1
|
Arai Y, Kadekaru R, Okanishi T, Tamasaki A, Maegaki Y. Assessing the Subjective Happiness of Parents of Children With Severe Motor and Intellectual Disabilities Receiving Home Care. Cureus 2024; 16:e64562. [PMID: 39144842 PMCID: PMC11323715 DOI: 10.7759/cureus.64562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Home care for children with severe motor and intellectual disabilities (SMID) is challenging for parents because it is highly intensive and long-lasting. The pursuit of happiness is an essential goal for everyone. However, only a few studies have focused on the happiness of families with such children. OBJECTIVE The study aimed to examine the subjective happiness of parents of children with SMID receiving home care and identify the factors associated with their happiness. METHODS We conducted a cross-sectional online questionnaire-based survey of 23 parents of children with SMID and nurses with children without disabilities as controls at Tottori University Hospital, Yonago, Japan from July 1 to August 31, 2023. We set the subjective happiness scale (SHS) scores as the outcomes. We used the Mann-Whitney U test to compare the SHS scores between the two groups. Moreover, we extracted the clinical and demographic factors affecting the SHS scores of parents of children with SMID using univariate linear regression analysis. RESULTS We obtained responses from 12 parents with SMID and 105 controls. The average SHS scores of parents with SMID and controls were 4.8 and 4.7, respectively, and both groups did not differ significantly. Univariate analysis showed that parental male sex and the presence of a tracheostomy were negatively associated with the SHS scores of parents. CONCLUSIONS The SHS scores did not differ significantly between parents with SMID and controls. However, more attention seemed necessary for fathers and parents of children who have undergone tracheostomies. Given the exploratory nature of this study and its small sample size, larger-scale investigations are warranted. Additionally, qualitative research conducted after establishing trustful relationships could provide further insights.
Collapse
Affiliation(s)
- Yuto Arai
- Child Neurology, Tottori University Hospital, Yonago, JPN
| | - Ryuki Kadekaru
- Psychology, Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Yonago, JPN
| | - Tohru Okanishi
- Child Neurology, Tottori University Hospital, Yonago, JPN
| | | | - Yoshihiro Maegaki
- Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Tottori, JPN
| |
Collapse
|
2
|
Larsen JL, Hansson H, Bisgaard AM, Stahlhut M. Psychological aspects of being a parent of an individual with Rett syndrome: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13188. [PMID: 38369306 DOI: 10.1111/jar.13188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/28/2023] [Accepted: 12/09/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Rett syndrome (RTT) causes multiple disabilities with a lifelong need for substantial care, placing a tremendous lifelong responsibility on the parents. Parenting an individual with RTT can therefore be challenging. Research on the psychological aspects of parenting individuals with RTT is limited and unclear. We aimed to identify and map the existing literature on this subject. METHOD A scoping review was conducted with systematic searches in PubMed, PsycINFO and CINAHL. RESULTS Eighteen studies were included. Negative and positive psychological aspects were described with the majority focusing on the negative. Three factors seemed to especially affect the parents: severity of the diagnosis, time (increasing age of parents or individual with RTT; years of caretaking), work-status of the mother. CONCLUSIONS Seemingly, parents are highly affected; however, the literature is scarce and has several gaps. Future research should include older parents, fathers, parents of individuals living in group homes, and positive aspects.
Collapse
Affiliation(s)
- Jane Lunding Larsen
- Department of Pediatrics and Adolescent Medicine, Center for Rett Syndrome, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Helena Hansson
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Bisgaard
- Department of Pediatrics and Adolescent Medicine, Center for Rett Syndrome, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Michelle Stahlhut
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| |
Collapse
|
3
|
Rousseau MC, Winance M, Baumstarck K. Polyhandicap, profound intellectual multiple disabilities : Concept and definition of a highly specific public health issue. Rev Epidemiol Sante Publique 2023; 71:102184. [PMID: 37918043 DOI: 10.1016/j.respe.2023.102184] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES The concept of polyhandicap first emerged in the late '60s in France, with actually a consensus on its definition. This consensus has yet to be reached internationally. The absence of an international consensus on a definition and name for persons with polyhandicap limits progress in research and health planning for these people. METHODS This article describes the history of the emergence of the concept of polyhandicap in France and internationally. RESULTS The emergence of the concept and definition of polyhandicap is part of the history of the development of special education and care for children with disabilities started at the end of the 19th century and during the first half of the 20th century. In France, between 1970 and 2002, working groups composed of professionals and family associations gradually developed and refined the definition of polyhandicap, differentiating it from other clinical entities such as cerebral palsy. Internationally, the term polyhandicap is used in 4 European countries: in France where it first appeared, in Italy, in French-speaking Belgium, and in French-speaking Switzerland but also outside the EU. Various terms may be used around the world to describe clinical entities similar to polyhandicap; the most frequently used in the literature is the term Profound Intellectual and Multiple Disabilities (PIMD) or PIMD Spectrum which does not systematically refer to an early brain injury. DISCUSSION We are currently in the process of internationalizing the concept and definition of polyhandicap, and hopefully, as was the case for cerebral palsy in the 2000s, the various research teams working on this subject around the world will create collaborations and research networks targeting this specific population. CONCLUSION A consensus around a precise definition of polyhandicap is important to ensure that these people are recognized for their uniqueness and specific qualities and to provide them adapted care.
Collapse
Affiliation(s)
- Marie-Christine Rousseau
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27 boulevard Jean-Moulin, 13385 Marseille, France; Hôpital San Salvadour, Hospital Fédération des Hôpitaux de Polyhandicap et Multihandicap, University Hospital of Paris, 4312 Rte de l'Almanarre, 83400 Hyères, France.
| | - Myriam Winance
- CERMES3, INSERM, Université Paris Cité, CNRS, EHESS, France
| | - Karine Baumstarck
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27 boulevard Jean-Moulin, 13385 Marseille, France; Epidemiology and Health Economy Department, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille, France
| |
Collapse
|
4
|
Hamouda I, Rousseau MC, Beltran Anzola A, Aim MA, de Villemeur TB, Auquier P, Baumstarck K, de Villemeur TB, Rousseau MC, Khaldi-Cherif S, Maincent K, Felce A, Baumstarck K, Auquier P, Dany L, Beltran A, Hamouda I, Aim MA, Boutalbi N, Kemlin I, Roger J, Julien P, Heng P, Willocq D, Valkov M, Pietra S, Lenormand S, Lind K. The French EVAL-PLH cohort of persons with polyhandicap. Sci Rep 2022; 12:12512. [PMID: 35869128 PMCID: PMC9305042 DOI: 10.1038/s41598-022-16596-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/12/2022] [Indexed: 12/02/2022] Open
Abstract
Polyhandicap is characterized by a combination of profound intellectual disability and serious motor deficit, resulting in the extreme restriction of autonomy and communication. The aim of the EVAL-PLH (EVALuation PoLyHandicap) study is to identify the impact of socioeconomic, environmental, and epidemiological determinants on the health status of the persons with polyhandicap and the daily lives of their caregivers. EVAL-PLH is a prospective cohort study. The study involved persons with severe polyhandicap (who were cared for at reeducation centers, residential facilities, and one specialized pediatric/neurological department of a university hospital), their familial caregivers and the institutional caregivers. Data collection included sociodemographics, heath status, and psychocomportemental information. Data have been collected at 2 points (2015-2016 and 2020-2021). The French EVAL-PLH cohort is the first cohort study focusing on persons with polyhandicap, their families, and the health care workers caring for them. The sustainability of the device is essential to assist patients, families, clinicians, and health decision-making authorities in the optimization of care management.
Collapse
|
5
|
Development and initial validation of the polyhandicap severity scale. Rev Neurol (Paris) 2020; 177:683-689. [PMID: 33069376 DOI: 10.1016/j.neurol.2020.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/09/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Providing a new tool, based on the point of view of experts in polyhandicap, which assesses the global severity of the health status of polyhandicapped persons is necessary. We present herein the initial validation of the polyhandicap severity scale (PSS). METHODS The initial development of the tool was undertaken in two steps: item selection and validation process. The final set included 10 items related to abilities and 17 items related to comorbidities and impairments. The patient selection criteria were as follows: age>3 years, age at onset of cerebral lesion under 3 years old, with a combination of motor deficiency and profound intellectual impairment, associated with restricted mobility and everyday life dependence. External validity, reproducibility (20 patients), responsiveness (38 patients), and acceptability were explored. RESULTS During the 18-month study period, a total of 875 patients were included. Two scores were calculated: an abilities score and a comorbidities/impairments score (higher score, higher severity). The 2 scores were higher for: older patients, patients with a progressive etiology, patients with more devices and more medications, patients with higher dependency and lower mobility. Indicators of reproducibility and responsiveness were satisfactory. The mean time duration of fulfilling was 22minutes (standard deviation 5). CONCLUSIONS Quantifying the health severity of polyhandicapped persons is necessary for both healthcare workers and health decision makers. The polyhandicap severity scale provides the first reliable and valid measure of the health severity status for children and adults.
Collapse
|
6
|
Rousseau MC, Baumstarck K, Valkov M, Felce A, Brisse C, Khaldi-Cherif S, Loundou A, Auquier P, Billette de Villemeur T. Impact of severe polyhandicap cared for at home on French informal caregivers' burden: a cross-sectional study. BMJ Open 2020; 10:e032257. [PMID: 32014871 PMCID: PMC7045096 DOI: 10.1136/bmjopen-2019-032257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Polyhandicap (PLH), defined by a combination of profound intellectual impairment and serious motor deficits, is a severe condition with complex disabilities. In France, care of the large majority of PLH individuals is managed in specialised rehabilitation centres or residential facilities, but some of PLH individuals are cared for at home. The aims of this study were to assess the self-perceived burden among informal caregivers of PLH individuals and to identify potential determinants of this burden. DESIGN Cross-sectional study (Neuropaediatric Department, Trousseau Hospital, Paris, France). SETTINGS PLH children were recruited from a specialised paediatric/neurological department. PARTICIPANTS The selection criteria of caregivers were age above 18 years and being the PLH individual's next of kin. OUTCOMES MEASURES From March 2015 to December 2016, data were collected from the caregivers, including sociodemographical data, health status, psycho-behavioural data (quality of life, mood disorders and coping) and self-perceived burden. In addition, the health status of the PLH individual was collected. Relationships between the burden scores and potential determinants were tested (correlations coefficients, Mann-Whitney tests, generalised estimating equations models). RESULTS Eighty-four children were eligible; 77 families returned their questionnaire. The informal caregivers of PLH children experienced a high level of perceived burden (scores ranged from 55±20 to 81±12). Eighty per cent of them had more than 5 hours of daily caregiving and 51% of them had to get up more than twice during the night. The main factors associated with caregiver burden were age, financial issues, health status, daily care and coping strategies. The patients' health status was not associated with caregiver burden. CONCLUSIONS Some of the caregiver burden determinants might be modifiable. These findings should help healthcare workers and health-decision makers implement specific and appropriate interventions. TRIAL REGISTRATION NUMBER NCT02400528.
Collapse
Affiliation(s)
- Marie-Christine Rousseau
- Hôpital San Salvadour, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Karine Baumstarck
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Maria Valkov
- Hôpital San Salvadour, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Agnés Felce
- Hôpital Marin d'Hendaye, Assistance Publique Hopitaux de Paris, Paris, Île-de-France, France
| | - Catherine Brisse
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées, Paris, France
| | | | - Anderson Loundou
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Pascal Auquier
- EA 3279, Self-perceived Health Assessment Research Unit, Aix-Marseille Universite, Marseille, France
| | - Thierry Billette de Villemeur
- Hôpital de La Roche Guyon, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, France
- Pathologie du développement, Sorbonne Université, UPMC, GRC ConCer-LD, Paris, France
| |
Collapse
|