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Fedewa SA, Buckner TW, Parks SG, Tran DQ, Cafuir L, Antun AG, Mattis S, Kempton CL. Racial and Ethnic Differences in Distress, Depression, and Quality of Life in people with hemophilia. J Racial Ethn Health Disparities 2024; 11:1394-1404. [PMID: 37133726 DOI: 10.1007/s40615-023-01616-3] [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] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/04/2023]
Abstract
Hemophilia-related distress (HRD) has been shown to be higher among those with lower educational attainment, but potential racial/ethnic differences have not been previously described. Thus, we examined HRD according to race/ethnicity. This cross-sectional study was a planned secondary analysis of the hemophilia-related distress questionnaire (HRDq) validation study data. Adults aged ≥ 18 years with Hemophilia A or B were recruited from one of two hemophilia treatment centers between July 2017-December 2019. HRDq scores can range from 0-120, and higher scores indicate higher distress. Self-reported race/ethnicity was grouped as Hispanic, non-Hispanic White (NHW) and non-Hispanic Black (NHB). Unadjusted and multivariable linear regression models were used to examine mediators of race/ethnicity and HRDq scores. Among 149 participants enrolled, 143 completed the HRDq and were included in analyses. Approximately 17.5% of participants were NHB, 9.1% were Hispanic and 72.0% were NHW. HRDq scores ranged from 2 to 83, with a mean of 35.1 [standard deviation (SD) = 16.5]. Average HRDq scores were significantly higher among NHB participants (mean = 42.6,SD = 20.6; p-value = .038) and similar in Hispanic participants (mean = 33.8,SD = 16.7, p-value = .89) compared to NHW (mean = 33.2,SD = 14.9) participants. In multivariable models, differences between NHB vs NHW participants persisted when adjusting for inhibitor status, severity, and target joint. However, after household income was adjusted for, differences in HRDq scores were no longer statistically significant (β = 6.0 SD = 3.7; p-value = .10). NHB participants reported higher HRD than NHW participants. Household income mediated higher distress scores in NHB compared to NHW participants, highlighting the urgent need to understand social determinants of health and financial hardship in persons with hemophilia.
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Affiliation(s)
- Stacey A Fedewa
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, GA, USA.
| | - Tyler W Buckner
- Hemophilia and Thrombosis Center, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Duc Q Tran
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - Lorraine Cafuir
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - Ana G Antun
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Shanna Mattis
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - Christine L Kempton
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, GA, USA
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Feldberg G, Ricciardi JBS, Zorzi AR, Yamaguti-Hayakawa GG, Ozelo MC. Promoting pain coping skills in haemophilia: A remote intervention integrating exercise and pain education. Haemophilia 2024; 30:800-808. [PMID: 38523258 DOI: 10.1111/hae.14991] [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: 11/02/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Chronic joint pain is a significant and widespread symptom in people with haemophilia (PWH). Despite medical advancements, effective pain management remains challenging. AIM This study presents an innovative approach that integrates remote physical exercises, pain neuroscience education, and coping strategies to address chronic pain in PWH. METHODS The remote intervention consisted of sixteen 5-min videos encompassing physical exercises for chronic pain management and pain education strategies. These videos formed an 8-week remote intervention program. Clinical and physical assessments were conducted before and after the intervention. RESULTS A total of thirty-one PWHs, with a median age of 34 years (ranging from 16 to 59 years), completed the remote intervention. The study revealed significant improvements in pain intensity, disability, and physical performance among PWH with chronic pain. Enhanced functional capacity was evident in the Timed Up and Go and Single Leg Stance tests, accompanied by improved scores on the Functional Independence Score in Haemophilia (FISH). Although lacking a control group, our findings are consistent with other successful exercise and pain education programs. CONCLUSIONS This innovative intervention holds promise for managing chronic pain in PWH, underscoring patient empowerment, education, and collaboration. Notably, our study stands out by uniquely combining pain education and coping strategies, bolstering evidence for effective pain management.
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Affiliation(s)
- Glenda Feldberg
- Hemophilia Treatment Center (HTC) "Cláudio Luiz Pizzigatti Corrêa", Hemocentro UNICAMP, University of Campinas, Campinas, SP, Brazil
- Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Janaína B S Ricciardi
- Hemophilia Treatment Center (HTC) "Cláudio Luiz Pizzigatti Corrêa", Hemocentro UNICAMP, University of Campinas, Campinas, SP, Brazil
- Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Alessandro R Zorzi
- Department of Orthopedic, Rheumatology and Traumatology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, Brazil
| | - Gabriela G Yamaguti-Hayakawa
- Hemophilia Treatment Center (HTC) "Cláudio Luiz Pizzigatti Corrêa", Hemocentro UNICAMP, University of Campinas, Campinas, SP, Brazil
- Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Margareth C Ozelo
- Hemophilia Treatment Center (HTC) "Cláudio Luiz Pizzigatti Corrêa", Hemocentro UNICAMP, University of Campinas, Campinas, SP, Brazil
- Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil
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Zhang W, Zhu T, Wang S, Zhang Y, Chen W, Li K. Chain-mediating effects of kinesiophobia and self-efficacy on pain catastrophizing and physical activity in haemophilia patients. Haemophilia 2024; 30:809-816. [PMID: 38616526 DOI: 10.1111/hae.15008] [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: 10/26/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND There is a lack of research on the relationship between pain catastrophizing, kinesiophobia, and physical activity (PA) in people with haemophilia (PWH), and the underlying mechanisms connecting these variables remain unclear. AIM The study's aim was to clarify the roles of kinesiophobia and self-efficacy in the relationship between pain catastrophizing and PA in PWH. METHODS This cross-sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self-Efficacy Scale. RESULTS The study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET-min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self-efficacy, and through the chain-mediating effect of kinesiophobia and self-efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively. CONCLUSION The study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self-efficacy.
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Affiliation(s)
- Wenjing Zhang
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tienan Zhu
- Department of Haematology, Peking Union Medical College Hospital, Beijing, China
| | - Shujie Wang
- Department of Haematology, Peking Union Medical College Hospital, Beijing, China
| | - Yanbin Zhang
- Department of Haematology, Peking Union Medical College Hospital, Beijing, China
| | - Wenkun Chen
- Department of Haematology, Peking Union Medical College Hospital, Beijing, China
| | - Kuixing Li
- Department of Haematology, Peking Union Medical College Hospital, Beijing, China
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Ferri Grazzi E, Blenkiron T, Hawes C, Camp C, O'Hara J, Burke T, O'Brien G. Anxiety and depression among adults with haemophilia A: Patient and physician reported symptoms from the real-world European CHESS II study. Haemophilia 2024; 30:743-751. [PMID: 38507035 DOI: 10.1111/hae.14989] [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: 11/01/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION The physical pain and disability affecting many people with haemophilia A (PwHA) are known detractors from psychological wellbeing. While psychosocial support is considered a core tenet of the haemophilia comprehensive care structure, the extent to which mental health challenges are detected and monitored by the individuals treating haematologist remains relatively unexplored. AIM To describe prevalence of anxiety and depression in a real-world cohort of adult PwHA and evaluate the congruence in reporting of anxiety or depression (A/D) between PwHA and their treating physicians. METHODS Data for PwHA without inhibitors was drawn from the European 'Cost of Haemophilia: A Socioeconomic Survey II' (CHESS II) study. Haematologist-indicated comorbidities of anxiety and depression were unified into a single A/D indicator. The EQ-5D-5L health status measure was used to characterise self-reported A/D, with individuals stratified into two non-mutually exclusive subgroups based on level of A/D reported (Subgroup A: 'some' or above; Subgroup B: 'moderate' or above). RESULT Of 381 PwHA with evaluable EQ-5D-5L responses, 54% (n = 206) self-reported at least some A/D (Subgroup A) and 17% (n = 66) reported at least moderate A/D (Subgroup B). Patient-physician congruence in A/D reporting was 53% and 76% for Subgroups A and B, respectively. Descriptive analysis suggested that individuals with physician- and/or self-reported A/D experienced worse clinical outcomes (bleeding events, joint disease, chronic pain). CONCLUSION While adverse clinical outcomes appear to correlate with A/D, self-reports of moderate-severe symptoms occasionally lacked formal recognition from treating physicians. Cross-disciplinary surveillance of mental health issues could improve both psychological and clinical outcomes among PwHA.
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Affiliation(s)
| | - Thomas Blenkiron
- Health Economics and Outcomes Research, HCD Economics, Knutsford, UK
| | | | | | - Jamie O'Hara
- Health Economics and Outcomes Research, HCD Economics, Knutsford, UK
- Department of Health and Social Care, University of Chester, Chester, UK
| | - Tom Burke
- Health Economics and Outcomes Research, HCD Economics, Knutsford, UK
- Department of Health and Social Care, University of Chester, Chester, UK
| | - Gráinne O'Brien
- Department of Clinical Psychology, Royal Infirmary of Edinburgh, Edinburgh, UK
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Chozie NA, Ayu DR, Medise BE, Marsubrin PMT, Sari TT, Yuniar I, Wahyuni LK. Validity and reliability test of the Indonesian version of the PedHALshort questionnaire. Haemophilia 2024; 30:728-732. [PMID: 38578181 DOI: 10.1111/hae.15000] [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: 09/30/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION The PedHAL questionnaire is employed in measuring the activities of haemophilia children. The PedHALshort was developed in 2022 to determine the most relevant item for the assessment. Haemo-QoL questionnaire assesses the quality of life of haemophilia children. AIM Determine the validity and reliability of the PedHALshort Indonesia language version compared to the Haemo-QoL in the Indonesian population. METHODS A cross-sectional study was conducted in Jakarta, Indonesia. The subjects were children (4-16 years old) with moderate or severe haemophilia A or B with repeated joint bleeding. The daily activity was assessed using the PedHALshorts and Haemo-QoL. The validity and reliability were tested. The validity was determined with Pearson correlation test, construct validity was assessed using convergent and discriminant validity. The Spearman correlation was used to determine which domains of Haemo-QoL correlated with PedHALshort. The reliability was analyzed using test-retest reliability. Cronbach's α was used to determined internal consistency. RESULTS Fifty children were included in the study (78% haemophilia A, 70% severe group). All domains were valid (r > .284). The convergent validity test showed PedHALshort had a moderate negative correlation with physical health and sports school domain of Haemo-QoL (r = -.479, p < .001). The discriminant validity test showed the PedHALshort demonstrated a moderate negative correlation with physical health (r = -.585), view (r = -.590), sport school domain (r = -.430) in severe haemophilia subjects. The internal consistency of the PedHALshort questionnaire was high (Cronbach's α of .85 (.74-.92)). CONCLUSION The PedHALshort is valid and reliable, hence, it can be used to measure the functional physical activity of children with haemophilia.
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Affiliation(s)
- Novie Amelia Chozie
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dewi Rosariah Ayu
- Pediatric Subspecialist Consultant Program, Departement of Child Health, Cipto Mangunkusumo General hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Child Health, Mohammad Hoesin General Hospital, Universitas Sriwijaya Medical School, Palembang, Indonesia
| | - Bernie Endyarni Medise
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | - Teny Tjitra Sari
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Irene Yuniar
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Luh Karunia Wahyuni
- Department of Physical Medicine and Rehabilitation, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Koseoglu FD, Zuhal D, Onen-Sertoz O, Fahri S. Depression and anxiety in patients with hemophilia A and B. Int J Psychiatry Med 2024; 59:20-33. [PMID: 37565475 DOI: 10.1177/00912174231196343] [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] [Indexed: 08/12/2023]
Abstract
OBJECTIVE This study described the prevalence of and correlates of depression and anxiety in adult patients with hemophilia A and B. METHODS In this cross-sectional study, we investigated patients with hemophilia who were being seen at an adult hemophilia center in Turkey. Participants were screened for depression and anxiety during their annual clinic visit, which included administration of the Beck Depression Inventory and State-Trait Anxiety Scale. RESULTS Of the 90 patients, 22 (24.4%) met criteria for significant depressive symptoms and 67 (74.4%) met criteria for significant anxiety symptoms. There were no significant associations between depression and any psychosocial or clinical characteristics or adherence to hemophilia prophylaxis, except for educational status. No association was found between state and trait anxiety scores and psychosocial and clinical characteristics other than hemophilia type. After adjusting for confounding factors, multivariable analysis showed that high school education level was associated with depression (OR: 1.87, CI: 1.31-2.36, P = .010) and type B hemophilia was associated with anxiety (OR: 1.32, CI: 1.09-1.75, P = .042). CONCLUSION Depression and anxiety are major psychiatric comorbidities in patients with hemophilia in Turkey. Routine evaluation for mood and anxiety disorders are important in the routine care of patients with haemophilia.
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Affiliation(s)
- Fatos D Koseoglu
- Department of Hematology, Faculty of Medicine, İzmir Bakırçay University, Izmir, Turkey
| | - Demirci Zuhal
- Department of Hematology, Adult Hemophilia Center, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ozen Onen-Sertoz
- Department of Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sahin Fahri
- Department of Hematology, Adult Hemophilia Center, Faculty of Medicine, Ege University, Izmir, Turkey
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Khair K, McLaughlin P, Roussel N, Boyton M, Holland M. Prevalence and perceptions of pain in people with haemophilia: A UK study. Haemophilia 2023; 29:1509-1518. [PMID: 37694815 DOI: 10.1111/hae.14860] [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: 03/10/2023] [Revised: 08/11/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Joint bleeds in haemophilia cause destruction of articular structures, impaired function and pain. Up to 70% of people with haemophilia (PWH) report chronic pain. Little is known about the pain experiences in PWH in the UK. AIM To identify prevalence and perceptions of pain among PWH living in the UK. METHODS A cross-sectional, non-interventional survey study conducted among PWH (all severities). The survey incorporated elements from validated tools (EQ-5D; EQ-VAS) and was distributed via participating treatment centres. RESULTS Five hundred and ninety-nine PWH responded, 91% aged > 18. 81% used factor prophylactically or on demand. More pain was reported by those treated on demand versus prophylaxis particularly in those who reported daily pain. 65% reported 'problem joints' based on individual impact rather than medically defined 'target joints', 2/3 reported multiple joint issues. The ankle was most commonly affected. 59% reported frequent pain, with 56% aware of pain constantly or most of the time and were more likely to report less favourable EQ-5D or EQ-VAS scores (p < .001). Pain frequency/awareness was consistent across all severities. Most discussed pain with care teams, 31% only when asked; 25% did not discuss it. Pain discussions resulted in physiotherapy referral (63%) analgesia prescription (48%), and a minority specialist pain referral (9%). Most felt well supported with regard to their pain, but 70% reported learning to live with it. CONCLUSION Pain affects PWH of all ages and severities even in a well-resourced country significantly impacting quality of life. Clinicians must be more aware of chronic pain in PWH. Biopsychosocial approaches to pain assessment and management are recommended.
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Affiliation(s)
| | - Paul McLaughlin
- Katharine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free Hospital, London, UK
| | - Nathalie Roussel
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
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Obeidat HM, Habashneh MH, Dwairej DA, Obeidat AH, Al-Oran HM. The lived experience of mothers of children with haemophilia in Jordan: A phenomenological study. Haemophilia 2023; 29:1226-1233. [PMID: 37428628 DOI: 10.1111/hae.14820] [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] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Haemophilia is an inherited bleeding disorder. Mothers of children with haemophilia experience stress, anxiety and different types of burdens that affect their life negatively. OBJECTIVES This study aimed to explore the lived experience of mothers of children with haemophilia. METHODS A descriptive phenomenological design was utilized. The participants were selected purposively from the Jordanian Association for Thalassemia and Hemophilia. Data saturation was achieved by interviewing 20 mothers. RESULTS Five themes emerged: (1) the challenges related to the diagnosis, the availability and administration of the clotting factors, and the occurrence of the bleeding emergency; (2) physical, social, psychological and financial burden; (3) fear of child death and disability; (4) stigmatization; and (5) lack of educational and medical support. CONCLUSION Mothers of children with haemophilia suffer from physical, psychological and social consequences. Healthcare providers should carry out educational sessions regarding the importance of support for the family and throughout the life of the child.
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Asad F, Jahangarad S, Dorgalaleh A. Psychological complications among patients with congenital bleeding disorders. Blood Coagul Fibrinolysis 2023; 34:138-143. [PMID: 36719804 DOI: 10.1097/mbc.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Congenital bleeding disorders (CBDs), including inherited platelet function disorders and rare and common bleeding disorders, are a heterogeneous group of bleeding disorders with a wide range of clinical presentations, including psychological complications. Due to the chronic nature of CBDs, psychological complications are relatively common in these patients, which can affect treatment adherence, quality of life, and even the frequency of bleeding episodes. Chronic pain causes many psychological problems in CBDs, disrupting their social interactions, affecting all aspects of their lives, including their emotional functioning and behavior, and eventually leading to social exclusion. About one-third of patients with severe hemophilia A suffer from anxiety, 64% from depression, and 60% from other minor psychological complications such as withdrawal/depression, anxiety/depression, attention problems, and emotional problems. Anxiety, depression, and uncontrolled pain interfere with treatment adherence. For this reason, psychological interventions are needed in people with CBDs. Psychological interventions increase quality of life and treatment adherence. Therefore, early recognition of psychological complications in CBD patients may increase treatment adherence, leading to a reduction in bleeding episodes and thus an improvement in quality of life.
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Affiliation(s)
- Fatemeh Asad
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Sara Jahangarad
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Akbar Dorgalaleh
- Hematology and Blood Transfusion, Hamin Tis Research Institute, Tehran, Iran
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Brown C, Page A. Acquired haemophilia A in a patient who is a Jehovah's Witness. BMJ Case Rep 2022; 15:e244928. [PMID: 36038157 PMCID: PMC9438022 DOI: 10.1136/bcr-2021-244928] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We detail the case of a man in his 80s who was a Jehovah's Witness, presenting to hospital for the second time in 1 week with atraumatic, severe bruising affecting his right thigh and flank. He was subsequently diagnosed with idiopathic acquired haemophilia A (AHA) and was urgently treated with recombinant factor concentrate and immunosuppressive therapy. Management of his bleeding disorder and resultant severe anaemia was adapted in line with his religious beliefs. AHA is a rare bleeding disorder which should be considered in patients with an isolated prolonged activated partial thromboplastin time and a history of recent or acute bleeding. Prompt diagnosis and management are essential as delays may result in increased mortality. Given that this patient declined blood transfusion, management of his bleeding disorder presented a unique challenge.
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Affiliation(s)
- Clare Brown
- Department of Haematology, Royal Infirmary of Edinburgh, Edinburgh, Scotland
| | - Andrew Page
- Department of Haematology, Royal Infirmary of Edinburgh, Edinburgh, Scotland
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Scaturro D, Benedetti MG, Lomonaco G, Tomasello S, Farella MGG, Passantino G, Frizziero A, Letizia Mauro G. Effectiveness of rehabilitation on pain and function in people affected by hemophilia. Medicine (Baltimore) 2021; 100:e27863. [PMID: 34918635 PMCID: PMC8677972 DOI: 10.1097/md.0000000000027863] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Literature provides unclear evidence of the effectiveness of many physiotherapy interventions on pain intensity, quality of life, and functional ability in hemophilic patients, and suggests that rehabilitation programs should be focused on functional goals and the disability of patients. AIM The aim of the present study is to present the outcome of a case series of patients with hemophilia in which a rehabilitation program has been carried out on the basis of a specific individual patient's functional impairment. METHODS Fifty-one patients were enrolled: 32 patients (Rehab Group) received a rehabilitative treatment, 19 patients for different reasons (living far from the hospital, family problems) did not receive rehabilitation (Control Group). The rehabilitation program was planned with respect to the emergent problems: musculoskeletal pain, joint range of motion limitation, muscle flexibility, walking difficulties, the appearance of hematomas/hemartro, and postural problems. All the patients were assessed at baseline (T0), after 1 month (T1), and after 3 months (T2) through visual analogic scale for musculoskeletal pain, the Hemophilia Joint Health Score for joint range of motion, the Functional Independence Score in Hemophilia for disability, and postural assessment by visual inspection. RESULTS A significant reduction of pain and improvement of Hemophilia Joint Health Score and Functional Independence Score in Hemophilia score was found in the Rehab Group along with the follow-up. Pain in the Control Group was lower with respect to the other group at baseline and significantly decreased after 1 month. CONCLUSION A rehabilitation program focused on individual impairment of patients with hemophylia determined satisfying results in terms of pain control, functional, and disability improvement in 3 months follow-up.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo Rehabilitation Unit, Paolo Giaccone Hospital, Palermo, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, University of Bologna, IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giulia Lomonaco
- Physical Medicine and Rehabilitation Unit, University of Bologna, IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Sofia Tomasello
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo Rehabilitation Unit, Paolo Giaccone Hospital, Palermo, Italy
| | | | - Giuseppina Passantino
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo Rehabilitation Unit, Paolo Giaccone Hospital, Palermo, Italy
| | - Antonio Frizziero
- Physical and Rehabilitation Medicine, Department of Medicine and Surgery General Hospital, University of Parma, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo Rehabilitation Unit, Paolo Giaccone Hospital, Palermo, Italy
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13th Annual Congress of European Association for Haemophilia and Allied Disorders 2020, 5-7 February 2020, The Hague, The Netherlands. Haemophilia 2020; 26 Suppl 2:12-181. [PMID: 31991514 DOI: 10.1111/hae.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jiménez-Cebrián AM, López-López D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Navarro-Flores E, San-Antolín M, Calvo-Lobo C, Palomo-López P. Foot health-related quality of life in hemophiliacs: A case-control study. Int J Med Sci 2020; 17:2396-2401. [PMID: 32922206 PMCID: PMC7484635 DOI: 10.7150/ijms.48705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/10/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Haemophilia is considered as a chronic genetic disease related with alteration in coagulation mechanism which affects to health related quality of life (HQoL). Purpose: The goal compared marks of HQoL, in haemophiliacs with respect non haemophilic subjects. Methods: A population of 74 subjects, were recruited from association of haemophilic illness separated in haemophilic subjects (n = 37) and no haemophilic (n = 37). For subjects who suffered haemophilia were enlisted from the association of haemophilic illness after a seminar of 45 minutes to them and to their relatives about foot health. Control subjects, were recruited from their relatives who live with the patient. The marks of the Foot Health Status Questionnaire Spanish S_FHSQ sub-scales were recompiled. Results: All S_FHSQ domains as foot pain, foot function, tootwear, general foot health, general health, physical activity and social capacity showed lower scores in the haemophilic than non-haemophilic group (P <0.01) except for vigour (P = 0.173). Regarding the rest sub-scale marks of S_FHSQ, showed no significant difference P <0.01. Conclusion: Subjects with a haemophilia showed significant worse foot QoL in all S_FHSQ domains except vigour domain compared with non-haemophilic subjects.
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Affiliation(s)
- Ana María Jiménez-Cebrián
- Department Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, c/ Arquitecto Francisco Peñalosa 3, Ampliación del Campus de Teatinos, 29071 Málaga, Spain, Instituto de Investigación Biomédica de Málaga (IBIMA) https://orcid.org/000-0002-8634-7114
| | - Daniel López-López
- Research, Health and Podiatry Group. Department of Health Sciences, Faculty of Nursing and Podiatry. Universidade da Coruña, Ferrol, Spain
| | | | | | - Emmanuel Navarro-Flores
- Faculty of Nursing and Podiatry, Department of Nursing. University of Valencia. Frailty Research Organizaded Group (FROG)
| | - Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Spain
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Bago M, Butkovic A, Preloznik Zupan I, Faganel Kotnik B, Prga I, Bacic Vrca V, Zupancic Salek S. Depressive symptoms and adherence to prophylaxis in patients with haemophilia from Croatia and Slovenia. Haemophilia 2020; 26:e161-e167. [PMID: 32741039 DOI: 10.1111/hae.14011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/12/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Adherence to a prophylactic therapy is obligatory to prevent bleeding in patients with haemophilia. It has already been recognized that depression is associated with treatment adherence. AIM The aim of this study was to examine the prevalence of depressive symptoms in adults with haemophilia using an instrument designed or validated for diagnosing or screening for depression and to investigate the association of symptoms of depression with nonadherence to prophylactic therapy in patients from two East European countries. METHODS Adult patients with severe or moderate haemophilia receiving prophylaxis were eligible for the study. Depressive symptoms were assessed with BDI-II, adherence with VERITAS-Pro, demographic and socioeconomic data were collected using a questionnaire, and clinical data were obtained from medical records. RESULTS Final sample included 81 participants (median age was 45 years, range 18-73 years). There were 9 (11%) participants with scores on BDI-II above 14 points, the cut-off score for depressive symptomatology. In general, participants were adherent. However, there were 14 (17%) participants who had scores above 57 points, the cut-off score for nonadherence. There was an association between having depressive symptoms and being nonadherent, and depressive symptoms explained additional variance in adherence after controlling for sociodemographic, psychosocial and clinical characteristics. CONCLUSION Since there is an association between depressive symptoms and nonadherence, it would be beneficial for both patients and the public health system for screening for depressive symptoms to be included as a part of the treatment protocol.
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Affiliation(s)
- Martina Bago
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Ana Butkovic
- Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Irena Preloznik Zupan
- University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Barbara Faganel Kotnik
- University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ivana Prga
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Vesna Bacic Vrca
- Clinical Hospital Dubrava, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Silva Zupancic Salek
- University Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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15
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Al-Huniti A, Hernandez MR, Eyck PT, Staber JM. Mental health disorders in haemophilia: Systematic literature review and meta-analysis. Haemophilia 2020; 26:431-442. [PMID: 32307801 PMCID: PMC8475067 DOI: 10.1111/hae.13960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/26/2019] [Revised: 02/11/2020] [Accepted: 02/24/2020] [Indexed: 12/28/2022]
Abstract
AIM Despite significant advances in morbidity and mortality outcomes, quality of life for people with haemophilia (PWH) remains compromised. Underrecognized and undertreated mental health disorders decrease quality of life; however, reports are inconsistent regarding the true prevalence of mental health disorders in PWH. METHODS We conducted a systematic literature search of Ovid MEDLINE, EMBASE, Psychinfo and the Cochrane Library, and hand searched the journal Haemophilia to identify records and subsequently conducted a meta-analysis to determine the prevalence of depression, anxiety and attention deficit hyperactivity disorder (ADHD) in patients with congenital haemophilia. RESULTS Our search strategy identified 2315 records, and 28 studies met eligibility criteria. Meta-analysis demonstrated that PWH are at increased risk of depression (odds ratio (OR) 2.45; 95% confidence interval (CI) 1.64-3.68), anxiety (OR 1.74, 95% CI 1.01-3.00), anxiety/depression (OR 2.60, 95% CI 2.35-2.87) and ADHD (OR 3.48, 95% CI 1.74-6.96). We found considerable heterogeneity among the studies likely due to differences in assessment tools, populations studied and year of publication. This suggests that standardized tools to diagnose mental health disorders in PWH are needed. Additionally, high-quality studies investigating mental health disorders in PWH are necessary to adequately document the prevalence of these disorders. CONCLUSION Overall, our meta-analysis suggests that the prevalence of depression, anxiety and ADHD across decades is significantly increased in PWH compared to the general population.
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Affiliation(s)
- Ahmad Al-Huniti
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Melanie Reyes Hernandez
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Patrick Ten Eyck
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA
| | - Janice M. Staber
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA
- Pappajohn Biomedical Institute, University of Iowa, Iowa City, IA
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16
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Sekhar M, Jadhav S. Why stay? Resilience in haemophilia physicians in the 1980s. Haemophilia 2020; 26:401-408. [PMID: 32243025 DOI: 10.1111/hae.13967] [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] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/13/2020] [Accepted: 03/02/2020] [Indexed: 06/11/2023]
Abstract
AIMS The occurrence of AIDS in 1980s posed difficult problems for haemophilia clinicians worldwide. The impact of these events is substantial, and the events continue to be subject to judicial proceedings and publications. The stance of haemophilia physicians, particularly their professional resilience, is of importance and remains unexamined. METHODS Deploying oral histories informed by literature review of scientific publications and past inquiry reports, this qualitative study addresses how physicians continued to work in haemophilia during those years and attributes that contributed to their resilience. RESULTS AND CONCLUSIONS Experience and role in laboratory aspects were of value in handling and communicating uncertainty. Collegiality, peer support and scholarship were important in sustaining their roles, in clinical decision-making and re-instating confidence in the therapeutic relationship during the toughest years of their practice.
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Affiliation(s)
- Mallika Sekhar
- Royal Free London NHS Trust, London, UK
- Department of Haematology, University College London, London, UK
| | - Sushrut Jadhav
- Division of Psychiatry, University College London, London, UK
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17
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Abstract
BACKGROUND Managing hemophilia is challenging both in terms of medical treatment and its broad impact on many aspects of the individual's life, including self-perception. Several psychosocial issues are potentially relevant in the clinical management of hemophilia, including it being a chronic and incurable condition; e.g. people with hemophilia must adapt to optimally interact with peers and to practice sports - even choosing a sport represents an issue for perceived limitations, expectations and cultural influences on the individual and their family. People with hemophilia can react by denying their condition and its manifestations and not adhering to treatment. Due to the complexity of relationships surrounding genetic diseases, parents and relatives may have their own issues that contribute to making life easier or more difficult for the person with hemophilia. Anxiety, sadness and depression resulting in mental health disorders are reported in this population and may influence quality of life (QoL) depending on cultural background, religious beliefs, family support and other variables. OBJECTIVES Primarily to assess the effectiveness of psychological therapies for improving the ability of people with hemophilia to cope with their chronic condition. SEARCH METHODS We aimed to identify trials from the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, Embase and PsycINFO, CINAHL, MEDLINE and trial registries. We searched reference lists of included publications. Most recent search of the Group's register: 13 June 2019. SELECTION CRITERIA Randomized controlled trials (RCTs) and quasi-RCTs in people with hemophilia of any age or gender, type A or B, any severity, with or without inhibitors, with or without HIV or hepatitis C virus. All psychological interventions for promoting emotional, intellectual and spiritual wellness. Individual, group or family group therapy interventions were eligible. DATA COLLECTION AND ANALYSIS We independently assessed trials, extracted data and assessed the risk of bias and assessed the quality of the evidence using GRADE. MAIN RESULTS Seven trials were included (362 participants randomized, data from 264 participants available for analysis); six of parallel design and one a partial cross-over design. One multicenter trial was conducted in Canada; the remaining six were single centre undertaken in the UK, USA, Iran and in the Netherlands. All trials had a high risk of bias for participant blinding and use of patient-reported outcomes. Evidence was retrieved on four interventions: psycho-education (DVD plus information booklet versus information booklet alone; computerised learning versus no intervention); cognitive therapy (auto-hypnosis (self-hypnosis) versus control); and behavioural therapy (relaxation (progressive or self control) versus no treatment). We also aimed to assess psychodynamic therapy and systemic therapy, but no trials were identified. Heterogeneity of the outcome measures and measurements precluded meta-analyses. No trial reported the cost of the psychological intervention and family adjustment. DVD plus information booklet compared to information booklet alone One trial (108 participants) showed coping strategies may lower pre-contemplation scores and negative thoughts, mean difference (MD) -0.24 (95%CI -0.48 - 0.00, low-certainty evidence), however, other measures of coping strategies in the same trial suggest little or no difference between groups, e.g. contemplation, MD (-0.09, 95%CI -0.32 - 0.14, low-certainty evidence). The same trial measured QoL and showed little or no difference between treatment groups for the physical domain, MD 0.59 (95% CI -3.66 to 4.84, low-certainty evidence), but may improve scores in the mental health domain for those receiving the booklet plus DVD compared to booklet alone, MD (4.70, 95% CI 0.33 to 9.07, low-certainty evidence). Mood or personal well-being were not reported. Computerised learning compared to no intervention Two trials (57 participants) reported on interventions aimed at children and adolescents and their impact on promoting a sense of self-efficacy (primary outcome 'Mood and personal well-being'), but only one showed an increase, MD 7.46 (95%CI 3.21 to 11.71, 17 participants, very low-certainty evidence); the second did not report control group data. One trial (30 participants) showed the intervention did not improve self-efficacy in adults, but appropriate data could not be extracted. Two trials (47 participants) reported coping strategies; one only reported within-group differences from baseline, the second showed an increase from baseline in coping strategies in the Internet program group compared to the no intervention group (disease-specific knowledge, MD 2.45 (95% CI 0.89 to 4.01); self-management ability and transition readiness, MD 19.90 (95% CI 3.61 to 36.19; low-certainty evidence). One trial reported QoL but with insufficient information to calculate changes from baseline; no difference in post-treatment scores was seen between groups, MD -8.65, 95% CI -18.30 to 1.00, very low-certainty evidence). Auto-hypnosis (self-hypnosis) compared to control There were two older trials that reported on this intervention (50 participants) focusing mainly on the secondary outcome 'physical health'; only one trial reported the primary outcome 'mood and personal well-being' (only within-group differences in the treatment group). Coping strategies and QoL were not assessed in the trials. Relaxation (progressive or self control) compared to no treatment Only one trial (seven participants) from 1985, was included which focused on 'physical health' and did not report on any of our primary outcomes. AUTHORS' CONCLUSIONS Not all of the seven included trials analysed the effects of the interventions on our primary outcomes (mood and personal well-being, coping strategies and QoL). Three trials were conducted in the 1970s and 1980s using techniques of auto-hypnosis or relaxation and, in accordance with the needs and therapeutic possibilities of the time, they focused on secondary outcomes, e.g. frequency of bleeding (physical health) and adherence to the intervention. The four newer trials assessed psycho-educational interventions all mediated by the use of technologies (DVD or computer) and often created according to age needs of the target group. In these cases, attention was shifted to our pre-defined primary outcomes. This review has identified low- and very low-certainty evidence, prompting caution in its interpretation. The major problem we encountered was the heterogeneity of trial designs, of interventions and of outcome measures used across the trials. We strongly suggest that researchers consider developing a core outcome set to streamline future research; randomization was proven to be safe and acceptable, and blinding should be considered for those assessing patient-reported outcomes.
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Affiliation(s)
- Laura Palareti
- University of BolognaDepartment of Education Studies “G.M. Bertin”Via Filippo Re, 6BolognaItaly40126
| | - Giannino Melotti
- University of BolognaDepartment of Education Studies “G.M. Bertin”Via Filippo Re, 6BolognaItaly40126
| | - Frederica Cassis
- FMUSPHemophilia Centre of Hospital Das ClinicasUmburanas street 307San PabloSao PauloBrazil05464000
| | - Sarah J Nevitt
- University of LiverpoolDepartment of BiostatisticsBlock F, Waterhouse Building1‐5 Brownlow HillLiverpoolUKL69 3GL
| | - Alfonso Iorio
- McMaster UniversityDepartment of Health Research Methods, Evidence and Impact (HEI)1280 Main Street WestCRL ‐ 140HamiltonONCanadaL8S 4K1
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18
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Abstract
Highlighting the importance and quality of the support provided by the nursing team to her young son with moderate haemophilia, a mother expresses how this care is essential in terms of the family's quality of life, her son's happiness and in ensuring his autonomy as an adult.
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Affiliation(s)
- Mélanie Poupard
- c/o La revue de l'infirmière, 65, rue Camille-Desmoulins, 92130 Issy-les-Moulineaux cedex, France.
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19
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Mousavi SH, Dayer MS, Pourhaji F, Delshad MH, Mesbah-Namin SA. Determinants of Quality of Life in Children and Adolescents With Hemophilia in Kabul, Afghanistan: First Report. Arch Iran Med 2019; 22:384-389. [PMID: 31679381] [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] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 05/18/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Hemophilia is a rare inherited disorder associated with abnormal repeated bleeding and debilitating joint pain due to deficiency in coagulating factors VIII and IX. This study aimed to provide an updated account on the health-related quality of life (HRQoL) in children with hemophilia in Afghanistan. METHODS This cross-sectional study included 65 randomly selected hemophiliacs out of 350 children registered with the Afghanistan Hemophilia Patient Association (AHPA). The patients were 8-16 years old and voluntarily entered the study. Data were collected through a demographic questionnaire and a Persian version of Haemo-QoL Questionnaire (short version) for children aged 8-16 years. RESULTS The patients' age averaged 12.9 ± 3.9 years with a mean QoL score of 75.9 ± 17.4. The patients were suffering from hemophilia A, mostly the severe type (80%). They were born to low income families (95 %) with high illiteracy rates (>50%) and hemophilia family history (90%). Spearman test showed a significant correlation between age and QoL scores (r = 0.8, P = 0.02). One-way ANOVA indicated no significant difference between QoL scores of patients categorized based on hemophilia severity (P = 0.2, F = 1.3), family incomes (P = 0.9, F = 0.01) and parents' levels of education (P = 0.2-0.4, F = 0.82-1.3). The Cronbach alpha for the instrument was 0.82. CONCLUSION Regardless of hemophilia severity, Family and Sports were the most impaired domains of QoL. Herein, we have presented the first reliable and updated data on hemophiliacs' demographic characteristics and their quality of life in Kabul.
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Affiliation(s)
- Sayed Hamid Mousavi
- Medical Research Center, Kateb University, Kabul, Afghanistan
- Afghanistan National Charity Organization for Special Diseases (ANCOSD), Kabul, Afghanistan
| | - Mohammad Saaid Dayer
- Department of Parasitology and Medical Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Pourhaji
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad-Hossein Delshad
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyed Alireza Mesbah-Namin
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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20
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Abstract
Spirituality plays an important role in coping with chronic diseases. However, the meaning of spirituality is not known in hemophilia, as a chronic disease. This study aimed to explore the essence of spirituality in hemophilia patients. This qualitative study with a hermeneutic phenomenological approach was conducted on twelve Muslim adult hemophilia patients. The participants were selected using purposeful sampling. The data were gathered through interview. Then, the data were analyzed using thematic analysis and van Manen's methodological framework. MAX.QDA qualitative software package 2010 was used to import the transcripts and analyze the data. Four themes were identified: "relationship with God," "God as the fulcrum," "strong religious beliefs," and "spiritual satisfaction." "Relationship with God" meant "to ask God for help" and "praying for oneself and others." "God as the fulcrum" consisted of two subthemes, i.e., "hope in God" and "Trust in God." "Strong religious beliefs" also included "belief in openness of God's mercy," "belief in God and the omnipotence of God," and "belief in creation by God." Finally, "spiritual satisfaction" consisted of two subthemes, namely "accepting the providence" and "thanking the divine blessings." Spirituality in hemophilia patients meant having relationship with God who was considered as the fulcrum, strong religious beliefs, and spiritual satisfaction. By understanding the hemophilia patients' spirituality experiences, the nurses and healthcare workers could provide holistic care focused on spirituality. Yet, more studies are recommended to be conducted on hemophilia patients to explore spirituality in other religions.
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Affiliation(s)
- Masoume Rambod
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farkhondeh Sharif
- Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Nemazee Sq., Shiraz, 7193613119, Iran.
| | - Zahra Molazem
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kate Khair
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
- London South Bank University, London, UK
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21
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Chai-Adisaksopha C, Skinner MW, Curtis R, Frick N, Nichol MB, Noone D, O'Mahony B, Page D, Stonebraker J, Thabane L, Crowther M, Iorio A. Psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire. BMJ Open 2018; 8:e021900. [PMID: 30093520 PMCID: PMC6089314 DOI: 10.1136/bmjopen-2018-021900] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To assess the psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire. METHODS This study was a cross-sectional, multinational study. Participants were enrolled if they were more than 10 years old and people with haemophilia A or B or people without a bleeding disorder. Participants were invited through non-governmental patient organisations in 21 countries between 01/27/2016 and 02/23/2017. The following psychometric properties: missing data, floor and ceiling effects, exploratory factor analysis and internal consistency reliability were examined. A PROBE Score was derived and assessed for its convergent and known groups validity. RESULTS The study analysed the data on 916 participants with median age of 37.0 (IQR 27.0 to 48.0) years, 74.8% male. In the domain assessing patient-reported outcomes (PROs), more than 15% of participants presented a ceiling effect for all items but two, and a floor effect for one item. Factor analysis identified three factors explaining the majority of the variance. Cronbach's alpha coefficient indicated good internal consistency reliability (0.84). PROBE items showed moderate to strong correlations with corresponding EuroQol five dimension 5-level instrument (EQ-5D-5L) domains. The PROBE Score has a strong correlation (r=0.67) with EQ-5D-5L utility index score. The PROBE Score has a known groups validity among various groups. CONCLUSIONS The results of this study suggest that PROBE is a valid questionnaire for evaluating PROs in people with haemophilia as well as control population. The known-group property of PROBE will allow its use in future clinical trials, longitudinal studies, health technology assessment studies, routine clinical care or registries. Additional studies are needed to test responsiveness and sensitivity to change. TRIAL REGISTRATION NUMBER NCT02439710; Results.
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Affiliation(s)
- Chatree Chai-Adisaksopha
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mark W Skinner
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Institute for Policy Advancement Ltd, Washington, District of Columbia, USA
| | | | - Neil Frick
- Research and Medical Information, National Hemophilia Foundation, New York City, New York, USA
| | - Michael B Nichol
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA
| | | | - Brian O'Mahony
- Irish Haemophilia Society, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
| | - David Page
- Canadian Hemophilia Society, Montreal, Quebec, Canada
| | - Jeffrey Stonebraker
- Poole College of Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Mark Crowther
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alfonso Iorio
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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22
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Resseguier N, Rosso-Delsemme N, Beltran Anzola A, Baumstarck K, Milien V, Ardillon L, Bayart S, Berger C, Bertrand MA, Biron-Andreani C, Borel-Derlon A, Castet S, Chamouni P, Claeyssens Donadel S, De Raucourt E, Desprez D, Falaise C, Frotscher B, Gay V, Goudemand J, Gruel Y, Guillet B, Harroche A, Hassoun A, Huguenin Y, Lambert T, Lebreton A, Lienhart A, Martin M, Meunier S, Monpoux F, Mourey G, Negrier C, Nguyen P, Nyombe P, Oudot C, Pan-Petesch B, Polack B, Rafowicz A, Rauch A, Rivaud D, Schneider P, Spiegel A, Stoven C, Tardy B, Trossaërt M, Valentin JB, Vanderbecken S, Volot F, Voyer-Ebrard A, Wibaut B, Leroy T, Sannie T, Chambost H, Auquier P. Determinants of adherence and consequences of the transition from adolescence to adulthood among young people with severe haemophilia (TRANSHEMO): study protocol for a multicentric French national observational cross-sectional study. BMJ Open 2018; 8:e022409. [PMID: 30049701 PMCID: PMC6067371 DOI: 10.1136/bmjopen-2018-022409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/08/2018] [Accepted: 06/14/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Severe haemophilia is a rare disease characterised by spontaneous bleeding from early childhood, which may lead to various complications, especially in joints. It is nowadays possible to avoid these complications thanks to substitutive therapies for which the issue of adherence is major. The transition from adolescence to adulthood in young people with severe haemophilia is a critical period as it is associated with a high risk of lack of adherence to healthcare, which might have serious consequences on daily activities and on quality of life. METHODS AND ANALYSIS We present the protocol for a cross-sectional, observational, multicentric study to assess the differences between adolescents and young adults with severe haemophilia in France through the transition process, especially on adherence to healthcare. This study is based on a mixed methods design, with two complementary and consecutive phases, comparing data from a group of adolescents (aged 14-17 years) with those from a group of young adults (aged 20-29 years). The quantitative phase focuses on the determinants (medical, organisational, sociodemographic and social and psychosocial and behavioural factors) of adherence to healthcare (considered as a marker of the success of transition). The qualitative phase explores participants' views in more depth to explain and refine the results from the quantitative phase. Eligible patients are contacted by the various Haemophilia Treatment Centres participating in the French national registry FranceCoag. ETHICS AND DISSEMINATION The study was approved by the French Ethics Committee and by the French National Agency for Medicines and Health Products Safety (number: 2016-A01034-47). Study findings will be disseminated to the scientific and medical community in peer-reviewed journals and presented at scientific meetings. Results will be popularised to be communicated via the French association for people with haemophilia to participants and to the general public. TRIAL REGISTRATION NUMBER NCT02866526; Pre-results.
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Affiliation(s)
| | - Natacha Rosso-Delsemme
- LPCPP, Aix Marseille Unviersity, Aix-en-Provence, France
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
| | | | - Karine Baumstarck
- CERESS, Aix Marseille University, Marseille, France
- FranceCoag Network, Marseille, France
| | - Vanessa Milien
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
- FranceCoag Network, Marseille, France
| | - Laurent Ardillon
- Haemophilia Treatment Centre, University Hospital of Tours, Tours, France
| | - Sophie Bayart
- Haemophilia Treatment Centre, University Hospital of Rennes, Rennes, France
| | - Claire Berger
- Haemophilia Treatment Centre, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Marie-Anne Bertrand
- Haemophilia Treatment Centre, University Hospital of Besançon, Besançon, France
| | | | | | - Sabine Castet
- Haemophilia Treatment Centre, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre Chamouni
- Haemophilia Treatment Centre, University Hospital of Rouen, Rouen, France
| | | | | | - Dominique Desprez
- Haemophilia Treatment Centre, University Regional Hospital of Strasbourg, Strasbourg, France
| | - Céline Falaise
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
| | - Birgit Frotscher
- Haemophilia Treatment Centre, University Hospital of Nancy, Nancy, France
| | - Valérie Gay
- Haemophilia Treatment Centre, Hospital of Chambery, Chambery, France
| | - Jenny Goudemand
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Yves Gruel
- Haemophilia Treatment Centre, University Hospital of Tours, Tours, France
| | - Benoît Guillet
- Haemophilia Treatment Centre, University Hospital of Rennes, Rennes, France
| | - Annie Harroche
- Haemophilia Treatment Centre, Hospital Necker, Assistance Publique—Hopitaux de Paris, Paris, France
| | - Abel Hassoun
- Haemophilia Treatment Centre, Hospital of Simone Veil d’Eaubonne, Montmorency, France
| | - Yoann Huguenin
- Haemophilia Treatment Centre, University Hospital of Bordeaux, Bordeaux, France
| | - Thierry Lambert
- Haemophilia Treatment Centre, Hospital Bicêtre, Assistance Publique—Hopitaux de Paris, Paris, France
| | - Aurélien Lebreton
- Haemophilia Treatment Centre, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Anne Lienhart
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Lyon, France
| | - Michèle Martin
- Haemophilia Treatment Centre, University Hospital of Nancy, Nancy, France
| | - Sandrine Meunier
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Lyon, France
| | - Fabrice Monpoux
- Haemophilia Treatment Centre, University Hospital of Nice, Nice, France
| | - Guillaume Mourey
- Haemophilia Treatment Centre, University Hospital of Besançon, Besançon, France
| | - Claude Negrier
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Lyon, France
| | - Philippe Nguyen
- Haemophilia Treatment Centre, University Hospital of Reims, Reims, France
| | - Placide Nyombe
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Caroline Oudot
- Haemophilia Treatment Centre, University Hospital of Limoges, Limoges, France
| | | | - Benoît Polack
- Haemophilia Treatment Centre, University Hospital of Grenoble, Grenoble, France
| | - Anne Rafowicz
- Haemophilia Treatment Centre, Hospital of Versailles, Versailles, France
- Haemophilia Treatment Centre, Hospital Bicêtre, Assistance Publique—Hopitaux de Paris, Paris, France
| | - Antoine Rauch
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Delphine Rivaud
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Pascale Schneider
- Haemophilia Treatment Centre, University Hospital of Rouen, Rouen, France
| | - Alexandra Spiegel
- Haemophilia Treatment Centre, University Regional Hospital of Strasbourg, Strasbourg, France
| | - Cecile Stoven
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Brigitte Tardy
- Haemophilia Treatment Centre, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Marc Trossaërt
- Haemophilia Treatment Centre, University Hospital of Nantes, Nantes, France
| | | | - Stéphane Vanderbecken
- Haemophilia Treatment Centre, University Hospital of Reunion, Reunion Island, France
| | - Fabienne Volot
- Haemophilia Treatment Centre, University Hospital of Dijon, Dijon, France
| | | | - Bénédicte Wibaut
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Tanguy Leroy
- CERESS, Aix Marseille University, Marseille, France
- Social Psychology Research Group (GRePS EA 4163), Lumière Lyon 2 University, Lyon, France
| | - Thomas Sannie
- French Patients' Association for People with Haemophilia (AFH), Paris, France
| | - Hervé Chambost
- Department of Paediatric Haematology, Children Hospital La Timone, APHM, Marseille, France
- FranceCoag Network, Marseille, France
| | - Pascal Auquier
- CERESS, Aix Marseille University, Marseille, France
- FranceCoag Network, Marseille, France
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Pinto PR, Paredes AC, Costa P, Carvalho M, Lopes M, Fernandes S, Pedras S, Almeida A. Effectiveness of two psychological interventions for pain management, emotional regulation and promotion of quality of life among adult Portuguese men with haemophilia (PSY-HaEMOPEQ): study protocol for a single-centre prospective randomised controlled trial. BMJ Open 2017; 7:e016973. [PMID: 28871021 PMCID: PMC5588949 DOI: 10.1136/bmjopen-2017-016973] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/24/2017] [Accepted: 06/12/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Haemophilia is a bleeding disorder associated with significant pain, emotional distress, quality of life (QoL) impairment and considerable healthcare costs. Psychosocial health and effective pain management are considered essential end points for optimal haemophilia care, but there is a significant gap in evidence-based treatments targeting these outcomes in people with haemophilia (PWH). Psychological interventions are cost-effective in promoting emotional well-being, QoL and pain control, although these have been scarcely used in haemophilia field. This investigation aims to evaluate the effectiveness of two psychological interventions for pain management, emotional regulation and promotion of QoL in PWH. METHODS AND ANALYSIS This is a single-centre parallel randomised controlled trial conducted at a European Haemophilia Comprehensive Care Centre in Portugal, with five assessment points: baseline (T0), postintervention (T1), 3 (T2), 6 (T3) and 12 (T4) months follow-up. Eligible adult males, with moderate or severe haemophilia A or B will be randomised to experimental (EG) or control (CG) group. Intervention is either cognitive-behavioural therapy (EG1) or hypnosis (EG2), both consisting of four weekly sessions following standardised scripts delivered by trained psychologists. Randomisation will be computer generated, allocation concealment will be guaranteed and outcome assessors will be blind to EG/CG allocation. Main outcomes are pain and haemophilia-related QoL and secondary outcomes include clinical (clotting factor replacement consumption, joint bleeding episodes, analgesic intake) and psychological (pain coping strategies, anxiety, depression, illness perceptions) variables, functional assessment of the joints, inflammatory biomarkers (cytokines, high-sensitivity C reactive protein) and white blood cell count. ETHICS AND DISSEMINATION This study was approved by the competent authorities and all procedures will comply with international ethical guidelines for clinical studies involving humans. Written informed consent will be obtained from all participants. The dissemination plan includes peer-reviewed scientific publications, conference participation and web and media coverage. TRIAL REGISTRATION NUMBER NCT02870452.
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Affiliation(s)
- Patrícia Ribeiro Pinto
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
| | - Ana Cristina Paredes
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Manuela Carvalho
- Centre of Hemophilia, Department of Transfusion Medicine and Blood Bank, Centro Hospitalar São João, Porto, Portugal
| | - Manuela Lopes
- Centre of Hemophilia, Department of Transfusion Medicine and Blood Bank, Centro Hospitalar São João, Porto, Portugal
| | - Susana Fernandes
- Centre of Hemophilia, Department of Transfusion Medicine and Blood Bank, Centro Hospitalar São João, Porto, Portugal
| | - Susana Pedras
- School of Psychology, University of Minho, Braga, Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
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Suárez Vázquez A, Del Río Lanza AB, Suárez Álvarez L, Vázquez Casielles R. Empower Me? Yes, Please, But in My Way: Different Patterns of Experiencing Empowerment in Patients with Chronic Conditions. Health Commun 2017; 32:910-915. [PMID: 27435319 DOI: 10.1080/10410236.2016.1196409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Empowerment is a widely used word within the realm of health care. This is especially true in the case of patients living with a chronic illness, who may be active participants and learn to manage their disease, irrespective of their desires or preferences. This article focuses on the empowering experience of patients with chronic conditions. We have built on earlier research that explains the factors that mediate communication between health care professionals and patients: patient participation, patient impact, meaning, health care professionals' information provision, health care professionals' emotional support, health care professionals' attentive listening, health care professionals' trust, and patient collaboration. We propose a new model for detecting types of patients who differ in the way they live their empowering experience. Using survey data from a sample of 181 patients of hemophilia, we found two types of patients: patients with an inner locus of empowerment and patients with an outer locus of empowerment. We conclude by discussing different strategies for fostering the sense of power in each of these types of patients.
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Affiliation(s)
- Ana Suárez Vázquez
- a Biomedicine and Health Cluster , Business Administration Department, University of Oviedo
| | | | - Leticia Suárez Álvarez
- a Biomedicine and Health Cluster , Business Administration Department, University of Oviedo
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25
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Osorio-Guzmán M, Gutiérrez-González G, Bazán-Riverón GE, Núñez-Villegas NN, Fernández-Castillo GJ. [Perception of quality of life related with health and depression in patients with hemophilia]. Rev Med Inst Mex Seguro Soc 2017; 55:416-422. [PMID: 28591493] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Hemophilia is a hemorrhagic disease characterized by the deficiency of either coagulation factor VIII or IX. It impacts negatively in people's quality of life and it causes side effects, such as depression. The objective was to describe and analyze the health-related quality of life (HRQoL) and depression levels in a group of 50 pediatric patients with hemophilia (PPwH) and their parents. The specific objectives were: to analyze the correlation between HRQoL levels reported by patients and their parents, and to analyze the correlation between HRQoL levels and depression in PPwH. METHODS Descriptive, cross-sectional and correlational study with a group of 50 PPwH and their parents. The Pediatric Life Quality Questionnaire [PedsQLTM 4.0] was completed by PPwH and their parents and the Children's Depression Inventory (CDI) was answered only by PPwH. RESULTS The average age of PPwH was 10.66 years (SD = 2.61) and that of parents was 36.28 years (SD = 6.4). 82% suffered from hemophilia A and 70% suffered from severe hemophilia. 78% of participants felt at risk or at high risk with regards to their quality of life, and, concerning their depression levels, we found moderate symptoms in 54% and severe symptoms in 10%. CONCLUSIONS The HRQoL and depression levels we found are alarming. They show the importance of evaluating objective and subjective indicators; in addition, we emphasize the need of assisting the severe cases detected and suggest the activities to face these health issues.
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Affiliation(s)
- Maricela Osorio-Guzmán
- Licenciatura en Psicología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México.
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26
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van Os SB, Troop NA, Sullivan KR, Hart DP. Adherence to Prophylaxis in Adolescents and Young Adults with Severe Haemophilia: A Quantitative Study with Patients. PLoS One 2017; 12:e0169880. [PMID: 28103266 PMCID: PMC5245860 DOI: 10.1371/journal.pone.0169880] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 12/23/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION haemophilia is an inherited bleeding disorder caused by a deficiency in one of the blood coagulation factors. For people affected by severe haemophilia, the deficiency can cause spontaneous internal bleeding. Most young people with severe haemophilia in the UK follow a preventative treatment regimen (prophylaxis) consisting of several intravenous injections of factor concentrate each week. There is good evidence that prophylaxis reduces bleeds whilst also improving quality of life. However, levels of adherence among young people with haemophilia reported in the existing literature vary widely and are predominately based on estimations made by healthcare professionals and parents. Additionally, drivers of (non)adherence among young people specifically have not been evidenced. AIM to assess self-reported adherence among young people with haemophilia, provide evidence of psychosocial predictors of adherence, and to establish the associations between non-adherence and number of bleeds and hospital visits. METHODS 91 participants were recruited during outpatient appointments in 13 haemophilia centres across England and Wales, and invited to complete a questionnaire assessing self-reported adherence (VERITAS-Pro), Haemophilia-related pain and impact of pain, Illness Perceptions, Beliefs about Medications, Self-efficacy, Outcome expectations, Positive and Negative Affect, and Social support. Number of hospital visits and bleeds during the previous six months were collected from medical files. RESULTS Of 78 participants with complete data, just 18% had scores indicating non-adherence. Psychosocial predictors differed between intentional (skipping) and un-intentional (forgetting) non-adherence. Overall, however, better adherence was reported where participants perceived the need for prophylaxis was greater than their concern over taking it as well as having a positive expectancy of its effectiveness, good social support and a stronger emotional reaction to having haemophilia. CONCLUSION The findings indicate that adherence is generally good, and that assessing illness and treatment beliefs, social support and outcome expectations may play a valuable role in identifying which individuals are at risk of non-adherence. Interventions aimed at improving adherence should particularly consider improving social support, reducing patients' concerns about prophylaxis, increasing their belief in the necessity of prophylaxis, and increasing positive outcome expectations.
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Affiliation(s)
- Sandra B. van Os
- Psychology and Sport Sciences Department, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- * E-mail:
| | - Nick A. Troop
- Psychology and Sport Sciences Department, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Keith R. Sullivan
- Psychology and Sport Sciences Department, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Daniel P. Hart
- The Royal London Hospital Haemophilia Centre, Barts Health NHS Trust, London, United Kingdom
- Barts and The London School of Medicine and Dentistry, QMUL, London, United Kingdom
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Schrijvers L, Beijlevelt-Van der Zande M, Peters M, Lock J, Cnossen M, Schuurmans M, Fischer K. Achieving self-management of prophylactic treatment in adolescents: The case of haemophilia. Patient Educ Couns 2016; 99:1179-1183. [PMID: 26851159 DOI: 10.1016/j.pec.2016.01.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/29/2015] [Accepted: 01/23/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Adolescents with a chronic disorder, such as haemophilia, need to attain responsibility for their disease. The aim was to gain insight into how adolescents achieve self-management of prophylactic treatment. METHODS In three Dutch Haemophilia Treatment Centres, adolescents (10-25 years) received structured questions on treatment responsibility and self-management (pre-specified definitions) during routine nursing consultation. RESULTS In total, 155 interviews were performed in 100 patients (median age 14.4 years). Self-infusion was initiated at a median age of 12.3 years (IQR 11.5-13.0) and self-management was achieved 9.6 years later, at a median age of 22.6 years. This process included three phases coinciding with known stages of adolescence. In early adolescence, patients acquired the technique of self-infusion (12.3 years) leading to independent self-infusion in middle adolescence (17.2 years). In late adolescence, patients demonstrated an increase in more complex skills, such as bleeding management and communication with the haemophilia physician (19.9-22.6 years). CONCLUSION Although, the first steps in self-management with regard to self-infusion are taken in early adolescence, complete self-management was achieved in late adolescence after almost 10 years. PRACTICE IMPLICATIONS Insight in this transitional process helps to provide individualized support and emphasizes the need for continued education with regard to self-management skills.
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Affiliation(s)
- Liesbeth Schrijvers
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | | - Marjolein Peters
- Haemophilia Treatment Centre, Emma Children's Hospital-Academical Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Janske Lock
- Department of Paediatric Haematology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marjon Cnossen
- Department of Paediatric Haematology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marieke Schuurmans
- Nursing Science, Faculty of Health Care, University of Applied Science, Utrecht, The Netherlands; Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht, The Netherlands
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Cavazza M, Kodra Y, Armeni P, De Santis M, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Taruscio D, Schieppati A, Iskrov G, Gulácsi L, von der Schulenburg JMG, Kanavos P, Chevreul K, Persson U, Fattore G. Social/economic costs and quality of life in patients with haemophilia in Europe. Eur J Health Econ 2016; 17 Suppl 1:53-65. [PMID: 27048374 DOI: 10.1007/s10198-016-0785-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with haemophilia in Europe. METHODS We conducted a cross-sectional study of patients with haemophilia from Bulgaria, France, Germany, Hungary, Italy, Spain Sweden and the UK. Data on demographic characteristics, health resource utilisation, informal care, loss of labour productivity and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire. The costs have been estimated from a societal perspective adopting a bottom-up approach. RESULTS A total of 401 questionnaires were included in the study, of which 339 were collected from patients with haemophilia and 62 from caregivers. The lowest average annual cost per person was reported in Bulgaria (€6,660) and the highest in Germany (€194,490). Our results demonstrate both a large difference from country to country in the average annual cost per patient in 2012 and the driving role of drugs in costs. Drugs represent nearly 90 % of direct healthcare costs in a majority of the countries analysed (Hungary, Italy, Spain and Germany). In Bulgaria, France and Sweden, however, healthcare services (visits, tests and hospitalisations) prevail. Costs are also shown to differ between children and adults. The mean EQ-5D index score for adult patients was 0.69 and mean EQ-5D VAS was 66.6. The mean EQ-5D index score for carers was 0.87 and mean EQ-5D VAS was 75.5. In the disability score, 60 % showed no disability and measuring caregiver burden with the Zarit Index produced an overall mean score of 25.3. CONCLUSION We have shown that haemophilia is associated with a substantial economic burden and impaired HRQOL. Studies on cost of illness and HRQOL are important for haemophilia as the future of this disease is likely to change with the development of new innovative treatments. The introduction of these treatments will most likely impact future costs related to haemophilia.
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Affiliation(s)
- Marianna Cavazza
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy.
| | - Yllka Kodra
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Patrizio Armeni
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy
| | - Marta De Santis
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Julio López-Bastida
- University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Renata Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - Juan Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- University of Castilla-La Mancha, Toledo, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | | | - Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Arrigo Schieppati
- "Aldo and Cele Daccò" Clinical Research Center for Rare Diseases, Mario Negri Institute for Pharmacological Research, Ranica (Bergamo), Italy
| | - Georgi Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | | | - Panos Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, UK
| | - Karine Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - Ulf Persson
- The Swedish Institute for Health Economics, Lund, Sweden
| | - Giovanni Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy
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Palareti L, Potì S, Cassis F, Emiliani F, Matino D, Iorio A. Shared topics on the experience of people with haemophilia living in the UK and the USA and the influence of individual and contextual variables: Results from the HERO qualitative study. Int J Qual Stud Health Well-being 2015; 10:28915. [PMID: 26578360 PMCID: PMC4649019 DOI: 10.3402/qhw.v10.28915] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 11/30/2022] Open
Abstract
The study illuminates the subjective experience of haemophilia in people who took part in the Haemophilia Experience, Results and Opportunities (HERO) initiative, a quali-quantitative research program aimed at exploring psychosocial issues concerning this illness around the world. Applying a bottom-up analytic process with the help of software for textual data, we investigated 19 interviews in order to describe the core themes and the latent factors of speech, to explore the role of different variables in shaping the participants' illness experiences. The five themes detected are feeling different from others, body pain, acquisition of knowledge and resources, family history, and integration of care practices in everyday life. We illustrate how nationality, age, family situation, the use of prophylaxis or on-demand treatment, and the presence of human immunodeficiency virus or hepatitis C virus affect the experience of our participants in different ways. Findings are used to bring insights on research, clinical practice, and psychosocial support.
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Affiliation(s)
- Laura Palareti
- Department of Education Studies, University of Bologna, Bologna, Italy;
| | - Silvia Potì
- Department of Education Studies, University of Bologna, Bologna, Italy
| | - Frederica Cassis
- Hemophilia Center, University of São Paulo Faculty of Medicine Clinics Hospital, São Paulo, Brazil
| | | | - Davide Matino
- Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Alfonso Iorio
- Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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30
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Rolstad EB. Social Worker Perceptions and Observations Regarding Men's Management of Hemophilia and Use of Community-Based Support. Health Soc Work 2015; 40:239-244. [PMID: 26285364 DOI: 10.1093/hsw/hlv047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The study reported in this article was conducted in response to Utah service provider concerns that men with hemophilia may be disengaged from their local community-based support network. This study explored the challenges, adaptations, and needs of men with hemophilia from the perspective of Hemophilia Treatment Center (HTC) social workers. Utah's two active HTC social workers participated in face-to-face interviews. Fourteen HTC social workers from surrounding regions completed written interviews. The researcher used a qualitative, grounded theory approach to analyze the data. Resilience theory provided a lens for interpreting the results. Findings from these professionals indicate that men with hemophilia appear to be ambivalent toward services that are available to them for reasons that include work and insurance status, prior personal history with the bleeding disorders community, strength of relationship with local service providers, degree of customization of HTC services, and the desire to maintain personal independence. Understanding this dynamic may be helpful in developing services that are more specifically tailored to the needs of men with hemophilia, in addition to potentially providing stronger community-based support to men with other genetic disorders.
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31
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Osorio-Guzmán M, Olvera-González S, Bazán-Riverón GE, Gaitán-Fitch RC. [Not Available]. Salud Publica Mex 2015; 57:112-114. [PMID: 26235768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- Maricela Osorio-Guzmán
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México,
| | - Sandra Olvera-González
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México,
| | - Georgina Eugenia Bazán-Riverón
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México,
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32
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Young NL, Wakefield C, Burke TA, Ray R, McCusker PJ, Blanchette V. Updating the Canadian hemophilia outcomes-kids life assessment tool (CHO-KLAT Version2.0). Value Health 2013; 16:837-841. [PMID: 23947978 DOI: 10.1016/j.jval.2013.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 12/06/2012] [Accepted: 02/01/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Hemophilia is an X-chromosome-linked disorder associated with recurrent bleeding into muscles and joints, leading to pain and limitations in physical function that may diminish quality of life. The Canadian Hemophilia Outcomes-Kids Life Assessment Tool (CHO-KLAT) is a disease-specific measure of quality of life that was recently revised to facilitate cross-cultural adaptation. This study assessed the validity and reliability of version 2.0 of the CHO-KLAT (CHO-KLAT2.0). METHODS Content validity was assessed via detailed cognitive debriefing to confirm that Canadian boys understood the CHO-KLAT2.0. The measurement properties of the CHO-KLAT2.0 were assessed in comparison to those of the PedsQL, the Haemo-QoL, and two global ratings. Most children completed the CHO-KLAT2.0 a second time to assess test-retest reliability. RESULTS Cognitive debriefing was completed with 12 boys (age 8.6-17.8 years) and 9 of their parents and resulted in no substantive changes. Sixty boys (mean age 11.8 years) participated in the validation phase, which showed a mean CHO-KLAT2.0 score of 75.4±12.0, strong correlations with the PedsQL (r = 0.62, P<0.001) and Haemo-QoL (r = 0.64, P<0.001), and moderate correlations with global ratings of hemophilia bother (ρ =-0.39, P = 0.002) and health (ρ =-0.47, P = 0.0002). Test-retest concordance was better among parents (0.79) than among boys (0.63). CONCLUSIONS This study establishes the measurement properties of the CHO-KLAT2.0. The summary scores are very similar to those from the original development study, and thus, these have not been affected by the revisions. These results provide reference standards for comparing data from other countries to the Canadian experience and to estimate sample sizes for future clinical trials.
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Affiliation(s)
- Nancy L Young
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.
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Abstract
AIM To describe the use of an innovative, multimethodological approach to exploring the day-to-day experiences of boys across a wide age range to better understand the effects of modern haemophilia treatment on their lives. BACKGROUND Children and young people with severe haemophilia can now be treated with prophylaxis and potentially have a lifestyle close to that of those without haemophilia. However, boys frequently describe living with haemophilia as burdensome. DATA SOURCES The study, based on a grounded theory approach, was conducted with boys aged four to 16 years old, using research methods that included photo-elicitation, 'draw and write' techniques, focus groups run by participant co-researchers and individual interviews. REVIEW METHODS Grounded theory was used to enable rich data capture, through reshaping of research questions as theory developed. DISCUSSION The effectiveness of the methods used is discussed, along with consideration of the issues raised. CONCLUSION These methods are effective for use with children. They can result in robust data and are also fun for child participants. IMPLICATIONS FOR RESEARCH/PRACTICE Understanding life with chronic disease from a child's perspective can improve clinical care through a better understanding of health behaviour and lifestyle implications.
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Affiliation(s)
- Kate Khair
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
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Krug P, Kramer D, Bukatman R, Gordon P, Mermelstein P. Energy dialogue technique in healing and health: relieving side effects and thyroid dysfunction in a male with hemophilia receiving pegylated interferon and ribavirin treatment for hepatitis C virus--an anecdotal case study. J Holist Nurs 2013; 31:204-13. [PMID: 23686464 DOI: 10.1177/0898010113488992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article describes the use of energy dialogue technique (EDT), a healing intervention that provides awareness of imbalances in the energetic field that affect patients' health and guide the practitioner to sense and direct the frequency, vibration, intention, awareness, or consciousness to correct these imbalances. The authors document the effectiveness of this technique as it was used to treat side effects of the medical intervention for hepatitis C in a male with hemophilia. Following EDT, the client's symptoms of fatigue and pain improved by 30% to 40%; moreover, thyroid function returned to normal. The authors suggest that EDT be studied and explored for inclusion as a treatment modality.
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Haghpanah S, Ardeshiri R, Zahedi Z, Golzadeh MH, Silavizadeh S, Karimi M. Attitudes and practices with regard to circumcision in haemophilia patients in Southern Iran. Haemophilia 2013; 19:e177-8. [PMID: 23490218 DOI: 10.1111/hae.12120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/27/2022]
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Miesbach W, Schelle G, Kalnins W. [Life with haemophilia. The patient's perspective of ageing]. Hamostaseologie 2013; 33 Suppl 1:S22-S24. [PMID: 24170034] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/27/2013] [Indexed: 06/02/2023] Open
Abstract
Patients with haemophilia are growing older and may be faced with age-dependent co-morbidities. To evaluate the impact of growing age in patients with haemophilia, a questionaire was sent to members of German patients' organisations DHG and IGH with focus on medical care and psychosocial questions. This questionnaire was answered by 466 individuals (aged 50 years, 21-85 years), predominantly suffering from severe haemophilia. The majority of individuals considered the question of substitution of factor concentrates in case of bleeding as most important. Concerns were expressed regarding the financial situation and lack of medical care in higher age. The results provide an insight into issues of growing age from the patient's perspective.
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Affiliation(s)
- W Miesbach
- Priv.-Doz. Dr. Wolfgang Miesbach, Hämophiliezentrum Medizinische Klinik III, Institut für Transfusionsmedizin, J.-W.-Goethe-Universität Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Tel. 069/63 01 50 51, Fax 069/603 01 67 38, E-Mail:
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Khaliavina IN, Gileva OS, Plenkina IA, Libik TV, Murav'eva MA, Gorodilova EA. [Life quality improvement in hemophilia patients after esthetical teeth restoration]. Stomatologiia (Mosk) 2012; 91:26-28. [PMID: 22810571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
to study the effect of esthetical teeth restoration on life quality in hemophilia patients. Life quality was assessed by means of adapted OHIP-14 questionary translated into Russian. The study showed life quality to be sensible to dental status: cavities, dental arch defects, poor restorations and dentures. Dental treatment tends to improve life quality in hemophilia patients.
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Abstract
To understand the normalization process in families with hemophiliac children, and to explore the impact of two different therapeutic regimes on it (on-demand therapy and prophylaxis), we conducted a two-phase study using semistructured interviews. In the course of the first phase, we interviewed 13 parents belonging to 10 families with hemophiliac children in on-demand therapy. In the second phase, 5 years later, we repeated the interviews with three families who began prophylaxis at different times. We analyzed the interviews using text analysis software. The results show very different representations of hemophilia and daily life. Normalization processes involve the overcoming of a divided conception of life, and encourage the integration of care practices within daily life. Moreover, in our article we suggest that although prophylaxis facilitates the recovery of a regular family routine, it alone cannot produce normalization.
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Schneider MM, Shows A, Giebl A, Schramm W. Haemophilia patients with HIV- and HCV-infection. Long term survival. Hamostaseologie 2011; 31 Suppl 1:S14-S19. [PMID: 22057841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 05/13/2011] [Indexed: 05/31/2023] Open
Abstract
UNLABELLED At present (2010), we investigate in a long term study on psychosocial aspects of haemophilia at the Munich Haemophilia Centre factors which could be held responsible for the large number of still living HIV+ patients while many patients died from AIDS or from diseases caused by HCV during the 1990ies. PATIENTS, METHODS We retrospectively compare medical and psychosocial data of 15 HIV+ long term survivors (L-S), 15 HIV+ later on deceased patients and 15 HIV-, all of them deriving from the original investigation group from 1985 including 52 patients (30 HIV+, 22 HIV-). We prove the validity of our psychosocial factors by the SF 36 which currently serves as gold standard. The actual psychosocial factors and medical parameters of the 15 L-S are checked against the data of the 15 HIV- patients. RESULTS, CONCLUSION In 1985 already, we retrospectively found significantly higher values regarding psychosocial factors within the group of the L-S as opposed to the later on deceased ones. Highly significant are the facts that more than 90 % of HIV+ L-S have had a good relationship to their fathers and are still employed today in contrast to the deceased HIV+ patients. At present, the differences regarding psychosocial factors between HIV+ L-S and HIV-negative patients are vanishing.
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Affiliation(s)
- M M Schneider
- Facharzt für Psychosomatische Medizin, Psychotherapie Psychoanalyse, München.
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Affiliation(s)
- Mahinda Kommalage
- Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
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Abstract
The impact of pediatric chronic illness on peer relations and social adjustment in nine school-aged boys with hemophilia was examined using qualitative interview methods. Literature on boys' psychosocial development provided a theoretical perspective to interpret findings. Three main themes emerged from the interviews: Awareness of difference, efforts to conceal difference, and efforts to connect with peers and friends. Findings suggest that hemophilia may be a socially stigmatizing condition for many boys because it limits gender-typical interactions with same-sex peers. Recommendations are offered for research on interventions to assist children in communicating with peers about their health condition and to involve close friends and parents in such interventions.
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Affiliation(s)
- Kelly A Williams
- Department of Social Work at Appalachian State University, Boone, North Carolina 28608-2155, USA.
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Schneider MM, Schramm W. [A quarter century of psychosocial haemophilia-counseling]. Hamostaseologie 2010; 30 Suppl 1:S19-S22. [PMID: 21042670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
UNLABELLED With the development of clotting-factors in the seventies the haemophilia patients were released from being handicapped and began to live a quite normal life. Thus, psychosocial counselling did not seem to be necessary. But the impact of HIV-infection to the world of haemophilia was so intense that professional help was offered at the Munich Hemophilia Centre since 1985. During the preceeding 25 years we talked to about 120 patients and relatives every year in more than 10000 psychotherapeutic talks. 70 of our patients were HIV-infected. For about half of them we took care until they died on AIDS or of liver-disease. The other 50 patients (HIV-negative) were also distressed enormously. At the beginning the highlights in counselling were e. g. fear of manifestation of AIDS, dying and death, social stigma. Around 1993 with the decoding of HCV and the first useful HIV therapies the topics in counselling changed: New HIV-medical-treatment, menacing by HCV, wish for own children due to improved HIV medical care etc. CONCLUSION Our experiences have shown that self esteem and social integration of haemophilia patients have reached again normality. By our psychosocial counselling we would like to contribute.
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Affiliation(s)
- M M Schneider
- Abteilung für Hämostaseologie und Transfusionsmedizin, Medizinische Klinik Innenstadt, Universität München, Germany; Bluter Betreuung Bayern e.V.
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Affiliation(s)
- C E Walsh
- Department of Medicine, Tisch Cancer Center, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Bullinger M, Globe D, Wasserman J, Young NL, von Mackensen S. Challenges of patient-reported outcome assessment in hemophilia care—a state of the art review. Value Health 2009; 12:808-820. [PMID: 19490552 DOI: 10.1111/j.1524-4733.2009.00523.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION One of the recent advances in assessing outcomes of medical care is the inclusion of the patient perspective. The term patient-reported outcome (PRO) is used to reflect the patient perceptions of disease and its consequences as well as of treatment and health-care provision. The development of PRO measures has advanced rapidly, and implementation in clinical research and practice is now underway. From an evaluation perspective, recommendations for the choice of PRO measures and an appraisal of the potential benefits of PRO data collection within specific health conditions are needed. METHODS Hemophilia is a rare and clinically well-defined health condition with established and cost-intensive treatment strategies, in which PRO assessment is increasingly recognized as important. For this reason, measurement of PROs in hemophilia focusing on health-related quality of life (HRQoL) and patient preferences were reviewed to identify appropriate measures, to make recommendations for their choice, and to critically examine their impact in international hemophilia research and practice. RESULTS Using literature searches and expert discussion strategies, generic and targeted measures for HRQoL and patient preferences in adults and children with hemophilia were screened, and 20 were reviewed on the basis of their psychometric properties and international availability. Only a few of the 20 measures have been used in clinical settings or research related to persons with hemophilia. CONCLUSION Consequently, an increased use of these measures is recommended to understand patient views on disease and treatment and to judge the impact of PROs for improvements in health care.
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Affiliation(s)
- Monika Bullinger
- Institute for Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
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Levine SB. Introduction to the sexual consequences of hemophilia. Scand J Haematol Suppl 2009; 40:75-82. [PMID: 6591415 DOI: 10.1111/j.1600-0609.1984.tb02547.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Pittadaki J, Louizou C, Mandalaki T. A study of psycho-social aspects of both haemophiliacs and carriers in Greece. Scand J Haematol Suppl 2009; 40:87-90. [PMID: 6591417 DOI: 10.1111/j.1600-0609.1984.tb02549.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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