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Tasdemir T, Erbas Unverdi G, Ballikaya E, Aypar E, Aykan HH, Karagoz T, Uzamıs Tekcicek M. Evaluation of Oral Health Status and Treatment Needs of Children with Congenital and Acquired Heart Disease. J Clin Med 2024; 13:4060. [PMID: 39064100 PMCID: PMC11278448 DOI: 10.3390/jcm13144060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/19/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Objective: To evaluate the oral health status and treatment needs of children with congenital and acquired heart disease. Methods: This descriptive study included 301 children aged 5-14 from June 2022 to June 2023. Heart conditions were classified by congenital/acquired status and severity. The children's sociodemographic characteristics, medical and dental history, tooth brushing habits, and non-nutritional habits (bruxism, nail-biting, thumb-sucking, etc.) were evaluated. Oral health assessments including caries, oral hygiene, enamel defects, and dental treatment needs-related indices were recorded. Results: The mean age was 8.95 ± 2.91 years, and 271 (90%) of the children had congenital heart disease. The children with moderate and severe heart disease had significantly higher decayed/missing/filled surfaces (dmfs) (p = 0.038) and pulp exposure (p = 0.015) compared to the children with mild heart disease. According to the International Caries Detection and Assessment System II (ICDAS II) index, which included initial caries lesions, there were no caries-free children and 75.7% had extensive caries. The mean plaque index and gingival index were found to be 1.18 ± 0.38 and 0.69 ± 0.53, respectively. Enamel defects were observed in 15.9%. The Treatment Needs Index (TNI) was 85.8% for the primary teeth and 88.9% for the permanent teeth. The Care Index (CI) was 12.4% for the primary teeth and 10.8% for the permanent teeth. Conclusions: Children with congenital and acquired heart disease exhibit a high prevalence of untreated dental caries, gingivitis, and plaque accumulation, with a high need for dental treatments. Dentists should prioritize addressing these issues to prevent the risk of infective endocarditis (IE) and improve oral health outcomes in this population.
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Affiliation(s)
- Tulin Tasdemir
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.E.U.); (E.B.); (M.U.T.)
| | - Gizem Erbas Unverdi
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.E.U.); (E.B.); (M.U.T.)
| | - Elif Ballikaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.E.U.); (E.B.); (M.U.T.)
| | - Ebru Aypar
- Pediatric Cardiology Department, Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey; (E.A.); (H.H.A.); (T.K.)
| | - Hayrettin Hakan Aykan
- Pediatric Cardiology Department, Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey; (E.A.); (H.H.A.); (T.K.)
| | - Tevfik Karagoz
- Pediatric Cardiology Department, Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey; (E.A.); (H.H.A.); (T.K.)
| | - Meryem Uzamıs Tekcicek
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.E.U.); (E.B.); (M.U.T.)
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Ballatori S, Bauer A, Wang A, Samora J, Steinman S, Manske C, Shah A, Wall LB. The Impact on Families of Children With Congenital Upper Extremity Differences. J Hand Surg Am 2024; 49:681-689. [PMID: 38639681 DOI: 10.1016/j.jhsa.2024.02.011] [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] [Received: 03/28/2023] [Revised: 02/07/2024] [Accepted: 02/28/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE To investigate the impact on caregivers of caring for a child with congenital upper extremity differences. METHODS In this cross-sectional study, caregivers of patients enrolled in the multi-institutional Congenital Upper Limb Difference (CoULD) registry were contacted. Demographic information and the Impact on Family Scale (IOFS), a validated measure of perceived caregiver strain, were collected. Patient-reported outcome measures from the CoULD registry, the Pediatric Outcomes Data Collection Instrument (PODCI), and Patient-Reported Outcomes Measurement Information System (PROMIS) were also analyzed for correlation with IOFS. RESULTS Two hundred ninety-nine caregivers participated. Factors with significantly stronger impact on family included public insurance; bilateral upper extremity involvement; household income of $20,000-40,000; additional musculoskeletal diagnosis; and a single adult caregiver household. There was a significantly increased subcategory of IOFS-Finance score for distant travel to see the surgeon. Additionally, all categories of the PODCI (upper extremity, mobility, sports, pain, happiness, and global) demonstrated a negative correlation with IOFS. PROMIS upper extremity and peer relations also demonstrated an inverse relationship with IOFS, whereas PROMIS pain interference had a positive correlation with IOFS. The overall IOFS for children with CoULDs was greater than previously reported for children with brachial plexus birth injury, and less than cerebral palsy and congenital heart disease. CONCLUSIONS Caregivers of children with congenital upper extremity differences report a significant impact on family life. Socioeconomic factors, such as economically disadvantaged or single-caregiver households, and clinical factors, such as bilateral upper extremity involvement, correlate with greater family impact. These findings represent opportunities to identify at-risk families and underscore the importance of caring for the whole family through a multidisciplinary approach. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Sarah Ballatori
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO
| | - Andrea Bauer
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA
| | - Angela Wang
- Department of Orthopeadic Surgery, University of Utah, Salt Lake City, UT
| | - Julie Samora
- Department of Orthopaedic Surgery, Nationwide Children's Hospital, Columbus, OH
| | - Suzanne Steinman
- Department of Orthopeadic Surgery, Seattle Children's Hospital, Seattle, WA
| | - Claire Manske
- Department of Orthopaedic Surgery, Shriner's Hospital, Sacramento, CA
| | - Apurva Shah
- Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Lindley B Wall
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO.
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Lin WH, Chen YK, Lin SH, Cao H, Chen Q. The Association Between Religious Belief and Postoperative Psychological Status and Quality of Life of Parents of Children with Congenital Heart Disease: A Single Center Experience in Southeast China. JOURNAL OF RELIGION AND HEALTH 2024; 63:2413-2422. [PMID: 37493816 DOI: 10.1007/s10943-023-01874-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Abstract
This study aimed to investigate the association of religious belief on the postoperative psychological status and quality of life of parents of children with congenital heart disease (CHD). This was a cross-sectional study conducted at a provincial children's hospital in Fujian Province, China. Parents of postoperative children with CHD in the early postoperative period were included in this study between January 2020 and September 2020. The parents were divided into a religious belief group (n = 39) and a nonreligious belief group (n = 42) depending on whether they had religious beliefs. The Religious Coping Questionnaire, WHOQOL-BREF scale, Self-rating depression scale (SDS), and Self-rating anxiety scale (SAS) were used to evaluate psychological status and quality of life. The results showed that the SDS and SAS scores in the religious belief group were significantly lower than those in the nonreligious belief group (P = 0.012 and P = 0.003, respectively). The WHOQOL-BREF scale results showed that the religious belief group's score was significantly higher than those in the nonreligious belief group on the subscale scores of physiology, psychology, social relations, and environment on the WHOQOL-BREF. The total score of quality of life in the religious belief group was significantly higher than that in the nonreligious belief group. Religious belief was associated with lower SDS score (β = - 0.324, P = 0.005) and SAS score (β = - 0.245, P = 0.026), while religious belief was positively correlated with the score of WHOQOL-BREF (β = 0.506, P < 0.001). In this study, we concluded that comparing to those with no religious beliefs, parents with religious belief experienced more positive emotions and higher quality of life when taking care of children in the early postoperative period after congenital heart surgery.
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Affiliation(s)
- Wen-Hao Lin
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Yu-Kun Chen
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Shi-Hao Lin
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
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Mustafa Kamal N, Salih AF, Ali BM. Assessment of Health-Related Quality of Life in Children with Totally Corrected Tetralogy of Fallot in Sulaymaniyah, Iraq. J Community Health Nurs 2024; 41:123-137. [PMID: 37905724 DOI: 10.1080/07370016.2023.2272996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE This study examined the health-related quality of life among children who have undergone surgery for tetralogy of Fallot (TOF) compared to healthy children. DESIGN Cross-sectional study. METHODS The study was carried out at Children's Heart Hospital and Primary Healthcare Centers in Sulaymaniyah, Iraq, between July 1, 2022, and November 1, 2022. The study involved 400 participants, comprised of 200 parents of healthy children and 200 parents with children with repaired TOF. Data collection involved utilizing a 5-point Likert Scale questionnaire administered through direct face-to-face interviews with the parents of the children. FINDINGS Children with surgically repaired TOF had markedly lower mean scores (P ≤ 0.001) in the overall dimension of QoL (Mean rank = 137) when compared to healthy children (Mean rank = 263). Furthermore, it was observed that children with repaired TOF had significantly lower mean scores (P < 0.001) across all subdimensions of QoL compared to their healthy counterparts. In the subject of children with repaired TOF, the impact of maternal education (illiterate and lower education) on overall QoL was found to be highly significant (P < 0.001). In addition, children with repaired TOF from lower socioeconomic status (SES) families had worse quality of life than those from medium and high SES families, with a p-value <0.001. CONCLUSIONS Repaired TOF children exhibited notable deficiencies across all dimensions of QoL compared to healthy children. Moreover, SES emerged as a significant determinant influencing the QoL outcomes of repaired TOF children. CLINICAL EVIDENCE Despite undergoing corrective surgery for TOF, the QoL in children with repaired TOF continues to be lower than that of their healthy counterparts. Notably, the economic and educational status of the family significantly impacts the way these children perceive and experience their QoL. This finding underscores the critical significance of factoring in socioeconomic elements when addressing the well-being of this particular group of children.
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Affiliation(s)
- Niaz Mustafa Kamal
- Community Health, Pediatrics Nursing Department, Technical Institute, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Aso Faiq Salih
- Pediatric Cardiology, Pediatrics Department, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq
| | - Bushra Mohammed Ali
- Family and Community Medicine Department, University of Sulaimani, Sulaymaniyah, Iraq
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Avery M, Wolfe J, DeCourcey DD. Economic Hardship at the End of Life for Families of Children With Complex Chronic Conditions. J Pain Symptom Manage 2024; 67:e313-e319. [PMID: 38151216 DOI: 10.1016/j.jpainsymman.2023.12.014] [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] [Received: 10/10/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/29/2023]
Abstract
CONTEXT Many children with complex chronic medical conditions (CCC), though living longer, die prematurely. Little is known about family economic hardship during end of life (EOL), nor associated differences in patterns of care. OBJECTIVES To describe the prevalence, experience, and characteristics of families of patients with CCC who report great economic hardship (GEH), and associations with end-of-life care patterns and suffering. METHODS We conducted a 183-item cross-sectional survey of bereaved parents of patients cared for at Boston Children's Hospital and chart reviews for each patient. Fifteen survey items on economic hardship related to financial and material hardships including food, housing, and utility insecurity. RESULTS A total of 114 bereaved parents completed the survey (54% response rate) and economic hardship data was analyzed for 105. Nearly a fifth reported GEH. This group was characterized by fewer two parent households. Children from families with GEH had spent more time hospitalized than those without GEH. CONCLUSION Economic burden on families of children with CCC correlates with higher health care utilization demonstrating the need for ameliorative resources and preventative measures.
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Affiliation(s)
- Madeline Avery
- Pediatric Palliative Care (M.V., J.W.), Department of Pediatrics, Massachusetts General Hospital, Boston Massachusetts, USA.
| | - Joanne Wolfe
- Pediatric Palliative Care (M.V., J.W.), Department of Pediatrics, Massachusetts General Hospital, Boston Massachusetts, USA
| | - Danielle D DeCourcey
- Division of Medical Critical Care (D.D.D.), Department of Pediatrics, Boston Children's Hospital, Boston Massachusetts, USA
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Dahlawi N, Milnes L, Swallow V. Children's behavioural and emotional reactions towards living with congenital heart disease in Saudi Arabia: A grounded theory study. Health Expect 2024; 27:e13959. [PMID: 38411365 PMCID: PMC10897868 DOI: 10.1111/hex.13959] [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: 05/10/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND A high incidence of children with congenital heart disease (CHD) was found in Saudi Arabia (SA). International literature reports that children with CHD exhibit behavioural and emotional issues due to experiencing hospitalisation and clinical treatments combined with a dearth of qualitative understanding of the experiences of younger children with CHD. Therefore, the aim was to explore the behaviour and emotions of 4-10-year-olds with CHD in SA through children's accounts of their own experiences and parental proxy reports of children's behaviour and emotions. METHODS Charmaz's constructivist grounded theory (GT) approach was used. Twenty single semi-structured interviews of 10 child/parent dyads were undertaken at a hospital clinic in SA. Children's interviews were combined with an arts-based approach using drawings, pictures and faces of emotions (emojis). Constant comparison analysis was undertaken. Consolidated Criteria for Reporting Qualitative Research guidelines was followed in reporting this study. FINDINGS A substantive GT: children's behavioural and emotional reactions towards stressors related to living with CHD was developed and provides new insights into children's and parents' perceptions of the children's behavioural and emotional reactions to living with CHD in SA. The theory proposes that children's reactions to living with CHD relate to medical treatment stressors, sociocultural stressors and physical change stressors. Several further factors influenced children's responses to these stressors. CONCLUSION Children and parents in SA contributed to a new understanding of the relationship between CHD and children's behavioural and emotional reactions. In addition, findings support the need for early assessment of behaviour and emotions among children with CHD and the application of preventative and supportive measures for the children and their families in SA. PATIENT OR PUBLIC CONTRIBUTION Before the research commenced, the developmental appropriateness of the proposed arts-based data collection tools was tested with three healthy children aged 6-9 years old; the tools were then revised accordingly before the interviews were undertaken.
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Affiliation(s)
- Nada Dahlawi
- Nursing FacultyKing Abdulaziz UniversityJeddahSaudi Arabia
- School of HealthcareUniversity of LeedsLeedsUK
| | | | - Veronica Swallow
- Department of Nursing and MidwiferySheffield Hallam UniversitySheffieldUK
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7
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Perceived family impact and coping mechanisms of caregivers of children with nephrotic syndrome. Pediatr Nephrol 2023; 38:1177-1185. [PMID: 35913565 DOI: 10.1007/s00467-022-05619-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Pediatric chronic disease impacts the affected child and their family structure. There is limited literature investigating the psychosocial impact of nephrotic syndrome on families. METHODS Caregivers of children with nephrotic syndrome completed two validated surveys: (1) Impact on Family (IOF) that evaluates the family impact (degree to which family is affected by a pediatric chronic illness) and (2) Coping Health Inventory for Parents (CHIP) that examines the coping patterns used by caregivers. Linear regression models were utilized to determine predictors of perceived family impact and coping patterns. RESULTS Seventy-five caregivers of a child with nephrotic syndrome completed the surveys. On a scale from low impact to significant impact to very serious impact, results indicated that nephrotic syndrome had a significant impact on families (mean revised IOF total score 33.04 ± 9.38). Families in the steroid-resistant nephrotic syndrome (SRNS) group reported a higher financial impact compared to the steroid-sensitive nephrotic syndrome (SSNS) group (p = 0.03). Families in the frequently relapsing group (FRNS) reported a higher impact on the caregiver's ability to cope with the child's condition compared to the SRNS group (p = 0.02). Tacrolimus use was associated with increasing the perceived family impact (β = 4.76, p = 0.046). CHIP scores indicated that caregivers did not cope well with family integration (component I) but coped well with social support (component II) and communication (component III). CONCLUSIONS Childhood nephrotic syndrome has a significant overall perceived impact on the family, and caregivers did not cope well regarding strengthening their family life. These findings can be used as outcome measures for future intervention studies to find solutions that would decrease the perceived family burden. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Simeone S, Rea T, Platone N, Guillari A, Lanzuise A, Assanta N, Da Valle P, Baratta S, Pucciarelli G. Quality of Life of Families with Children Presenting Congenital Heart Disease:Longitudinal Study Protocol. Healthcare (Basel) 2022; 10:healthcare10071273. [PMID: 35885800 PMCID: PMC9317531 DOI: 10.3390/healthcare10071273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Advances in medicine have caused a notable increase in the survival rates of children born with congenital heart disease, even in the most complicated cases, almost mitigating the disease’s pathology from lethal to chronic. The quality of life perceived by such children is influenced by the perceptions of their parents. However, the international literature has rarely considered the entire family nucleus. AIMS: This study aims to study the temporal trend of quality of life of families with children with congenital heart disease, particularly with respect to parents following a child’s hospitalization for an invasive procedure. DESIGN: A longitudinal study. METHOD: A sample of families (that is, those including a child with congenital heart disease and their parents) will be enrolled following the patient’s discharge from the hospital and examined every 3 months for 1 year. The study’s adopted hypothesis is that there is an interdependence between the subjects of the study that is capable of influencing individual perceptions of quality of life. RESULTS: This study will attempt to identify variables (and their temporal trend) that can be attributed to the family unit and—together with physical and clinical variables—that may influence the quality of life of children with congenital heart disease. CONCLUSION: Examining family quality of life with the longitudinal method will allow us to identify the predictors and interdependence of this factor with respect to children and their parents. This will help to correct and elaborate upon care guidelines, providing better assistance to patients and their caregivers.
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Affiliation(s)
- Silvio Simeone
- Clinical and Experimental Medicine Department, “Magna Graecia” University, 88100 Catanzaro, Italy;
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy;
| | - Nicol Platone
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Assunta Guillari
- Department of Public Health, University Federico II of Naples, 80145 Napoli, Italy
- Correspondence:
| | | | - Nadia Assanta
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Paola Da Valle
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Stefania Baratta
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevenion, University of Rome Tor Vergata, 00133 Rome, Italy;
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Chinawa AT, Chinawa JM. Compendium of cardiac diseases among children presenting in tertiary institutions in southern Nigeria: a rising trend. Libyan J Med 2021; 16:1966217. [PMID: 34382500 PMCID: PMC8366613 DOI: 10.1080/19932820.2021.1966217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/06/2021] [Indexed: 10/26/2022] Open
Abstract
The burdenofchildren with cardiovascular disease is on a rising trend. These rising trends are enhanced by the development of new technology in the diagnosis of cardiac lesions.This article is aimed at documenting the current trends in the occurrence of cardiac disease among children attending tertiary hospitals in Sothern Nigeria.This is a descriptive study which involved four hundred and thirty-nine (439) children who had cardiac disease confirmed with echocardiography from four health institutions, namely; Niger Delta University, Bayelsa, Nigeria; University of Nigeria Teaching Hospital, Enugu, Nigeria; Triple care hospital, Enugu, Nigeria and; Blessed children hospital, Enugu, Nigeria over a -five -year period from July 2016- July 2020.The prevalence of congenital heart disease was 83.6% and only 16.4% being acquired heart disease. Many of the children with congenital cardiac defects have associated features of Down syndrome (trisomy 21) and the frequency was related to the type of defect; 6.4% (28/439). These features of Down syndrome are seen mainly in children with AV canal defect 33.3% (14/42) and least in children with TOF 2.0% (1/51). Zero-point two nine percent (1/439) had dextro-cardia and 0.2% (1/340) had VACTERAL (ano-rectal malformation) association, 0.2 % (1/439) had cleft lip, 1.8% (8/439) had dysmorphism other than down syndrome. Five 62.5% (5/8) of such dysmorphic features were associated with VSD.The majority of the children with cardiac disease were from the middle class 63.6% followed by the higher class 21.9% and the least is from the lower class 14.5%. The prevalence values of heart disease were quite higher than that documented in previous studiesThe is a rising prevalence of congenital heart disease (83.6%) and acquired heart disease (16.4%) among children with cardiac disease in southern Nigeria. Extracardiac anomalies were also associated with these trends.
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Affiliation(s)
- Awoere T. Chinawa
- Department Of Community Medicine, Enugu State University Teaching Hospital, Enugu State, Nigeria
| | - Josephat M. Chinawa
- Deprtment of paediatrics, University of Nigeria/University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
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Ison HE, Griffin EL, Parrott A, Shikany AR, Meyers L, Thomas MJ, Syverson E, Demo EM, Fitzgerald KK, Fitzgerald-Butt S, Ziegler KL, Schartman AF, Stone KM, Helm BM. Genetic counseling for congenital heart disease - Practice resource of the national society of genetic counselors. J Genet Couns 2021; 31:9-33. [PMID: 34510635 DOI: 10.1002/jgc4.1498] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Congenital heart disease (CHD) is an indication which spans multiple specialties across various genetic counseling practices. This practice resource aims to provide guidance on key considerations when approaching counseling for this particular indication while recognizing the rapidly changing landscape of knowledge within this domain. This resource was developed with consensus from a diverse group of certified genetic counselors utilizing literature relevant for CHD genetic counseling practice and is aimed at supporting genetic counselors who encounter this indication in their practice both pre- and postnatally.
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Affiliation(s)
- Hannah E Ison
- Stanford Center for Inherited Cardiovascular Disease, Stanford Health Care, Stanford, California, USA
| | - Emily L Griffin
- Department of Pediatrics, Columbia University Medical Center, New York, New York, USA
| | | | - Amy R Shikany
- Cincinnati Children's Hospital Medical Center, The Heart Institute, Cincinnati, Ohio, USA
| | | | - Matthew J Thomas
- Department of Pediatrics, Division of Genetics, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Erin Syverson
- Department of Pediatrics, Division of Genetics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Erin M Demo
- Sibley Heart Center Cardiology at Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kristi K Fitzgerald
- Nemours Cardiac Center, Alfred I. DuPont Hospital for Children, Wilmington, Delaware, USA
| | - Sara Fitzgerald-Butt
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Allison F Schartman
- Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, Indiana University Health, Indianapolis, Indiana, USA
| | - Kristyne M Stone
- Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, Indiana University Health, Indianapolis, Indiana, USA
| | - Benjamin M Helm
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Epidemiology, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA
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11
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Man MA, Segers EW, Schappin R, Leeden K, Wösten‐van Asperen RM, Breur H, Weerth C, Hoogen A. Parental experiences of their infant's hospital admission undergoing cardiac surgery: A systematic review. Acta Paediatr 2021; 110:1730-1740. [PMID: 33251633 PMCID: PMC8248104 DOI: 10.1111/apa.15694] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 12/31/2022]
Abstract
AIM To explore parents' experiences of parenting a child hospitalised with congenital heart disease (CHD) and undergoing surgery. METHODS Five electronic databases were systematically searched for articles describing the experiences of parents with a child with a CHD. A thematic analysis approach was used to identify the most common themes. RESULTS A total of 188 articles were identified. Eight studies were included in the review. Four themes emerged, including balancing the parental role, experiencing anticipatory grief, decreasing parental stress using coping strategies and professional support. CONCLUSION Having a child with CHD undergoing heart surgery is a stressful experience due to, among other things, the different situation-related parenting role during the hospital stay and feelings of anticipatory grief. Healthcare professionals in the PICU have an essential role in supporting parents and understanding the needs that are crucial for the parents in order to provide better support and reduce stress and anxiety. More qualitative research regarding the pathway from the prenatal diagnosis through the early childhood period is warranted.
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Affiliation(s)
- Marjorie A.C.P. Man
- Wilhelmina Children’s Hospital University Medical Centre Utrecht Utrecht The Netherlands
| | - Elisabeth W. Segers
- Wilhelmina Children’s Hospital University Medical Centre Utrecht Utrecht The Netherlands
| | - Renske Schappin
- Department of Development and Education of Youth in Diverse Societies Utrecht University Utrecht The Netherlands
| | - Kees Leeden
- Wilhelmina Children’s Hospital University Medical Centre Utrecht Utrecht The Netherlands
| | | | - Hans Breur
- Wilhelmina Children’s Hospital University Medical Centre Utrecht Utrecht The Netherlands
| | - Carolina Weerth
- Donders Institute for Brain Cognition and Behaviour Radboud University Medical Center Nijmegen The Netherlands
| | - Agnes Hoogen
- Wilhelmina Children’s Hospital University Medical Centre Utrecht Utrecht The Netherlands
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12
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Zhang QL, Xu N, Huang ST, Cao H, Chen Q. WeChat-assisted pre-operative health education improves the quality of life of parents of children with ventricular septal defects: A prospective randomised controlled study. J Paediatr Child Health 2021; 57:664-669. [PMID: 33656232 DOI: 10.1111/jpc.15307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/09/2020] [Accepted: 11/17/2020] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to explore the effect of implementing pre-operative WeChat-assisted health education for parents of children with restrictive ventricular septal defects to improve their quality of life. METHODS A prospective randomised controlled study was conducted in a provincial hospital in China. Participants were randomly divided into the intervention group (WeChat group, n = 35) and the control group (leaflet group, n = 35). The quality of life of parents of children with restricted ventricular septal defects was studied. RESULTS Compared with the leaflet group, the WeChat group had a significantly lower score for the pre-operative Self-Rating Anxiety Scale (SAS) (P < 0.05). The pre-operative SAS score in the WeChat group was significantly lower than that at the first visit (P < 0.05). However, the SAS score in the leaflet group was similar at the time of preoperation and the first visit (P > 0.05). The pre-operative scores of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale in the physiological, psychological, social, and environmental fields and the total life quality score in the WeChat group were significantly higher than those of the leaflet group (P < 0.05). CONCLUSION Implementing pre-operative WeChat-assisted health education for parents of children with restrictive ventricular septal defects can effectively relieve their anxiety and improve their quality of life.
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Affiliation(s)
- Qi-Liang Zhang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
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13
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Calazans JCC, Abreu PDD, Araújo ECD, Linhares FMP, Pontes CM, Lacerda ACTD, Vasconcelos MGLD. Adaptive problems arising out of the progenitor's abandonment after Zika Congenital Syndrome. Rev Bras Enferm 2020; 73:e20190602. [PMID: 32965421 DOI: 10.1590/0034-7167-2019-0602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 03/03/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to reveal the adaptive problems of the woman abandoned by the child's parent after Congenital Zika Syndrome, in the light of Roy's Adaptation Model. METHOD a qualitative, descriptive study, based on Roy's Adaptation Model, developed with six women abandoned by their child's parent after Zika Congenital Syndrome diagnosis, through interview and Content Analysis technique. RESULTS adaptive problems appeared in nutrition, activity, rest, and protection patterns, due to limitations in self-care; self-concept, related to dissatisfaction with body image and personal being; in the role of transition role, through difficulties in taking over new roles and in interdependence, related to changes in affective needs. FINAL CONSIDERATIONS the overload of care for children with Congenital Zika Syndrome, added to the challenges of the abandoned woman by her child's parent, led to adaptive problems, showing their main difficulties of coping.
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Abstract
Congenital heart disease (CHD) is the most common birth defect. Little is known of the impact of having a sibling with CHD. Available literature documents negative impact of having a sibling with other chronic conditions. This literature review considers empirical evidence investigating the impact of having a sibling with CHD. Twelve databases were searched, and 202 articles retrieved. Eleven articles met the inclusion criteria and were subject to data extraction, quality appraisal, and narrative synthesis. Three themes emerged: changes in normal life, impact on siblings, and factors affecting the extent of impact on siblings. Only one intervention study was identified, 5 of 10 studies were conducted over 20 years ago, and only 4 studies included children as participants. Evidence suggests siblings of children with CHD experience adverse life changes which lead to negative impacts in several domains. Evidence is inconclusive regarding mitigating factors of these impacts. Further research is needed to understand the experiences of being a sibling of a child with CHD.
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Affiliation(s)
- Roses Parker
- The Cochrane Collaboration, St Albans House, Haymarket, St. James’s, London,Roses Parker, The Cochrane Collaboration, St Albans House, 57-59 Haymarket, St. James’s, London SW1Y 4QX, UK.
| | - Sarah Houghton
- Department of Advanced and Integrated Practice, School of Health and Social Care, London South Bank University, Borough Road, London, UK
| | - Elizabeth Bichard
- Department of Advanced and Integrated Practice, School of Health and Social Care, London South Bank University, Borough Road, London, UK
| | - Stephen McKeever
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, UK
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15
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Congenital heart diseases: genetics, non-inherited risk factors, and signaling pathways. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2020. [DOI: 10.1186/s43042-020-0050-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract
Background
Congenital heart diseases (CHDs) are the most common congenital anomalies with an estimated prevalence of 8 in 1000 live births. CHDs occur as a result of abnormal embryogenesis of the heart. Congenital heart diseases are associated with significant mortality and morbidity. The damage of the heart is irreversible due to a lack of regeneration potential, and usually, the patients may require surgical intervention. Studying the developmental biology of the heart is essential not only in understanding the mechanisms and pathogenesis of congenital heart diseases but also in providing us with insight towards developing new preventive and treatment methods.
Main body
The etiology of congenital heart diseases is still elusive. Both genetic and environmental factors have been implicated to play a role in the pathogenesis of the diseases. Recently, cardiac transcription factors, cardiac-specific genes, and signaling pathways, which are responsible for early cardiac morphogenesis have been extensively studied in both human and animal experiments but leave much to be desired. The discovery of novel genetic methods such as next generation sequencing and chromosomal microarrays have led to further study the genes, non-coding RNAs and subtle chromosomal changes, elucidating their implications to the etiology of congenital heart diseases. Studies have also implicated non-hereditary risk factors such as rubella infection, teratogens, maternal age, diabetes mellitus, and abnormal hemodynamics in causing CHDs.
These etiological factors raise questions on multifactorial etiology of CHDs. It is therefore important to endeavor in research based on finding the causes of CHDs. Finding causative factors will enable us to plan intervention strategies and mitigate the consequences associated with CHDs. This review, therefore, puts forward the genetic and non-genetic causes of congenital heart diseases. Besides, it discusses crucial signaling pathways which are involved in early cardiac morphogenesis. Consequently, we aim to consolidate our knowledge on multifactorial causes of CHDs so as to pave a way for further research regarding CHDs.
Conclusion
The multifactorial etiology of congenital heart diseases gives us a challenge to explicitly establishing specific causative factors and therefore plan intervention strategies. More well-designed studies and the use of novel genetic technologies could be the way through the discovery of etiological factors implicated in the pathogenesis of congenital heart diseases.
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16
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Biber S, Andonian C, Beckmann J, Ewert P, Freilinger S, Nagdyman N, Kaemmerer H, Oberhoffer R, Pieper L, Neidenbach RC. Current research status on the psychological situation of parents of children with congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S369-S376. [PMID: 31737543 DOI: 10.21037/cdt.2019.07.07] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congenital heart diseases (CHD) are a leading cause of morbidity in children with a high impact on the psychological health of parents. Possible short-term and long-term psychological problems among parents are addressed in the current paper. The diagnosis of CHD paired with subsequent surgical and interventional treatment and prolonged hospital stays cause acute psychological distress and can lead to posttraumatic stress disorders (PTSD). As the disease course progresses, the impact on parents' health tends to decrease, but the risk of developing long-term psychological issues remains high. Studies have focused mainly on stress and other distressing symptoms without explicitly addressing the effects of a CHD diagnosis on the family system. Since the social environment may play an important role in parent's life, it may be useful to conduct studies to address these issues. In particular, the psychological situation of the father and the impact of the child's disease on the different dimensions of the father's life, such as parenting skills and influences on the parental relationship, have been largely neglected. Recent research has also disregarded the impact of CHD on siblings of the affected child. Research on chronic diseases in general has shown that the children's age and severity of the disease are related to an increased level of stress. Given the severity of CHD, anxiety and depression were higher in parents with children with more severe conditions. In addition, the results suggest that a positive construction of the parent-child relationship (attachment and bonding) is impaired, especially in mothers. Mothers reported worries and concerns about the challenging tasks they would face after learning about their child's CHD and how they can deal with their child's needs. It has also been shown that the child's illness has a negative impact on the whole family system, including the parent's relationship. Impairments on the parental relationship were perceived differently among mothers and fathers. Thus, there is high need for major changes to be identified, developed and implemented in the psychological care of parents with chronically ill children. So far, research has focused more on the psychological status of parents with chronically ill children, but less research has closely examined the effects of a child's CHD on its parent's mental health even though there is a high demand in additional support. A holistic treatment approach should include professional parental support, especially during children's hospitalization, information on the home care resources and services (especially respite services) and psychological support for parents.
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Affiliation(s)
- Sabina Biber
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Caroline Andonian
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Jürgen Beckmann
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Peter Ewert
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Lars Pieper
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Germany
| | - Rhoia Clara Neidenbach
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
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17
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Kolmar A, Hueckel RM, Kamal A, Dickerman M. Top Ten Tips Palliative Care Clinicians Should Know About Caring for Children in Neonatal and Pediatric Intensive Care Units. J Palliat Med 2019; 22:1149-1153. [DOI: 10.1089/jpm.2019.0378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Amanda Kolmar
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina
| | - Rémi M. Hueckel
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina
| | - Arif Kamal
- Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina
| | - Mindy Dickerman
- Division of Critical Care Medicine, Department of Pediatrics, Nemours/A.I. duPont Hospital for Children, Wilmington, Delaware
- Division of Palliative Medicine, Department of Pediatrics, Nemours/A.I. duPont Hospital for Children, Wilmington, Delaware
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18
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19
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Parent's Perspectives on How They Cope With the Impact on Their Family of a Child With Heart Disease. J Pediatr Nurs 2018; 40:e9-e17. [PMID: 29396310 DOI: 10.1016/j.pedn.2018.01.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/24/2018] [Accepted: 01/24/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Studies of familial coping with a child's chronic condition have highlighted psychological distress; family functioning; and quality of life; as issues that demand coping strategies. There are conflicting findings on impact and coping and a paucity of information about the specific coping challenges for parents of a child with heart disease, with few qualitative studies in this area. The purpose of the study was to explore the way parents coped with their child's heart condition as it impacted on different domains of family functioning. DESIGN AND METHOD In this qualitative study, interviews were held with 17 parents attending a pediatric hospital-based family support program in 2015. Fifteen of the 17 children's conditions were classified as "major". Domains covered in the interviews included: coping challenges posed at different stages of the illness trajectory, parenting, condition management, transitions, psychological impact, social support and coping strategies. Interview transcripts were coded thematically. RESULTS Multiple points of stress and challenges to coping were identified: coping with the diagnosis, including consideration of termination; dealing with the challenges facing their child; coping with parenting including co-parenting issues; the role of social support in coping; and identification of adaptive and maladaptive coping behaviours. CONCLUSION A large range of positive coping strategies were identified, as was the need for coping-focused psychological support throughout the parents' and children's journey. PRACTICE IMPLICATIONS The strategies identified have formed the basis of a manualised intervention for these parents.
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20
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Huang HR, Chen CW, Chen CM, Yang HL, Su WJ, Wang JK, Tsai PK. A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease. Eur J Cardiovasc Nurs 2017; 17:217-225. [DOI: 10.1177/1474515117728609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. Aim: The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. Methods: A total of 320 adolescents with congenital heart disease who were aged 12–18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Results: Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. Conclusion: The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.
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Affiliation(s)
- Hui-Ru Huang
- Department of Nursing, Fu Jen Catholic University Hospital, Taiwan
| | - Chi-Wen Chen
- School of Nursing, National Yang-Ming University, Taiwan
| | - Chin-Mi Chen
- Department of Nursing, Fu Jen Catholic University, Taiwan
| | | | - Wen-Jen Su
- Department of Pediatrics, Chang Gung Children’s Hospital, Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, Taiwan
| | - Pei-Kwei Tsai
- Department of Public Health and Center of Biostatistics, Chang Gung University, Taiwan
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21
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Azhar AS, AlShammasi ZH, Higgi RE. The impact of congenital heart diseases on the quality of life of patients and their families in Saudi Arabia. Biological, psychological, and social dimensions. Saudi Med J 2017; 37:392-402. [PMID: 27052282 PMCID: PMC4852017 DOI: 10.15537/smj.2016.4.13626] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: To assess the impact of congenital heart diseases (CHDs) on bio-psychosocial aspects of the quality of life (QOL) of patients and their families. Methods: A cross-sectional study was carried out between May 2014 and August 2015, including children aged <16 years, and followed-up at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia for CHD. A broad questionnaire was administered to investigate biological, psychological, and social dimensions of afflicted children, their parents, and siblings. Outcomes were computed as impact scores (0-100%) for each dimension and family member. Results: A total of 180 children (104 [57.8%] males; mean age ± standard deviation [SD] = 5.65 ± 4.8 years) were included. There were 25% children complaining of recurrent respiratory infections, 35% of frequent hospitalizations, 38.9% had milestone delay, and 12 (6.7%) only had a social security registration. Mothers declared difficulty coping with their children’s disease in 20% of cases and 22.2% reported being depressed. Mean ± SD impact scores in afflicted children were: 26.1 ± 26.2 (biological), 28.7 ± 28.8 (psychological), and (20.2 ± 25.7) social dimensions. Mothers’ impact scores were higher than fathers’. Complex CHDs had an additional impact, and children from families with less knowledge on CHD had relatively greater impact scores. Conclusion: Congenital heart diseases impact all aspects of QOL of patients and their families, and are associated with high comorbidity. Social and psychological support and education for patients and their parents are crucial factors for improving QOL.
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Affiliation(s)
- Ahmad S Azhar
- Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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22
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Jagt-van Kampen CT, Kars MC, Colenbrander DA, Bosman DK, Grootenhuis MA, Caron HN, Schouten-van Meeteren AYN. A prospective study on the characteristics and subjects of pediatric palliative care case management provided by a hospital based palliative care team. BMC Palliat Care 2017; 16:1. [PMID: 28077099 PMCID: PMC5228175 DOI: 10.1186/s12904-016-0166-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 11/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Case management is a subject of interest within pediatric palliative care. Detailed descriptions of the content of this type of case management are lacking. We aim to describe the contents of care provided, utilization of different disciplines, and times of usage of a pediatric palliative care case management program compared for patients with malignant disease (MD) and non-malignant disease (NMD). Methods A three-month prospective study, with questionnaires filled in by members of a pediatric palliative care team (PPCT) for each contact with parents. Results Four hundred fifty-five contacts took place with parents of 70 patients (27MD, 43NMD). Sixty-two percent of all contacts were with the specialized nurse. The child life specialists, psychologist and social worker were also regularly consulted, the chaplain was not consulted. Ninety-five percent of all contacts took place between 8 am and 6 pm during weekdays, a limited number between 6 pm and 9 pm. Twenty-five percent of all contacts were proactively initiated by the PPCT, 25 % were initiated by parents. In these care characteristics, no differences were seen for MD and NMD patients. Psychosocial topics were addressed most frequently. MD patients consulted the PPCT more often about school and NMD patients about socio-economic issues. Conclusions All different disciplines of the PPCT were regularly consulted, except for the chaplain. With an easy accessible team with a highly pro-active approach, availability from 8 am to 9 pm seems sufficient to accommodate patient’s and parent’s needs. More anticipation seems required for socio-economic topics. This insight in pediatric palliative case management can provide guidance in the development of a new PPCT.
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Affiliation(s)
- Charissa T Jagt-van Kampen
- Department of pediatric oncology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, Netherlands.
| | - Marijke C Kars
- Department of medical humanities, Julius Center for health sciences and primary care, UMCU, Utrecht, Netherlands
| | - Derk A Colenbrander
- Department of pediatrics, Emma Children's Hospital, Academic Medical Centre, Amsterdam, Netherlands
| | - Diederik K Bosman
- Department of pediatrics, Emma Children's Hospital, Academic Medical Centre, Amsterdam, Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Academic Medical Centre, Amsterdam, Netherlands
| | - Huib N Caron
- Department of pediatric oncology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, Netherlands
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23
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Garcia RU, Aggarwal S, Natarajan G. Parental perception of functional status and impact on the family of children with congenital heart surgery. Early Hum Dev 2016; 96:45-51. [PMID: 27037482 DOI: 10.1016/j.earlhumdev.2016.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/02/2016] [Accepted: 03/08/2016] [Indexed: 01/20/2023]
Abstract
AIMS To assess the functional status and the family impact of children with congenital heart defects (CHD), using the parental Functional Status II (FS-II) and the Impact on Family (IOF) questionnaires. METHODS In this prospective observational study, parents of children who underwent surgery for CHD during the first year of life completed the FS-II and the IOF questionnaires. Genetic syndromes and prematurity <32weeks were exclusion criteria. The FS-II generates a total score and age specific general health (GH), activity (A) and, responsiveness (R) subscales. The IOF generates a total scale and financial and sibling subscales. RESULTS Our cohort (n=100), comprised 54% males; the median (IQR) age was 32 (10-56) months. Eighteen children had age-specific scores in the 1-2 SD below mean range (n=17) or more than 2 SD below the mean (n=1) for "ill children". There were significant negative correlations between the total FS-II and total IOF (r=-0.35, p<0.001) and financial IOF (r=-0.35, p<0.001). RACHS-1 category of CHD 4-6 was associated with higher likelihood of lower functional status. CONCLUSIONS More complex CHD was associated with lower functional status, which correlated with a greater impact on the families. Parental questionnaires may be useful instruments for developmental surveillance in this population.
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Affiliation(s)
- Richard U Garcia
- Division of Cardiology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA.
| | - Sanjeev Aggarwal
- Division of Cardiology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Girija Natarajan
- Division of Neonatology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
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24
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Louden E, Allgier A, Overton M, Welge J, Mehlman CT. The impact of pediatric brachial plexus injury on families. J Hand Surg Am 2015; 40:1190-5. [PMID: 25936738 PMCID: PMC4469034 DOI: 10.1016/j.jhsa.2015.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 03/18/2015] [Accepted: 03/18/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the impact of brachial plexus injuries on families to best meet their clinical and social needs. METHODS Our cross-sectional study included families with children between the ages of 1 and 18 years with birth or non-neonatal brachial plexus injuries (BPIs). The consenting parent or guardian completed a demographic questionnaire and the validated Impact on Family Scale during a single assessment. Total scores can range from 0 to 100, with the higher the score indicating a higher impact on the family. Factor analysis and item-total correlations were used to examine structure, individual items, and dimensions of family impact. RESULTS A total of 102 caregivers participated. Overall, families perceived various dimensions of impact on having a child with a BPI. Total family impact was 43. The 2 individual items correlating most strongly with the overall total score were from the financial dimension of the Impact on Family Scale. The strongest demographic relationship was traveling nationally for care and treatment of the BPI. Severity of injury was marginally correlated with impact on the family. Parent-child agreement about the severity of the illness was relatively high. CONCLUSIONS Caretakers of children with a BPI perceived impact on their families in the form of personal strain, family/social factors, financial stress, and mastery. A multidisciplinary clinical care team should address the various realms of impact on family throughout the course of treatment. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Emily Louden
- Cincinnati Children's Hospital Medical Center 3333 Burnet Ave. MLC 9018 Cincinnati, OH 45219, Phone: 513-636-6972, Fax: 513-803-044
| | - Allison Allgier
- Cincinnati Children's Hospital Medical Center 3333 Burnet Ave. MLC 9018 Cincinnati, OH 45219, Phone: 513-803-6052, Fax: 513-803-044
| | - Myra Overton
- Cincinnati Children's Hospital Medical Center 3333 Burnet Ave. MLC 9018 Cincinnati, OH 45219, Phone 513-636-0067
| | - Jeffrey Welge
- University of Cincinnati, Ohio, USA 45267, Phone 513-558-0856
| | - Charles T. Mehlman
- Cincinnati Children's Hospital Medical Center 3333 Burnet Ave. MLC 9018 Cincinnati, OH 45219, Phone: 513-636-4087, Fax: 513-803-044
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25
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Jackson AC, Frydenberg E, Liang RPT, Higgins RO, Murphy BM. Familial impact and coping with child heart disease: a systematic review. Pediatr Cardiol 2015; 36:695-712. [PMID: 25618163 DOI: 10.1007/s00246-015-1121-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
Abstract
Families of children with congenital heart disease (CHD) cope differently depending on individual and familial factors beyond the severity of the child's condition. Recent research has shifted from an emphasis on the psychopathology of family functioning to a focus on the resilience of families in coping with the challenges presented by a young child's condition. The increasing number of studies on the relationship between psychological adaptation, parental coping and parenting practices and quality of life in families of children with CHD necessitates an in-depth re-exploration. The present study reviews published literature in this area over the past 25 years to generate evidence to inform clinical practice, particularly to better target parent and family interventions designed to enhance family coping. Twenty-five studies were selected for inclusion, using the PRISMA guidelines. Thematic analysis identified a number of themes including psychological distress and well-being, gender differences in parental coping, and variable parenting practices and a number of subthemes. There is general agreement in the literature that families who have fewer psychosocial resources and lower levels of support may be at risk of higher psychological distress and lower well-being over time, for both parent and the child. Moreover, familial factors such as cohesiveness and adaptive parental coping strategies are necessary for successful parental adaptation to CHD in their child. The experiences, needs and ways of coping in families of children with CHD are diverse and multi-faceted. A holistic approach to early psychosocial intervention should target improved adaptive coping and enhanced productive parenting practices in this population. This should lay a strong foundation for these families to successfully cope with future uncertainties and challenges at various phases in the trajectory of the child's condition.
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Affiliation(s)
- Alun C Jackson
- Heart Research Centre, 14-20 Blackwood Street, North Melbourne, VIC, 3051, Australia,
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