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Gualtierotti R, Garagiola I, Mortarino M, Spena S, Romero-Lux O, Peyvandi F. Gender equity in hemophilia: need for healthcare, familial, and societal advocacy. Front Med (Lausanne) 2024; 11:1345496. [PMID: 38646558 PMCID: PMC11026857 DOI: 10.3389/fmed.2024.1345496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/11/2024] [Indexed: 04/23/2024] Open
Abstract
Hemophilia is a rare bleeding disorder caused by a genetic defect on chromosome X. It is inherited as an X-linked trait, and hence, it is more frequently diagnosed in males, whereas women have been traditionally considered only as carriers of the disease. However, the role of women in families of patients with hemophilia is pivotal. As mothers, sisters, daughters, and female partners of patients with hemophilia, they play a central role in the management of the patient, considering healthcare, social, and familial aspects, but they might be affected by the disease as well, particularly in regions where consanguinity is frequent. This paper aims to explore the involvement of women in hemophilia, including their carrier status, bleeding symptoms, treatment challenges, and psychosocial impact not only related to male patients, but also as patients affected with hemophilia themselves. We advocate health equity, equal access to healthcare for men and women with hemophilia and dedicated resources to improve the unique needs of the women dealing with hemophilia, ultimately leading to improved care and quality of life.
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Affiliation(s)
- Roberta Gualtierotti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Isabella Garagiola
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Milan, Italy
| | - Mimosa Mortarino
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Milan, Italy
| | - Silvia Spena
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Milan, Italy
| | | | - Flora Peyvandi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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2
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Lopez K, Norris K, Hardy M, Valentino LA. Defining the Impact of Social Drivers on Health Outcomes for People with Inherited Bleeding Disorders. J Clin Med 2022; 11:jcm11154443. [PMID: 35956060 PMCID: PMC9369198 DOI: 10.3390/jcm11154443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
The ways in which the social drivers of health, also known as the social determinants of health (SDOH), affect health outcomes for people with inherited bleeding disorders (PwIBDs) is unclear. This systematic review of the published literature examines the impact of SDOH on health outcomes in PwIBDs. Articles that included the following parameters in PubMed informed this study: published in English between 2011–2021; available in free full text; study population diagnosed with an inherited bleeding disorder; and study measured at least one of the clinical/non-clinical outcome measures: bleeding frequency, chronic pain, mortality, quality of life (QOL), and/or cost. The main findings from the 13 included articles emphasized the unmet need for reducing the economic burden with sustainable population health strategies and treatment options for PwIBDs. Rural location was also a significant contributor to both delayed diagnosis and decreased access to care. Furthermore, the need for a multidisciplinary comprehensive care team to address physical, psychosocial, and emotional needs of PwIBDs was raised as a priority target in the desire for equitable and optimal health. This systematic literature review suggests that the SDOH are associated with inferior health outcomes and may influence the clinical progression of inherited bleeding disorders.
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Affiliation(s)
- Karina Lopez
- National Hemophilia Foundation, New York, NY 10001, USA; (K.N.); (M.H.); (L.A.V.)
- Correspondence:
| | - Keri Norris
- National Hemophilia Foundation, New York, NY 10001, USA; (K.N.); (M.H.); (L.A.V.)
| | - Marci Hardy
- National Hemophilia Foundation, New York, NY 10001, USA; (K.N.); (M.H.); (L.A.V.)
| | - Leonard A. Valentino
- National Hemophilia Foundation, New York, NY 10001, USA; (K.N.); (M.H.); (L.A.V.)
- Rush University, Chicago, IL 60612, USA
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Quinn J, Delaney KA, Wong WY, Miesbach W, Bullinger M. Psychometric Validation of the Haemo-QOL-A in Participants with Hemophilia A Treated with Gene Therapy. Patient Relat Outcome Meas 2022; 13:169-180. [PMID: 35879931 PMCID: PMC9307866 DOI: 10.2147/prom.s357555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The hemophilia-specific health-related quality of life (HRQOL) questionnaire (Haemo-QOL-A) is validated for detecting QOL changes following standard therapy for hemophilia A, but has not been rigorously evaluated after gene therapy. This post hoc analysis evaluated the psychometric properties of Haemo-QOL-A in adult people with severe hemophilia A (PWSHA) receiving valoctocogene roxaparvovec (AAV5-hFVIII-SQ) in 2 clinical trials (phase 1/2, NCT02576795; phase 3, NCT03370913). Patients and Methods Adult PWSHA (factor VIII levels ≤1 IU/dL) received 1 AAV5-hFVIII-SQ infusion (6×1013 vg/kg). Participants were assessed using the Haemo-QOL-A and the EuroQOL (EQ)-5D-5L and visual analog scale (VAS) questionnaires pre- and post-infusion. Psychometric analyses included convergent and discriminant validity, internal consistency, and reliability. Clinically important difference (CID) was estimated using 3-point change in EQ-5D-5L VAS as anchor. Results Haemo-QOL-A data were analyzed from 7 (phase 1/2, 3-year follow-up) and 16 participants (phase 3, 26-week analysis). Change in Haemo-QOL-A Total Scores correlated with EQ-5D-5L VAS score change at 26 weeks (Pearson’s correlation 0.77). At 26 weeks, increased Haemo-QOL-A Physical Functioning was associated with decreased EQ-5D-5L Pain and Discomfort and decreased Anxiety and Depression (Spearman’s Rank correlations −0.73 and −0.62, respectively, P <0.01). Internal consistency analysis showed good reliability for all domains (Cronbach’s alpha >0.7) except Treatment Concern (Cronbach’s alpha = 0.31). Anchor-based CID estimates were met for Haemo-QOL-A Total Score (≥5.5) and domain scores (≥6) for Consequences of Bleeding, Physical Functioning, Role Functioning, and Worry. Conclusion Our preliminary results suggest that the Haemo‐QOL‐A is a valid, reliable instrument for HRQOL assessment in PWSHA undergoing gene therapy. Future research should be undertaken to confirm these findings in a larger number of participants.
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Affiliation(s)
- Jennifer Quinn
- BioMarin Pharmaceuticals UK Ltd, London, UK
- Correspondence: Jennifer Quinn, BioMarin Pharmaceuticals UK Ltd, 10 Bloomsbury Way, London, WC1A 2SL, UK, Tel +44 7976 129 039, Email
| | | | | | - Wolfgang Miesbach
- Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
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Heesterbeek MR, Luijten MAJ, Gouw SC, Limperg PF, Fijnvandraat K, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Flens G, Terwee CB, Peters M, Haverman L. Measuring anxiety and depression in young adult men with haemophilia using PROMIS. Haemophilia 2022; 28:e79-e82. [PMID: 35305286 DOI: 10.1111/hae.14534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M R Heesterbeek
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - M A J Luijten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands.,Amsterdam UMC, Epidemiology and Data Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - S C Gouw
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - P F Limperg
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - K Fijnvandraat
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - M J H A Kruip
- Erasmus MC, Department of Haematology Rotterdam, Erasmus University Medical Centre, The Netherlands
| | - J Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands
| | - G Flens
- Alliance for Quality in Mental Health Care, Utrecht, The Netherlands
| | - C B Terwee
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Peters
- Amsterdam UMC, Epidemiology and Data Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - L Haverman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
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Khair K, Holland M, Dodgson S, McLaughlin P, Fletcher S, Christie D. Fitness enhances psychosocial well-being and self-confidence in young men with hemophilia: Results from Project GYM. Res Pract Thromb Haemost 2021; 5:e12622. [PMID: 34870069 PMCID: PMC8626601 DOI: 10.1002/rth2.12622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/08/2021] [Accepted: 09/29/2021] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Contemporary hemophilia care supports physical activity, its benefits being well recognized. Despite recognition of the psychological challenges encountered by people with hemophilia, little is known about the psychological impact of physical fitness in this population. AIM To identify changes in psychological well-being in young men with hemophilia through participation in a gym program. METHODS This observational feasibility study of a 6-month gym participation program used validated questionnaires pre- and poststudy to evaluate motivation to exercise, physical activity levels, self-efficacy, self-esteem, and quality of life. Individual audio-recorded interviews about study participation and impact were transcribed verbatim and analyzed for recurring themes using thematic analysis. RESULTS Nineteen participants aged 18-25 years with hemophilia A or B (all severities ± inhibitor) consented to the study; two were lost to follow-up. There was a shift in motivation to exercise as shown by the Stages of Change grouping moving from contemplation to action and maintenance phases (p = 0.03). Self-efficacy overall scores showed a trend (p < 0.06) towards improvement. Median self-esteem scores improved from 22 (range 12-30, n = 19) to 25 (range 13-30, n = 17), a statistically significant change (p = 0.02). Three participants recorded scores below the accepted normal range before study, of whom two improved at study end. The key themes identified from the interviews were: fear, self-confidence, "being normal," pain, weight loss, ability, getting fitter. CONCLUSIONS The psychological wellbeing of young men with hemophilia improved during this study. This may have been related to participating in a gym-based, physical exercise program.
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Affiliation(s)
| | | | | | - Paul McLaughlin
- Katharine Dormandy Haemophilia Centre and Thrombosis UnitRoyal Free NHS Foundation TrustLondonUK
| | - Simon Fletcher
- Haemophilia CentreOxford Haemophilia and Thrombosis CentreThe Churchill HospitalOxfordUK
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Arbab Siyar N, Amiri Majd M, Baghdassarians A. The effectiveness of cognitive-behavioural therapy on emotional regulation and quality of life in children with Haemophilia. Haemophilia 2021; 27:599-605. [PMID: 33993585 DOI: 10.1111/hae.14155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/07/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
AND BACKGROUND DATA Haemophilia has known as an inherited bleeding disorder accompanied by remarkable pain, emotional distress, and impaired quality of life (QoL) and emotional regulation. Psychological interventions, such as cognitive-behavioural therapy (CBT), have cost-effectiveness to promote emotional well-being, QoL and emotional regulation; however, they have been scarcely used in the treatment of haemophilia. OBJECTIVES OF THE STUDY This research aimed at examining the effect of CBT on emotional regulation and QoL in children with haemophilia using quasi-experimental research with pretest and post-test design and a control group. METHOD 30 subjects were selected using convenient sampling and divided into two groups (n = 15). Both groups responded to the QoL questionnaire, the Persian version of the Pediatric Quality of Life Inventory (PedsQL) developed and the Cognitive Emotion Regulation Questionnaire (CERQ-k) in the pretest. The experimental group was then subjected to the CBT intervention through 9 sessions. The analysis of covariance was used for data analysis. RESULTS There was a significant increase in the QoL and emotion regulation in the experimental group than the control group. CONCLUSION The CBT training was effective to stop negative thinking and control their anger at school and also to adopt more appropriate strategies to deal efficaciously with concerns in social situations. Awareness about the thoughts, feelings and behaviours and being able to solve problems enables children to have better social relations and friendships with peers and also in other social situations. It also can increase the QoL and emotion regulation.
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Affiliation(s)
- Nikoo Arbab Siyar
- Department of General Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mojtaba Amiri Majd
- Department of Psychology, Faculty of Humanities Abhar Branch, Islamic Azad University, Abhar, Iran
| | - Anita Baghdassarians
- Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
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Ucero-Lozano R, López-Pina JA, Ortiz-Pérez A, Cuesta-Barriuso R. Quality of life and its predictors among adult patients with haemophilic arthropathy. An observational study. BMC Musculoskelet Disord 2021; 22:448. [PMID: 33992116 PMCID: PMC8126122 DOI: 10.1186/s12891-021-04319-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/05/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Recurrent hemarthrosis that begin in childhood lead to progressive joint deterioration. Patients with haemophilia have chronic pain, functional disability and a reduced perception of health-related quality of life. PURPOSE To analyse the perceived quality of life of adult patients with haemophilic arthropathy and its relationship with pain, joint condition, kinesiophobia and catastrophism. METHODS Eighty-three adult patients with haemophilia were included in this multicentre, cross-sectional, descriptive study. Perceived quality of life (36-Item Short Form Health Survey), perceived usual and maximum pain (visual analogue scale), joint condition (Haemophilia Joint Health Score), kinesiophobia (Tampa Scale of Kinesiophobia) and catastrophism (Pain Catastrophizing Scale) were assessed. Sociodemographic, clinical and therapeutic variables and drug consumption for pain control were collected. Descriptive statistics used means and standard deviations. The correlation of quality of life with the dependent variables was calculated with the Pearson correlation test. The differences in quality of life as a function of the binomial variables were calculated with Student's t-test for independent samples. RESULTS Physical component of quality of life perceived by patients with hemophilia is lower than Spanish population (30.51 VS 48.85). Regarding the mental component, patients with hemophilia showed higher values (56.07 VS 49.97). Catastrophism correlated (p < .05) with all items of quality of life questionnaire. Kinesiophobia correlated (p < .05) with all items of quality of life except to role-emotional (r = -.18; p > .05). Habitual and maximal joint pain correlated with all items except to role-emotional (r = - .19 and r = - .09, respectively) and mental component score (r = - .16 and r = - .07, respectively). Catastrophism and weekly drug intake were inversely correlated with quality of life. Age was positively correlated with perceived quality of life. There were differences in quality of life as a function of the severity of haemophilia and the intake of drugs for pain control. CONCLUSIONS The perceived quality of life of adult patients with haemophilia is worse than that of the Spanish population. Pain, kinesiophobia, catastrophism, haemophilia severity and the intake of pain-control medication influence the quality of life of these patients.
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Affiliation(s)
| | | | - Alba Ortiz-Pérez
- Health Psychologist, Free Exercise of the Profession, Madrid, Spain
| | - Rubén Cuesta-Barriuso
- Department of Physiotherapy, University of Murcia, Murcia, Spain.
- Royal Victoria Eugenia Foundation, Madrid, Spain.
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Mauser‐Bunschoten EP, Kadir RA, Laan ETM, Elfvinge P, Haverman L, Teela L, Degenaar MEL, Fransen van de Putte DE, D'Oiron R, van Galen KPM. Managing women-specific bleeding in inherited bleeding disorders: A multidisciplinary approach. Haemophilia 2021; 27:463-469. [PMID: 33314402 PMCID: PMC8246991 DOI: 10.1111/hae.14221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Multidisciplinary management of women-specific bleeding is important to preserve quality of life, healthy reproduction and social participation of women and girls with bleeding disorders (WBD). AIM To support appropriate multidisciplinary care for WBD in haemophilia treatment centres. METHODS Two case examples are presented and management issues discussed from different health care perspectives, including the nurse, patient, psychologist, gynaecologist, geneticist, psychosexual therapist and haematologist. RESULTS Woman with bleeding disorders may experience heavy menstruation from menarche onwards. This has a physical and psychosocial impact requiring a multidisciplinary approach. If a woman with an inherited bleeding disorder desires to become pregnant, preconception counselling is essential, to discuss genetic diagnosis, state of the art treatment options for the bleeding disorder in question and possible choices to prevent having an affected child, as well as maternal bleeding risks during conception, delivery and the post-partum period. CONCLUSION Adequate management and good education of WBD requires a patient-centred multidisciplinary approach with experienced specialists in a haemophilia treatment centre.
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Affiliation(s)
| | - Rezan A. Kadir
- Katharine Dormandy Haemophilia and Thrombosis UnitDepartment of Obstetrics and GynaecologyRoyal Free Foundation Hospital and Insitiute for Women's HealthUniversity College LondonLondonUK
| | - Ellen T. M. Laan
- Department of Sexology and Psychosomatic GynaecologyAmsterdam University Medical CenterAmsterdamThe Netherlands
| | - Petra Elfvinge
- Department of HaematologyKarolinska UniversityStockholmSweden
| | - Lotte Haverman
- Department of PsychologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Lorynn Teela
- Department of PsychologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | | | | | - Roseline D'Oiron
- APHP Paris SaclayHôpital BicêtreINSERM U 1176Le Kremlin BicêtreFrance
| | - Karin P. M. van Galen
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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Lopetegui Lia N, Luke A, Asad SD, Sama S, Wolansky LJ, Hegde UP. Intracranial bleeding following soccer-related head trauma in a young student with occult factor VII deficiency. Clin Case Rep 2020; 8:2148-2151. [PMID: 33235747 PMCID: PMC7669399 DOI: 10.1002/ccr3.3094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/25/2020] [Accepted: 06/04/2020] [Indexed: 11/19/2022] Open
Abstract
It is important to obtain coagulation tests to assess bleeding risk in trauma patients undergoing emergency surgery when a bleeding disorder may be obscured. Identifying specific clotting factor defects is critical in successful patient management.
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Affiliation(s)
- Nerea Lopetegui Lia
- Department of Internal MedicineUniversity of Connecticut School of MedicineFarmingtonCTUSA
| | - Abigael Luke
- Division of Hematology/OncologyDepartment of MedicineThe Carole and Ray Neag Cancer CenterUniversity of Connecticut School of MedicineFarmingtonCTUSA
| | - Syed Daniyal Asad
- Department of NeurologyUniversity of Connecticut School of Medicine/Hartford HospitalFarmingtonCTUSA
| | - Shashank Sama
- Department of Internal MedicineUniversity of Connecticut School of MedicineFarmingtonCTUSA
| | - Leo J. Wolansky
- Department of Radiology/Diagnostic ImagingUniversity of ConnecticutFarmingtonCTUSA
| | - Upendra P. Hegde
- Division of Hematology/OncologyDepartment of MedicineThe Carole and Ray Neag Cancer CenterUniversity of Connecticut School of MedicineFarmingtonCTUSA
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Limperg PF, Maurice-Stam H, Heesterbeek MR, Peters M, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Haverman L. Illness cognitions associated with health-related quality of life in young adult men with haemophilia. Haemophilia 2020; 26:793-799. [PMID: 32842171 DOI: 10.1111/hae.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 07/01/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIM Knowledge on patterns of beliefs about the illness (illness cognitions) can provide insight into individual differences in adjustment to haemophilia. The current study aimed to identify (a) which sociodemographic and disease characteristics were associated with illness cognitions and (b) which illness cognitions were associated with health-related quality of life (HRQOL) in young adult men with haemophilia, besides sociodemographic and disease characteristics. METHODS Young adult men (18-30 years) with haemophilia in the Netherlands participated in an online multicentre cross-sectional study. Participants completed the Pediatric Quality of Life Inventory Young Adult version (PedsQL_YA). Potential sociodemographic determinants were assessed with the Course of Life Questionnaire (CoLQ) and illness cognitions with the Illness Cognition Questionnaire (ICQ). Multiple linear regression analyses were performed to assess potential determinants of illness cognitions and HRQOL. RESULTS Seventy young adult men with haemophilia (mean age 24.7 years, SD 3.5) participated. Born outside the Netherlands (β -0.24) and >1 bleed past 6 months (β -0.32) were associated with less acceptance of the disease. More acceptance was associated with better HRQOL in all domains: β 0.23-0.39. More helplessness was associated with worse total (β -0.30) and physical (β -0.42) HRQOL. Disease benefits, sociodemographic and disease characteristics were not associated with HRQOL. CONCLUSION Illness cognitions are associated with HRQOL in young adult men with haemophilia. Early recognition and identification of illness cognitions are important to facilitate support and psychosocial treatment to optimize young adults' well-being. Extra attention is needed for young adult men with frequent bleeds because they are at risk of lowered levels of acceptance of the disease.
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Affiliation(s)
- Perrine F Limperg
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Madelief R Heesterbeek
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Peters
- Department of Pediatric-Hematology, Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Assessment of Self-Image With the Offer Self-Image Questionnaire in Adolescents With Hemophilia: A Single-Center Experience. J Pediatr Hematol Oncol 2020; 42:e159-e163. [PMID: 31725545 DOI: 10.1097/mph.0000000000001664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hemophilia, which is a chronic illness associated with recurrent bleeding, may occur with psychosocial and behavioral problems. AIM The aim of this study was to evaluate the clinical characteristics and demographic features and changes in the self-image of adolescents with hemophilia. MATERIALS AND METHODS Data about hemophilia type, the severity of hemophilia, secondary prophylaxis received, and annual bleeding rate (ABR) were recorded from patient files. Hemophilia Joint Health Score (HJHS) and the Offer Self-Image Questionnaire (OSIQ) (as a measure of self-esteem) were applied to hemophilia patients and a healthy control group. RESULTS Thirty-two hemophilia patients (mean age=16.2±3.06 y) and 35 healthy male individuals (mean age=16.02±1.4 y) were enrolled in the study. Hemophilia patients had lower total OSIQ score than their peers (P=0.007). There was no difference between patients who received and who did not receive secondary prophylaxis (P=0.408) in terms of total OSIQ score. The median total OSIQ score of patients with pathologic HJHS (>0 points) was lower than that of patients with normal HJHS (0 points) (P=0.010). The median of ABR was 6 (range: 0 to 20) in the whole hemophilia group. There were no differences between hemophilia patients with ABR≤4 and >4 (P=0.084). All of the subscale parameters of the OSIQ were lower for hemophilia patients compared with their peers, besides one. The subscale of sexuality attitudes was better for hemophilia patients than for the healthy control group (P=0.028). CONCLUSIONS Low self-esteem in hemophilia patients indicates the importance of lifelong psychosocial support. Patients with pathologic HJHS are at risk of low-esteem. Using OSIQ with HJHS during follow-up of hemophilia patients may be useful for management.
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Maurice‐Stam H, Nijhof SL, Monninkhof AS, Heymans HSA, Grootenhuis MA. Review about the impact of growing up with a chronic disease showed delays achieving psychosocial milestones. Acta Paediatr 2019; 108:2157-2169. [PMID: 31250466 DOI: 10.1111/apa.14918] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 01/02/2023]
Abstract
AIM This review aimed to provide a comprehensive overview of the psychosocial developmental trajectory of various diseases during childhood and adolescence. METHODS Studies of Dutch young adults aged 18-35 years, who had grown up with a chronic disease, were included if the Course of Life Questionnaire had been used to assess psychosocial developmental milestones in three domains: social, autonomy and psychosexual. Differences between the disease groups and the general population were presented as Cohen's d and odds ratios. RESULTS We included 17 studies comprising 1899 young adults, who had grown up with 18 different paediatric diseases. Psychosocial development was delayed in all three questionnaire domains. Remarkable findings with regard to specific milestones were as follows: less participation in sports clubs in the social domain, less likely to have had paid jobs in the autonomy domain and later sexual intimacy in the psychosexual domain. End-stage renal disease, galactosaemia (males), childhood cancer and orthotopic liver transplants were the most affected disease groups. CONCLUSION Children and adolescents with chronic diseases risked delays in psychosocial development. This should be addressed by healthcare providers, along with the physical aspects of diseases, and they should focus on the optimal psychosocial development of the patient.
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Affiliation(s)
- Heleen Maurice‐Stam
- Psychosocial Department Emma Children's Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Sanne L. Nijhof
- Division of Paediatrics Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Anneke S. Monninkhof
- Division of Paediatrics Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Hugo S. A. Heymans
- Department of Paediatrics Emma Children's Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Martha A. Grootenhuis
- Psychosocial Department Emma Children's Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
- Princess Máxima Center for Paediatric Oncology Utrecht The Netherlands
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13
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Limperg PF, Maurice-Stam H, Haverman L, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Peters M. Professional functioning of young adults with congenital coagulation disorders in the Netherlands. Haemophilia 2019; 25:e138-e145. [PMID: 30859671 PMCID: PMC6850762 DOI: 10.1111/hae.13698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2019] [Indexed: 01/17/2023]
Abstract
Introduction and Aim Suboptimal health‐related quality of life and lowered employment rates found in a previous study in young adults (YA) with congenital coagulation disorders (CCD) in the Netherlands underline the need for more insight into professional functioning of YA with CCD and into determinants of professional functioning. Methods Young adults (18‐30 years) with CCD participated in a cross‐sectional study. Professional functioning was assessed with the Work Productivity and Activity Impairment questionnaire (WPAI). Potential determinants were assessed with the Course of Life Questionnaire (CoLQ), Pediatric Quality of Life Inventory Young Adult version (PedsQL_YA), Illness Cognition Questionnaire (ICQ) and Haemophilia Activities List (HAL). Logistic regression analyses were performed in the complete sample of YA with CCD, and in YA men with haemophilia separately, to examine determinants of WPAI outcomes. Results Ninety‐four YA (77 men; mean age 24.1 years, SD 3.5 and 17 women; mean age 24.5 years, SD 3.8) with CCD (74% haemophilia A/B) participated. 74.5% of YA were paid employed for on average 30 hours per week. Of these, more than a quarter reported work impairment. Older age and a non‐severe type of haemophilia (in the sample of YA men with haemophilia) were associated with successful (paid) employment. No variables were associated with professional functioning (expressed as Presenteeism and Overall work impairment) in patients with CCD or haemophilia. Conclusion Three‐quarters of YA with CCD were successful in finding paid employment. Though absenteeism was low, YA with paid employment needs attention as a considerable part experienced work impairment.
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Affiliation(s)
- Perrine F Limperg
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Section Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Peters
- Department of Pediatric-Hematology and Hemophilia Comprehensive Care Treatment Center, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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14
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Rebane K, Ristolainen L, Relas H, Orenius T, Kautiainen H, Luosujärvi R, Aalto K, Säilä H. Disability and health-related quality of life are associated with restricted social participation in young adults with juvenile idiopathic arthritis. Scand J Rheumatol 2018; 48:105-113. [PMID: 30270708 DOI: 10.1080/03009742.2018.1493140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To describe a cohort of Finnish juvenile idiopathic arthritis (JIA) patients, to recognize those young adults who are at risk of becoming socially restricted by their long-term rheumatic disease, and to assess which areas of self-rated health-related quality of life (HRQoL) are associated with the emergence of restricted social participation. METHODS A total of 195 young adults with JIA completed questionnaires addressing demographics, health behaviour, physical activity, functional ability, HRQoL, depressive symptoms, and self-esteem. Patients were classified as having non-restricted social participation if they were engaged in studying, working, maternity leave, or military service, and restricted social participation if they were unemployed or on disability pension. RESULTS Of the patients, 162 (83%) were considered as having non-restricted social participation and 33 (16%) restricted social participation. Among patients with restricted social participation, five (15%) were on disability pension and 28 (85%) were unemployed. Patients with restricted social participation participated less in leisure-time non-physical activities (p = 0.033), felt more disturbed during their leisure time (p = 0.010), had lower self-esteem (p = 0.005), and had higher disability scores (p = 0.024). HRQoL scores revealed statistically significant differences between the groups: physical functioning (p = 0.043), social functioning (p = 0.016), and emotional well-being (p = 0.049) were all lower in patients with restricted social participation. CONCLUSIONS Socially restricted patients showed a higher degree of disability, and lower levels of physical functioning, self-esteem, emotional well-being, and social functioning. These patients should be recognized earlier and interventions provided to enhance their social participation.
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Affiliation(s)
- K Rebane
- a Children's Hospital , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - L Ristolainen
- b Research Institute Orton , Orton, Helsinki , Finland
| | - H Relas
- c Department of Medicine, Division of Rheumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - T Orenius
- d Orton Orthopaedic Hospital , Orton, Helsinki , Finland
| | - H Kautiainen
- e Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - R Luosujärvi
- c Department of Medicine, Division of Rheumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - K Aalto
- a Children's Hospital , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - H Säilä
- d Orton Orthopaedic Hospital , Orton, Helsinki , Finland
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15
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Limperg PF, Joosten MMH, Fijnvandraat K, Peters M, Grootenhuis MA, Haverman L. Male gender, school attendance and sports participation are positively associated with health-related quality of life in children and adolescents with congenital bleeding disorders. Haemophilia 2018; 24:395-404. [DOI: 10.1111/hae.13420] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 12/19/2022]
Affiliation(s)
- P. F. Limperg
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
| | - M. M. H. Joosten
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
| | - K. Fijnvandraat
- Department of Pediatric-Hematology; Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Emma Children's Hospital; Amsterdam The Netherlands
| | - M. Peters
- Department of Pediatric-Hematology; Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Emma Children's Hospital; Amsterdam The Netherlands
| | - M. A. Grootenhuis
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
| | - L. Haverman
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
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