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DeLone AM, Fisher RS, Traino KA, Basile NL, Buchanan CL, Cheng EY, Poppas DP, Baraldi AN, Wisniewski AB, Mullins LL. Exploratory factor analysis of the Illness Intrusiveness Rating Scale for parents of children with atypical genital appearance due to differences of sex development (DSD). J Pediatr Psychol 2024:jsae027. [PMID: 38578612 DOI: 10.1093/jpepsy/jsae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE Illness intrusiveness refers to the subjective cognitive appraisal of a chronic health condition interfering in daily, valued activities and may be highly relevant for parents of children with atypical genital appearance due to differences of sex development (DSD). However, a measure of illness intrusiveness has not been validated for this population. The current study aimed to evaluate the factor structure of the Illness Intrusiveness Scale for Parents (IIS-P) and examine convergent validity. METHODS Participants included 102 parents (Mage = 33.39 years, SD = 6.48; 58% mothers) of 65 children (<2 years old) diagnosed with DSD participating in a larger, longitudinal study. Parents completed the IIS-P as well as self-report measures of stigma, and anxious and depressive symptoms. An exploratory factor analysis (EFA) was conducted. RESULTS EFA results supported a 1-factor intrusiveness solution (α = .93), as well as a 2-factor solution measuring intrusiveness on daily living (α = .92) and community connectedness (α = .85). The 1-factor solution and both factors of the 2-factor solution demonstrated significant convergent validity with stigma as well as anxious and depressive symptoms. CONCLUSIONS Support emerged for both 1- and 2-factor solutions of the IIS-P in parents of children with DSD. The decision to evaluate illness intrusiveness as a total score or to examine the subscales of daily living and community connectedness should be tailored to the unique aims of researchers and clinicians. Future research should conduct a confirmatory factor analysis with both 1- and 2-factor models with larger, more diverse samples of caregivers.
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Affiliation(s)
- Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Katherine A Traino
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, United States
| | - Earl Y Cheng
- Department of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, United States
| | - Dix P Poppas
- James Buchanan Brady Department of Urology, Komansky Children's Hospital, New York Presbyterian Hospital-Weill Cornell Medicine, New York, United States
| | - Amanda N Baraldi
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Amy B Wisniewski
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
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Fisher RS, Dattilo TM, DeLone AM, Basile NL, Kenney AE, Hill KN, Chang HF, Gerhardt CA, Mullins LL. The study of psychosocial outcomes of parents bereaved by pediatric illness: a scoping review of methodology and sample composition. J Pediatr Psychol 2024; 49:207-223. [PMID: 38423530 DOI: 10.1093/jpepsy/jsae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Parents of children who died of a medical condition experience a range of psychosocial outcomes. The current scoping review aims to summarize the outcomes assessed, methodology, and sample characteristics of recent psychosocial research conducted with this population. METHODS Included studies were limited to peer-reviewed, psychosocial outcomes research published between August 2011 and August 2022, written in English, and including caregiver study participants of children who died of a medical condition. Data sources were scholarly journal articles from 9 electronic databases, including Scopus, Web of Science, Academic Search Primer, ProQuest Research Library, PubMed, Embase, PsycINFO, Psychology & Behavioral Sciences Collection, and Health Source: Nursing/Academic Edition. The Mixed Methods Appraisal Tool-2018 evaluated methodological quality. RESULTS The study sample included 106 studies, most of which were either qualitative (60%) or quantitative (29%). Mixed-methods studies (8%) and randomized clinical trials (2%) were also identified. Study quality was variable, but most studies met all quality criteria (73%). Studies primarily represented cancer populations (58%), White participants (71%), and mothers (66%). Risk-based psychosocial outcomes (e.g., grief) were more commonly assessed than resilience-based outcomes. CONCLUSIONS The current scoping review revealed that recent research assessing the psychosocial outcomes of bereaved parents is limited in the representation of diverse populations, primarily qualitative, of broadly strong methodological quality, and oriented to psychosocial risk. To enhance the state of the science and inform evidence-based psychosocial services, future research should consider varied methodologies to comprehensively assess processes of risk and resilience with demographically and medically diverse populations.
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Affiliation(s)
- Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Ansley E Kenney
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Kylie N Hill
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Hui-Fen Chang
- William E. Brock Memorial Library, Oklahoma State University, Stillwater, OK, United States
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
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Edwards CS, Baudino MN, Roberts CM, Basile NL, Dattilo TM, Gamwell KL, Jacobs NJ, Edwards DS, Tung J, Parker CV, Chaney JM. The contributions of clinical disease activity, functional disability, and illness intrusiveness to depressive symptoms in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:77-84. [PMID: 38291697 DOI: 10.1002/jpn3.12056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/13/2023] [Accepted: 09/29/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Clinical disease activity associated with inflammatory bowel disease (IBD) can place physical limitations on youths' activities of daily living. In turn, functional limitations potentially contribute to youths' heightened experience of IBD-induced intrusions on a wide range of routine and valued activities (i.e., illness intrusiveness), which can increase their risk for depressive symptoms. The present study examined the contributions of clinical disease activity, functional disability, and illness intrusiveness to depressive symptoms in youth with IBD. METHODS Youth (N = 180) completed the Functional Disability Inventory (FDI), Illness Intrusiveness Scale-Child (IIS-C), and Children's Depression Inventory-2 (CDI-2). Physicians completed the Physicians Global Assessment of disease activity (PGA). RESULTS Results revealed a mediating effect for functional disability in the association between disease activity and depressive symptoms (PGA → FDI → CDI-2); illness intrusiveness mediated the association between functional disability and depressive symptoms (i.e., FDI → IIS-C → CDI-2). Serial mediation revealed that clinical disease activity conferred an indirect effect on youth depressive symptoms through the sequential effects of functional disability and illness intrusiveness (i.e., PGA → FDI → IIS-C → CDI-2). CONCLUSIONS Taken together, these findings indicate that youth who encounter more physical limitations as a function of clinical disease activity are more likely to experience an amplified sense of IBD-related intrusions on their ability to participate in meaningful activities. In turn, heightened illness intrusiveness increases the likelihood of depressive symptoms. Clinical interventions that help youth maintain adequate functional ability in the face of IBD disease activity and encourage involvement in positively valued activities could decrease the negative impact of IBD on youths' emotional adjustment.
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Affiliation(s)
- Clayton S Edwards
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Marissa N Baudino
- Baylor College of Medicine - Texas Children's Hospital, Houston, Texas, USA
| | - Caroline M Roberts
- Baylor College of Medicine - Texas Children's Hospital, Houston, Texas, USA
| | - Nathan L Basile
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Taylor M Dattilo
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Kaitlyn L Gamwell
- School of Medicine, University of South Carolina, Columbia, South Carolina, USA
| | - Noel J Jacobs
- Department of Psychology, Oklahoma City University, Oklahoma City, Oklahoma, USA
| | - Desti S Edwards
- Pediatric Gastroenterology, Oklahoma Children's Hospital OU Health, Oklahoma City, Oklahoma, USA
| | - Jeanne Tung
- Pediatric Gastroenterology, Oklahoma Children's Hospital OU Health, Oklahoma City, Oklahoma, USA
| | - Colton V Parker
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - John M Chaney
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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Traino KA, Fisher RS, Basile NL, Dattilo TM, Baskin LS, Buchanan CL, Chan YM, Cheng EY, Coplen DE, Kolon TF, Lakshmanan Y, Palmer BW, Mullins LL, Ciciolla LM, Wisniewski AB. Adverse Birth Experiences and Parent Adjustment Associated With Atypical Genital Appearance Due to Differences of Sex Development. J Pediatr Psychol 2023; 48:759-767. [PMID: 37500595 PMCID: PMC10516460 DOI: 10.1093/jpepsy/jsad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Differences/disorders of sex development (DSDs) are rare, congenital conditions involving discordance between chromosomes, gonads, and phenotypic sex and are often diagnosed in infancy. A key subset of parents of children newly diagnosed with a DSD experience clinically elevated distress. The present study examines the relationship between perinatal factors (i.e., gestational age, delivery method) and trajectories of parental adjustment. METHODS Parent participants (mothers = 37; fathers = 27) completed measures at baseline, 6- and 12-month follow-up. Multilevel linear regression controlled for clustering of the data at three levels (i.e., time point, parent, and family) and examined the relationship between perinatal factors and trajectories of depressive and anxious symptoms. Two-way interactions between perinatal factors and parent type were evaluated. RESULTS Overall depressive and anxious symptoms decreased over time. There were significant interactions between gestational age and parent type for depressive and anxious symptoms, with younger gestational age having a stronger negative effect on mothers vs. fathers. There was a significant interaction between time and gestational age for depressive symptoms, with 36 weeks' gestational age demonstrating a higher overall trajectory of depressive symptoms across time compared to 38 and 40 weeks. Findings for the delivery method were not significant. CONCLUSIONS Findings uniquely demonstrated younger gestational age was associated with increased depressive symptoms, particularly for mothers compared to fathers. Thus, a more premature birth may predispose parents of infants with DSD to distress. Psychosocial providers should contextualize early diagnosis-related discussions within stressful birth experiences when providing support.
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Affiliation(s)
- Katherine A Traino
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Laurence S Baskin
- Department of Urology, University of California San Francisco Medical Center, USA
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, USA
| | - Yee-Ming Chan
- Division of Endocrinology, and Harvard Medical School, Boston Children’s Hospital, USA
| | - Earl Y Cheng
- Department of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, USA
| | - Douglas E Coplen
- Division of Urologic Surgery, St. Louis Children’s Hospital, USA
| | - Thomas F Kolon
- Division of Urology, Children’s Hospital of Philadelphia, USA
| | | | - Blake W Palmer
- Department of Pediatric Urology, Cook Children’s Medical Center, USA
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Lucia M Ciciolla
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Amy B Wisniewski
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
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Traino KA, Basile NL, Chang HF, Fisher RS, Dattilo TM, Mullins LL, Ediati A, Wisniewski AB. Cross-Cultural Disparities in Psychosocial Research with Individuals with Classical Congenital Adrenal Hyperplasia: A Scoping Review. Horm Res Paediatr 2023; 97:99-105. [PMID: 37552959 DOI: 10.1159/000531167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/10/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION There are increased calls to address psychosocial needs among individuals with classical congenital adrenal hyperplasia (CAH). However, cross-cultural disparities exist in treatment practices and psychosocial outcomes that impact the generalizability of evidence-based recommendations. To date, this disparity has not been quantified. The present scoping review uses a dual approach to contrast rates of CAH diagnosis with CAH psychosocial research rates across countries. METHODS Six electronic database searches were conducted for: (1) CAH incidence/birth/prevalence rates; and (2) psychosocial research with affected individuals and their families. Two authors reviewed each abstract for inclusion criteria. RESULTS Sixty-eight and 93 full-text articles, respectively, were evaluated for incidence and country. The countries/regions with the highest reported CAH rates are Thailand, Ghana, and India. Those with the greatest portion of psychosocial publications are the USA, Germany, and the UK. CONCLUSION A discrepancy exists between those countries with the highest CAH rates and those publishing psychosocial research. Specifically, increased rates of CAH are seen in non-Western countries/regions, whereas most psychosocial research arises out of Western Europe and the USA. Due to cultural differences between these regions, increased global collaboration is needed to both inform psychosocial research and translate findings in ways that are representative worldwide.
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Affiliation(s)
- Katherine A Traino
- Psychology Department, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Nathan L Basile
- Psychology Department, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Hui-Fen Chang
- William E. Brock Memorial Library, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Rachel S Fisher
- Psychology Department, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Taylor M Dattilo
- Psychology Department, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Larry L Mullins
- Psychology Department, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | | | - Amy B Wisniewski
- Psychology Department, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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6
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Traino KA, Fisher RS, Basile NL, Edwards CS, Bakula DM, Chaney JM, Mullins LL. Transition readiness and quality of life in emerging adult college students. J Am Coll Health 2023; 71:1167-1174. [PMID: 34242532 DOI: 10.1080/07448481.2021.1923507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/23/2021] [Accepted: 04/25/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To examine the relative contribution of transition readiness (i.e., healthcare self-management) to health-related quality of life (HRQoL) among emerging adult (EA) college students without a chronic medical condition (CMC).Participants: College students (n = 2372; Mage = 19.32, SD = 1.26) from a Midwestern university.Methods: Participants completed online measures of demographics, HRQoL, and transition readiness.Results: Hierarchical regression analyses found transition readiness accounted an additional 3-4% of the variability in mental and physical HRQoL (p < .001), beyond demographic factors. 11.3% of EAs reported overall mastery of transition readiness, with navigating health insurance being the weakest area.Conclusions: Findings support the consensus that transition readiness is relevant to HRQoL for all EAs, including those without a CMC. EAs without a CMC demonstrate relatively weak transition readiness skills. Primary and university-based healthcare might consider programs supporting transition readiness and HRQoL among underresourced EAs.
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Affiliation(s)
- Katherine A Traino
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Clayton S Edwards
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Dana M Bakula
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - John M Chaney
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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Basile NL, Dattilo TM, DeLone AM, Kraft JD, Edwards CS, Buchanan CL, Cheng EY, Poppas DP, Wisniewski AB, Mullins LL. Parental Uncertainty Scale Factor Structure in Pediatric DSD With Ambiguous Genitalia. J Pediatr Psychol 2023; 48:386-395. [PMID: 36728708 PMCID: PMC10118853 DOI: 10.1093/jpepsy/jsad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Illness uncertainty is a salient experience for caregivers of children with disorders/differences of sex development (DSD) presenting with ambiguous genitalia; however, no validated measure of illness uncertainty exists for this unique population. Thus, the current study aimed to preliminarily identify the factor structure of the Parental Perception of Uncertainty Scale (PPUS) in caregivers of children with DSD presenting with ambiguous genitalia and examine the convergent validity of the PPUS. METHODS Participants included 115 caregivers (Mage = 32.12 years, SD = 6.54; 57% mothers) of children (<2-year-olds) diagnosed with DSD participating in a larger, longitudinal study. Caregivers completed the PPUS as well as self-report measures of anxious, depressive, and posttraumatic stress symptoms. An exploratory factor analysis was conducted. RESULTS Exploratory factor analysis results indicated that a 23-item 1-factor solution was the most parsimonious and theoretically sound factor structure (α = 0.92). Convergent validity analyses demonstrated further support for the use of the 23-item 1-factor solution over the original PPUS factor structure. CONCLUSION These results demonstrate the preliminary clinical and research utility of the PPUS with caregivers of children with DSD presenting with ambiguous genitalia. The PPUS may benefit from further refinement through qualitative research and item adaptation to capture uncertainties unique to DSD presenting with ambiguous genitalia. In addition, future research should replicate the proposed factor structure using confirmatory factor analysis with a separate, larger sample of caregivers of children with DSD to confirm the factor structure.
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Affiliation(s)
- Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Jacob D Kraft
- Department of Psychiatry, University of Michigan, USA
| | - Clayton S Edwards
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, USA
| | - Earl Y Cheng
- Department of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, USA
| | - Dix P Poppas
- Institute for Pediatric Urology, Komansky Children’s Hospital, New York Presbyterian Hospital-Weill Cornell Medicine, USA
| | - Amy B Wisniewski
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
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Morrison CF, Drake S, Basile NL, Horn MJ, Lambert J, Myers KC, Pai AL. Symptoms of Survivors of Pediatric Hematopoietic Stem Cell Transplant by Age, Sex, and Transplant Type. J Pediatr Hematol Oncol Nurs 2022; 39:277-289. [PMID: 36129887 PMCID: PMC9807777 DOI: 10.1177/27527530211068746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose: The purpose of this study was to describe symptoms experienced by survivors of pediatric hematopoietic stem cell transplant (HSCT), and demographic and treatment-factors associated with ongoing symptomology. Methods: Fifty pediatric survivors completed a cross-sectional pilot study. Questionnaires were administered online via REDCap to assess symptoms experienced in the last week. Survivors also consented to a medical record chart review. Results: Survivors were on average 5.4 years post-HSCT (range 1.1 to 9 years), male (58%), and Caucasian (80%) who received an allogeneic HSCT (92%). The most commonly reported symptoms were difficulty concentrating (42.5%), pain (38%), worry (38%), nervousness (37.5%), and lack of energy/fatigue (34%). Survivors reported up to 14 symptoms, with 90% of the sample experiencing at least one symptom in the previous week. Average number of symptoms varied by age group between 2.1 (8-9 years) and 6.8 (18 and older). Age and female gender were associated with higher levels of fatigue. Conclusions: The majority of survivors experienced at least one symptom in the previous week. Neuropsychological symptoms and pain endure well into survivorship that can influence outcomes such as function and health-related quality of life (HRQOL). Research is needed on biological mechanisms of ongoing symptomology, effective interventions to prevent or mitigate symptoms, and the impact of symptoms on patient outcomes including daily functioning and HRQOL. Implications Survivors of pediatric HSCT continued to experience symptoms for up to nine years. Survivors should be frequently screened for symptoms, as symptoms may affect function, learning/employment outcomes, and HRQOL.
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Affiliation(s)
- Caroline F. Morrison
- Assistant Professor, University of Cincinnati, College of Nursing, Proctor Hall, 3110 Vine Street, MLC 0038,
Cincinnati, Ohio 45267,Caroline F. Morrison, PhD, RN, Assistant
Professor, University of Cincinnati, College of Nursing, Proctor Hall, 3110 Vine
Street, MLC 0038, Cincinnati, Ohio 45267.
| | - Sarah Drake
- Clinical Research Coordinator, Cincinnati Children's Hospital Medical
Center, Division of Behavioral Medicine and Clinical Psychology
| | | | - Mary Jane Horn
- Research Associate, University of Cincinnati, College of Nursing
| | - Joshua Lambert
- Assistant Professor, Biostatistician, University of Cincinnati, College of Nursing
| | - Kasiani C. Myers
- Assistant Professor, Cincinnati Children's Hospital Medical
Center, Division of Bone Marrow Transplantation and Immune Deficiency, University of Cincinnati, College of Medicine, Department of Pediatrics
| | - Ahna L.H. Pai
- Professor, Cincinnati Children's Hospital Medical Center, Division
of Behavioral Medicine and Clinical Psychology, Director of the Wellness Center, Cancer and Blood Diseases
Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Department of Pediatrics
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Dattilo TM, Roberts CM, Traino KA, Bakula DM, Fisher R, Basile NL, Chaney JM, Mullins LL. Illness stigma, health anxiety, illness intrusiveness, and depressive symptoms in adolescents and young adults: A path model. Stigma and Health 2022. [DOI: 10.1037/sah0000390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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Traino KA, Baudino MN, Kraft JD, Basile NL, Dattilo TM, Davis MP, Buchanan C, Cheng EY, Poppas DP, Wisniewski AB, Mullins LL. Factor Analysis of the Stigma Scale-Parent Version in Pediatric Disorders/Differences of Sex Development. Stigma Health 2021; 6:390-396. [PMID: 35497259 PMCID: PMC9053364 DOI: 10.1037/sah0000346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Stigma is a salient experience for both caregivers/parents and individuals with Disorders/Differences of Sex Development (DSD) as evidenced through qualitative and preliminary quantitative reports. However, few validated measures of associative stigma (i.e., vicarious stigma experienced through close association with someone who is socially stigmatized) for parents of children with DSD exist. The present study aims to (1) determine the factor structure of the adapted Stigma Scale - Parent, and (2) examine convergent validity of the factor structure with measures of parent psychosocial adjustment. Confirmatory factor analytic results revealed two factors: a parent-focused factor and a child-focused factor. The parent-focused factor demonstrated convergent validity with parent adjustment measures, but the child-focused factor did not. Together, these results indicate that parent-focused and child-focused stigma are distinct factors, with parent-focused associative stigma being related to parent adjustment following DSD diagnosis. Future research should further refine this measure to determine predictive validity and clinical value.
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Affiliation(s)
| | | | - Jacob D. Kraft
- Psychology Department, Oklahoma State University, Stillwater, OK
| | - Nathan L. Basile
- Psychology Department, Oklahoma State University, Stillwater, OK
| | | | - Morgan P. Davis
- Psychology Department, Oklahoma State University, Stillwater, OK
| | - Cindy Buchanan
- University of Colorado Anschutz Medical Campus, Department of Psychiatry, Aurora, CO
| | - Earl Y. Cheng
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Department of Urology, Chicago, IL
| | - Dix P. Poppas
- Phyllis & David Komansky Center for Children’s Health of New York Presbyterian Hospital Weill Cornell Medical Center
| | | | - Larry L. Mullins
- Psychology Department, Oklahoma State University, Stillwater, OK
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Fisher RS, Perez MN, Basile NL, Pepper M, Gamwell KL, McNall-Knapp R, Carter JC, Mayes S, Chaney JM, Mullins LL. Childhood cancer physical symptom burden and parent distress: The role of parent rumination. Clinical Practice in Pediatric Psychology 2021. [DOI: 10.1037/cpp0000403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Basile NL, Chardon ML, Peugh J, Edwards CS, Szulczewski L, Morrison CF, Nagarajan R, El-Sheikh A, Chaney JM, Pai ALH, Mullins LL. Relationship Between Caregiver Uncertainty, Problem-Solving, and Psychological Adjustment in Pediatric Cancer. J Pediatr Psychol 2021; 46:1258-1266. [PMID: 34350968 DOI: 10.1093/jpepsy/jsab065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/26/2021] [Accepted: 05/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The current study examined the roles of constructive and dysfunctional problem-solving strategies in the relationships between illness uncertainty and adjustment outcomes (i.e., anxious, depressive, and posttraumatic stress symptoms) in caregivers of children newly diagnosed with cancer. METHODS Two hundred thirty-eight caregivers of children (0-19 years of age) newly diagnosed with cancer (2-14 weeks since diagnosis) completed measures of illness uncertainty, problem-solving strategies, and symptoms of anxiety, depression, and posttraumatic stress. RESULTS A mediation model path analysis assessed constructive and dysfunctional problem-solving strategies as mediators between illness uncertainty and caregiver anxious, depressive, and posttraumatic stress symptoms. Dysfunctional problem-solving scores partially mediated the relationships between illness uncertainty and anxious, depressive, and posttraumatic stress symptoms. Constructive problem-solving scores did not mediate these relationships. CONCLUSIONS The current findings suggest that illness uncertainty and dysfunctional problem-solving strategies, but not constructive problem-solving strategies, may play a key role in the adjustment of caregivers of children newly diagnosed with cancer. Interventions aimed at managing illness uncertainty and mitigating the impact of dysfunctional problem-solving strategies may promote psychological adjustment.
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Affiliation(s)
- Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University
| | - Marie L Chardon
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - James Peugh
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
| | - Clayton S Edwards
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University
| | - Lauren Szulczewski
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
| | | | - Rajaram Nagarajan
- Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center
| | - Ayman El-Sheikh
- Department of Hematology/Oncology, Dayton Children's Hospital
| | - John M Chaney
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University
| | - Ahna L H Pai
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University
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Pai ALH, Chardon ML, Mara CA, Basile NL, Schwartz LA, Phipps S. Parental Efficacy and Control Questionnaire in Hematopoietic Stem Cell Transplant: Preliminary Validation. J Pediatr Psychol 2020; 45:454-462. [PMID: 32219411 DOI: 10.1093/jpepsy/jsaa010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Develop and evaluate the preliminary validity of a self-report measure of parents' treatment-related efficacy and control, Parental Efficacy and Control Questionnaire-Hematopoietic Stem Cell Transplant (PECQ-HCT), in a pediatric HCT sample. METHODS Participants included 185 parents of children (≤12 years old) receiving HCT participating in a larger, longitudinal study. Parents completed the PECQ-HCT as well as measures of social problem-solving skills, collective family efficacy, family beliefs, and parental distress. RESULTS Exploratory factor analysis results indicated that a 37-item four-factor model was the best fitting and most theoretically sound, χ2(df = 1,596) = 14,089.95, p < .01, comparative fit index = 0.92, Tucker-Lewis Index = 0.90, and root mean square error of approximation = 0.07. Preliminary subscale scores demonstrated adequate internal consistency as well as good content and criterion-related validity. CONCLUSIONS If replicated using a confirmatory factor analysis in a separate sample, these findings suggest that the four-factor PECQ-HCT measure may be useful for measuring HCT-related parental efficacy and perceived control.
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Affiliation(s)
- Ahna L H Pai
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Pediatrics, University of Cincinnati College of Medicine
| | - Marie L Chardon
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Constance A Mara
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Pediatrics, University of Cincinnati College of Medicine
| | - Nathan L Basile
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | | | - Sean Phipps
- Behavioral Medicine, St. Jude Children's Research Hospital
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