami-Leigh Sawyer
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S1V4 Canada
| | - Faye Mishna
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S1V4 Canada
| | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON Canada
- Department of Paediatrics, University of Toronto, Toronto, ON Canada
| | - Michael Saini
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S1V4 Canada
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Yang Q, Millette D, Zhou C, Beatty M, Carcioppolo N, Wilson G. The Effectiveness of Interactivity in Improving Mediating Variables, Behaviors and Outcomes of Web-Based Health Interventions: A Meta-Analytic Review. HEALTH COMMUNICATION 2020; 35:1334-1348. [PMID: 31240958 DOI: 10.1080/10410236.2019.1631992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite the increasing amount of research investigating health interventions that applies to interactive computer technology, the effect sizes in Cohen's d obtained across these studies range from -0.32 to 1.74. The lack of systematic review of interactive health interventions leaves their overall effectiveness unknown. To address this, a meta-analysis of 67 studies examining the effects of web-based interactive health interventions was conducted. Results indicated that web-based interactive health interventions were effective in general, but the effects were moderated by health topic, theoretical framework, and design of treatment and control groups. The unique advantage of interactivity was small but significant when comparing to health interventions with comparable information in non-interactive version. Theoretical and practical implications of findings were discussed.
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Affiliation(s)
- Qinghua Yang
- Department of Communication Studies, Texas Christian University
| | - Diane Millette
- Department of Communication Studies, University of Miami
| | - Chun Zhou
- Department of Communication, Florida International University
| | - Michael Beatty
- Department of Communication Studies, University of Miami
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Badawy SM, Cronin RM, Hankins J, Crosby L, DeBaun M, Thompson AA, Shah N. Patient-Centered eHealth Interventions for Children, Adolescents, and Adults With Sickle Cell Disease: Systematic Review. J Med Internet Res 2018; 20:e10940. [PMID: 30026178 PMCID: PMC6072976 DOI: 10.2196/10940] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/06/2018] [Accepted: 06/21/2018] [Indexed: 12/18/2022] Open
Abstract
Background Sickle cell disease is an inherited blood disorder that affects over 100,000 Americans. Sickle cell disease–related complications lead to significant morbidity and early death. Evidence supporting the feasibility, acceptability, and efficacy of self-management electronic health (eHealth) interventions in chronic diseases is growing; however, the evidence is unclear in sickle cell disease. Objective We systematically evaluated the most recent evidence in the literature to (1) review the different types of technological tools used for self-management of sickle cell disease, (2) discover and describe what self-management activities these tools were used for, and (3) assess the efficacy of these technologies in self-management. Methods We reviewed literature published between 1995 and 2016 with no language limits. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and other sources. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers screened titles and abstracts, assessed full-text articles, and extracted data from articles that met inclusion criteria. Eligible studies were original research articles that included texting, mobile phone–based apps, or other eHealth interventions designed to improve self-management in pediatric and adult patients with sickle cell disease. Results Of 1680 citations, 16 articles met all predefined criteria with a total of 747 study participants. Interventions were text messaging (4/16, 25%), native mobile apps (3/16, 19%), Web-based apps (5/16, 31%), mobile directly observed therapy (2/16, 13%), internet-delivered cognitive behavioral therapy (2/16, 13%), electronic pill bottle (1/16, 6%), or interactive gamification (2/16, 13%). Interventions targeted monitoring or improvement of medication adherence (5/16, 31%); self-management, pain reporting, and symptom reporting (7/16, 44%); stress, coping, sleep, and daily activities reporting (4/16, 25%); cognitive training for memory (1/16, 6%); sickle cell disease and reproductive health knowledge (5/16, 31%); cognitive behavioral therapy (2/16, 13%); and guided relaxation interventions (1/16, 6%). Most studies (11/16, 69%) included older children or adolescents (mean or median age 10-17 years; 11/16, 69%) and 5 included young adults (≥18 years old) (5/16, 31%). Sample size ranged from 11 to 236, with a median of 21 per study: <20 in 6 (38%), ≥20 to <50 in 6 (38%), and >50 participants in 4 studies (25%). Most reported improvement in self-management–related outcomes (15/16, 94%), as well as high satisfaction and acceptability of different study interventions (10/16, 63%). Conclusions Our systematic review identified eHealth interventions measuring a variety of outcomes, which showed improvement in multiple components of self-management of sickle cell disease. Despite the promising feasibility and acceptability of eHealth interventions in improving self-management of sickle cell disease, the evidence overall is modest. Future eHealth intervention studies are needed to evaluate their efficacy, effectiveness, and cost effectiveness in promoting self-management in patients with sickle cell disease using rigorous methods and theoretical frameworks with clearly defined clinical outcomes.
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Affiliation(s)
- Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Pediatrics, Division of Hematology and Oncology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.,Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jane Hankins
- Department of Hematology, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Lori Crosby
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Psychology, University of Cincinnati, Cincinnati, OH, United States
| | - Michael DeBaun
- Division of Hematology and Oncology, Department of Pediatrics, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Alexis A Thompson
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Nirmish Shah
- Division of Hematology, Duke University School of Medicine, Durham, NC, United States
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Morrison-Levy N, Knight-Madden J, Royal-Thomas T, King L, Asnani M. Improving disease knowledge in 6- to 10-year-olds with sickle cell disease: A quasi-experimental study. Child Care Health Dev 2018; 44:501-506. [PMID: 29436011 DOI: 10.1111/cch.12559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 01/12/2018] [Accepted: 01/21/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increasing knowledge and understanding of disease is known to improve outcomes in persons living with a chronic illness. In this paper, we aim to compare the disease knowledge of children with sickle cell disease (SCD), age 6-10 years, who received an intervention (an educational colouring book on SCD) geared towards improving disease knowledge, to those who did not received the colouring book. METHODS A quasi-experimental study was conducted where disease knowledge was determined in 56 children who had received the colouring book and compared to 60 children who did not receive this intervention. RESULTS The mean knowledge score was significantly higher in the intervention group (mean difference = 2.65; 95% CI [1.43, 3.86]), as well as in older children and in those in higher grades but there was no difference between sexes. In a multiple regression model (adjusted R2 : 0.39; p value < .001), knowledge score was significantly higher in those who received the intervention (β: 2.62; 95% CI [1.48, 3.76]) while adjusting for age, gender, persons living at home, and the father's employment status. CONCLUSION The study highlights that a simple, inexpensive (cost: US$1/book) child-friendly intervention can significantly improve knowledge about SCD even in young children. It also underlines various social factors that are associated with children's understanding of their disease.
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Affiliation(s)
- N Morrison-Levy
- Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | - J Knight-Madden
- Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | - T Royal-Thomas
- Mathematics & Statistics Department, The College of New Jersey, 2000 Pennington Road Ewing, 08628, New Jersey
| | - L King
- Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | - M Asnani
- Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
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Asnani MR, Quimby KR, Bennett NR, Francis DK. Interventions for patients and caregivers to improve knowledge of sickle cell disease and recognition of its related complications. Cochrane Database Syst Rev 2016; 10:CD011175. [PMID: 27711980 PMCID: PMC6457882 DOI: 10.1002/14651858.cd011175.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sickle cell disease is a group of genetic diseases which is especially prevalent in tropical and subtropical regions; however, forced migration and ongoing population movement have spread it throughout the world, with estimated birth rates reaching 0.49 per 1000 in the Americas, 0.07 per 1000 in Europe, 0.68 per 1000 in South and Southeast Asia, and 10.68 per 1000 in Africa. Life for individuals with sickle cell disease can be affected by repeated acute complications and compounded by progressive organ damage. Studies reveal that when people with chronic illness learn self-management, their clinical outcomes and quality of life improves; and they show lower dependence on healthcare services. There are, however, no reviews identifying which interventions improve knowledge and little is known about the impact of patient or care-giver knowledge on clinical and psychosocial outcomes in people with sickle cell disease. OBJECTIVES 1. To determine the effectiveness of patient- and caregiver-centred educational interventions for changing knowledge and understanding of sickle cell disease among patients as well as caregivers of people with the disease.2. To assess the effectiveness and safety of patient- and caregiver-centred educational interventions and programs for the recognition of signs and symptoms of disease-related morbidity, adherence to treatment and healthcare utilization in patients with sickle cell disease. SEARCH METHODS The authors searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Additional trials were sought from the reference lists of the trials and reviews identified by the search strategy.Date of last search: 11 April 2016. SELECTION CRITERIA Randomized and quasi-randomized controlled trials which evaluate the effectiveness of individual- and group-based interventions for either the patient with sickle cell disease or their caregivers, or both. Eligible interventions will aim to change knowledge, attitudes or skills, improve psychosocial aspects of the disease as well as treatment adherence and healthcare utilization. Trials evaluating the intervention versus no program, comparing two interventions and those which are part of a multi-faceted intervention to improve a range of sickle cell-related health outcomes are all eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials based on stated inclusion criteria and thereafter examined each selected report to extract data using a prepared, piloted, data collection form. A third author assisted in reaching consensus if there were any discrepancies. Similarly, risk of bias was assessed by two authors and verified by a third author. MAIN RESULTS A total of 12 trials (11 randomized controlled trials and one quasi-randomized trial) of 563 people with HbSS, HbSC or HbSβthal, aged six to 35 years old, were included in the review; the majority of participants were African-American. Interventions ranged from a total of one hour to weekly sessions for eight weeks and the post-intervention assessments ranged from the end of the intervention period to 12 months after completion. The heterogeneity of the included trials, which encompasses setting, inclusion and exclusion criteria, interventional method and time of assessment, ranged from 'not important' to 'moderate to substantial' for different review outcomes. The overall risk of bias was low for selective reporting, unclear for random sequence generation, allocation concealment, blinding of participants and blinding of outcome assessment. Incomplete outcome reporting and blinding of personnel showed mixed bias representations.Patient knowledge was assessed by four trials (160 participants) with moderate to substantial heterogeneity. There was evidence that educational programs improved patient knowledge, standardised mean difference 0.87 points (95% confidence interval 0.28 to 1.45, moderate quality evidence), which improved further when a trial with high bias was removed in a sensitivity analysis. Caregiver knowledge, reported in a single trial of 20 families, also showed an improvement, standardised mean difference 0.52 points (95% confidence interval 0.03 to 1.00, moderate quality evidence). The effect on patient knowledge was sustained at longer follow-up periods, whereas the effect on caregiver knowledge was not sustained.There were two primary outcomes related to the effectiveness of educational programs on the recognition of signs and symptoms of disease-related morbidity. No comparative data were reported for patients or caregivers (or both) recognising signs and symptoms leading to self-management. Data from two trials were analysed for the utilization of health services and showed no evidence of an effect, mean difference 0.33 (95% confidence interval -0.57 to 1.23, moderate quality evidence).With regard to the review's secondary outcomes, depression showed a statistically significant decline in intervention groups, standardised mean difference -0.66 points (95% confidence interval -1.18, to -0.14, moderate quality evidence). Adherence to treatment was not assessed in any of the identified trials. No effects of interventions were seen on coping, family relationships or health-related quality of life of patients.The quality of evidence was low for positive coping and moderate for child knowledge, healthcare utilization and depression. This suggests that further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimates. AUTHORS' CONCLUSIONS This review identifies important positive effects of educational interventions on improving patient knowledge of sickle cell disease and depression. Effects on patients' knowledge were maintained for longer than for caregivers. The effect on knowledge was significant but small and whether it offers any clinical benefit is uncertain. Significant factors limiting these effects could be trials being under powered as well as attrition rates. Effects were not statistically significant in assessments of secondary outcomes, possibly due to the paucity of the number of trials and patients and caregivers. Trials showed moderate to high heterogeneity which might impact the results. To better study effects on outcomes, further controlled trials are needed with rigorous attention given to improve recruitment and retention and to decrease bias. Predetermined protocols using similar measurements should be used across multiple sites.
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Affiliation(s)
- Monika R Asnani
- Caribbean Institute for Health Research, University of the West IndiesSickle Cell Unit7 Ring Road, Mona CampusKingston 7Jamaica
| | - Kim R Quimby
- Caribbean Institute for Health Research, The University of the West IndiesChronic Disease Research CentreJermott's LaneBridgetownSt MichaelBarbadosBB11110
| | - Nadia R Bennett
- Caribbean Institute for Health Research, The University of the West Indies, MonaEpidemiology Research Unit7 Ring RoadKingstonJamaica
| | - Damian K Francis
- Caribbean Institute for Health Research, The University of the West Indies, MonaEpidemiology Research Unit7 Ring RoadKingstonJamaica
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Proudfoot J, Klein B, Barak A, Carlbring P, Cuijpers P, Lange A, Ritterband L, Andersson G. Establishing guidelines for executing and reporting Internet intervention research. Cogn Behav Ther 2015; 40:82-97. [PMID: 25155812 DOI: 10.1080/16506073.2011.573807] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The field of Internet interventions is growing rapidly. New programs are continually being developed to facilitate health and mental health promotion, disease and emotional distress prevention, risk factor management, treatment, and relapse prevention. However, a clear definition of Internet interventions, guidelines for research, and evidence of effectiveness have been slower to follow. This article focuses on the quality standardization of research on Internet-delivered psychological and behavioural interventions. Although the science underpinning Internet interventions is just starting to be established, across research studies there are often conceptual and methodological difficulties. The authors argue that this situation is due to the lack of universally accepted operational guidelines and evaluation methods. Following a critical appraisal of existing codes of conduct and guidelines for Internet-assisted psychological and health interventions, the authors developed a framework of guidelines for Internet intervention research utilizing aspects of facet theory (Guttman & Greenbaum, 1998). The framework of facets, elements, and guidelines of best practice in reporting Internet intervention research was then sent to several leading researchers in the field for their comment and input, so that a consensus framework could be agreed on. The authors outline 12 key facets to be considered when evaluating and reporting Internet intervention studies. Each facet consists of a range of recommended elements, designed as the minimum features for reporting Internet intervention studies. The authors propose that this framework be utilized when designing and reporting Internet intervention research, so results across studies can be replicated, extended, compared, and contrasted with greater ease and clarity.
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Affiliation(s)
- Judith Proudfoot
- a Black Dog Institute and School of Psychiatry, University of New South Wales , Sydney , New South Wales , Australia
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Thompson RA. Social support and child protection: Lessons learned and learning. CHILD ABUSE & NEGLECT 2015; 41:19-29. [PMID: 25043921 DOI: 10.1016/j.chiabu.2014.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/17/2014] [Accepted: 06/22/2014] [Indexed: 06/03/2023]
Abstract
Social support has been a topic of research for nearly 50 years, and its applications to prevention and intervention have grown significantly, including programs advancing child protection. This article summarizes the central conclusions of the 1994 review of research on social support and the prevention of child maltreatment prepared for the U.S. Advisory Board on Child Abuse and Neglect, and surveys advances in the field since its publication. Among the lessons learned twenty years ago are (a) the diversity of the social support needs of at-risk families and their association with child endangerment, (b) the need to supplement the emotionally affirmative aspects of social support with efforts to socialize parenting practices and monitor child well-being, (c) the desirability of integrating formal and informal sources of social support for recipients, and (d) the importance of considering the complex recipient reactions to receiving support from others. The lessons we are now learning derive from research exploring the potential of online communication to enhance social support, the neurobiology of stress and its buffering through social support, and the lessons of evaluation research that are identifying the effective ingredients of social support interventions.
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Aldiss S, Baggott C, Gibson F, Mobbs S, Taylor RM. A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions. J Pediatr Nurs 2015; 30:87-101. [PMID: 25316197 DOI: 10.1016/j.pedn.2014.09.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 07/21/2014] [Accepted: 09/24/2014] [Indexed: 11/16/2022]
Abstract
Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial.
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Affiliation(s)
- Susie Aldiss
- Department of Children's Nursing, London South Bank University, London UK.
| | - Christina Baggott
- Cancer Clinical Trials Office, Pediatric Hematology/Oncology, Stanford University, Palo Alto, CA
| | - Faith Gibson
- Department of Children's Nursing, London South Bank University, London UK; Centre for Outcomes and Experiences Research in Children's Health, Illness, and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK
| | - Sarah Mobbs
- Department of Children's Nursing, London South Bank University, London UK
| | - Rachel M Taylor
- Department of Children's Nursing, London South Bank University, London UK; Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London UK
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Sneller J, Buchanan H, Parekh S. The impact of amelogenesis imperfecta and support needs of adolescents with AI and their parents: an exploratory study. Int J Paediatr Dent 2014; 24:409-16. [PMID: 24404886 DOI: 10.1111/ipd.12086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Amelogenesis imperfecta (AI) is a rare inherited dental defect where enamel does not form properly on the teeth. Research has shown that adolescents with AI may experience adverse psychosocial effects; however the impact on parents has not been explored. AIMS We aimed to explore: (1) experience and perceptions of AI from both the adolescent and their parent's perspective (2) their views on the usefulness of an online support group (OSG) for patients/parents and the potential salient functions of such a resource. DESIGN We conducted two focus groups; one for adolescent AI patients and one for their parents. Transcripts were analysed using Thematic Analysis. RESULTS Three themes emerged from the data: 'Living with AI: Do I look bothered?', 'Need for the 'right' online environment' and 'Support needs: Information and beyond'. CONCLUSIONS The adolescents did not appear to experience adverse psychosocial effects of having AI, which was contrary to their parents' perceptions. Parents reported some adverse consequences of having a child with AI (e.g., practical challenges). If an OSG was to be developed, it would need to be primarily information based and moderated by an AI specialist. Parents may benefit from additional support beyond that of information, such as emotional and tangible support.
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Affiliation(s)
- Jennifer Sneller
- Institute of Work, Health & Organisations, University of Nottingham, Nottingham, UK
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Raaff C, Glazebrook C, Wharrad H. A systematic review of interactive multimedia interventions to promote children's communication with health professionals: implications for communicating with overweight children. BMC Med Inform Decis Mak 2014; 14:8. [PMID: 24447844 PMCID: PMC3926331 DOI: 10.1186/1472-6947-14-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 01/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interactive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes. METHODS An extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11-years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods. RESULTS A total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children's health-related self-efficacy, which could make them more able partners in face-to-face communications with health professionals. CONCLUSIONS The findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research in this field is needed. Particular attention should be given to designing appropriate MIs that are clinically relevant.
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Affiliation(s)
- Carol Raaff
- School of Medicine, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham, UK
| | - Cris Glazebrook
- School of Medicine, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham, UK
| | - Heather Wharrad
- School of Health Sciences, Division of Nursing, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
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Smith Carter J, Martinez W, Legato LJ. Response to Commentary: Social Competence in Children With Chronic Illness: Moving the Field Forward. J Pediatr Psychol 2012. [DOI: 10.1093/jpepsy/jss089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Impact of online support for youth with asthma and allergies: pilot study. J Pediatr Nurs 2012; 27:65-73. [PMID: 22222108 DOI: 10.1016/j.pedn.2010.07.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 07/10/2010] [Accepted: 07/19/2010] [Indexed: 11/24/2022]
Abstract
Youth with asthma and allergies often feel isolated and different from their peers. The objective of this study was to test the impact of online social support for these youth. Three months of support was provided using weekly synchronous chat sessions. Online sessions were facilitated by trained peer mentors (older youth with asthma and/or allergies) and health professionals. Youth could also e-mail one another between chat sessions and post messages on an electronic community bulletin board. Twenty-eight adolescents across Canada participated. Social isolation and loneliness were significantly reduced. Youth reported gaining confidence and a sense of normality.
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Martinez W, Carter JS, Legato LJ. Social Competence in Children with Chronic Illness: A Meta-analytic Review. J Pediatr Psychol 2011; 36:878-90. [DOI: 10.1093/jpepsy/jsr035] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stewart M, Masuda JR, Letourneau N, Anderson S, Cicutto L, McGhan S, Watt S. Online Support Intervention for Adolescents With Asthma and Allergies. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/2150129711402686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives. To determine appropriate components and contents of an online peer support intervention for young adolescents and to evaluate intervention processes, perceived benefits, and satisfaction with the intervention. Methods. Three months of support were provided through synchronous chat, e-mail exchange, instant messaging, and bulletin boards. Online support group sessions were facilitated by trained peer mentors (older youth/young adults with asthma and allergies) and health professionals. Participant use of online options was tracked (eg, log-ons, e-mails, chat minutes). Qualitative data were elicited from peer mentor reports, online support group chat transcripts, project coordinators’ field notes, peer mentor exit interviews, and adolescent telephone interviews. Results. Almost all adolescents were satisfied with this online support intervention. Topics discussed in the support groups were pertinent to their educational and support needs. Peer mentors provided emotional, affirmation, and information support. Participants appreciated opportunities for social comparison and reciprocal exchange of support with peers. Conclusion and implications. A major contribution was documentation of the complex intervention ingredients and processes through qualitative and quantitative methods that elicited diverse stakeholders’ perspectives. This strategy enables adaptation and integration into practice. Adolescents who benefited most felt isolated, suggesting the importance of targeting vulnerable youth for support programs.
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Affiliation(s)
- Miriam Stewart
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Jeffrey R. Masuda
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Nicole Letourneau
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Sharon Anderson
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Lisa Cicutto
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Shawna McGhan
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Susan Watt
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
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A family-based randomized controlled trial of pain intervention for adolescents with sickle cell disease. J Pediatr Hematol Oncol 2010; 32:540-7. [PMID: 20686425 PMCID: PMC2950888 DOI: 10.1097/mph.0b013e3181e793f9] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The study had 2 aims---to determine the efficacy of a family-based cognitive-behavioral pain management intervention for adolescents with sickle cell disease (SCD) in (1) reducing pain and improving health-related variables and (2) improving psychosocial outcomes. Each adolescent and a family support person were randomly assigned to receive a brief pain intervention (PAIN) (n=27) or a disease education attention control intervention (DISEASE ED) (n=26) delivered at home. Assessment of primary pain and health-related variables (health service use, pain coping, pain-related hindrance of goals) and secondary psychosocial outcomes (disease knowledge, disease self-efficacy, and family communication) occurred at baseline (before randomization), postintervention, and 1-year follow-up. Change on outcomes did not differ significantly by group at either time point. When groups were combined in exploratory analyses, there was evidence of small to medium effects of intervention on health-related and psychosocial variables. Efforts to address barriers to participation and improve feasibility of psychosocial interventions for pediatric SCD are critical to advancing development of effective treatments for pain. Sample size was insufficient to adequately test efficacy, and analyses did not support this focused cognitive-behavioral pain management intervention in this sample of adolescents with SCD. Exploratory analyses suggest that comprehensive interventions, that address a broad range of skills related to disease management and adolescent health concerns, may be more effective in supporting teens during healthcare transition.
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Barak A, Boniel-Nissim M, Suler J. Fostering empowerment in online support groups. COMPUTERS IN HUMAN BEHAVIOR 2008. [DOI: 10.1016/j.chb.2008.02.004] [Citation(s) in RCA: 421] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thurber CA, Patterson DR, Mount KK. Homesickness and Children's Adjustment to Hospitalization: Toward a Preliminary Model. CHILDRENS HEALTH CARE 2007. [DOI: 10.1080/02739610701316753] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nicholas DB, Darch J, McNeill T, Brister L, O'Leary K, Berlin D, Koller DF. Perceptions of online support for hospitalized children and adolescents. SOCIAL WORK IN HEALTH CARE 2007; 44:205-23. [PMID: 17548276 DOI: 10.1300/j010v44n03_06] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study identifies perceived outcomes following hospitalized children's participation in a pediatric online support network. Nineteen participants were interviewed, including child and adolescent patients who had used the network while in hospital, their parent/family caregiver, and a familiar health care provider. This triadic sampling approach provided a range of stakeholder perceptions. Results convey a wide spectrum of benefits and challenges in accessing and utilizing an online support network for hospitalized children. Participation in the network was identified as a means of fostering pediatric patient enjoyment, education, connection with peers, and coping. Information, social connection and distraction served as catalysts fostering positive outcomes for children. Identified barriers to network participation included inaccessibility and limited availability of computers, issues with technology, and discomfort with online interaction. Findings advance understanding of online networks as supportive resources for seriously ill children and their families.
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Affiliation(s)
- David B Nicholas
- The Hospital for Sick Children, 555 University Avenue, Room 1171, Toronto, ON, Canada
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Murray E, Burns J, See TS, Lai R, Nazareth I. Interactive Health Communication Applications for people with chronic disease. Cochrane Database Syst Rev 2005:CD004274. [PMID: 16235356 DOI: 10.1002/14651858.cd004274.pub4] [Citation(s) in RCA: 334] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Interactive Health Communication Applications (IHCAs) are computer-based, usually web-based, information packages for patients that combine health information with at least one of social support, decision support, or behaviour change support. These are innovations in health care and their effects on health are uncertain. OBJECTIVES To assess the effects of IHCAs for people with chronic disease. SEARCH STRATEGY We designed a four-part search strategy. First, we searched electronic bibliographic databases for published work; second, we searched the grey literature; and third, we searched for ongoing and recently completed clinical trials in the appropriate databases. Finally, researchers of included studies were contacted, and reference lists from relevant primary and review articles were followed up. As IHCAs require relatively new technology, the search time period commenced at 1990, where possible, and ran until 31 December 2003. SELECTION CRITERIA Randomised controlled trials (RCTs) of IHCAs for adults and children with chronic disease. DATA COLLECTION AND ANALYSIS One reviewer screened abstracts for relevance. Two reviewers screened all candidate studies to determine eligibility, apply quality criteria, and extract data from included studies. Authors of included RCTs were contacted for missing data. Results of RCTs were pooled using random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios for binary outcomes; heterogeneity was assessed using the I(2 )statistic. MAIN RESULTS We identified 24 RCTs involving 3739 participants which were included in the review.IHCAs had a significant positive effect on knowledge (SMD 0.46; 95% confidence interval (CI) 0.22 to 0.69), social support (SMD 0.35; 95% CI 0.18 to 0.52) and clinical outcomes (SMD 0.18; 95% CI 0.01 to 0.35). Results suggest it is more likely than not that IHCAs have a positive effect on self-efficacy (a person's belief in their capacity to carry out a specific action) (SMD 0.24; 95% CI 0.00 to 0.48). IHCAs had a significant positive effect on continuous behavioural outcomes (SMD 0.20; 95% CI 0.01 to 0.40). Binary behavioural outcomes also showed a positive effect for IHCAs, although this result was not statistically significant (OR 1.66; 95% CI 0.71 to 3.87). It was not possible to determine the effects of IHCAs on emotional or economic outcomes. AUTHORS' CONCLUSIONS IHCAs appear to have largely positive effects on users, in that users tend to become more knowledgeable, feel better socially supported, and may have improved behavioural and clinical outcomes compared to non-users. There is a need for more high quality studies with large sample sizes to confirm these preliminary findings, to determine the best type and best way to deliver IHCAs, and to establish how IHCAs have their effects for different groups of people with chronic illness.
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Affiliation(s)
- E Murray
- RF&UCMS at University College London, Primary Care and Population Sciences, Level 2 Holborn Union Building, Archway Campus, London, UK N19 5LW.
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Beale IL. Scholarly Literature Review: Efficacy of Psychological Interventions for Pediatric Chronic Illnesses. J Pediatr Psychol 2005; 31:437-51. [PMID: 16162841 DOI: 10.1093/jpepsy/jsj079] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To review empirical studies of the efficacy of psychological interventions as adjuvant therapies for children with pediatric diabetes, cancer, cystic fibrosis, and sickle cell disease. METHODS A search was conducted for qualifying studies published since 1980. Only studies meeting basic criteria for external and internal validity were included. Nineteen studies were identified, providing data on 62 outcome variables. Effect sizes (ESs) were analyzed by illness type, intervention type, and strength of internal and external validity of the research design. RESULTS Overall, interventions were associated with large ESs, which were not significantly moderated by illness type or intervention type. However, larger ESs were associated with lower scores on validity of research design. CONCLUSIONS Adjuvant psychological interventions for pediatric chronic illnesses appear in general to be efficacious, associated with a large mean ES across a range of outcome variables. However, until more studies have been completed using stronger research designs, only tentative conclusions can be drawn.
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Affiliation(s)
- Ivan L Beale
- School of Psychology, University of New South Wales, Sydney 2052, Australia.
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Murray E, Burns J, See TS, Lai R, Nazareth I. Interactive Health Communication Applications for people with chronic disease. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2004. [DOI: 10.1002/14651858.cd004274.pub3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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LaMontagne LL, Hepworth JT, Cohen F, Salisbury MH. Adolescent scoliosis: Effects of corrective surgery, cognitive-behavioral interventions, and age on activity outcomes. Appl Nurs Res 2004; 17:168-77. [PMID: 15343550 DOI: 10.1016/j.apnr.2004.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The effects of spinal fusion surgery and cognitive-behavioral interventions on 88 adolescents' (11-18 years) activity outcomes were examined using a randomized trial with three intervention groups (information only, coping only, coping plus information) and a control group. The effects included a significant drop from baseline (preoperative) in usual activities and social activities at 1 month postsurgery for all groups, indicating that initially postsurgical recovery is particularly disruptive to patients' lives. At 3 months after surgery, all groups showed increased usual activities and social activities. Between the 3- and 6-month assessments, all groups had increases in social activities. Furthermore, the information only group had a significant increase in usual activities from 3 to 6 months. Younger adolescents (ages 11-14) in the combined information plus coping group and the control group had higher social scores over the postsurgery recovery period compared with those in the coping-only group. No differences were found on academic performance. The adolescents did not return to their baseline social activity levels during the 9-month recovery period (typically when long-term recovery is completed), indicating that the surgery itself has a long-term negative effect on patients' social life.
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Affiliation(s)
- Lynda L LaMontagne
- School of Nursing, Vanderbilt University, 412 Godchaux Hall, 461 21st Avenue South, Nashville, TN 37240, USA.
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Neul SKT, Elkin TD, Applegate H, Griffin KJ, Bockewitz L, Iyer R, Smith MG, Mitchell T. Developmental Concepts of Disease and Pain in Pediatric Sickle Cell Patients. CHILDRENS HEALTH CARE 2003. [DOI: 10.1207/s15326888chc3202_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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