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Xavier WDS, Nunes MDR, Abreu MP, Nascimento LC, Rebustini F. Children and adolescents hospitalized with chronic conditions: sleep patterns, resilience and quality of life. Rev Esc Enferm USP 2024; 58:e20230363. [PMID: 38738684 PMCID: PMC11089662 DOI: 10.1590/1980-220x-reeusp-2023-0363en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/28/2024] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVE To evaluate the sleep pattern of children and adolescents with chronic conditions during hospitalization and correlate it with resilience, quality of life, clinical and sociodemographic data. METHOD Quantitative, descriptive and cross-sectional study. Data collection took place between May 2022 and January 2023, with children and adolescents with chronic conditions from two hospitals in Rio de Janeiro. The instruments used were the Actigraph, Sandra Prince-Embury's Resilience Scale for Children and Adolescents and the Pediatric Quality of Life Inventory. Data analysis involved descriptive statistics and correlation tests. RESULTS 40 hospitalized children and adolescents between the ages of nine and 18 took part. The results showed compromised sleep, especially in terms of duration and time awake after sleep onset. Quality of life scores were low and resilience levels were classified as medium to high. Correlations were found between resilience and sleep. In addition, sleep was influenced by diagnosis and treatment. CONCLUSION Children and adolescents hospitalized with chronic conditions experience significant sleep disturbances and have a low quality of life, but have satisfactory levels of resilience.
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Affiliation(s)
- Welker da Silva Xavier
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Rio de Janeiro, RJ, Brazil.Universidade do Estado do Rio de JaneiroFaculdade de EnfermagemRio de JaneiroRJBrazil
| | - Michelle Darezzo Rodrigues Nunes
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Rio de Janeiro, RJ, Brazil.Universidade do Estado do Rio de JaneiroFaculdade de EnfermagemRio de JaneiroRJBrazil
| | - Madalena Paulos Abreu
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Rio de Janeiro, RJ, Brazil.Universidade do Estado do Rio de JaneiroFaculdade de EnfermagemRio de JaneiroRJBrazil
| | - Lucila Castanheira Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil.Universidade de São PauloEscola de Enfermagem de Ribeirão PretoDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaRibeirão PretoSPBrazil
| | - Flávio Rebustini
- Universidade de São Paulo, Escola de Artes, Ciência e Humanidades, Ribeirão Preto, SP, Brazil.Universidade de São PauloEscola de Artes, Ciência e HumanidadesRibeirão PretoSPBrazil
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Hilberath J, Mast AS, Holweg M, Kränkel L, Remppis J, Renk H, Lang P, Schulte J, Fuchs J, Slavetinsky C. Quality of life and healthcare utilization during the COVID-19 pandemic are more restricted in chronically ill than in healthy children: a tertiary care children's hospital experience. Eur J Pediatr 2024; 183:1801-1810. [PMID: 38253757 PMCID: PMC11001739 DOI: 10.1007/s00431-023-05382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 01/24/2024]
Abstract
The global COVID-19 pandemic forced changes in everyday life of children and adolescents due to government containment measures, an altered healthcare accessibility and utilization, and public concern about SARS-CoV-2 transmission. Data on the challenges and impact on children and their families with chronic diseases are limited. The primary objectives of this study were to assess (i) concerns for SARS-CoV-2 infection, (ii) perceived effects on health-related and overall quality of life (HRQoL and QoL), and (iii) accessibility and utilization of healthcare, comparing families with chronically ill children to families with healthy children during the second SARS-CoV-2 infection wave in Germany. A caregiver questionnaire was designed and participation offered in the emergency department and outpatient clinic of a German tertiary care children's hospital. 45.9% of the 205 participants were majorly concerned about their children contracting a SARS-CoV-2 infection. Caregivers of chronically ill children (128/205, 62.4%) stated significantly more often a negative impact on their child's QoL (w = 0.17; p = 0.014), while caregivers of chronically ill adolescents over the age of 13 expressed significantly more frequent a negative impact on their child's HRQoL (w = 0.21; p = 0.016). Outpatient appointments for chronically ill children were significantly more often canceled (w = 0.17; p = 0.025). Caregivers of chronically ill children were significantly more likely to report that they would actively delay hospital visits for emerging health issues due to the pandemic (w = 0.12; p = 0.049). Conclusion: Our findings underscore the importance of identifying families with chronically ill children as a vulnerable patient group with higher burdens during the COVID-19 pandemic and potential future pandemics. Healthcare providers may mitigate such burdens by ensuring reliable appointment allocation, offering contactless healthcare options, and providing tailored advice regarding vulnerabilities and preventive measures specific to their chronically ill children. What is Known: • The SARS-CoV-2 pandemic has led to significant restrictions in everyday life and both accessibility and utilization of healthcare for children and adolescents. • Chronically ill children faced exceptional challenges as they depend on regular and functioning medical care, but data comparing the pandemic's impact between chronically ill and healthy children are lacking. What is New: • The perceived impact of the SARS-CoV-2 pandemic on quality of life is more negative for chronically ill children and their health-related quality of life is more often affected compared to healthy children. • Caregivers of chronically ill children would more often delay a visit to their child's doctor during the SARS-CoV-2 pandemic and their medical appointments are more often postponed which both could increase health burdens for such vulnerable patients.
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Affiliation(s)
- Johannes Hilberath
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Anna-Sophia Mast
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany.
| | - Maximilian Holweg
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Lara Kränkel
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
- Institute of Medical Microbiology and Hygiene, University Hospital Tübingen, Tübingen, Germany
| | - Jonathan Remppis
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Hanna Renk
- University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Peter Lang
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Johannes Schulte
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Jörg Fuchs
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Christoph Slavetinsky
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
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