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Giroux CM, Wilson LA, Corkett JK. Parents as partners: investigating the role(s) of mothers in coordinating health and education activities for children with chronic care needs. J Interprof Care 2018; 33:243-251. [PMID: 30303428 DOI: 10.1080/13561820.2018.1531833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Interprofessional collaboration (IPC) between health professionals, and educators is an essential component of academic success and well-being for children who experience chronic illnesses. This study sought to understand parents' roles in and perceptions of IPC between their child's healthcare professionals and educators. We recruited 23 mothers to participate in our study. Data were analyzed using a combination of univariate analyses and content analysis. Overall, parents reported that they could effectively communicate their child's health and educational needs with health and educational professionals, but statistical analysis determined moderately increased challenges presenting information across professions. Most participants (n = 19) indicated that IPC between health and educational professionals could be improved. Effectively engaging parents as partners in IPC can promote more seamless collaboration and communication of a child's needs and offer a greater likelihood of achieving a child's health and educational goals.
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Affiliation(s)
| | - Lindsay A Wilson
- b School of Epidemiology, Public Health, and Preventative Medicine , University of Ottawa , Canada
| | - Julie K Corkett
- c Schulich School of Education , Nipissing University , North Bay , Canada
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Williamson I, Vennik J, Harnden A, Voysey M, Perera R, Breen M, Bradley B, Kelly S, Yao G, Raftery J, Mant D, Little P. An open randomised study of autoinflation in 4- to 11-year-old school children with otitis media with effusion in primary care. Health Technol Assess 2016; 19:1-150. [PMID: 26377389 DOI: 10.3310/hta19720] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Otitis media with effusion (OME) is a very common problem in primary care, but one that lacks an evidence-based non-surgical treatment. OBJECTIVE To determine the clinical effectiveness of nasal balloon autoinflation for the treatment of OME in children. DESIGN A pragmatic, two-arm, open randomised controlled trial. SETTING Forty-three general practices from 17 UK primary care trusts recruited between January 2012 and February 2013. PARTICIPANTS School children aged 4-11 years with a history of OME symptoms or related concerns in the previous 3 months, and a type B tympanogram, diagnostic of a middle ear effusion, in one or both ears. INTERVENTION Three hundred and twenty children were randomised, 160 to each group, using independent web-based computer-generated randomisation (with minimisation based on age, sex and baseline severity of OME) to either nasal balloon autoinflation performed three times per day for 1-3 months plus usual care, or usual care alone. MAIN OUTCOME MEASURES The proportion of children demonstrating clearance of middle ear fluid in at least one ear (with normal tympanograms) at 1 and 3 months, assessed blind to treatment. An ear-related measure of quality of life (QoL) [a 14-point questionnaire on the impact of OME (OMQ-14)], weekly diary recorded symptoms, compliance and adverse events were all secondary outcomes. RESULTS At 1 month, the proportion of children with normal tympanograms was 47.3% (62/131) in those allocated to autoinflation and 35.6% (47/132) in those receiving usual care [adjusted relative risk (RR) 1.36, 95% confidence interval (CI) 0.99 to 1.88]. At 3 months, the proportions were 49.6% (62/125) and 38.3% (46/120), respectively (adjusted RR 1.37, 95% CI 1.03 to 1.83; number needed to treat = 9). The change in OMQ-14 also favoured the intervention arm (adjusted global score difference -0.42; p = 0.001). Reported compliance was good: 89% in the first month and 80% in months 2 and 3. Adverse events included otalgia in 4% of treated children compared with 1% in the control group. Minor nosebleeds (14% vs. 15%) and respiratory tract infections (18% vs. 13%) were noted. CONCLUSION We found the use of autoinflation in young children with OME to be feasible in primary care and effective in both clearing effusions and improving child and parent ear-related QoL and symptoms. This method has scope to be used more widely. Further research is needed for very young children, and to inform prudent use in different health settings.
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Affiliation(s)
- Ian Williamson
- Primary Medical Care, University of Southampton, Southampton, UK
| | - Jane Vennik
- Primary Medical Care, University of Southampton, Southampton, UK
| | - Anthony Harnden
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Merryn Voysey
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Rafael Perera
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Maria Breen
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Brendan Bradley
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Sadie Kelly
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Guiqing Yao
- Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - James Raftery
- Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - David Mant
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Paul Little
- Primary Medical Care, University of Southampton, Southampton, UK
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Williamson I, Vennik J, Harnden A, Voysey M, Perera R, Kelly S, Yao G, Raftery J, Mant D, Little P. Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial. CMAJ 2015; 187:961-969. [PMID: 26216608 PMCID: PMC4577342 DOI: 10.1503/cmaj.141608] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Otitis media with effusion is a common problem that lacks an evidence-based nonsurgical treatment option. We assessed the clinical effectiveness of treatment with a nasal balloon device in a primary care setting. METHODS We conducted an open, pragmatic randomized controlled trial set in 43 family practices in the United Kingdom. Children aged 4-11 years with a recent history of ear symptoms and otitis media with effusion in 1 or both ears, confirmed by tympanometry, were allocated to receive either autoinflation 3 times daily for 1-3 months plus usual care or usual care alone. Clearance of middle-ear fluid at 1 and 3 months was assessed by experts masked to allocation. RESULTS Of 320 children enrolled, those receiving autoinflation were more likely than controls to have normal tympanograms at 1 month (47.3% [62/131] v. 35.6% [47/132]; adjusted relative risk [RR] 1.36, 95% confidence interval [CI] 0.99 to 1.88) and at 3 months (49.6% [62/125] v. 38.3% [46/120]; adjusted RR 1.37, 95% CI 1.03 to 1.83; number needed to treat = 9). Autoinflation produced greater improvements in ear-related quality of life (adjusted between-group difference in change from baseline in OMQ-14 [an ear-related measure of quality of life] score -0.42, 95% CI -0.63 to -0.22). Compliance was 89% at 1 month and 80% at 3 months. Adverse events were mild, infrequent and comparable between groups. INTERPRETATION Autoinflation in children aged 4-11 years with otitis media with effusion is feasible in primary care and effective both in clearing effusions and improving symptoms and ear-related child and parent quality of life. TRIAL REGISTRATION ISRCTN, No. 55208702.
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Affiliation(s)
- Ian Williamson
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jane Vennik
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Anthony Harnden
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Merryn Voysey
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Rafael Perera
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Sadie Kelly
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Guiqing Yao
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - James Raftery
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - David Mant
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
| | - Paul Little
- Primary Care and Population Sciences (Williamson, Vennik, Little), Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, UK; Nuffield Department of Primary Care Health Sciences (Harnden, Voysey, Perera, Kelly, Mant), University of Oxford, Oxford, UK; Faculty of Medicine (Yao, Raftery), University of Southampton, Southampton General Hospital, Southampton, UK
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Fortnum H, Leighton P, Smith MD, Brown L, Jones M, Benton C, Marder E, Marshall A, Sutton K. Assessment of the feasibility and clinical value of further research to evaluate the management options for children with Down syndrome and otitis media with effusion: a feasibility study. Health Technol Assess 2015; 18:1-147, v-vi. [PMID: 25270051 DOI: 10.3310/hta18600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is clinical uncertainty of the benefits and costs of different treatment options for children with Down syndrome who have glue ear. This study was designed to assess the extent of this lack of knowledge and determine if pursuing further information would be practical, beneficial and cost-effective. OBJECTIVES To assess the level and practical effect of current uncertainty around treatment options for children with Down syndrome and glue ear. To assess the feasibility of studying the options for management of glue ear in children with Down syndrome via a randomised controlled trial (RCT) or multicentre prospective cohort study by evaluating the willingness of (1) parents to agree to randomisation for their children and (2) clinicians to recruit participants to a definitive study. To undertake value of information analyses to demonstrate the potential economic benefit from undertaking further research. DESIGN A feasibility study exploring the views of parents of children with Down syndrome and professionals who have responsibility for the health and education of children with Down syndrome, on the participation in, and value of, future research into interventions for glue ear. Data were collected from parents via self-completed questionnaires, face-to-face interviews and focus groups and from professionals via online questionnaires and a Delphi review exercise. Development of economic models to represent clinical pathways of care and a RCT informed a value of information (VOI) analysis. SETTING UK (professionals); East Midlands region of the UK (parents). PARTICIPANTS Parents of children aged 1-11 years with Down syndrome (n = 156). Professionals including audiologists, ear, nose and throat surgeons, audiological physicians, speech and language therapists, and teachers of the deaf (n = 128). MAIN OUTCOME MEASURES Quantitative and qualitative data on parental views and experiences of glue ear and its effects; interventions and treatment received; taking part in research and factors that would encourage or discourage participation; and the importance of various outcome domains to them and for their children. For professionals: information on caseloads; approaches to clinical management; opinions on frequency and significance of the consequences of glue ear for this population; importance of different outcome measures; opinions of interventions and their role in future research; views on health research; facilitators and barriers to recruitment, and participation in research involving RCTs. RESULTS The complexity of the experience and individual characteristics of children with Down syndrome poses challenges for the design of any future research but these challenges were not considered by professionals to raise sufficient barriers to prevent it being undertaken. Parents were generally supportive of the need for, and value of, research but identified practical and emotional issues that would need addressing. Glue ear was considered to impact more on speech, language and communication than on hearing. Outcome measures for future research would need to evaluate these elements but measures should be designed specifically for the population. Parents and professionals identified randomisation as a significant barrier to participation. The VOI analyses identified lack of data as problematic but concluded that a future trial involving surgical intervention would be feasible at costs of < £650,000. CONCLUSIONS Future research into the benefits of interventions for glue ear in children with Down syndrome would be feasible and could be cost-effective but should be carefully designed to facilitate and maximise participation from parents and professionals responsible for recruitment. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Heather Fortnum
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, Nottingham, UK
| | - Paul Leighton
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Murray D Smith
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Lisa Brown
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, Nottingham, UK
| | - Matthew Jones
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Claire Benton
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Kate Sutton
- Nottinghamshire Healthcare, County Health Partnerships, Nottingham, UK
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Jung TTK, Alper CM, Hellstrom SO, Hunter LL, Casselbrant ML, Groth A, Kemaloglu YK, Kim SG, Lim D, Nittrouer S, Park KH, Sabo D, Spratley J. Panel 8. Otolaryngol Head Neck Surg 2013; 148:E122-43. [DOI: 10.1177/0194599812467425] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background and Objectives Although serious complications of otitis media (OM) such as brain abscess are rare, sequelae of OM such as tympanic membrane perforation and atelectatic tympanic membrane are quite common. Inner ear sequelae can cause hearing loss and speech and language problems. The objectives of this article are to provide a state-of-the-art review on recent articles on complications and sequelae of OM in different anatomic locations, from the tympanic membrane to intracranial sites, as well as hearing loss and speech and language development. Data Sources Primarily PubMed supplemented by Ovid MEDLINE and the Cochrane Database. Review Methods All types of articles related to OM complications and sequelae published in English between January 2007 and June 2011 were identified. A total of 127 relevant quality articles are summarized and included in this report. Results Key findings are summarized based on the following major anatomic locations and categories: tympanic membrane; cholesteatoma; ossicular problems; mucosal sequelae; inner ear sequelae; speech and language development; extracranial areas, including mastoiditis and facial nerve paralysis; intracranial complications; and future research goals. New information and insights were gained to prevent complications and sequelae. Conclusion and Implications for Practice Over the past 4 years, progress has been made in advancing the knowledge on the complications and sequelae of OM, which can be used to prevent and treat them effectively. Areas of potential future research have been identified and outlined.
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Affiliation(s)
- Timothy T. K. Jung
- Department of Otolaryngology, Loma Linda University, Loma Linda, California, USA
| | - Cuneyt M. Alper
- Division of Pediatric Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sten O. Hellstrom
- Department of Audiology, Karolinska University Hospital, Stockholm, Sweden
| | - Lisa L. Hunter
- Division of Audiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Anita Groth
- Department of Otolaryngology, University of Lund, Lund, Sweden
| | | | - Sang Gyoon Kim
- Department of Otolaryngology, Loma Linda University, Loma Linda, California, USA
| | - David Lim
- House Ear Institute, Los Angeles, California, USA
| | - Susan Nittrouer
- Division of Audiology, Ohio State University, Columbus, Ohio, USA
| | - Kee Hyun Park
- Department of Otolaryngology, Ajou University, Suwon, Korea
| | - Diane Sabo
- Division of Audiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jorge Spratley
- Department of Otolaryngology, University of Porto, Porto, Portugal
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Danhauer JL, Johnson CE, Caudle AT. Survey of K–3
rd
-Grade Teachers' Knowledge of Ear Infections and Willingness to Participate in Prevention Programs. Lang Speech Hear Serv Sch 2011; 42:207-22. [DOI: 10.1044/0161-1461(2011/10-0043)] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
Ear infections are prevalent in kindergarten through 3
rd
-grade (K–3
rd
) children and can affect their performance at school. Chewing gum, when administered by parents and teachers, can help prevent ear infections in children. This pilot study surveyed K–3
rd
-grade teachers in the Santa Barbara School Districts to assess their knowledge about ear infections and their willingness to participate in ear infection prevention programs.
Method
A 37-item questionnaire was developed and was e-mailed to a convenience sample of 112 teachers in February 2010.
Results
Response rate was 26%; 29 teachers responded. Most respondents were experienced females ≥36 years of age who said that their education provided no information about ear infections. Less than half said that they knew signs of ear infections or that ear infections could be prevented, but more than half believed that ear infections could hinder children’s development and quality of life. All of the schools and almost all of the teachers did not permit chewing gum on campus or in their classrooms, but most teachers said they would participate in ear infection prevention programs, let students chew xylitol gum if it prevented ear infections, and wanted more information on this topic.
Conclusion
Although teachers said they would participate in ear infection prevention programs, obstacles were identified that could preclude the use of xylitol chewing gum. Prevention programs should be developed, but xylitol gum prophylaxis regimens may be better directed at in-home use.
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Mapping analyses to estimate health utilities based on responses to the OM8-30 Otitis Media Questionnaire. Qual Life Res 2009; 19:65-80. [PMID: 19941078 DOI: 10.1007/s11136-009-9558-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the statistical relationship between the OM8-30 health-related quality of life measure for children with otitis media with effusion (OME) and measures of health utility (Health Utilities Index [HUI] Mark 3 and Mark 2) and to develop models to estimate HUI3 and HUI2 health utilities from OM8-30 scores. METHODS A placebo-controlled, randomised trial (GNOME) evaluating intranasal mometasone in 217 children with OME provided concurrent responses to OM8-30 and HUI at three time points. Ordinary least squares (OLS), generalised linear models and two-step regression analyses were used to predict HUI3 and HUI2 utilities based on OM8-30 facet and domain scores. RESULTS OLS models including all nine OM8-30 facets with or without predicted hearing level (HL) produced the best predictions of HUI3 utilities (mean absolute error: 0.134 with HL and 0.132 without; R(2): 0.63 with HL and 0.596 without). An OLS model predicting HUI3 utilities based on the two OM8-30 domain scores, reported hearing difficulties, predicted HL, age and sex also produced accurate predictions. CONCLUSION Regression equations predicting HUI3 and HUI2 utilities based on OM8-30 facet and domain scores have been developed. These provide an empirical basis for estimating quality-adjusted life years (QALYs) for interventions in children with OME.
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Timmerman A, Meesters C, Speyer R, Anteunis L. Psychometric qualities of questionnaires for the assessment of otitis media impact. Clin Otolaryngol 2007; 32:429-39. [DOI: 10.1111/j.1749-4486.2007.01570.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Timmerman A, Meesters C, Anteunis L, Chenault M. Level of psychosocial adaptation in young school children with otitis media. Int J Pediatr Otorhinolaryngol 2007; 71:1843-8. [PMID: 17889940 DOI: 10.1016/j.ijporl.2007.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 08/09/2007] [Accepted: 08/09/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Assessment of the level of psychosocial adaptation in Dutch young school children with persistent and/or recurrent otitis media compared to a U.S. community sample. The goal of this study was to determine the presence of behavioural effects related to a history of hearing loss resulting from recurrent or persistent otitis media. METHODS Caregivers of 160 children, age range 4-7 years, suffering from either upper respiratory tract infections (URTI) and/or otitis media with effusion (OME), completed the generic Strengths and Difficulties Questionnaire (SDQ) and impact supplement before consulting the ENT physician. RESULTS In the ENT sample significant differences were found for the SDQ subscales hyperactivity-inattention and emotional symptoms, as well as for the total difficulties score and impact rating, compared to the U.S. community sample (p<.0005). Classification of severity (low, medium, high difficulties) for SDQ symptom scores, according to U.S. normative scoring bands, showed significantly more children in higher severity bands for SDQ total difficulties (p<.0005), emotional symptoms (p<.005), hyperactivity-inattention (p<.001) and prosocial behaviour (p<.005). This is expressed in a larger percentage of scores in the high difficulties (>90% of scores) than in the medium difficulties (80-90% of scores) band for most ENT SDQ scores, except for SDQ prosocial behaviour (18.1%) and total difficulties (17.5%). CONCLUSION The level of psychosocial adaptation seems to be compromised in the Dutch ENT sample for both internalising (emotional symptoms) and externalising (hyperactivity-inattention) behaviour dimensions, which indirectly supports the cumulative effects of a disease history with chronic otitis media, resulting in poorer attention skills and fewer social interactions present. The classification of SDQ symptom severity, indicates that any behavioural effect of otitis media and resulting hearing loss is within the borderline score range, asking for vigilance regarding possible developmental and educational sequelae during childhood.
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Affiliation(s)
- Angelique Timmerman
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
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