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Vuong C, Moussa I, van Muilekom MM, Heijboer H, Rettenbacher E, Haverman L, Twisk J, Fijnvandraat K, Eckhardt CL. Impact of hospitalization for vaso-occlusive crisis on health-related quality of life in children with sickle cell disease. Pediatr Blood Cancer 2023; 70:e30691. [PMID: 37749772 DOI: 10.1002/pbc.30691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/18/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is characterized by vaso-occlusive crises (VOCs) that impair the health-related quality of life (HRQoL). The aim of this study is to evaluate the impact of hospitalization for VOCs on HRQoL in children with SCD over time. METHODS In this longitudinal cohort study, children aged 8-18 years diagnosed with SCD at the Amsterdam UMC were included between 2012 and 2021. HRQoL was annually measured as part of standard care using the Pediatric Quality of Life Inventory. The impact of hospitalization for VOC on HRQoL was evaluated using linear mixed models 3, 6, 9, and 12 months after hospitalization. The effect of frequency of hospitalization for VOC on HRQoL was evaluated over the last 12 months. RESULTS In total, 94 children with SCD were included with a median age of 11.8 years (interquartile range [IQR]: 9-14). Thirty-seven patients (39%) had been hospitalized for a VOC. Hospitalization for VOC led to a decrease of 3.2-4.8 points in total HRQoL compared to patients without hospitalization, most pronounced 3 months after hospitalization. Recurrent admission for VOC in the last 12 months was associated with a decrease of 2.3 points in total HRQoL (p = .04). The most affected subscale was physical functioning. CONCLUSION The adverse effects of hospitalization for VOC in children with SCD persist up to 12 months after hospitalization. After hospitalization for VOC, extra attention and support for its negative impact on HRQoL are recommended. This study also underlines the importance of systematically measuring HRQoL, allowing clinicians to intervene accordingly.
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Affiliation(s)
- Caroline Vuong
- Department of Pediatric Hematology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Ibtissame Moussa
- Department of Pediatric Hematology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Maud M van Muilekom
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Harriët Heijboer
- Department of Pediatric Hematology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Eva Rettenbacher
- Department of Pediatric Hematology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Jos Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Corien L Eckhardt
- Department of Pediatric Hematology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
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Nwagha T, Omotowo BI. Determinants of Psychosocial Health-related Quality of Life of Adults with Sickle Cell Disease in a Nigerian Setting. Niger Med J 2020; 61:114-119. [PMID: 33100460 PMCID: PMC7547751 DOI: 10.4103/nmj.nmj_122_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/04/2019] [Accepted: 03/25/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND With improved understanding of disease mechanism in sickle cell disorder, many persons living with sickle cell disease (SCD) are surviving unto adulthood. There is a growing concern that SCD may impair the psychosocial health-related quality of life (HRQoL), with a resultant lack of psychosocial stability and integration. The objective of this study was to assess the determinants of psychosocial quality of life (QoL) among adults with SCD. MATERIALS AND METHODS This was a cross-sectional study of adults with SCD. A multidimensional self-administered instrument, prevalidated for use in adults with chronic disease, was used. It consisted of 31 items that assessed physical function, physical and emotional role function, bodily pain, vitality, social function, mental health, and general health within 2 weeks prior to the time of survey. Questionnaires were administered to adults with sickle cell anemia who presented for their routine visit to the Sickle Cell Clinic at the Hematology Clinic in University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, or during sickle cell support group meetings. Psychosocial HRQoL was the primary outcome measured. Sociodemographic features such as marital status, gender, educational qualification, and SCD were the primary independent variables of interest. RESULTS A total of I16 adults with SCD were participated in the study. After adjusting for marital status, gender, and educational qualification of adults with SCD, gender and marital status did not significantly affect psychosocial HRQoL (P = 0.619 and P = 0.146), respectively, while educational status significantly affected their HRQoL (P = 0.013). CONCLUSIONS Adults with SCD have impaired psychosocial HRQoL. There is a need to upscale patient-focused interventions to improve self-esteem and overall QoL.
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Affiliation(s)
- Theresa Nwagha
- Department of Haematology and Immunology UNTH/Departmant of Haematoogy, AEFUTHA, College of Medicine, Enugu Campus, Enugu State, Nigeria
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Kambasu DM, Rujumba J, Lekuya HM, Munube D, Mupere E. Health-related quality of life of adolescents with sickle cell disease in sub-Saharan Africa: a cross-sectional study. BMC HEMATOLOGY 2019; 19:9. [PMID: 31114692 PMCID: PMC6518788 DOI: 10.1186/s12878-019-0141-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/22/2019] [Indexed: 11/10/2022]
Abstract
Background Sickle cell disease (SCD) is a chronic hematologic disease associated with increased morbidity and mortality. Hemoglobinopathies are the most prevalent genetic disease globally, and SCD is estimated to affect 0.7% of Ugandan. The disease may adversely impact on the quality of life of sickle cell patients. This study aimed to evaluate the health related quality of life (HRoL) of adolescents with SCD. Methods This was a mixed-methods study of adolescents with sickle cell disease and their caretakers living in Kampala city, Uganda. All children aged 8-17 years with homozygous sickle cell disease attending the sickle cell clinic at Mulago Hospital during the study period were included in this study. Participants completed the PedsQL™ generic core scales parent-proxy and child self-report questionnaire during a routine clinic visit. HRQoL was the primary outcome measured. Socio-demographics and disease related data were obtained through personal interview with caretakers and reviewing patients' medical records. Mean scores were used for HRQoL and linear regression for associated factors. Results Of the 140 adolescents with SCD included in the study, 40% were male. A total of 95 adolescents (68%) were between the age of 8-12 years with a mean age of 14.25 years. The physical function was assessed slightly higher by adolescents with a mean score of57.5 ± 20.3 compare to caretakers with 52.8 ± 22.1(p < 0.001). As assessed by caretakers, physical HRQoL scores were negatively associated with pain about-10.02 CI [- 19.22, - 0.81](p = 0.033), whereas it was positively associated with Pneumococcal vaccine with the score of 28.43 CI [16.78,40.09](p < 0.001) as assessed by adolescents and 31.37CI [22.22,40.51](p < 0.001) by caretakers. Pneumococcal vaccination impacted positively the psychosocial functioning with a score of 8.67CI [1.51,15.84] (p = 0.018) as assessed by children and 15.94 CI [5.50,26.38](p = 0.003) as assessed by the caretakers. Conclusions This study highlighted that pain was negatively associated with both physical and psychosocial functioning; whereas getting Pneumococcal vaccine was positively associated with both physical and psychosocial functioning as reported by children and caretakers.
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Affiliation(s)
- David Muthahi Kambasu
- 1Pediatrics and Child Health, School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Joseph Rujumba
- 1Pediatrics and Child Health, School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Hervé Monka Lekuya
- 2Department of Surgery, College of Health Sciences Makerere University, Kampala, Uganda
| | - Deogratias Munube
- 1Pediatrics and Child Health, School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda.,3Mulago National Referral Hospital, Kampala, Uganda
| | - Ezekiel Mupere
- 1Pediatrics and Child Health, School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda
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Leo DG, Murphy R, Gambling T, Long A, Jones H, Perry DC. Perspectives on the Social, Physical, and Emotional Impact of Living With Perthes' Disease in Children and Their Family: A Mixed Methods Study. Glob Pediatr Health 2019; 6:2333794X19835235. [PMID: 30993152 PMCID: PMC6449807 DOI: 10.1177/2333794x19835235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022] Open
Abstract
Aim. To determine the social, physical, and emotional impact of
living with Perthes’ disease on affected children and their family (caregivers).
Patients and Methods. Through a mixed methods approach, we
interviewed 18 parents and explored the perspectives of 12 children affected by
Perthes’ disease (mean = 7.1 years, SD = ±4.1 years) using a survey tool.
Thematic analysis of parents’ interviews provided an insight into
disease-specific factors influencing patients and family’s daily life
activities. Using the childhood survey tool, good and bad day scores were
analyzed using MANOVA (multivariate analysis of variance).
Results. Thematic analysis of the parent interviews (main
themes n = 4) identified a marked effect of the disease on many facets of the
child’s life, particularly pain and the impact on sleep, play, and school
attendance. In addition, the interviews identified a negative effect on the
family life of the parents and siblings. Children indicated that activities of
daily living were affected even during “good days” (P <
.05), but pain was the key limiting factor. Conclusion.
Perthes’ disease negatively affects the social, physical, and emotional
well-being of children and their family. These findings provide outcome domains
that are important to measure in day-to-day care and add in-depth insight into
the challenges caused by this disease for health care professionals involved in
clinical management.
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Affiliation(s)
| | | | | | | | - Helen Jones
- Liverpool John Moores University,
Liverpool, UK
| | - Daniel C. Perry
- University of Liverpool, Liverpool,
UK
- Daniel C. Perry, University of Liverpool,
Alder Hey Hospital, Eaton Road, Liverpool, L12 2AP, UK.
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Sehlo MG, Kamfar HZ. Depression and quality of life in children with sickle cell disease: the effect of social support. BMC Psychiatry 2015; 15:78. [PMID: 25880537 PMCID: PMC4394397 DOI: 10.1186/s12888-015-0461-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 03/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms than those without. The present study aimed to: assess the prevalence of depression in a sample of children with SCD; evaluate the association between disease severity, social support and depression, and the combined and/or singular effect on health-related quality of life (HRQL) in children with SCD; and show the predictive value of social support and disease severity on depression. METHODS A total of 120 children were included in the study, 60 (group I) with SCD and 60 matched, healthy control children (group II). Depression was assessed in both groups using the Children's Depression Inventory (CDI) and the Children's Depression Inventory-Parent (CDI-P). Children with CDI and CDI-P scores of more than 12 were interviewed for further assessment of depression using the Diagnostic Interview Schedule for Children Version IV (DISC-IV). The Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) was used to assess HRQL in both groups, and social support was measured with the Child and Adolescent Social Support Scale (CASSS). RESULTS Eight (13%) of the 60 children with SCD had CDI and CDI-P scores of more than 12 (CDI mean score 14.50 ± 1.19, CDI-P mean score 14.13 ± 1.12), and were diagnosed as having clinical depression using the diagnostic interview DISC-IV. For group I, HRQL was poor across all PedsQL 4.0 domains in both self- and parent-reports (P < 0.001) compared with group II. A higher level of parent support was a significantly associated with decreased depressive symptoms, demonstrated by lower CDI scores. Better quality of life was shown by the associated higher total PedsQL 4.0 self-scores of children with SCD (B = -1.79, P = 0.01 and B = 1.89, P = 0.02 respectively). CONCLUSIONS The present study demonstrates that higher levels of parent support were significantly associated with decreased depressive symptoms and better quality of life in children with SCD. Interventions focused on increasing parent support may be an important part of treatment for depression in children with SCD.
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Affiliation(s)
- Mohammad Gamal Sehlo
- Department of Medicine, Psychiatry Unit, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, P. O. Box 80205, Jeddah, Kingdom of Saudi Arabia.
- Department of Psychiatry, Zagazig University, Zagazig, Egypt.
| | - Hayat Zakaria Kamfar
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Panepinto JA, Bonner M. Health-related quality of life in sickle cell disease: past, present, and future. Pediatr Blood Cancer 2012; 59:377-85. [PMID: 22522407 DOI: 10.1002/pbc.24176] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 03/27/2012] [Indexed: 01/06/2023]
Abstract
Health-related quality of life (HRQL) is defined as the patient's appraisal of how his/her well being and level of functioning, compared to the perceived ideal, are affected by individual health. The study of HRQL in children and adults with sickle cell disease (SCD) has begun to flourish. Given the devastating complications of the disease and other co-morbid factors patients experience that influence HRQL, it is increasingly important to understand HRQL. The focus of this critical review was to examine past and current research in HRQL in SCD where a validated instrument was used. In addition, future directions for HRQL in SCD are explored.
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Affiliation(s)
- Julie A Panepinto
- Department of Pediatrics, Children's Hospital of Wisconsin of the Children's Research Institute/Medical College of Wisconsin, Hematology/Oncology/Bone Marrow Transplantation, Milwaukee, Wisconsin, USA.
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Dale JC, Cochran CJ, Roy L, Jernigan E, Buchanan GR. Health-related quality of life in children and adolescents with sickle cell disease. J Pediatr Health Care 2011; 25:208-15. [PMID: 21700135 PMCID: PMC3124665 DOI: 10.1016/j.pedhc.2009.12.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 12/24/2009] [Accepted: 12/30/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess health-related quality of life (HRQOL) in children and adolescents with sickle cell disease (SCD). DESIGN, SETTING, AND PARTICIPANTS The PedsQL 4.0 Generic Scales, a multidimensional self-report instrument that has been shown to be valid and reliable for use in children and adolescents with chronic illness, consists of 23 items that assess physical, emotional, social, and school functioning. Questionnaires were administered to 124 children and adolescents (ages 8 to 18 years, child self-report) with SCD (100 sickle cell anemia, 24 sickle β zero thalassemia) and their parents (parent-proxy report). Summary scores for children's and parents' ratings of overall HRQOL and psychosocial health and subscale scores for physical, emotional, social, and school functioning were compared with published data for healthy children. Both summary and subscale scores for children with SCD also were compared with those of their parents. RESULTS Children with SCD and their parents rated overall HRQOL and all subdomains of HRQOL lower than did healthy children and their parents (P < .001). Children with SCD rated their own HRQOL significantly better than their parents did for overall HRQOL and all subdomains (P < .001) except emotional functioning (P = .06). CONCLUSIONS Children with SCD and their parents perceived overall HRQOL and all HRQOL subdomains to be lower than scores reported in healthy children. Therefore, successful therapeutic efforts to improve HRQOL could represent important advances in the health of children with SCD.
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Bediako SM, Neblett EW. Optimism and Perceived Stress in Sickle-Cell Disease: The Role of an Afrocultural Social Ethos. JOURNAL OF BLACK PSYCHOLOGY 2010. [DOI: 10.1177/0095798410385681] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Given its prevalence among African diasporic populations, sickle-cell disease (SCD) is an individual and global public health issue that is especially relevant to health psychologists. Despite evidence that sociocultural variables generally exert a significant influence on health outcomes, very little is known about the social and cultural contexts of adjustment to SCD. The present study explored whether specific variables representing an Afrocultural social ethos (i.e., spirituality, positive affect, and communalism) indirectly influenced the relation between optimism and perceived stress among individuals coping with SCD. Eighty-three African American adults attending an outpatient clinic completed a demographic profile and a brief survey assessing optimism, pain, stress, and the aforementioned Afrocultural domains. Multiple mediation analyses controlling for age and pain severity indicated that the relation between optimism and stress was unaffected by an Afrocultural ethos. The implications of these findings for research on psychosocial aspects of SCD are discussed.
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McClish DK, Penberthy LT, Bovbjerg VE, Roberts JD, Aisiku IP, Levenson JL, Roseff SD, Smith WR. Health related quality of life in sickle cell patients: the PiSCES project. Health Qual Life Outcomes 2005; 3:50. [PMID: 16129027 PMCID: PMC1253526 DOI: 10.1186/1477-7525-3-50] [Citation(s) in RCA: 171] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2005] [Accepted: 08/29/2005] [Indexed: 11/16/2022] Open
Abstract
Background Sickle cell disease (SCD) is a chronic disease associated with high degrees of morbidity and increased mortality. Health-related quality of life (HRQOL) among adults with sickle cell disease has not been widely reported. Methods We administered the Medical Outcomes Study 36-item Short-Form to 308 patients in the Pain in Sickle Cell Epidemiology Study (PiSCES) to assess HRQOL. Scales included physical function, physical and emotional role function, bodily pain, vitality, social function, mental health, and general health. We compared scores with national norms using t-tests, and with three chronic disease cohorts: asthma, cystic fibrosis and hemodialysis patients using analysis of variance and Dunnett's test for comparison with a control. We also assessed whether SCD specific variables (genotype, pain, crisis and utilization) were independently predictive of SF-36 subscales, controlling for socio-demographic variables using regression. Results Patients with SCD scored significantly worse than national norms on all subscales except mental health. Patients with SCD had lower HRQOL than cystic fibrosis patients except for mental health. Scores were similar for physical function, role function and mental health as compared to asthma patients, but worse for bodily pain, vitality, social function and general health subscales. Compared to dialysis patients, sickle cell disease patients scored similarly on physical role and emotional role function, social functioning and mental health, worse on bodily pain, general health and vitality and better on physical functioning. Surprisingly, genotype did not influence HRQOL except for vitality. However, scores significantly decreased as pain levels increased. Conclusion SCD patients experience health related quality of life worse than the general population, and in general, their scores were most similar to patients undergoing hemodialysis. Practitioners should regard their HRQOL as severely compromised. Interventions in SCD should consider improvements in health related quality of life as important outcomes.
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Affiliation(s)
- Donna K McClish
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
- Division of Quality Health Care, Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Lynne T Penberthy
- Division of Quality Health Care, Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Viktor E Bovbjerg
- Department of Health Evaluation Sciences, University of Virginia, Charlottesville, VA, USA
| | - John D Roberts
- Division of Hematology/Oncology, Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Imoigele P Aisiku
- Division of Quality Health Care, Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - James L Levenson
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Susan D Roseff
- Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA
| | - Wally R Smith
- Division of Quality Health Care, Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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