1
|
Rubinstein TB, Bullock DR, Ardalan K, Mowrey WB, Brown NM, Bauman LJ, Stein REK. Adverse Childhood Experiences Are Associated with Childhood-Onset Arthritis in a National Sample of US Youth: An Analysis of the 2016 National Survey of Children's Health. J Pediatr 2020; 226:243-250.e2. [PMID: 32553837 DOI: 10.1016/j.jpeds.2020.06.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To determine whether there is an association between adverse childhood experiences (ACEs) and childhood-onset arthritis, comparing youth with arthritis to both healthy youth and youth with other acquired chronic physical diseases (OCPD); and to examine whether ACEs are associated with disease-related characteristics among children with arthritis. STUDY DESIGN In a cross-sectional analysis of data from the 2016 National Survey of Children's Health we examined whether ACEs were associated with having arthritis vs either being healthy or having a nonrheumatologic OCPD. ACE scores were categorized as 0, 1, 2-3, ≥4 ACEs. Multinomial logistic regression models examined associations between ACEs and health status while adjusting for age, sex, race/ethnicity, and poverty status. Among children with arthritis, associations between ACEs and disease-related characteristics were assessed by Pearson χ2 analyses. RESULTS Compared with children with no ACEs, children with 1, 2-3, and ≥4 ACEs had an increased odds of having arthritis vs being healthy (adjusted OR for ≥4 ACEs, 9.4; 95% CI, 4.0-22.1) and vs OCPD (adjusted OR for ≥4 ACEs, 3.7; 95% CI-1.7, 8.1). Among children with arthritis, ACEs were associated with worse physical impairment. CONCLUSIONS Children with higher numbers of ACEs are more likely to have arthritis, when arthritis status is compared either with being healthy or with having OCPD. Further studies are needed to determine the direction of the association between ACEs and childhood arthritis, its impact on disease course, and potential intervention targets that might mitigate these effects.
Collapse
Affiliation(s)
- Tamar B Rubinstein
- Division of Pediatric Rheumatology, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; Division of Pediatric Rheumatology, Children's Hospital at Montefiore, Bronx, NY.
| | - Danielle R Bullock
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Kaveh Ardalan
- Division of Pediatric Rheumatology, Department of Pediatrics, Duke University School of Medicine, Durham, NC; Division of Rheumatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Wenzhu B Mowrey
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Nicole M Brown
- Albert Einstein College of Medicine, Bronx, NY; Strong Children Wellness Medical Group Jamaica, NY
| | - Laurie J Bauman
- Division of Academic General Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Bronx, NY
| | - Ruth E K Stein
- Division of Developmental Medicine, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; Division of Developmental Medicine, Children's Hospital at Montefiore, Bronx, NY
| |
Collapse
|
2
|
Hill DL, Carroll KW, Snyder KJG, Mascarenhas M, Erlichman J, Patterson CA, Barakat LP, Feudtner C. Development and Pilot Testing of a Coping Kit for Parents of Hospitalized Children. Acad Pediatr 2019; 19:454-463. [PMID: 30415078 DOI: 10.1016/j.acap.2018.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/20/2018] [Accepted: 11/02/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Serious pediatric illness places great stress on families. Parents who learn coping skills may better manage these stressors. This study sought to develop and refine a stress coping intervention for parents of hospitalized children, assess the intervention acceptability among these parents, and gather preliminary data on stress, negative and positive affect, anxiety, depression, and self-efficacy. METHODS We conducted an observational study in 2 phases, enrolling parents of children who were inpatients with serious illness, 10 in Phase 1 and 40 in Phase 2. All parents completed at baseline measures of stress and psychological well-being and were introduced to the Coping Kit for Parents. Follow-up interviews were conducted at 1 week (all parents) and 1 month (Phase 2 parents only) regarding the acceptability of the intervention. RESULTS At baseline, parents reported that stressful situations were frequent (mean = 30.6, standard deviation [SD] = 6.8) and difficult (mean = 26.2, SD = 7.1) and revealed elevated levels of negative affect (mean = 27.3, SD = 7.7), depression (mean = 8.5, SD = 3.7), and anxiety (mean = 11.3, SD = 3.1) and moderate levels of self-efficacy related to their child's illness (mean = 3.3, SD = 0.5). The majority of parents used the kit regularly and on a scale of 1 to 7 agreed that the kit was helpful (mean = 6.0, SD = 0.9), interesting (mean = 5.7, SD = 1.3), practical (mean = 5.7, SD = 1.4), enjoyable (mean = 6.0, SD = 1.3), and they would recommend it to other parents (mean = 6.4, SD = 0.9). CONCLUSIONS The Coping Kit for Parents is an acceptable stress management intervention that could be made available to parents of children with serious illness at pediatric hospitals with minimal staff training or time commitment.
Collapse
Affiliation(s)
- Douglas L Hill
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa.
| | - Karen W Carroll
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - K J G Snyder
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Maria Mascarenhas
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Jessi Erlichman
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Chavis A Patterson
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Lamia P Barakat
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Chris Feudtner
- Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa
| |
Collapse
|
3
|
Berg CA, Butner J, Wiebe DJ, Lansing AH, Osborn P, King PS, Palmer DL, Butler JM. Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example. DEVELOPMENTAL REVIEW 2017; 46:1-26. [DOI: 10.1016/j.dr.2017.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
4
|
Die Kölner Nephro-Krabbelgruppe. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0387-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Eating-Disordered Behaviour in Adolescents with Type 1 Diabetes. Can J Diabetes 2016; 40:152-7. [PMID: 26874893 DOI: 10.1016/j.jcjd.2015.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 09/11/2015] [Accepted: 09/17/2015] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate dysfunctional eating behaviour, self-esteem, social physique anxiety and quality of life in adolescents with type 1 diabetes who have differing desired weights and to evaluate the predictors of dysfunctional eating behaviour in these adolescents, with a focus on personal and psychological variables. METHODS We evaluated 79 adolescents with type 1 diabetes (mean age of 15.71 years) of both sexes (58.2% females) using the Eating Disorders Examination Questionnaire (EDE-Q), the Rosenberg Self-Esteem Scale (RSES), the Social Physique Anxiety Scale (SPAS-R) and the Diabetes Quality of Life (DQoL) measure. RESULTS Of the adolescents, 44 with type 1 diabetes reported the desire to maintain or increase their current weight, and 35 reported the desire to reduce their current weight. The participants with the desire to weigh less were mainly females who exercised regularly and demonstrated more frequent binge eating and purging. Additionally, this group exhibited an increased frequency of eating disturbances, such as restraint and eating, weight and shape concerns. Moreover, this group demonstrated increased social physique anxiety and decreased diabetes quality of life in relation to the impact of diabetes, worries about diabetes and satisfaction with life. Finally, predictors of eating disturbances included the desire for lower weight, higher social physique anxiety and lower diabetes-related quality of life. CONCLUSIONS The desire for a lower weight in adolescents with type 1 diabetes may increase problems related to eating behaviour and general quality of life.
Collapse
|
6
|
Akay AP, Ozturk Y, Avcil SN, Kavurma C, Tufan E. Relationships between pediatric obesity and maternal emotional states and attitudes. Int J Psychiatry Med 2015; 50:178-90. [PMID: 26359289 DOI: 10.1177/0091217415605032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The goal of this study was to investigate depression and anxiety levels of mothers whose child (7-11 years) and adolescent (12-18 years) offspring had obesity, as well as those mothers' attitudes toward their children and their family relationships. METHOD This is a cross-sectional, case-control study of 100 dyads. All mothers completed the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Parental Attitude Research Instrument, and the Family Assessment Device. RESULTS Maternal state anxiety in the group with obesity was significantly higher than controls (p = 0.03). As measured by Family Assessment Device, affective involvement (p = 0.05) and behavior control (p = 0.00) scores were significantly higher for those with obesity. Obesity and adolescence have independent effects on maternal state anxiety; affective involvement domain of family function is affected by both obesity and its interaction with adolescence, while behavior control domain is singularly affected by obesity. CONCLUSIONS Our results may demonstrate that, for the mothers of children who have obesity, this condition may have an adverse effect on their lives and their family relationships. Pediatric obesity and developmental stage of offspring may have different effects on maternally reported psychometric variables. Cross-sectional design may hinder causal explanations. Further studies with longitudinal designs are needed.
Collapse
Affiliation(s)
- Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Yesim Ozturk
- Division of Pediatric Gastroenterology, Hepatology and Nutrition Department of Pediatrics, Dokuz Eylul University School of Medicine, Izmir, Turkey Division of Pediatric Metabolic Disease, Department of Pediatrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Sibel Nur Avcil
- Department of Child and Adolescent Psychiatry, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Canem Kavurma
- İzmir Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Izmir, Turkey
| | - Evren Tufan
- Department of Child and Adolescent Psychiatry, Abant İzzet Baysal University Medical Faculty, Bolu, Turkey
| |
Collapse
|
7
|
Morawska A, Calam R, Fraser J. Parenting interventions for childhood chronic illness: a review and recommendations for intervention design and delivery. J Child Health Care 2015; 19:5-17. [PMID: 24486817 DOI: 10.1177/1367493513496664] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Every day, thousands of children suffer the effects of chronic health conditions and families struggle with illness management and children's behavioural and emotional adjustment. Many parents experience difficulties with their caregiving role and lack confidence in their ability to manage their child's illness and ensure the child's well-being. While there is consistent evidence as to the extent and impact of childhood chronic illness, there is a paucity of evidence-based parenting approaches to help children with chronic health conditions and their families. This paper provides a narrative review of the current literature to examine relationships between chronic childhood illness, emotional and behavioural disorders and parenting. Key guidelines and recommendations for the development of evidence-based parenting programs for parents of children affected by chronic health conditions are provided.
Collapse
|
8
|
Connelly M, Anthony KK, Schanberg LE. Parent perceptions of child vulnerability are associated with functioning and health care use in children with chronic pain. J Pain Symptom Manage 2012; 43:953-60. [PMID: 22285288 PMCID: PMC4104198 DOI: 10.1016/j.jpainsymman.2011.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 05/13/2011] [Accepted: 05/18/2011] [Indexed: 01/01/2023]
Abstract
CONTEXT The extent to which parent variables are associated with the level of disability experienced by children with persistent pain has been an area of increasing research. OBJECTIVES To evaluate the extent to which parent perceptions of their child's vulnerability are associated with functioning and health care utilization among children with persistent pain. We also evaluated whether perceptions of child vulnerability contribute to an indirect relationship between parent distress and child functioning and/or child health care utilization. METHODS The study sample comprised 87 patients aged 6-18 years and a parent attending a chronic pain clinic. Children completed questionnaires on functional limitations, and parents completed questionnaires on parent distress, perceptions of child vulnerability, and extent of the child's pain-related health care utilization. Hierarchical regression and bootstrapping mediation analyses were used to test study hypotheses. RESULTS Perceptions of child vulnerability were found to be clinically elevated in nearly half (46%) of parents/caregivers, and average child functional ability for the sample was substantially lower than healthy norms. Parent perceptions of greater child vulnerability were significantly associated with poorer child functioning and more child pain-related health care utilization regardless of child age, sex, and duration of persistent pain. Parent distress was found to be indirectly related to child health care utilization through parent perceptions of child vulnerability but directly related to child functioning. CONCLUSION Parent perceptions of child vulnerability appear important for understanding levels of child functional limitations and health care utilization among children with chronic pain.
Collapse
Affiliation(s)
- Mark Connelly
- Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA.
| | | | | |
Collapse
|
9
|
The associations among economic hardship, caregiver psychological distress, disease activity, and health-related quality of life in children with juvenile idiopathic arthritis. Qual Life Res 2011; 21:1185-91. [DOI: 10.1007/s11136-011-0033-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2011] [Indexed: 11/26/2022]
|
10
|
Reynolds KA, Helgeson VS. Children with diabetes compared to peers: depressed? Distressed? A meta-analytic review. Ann Behav Med 2011; 42:29-41. [PMID: 21445720 PMCID: PMC3140576 DOI: 10.1007/s12160-011-9262-4] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND It is not clear from the literature whether children with diabetes have more psychological difficulties than their peers. PURPOSE This study aims to use meta-analysis to determine if children with diabetes differ from children without a chronic illness in a variety of domains reflecting psychological well-being. METHOD A meta-analysis was undertaken of 22 studies that compared children with diabetes to a comparison group. Outcomes included depression, anxiety, behavioral problems, and related constructs. RESULTS Children with diabetes were more likely than comparison groups to experience a variety of psychological difficulties. However, these effects were small to medium in magnitude and were typically smaller among more recent studies and studies with well-matched comparison groups. CONCLUSIONS This meta-analysis suggests that children with diabetes are at slightly elevated risk for psychological difficulties. Future work will need to help identify children at the highest risk, and to identify factors associated with resilience.
Collapse
Affiliation(s)
| | - Vicki S. Helgeson
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA,
| |
Collapse
|
11
|
Pekcanlar Akay A, Hiz Kurul S, Ozek H, Cengizhan S, Emiroglu N, Ellidokuz H. Maternal reactions to a child with epilepsy: Depression, anxiety, parental attitudes and family functions. Epilepsy Res 2011; 95:213-20. [PMID: 21543187 DOI: 10.1016/j.eplepsyres.2011.03.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 03/17/2011] [Accepted: 03/25/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The goal of this study was to investigate how the disease and treatment of epilepsy affected the psychological profile (depression and anxiety) of mothers whose children had epilepsy, as well as these mothers' attitudes towards their children and their family relationships. METHODS Both the case and control groups consisted of 50 children and their mothers. All mothers were asked to complete the Beck Depression Inventory, State-Trait Anxiety Inventory, Parental Attitude Research Instrument and Family Assessment Device. RESULTS Mothers whose children had epilepsy scored significantly higher in depression and state anxiety compared to the mothers of the control group. The mothers of children diagnosed with epilepsy also failed to develop supportive and friendly relationships with their children. In addition, these mothers scored significantly higher in the Attitude of Hostility and Rejection, Marital Discordance and Authoritarian Attitude as compared to the mothers of the control group. CONCLUSION This cross-sectional study demonstrated that, for the mothers of children who had epilepsy, the illness might have an adverse effect on their lives and their family relationships.
Collapse
Affiliation(s)
- Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, 35340 Inciralti, Izmir, Turkey.
| | | | | | | | | | | |
Collapse
|
12
|
Connelly M, Anthony KK, Sarniak R, Bromberg MH, Gil KM, Schanberg LE. Parent pain responses as predictors of daily activities and mood in children with juvenile idiopathic arthritis: the utility of electronic diaries. J Pain Symptom Manage 2010; 39:579-90. [PMID: 20303032 PMCID: PMC4049627 DOI: 10.1016/j.jpainsymman.2009.07.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 07/24/2009] [Accepted: 08/03/2009] [Indexed: 11/23/2022]
Abstract
The present study used electronic diaries to examine how parent responses to their child's pain predict daily adjustment of children with juvenile idiopathic arthritis (JIA). Nine school-aged children with JIA along with one of their parents completed thrice-daily assessments of pain-related variables, activity participation, and mood using handheld computers (Palm pilots) for 14 days, yielding a potential of 42 child and parent assessments for each dyad. Children provided information on current pain level, mood, and participation in social, physical, and school activities. Parents independently rated their own mood as well as their behavioral responses to their child's pain at the same time points using a separate handheld computer. Results of multilevel modeling analyses demonstrated that use of "protective" pain responses by parents significantly predicted decreases in child activity and positive mood, with an even stronger inverse relationship between protective pain response and positive mood observed in children with higher than average disease severity. Protective pain responses were not found to be significantly predictive of daily negative mood in children. The use of "distracting" responses by parents significantly predicted less child activity restrictions but only in children having higher disease severity. There also was an unexpected trend in which parent use of more distracting pain responses tended to be associated with lower child positive mood. These preliminary findings suggest the importance of the parent in influencing adjustment in children with JIA and lend support to the incorporation of parents into comprehensive pain management approaches. The potential benefits of using electronic daily diaries as a strategy to examine pain and adjustment in children with JIA pain are discussed.
Collapse
Affiliation(s)
- Mark Connelly
- Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA.
| | | | | | | | | | | |
Collapse
|
13
|
Jones F, Rodger S, Broderick S, De Monte R. Living with Juvenile Idiopathic Arthritis: Parents' Experiences of Treatment Regimens and Home Exercise Programmes. Br J Occup Ther 2009. [DOI: 10.1177/030802260907200603] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The parents of children with juvenile idiopathic arthritis have been identified as pivotal facilitators of children's involvement in treatment regimens, including home exercise programmes. As such, parents' perspectives regarding the factors that influence participation in their children's treatment regimens, and in particular home exercise programmes, are addressed in this study. In depth, semi-structured interviews were conducted with 16 families. Rigour was ensured through a rich description of participants, peer and member checking, field journals and audit trails. Four key topics related to the process — the experience of the child's diagnosis, community access and participation, treatment regimens and the impact of these regimens on the parent's roles and relationships — and were addressed. Seven key themes emerged, namely the difficult process of diagnosis, the emotional toll, medications, exercises, life revolves around arthritis, parents' relationship with their child and other family members, and parents and paid work. The implications for clinical practice and future research are discussed.
Collapse
Affiliation(s)
- Fiona Jones
- Formerly Occupational Therapy (Honours) student, The University of Queensland, Brisbane, Queensland, Australia
| | - Sylvia Rodger
- The University of Queensland, Brisbane, Queensland, Australia
| | | | - Rachel De Monte
- Formerly Occupational Therapy (Honours) student, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
14
|
Abstract
There are many challenges in coping with and adapting to life with a chronic disease, and increased survival cannot be assumed to be associated with increased quality of life. A recent systematic review shows there is wide variation in outcomes depending on the definitions and measurements used to estimate the prevalence of chronic health conditions, making the impact of disability on children's health and social functioning difficult to assess; various authors have called for an international consensus about the conceptual definition of chronic health conditions in childhood. It frequently is difficult to determine if problems in psychosocial functioning are caused by the underlying illness, by treatment, or by the resultant effects of either illness or treatment on physical growth or cognitive development. Assessment and treatment of mental health should be an integral component of the comprehensive care of chronically ill children and adolescents. Transition of care is an important process that addresses significant changes from child-oriented to adult-oriented care. Adults who have chronic health conditions should continue to be evaluated periodically for late consequences of the childhood illness and early medical care, and attention should be paid to their ongoing psychosocial, psychiatric, educational, and vocational needs.
Collapse
Affiliation(s)
- Susan Turkel
- Childrens Hospital Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd #82, Los Angeles, CA 90027, USA
| | | |
Collapse
|
15
|
Lebovidge JS, Stone KD, Twarog FJ, Raiselis SW, Kalish LA, Bailey EP, Schneider LC. Development of a preliminary questionnaire to assess parental response to children's food allergies. Ann Allergy Asthma Immunol 2006; 96:472-7. [PMID: 16597083 DOI: 10.1016/s1081-1206(10)60916-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Food allergy affects up to 8% of children. Unintentional exposure may result in minor to potentially fatal episodes. Management of allergies depends on strict allergen avoidance and emergency preparedness. The demands of allergy management and concerns for the child's safety may place parents at risk of developing emotional distress or difficulties in coping. OBJECTIVE To develop a brief condition-specific measure to evaluate parental adjustment to and coping with children's food allergy. METHODS A total of 221 parents of children 18 year or younger with food allergy were recruited from a private allergy practice and local food allergy support groups. Parents completed an 18-item questionnaire, the Food Allergy Parent Questionnaire (FAPQ), that assessed parental coping with a child's food allergy and questions related to their child's food allergy diagnosis and course. RESULTS Factor analysis of the items on the FAPQ suggested 4 factors that accounted for 53.6% of the variance: parental anxiety/distress, psychosocial impact of allergies, parental coping/competence, and family support. Medical variables (greater number of food allergies, positive history of anaphylaxis) were associated with higher scores on the anxiety/distress and psychosocial impact subscales. Internal consistency was good for the anxiety/distress and psychosocial impact subscales (Cronbach alpha = .80 and .77, respectively) but lower for the parental coping/competence and family support subscales (alpha = .57 and .32, respectively). CONCLUSIONS Although further psychometric data for the FAPQ is needed, preliminary findings suggest that the measure may be useful in screening for parental anxiety, perceived impact of food allergies, level of family support, and coping skills.
Collapse
|
16
|
Psychosoziale Anpassung bei chronischen Arthritiden. Monatsschr Kinderheilkd 2006. [DOI: 10.1007/s00112-004-1042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
17
|
Wagner VM, Müller-Godeffroy E, von Sengbusch S, Häger S, Thyen U. Age, metabolic control and type of insulin regime influences health-related quality of life in children and adolescents with type 1 diabetes mellitus. Eur J Pediatr 2005; 164:491-6. [PMID: 15875213 DOI: 10.1007/s00431-005-1681-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2004] [Revised: 03/15/2005] [Accepted: 03/18/2005] [Indexed: 10/25/2022]
Abstract
UNLABELLED The effects of illness and treatment of diabetes mellitus extend beyond medical outcomes. We therefore evaluated health-related quality of life (HRQOL) in children (aged 8-12 years) and adolescents (aged 13-16 years) with type 1 diabetes to compare their results with healthy peers and to identify HRQOL determinants. A total of 68 children and adolescents from a tertiary care clinic which specialises in the management of diabetes, completed the generic KINDL-R questionnaire. This instrument for children and adolescents has six dimensions and an additional module assessing condition-related HRQOL. Overall, the HRQOL was not different between patients with type 1 diabetes and healthy controls. In some areas, children and adolescents with diabetes reported a better HRQOL compared to healthy peers: adolescents reported better psychological well-being (P < 0.05) and children higher levels of well-being in the school domain (P < 0.05). In general, children reported a better HRQOL (P < 0.05) than adolescents with type 1 diabetes confirming age-related differences in HRQOL in the general population. Lower HbA1c (<8%) and intensified insulin therapy (>3 injections/day) were associated with a better HRQOL in different domains (P < 0.05). The subscale "chronic illness" showed a better HRQOL (P < 0.001) in children and adolescents with diabetes compared to age-matched controls with other chronic conditions. CONCLUSION Children and adolescents from a paediatric department specialising in diabetes management report good health-related quality of life. Younger age, good metabolic control and intensified insulin therapy are associated with a better health-related quality of life. Dimensions of health-related quality of life appear to play different roles at different ages, emphasising the importance of the multidimensional health-related quality of life concept and the value of age-appropriate self-reports.
Collapse
Affiliation(s)
- Verena M Wagner
- Klinik für Kinder- und Jugendmedizin, Universtätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
| | | | | | | | | |
Collapse
|
18
|
Abstract
PURPOSE The aim of the study was to investigate the psychological profile of mothers of children with strabismus, their attitudes to their children, and their family functioning. METHODS This study was conducted at Dokuz Eylül University School of Medicine, from 2000 to 2002 and involved a series of 30 children with strabismus and 31 healthy controls. All mothers were asked to complete Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Parental Attitude Research Instrument (PARI), and Family Assessment Device (FAD). RESULTS Mothers of the children with strabismus had significantly higher depression scores ( P = 0.042) compared with mothers of the control group. They demonstrated significantly lower scores in democratic attitude, meaning that they failed to constitute a supportive and friendship relation with their children, ( P = 0.0001). These mothers had significantly higher scores in rejection of maternal role ( P = 0.017) as compared with mothers of the control group. They were nervous, distressed, and angry in the relationship with their children, with unhappiness and more dissatisfaction with respect to maternal role. Mothers of the children with strabismus had poor role functioning in the family, which is related to satisfying the food, clothing, and support needs ( P = 0.034). They also had poor affective responsiveness, which means the ability of family members to respond with appropriate emotion ( P = 0.003), and poor general functioning ( P = 0.040) as compared with mothers of the control group. CONCLUSIONS This study demonstrated that, for mothers who have children with strabismus, strabismus had an adverse effect on their lives, and their family relationships.
Collapse
Affiliation(s)
- Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | | | | | | |
Collapse
|
19
|
Müller-Godeffroy E, Lehmann H, Küster RM, Thyen U. Lebensqualität und psychosoziale Anpassung bei Kindern und Jugendlichen mit juveniler idiopathischer Arthritis und reaktiven Arthritiden. Z Rheumatol 2005; 64:177-87. [PMID: 15868335 DOI: 10.1007/s00393-005-0652-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2003] [Accepted: 08/02/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We sought to measure self-reported health related quality of life (HRQOL) and psychosocial adaptation in children and adolescents with juvenile idiopathic arthritis (JIA) and reactive arthritis and to determine factors associated with these outcomes. METHODS We interviewed 72 children and adolescents with chronic arthritis, age 8-16, about HRQOL (KINDL-R-Questionnaire) and functional ability in activities of daily living (Childhood Health Assessment Questionnaire-CHAQ). Mothers reported behavior problems (Child Behavior Checklist-CBCL). RESULTS Children and adolescents with juvenile idiopathic arthritis and reactive arthritis reported lower HRQOL compared to normative data in several areas. Children reported lower QOL in the dimensions self-esteem; adolescents reported lower QOL in the dimensions physical well being and total QOL. Almost 20% of the sample appeared to have serious behavior problems, mostly social isolation and depression/anxiety. Functional limitations affected HRQOL and behavior problems. Inpatient children and adolescents and those with shorter disease duration reported lower QOL than outpatient children and adolescents and those with longer disease duration. Best predictors for impaired HRQOL were functional limitations, social isolation and depression/anxiety. CONCLUSIONS Self-reported HRQOL and behavior problems may be relevant outcome measures in children and adolescents with chronic arthritis and useful to monitor psychosocial support in this population.
Collapse
Affiliation(s)
- E Müller-Godeffroy
- Universitätsklinikum Lübeck, Klinik für Kinder- und Jugendmedizin, Ratzburger Allee 160, 23538 Lübeck, Germany
| | | | | | | |
Collapse
|
20
|
LeBovidge JS, Lavigne JV, Miller ML. Adjustment to chronic arthritis of childhood: the roles of illness-related stress and attitude toward illness. J Pediatr Psychol 2005; 30:273-86. [PMID: 15784923 DOI: 10.1093/jpepsy/jsi037] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine the relationship of psychosocial stress and attitude toward illness to psychological adjustment among youth with chronic arthritis. METHODS Seventy-five youths with chronic arthritis aged 8-18 years were administered a semi-structured interview assessing illness-related and nonillness-related stressors in important life domains. Children also completed measures of attitude toward illness, depressive symptoms, and anxiety. Parents completed a measure of child psychosocial adjustment. RESULTS Higher levels of illness-related and nonillness-related stress were associated with higher levels of anxiety and depressive symptoms and parent-reported adjustment problems, while a more positive attitude toward illness was associated with lower levels of anxiety and depressive symptoms. Attitude toward illness moderated the relationship between stress and depressive symptoms. CONCLUSIONS Results suggest the importance of assessing life stress and attitude toward illness among youth with arthritis and developing interventions to help children cope with arthritis-related stressors and promote a more positive attitude toward illness.
Collapse
|
21
|
Validation of the Pediatric Inventory for Parents in Mothers of Children With Type 1 Diabetes: An Examination of Parenting Stress, Anxiety, and Childhood Psychopathology. ACTA ACUST UNITED AC 2005. [DOI: 10.1037/1091-7527.23.1.56] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
22
|
White MM, Chaney JM, Mullins LL, Wagner JL, Hommel KA, Andrews NR, Jarvis JN. Children's Perceived Illness Uncertainty as a Moderator in the Parent-Child Distress Relation in Juvenile Rheumatic Diseases. Rehabil Psychol 2005. [DOI: 10.1037/0090-5550.50.3.224] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
23
|
Miller ML, LeBovidge J, Feldman B. Health-related quality of life in children with arthritis. Rheum Dis Clin North Am 2002; 28:493-501, vi. [PMID: 12380367 DOI: 10.1016/s0889-857x(02)00019-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Health status results from an individual's values placed on the interactions among a person's physical state, associated mental perceptions and emotions, resulting behaviors, and environment. Improving health-related quality of life is the goal of all disease treatment. This article reviews the components of health status, summarizes relevant studies in children with rheumatic and related diseases, and considers the role that future studies will play in improving care for children with rheumatic diseases.
Collapse
Affiliation(s)
- Michael L Miller
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL 60614, USA.
| | | | | |
Collapse
|
24
|
Turner AP, Barlow JH, Wright CC. Residential workshop for parents of adolescents with juvenile idiopathic arthritis: A preliminary evaluation. PSYCHOL HEALTH MED 2001. [DOI: 10.1080/13548500126540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
25
|
|
26
|
Weiss KA, Schiaffino KM, Ilowite N. Predictors of Sibling Relationship Characteristics in Youth With Juvenile Chronic Arthritis. CHILDRENS HEALTH CARE 2001. [DOI: 10.1207/s15326888chc3001_6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|