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France E, Uny I, Turley R, Thomson K, Noyes J, Jordan A, Forbat L, Caes L, Silveira Bianchim M. A meta-ethnography of how children and young people with chronic non-cancer pain and their families experience and understand their condition, pain services, and treatments. Cochrane Database Syst Rev 2023; 10:CD014873. [PMID: 37795766 PMCID: PMC10552070 DOI: 10.1002/14651858.cd014873.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Chronic non-cancer pain in childhood is widespread, affecting 20% to 35% of children and young people worldwide. For a sizeable number of children, chronic non-cancer pain has considerable negative impacts on their lives and quality of life, and leads to increased use of healthcare services and medication. In many countries, there are few services for managing children's chronic non-cancer pain, with many services being inadequate. Fourteen Cochrane Reviews assessing the effects of pharmacological, psychological, psychosocial, dietary or physical activity interventions for managing children's chronic non-cancer pain identified a lack of high-quality evidence to inform pain management. To design and deliver services and interventions that meet the needs of patients and their families, we need to understand how children with chronic non-cancer pain and their families experience pain, their views of services and treatments for chronic pain, and which outcomes are important to them. OBJECTIVES 1. To synthesise qualitative studies that examine the experiences and perceptions of children with chronic non-cancer pain and their families regarding chronic non-cancer pain, treatments and services to inform the design and delivery of health and social care services, interventions and future research. 2. To explore whether our review findings help to explain the results of Cochrane Reviews of intervention effects of treatments for children's chronic non-cancer pain. 3. To determine if programme theories and outcomes of interventions match children and their families' views of desired treatments and outcomes. 4. To use our findings to inform the selection and design of patient-reported outcome measures for use in chronic non-cancer pain studies and interventions and care provision to children and their families. The review questions are: 1. How do children with chronic non-cancer pain and their families conceptualise chronic pain? 2. How do children with chronic non-cancer pain and their families live with chronic pain? 3. What do children with chronic non-cancer pain and their families think of how health and social care services respond to and manage their child's chronic pain? 4. What do children with chronic non-cancer pain and their families conceptualise as 'good' chronic pain management and what do they want to achieve from chronic pain management interventions and services? SEARCH METHODS Review strategy: we comprehensively searched 12 bibliographic databases including MEDLINE, CINAHL, PsycInfo and grey literature sources, and conducted supplementary searches in 2020. We updated the database searches in September 2022. SELECTION CRITERIA To identify published and unpublished qualitative research with children aged 3 months to 18 years with chronic non-cancer pain and their families focusing on their perceptions, experiences and views of chronic pain, services and treatments. The final inclusion criteria were agreed with a patient and public involvement group of children and young people with chronic non-cancer pain and their families. DATA COLLECTION AND ANALYSIS We conducted a qualitative evidence synthesis using meta-ethnography, a seven-phase, systematic, interpretive, inductive methodology that takes into account the contexts and meanings of the original studies. We assessed the richness of eligible studies and purposively sampled rich studies ensuring they addressed the review questions. Cochrane Qualitative Methods Implementation Group guidance guided sampling. We assessed the methodological limitations of studies using the Critical Appraisal Skills Programme tool. We extracted data on study aims, focus, characteristics and conceptual findings from study reports using NVivo software. We compared these study data to determine how the studies related to one another and grouped studies by pain conditions for synthesis. We used meta-ethnography to synthesise each group of studies separately before synthesising them all together. Analysis and interpretation of studies involved children with chronic non-cancer pain and their families and has resulted in theory to inform service design and delivery. Sampling, organising studies for synthesis, and analysis and interpretation involved our patient and public involvement group who contributed throughout the conduct of the review. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each review finding. We used a matrix approach to integrate our findings with existing Cochrane Reviews on treatment effectiveness for children's chronic non-cancer pain. MAIN RESULTS We synthesised 43 studies sampled from 170 eligible studies reported in 182 publications. Included studies involved 633 participants. GRADE-CERQual assessments of findings were mostly high (n = 21, 58%) or moderate (n = 12, 33%) confidence with three (8%) low or very low confidence. Poorly managed, moderate or severe chronic non-cancer pain had profound adverse impacts on family dynamics and relationships; family members' emotions, well-being, autonomy and sense of self-identity; parenting strategies; friendships and socialising; children's education and future employment prospects; and parental employment. Most children and parents understood chronic non-cancer pain as having an underlying biological cause and wanted curative treatment. However, families had difficulties seeking and obtaining support from health services to manage their child's pain and its impacts. Children and parents felt that healthcare professionals did not always listen to their experiences and expertise, or believe the child's pain. Some families repeatedly visited health services seeking a diagnosis and cure. Over time, some children and families gave up hope of effective treatment. Outcomes measured within trials and Cochrane Reviews of intervention effects did not include some outcomes of importance to children and families, including impacts of pain on the whole family and absence of pain. Cochrane Reviews have mainly neglected a holistic biopsychosocial approach, which specifies the interrelatedness of biological, psychological and social aspects of illness, when selecting outcome measures and considering how chronic pain management interventions work. AUTHORS' CONCLUSIONS We had high or moderate confidence in the evidence contributing to most review findings. Further research, especially into families' experiences of treatments and services, could strengthen the evidence for low or very low confidence findings. Future research should also explore families' experiences in low- to middle-income contexts; of pain treatments including opioid use in children, which remains controversial; and of social care services. We need development and testing of family-centred interventions and services acceptable to families. Future trials of children's chronic non-cancer pain interventions should include family-centred outcomes.
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Affiliation(s)
- Emma France
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | - Isabelle Uny
- Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Ruth Turley
- Development Directorate, Cochrane Central Executive, Cochrane, London, UK
| | - Katie Thomson
- Occupational Therapy, Human Nutrition & Dietetics, Glasgow Caledonian University, Glasgow, UK
| | - Jane Noyes
- Centre for Health-Related Research, Fron Heulog, Bangor University, Bangor, UK
| | - Abbie Jordan
- Department of Psychology, University of Bath, Bath, UK
- Bath Centre for Pain Research, University of Bath, Bath, UK
| | - Liz Forbat
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Line Caes
- Department of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | - Mayara Silveira Bianchim
- NMAHP Research Unit, University of Stirling, Stirling, UK
- Centre for Population Health and Wellbeing Research, School of Medical and Health Sciences, Bangor University, Bangor, UK
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Harris KM, Preiss L, Varughese T, Bauer A, Calhoun CL, Treadwell M, Masese R, Hankins JS, Hussain FA, Glassberg J, Melvin CL, Gibson R, King AA. Examining Mental Health, Education, Employment, and Pain in Sickle Cell Disease. JAMA Netw Open 2023; 6:e2314070. [PMID: 37200033 PMCID: PMC10196879 DOI: 10.1001/jamanetworkopen.2023.14070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/21/2023] [Indexed: 05/19/2023] Open
Abstract
Importance Pain related to sickle cell disease (SCD) is complex and associated with social determinants of health. Emotional and stress-related effects of SCD impact daily quality of life and the frequency and severity of pain. Objective To explore the association of educational attainment, employment status, and mental health with pain episode frequency and severity among individuals with SCD. Design, Setting, and Participants This is a cross-sectional analysis of patient registry data collected at baseline (2017-2018) from patients treated at 8 sites of the US Sickle Cell Disease Implementation Consortium. Data analysis was performed from September 2020 to March 2022. Main Outcomes and Measures Electronic medical record abstraction and a participant survey provided demographic data, mental health diagnosis, and Adult Sickle Cell Quality of Life Measurement Information System pain scores. Multivariable regression was used to examine the associations of education, employment, and mental health with the main outcomes (pain frequency and pain severity). Results The study enrolled a total of 2264 participants aged 15 to 45 years (mean [SD] age, 27.9 [7.9] years; 1272 female participants [56.2%]) with SCD. Nearly one-half of the participant sample reported taking daily pain medication (1057 participants [47.0%]) and/or hydroxyurea use (1091 participants [49.2%]), 627 participants (28.0%) received regular blood transfusion, 457 (20.0%) had a depression diagnosis confirmed by medical record abstraction, 1789 (79.8%) reported severe pain (rated most recent pain crises as ≥7 out of 10), and 1078 (47.8%) reported more than 4 pain episodes in the prior 12 months. The mean (SD) pain frequency and severity t scores for the sample were 48.6 (11.4) and 50.3 (10.1), respectively. Educational attainment and income were not associated with increased pain frequency or severity. Unemployment (β, 2.13; 95% CI, 0.99 to 3.23; P < .001) and female sex (β, 1.78; 95% CI, 0.80 to 2.76; P < .001) were associated with increased pain frequency. Age younger than 18 years was inversely associated with pain frequency (β, -5.72; 95% CI, -7.72 to -3.72; P < .001) and pain severity (β, 5.10; 95% CI, -6.70 to -3.51; P < .001). Depression was associated with increased pain frequency (β, 2.18; 95% CI, 1.04 to 3.31; P < .001) but not pain severity. Hydroxyurea use was associated with increased pain severity (β, 1.36; 95% CI, 0.47 to 2.24; P = .003), and daily use of pain medication was associated with both increased pain frequency (β, 6.29; 95% CI, 5.28 to 7.31; P < .001) and pain severity (β, 2.87; 95% CI, 1.95 to 3.80; P < .001). Conclusions and Relevance These findings suggest that employment status, sex, age, and depression are associated with pain frequency among patients with SCD. Depression screening for these patients is warranted, especially among those experiencing higher pain frequency and severity. Comprehensive treatment and pain reduction must consider the full experiences of patients with SCD, including impacts on mental health.
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Affiliation(s)
- Kelly M. Harris
- Program in Occupational Therapy, Washington University in St Louis School of Medicine, St Louis, Missouri
- Department of Surgery, Division of Public Health Sciences, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Liliana Preiss
- RTI International, Research Triangle Park, North Carolina
| | - Taniya Varughese
- Program in Occupational Therapy, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Anna Bauer
- School of Medicine, University of Missouri at Columbia, Columbia
| | - Cecelia L. Calhoun
- Department of Pediatrics, Pediatric Hematology/Oncology, and Cancer Center, Hematology Program, Yale University School of Medicine, New Haven, Connecticut
| | - Marsha Treadwell
- School of Medicine, Department of Pediatrics, Division of Hematology, University of California, San Francisco
| | - Rita Masese
- School of Nursing, Duke University, Durham, North Carolina
| | - Jane S. Hankins
- Department of Hematology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Faiz Ahmed Hussain
- Department of Medicine, Division of Hematology and Oncology, College of Medicine, University of Illinois at Chicago, Chicago
| | - Jeffrey Glassberg
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cathy L. Melvin
- College of Medicine, Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Robert Gibson
- Department of Emergency Medicine, Augusta University, Medical College of Georgia, Augusta
| | - Allison A. King
- Program in Occupational Therapy, Washington University in St Louis School of Medicine, St Louis, Missouri
- Department of Surgery, Division of Public Health Sciences, Washington University in St Louis School of Medicine, St Louis, Missouri
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, St Louis Children’s Hospital, Washington University in St Louis, School of Medicine, St Louis, Missouri
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3
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Constantinou C, Payne N, van den Akker O, Inusa B. A qualitative exploration of health-related quality of life and health behaviours in children with sickle cell disease and healthy siblings. Psychol Health 2023; 38:125-146. [PMID: 34339316 DOI: 10.1080/08870446.2021.1955119] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study explored the health-related quality of life (HRQL) and health behaviours of children with sickle cell disease (SCD) and healthy siblings, drawing on Gap theory, which suggests HRQL is the discrepancy between current and ideal selves. DESIGN Thirty-two interviews, facilitated by children's drawings of their current and ideal selves were thematically analysed. RESULTS Two themes were identified. First, limitations of SCD and adjusted expectations. Children with SCD report some discrepancy in HRQL as they would like to participate in more physical activity, but overall, they appear to have normalised their condition and adjusted their expectations in the context of the limits of their condition. Healthy siblings worry about their sibling and have greater expectations about engaging in adventurous activities and for their future. Second, coping with SCD. Children have limited social support, although children with SCD seek support from their mothers. They also modify health behaviours, like reducing exercise to help prevent and cope with sickle-related pain. CONCLUSION Children have some discrepancies in their HRQL but adjusted expectations among children with SCD may reduce discrepancy. Adapting health behaviours may help to cope with SCD but it is important that reductions in physical activity do not impair HRQL.
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Affiliation(s)
| | - Nicola Payne
- Psychology Department, Middlesex University, London, UK
| | | | - Baba Inusa
- Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK
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Moody KL. Healthcare utilization and the quality of life of children and adolescents with sickle cell disease. Pediatr Blood Cancer 2022; 69:e29685. [PMID: 35373909 DOI: 10.1002/pbc.29685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVE Youth diagnosed with sickle cell disease (SCD) are at increased risk of poor health-related quality of life (HRQOL) due to the complexities associated with this disease. The literature notes that predictors such as pain and poor mental health are associated with increased healthcare access; however, the connection between healthcare use and their overall well-being has been understudied. This study investigates whether healthcare utilization predicts the HRQOL in youth with SCD. DESIGN/METHODS Patients completed the Pediatric Quality of Life (PedsQL) 3.0 SCD module, whereas the researcher conducted a retrospective chart review to gather patient characteristics such as emergency room (ER) and hospitalization occurrences over the past 12 months. RESULTS The study consisted of 150 pediatric patients with SCD, ages 8-17 years old, and their parents. Patients with ≥ 4 ER visits and hospitalizations reported worse HRQOL scores than their respective counterparts. Additionally, a higher frequency of ER visits (P = 0.05) and hospitalizations (P = 0.005) predicted lower HRQOL scores. Age (P = 0.04) also emerged as a significant predictor for both regression models, as increased healthcare access among older patients with SCD was associated with poorer HRQOL. CONCLUSION This study found that as youth with SCD require ER treatment and/or hospital admission, they are at increased risk for lower HRQOL, specifically as they get older. Findings suggest that attention should be paid to patients who require more frequent healthcare intervention. Improvement in outpatient care of pediatric patients with SCD may help to mitigate ER and inpatient use.
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Affiliation(s)
- Kendall L Moody
- School of Social Work, Howard University, Washington, District of Columbia
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5
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Ser adolescente apesar das restrições e da discriminação impostas pela doença falciforme. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao0243345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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6
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Jones A, Caes L, McMurtry CM, Eccleston C, Jordan A. Sociodevelopmental Challenges Faced by Young People with Chronic Pain: A Scoping Review. J Pediatr Psychol 2021; 46:219-230. [PMID: 33211876 DOI: 10.1093/jpepsy/jsaa101] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/21/2020] [Accepted: 10/03/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Map the current literature investigating autonomy development, identity development, and peer relationships in young people aged 10-24 years with chronic pain. METHODS A scoping review method was used to systematically search four databases (APA PsycNET, PubMed, Web of Science, and Cinahl) for peer-reviewed articles. Search results were screened against inclusion and exclusion criteria to ensure they met the objective. Eligible papers were assessed for quality, their data relating to the objective were extracted, and results are synthesized. RESULTS Searches returned 3,815 papers after the removal of duplicates, with 42 papers included in the full review. The majority of papers investigated peer relationships (86%). Fewer papers investigated autonomy (43%) and identity (21%) development. Included papers were mostly quantitative (64%), with fewer qualitative (34%) and mixed-methods papers (2%). Overall, we found bidirectional relationships between chronic pain in young people, their social development, and a range of functional outcomes. However, the mechanisms underlying these relationships remain relatively unexplored. CONCLUSIONS Review results are mapped onto the model proposed by Palermo et al. (2014). Guided by this model, clinical treatment for young people with chronic pain should consider social development. The model also sets out a future research agenda focused on exploring: (a) identity development, (b) the mechanisms underlying the relationships between social-developmental domains, pain, and outcomes, (c) a variety of participants and populations, and (d) a variety of methods, including longitudinal study designs.
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Affiliation(s)
- Abigail Jones
- Department of Psychology, University of Bath.,Centre for Pain Research, University of Bath
| | - Line Caes
- Division of Psychology, Faculty of Natural Sciences, University of Stirling
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph.,Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton
| | - Christopher Eccleston
- Centre for Pain Research, University of Bath.,Department of Health, University of Bath
| | - Abbie Jordan
- Department of Psychology, University of Bath.,Centre for Pain Research, University of Bath
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7
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Hoegy D, Guilloux R, Bleyzac N, Gauthier-Vasserot A, Cannas G, Bertrand Y, Hot A, Dussart C, Janoly-Dumenil A. Sickle cell disease perceptions of caregivers, adolescent, and adult patients: Barriers and facilitators to medical care adherence. J Adv Nurs 2020; 76:2391-2400. [PMID: 32692432 DOI: 10.1111/jan.14456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/18/2020] [Accepted: 06/12/2020] [Indexed: 12/01/2022]
Abstract
AIMS To provide an understanding of medical care adherence factors as reported by caregivers, adolescent, and adult patients with sickle cell disease and to analyse those concerns to identify barriers and facilitators about medical care adherence. Three topics influenced medical care adherence: the disease itself, therapeutics, and the healthcare system. This study will focus on the first topic. DESIGN Qualitative explorative study, using semi-structured and life-experience interviews and manual inductive content analysis. METHODS From December 2016 - March 2017, one semi-structured interview was conducted by a researcher with each of the 15 adolescent patients, 10 adult patients, and 19 caregivers in a French public hospital. Interviews were audio-taped and transcribed before a content analysis. Perceptions were classified into barriers and facilitators of medical care adherence. RESULTS This article presents disease perceptions of caregivers and patients (adolescents and adults): daily management and social representations. These perceptions differ among parents, adolescent patients, and adult patients. However, all report important disease-related "limitations" in their lives. The objective for adults (parents and patients) is to "live with the disease" and to achieve this, they find coping resources. Two major resources expressed by adults emerged: social resources (support from friends, patients' association, and social visibility) and disease knowledge (theoretical and derived from experience). This is not the case of adolescents for whom social normality was the main concern. CONCLUSION Care management adherence is partly based on coping with the disease. Given the lower number of facilitators expressed by adolescents, it is essential to propose interventions in this population. It will help them cope with the disease and, consequently, optimize care management adherence. IMPACT Showing differences among caregivers, adult, and adolescent patient perceptions, this study impact future care practices. It revealed needs of intervention for adolescents.
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Affiliation(s)
- Delphine Hoegy
- EA Parcours Santé Systémique, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie, Hôpital Edouard Herriot, Hospices civils de Lyon, France.,Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
| | - Ronald Guilloux
- Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Laboratoire S2HEP, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
| | - Nathalie Bleyzac
- EMR 3738, PK/PD Modeling in Oncology, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie, Hôpital Pierre Garraud, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier-Vasserot
- Centre de Référence Constitutif Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Hospices Civils de Lyon, Lyon, France.,Institut d'Hématologie et d'Oncologie Pédiatrique de Lyon, Hospices Civils de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Giovanna Cannas
- Centre de Référence Constitutif Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Hospices Civils de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- Centre de Référence Constitutif Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Hospices Civils de Lyon, Lyon, France.,Institut d'Hématologie et d'Oncologie Pédiatrique de Lyon, Hospices Civils de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Arnaud Hot
- Centre de Référence Constitutif Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Hospices Civils de Lyon, Lyon, France.,Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Claude Dussart
- EA Parcours Santé Systémique, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie centrale, Hospices Civils de Lyon, Lyon, France
| | - Audrey Janoly-Dumenil
- EA Parcours Santé Systémique, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie, Hôpital Edouard Herriot, Hospices civils de Lyon, France.,Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
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8
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Druye AA, Nelson K, Robinson B. Self-management recommendations for sickle cell disease: A content analysis of websites. Nurs Health Sci 2020; 22:881-891. [PMID: 32424879 DOI: 10.1111/nhs.12741] [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: 12/27/2019] [Revised: 05/10/2020] [Accepted: 05/14/2020] [Indexed: 11/28/2022]
Abstract
This authors report on the findings of a study designed to establish website-based self-management recommendations for sickle cell disease. Google and Yahoo search engines were used to search the World Wide Web. Purposive sampling was used to select 28 websites that met the inclusion criteria. Data were manually collected from health education materials and subjected to qualitative content analysis. Self-management was conceptualized as actions involving preventive health, self-monitoring, self-diagnosing, and self-treatment. The results show that the websites recommend more self-management actions for preventive health and self-treatment than for self-monitoring and self-diagnosis. Frequent oral fluid intake, limitation of overactivity, eating a healthy diet, avoiding extreme temperatures, and infections were the most common preventive health recommendations. Daily pain monitoring and general bodily inspections were the most frequent self-monitoring recommendations. Commonly cited self-diagnostic indicators were fever, persistent pain, enlarged spleen, and leg ulcers. The use of analgesics and nonpharmacological measures were regularly cited for self-treatment. Most recommendations were assessed as clinically safe as they align with standards for sickle cell management. Nurses and other professionals should teach clients how to assess the credibility of websites.
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Affiliation(s)
- Andrews A Druye
- School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Katherine Nelson
- Graduate School of Nursing, Midwifery & Health, Victoria University of Wellington, Wellington, New Zealand
| | - Brian Robinson
- Graduate School of Nursing, Midwifery & Health, Victoria University of Wellington, Wellington, New Zealand
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9
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Namisango E, Bristowe K, Murtagh FE, Downing J, Powell RA, Abas M, Lohfeld L, Ali Z, Atieno M, Haufiku D, Guma S, Luyirika EB, Mwangi-Powell FN, Higginson IJ, Harding R. Towards person-centred quality care for children with life-limiting and life-threatening illness: Self-reported symptoms, concerns and priority outcomes from a multi-country qualitative study. Palliat Med 2020; 34:319-335. [PMID: 32081084 DOI: 10.1177/0269216319900137] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Paediatric life-limiting and life-threatening conditions (life-limiting conditions) place significant strain on children, families and health systems. Given high service use among this population, it is essential that care addresses their main symptoms and concerns. AIM This study aimed to identify the symptoms, concerns and other outcomes that matter to children with life-limiting conditions and their families in sub-Saharan Africa. SETTING AND PARTICIPANTS Cross-sectional qualitative study in Kenya, Namibia, South Africa and Uganda. Children/caregivers of children aged 0-17 years with life-limiting conditions were purposively sampled by age, sex and diagnosis. Children aged 7 and above self-reported; caregiver proxies reported for children below 7 and those aged 7 and above unable to self-report. RESULTS A total of 120 interviews were conducted with children with life-limiting conditions (n = 61; age range: 7-17 years), and where self-report was not possible, caregivers (n = 59) of children (age range: 0-17) were included. Conditions included advanced HIV (22%), cancer (19%), heart disease (16%) endocrine, blood and immune disorders (13%), neurological conditions (12%), sickle cell anaemia (10%) and renal disease (8%). Outcomes identified included physical concerns - pain and symptom distress; psycho-social concerns - family and social relationships, ability to engage with age-appropriate activities (e.g. play, school attendance); existential concerns - worry about death, and loss of ambitions; health care quality - child- and adolescent-friendly services. Priority psycho-social concerns and health service factors varied by age. CONCLUSION This study bridges an important knowledge gap regarding symptoms, concerns and outcomes that matter to children living with life-limiting conditions and their families and informs service development and evaluation.
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Affiliation(s)
- Eve Namisango
- African Palliative Care Association, Kampala, Uganda.,Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Katherine Bristowe
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Fliss Em Murtagh
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.,Wolfson Palliative Care Research Center, Hull York Medical School, Hull, UK
| | - Julia Downing
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.,International Children's Palliative Care Network, Assagay, South Africa.,Palliative Care Unit, Makerere University, Kampala, Uganda
| | | | - Melanie Abas
- Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lynne Lohfeld
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Zipporah Ali
- Kenya Hospice and Palliative Care Association, Nairobi, Kenya
| | | | | | | | | | | | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
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Rambod M, Sharif F, Molazem Z, Khair K. Spirituality Experiences in Hemophilia Patients: A Phenomenological Study. JOURNAL OF RELIGION AND HEALTH 2019; 58:992-1002. [PMID: 29667073 DOI: 10.1007/s10943-018-0621-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Spirituality plays an important role in coping with chronic diseases. However, the meaning of spirituality is not known in hemophilia, as a chronic disease. This study aimed to explore the essence of spirituality in hemophilia patients. This qualitative study with a hermeneutic phenomenological approach was conducted on twelve Muslim adult hemophilia patients. The participants were selected using purposeful sampling. The data were gathered through interview. Then, the data were analyzed using thematic analysis and van Manen's methodological framework. MAX.QDA qualitative software package 2010 was used to import the transcripts and analyze the data. Four themes were identified: "relationship with God," "God as the fulcrum," "strong religious beliefs," and "spiritual satisfaction." "Relationship with God" meant "to ask God for help" and "praying for oneself and others." "God as the fulcrum" consisted of two subthemes, i.e., "hope in God" and "Trust in God." "Strong religious beliefs" also included "belief in openness of God's mercy," "belief in God and the omnipotence of God," and "belief in creation by God." Finally, "spiritual satisfaction" consisted of two subthemes, namely "accepting the providence" and "thanking the divine blessings." Spirituality in hemophilia patients meant having relationship with God who was considered as the fulcrum, strong religious beliefs, and spiritual satisfaction. By understanding the hemophilia patients' spirituality experiences, the nurses and healthcare workers could provide holistic care focused on spirituality. Yet, more studies are recommended to be conducted on hemophilia patients to explore spirituality in other religions.
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Affiliation(s)
- Masoume Rambod
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farkhondeh Sharif
- Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Nemazee Sq., Shiraz, 7193613119, Iran.
| | - Zahra Molazem
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kate Khair
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
- London South Bank University, London, UK
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Druye A, Robinson B, Nelson K. Self-management recommendations for sickle cell disease: A Ghanaian health professionals' perspective. Health Sci Rep 2018; 1:e88. [PMID: 30623043 PMCID: PMC6242362 DOI: 10.1002/hsr2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/11/2018] [Accepted: 08/02/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe self-management recommendations for sickle cell disease (SCD) care among health professionals who manage SCD in Ghana. METHOD Nine health care professionals (nurses, doctors, and physician assistants) who work in SCD were interviewed. The semistructured interviews were recorded, transcribed, and analysed using the qualitative content analysis method. Self-management recommendations were conceptualised as preventive health, self-monitoring, self-diagnosis, self-treatment, and self-evaluation. RESULTS Preventive health recommendations were the commonest, where the professionals described similar topics including avoidance of cold temperature, frequent oral hydration, and healthy nutrition. Self-monitoring recommendations included regular checks for pallor, urine colour, and splenic enlargement. Self-diagnosis recommendations were captured as warning signs and included pain, fever, unusual feelings, and enlarged spleen. Pain and fever management were the focus of most self-treatment advice, and there were some self-treatment recommendations for dactylitis, anaemia, and priapism. There was considerable variation in the strategies recommended for the management of individual SCD-related problems. CONCLUSION Ghanaian health professionals involved in SCD care provide limited and inconsistent self-management recommendations. There is a need for the development of SCD standards and guidelines that support effective self-management. Health professionals working in SCD require continuing education in self-management.
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Affiliation(s)
- Andrews Druye
- School of Nursing and MidwiferyUniversity of Cape CoastCape CoastGhana
| | - Brian Robinson
- Graduate School of Nursing, Midwifery and HealthVictoria University of WellingtonWellingtonNew Zealand
| | - Katherine Nelson
- Graduate School of Nursing, Midwifery and HealthVictoria University of WellingtonWellingtonNew Zealand
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Namisango E, Bristowe K, Allsop MJ, Murtagh FEM, Abas M, Higginson IJ, Downing J, Harding R. Symptoms and Concerns Among Children and Young People with Life-Limiting and Life-Threatening Conditions: A Systematic Review Highlighting Meaningful Health Outcomes. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 12:15-55. [DOI: 10.1007/s40271-018-0333-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Adolescents’ experiences of living with sickle cell disease: An integrative narrative review of the literature. Int J Nurs Stud 2018; 80:20-28. [DOI: 10.1016/j.ijnurstu.2017.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 12/19/2022]
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Passiatore Y, Grimaldi Capitello T, De Stasio S, Millioni M, Gentile S, Fiorilli C. Children's Mathematics and Verbal Self-concepts and Externalizing Behaviors: The Moderating Role of Peer Rejection at School. Front Psychol 2017; 8:1912. [PMID: 29163290 PMCID: PMC5672014 DOI: 10.3389/fpsyg.2017.01912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022] Open
Abstract
Previous research has found a strong correlation between children’s academic self-concept and their behavioral problems. The present study examined whether children’s peer rejection moderated the relationship between children’s math and verbal self-concepts and their behavioral problems at school. We expected that children’s social competence, as measured by peer rejection, moderated the negative effect of low self-concept on children’s externalizing behaviors. Participants were 173 children (males = 93, Mage = 10.31 years, SD = 1.43). The main findings showed that peer rejection moderated the effect of both low verbal and math self-concepts on children’s externalizing behavior. The results are discussed in terms of the protective factor played by children’s social competence reducing the impact of low self-concept on children’s externalizing behaviors.
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Affiliation(s)
- Ylenia Passiatore
- Department of Human Sciences, Libera Università Maria SS. Assunta, Rome, Italy
| | - Teresa Grimaldi Capitello
- Department of Human Sciences, Libera Università Maria SS. Assunta, Rome, Italy.,Department of Neuroscience, Bambino Gesù Ospedale Pediatrico, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Simona De Stasio
- Department of Human Sciences, Libera Università Maria SS. Assunta, Rome, Italy
| | | | - Simonetta Gentile
- Department of Human Sciences, Libera Università Maria SS. Assunta, Rome, Italy.,Department of Neuroscience, Bambino Gesù Ospedale Pediatrico, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Caterina Fiorilli
- Department of Human Sciences, Libera Università Maria SS. Assunta, Rome, Italy
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