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Choi EK, Yun H, Bae E. An Online-Based Transition Care Program for Adolescents with Spina Bifida Using Intervention Mapping: A Protocol for Program Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031056. [PMID: 35162083 PMCID: PMC8834098 DOI: 10.3390/ijerph19031056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 11/25/2022]
Abstract
Adolescents with spina bifida (SB) face challenges in their transition to adulthood due to intensive medical regimens and delayed development of independence. Despite an increasing interest in the transition of adolescents with SB to adulthood, the clinical evidence of transition care remains limited, and existing studies have focused on the effects of intervention programs. This study aims to describe the process of systematically developing an online-based transition care program for adolescents with SB using the intervention mapping (IM) protocol. IM consists of six steps: (1) logic model of the problem; (2) program objectives; (3) program design; (4) program production; (5) plan to implement the program; (6) plan for evaluation. At first, five problems faced during the transition were identified, based on which four program objectives and six program strategies were established. The online transition care program for adolescents with SB was developed as a six-week program. The main strength of this program is that it reflects the diverse perspectives of adults with SB and health care professionals and is easy to apply because it is online. We aim to further validate the feasibility of this transitional care program to evaluate its effect based on our evaluation plan.
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Affiliation(s)
- Eun Kyoung Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul 03722, Korea;
| | - Hyeseon Yun
- Brain Korea 21 FOUR Project, College of Nursing, Yonsei University, Seoul 03722, Korea;
| | - Eunjeong Bae
- Brain Korea 21 FOUR Project, College of Nursing, Yonsei University, Seoul 03722, Korea;
- Correspondence: ; Tel.: +82-2-2228-3340
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Booysen F, Botha F, Wouters E. Conceptual causal models of socioeconomic status, family structure, family functioning and their role in public health. BMC Public Health 2021; 21:191. [PMID: 33478444 PMCID: PMC7821511 DOI: 10.1186/s12889-021-10214-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
Social determinants of health frameworks are standard tools in public health. These frameworks for the most part omit a crucial factor: the family. Socioeconomic status moreover is a prominent social determinant of health. Insofar as family functioning is poorer in poor families and family structure and functioning are linked to health, it is critical to consider the pathways between these four constructs. In this correspondence, we reflect on how empirical studies of this conceptual nexus mirror two causal models. We conclude by reflecting on future directions for research in this field.
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Affiliation(s)
- Frederik Booysen
- School of Economics and Finance, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, 2050, Johannesburg, South Africa.
| | - Ferdi Botha
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Melbourne, Australia.,ARC Centre of Excellence for Families and Children Over the Life Course, Melbourne, Australia
| | - Edwin Wouters
- Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
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Altınay Kırlı E, Türk Ş, Kırlı S. The Burden of Urinary Incontinence on Caregivers and Evaluation of Its Impact on Their Emotional Status. ALPHA PSYCHIATRY 2021; 22:43-48. [PMID: 36426208 PMCID: PMC9590664 DOI: 10.5455/apd.119660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to evaluate caregivers of children with urinary incontinence in terms of the caregiving burden and its associated manifestations. METHODS Caregivers of children who are being treated for urinary incontinence secondary to neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD) were evaluated for caregiver burden (Zarit score), depression (Beck Depression Inventory [BDI]), and anxiety (Beck Anxiety Inventory [BAI]). Additionally, children were evaluated for dysfunctional voiding score. All scores were statistically analyzed for correlation with and relation to the caregiver's emotional status. RESULTS Zarit score was equal in caregivers of children with neurogenic and non-neurogenic LUTD. BDI score was higher in caregivers of patients with neurogenic LUTD, whereas BAI score was higher in caregivers of patients with non-neurogenic LUTD. In the evaluation performed, considering the etiological difference, Zarit score in the group with non-neurogenic LUTD correlated positively with BAI and BDI scores. In the neurogenic bladder group, Zarit score correlated with BDI score. CONCLUSION It is important not only in psychiatric patients, but also in those with other chronic disease processes, to evaluate the mental status of caregivers and to support them in dealing with the problem.
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Affiliation(s)
| | - Şeyda Türk
- Department of Psychiatry, Uludağ University School of Medicine,
Bursa,
Turkey
| | - Selçuk Kırlı
- Department of Psychiatry, Uludağ University School of Medicine,
Bursa,
Turkey
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Choi EK, Jung E, Bae E, Ji Y, Lee A. Two-Step Integrative Education Program and mHealth for Korean Children with Spina Bifida: A Quasi-Experimental Pre-Post Study. J Pediatr Nurs 2020; 51:e92-e99. [PMID: 31924471 DOI: 10.1016/j.pedn.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Self-management of the daily tasks associated with condition management is an important goal for children with spina bifida (SB)to achieve for adolescence. This study investigated the effects of a two-step self-management improvement program including an onsite, integrative education program and mHealth on children with SB based on the Individual and Family Self-Management Theory. DESIGN AND METHODS We used a pretest-posttest, quasi-experimental design with a nonequivalent control group. Open-ended questions were administered to obtain the opinions of the participants and their parents on the intervention program. The intervention effectiveness was evaluated by repeated-measures ANOVA using factors such as school adjustment, self-management knowledge, self-efficacy, self-management behavior, and quality of life measurement in 35 children with SB aged 7-12 years and their parents from July 2018 to October 2018. RESULTS This intervention program did not result in a significant difference in quantitative outcomes between the experimental and control groups, but qualitatively, the children participating in this study and their parents responded positively to the self-management program. CONCLUSION The current study demonstrated the potential effectiveness of this self-management program in children with SB. PRACTICE IMPLICATIONS When healthcare providers develop an intervention for school-going children who are the digital native generation, up-to-date technological interventions, level of motivation of children, and intervention dosage should be taken into consideration.
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Affiliation(s)
- Eun Kyoung Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
| | - Eunyoung Jung
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Eunjeong Bae
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Yoonhye Ji
- Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Healthcare System, Seoul, South Korea.
| | - Anna Lee
- Department of Nursing, College of Health and Welfare, Gangneung-Wonju National University, Wonju, South Korea; Department of Nursing, College of Medicine, University of Ulsan, Ulsan, South Korea.
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Schulz A, Jain M, Butt T, Ballinger R, Eliasson L, Macey J, Peasgood T, Olaye A, Terzakis-Snyder IA, Dyck I, West A. The Challenges of Living with and Caring for a Child or Children Affected by Neuronal Ceroid Lipofuscinosis Type 2 Disease: In-Depth Family Surveys in the United Kingdom and Germany. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2020. [DOI: 10.1590/2326-4594-jiems-2019-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Angela Schulz
- University Medical Center Hamburg-Eppendorf, Germany
| | | | | | | | | | | | | | | | | | - Iris Dyck
- NCL-Gruppe Deutschland e.V., Germany
| | - Andrea West
- Batten Disease Family Association, United Kingdom
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Nahal MS, Axelsson ÅB, Imam A, Wigert H. Palestinian children's narratives about living with spina bifida: Stigma, vulnerability, and social exclusion. Child Care Health Dev 2019; 45:54-62. [PMID: 30335194 DOI: 10.1111/cch.12625] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Living with spina bifida in Palestine is a critical issue that might influence various aspects of the individual's life. It is a challenge for children, their families, and health care providers because it requires lifelong treatment and follow-up of care provision. However, little focus has been placed on these children's perceptions about their daily life experiences with spina bifida. PURPOSE To illuminate the lived experience of children with spina bifida in the West Bank, Palestine. METHODS A qualitative study was conducted using the phenomenological hermeneutical method to interpret the meaning of being a child with spina bifida in Palestine. Ten children with spina bifida, aged 7-18 years, were interviewed. The two local authors independently analyzed the Arabic transcriptions, whereas the two Swedish authors analyzed the transcriptions after translation to English. Finally, the four authors discussed their analysis and reached agreement about the themes. RESULTS Studying the children's experience with spina bifida helped us highlight their feelings, needs, and challenges. The findings were formulated into one main theme, Vulnerability and suffering due to social exclusion and stigma, which was grounded in three themes: Experiencing negative self-concept, Experiencing vulnerability, and Obtaining a sense of security. These three themes were in turn derived from subthemes. CONCLUSION The Palestinian children in this study faced physical, emotional, and psychosocial challenges, which negatively influenced their health and development. They were vulnerable and stigmatized, and they lived with a negative self-concept. The findings could help health professionals, families, and caregivers to achieve a deeper understanding of what being a child with disabilities entails, and the findings may also serve as a platform for interventions that seek to promote these children's development and to enable them to experience childhood as a meaningful and positive process.
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Affiliation(s)
- Maha Sudki Nahal
- Faculty of Health Professions, Department of Nursing, Al-Quds University, Abu Dis Campus, Jerusalem, Palestine
| | - Åsa B Axelsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Asma Imam
- School of Public Health, Al-Quds University, Abu Dies Campus, Jerusalem, Palestine
| | - Helena Wigert
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Nahal MSH, Wigert H, Imam A, Axelsson ÅB. From Feeling Broken to Looking Beyond Broken: Palestinian Mothers' Experiences of Having a Child With Spina Bifida. JOURNAL OF FAMILY NURSING 2017; 23:226-251. [PMID: 28795898 DOI: 10.1177/1074840717697436] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Spina bifida (SB) is the second most common birth defect worldwide. Mothers of children with SB face extraordinary challenges due to the complicated conditions and disability of their children. Little is known about the impact of these challenges on the mothers' well-being, particularly in Middle Eastern culture, where chronic illness and disability are perceived as a stigma, and care of disabled children has traditionally been the responsibility of the mother. The aim of this study was to illuminate mothers' lived experience of having a child with SB in Palestine. Twenty Arab-Muslim mothers living in Palestine were purposefully recruited from several rehabilitation centers in Palestine and were interviewed in 2014. The transcribed interviews were analyzed according to phenomenological hermeneutics. The mothers' experiences were described in the main theme: From feeling broken to looking beyond broken. Four themes were interwoven: living with constant anxiety, living with uncertainty, living with a burden, and living with a difficult life situation. These findings highlight the burden and resilience of the Arab-Muslim Palestinian mothers while striving to maintain the well-being of the whole family as well as facilitating the child's welfare.
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Affiliation(s)
| | - Helena Wigert
- 1 University of Gothenburg, Sweden
- 3 Sahlgrenska University Hospital, Göteborg, Sweden
| | - Asma Imam
- 2 Al-Quds University, Jerusalem, Palestine
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Ridosh MM, Sawin KJ, Klein-Tasman BP, Holmbeck GN. Depressive Symptoms in Parents of Children with Spina Bifida: A Review of the Literature. Compr Child Adolesc Nurs 2017; 40:71-110. [PMID: 29318952 DOI: 10.1080/24694193.2016.1273978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To review the literature on the prevalence of depressive symptoms in parents of children with spina bifida (SB) and factors related to these symptoms. A search was conducted using the major health databases (CINAHL, MEDLINE, and PsycINFO). Nineteen studies were identified that met inclusion and exclusion criteria. A context, process, and outcome framework was used to organize the findings. This review identified both: (a) a high prevalence of parental depressive symptoms (PDS); and (b) specific factors: demographics, condition, child, family functioning, and parent factors that explained 32-67% of parent depressive symptoms (PDS). Although contextual factors were important, they alone were not sufficient to explain PDS. Process factors accounted for more variance in PDS than context factors. Findings warrant implementation of depression screening in parents of children with spina bifida. This review identified factors related to PDS and highlighted gaps in the literature to guide future research.
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Affiliation(s)
- Monique M Ridosh
- a Marcella Niehoff School of Nursing , Loyola University Chicago , Chicago , Illinois , USA
| | - Kathleen J Sawin
- b Self-Management Science Center, College of Nursing , University of Wisconsin-Milwaukee and Children's Hospital of Wisconsin , Milwaukee , Wisconsin , USA
| | - Bonita P Klein-Tasman
- c Department of Psychology , University of Wisconsin-Milwaukee , Milwaukee , Wisconsin , USA
| | - Grayson N Holmbeck
- d Department of Psychology , Loyola University Chicago , Chicago , Illinois , USA
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Brekke I, Früh EA, Kvarme LG, Holmstrøm H. Long-time sickness absence among parents of pre-school children with cerebral palsy, spina bifida and down syndrome: a longitudinal study. BMC Pediatr 2017; 17:26. [PMID: 28100193 PMCID: PMC5242016 DOI: 10.1186/s12887-016-0774-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 12/30/2016] [Indexed: 11/21/2022] Open
Abstract
Background Taking care of a child with special needs can be draining and difficult and require a lot of parental time and resources. The present study investigated the long-term sickness absence of parents who have children with spina bifida, cerebral palsy and Down syndrome compared to that of parents without a child with special needs. Methods The sample consisted of primiparae women who gave birth between 2001 and 2005 and the fathers of the children (N = 202,593). Data were obtained from the Medical Birth Registry of Norway (MBRN), which is linked to the Central Population Register, education and income registries and Historical Event Database (FD-Trygd) of Statistics Norway (SSB). The linkage data provide longitudinal data, together with annual updates on children and their parents. Statistical analyses were performed using difference-in-difference (DD) study design. Results Caring for a child with special needs affected maternal sickness absence, particularly in the first year after the birth. The level of sickness absence of mothers caring for a child with spina bifida and cerebral palsy was greater than that of mothers caring for a child with Down syndrome. In contrast, the sickness absence of fathers caring for a child with special needs was, on average, comparable to that of fathers without a special-needs child in the post-birth period. Conclusions Caring for a child with special needs affected the long-term sickness absence of mothers but not fathers. The findings indicate that the burden of care in the case of children with special needs falls especially on the mother.
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Affiliation(s)
- Idunn Brekke
- Faculty of Health Sciences - Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Post Box 4, St. Olavs plass, N-0130, Oslo, Norway.
| | - Elena Albertini Früh
- Faculty of Health Sciences - Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Post Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Faculty of Health Sciences - Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Post Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - Henrik Holmstrøm
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
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Ridosh MM, Sawin KJ, Schiffman RF, Klein-Tasman BP. Factors associated with parent depressive symptoms and family quality of life in parents of adolescents and young adults with and without Spina Bifida. J Pediatr Rehabil Med 2016; 9:287-302. [PMID: 27935566 DOI: 10.3233/prm-160399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to explore factors related to parental depressive symptoms (PDS) and family quality of life (FQOL) in parents of adolescents and young adults (AYA) with and without a specific chronic health condition (CHC), spina bifida. METHODS Two hundred and nine parents of AYA (112 with SB; and 97 without) and their AYA (46% males and 54% females) took part in a multi-site cross-sectional descriptive correlational study. In telephone interviews parents reported on measures of family satisfaction, resources, cohesion, stress, demographic and clinical data. RESULTS In the multivariate analyses, 38% of the variance of PDS was explained by family income, family resources and parent stress. Having a child with SB was not predictive of PDS. However, having a child with SB, along with family satisfaction, parent stress and PDS explained 49% of the variance of FQOL. PDS partially mediate the relationship of family resources and FQOL. CONCLUSION PDS, family stress, and resources should be evaluated routinely, especially for those with low income. Parents of AYA with SB who have elevated PDS are at increased risk of having lower reported FQOL.
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Affiliation(s)
- Monique M Ridosh
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Kathleen J Sawin
- Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee, WI, USA.,Self-Management Science Center, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Rachel F Schiffman
- CON Self-Management Science Center Director, UWM Clinical and Translation Science Institute University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Bannink F, Idro R, van Hove G. Parental stress and support of parents of children with spina bifida in Uganda. Afr J Disabil 2016; 5:225. [PMID: 28730051 PMCID: PMC5433456 DOI: 10.4102/ajod.v5i1.225] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/13/2015] [Indexed: 11/12/2022] Open
Abstract
Background Children with disabilities in Sub-Saharan Africa depend for a large part of their functioning on their parent or caregiver. This study explores parental stress and support of parents of children with spina bifida in Uganda. Objectives The study aimed to explore perceived stress and support of parents of children with spina bifida living in Uganda and the factors that influence them. Methods A total of 134 parents were interviewed. Focus group discussions were held with four parent support groups in four different regions within the country. The Vineland Adaptive Behaviour Scales, Daily Functioning Subscales and Parental Stress Index Short Form (PSI/SF) were administered to measure the child’s daily functioning level and parental stress levels. Results Parental stress was high in our study population with over half of the parents having a > 90% percentile score on the PSI/SF. Stress outcomes were related to the ability to walk (Spearman’s correlation coefficient [ρ] = −0.245), continence (ρ = −0.182), use of clean intermittent catheterisation (ρ = −0.181) and bowel management (ρ = −0.213), receiving rehabilitative care (ρ = −0.211), household income (ρ = −0.178), geographical region (ρ = −0.203) and having support from another parent in taking care of the child (ρ = −0.234). Linear regression showed parental stress was mostly explained by the child’s inability to walk (β = −0.248), practicing bowel management (β = −0.468) and having another adult to provide support in caring for the child (β = −0.228). Parents in northern Uganda had significantly higher scores compared to parents in other regions (Parental Distress, F = 5.467*; Parent–Child Dysfunctional Interaction, F = 8.815**; Difficult Child score, F = 10.489**). Conclusion Parents of children with spina bifida experience high levels of stress. To reduce this stress, rehabilitation services should focus on improving mobility. Advocacy to reduce stigmatisation and peer support networks also need to be strengthened and developed.
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Affiliation(s)
- Femke Bannink
- Faculty of Psychology and Educational Sciences, Ghent University, Uganda
| | - Richard Idro
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Uganda
| | - Geert van Hove
- Faculty of Psychology and Educational Sciences, Ghent University, Uganda
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Kabra AT, Feustel PJ, Kogan BA. Screening for depression and anxiety in childhood neurogenic bladder dysfunction. J Pediatr Urol 2015; 11:75.e1-7. [PMID: 25824880 DOI: 10.1016/j.jpurol.2014.11.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 11/10/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Patients with chronic illnesses are known to have anxiety disorders and are likely to be depressed. Anxiety and depression (A/D) has been studied in adults with spina bifida (SB), however, no study has directly screened for A/D in pediatric patients with neurogenic bladder (NB) and their caregivers. OBJECTIVE The aims of our study were to determine the prevalence of A/D in caregivers of all children with SB and other NB dysfunction and in adolescents with validated screening measures. STUDY DESIGN & PATIENTS This was a preliminary cross-sectional screening investigation for A/D in pediatric patients with NB and their caregivers and adolescents with NB. Pediatric patients were defined as ages birth to 19 years and adolescents as ages 10 years-19 years. A caregiver was self-defined as a primary parent/guardian who took care of the pediatric patient for a majority of their time on a daily basis. MATERIALS AND METHODS We contacted 75 families by mail, of which 15 returned the consent and completed the questionnaires. Subsequently, 25 consecutive families whose children were seen for routine office appointments by the pediatric urology service at the Albany Medical Center in New York participated in person. 22 adolescents completed the Hospital Anxiety and Depression Scale (HADS). 47 caregivers completed both the HADS and the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS Depression among adolescents: Of the 22 adolescents who completed the HADS, the median HADS score was 5.5 (Inter-quartile range (IQR): 1.75-8.75) for anxiety and 1.5 (IQR: 0-4.25) for depression; both scores were within the normal range (<8/21). Individual abnormal HADS scores (≥8/21) were seen in 6/22 (27%) for anxiety and 1/22 (5%) for depression. Anxiety and depression among caregivers: Of the 47 caregivers who completed the HADS and CES-D, the median HADS score was 7 (IQR: 4-11) for anxiety and 4 (IQR: 1-7) for depression; both scores were within the normal range. Individual abnormal HADS scores were seen in 23/47 (49%) for anxiety and 10/47 (21%) for depression. Abnormal CES-D scores (>15) were seen in 15/47 (32%). The median CES-D scores were 8 (IQR: 3-19). DISCUSSION In this preliminary screening study, we found considerable anxiety in adolescents with NB and both A/D in caregivers. When screening by two validated surveys, adolescents with NB had median scores for A/D that were normal; yet 27% of these patients exhibited scores for anxiety that outwit the normal range. For the caregivers, the median scores were also normal; yet 49% and 32% had scores for A/D, respectively, that were abnormal. SB among pediatric patients has been shown to result in alterations in daily functioning and to increase the dependency on adult care, factors that are associated with altered self-concept, psychological distress, including A/D. Our findings underscore such results from previous studies. In caregivers, we observed a higher prevalence of anxiety than adolescents; similar findings have been reported for caregivers of other chronic conditions. Surprisingly, in caregivers, a lower percentage of scores for depression was observed. Although we have no data on the cause of this finding this may be related to a caregiver's ability to adapt to the demands of the situation in chronic illness or perhaps, lower expectations. The cross-sectional nature of our study limited us to draw any causal relationships for anxiety or depression between neurogenic patients and their caregivers. CONCLUSION Despite our study limitations, the prevalence of anxiety in adolescents and in the caregivers is striking. Our data highlight that clinicians should screen for A/D more aggressively in pediatric patients with NB dysfunction and in their caregivers.
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Affiliation(s)
- Aashish T Kabra
- Department of Urology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | | | - Barry A Kogan
- Urological Institute of Northeastern New York Community Care Physicians, Albany, NY, USA
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Limiñana-Gras RM, Sánchez-López MDP, Calvo-Llena MT, Corbalán FJ. Personality Styles, Psychological Adjustment and Gender Differences in Parents of Children with Congenital Disabilities. Health (London) 2015. [DOI: 10.4236/health.2015.711163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sirzai H, Dogu B, Demir S, Yilmaz F, Kuran B. Assessment on self-care, mobility and social function of children with spina bifida in Turkey. Neural Regen Res 2014; 9:1234-40. [PMID: 25206788 PMCID: PMC4146288 DOI: 10.4103/1673-5374.135332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2014] [Indexed: 01/27/2023] Open
Abstract
The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory (PEDI) to look into capacity of twenty-eight children with spina bifida with lesions at different levels in different dimensions of self-care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 (1-10) years. In the muscle test carried out, 13 patients (44.8%) had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients (54%) were non-ambulatory according to the Hoofer ambulation classification. Raw and scale scores in the self-care, mobility and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambulation Scale and muscle test (P < 0.05). A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test (P < 0.005). A negative relation was also found between Caregiver Assistance Scale-mobility and Functional Ambulation Scale and muscle test (P < 0.005). In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence.
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Affiliation(s)
- Hulya Sirzai
- Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Beril Dogu
- Department of Physical Medicine and Rehabilitation, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Selamet Demir
- Department of Physical Medicine and Rehabilitation, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Figen Yilmaz
- Department of Physical Medicine and Rehabilitation, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Banu Kuran
- Department of Physical Medicine and Rehabilitation, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
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