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Aarnio-Peterson CM, Grange DL, Mara CA, Modi AC, North EO, Zegarac M, Stevens K, Matthews A, Mitan L, Shaffer A. Emotion coaching skills as an augmentation to family-based therapy for adolescents with anorexia nervosa: A pilot effectiveness study with families with high expressed emotion. Int J Eat Disord 2024; 57:682-694. [PMID: 38318997 PMCID: PMC10947854 DOI: 10.1002/eat.24149] [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: 09/26/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To examine the feasibility and acceptability of augmenting family-based treatment (FBT) for adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) with a parent emotion coaching intervention (EC) focused on reducing parent expressed emotion. METHOD In this pilot effectiveness trial, families of adolescents with AN/AAN exhibiting high expressed emotion received standard FBT with either (1) EC group or (2) support group (an attention control condition focused on psychoeducation). RESULTS Forty-one adolescents with AN or AAN were recruited (88% female, Mage = 14.9 ± 1.6 years, 95% White: Non-Hispanic, 1% White: Hispanic, 1% Bi-racial: Asian). Most study adolescents were diagnosed with AN (59%) while 41% were diagnosed with AAN. Participating parents were predominantly mothers (95%). Recruitment and retention rates were moderately high (76% and 71%, respectively). High acceptability and feasibility ratings were obtained from parents and interventionists with 100% reporting the EC intervention was "beneficial"-"very beneficial." The FBT + EC group demonstrated higher parental warmth scores at post-treatment compared to the control group (standardized effect size difference, d = 1.58), which was maintained at 3-month follow-up. Finally, at post-treatment, the FBT + EC group demonstrated higher rates of full remission from AN/AAN (40%) compared to FBT + support (27%), and were nine times more likely to be weight restored by 3-month follow-up. DISCUSSION Augmenting FBT with emotion coaching for parents with high expressed emotion is acceptable, feasible, and demonstrates preliminary effectiveness. PUBLIC SIGNIFICANCE Family based treatment for AN/AAN is the recommended treatment for youth but families with high criticism/low warmth are less likely to respond to this treatment. Adding a parent emotion coaching group (EC) where parents learn to talk to their adolescents about tough emotions is feasible and well-liked by families.
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Affiliation(s)
- Claire M. Aarnio-Peterson
- Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Neurosciences, The University of Chicago, Chicago, IL, USA (Emeritus)
| | - Constance A. Mara
- Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Avani C. Modi
- Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Emily Offenbacker North
- Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
| | - Miriam Zegarac
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Kimberly Stevens
- Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Abigail Matthews
- Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Laurie Mitan
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
- Cincinnati Children’s Hospital Medical Center, Division of Adolescent Medicine, Cincinnati, OH USA
| | - Anne Shaffer
- Department of Psychology, University of Georgia, Athens, GA, USA
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Nicula M, Grennan L, Loewen T, Crews E, Giuliani K, Webb C, Gouveia MR, Couturier J. Virtual parent-led peer support groups for parents of children with eating disorders: A mixed methods feasibility study. Int J Eat Disord 2023; 56:2107-2119. [PMID: 37578287 DOI: 10.1002/eat.24042] [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: 03/24/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To examine the feasibility of a virtual parent-led peer support group (vPLPSG) intervention for parents of children with eating disorders (EDs). METHODS Forty-four parents were invited to attend 2-h-long vPLPSG sessions every other week for 6 months. A convergent mixed methods design was used to integrate quantitative survey data (collected at three timepoints and analyzed using repeated measures ANOVA) and qualitative interview data (collected at 6 months and analyzed using content analysis) to assess intervention feasibility. Feasibility was comprised of acceptability (e.g., recruitment and retention rates, desire to continue attending the groups) and preliminary effectiveness (e.g., change in parents' self-reported burden). RESULTS The recruitment rate (67%), retention rate (77%), and attendance rate (60%) demonstrated adequate acceptability. All parents expressed their recommendation of this group to other parents, and most wanted to continue attending vPLPSG sessions. Participants qualitatively reported less isolation and burden as well as improvements in skills and confidence to manage their child's symptoms. These preliminary effectiveness findings were corroborated by quantitative data, with participants reporting a significant decrease in burden [mean difference (MD) = 6.61; p < .004], increase in confidence (MD = 11.17; p < .001), and decrease in unmet needs (MD = 5.03; p < .001) from baseline to 6-months. DISCUSSION The vPLPSG intervention demonstrated feasibility with respect to acceptability and improvements in preliminary parental outcomes. Future research should evaluate the effectiveness of this intervention using a larger, more diverse sample. PUBLIC SIGNIFICANCE Dedicated efforts to support caregivers, such as through virtual parent-led peer support groups, have the potential to increase confidence and decrease burden for parents managing their child's eating disorder.
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Affiliation(s)
| | | | - Techiya Loewen
- Phoenix Wings Eating Disorder Recovery Initiative, Woodstock, Ontario, Canada
| | - Erica Crews
- Reach Out Centre for Kids, Burlington, Ontario, Canada
| | | | - Cheryl Webb
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | | | - Jennifer Couturier
- McMaster University, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
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Russell H, Aouad P, Le A, Marks P, Maloney D, Touyz S, Maguire S. Psychotherapies for eating disorders: findings from a rapid review. J Eat Disord 2023; 11:175. [PMID: 37794513 PMCID: PMC10548609 DOI: 10.1186/s40337-023-00886-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Psychotherapy is considered central to the effective treatment of eating disorders-focusing on behavioural, psychological, and social factors that contribute to the illness. Research indicates psychotherapeutic interventions out-perform placebo, waitlist, and/or other treatments; but, outcomes vary with room for major improvement. Thus, this review aims to (1) establish and consolidate knowledge on efficacious eating disorder psychotherapies; (2) highlight select emerging psychotherapeutic interventions; and (3) identify knowledge gaps to better inform future treatment research and development. METHODS The current review forms part of a series of Rapid Reviews published in a special issue in the Journal of Eating Disorders to inform the development of the Australian-government-funded National Eating Disorder Research and Translation Strategy 2021-2031. Three databases were searched for studies published between 2009 and 2023, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, and population studies). Data pertaining to psychotherapies for eating disorders were synthesised and outlined in the current paper. RESULTS 281 studies met inclusion criteria. Behavioural therapies were most commonly studied, with cognitive-behavioural and family-based therapies being the most researched; and thus, having the largest evidence-base for treating anorexia nervosa, bulimia nervosa, and binge eating disorder. Other therapies, such as interpersonal and dialectical behaviour therapies also demonstrated positive treatment outcomes. Emerging evidence supports specific use of Acceptance and Commitment; Integrative Cognitive Affective; Exposure; Mindfulness; and Emotionally-Focused therapies; however further research is needed to determine their efficacy. Similarly, growing support for self-help, group, and computer/internet-based therapeutic modalities was noted. Psychotherapies for avoidant/restrictive food intake disorder; other, and unspecified feeding and eating disorders were lacking evidence. CONCLUSIONS Currently, clinical practice is largely supported by research indicating that behavioural and cognitive-behavioural psychotherapies are most effective for the treatment of eating disorders. However, the efficacy of psychotherapeutic interventions varies across studies, highlighting the need for investment and expansion of research into enhanced variants and novel psychotherapies to improve illness outcomes. There is also a pressing need for investigation into the whole range of eating disorder presentations and populations, to determine the most effective interventions.
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Affiliation(s)
- Haley Russell
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
| | - Phillip Aouad
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia.
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, Australia
| | - Peta Marks
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
| | - Danielle Maloney
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
- Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarah Maguire
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
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Kramer R, Radin R, Forsberg S, Garber AK, Reilly EE, Hail L, Huryk KM, Keyser J, Bruett LD, Le Grange D, Gorrell S, Accurso EC. An exploration of the association between premorbid weight status on patient and caregiver factors at pre and post-treatment among youth with anorexia nervosa/atypical anorexia nervosa. Eat Behav 2023; 50:101786. [PMID: 37542754 PMCID: PMC10481430 DOI: 10.1016/j.eatbeh.2023.101786] [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: 11/30/2022] [Revised: 04/03/2023] [Accepted: 07/21/2023] [Indexed: 08/07/2023]
Abstract
Patients with atypical anorexia nervosa (AAN) or anorexia nervosa (AN) with premorbid history of higher weight (PHW; median BMI ≥ 85th %ile) may report greater eating disorder (ED) pathology, anxiety, and depression, than patients with premorbid history of lower weight (PLW; mBMI <85th %ile). Less is known about caregiver attitudes or treatment outcome related to premorbid weight history. The current study examined associations between premorbid weight history and patient/caregiver factors at presentation, during treatment, and end of treatment among adolescents (N = 138) diagnosed with AN/AAN and their caregivers who received interdisciplinary ED treatment. The sample comprised adolescents with PHW (n = 58, 40.6 %) or PLW (n = 82, 59.4 %). Adolescents with PHW did not differ with regard to patient- or caregiver-reported ED symptoms, comorbid psychopathology, rates of treatment completion, and attainment of estimated body weight compared to PLW (ps > .05). Adolescents with PHW (vs. PLW) were more likely to be diagnosed with AAN (67.9 %, p < .001), identify as cisgender male (p < .001) and to have lost more weight prior to presentation (p < .001). Perceived caregiver burden was lower among adolescents with PHW vs. PLW (p < .001). Further research should expand on this preliminary study exploring associations between premorbid weight history on patient and caregiver factors at treatment presentation and conclusion to enhance the efficacy of evidence-based treatment across the weight-spectrum.
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Affiliation(s)
- Rachel Kramer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Rachel Radin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sarah Forsberg
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Erin E Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lisa Hail
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Kathryn M Huryk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jessica Keyser
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lindsey D Bruett
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Erin C Accurso
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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Matthews A, Bruening AB, Aarnio-Peterson CM, Kramer R. Predictors of caregiver burden before starting family-based treatment for adolescent anorexia nervosa and associations with weight gain during treatment. Eat Weight Disord 2023; 28:21. [PMID: 36809428 PMCID: PMC9944026 DOI: 10.1007/s40519-023-01553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/10/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE Caregivers play a pivotal role in the success of family-based treatment (FBT) for anorexia nervosa (AN). Caregiver burden is frequently demonstrated in eating disorders (EDs) and may impact FBT outcomes. This study examined factors associated with caregiver burden before starting FBT and whether pre-treatment caregiver burden was associated with weight gain during FBT. METHODS Participants included 114 adolescents with AN or atypical AN (mean age = 15.6 years, SD = 1.4) and a primary caregiver (87.6% mothers) who received FBT in the United States. Before starting treatment, participants completed self-report measures of caregiver burden (via the Eating Disorder Symptom Impact Scale), caregiver anxiety, caregiver depression, and ED symptoms. Clinical characteristics and percentage of target goal weight (%TGW) at FBT session 1 and 3 and 6 months after starting treatment were obtained via retrospective chart review. Hierarchical regressions examined predictors of caregiver burden before FBT initiation. Associations between pre-treatment caregiver burden and %TGW gain at 3 and 6 months after starting FBT were assessed with hierarchical regressions. RESULTS Caregiver anxiety (p < 0.001), family history of EDs (p = 0.028), adolescent mental health treatment history (p = 0.024), and ED symptoms (p = 0.042) predicted caregiver burden before starting FBT. Pre-treatment caregiver burden was not associated with %TGW gain at 3 or 6 months. Males demonstrated less %TGW gain than females at 3 months (p = 0.010) and 6 months (p = 0.012). CONCLUSION Proactively evaluating caregiver burden before starting FBT is suggested. Providing recommendations and/or referrals for identified caregiver vulnerabilities could indirectly impact FBT progress. Males in FBT could require longer courses of treatment and extra vigilance to this demographic is suggested. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Abigail Matthews
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Amanda B Bruening
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Claire M Aarnio-Peterson
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rachel Kramer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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Caregivers in anorexia nervosa: is grief underlying parental burden? Eat Weight Disord 2023; 28:16. [PMID: 36807834 PMCID: PMC9941225 DOI: 10.1007/s40519-023-01530-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/13/2022] [Indexed: 02/23/2023] Open
Abstract
ABSTARCT PURPOSE: Anorexia Nervosa (AN) is a severe chronic disorder and parents' experience of caregiving is usually marked by emotional distress and burden. Severe chronic psychiatric disorders are known to be linked with the concept of grief. Grief has not been investigated in AN. The aim of this study was to explore parents' and adolescents' characteristics that may be related to parental burden and grief in AN, and the link between these two dimensions. METHODS Eighty mothers, 55 fathers and their adolescents (N = 84) hospitalized for AN participated in this study. Evaluations of clinical characteristics of the adolescent's illness were completed, as well as self-evaluations of adolescent and parental emotional distress (anxiety, depression, alexithymia). Levels of parental burden were evaluated with the Experience of Caregiving Inventory and levels of parental grief with the Mental Illness Version of the Texas Revised Inventory of Grief. RESULTS Main findings indicated that the burden was higher in parents of adolescents with a more severe AN; fathers' burden was also significantly and positively related to their own level of anxiety. Parental grief was higher when adolescents' clinical state was more severe. Paternal grief was related to higher anxiety and depression, while maternal grief was correlated to higher alexithymia and depression. Paternal burden was explained by the father's anxiety and grief, maternal burden by the mother's grief and her child's clinical state. CONCLUSION Parents of adolescents suffering from AN showed high levels of burden, emotional distress and grief. These inter-related experiences should be specific targets for intervention aimed at supporting parents. Our results support the extensive literature on the need to assist fathers and mothers in their caregiving role. This in turn may improve both their mental health and their abilities as caregivers of their suffering child. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Monteleone AM, Cascino G, Salerno L, Schmidt U, Micali N, Cardi V, Treasure J. A network analysis in adolescent anorexia nervosa exploring the connection between both patient and carer reactions and outcome. EUROPEAN EATING DISORDERS REVIEW 2023; 31:65-75. [PMID: 35717595 PMCID: PMC10084280 DOI: 10.1002/erv.2933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/23/2022] [Accepted: 06/03/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This paper used network analysis to test the associations between eating disorder-related psychopathology and carers' responses to anorexia nervosa symptoms in adolescents. Additionally, the prognostic value of central and bridge network nodes was explored. METHOD This is a secondary analysis of a three-armed randomised-controlled-trial of adolescents with anorexia nervosa (n = 149) and their primary carer (n = 149) who were allocated to either treatment as usual (TAU), or one of two versions of a carer skills intervention (ECHO) added to TAU. A network analysis was run in the full sample. The prognostic role of central and bridge nodes was tested through multiple regression analyses. RESULTS Carers' depression and emotional over-involvement, as well as patients' depression showed the highest strength centrality. Patients' depression and carers' accommodation exhibited the highest bridge expected influence. Across the full sample, and in the ECHO group, carers' accommodation predicted patients' higher body mass index (BMI), while patients' depression predicted worse psychosocial functioning at 1-year follow-up. In the ECHO group, higher carers' depression also predicted lower BMI. CONCLUSIONS Carers' accommodation and depression in both carers and patients were involved in the maintenance of psychopathology in adolescents with anorexia nervosa. Depression in both patients and carers is a potential treatment target for family interventions.
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Affiliation(s)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Laura Salerno
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Ulrike Schmidt
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Valentina Cardi
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of General Psychology, University of Padova, Padova, Italy
| | - Janet Treasure
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Murali CN, Lalani SR, Azamian MS, Miyake CY, Smith HS. Quality of life, illness perceptions, and parental lived experiences in TANGO2-related metabolic encephalopathy and arrhythmias. Eur J Hum Genet 2022; 30:1044-1050. [PMID: 35691983 PMCID: PMC9436934 DOI: 10.1038/s41431-022-01127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 04/02/2022] [Accepted: 05/26/2022] [Indexed: 11/08/2022] Open
Abstract
TANGO2 disorder is a rare genetic disease with multi-system effects that causes episodic crises. Quality of life and psychosocial effects of this rare disease have not previously been studied. To examine health-related quality of life (HRQoL), illness perceptions, and lived experience, we surveyed 16 children and 31 parents of children with TANGO2 disorder identified via a disease-specific social media group and research foundation email distribution list. We assessed HRQoL by parent proxy-report and child self-report using the Pediatric Quality of Life Inventory (PedsQL™). Parental perceptions of their child's condition were assessed using the revised illness perceptions questionnaire adapted for TANGO2 disorder (IPQ-R-TANGO2). To collect qualitative data on parents' lived experience, we used novel open-ended survey questions. Parent proxy-reported (n = 29) physical (78.4 (21)) and psychosocial health (73.4 (12.8)) were highest among toddlers with TANGO2 disorder. Parent proxy-reported physical health was lowest in young adults (34.4 (35.4)), and psychosocial health was lowest in teens (40.8 (10.8)). When compared to previously published PedsQL™ scores in healthy children, parent-proxy reported summary and scale scores for TANGO2 patients were significantly lower (all p < 0.001). Parents' IPQ-R-TANGO2 responses (n = 26) suggested that parents perceived significant negative consequences of the disease. Parents' open-ended survey responses (n = 21) highlighted that they derived support from the TANGO2 community. This study characterizes HRQoL in patients with TANGO2 disorder across a range of ages, identifies potential targets for HRQoL improvement, and provides valuable insight into the psychosocial effects of TANGO2 disorder on patients and their families.
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Affiliation(s)
- Chaya N Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
| | - Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Mahshid S Azamian
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Christina Y Miyake
- Department of Pediatrics, Division of Cardiology, Texas Children's Hospital, Houston, TX, USA
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, USA
| | - Hadley Stevens Smith
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
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Bösch F, Landolt MA, Baumgartner MR, Fernandez S, Forny P, Gautschi M, Grünert SC, Häberle J, Horvath C, Karall D, Lampis D, Rohrbach M, Scholl-Bürgi S, Szinnai G, Huemer M. Caregiver burden, and parents' perception of disease severity determine health-related quality of life in paediatric patients with intoxication-type inborn errors of metabolism. Mol Genet Metab Rep 2022; 31:100876. [PMID: 35762020 PMCID: PMC9233158 DOI: 10.1016/j.ymgmr.2022.100876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background Living with a non-acute (phenylketonuria) or acute (e.g. urea cycle disorders, organic acidurias) intoxication-type inborn error of metabolism (IT-IEM) can have a substantial impact on health-related quality of life (HrQoL) of paediatric patients and their families. Parents take primary responsibility for treatment monitoring and experience worry and fear about their child's health status. Quantitative evidence on parental psychological factors which may influence the HrQoL of patients with IT-IEM are sparse to non-existent. Methods In this multicenter survey study 50 parents of IT-IEM patients (ages 5–19) assessed the severity of their child's disease, reported on caregiver burden, and proxy-rated their child's HrQoL. Additionally, 35 patient self-reports on HrQoL were obtained (n = 16 female patients, n = 19 male patients). Multiple linear regressions were conducted to examine the predictive power of child age, sex, medical diagnosis type (acute / non-acute), parental perceived disease severity and caregiver burden on patients' HrQoL. Mediation analyses were used to investigate the relation of caregiver burden and parental ratings of disease severity with patients' HrQoL. Results Significant regression models for self-reported [F(5,34) = 10.752, p < .001, R2 adj.. = 0.59] and parent proxy reported HrQoL [F(5,49) = 20.513, p < .001, R2 adj.. = 0.67] emerged. High caregiver burden and perceived disease severity predicted significantly lower patient self- and proxy-reported HrQoL while type of diagnosis (acute versus non-acute) did not. Female sex predicted significantly lower self-reported HrQoL. High caregiver burden was the mediating factor between high perceived severity of the child's disease and lower proxy- by parent rated HrQoL. Conclusion Detecting elevated burden of care and providing support for parents seems crucial to prevent adverse consequences for their children's HrQoL. Intervention studies are needed, to assess which support programs are most efficient. Caregiver burden enforced by high parent-perceived disease severity is a considerable risk factor for low HrQoL in paediatric patients with IT-IEM. The parent perspective was a better estimator for the impact of disease than the mere medical type of diagnosis. Female sex predicted lower self-reported HrQoL
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Chu SY, Wen CC, Weng CY. Gender Differences in Caring for Children with Genetic or Rare Diseases: A Mixed-Methods Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:627. [PMID: 35626804 PMCID: PMC9139271 DOI: 10.3390/children9050627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/31/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
As a factor in parenting stress, gender differences in caring for children with genetic or rare diseases warrant research attention; therefore, this study explored gender differences in parenting stress, health outcomes, and illness perceptions among caregivers of pediatric genetic or rare disease populations to improve the understanding of such gender differences. Applying a concurrent triangulation mixed-methods design, we conducted a questionnaire survey to assess study measures for 100 family caregivers (42 men and 58 women), which included a free-text response item to probe caregivers' subjective perceptions of the children's illness. The gender differences hypothesis was tested with statistics and the qualitative data about illness perception was analyzed by directed content analysis. Most female caregivers served as the primary caregivers and provided more caregiving, while they experienced significantly increased levels of parenting stress and depressive symptoms compared with male caregivers. Female caregivers perceived the conditions of their children's diseases to be highly symptomatic, with negative consequences and requiring disease control. By contrast, male caregivers had stronger perceptions regarding the negative effects of the disease on the children's quality of life. The gender discrepancy in viewpoints of illness perception sequence may contribute to female caregivers' higher levels of stress and depressive symptoms than males.
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Affiliation(s)
- Shao-Yin Chu
- Genetic Counseling Center, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 97074, Taiwan; (S.-Y.C.); (C.-Y.W.)
- Department of Pediatrics, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 97074, Taiwan
- Department of Medicine, College of Medicine, Tzu Chi University, 701, Section 3, Chung-Yang Road, Hualien 97074, Taiwan
| | - Chin-Chen Wen
- Department of Human Development and Psychology, College of Humanities and Social Sciences, Tzu Chi University, No. 67, Jieren St., Hualien 97074, Taiwan
| | - Chun-Ying Weng
- Genetic Counseling Center, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 97074, Taiwan; (S.-Y.C.); (C.-Y.W.)
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11
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Nicula M, Pellegrini D, Grennan L, Bhatnagar N, McVey G, Couturier J. Help-seeking attitudes and behaviours among youth with eating disorders: a scoping review. J Eat Disord 2022; 10:21. [PMID: 35164872 PMCID: PMC8845232 DOI: 10.1186/s40337-022-00543-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although early intervention is crucial in interrupting the development of eating disorders, little is currently known about help-seeking behaviours among individuals experiencing eating disorder symptoms. Given that eating disorders typically begin early in life, it is necessary to investigate the processes employed by children, adolescents, and emerging adults when seeking services for troubling symptoms. This is a growing concern as the COVID-19 pandemic has resulted in an increase in the number of individuals engaging in disordered eating behaviours. This scoping review explores the current state of the literature for evidence on how youth with eating disorder symptoms seek help, with the aim of better understanding how to identify and treat more individuals earlier. METHODS Using scoping review methodology, we searched seven databases for studies published from January 2000 to April 2021 that reported on help-seeking attitudes, behaviours, and healthcare utilization patterns for children and adolescents (< 18 years), emerging adults (18-25 years), and a mixture of these groups (< 25 years). Seven thousand, two hundred, and eighteen articles were identified for review. After duplicates were removed, three reviewers independently screened titles and abstracts and reviewed full-text articles. Findings related to help-seeking activity were extracted from the 62 articles that were ultimately included in this scoping review. RESULTS Study findings were summarized into help-seeking patterns (i.e., rates, types) as well as factors ranging from the individual level to society that influenced help-seeking behaviour. Many youth meeting eating disorder criteria were not seeking help. Notable barriers to help-seeking included poor mental health literacy, experiences with healthcare providers who failed to detect and lacked knowledge about eating disorders, minimal support from family and friends, and stigma surrounding eating disorders and help-seeking for mental health concerns. CONCLUSIONS The results of this scoping review can be used to inform early intervention and health promotion program development. Future research should focus on the help-seeking attitudes and activities among underrepresented groups with eating disorders (e.g., men, ethnic and gender minorities), the perspectives of family and other supporters in the help-seeking process for youth, and retrospective accounts from adults with lived experience of an eating disorder. Plain English summary Addressing and interrupting eating disorder-related thoughts and behaviours as soon as possible, with the help of a mental health professional, leads to better outcomes for youth struggling with an eating disorder. However, little is known about what prompts youth to talk about their weight, body, or eating concerns with someone-like their parent, friend, teacher, guidance counsellor, or primary care practitioner. This review explores the available published research on help-seeking patterns and preferences among youth with eating disorder concerns. Our team followed a standardized process to find 62 relevant articles for this paper. Of note, many young people who reported eating disorder concerns were not seeking help for themselves. Feeling supported by family and their primary care provider, understanding the signs of an eating disorder, and not feeling shame for reaching out for help reportedly led youth to speak up about their concerns. The findings have clinical implications for learning effective ways to help youth feel safe to speak freely about their eating disorder-related concerns, which enhances the chances of intervening early and catching symptoms before they worsen.
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Affiliation(s)
- Maria Nicula
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | | | - Laura Grennan
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - Neera Bhatnagar
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - Gail McVey
- University Health Network, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Jennifer Couturier
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada. .,McMaster Children's Hospital, Hamilton, ON, Canada.
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12
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Giles EM, Cross AS, Matthews RV, Lacey JH. Disturbed families or families disturbed: a reconsideration. Eat Weight Disord 2022; 27:11-19. [PMID: 33721219 PMCID: PMC8860793 DOI: 10.1007/s40519-021-01160-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 01/25/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The relationship between anorexia nervosa (AN) and family disturbance has been a subject of debate since its first description. What began as a clear view of the pathologically disturbed family causing AN has become ever more complex over the decades. OBJECTIVE The aim of this review is to explore the literature to examine the changes and evolution of clinical opinion around family dysfunction and AN over the last 20 years. METHODS A narrative review of heterogeneous studies in peer-reviewed publications sourced from the major databases, including PubMed and ScienceDirect, to illuminate the topic of family distress and AN by highlighting the conflicting and complementary ways it has been studied. RESULTS This review has highlighted the complexity of the relationship between anorectic sufferers and their families. It has explored the literature about parental burden, emotions and cognitive mechanisms together with parental attitudes about weight and shape. It is clear that there is no consistent psycho-social pathology in families which has been shown to be causative. However, over the last twenty years, research has highlighted the distress and family dysfunction caused by having to look after an anoretic child with poor mentalisation skills, insecure attachment and emotion dysregulation. CONCLUSION The area has become clearer over the last 20 years; research suggests a bi-directional relationship between AN and family dysfunction, with difficult dynamics becoming entrenched within the family. This is best addressed, the consensus suggests, by specialist family therapy and carer skills interventions. Longitudinal research is needed to definitively answer the question with rigorous scientific certainty. EMB RATING Level V. LEVEL OF EVIDENCE Level I: Evidence obtained from: at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies. Level II: Evidence obtained from well-designed controlled trials without randomization. Level III: Evidence obtained from well-designed cohort or case-control analytic studies. Level IV: Evidence obtained from with multiple time series analysis such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence. Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
| | | | | | - J Hubert Lacey
- Schoen Clinic Newbridge, Birmingham, UK.
- St Georges, University of London, London, UK.
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13
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Collins MKR, Lazard AJ. How Narrative Engagement with Young Adult Literature Influences Perceptions of Anorexia Nervosa. HEALTH COMMUNICATION 2021; 36:1646-1655. [PMID: 32615042 DOI: 10.1080/10410236.2020.1785375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Narratives have been shown to alter health beliefs through a process called narrative engagement; however, this process has yet to be empirically investigated for how the increasingly popular young adult (YA) novel format can impact health beliefs about anorexia nervosa among emerging adults. Using an experimental design, we found that the YA format fosters narrative engagement through mechanisms of transportation, which is associated with greater endorsement of accurate social and emotional beliefs about anorexia nervosa. Compared to an informational brochure, the narrative format where the main character was a "supportive peer" (but not experiencing the illness herself) increased self-referencing and was perceived as more relevant among emerging adult participants. Results suggest narratives may be viable tools to communicate about little understood social and emotional aspects of chronic diseases with emerging adults, who are more likely to provide support for sick peers than experience chronic illnesses. Encouraging narrative engagement could facilitate a better understanding of the social and emotional complexity of anorexia nervosa and improve the quality of peer interactions.
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Affiliation(s)
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina
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14
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Wu YK, Brownley KA, Bardone-Cone AM, Bulik CM, Baker JH. Associations of Stress and Appetite Hormones with Binge Eating in Females with Anorexia Nervosa after Weight Restoration: A Longitudinal Study. J Pers Med 2021; 11:jpm11101020. [PMID: 34683161 PMCID: PMC8538976 DOI: 10.3390/jpm11101020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/29/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023] Open
Abstract
Binge eating is a transdiagnostic eating disorder symptom that can occur in patients with anorexia nervosa (AN), persisting after weight restoration, and impeding their recovery. However, little is known about the biological predictors of binge eating after AN weight restoration. The goals of this exploratory study of 73 females with AN were: (1) to examine changes in cortisol, the adrenocorticotropic hormone, norepinephrine, ghrelin (total and active), and leptin levels across the admission, discharge, and 3 months post-discharge from the inpatient AN weight restoration; and (2) to determine whether the target hormones were associated with objective or subjective binge eating (OBE or SBE). The participants completed the self-reported Eating Disorder Examination Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory-II, and provided fasting whole blood samples for hormone assays. The results showed significant changes in body mass index (BMI), cortisol, total ghrelin, and leptin levels over the three time points. The cortisol levels at admission and discharge were significantly associated with the number of SBE episodes at 3 months post-discharge. Findings suggest the need to replicate and confirm the role of cortisol in predicting the emergence of SBE and uncover the mechanisms underlying SBE and cortisol to prevent SBE and its negative consequences.
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Affiliation(s)
- Ya-Ke Wu
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.A.B.); (C.M.B.)
| | - Kimberly A. Brownley
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.A.B.); (C.M.B.)
| | - Anna M. Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.A.B.); (C.M.B.)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Solna, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jessica H. Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.A.B.); (C.M.B.)
- Correspondence: ; Tel.: +1-984-974-3834
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15
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Harrop EN, Mensinger JL, Moore M, Lindhorst T. Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature. Int J Eat Disord 2021; 54:1328-1357. [PMID: 33864277 PMCID: PMC9035356 DOI: 10.1002/eat.23519] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Currently, there is debate in the eating disorders field regarding how to define atypical anorexia (AAN), how prevalent it is in community and clinical settings, and how AAN rates compare with low-weight AN. This systematic review assesses AAN literature from 2007 to 2020, to investigate: (a) the demographic characteristics of AAN studies, (b) the prevalence of AAN compared with AN, (c) the range of operational definitions of AAN and the implications of these definitions, and (d) the proportion of patients with AAN and AN represented in consecutive admission and referral samples. METHOD PsychINFO, CINAHL, PubMed, Greylit.org, and ProQuest databases were searched according to methods for Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic reviews, yielding 3,184 potential articles. Seventy-five eligible studies were coded for sixty-one variables. RESULTS Clinical samples predominantly included younger, female, white samples with limited diversity. In epidemiological designs, AAN was typically as common or more common than AN, and AAN rates varied significantly based on the population studied and operational definitions. In consecutive clinical samples, AAN was frequently less represented. DISCUSSION Although AAN appears to occur more frequently than AN in communities, fewer patients with AAN are being referred and admitted to eating disorder specific care, particularly in the United States. Given the significant medical and psychosocial consequences of AAN, and the importance of early intervention, this represents a crucial treatment gap. Additionally, results suggest the need for fine-tuning diagnostic definitions, greater diversity in AAN studies, and increased screening and referral for this vulnerable population.
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Affiliation(s)
- Erin N. Harrop
- Graduate School of Social Work, University of Denver, Denver, Colorado,School of Social Work, University of Washington, Seattle, Washington
| | | | - Megan Moore
- School of Social Work, University of Washington, Seattle, Washington
| | - Taryn Lindhorst
- School of Social Work, University of Washington, Seattle, Washington
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16
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Naimi E, Babuei A, Moslemirad M, Rezaei K, Eilami O. The Effect of Spirituality Intervention on the Anxiety Parents of Hospitalized Newborns in a Neonatal Department. JOURNAL OF RELIGION AND HEALTH 2021; 60:354-361. [PMID: 30715661 DOI: 10.1007/s10943-018-00753-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Admission leads to many problems in the family, one of the most important of which is Stress parents. Therefore, specify The Effect of Religious Intervention on the Anxiety parents of hospitalized newborns in a neonatal department. The study was a semi-experimental study with experimental and control groups and before and after the intervention, Anxiety and care pressure questionnaires were given to parents. The religion intervention in the 8 Session parents of hospitalized newborns in a neonatal. Data were analyzed by SPSS16 and descriptive and analytical tests. The study indicated that religion has an effective role in enhancing and bettering stress of parents. Thus, it is suggested that a cleric be present in the section for religious intervention. Moreover, it is suggested that religious interventions should be done by nurses as a group of people with a close relationship with the patients and their parents.
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Affiliation(s)
- Ebrahim Naimi
- Department of Public Health, Faulty of Health, Yasuj University of Medical Science, Yasuj, Iran
| | - Amin Babuei
- Deputy of Development of Managment, Yasuj University of Medical Science, Yasuj, Iran
| | | | - Karim Rezaei
- Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Owrang Eilami
- School of Medicine Social, Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
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17
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Abstract
PURPOSE OF REVIEW To review the recent literature on the burden of eating disorders in terms of mortality, disability, quality of life, economic cost, and family burden, compared with people without an eating disorder. RECENT FINDINGS Estimates are that yearly over 3.3 million healthy life years worldwide are lost because of eating disorders. In contrast to other mental disorders, in anorexia nervosa and bulimia nervosa years lived with disability (YLDs) have increased. Despite treatment advances, mortality rates of anorexia nervosa and bulimia nervosa remain very high: those who have received inpatient treatment for anorexia nervosa still have a more than five times increased mortality risk. Mortality risks for bulimia nervosa, and for anorexia nervosa treated outside the hospital, are lower but still about twice those of controls. In people with an eating disorder, quality of life is reduced, yearly healthcare costs are 48% higher than in the general population, the presence of mental health comorbidity is associated with 48% lower yearly earnings, the number of offspring is reduced, and risks for adverse pregnancy and neonatal outcomes are increased. SUMMARY People with a current or former eating disorder are at risk of increased mortality, high YLD rates, a reduced quality of life, increased costs, and problems with childbearing.
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18
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Kurauchi G, Endo M, Odaira K, Ono R, Koseki A, Goto M, Sato Y, Kon S, Watanabe N, Sugawara N, Kimura E, Takada H. Caregiver Burden and Related Factors Among Caregivers of Patients with Myotonic Dystrophy Type 1. J Neuromuscul Dis 2020; 6:527-536. [PMID: 31640106 DOI: 10.3233/jnd-190386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Multi-systemic symptoms of varying severity in myotonic dystrophy type 1 (DM1) may pose difficulties in caregiving. However, the factors which affect their care burden are yet to be sufficiently understood. OBJECTIVE We investigated care burden and its correlates among caregivers of patients with DM1. METHODS General demographic information was obtained from patients with DM1, as well as Barthel index (ADL), body mass index, and genetic information. Patients completed SF-36v2 (health-related quality of life), CES-D (depressive symptoms), and ESS (daytime sleepiness) questionnaires. Caregivers reported their perception of patient's status through these questionnaires, and completed Zarit Caregiver Burden Interview (ZBI). Correlation analysis of these variables were performed, and regression analysis was utilized to assess the relationship between caregiver burden and other variables. RESULTS Forty-three patient-caregiver dyads participated. Mean ZBI score was 20.7±17.4, and 32.6% reported a significant care burden. ZBI correlated with caregiver-reported CES-D, but not with patient-reported CES-D. Both patient-reported and caregiver-reported physical QoL of patients correlated with patient ADL. Multiple regression analysis revealed that the combination of caregiver-reported CES-D, caregiver-reported mental QoL, and genetic characteristics predicted caregiver burden. CONCLUSIONS Caregiver burden was felt although patients were relatively well-functioning. Patients' and caregivers' assessment of patients' physical condition were similar. However, they did not agree on the evaluation of the patients' psychological state. Cognitive characteristic of the patients and the caregivers' perception of the patients' state may have affected the results. Future DM1 care strategies need to work on improvement of patient-caregiver communication and provide support for the caregiver's psychological health.
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Affiliation(s)
- Go Kurauchi
- Department of Rehabilitation, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Makiko Endo
- Clinical Research Unit, National Center Hospital, National Center of Neurology and Psychiatry, Ogawahigashi-cho, Kodaira, Tokyo, Japan
| | - Kaori Odaira
- Regional Medical Liaison Office, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Ryohei Ono
- Section for Development and Disability Training, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Atsushi Koseki
- Section for Development and Disability Training, National Hospital Organization, Hanamaki Hospital, Suwa, Hanamaki, Iwate, Japan
| | - Momoko Goto
- Section for Development and Disability Training, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Yumi Sato
- Department of Rehabilitation, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Seiko Kon
- Department of Neurology, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Norio Watanabe
- School of Public Health, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - En Kimura
- Department of Clinical Research Support, Translational Medical Center, National Center of Neurology and Psychiatry, Ogawahigashi-cho, Kodaira, Tokyo, Japan
| | - Hiroto Takada
- Department of Neurology, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
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19
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Dimitropoulos G, Landers A, Freeman V, Novick J, Schmidt U, Olmsted M. A feasibility study comparing a web‐based intervention to a workshop intervention for caregivers of adults with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2019; 27:641-654. [DOI: 10.1002/erv.2678] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 12/14/2022]
Affiliation(s)
| | - Ashley Landers
- Human Development and Family ScienceVirginia Polytechnic Institute and State University Falls Church Virginia
| | - Victoria Freeman
- University Health NetworkToronto General Hospital Toronto Ontario Canada
| | - Jason Novick
- Department of SociologyMount Royal University Calgary Alberta Canada
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
| | - Marion Olmsted
- University Health NetworkToronto General Hospital Toronto Ontario Canada
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