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Bent MA, Valenzuela-Moss JN, Smith KA, Castillo P, Van Speybroeck A, Omar H, Antoniak K, Lin A, Wren TAL. Using a mobile health app in a weight management program for overweight and obese adolescents and young adults with spina bifida. J Spinal Cord Med 2023:1-10. [PMID: 37769142 DOI: 10.1080/10790268.2023.2231675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
CONTEXT Adolescents and young adults (AYA) with spina bifida (SB) are more susceptible to obesity due to impaired mobility. There is limited access to physical activity for this population. OBJECTIVE The primary aim of this study was to evaluate the feasibility of a mobile health app in a weight management program for AYA with SB. This was determined by measuring program adherence, active use of the app (defined as ≥3 uses per week), and user rating of the Pt Pal™ mobile app. Secondary outcomes were changes in BMI, quality of life, and health behavior, and the number of active participants over time. METHODS Patients from the SB Clinic of a large metropolitan hospital between the ages of 11-21 years and overweight were invited to participate. The program consisted of group nutrition sessions and an individualized exercise plan using a mobile app with coaching. Outcome measures were program adherence, changes in BMI, and validated survey responses. Descriptive statistical analysis was performed. RESULTS Fifteen participants enrolled, and ten participants completed the program. Five of the ten participants attended the nutrition sessions. The number of active app users declined after the first week. Seventy percent of participants decreased their BMI. Most participants reported the program improved their ability to exercise regularly, eat a healthier diet and feel more self-confident. Peds QL™ psychosocial health domains increased postintervention. The YRBS showed increased physical activity and less sedentary time postintervention. CONCLUSIONS This mobile app-based weight management program with coaching implemented may not be feasible for adoption in the general population of AYA with SB; however, it was well received by some, and further testing is needed to determine how to improve feasibility. This study provides useful information to guide future programs utilizing digital health and coaching.
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Affiliation(s)
- Melissa A Bent
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, California, USA
- Spina Bifida Clinic, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Kathryn A Smith
- Spina Bifida Clinic, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Patricia Castillo
- Spina Bifida Clinic, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Alexander Van Speybroeck
- Spina Bifida Clinic, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Hanna Omar
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Katherine Antoniak
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Adrian Lin
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Tishya A L Wren
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Moore RP, Burjek NE, Brockel MA, Strine AC, Acks A, Boxley PJ, Chidambaran V, Vricella GJ, Chu DI, Sankaran-Raval M, Zee RS, Cladis FP, Chaudhry R, O'Reilly-Shah VN, Ahn JJ, Rove KO. Evaluating the role for regional analgesia in children with spina bifida: a retrospective observational study comparing the efficacy of regional versus systemic analgesia protocols following major urological surgery. Reg Anesth Pain Med 2023; 48:29-36. [PMID: 36167478 PMCID: PMC10026848 DOI: 10.1136/rapm-2022-103823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/15/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Regional techniques are a key component of multimodal analgesia and help decrease opioid use perioperatively, but some techniques may not be suitable for all patients, such as those with spina bifida. We hypothesized peripheral regional catheters would reduce postoperative opioid use compared with no regional analgesia without increasing pain scores in pediatric patients with spina bifida undergoing major urological surgery. METHODS A retrospective review of a multicenter database established for the study of enhanced recovery after surgery was performed of patients from 2009 to 2021 who underwent bladder augmentation or creation of catheterizable channels. Patients without spina bifida and those receiving epidural analgesia were excluded. Opioids were converted into morphine equivalents and normalized to patient weight. RESULTS 158 patients with pediatric spina bifida from 7 centers were included, including 87 with and 71 without regional catheters. There were no differences in baseline patient factors. Anesthesia setup increased from median 40 min (IQR 34-51) for no regional to 64 min (IQR 40-97) for regional catheters (p<0.01). The regional catheter group had lower median intraoperative opioid usage (0.24 vs 0.80 mg/kg morphine equivalents, p<0.01) as well as lower in-hospital postoperative opioid usage (0.05 vs 0.23 mg/kg/day morphine equivalents, p<0.01). Pain scores were not higher in the regional catheters group. DISCUSSION Continuous regional analgesia following major urological surgery in children with spina bifida was associated with a 70% intraoperative and 78% postoperative reduction in opioids without higher pain scores. This approach should be considered for similar surgical interventions in this population. TRIAL REGISTRATION NUMBER NCT03245242.
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Affiliation(s)
- Robert P Moore
- Department of Anesthesiology, Division of Pediatric Anesthesiology, Stony Brook Children's Hospital, Stony Brook, New York, USA
| | - Nicholas E Burjek
- Division of Pediatric Anesthesiology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Megan A Brockel
- Division of Pediatric Anesthesiology, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Anesthesiology, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Andrew C Strine
- Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Austin Acks
- Department of Surgery, Division of Urology, Washington University in St Louis, St. Louis, Missouri, USA
| | - Peter J Boxley
- Department of Surgery, Division of Urology, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Vidya Chidambaran
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Gino J Vricella
- Department of Surgery, Division of Urology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
- Department of Pediatric Urology, St Louis Children's Hospital, St Louis, Missouri, USA
| | - David I Chu
- Division of Urology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Marie Sankaran-Raval
- Division of Pediatric Anesthesiology, Children's Hospital of Richmond at VCU, Richmond, Virginia, USA
| | - Rebecca S Zee
- Division of Urology, Children's Hospital of Richmond at VCU, Richmond, Virginia, USA
| | - Franklyn P Cladis
- Department of Anesthesiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Rajeev Chaudhry
- Division of Pediatric Urology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Vikas N O'Reilly-Shah
- Department of Pediatric Anesthesiology, University of Washington, Seattle, Washington, USA
- Deperatment of Pedaitric Anesthesiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Jennifer J Ahn
- Department of Urology, University of Washington, Seattle, Washington, USA
- Department of Urology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Kyle O Rove
- Department of Surgery, Division of Urology, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Department of Pediatric Urology, Children's Hospital Colorado, Aurora, Colorado, USA
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Rague JT, Kim S, Hirsch J, Meyer T, Rosoklija I, Larson JE, Swaroop VT, Bowman R, Bowen DK, Cheng EY, Gordon EJ, Holmbeck G, Chu DI, Isakova T, Yerkes EB, Chu DI. The Association of Health Literacy with Health-Related Quality of Life in Youth and Young Adults with Spina Bifida: A Cross-Sectional Study. J Pediatr 2022; 251:156-163.e2. [PMID: 35970239 PMCID: PMC9843738 DOI: 10.1016/j.jpeds.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The objective of the study was to determine if health literacy is associated with health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with spina bifida. STUDY DESIGN Between June 2019 and March 2020, the Patient-Reported Outcome Measurement Information System Pediatric Global Health-7 (PGH-7), a measure of HRQOL, and the Brief Health Literacy Screening Tool (BRIEF) were administered to patients ≥12 years old with a diagnosis of spina bifida seen in our multidisciplinary spina bifida center. Questionnaires were completed at scheduled clinic visits. The primary outcome was the PGH-7 normalized T-score. The primary exposure was the BRIEF score. Demographic and clinical characteristics were obtained from the medical record. Nested, multivariable linear regression models assessed the association between health literacy and the PGH-7 score. RESULTS Of 232 eligible patients who presented to clinic, 226 (97.4%) met inclusion criteria for this study. The median age was 17.0 years (range: 12-31). Most individuals were female (54.0%) and had myelomeningocele (61.5%). Inadequate, marginal, and adequate health literacy levels were reported by 35.0%, 28.3%, and 36.7% of individuals. In univariable analysis, higher health literacy levels were associated with higher PGH-7 scores. In nested, sequentially adjusted multivariable linear regression models, a higher health literacy level was associated with a stepwise increase in the PGH-7 score. In the fully adjusted model, adequate health literacy and marginal health literacy, compared with inadequate health literacy, were associated with increases in a PGH-7 score of 3.3 (95% CI: 0.2-6.3) and 1.1 (95% CI: -2.0 to 4.2), respectively. CONCLUSIONS Health literacy was associated with HRQOL after adjusting for demographic and clinical factors. Strategies incorporating health literacy are needed to improve HRQOL in AYAs with spina bifida.
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Affiliation(s)
- James T Rague
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Soojin Kim
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Josephine Hirsch
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Theresa Meyer
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Ilina Rosoklija
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Jill E Larson
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Vineeta T Swaroop
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Robin Bowman
- Division of Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Diana K Bowen
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Earl Y Cheng
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Elisa J Gordon
- Department of Surgery-Division of Transplantation, Center of Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Grayson Holmbeck
- Department of Psychology, Loyola University of Chicago, Chicago, IL
| | - Daniel I Chu
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Tamara Isakova
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, and Division of Nephrology and Hypertension, Feinberg School of Medicine at Northwestern University, Chicago, IL
| | - Elizabeth B Yerkes
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - David I Chu
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
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Simpson TS, Grande LA, Kenny JJ, Wilson PE, Peterson RL. Child, Parent, and Family Adjustment for Patients Followed in a Multidisciplinary Spina Bifida Clinic. Top Spinal Cord Inj Rehabil 2022; 28:41-58. [PMID: 36017123 DOI: 10.46292/sci21-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives To characterize child, parent, and family adjustment for patients followed in a multidisciplinary spina bifida (SB) clinic. Methods Participants were drawn from clinical cases seen through a multidisciplinary outpatient SB clinic at a children's hospital between 2017 and 2019. Participants included 209 youth under 19 years old who were diagnosed with SB and their parents. Self-reported internalizing symptoms were measured in youth in grade 3 through 12 using the 25-item Revised Children's Anxiety and Depression Scale-25 (RCADS-25). Self- and parent-reported quality of life and family functioning were obtained using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and Family Impact Modules. Results A total of 45.7% of children and adolescents reported at-risk psychosocial functioning on the PedsQL. In contrast, only 5% of patients reported clinically elevated internalizing symptoms on the RCADS. Parents' quality of life and family functioning in the study were higher than in most studies of parents of children with other chronic health conditions, children with attention deficit-hyperactivity disorder, and healthy control samples. Conclusion Our findings indicate that children and adolescents with SB are at risk for poor health-related quality of life (HRQOL); however, poorer HRQOL may not necessarily be associated with more severe psychiatric symptoms in this population. Examining resilience factors that may help to buffer against challenges to HRQOL will be important in informing future interventions.
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Affiliation(s)
- Tess S Simpson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Leah A Grande
- Department of Psychology, University of Denver, Denver, Colorado
| | - Jessica J Kenny
- Department of Psychiatry, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Pamela E Wilson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Robin L Peterson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
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Benninger I, Lampart P, Mueller G, Augutis M, Eriks-Hoogland I, Grunt S, Kelly EH, Padden B, Scherer C, Shavit S, Taylor J, Rutz E, Scheel-Sailer A, Pepsci-Collaboration. Needs and Research Priorities for Young People with Spinal Cord Lesion or Spina Bifida and Their Caregivers: A National Survey in Switzerland within the PEPSCI Collaboration. Children (Basel) 2022; 9:318. [PMID: 35327690 DOI: 10.3390/children9030318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to describe the needs and research priorities of Swiss children/adolescents and young adults (from here, “young people”) with spinal cord injury/disorder (SCI/D) or spina bifida (SB) and their parents in the health and life domains as part of the international Pan-European Pediatric Spinal Cord Injury (PEPSCI) collaboration. Surveys included queries about the satisfaction, importance, research priorities, quality of life (QoL), and characteristics of the young people. Fifty-three surveys with corresponding parent-proxy reports were collected between April and November 2019. The self-report QoL sum scores from young people with SCI/D and SB were 77% and 73%, respectively. Parent-proxy report QoL sum scores were lower, with 70% scores for parents of young people with SCI/D and 64% scores for parents of young people with SB. “Having fun”, “relation to family members”, and “physical functioning” were found to be highly important for all young people. “Physical functioning”, “prevention of pressure injuries”, “general health”, and “bowel management” received the highest scores for research priority in at least one of the subgroups. As parents tend to underestimate the QoL of their children and young people prioritized research topics differently, both young peoples’ and caregivers’ perspectives should be included in the selection of research topics.
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Nikitina IL, Kelmanson IA. Health-related quality of life in 4-to-6-year-old children with type 1 diabetes mellitus estimated by children and their mothers. Eur J Pediatr 2022; 181:549-560. [PMID: 34424400 PMCID: PMC8380516 DOI: 10.1007/s00431-021-04239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/29/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
Administration of pediatric Health Related Quality of Life (HRQoL) inventories frequently assesses both the child and parent perspectives in young children with type 1 diabetes mellitus (T1DM), but parent-proxy and child self-reports may differ, and little is known on these discrepancies. The aim is to evaluate HRQoL estimated by young children with T1DM and by their mothers, potential discrepancies in the children-maternal estimates and the factors influencing these discrepancies. Thirty-five 4-to-6-year-old children (19 boys) with T1DM admitted to the Pediatric Endocrinology Department were approached with the self-report KINDL questionnaire for children aged 4-6 years (Kiddy-KINDL for children). Their mothers were approached with the parental version (Kiddy-KINDL for parents). Both versions enable measuring child HRQoL in physical, emotional wellbeing, self-esteem, family, friends, everyday functioning, and the disease dimensions, as well as KINDL total on a 0-100 scale. Statistically significant differences were found between children's and maternal estimates on the KINDL total and "Disease" scales, in that the maternal proxy-reports produced lower values. A statistically significant difference between self- and proxy-reports was found for the KINDL "Emotional wellbeing" scale values, and the maternal proxy-reports yielded higher estimates compared with children's self-reports. These associations remained significant after adjustment for major potential confounders. Maternal education, maternal marital status, insulin regimen, and achievement of glycemic control modified the effect of child-maternal discrepancies.Conclusion: Attempts should be made to improve parental understanding of child problems related to his/her disease with due account to individual family social and demographic characteristics. What is Known: • HRQoL in children with T1DM has been advocated as an important complementary outcome to clinical and laboratory markers. • Self-and parental proxy-reports on HRQoL may differ, but little is known on these discrepancies and on the factors influencing them in young children with T1DM. What is New: • Mothers tend to underestimate general and disease-related components of HRQoL but likely to overestimate psychological wellbeing of their ill young children with T1DM. • Maternal education, marital status, insulin regimen, and achievement of glycemic control modify estimations of HRQoL and child-maternal discrepancies.
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Affiliation(s)
- Irina L. Nikitina
- Department of Children’s Diseases, Institute for Medical Education of the V.A.Almazov National Medical Research Centre, Akkuratova Str., 2, 197341 St. Petersburg, Russia
| | - Igor A. Kelmanson
- Department of Children’s Diseases, Institute for Medical Education of the V.A.Almazov National Medical Research Centre, Akkuratova Str., 2, 197341 St. Petersburg, Russia
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Kamath NN, Kulesz PA, Fletcher JM, Houtrow AJ, Treble-Barna A. Association of ethnicity and adaptive functioning with health-related quality of life in pediatric myelomeningocele. J Pediatr Rehabil Med 2022; 15:571-580. [PMID: 36442218 PMCID: PMC10010265 DOI: 10.3233/prm-220021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate associations of ethnicity and adaptive function with health-related quality of life (HRQOL) in youths with spina bifida myelomeningocele (SBM). METHODS Participants included Hispanic (n = 75) and non-Hispanic White (n = 86) children and adolescents with SBM. Participants completed ratings of adaptive function and SBM-specific HRQOL. A series of linear multiple regression models was computed to investigate whether ethnicity moderates the relation between adaptive function and HRQOL. RESULTS Results showed that greater adaptive function was associated with higher HRQOL. While no relations were found between ethnicity and HRQOL, a significant interaction was observed between adaptive function and ethnicity over and above other terms. Although groups did not differ on HRQOL at lower levels of adaptive function, Hispanic participants rated higher HRQOL relative to non-Hispanic White participants at higher levels of adaptive function. Further analysis showed this was true of both nonmotor and motor aspects of adaptive function. CONCLUSION Results suggested complex relations between ethnicity and adaptive function with HRQOL, highlighting the importance of optimizing adaptive functioning in youth with SBM.
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Affiliation(s)
- Navya N Kamath
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem, Chicago, IL, USA
| | - Paulina A Kulesz
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jack M Fletcher
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Amy J Houtrow
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Pediatric Rehabilitation Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Amery Treble-Barna
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Pediatric Rehabilitation Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Holmbeck GN, Kritikos TK. Psychosocial Adjustment in Emerging Adults With and Without Spina Bifida: A 14-Year Follow-up Study. J Dev Behav Pediatr 2022; 43:e20-e28. [PMID: 34016827 PMCID: PMC8602426 DOI: 10.1097/dbp.0000000000000956] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/01/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE A 14-year follow-up of youth with spina bifida (SB), as compared to a matched comparison sample without a chronic health condition, focused on psychosocial adjustment during emerging adulthood (ages 22-23). METHODS The initial cohort at time 1 consisted of 68 families with an 8-year-old or 9-year-old child with SB and a matched comparison sample of 68 typically developing children and their families. At the final assessment (time 7), participants included 56 emerging adults with SB (82% of those who participated at time 1) and 62 comparison youth (91% of those who participated at time 1) who completed a set of self-report measures. RESULTS Emerging adults with SB continue to lag behind across several important developmental milestones, including decision-making responsibility, involvement in social and romantic relationships, sexual intimacy, educational and vocational achievement, financial independence, and engagement in health-related behaviors. However, from a resilience perspective, these individuals also exhibited a number of strengths across the following areas: identity development, quality of social supports, and fewer problem behaviors (e.g., alcohol and other substance use). Most findings were still significant after controlling for a verbal intelligence quotient proxy. CONCLUSION This study highlighted vulnerabilities and strengths of individuals with SB as they enter emerging adulthood, with considerable continuity across childhood, adolescence, and emerging adulthood.
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Keller M, Brennenstuhl H, Kuseyri Hübschmann O, Manti F, Julia Palacios NA, Friedman J, Yıldız Y, Koht JA, Wong SN, Zafeiriou DI, López-Laso E, Pons R, Kulhánek J, Jeltsch K, Serrano-Lomelin J, Garbade SF, Opladen T, Goez H, Burlina A, Cortès-Saladelafont E, Fernández Ramos JA, García-Cazorla A, Hoffmann GF, Kiat Hong ST, Honzík T, Kavecan I, Kurian MA, Leuzzi V, Lücke T, Manzoni F, Mastrangelo M, Mercimek-Andrews S, Mir P, Oppebøen M, Pearson TS, Sivri HS, Steel D, Stevanović G, Fung CW. Assessment of intellectual impairment, health-related quality of life, and behavioral phenotype in patients with neurotransmitter related disorders: Data from the iNTD registry. J Inherit Metab Dis 2021; 44:1489-1502. [PMID: 34245036 DOI: 10.1002/jimd.12416] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/30/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022]
Abstract
Inherited disorders of neurotransmitter metabolism are a group of rare diseases, which are caused by impaired synthesis, transport, or degradation of neurotransmitters or cofactors and result in various degrees of delayed or impaired psychomotor development. To assess the effect of neurotransmitter deficiencies on intelligence, quality of life, and behavior, the data of 148 patients in the registry of the International Working Group on Neurotransmitter Related Disorders (iNTD) was evaluated using results from standardized age-adjusted tests and questionnaires. Patients with a primary disorder of monoamine metabolism had lower IQ scores (mean IQ 58, range 40-100) within the range of cognitive impairment (<70) compared to patients with a BH4 deficiency (mean IQ 84, range 40-129). Short attention span and distractibility were most frequently mentioned by parents, while patients reported most frequently anxiety and distractibility when asked for behavioral traits. In individuals with succinic semialdehyde dehydrogenase deficiency, self-stimulatory behaviors were commonly reported by parents, whereas in patients with dopamine transporter deficiency, DNAJC12 deficiency, and monoamine oxidase A deficiency, self-injurious or mutilating behaviors have commonly been observed. Phobic fears were increased in patients with 6-pyruvoyltetrahydropterin synthase deficiency, while individuals with sepiapterin reductase deficiency frequently experienced communication and sleep difficulties. Patients with BH4 deficiencies achieved significantly higher quality of life as compared to other groups. This analysis of the iNTD registry data highlights: (a) difference in IQ and subdomains of quality of life between BH4 deficiencies and primary neurotransmitter-related disorders and (b) previously underreported behavioral traits.
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Affiliation(s)
- Mareike Keller
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Heiko Brennenstuhl
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Oya Kuseyri Hübschmann
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Filippo Manti
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Università degli Studi di Roma La Sapienza, Rome, Italy
| | - Natalia Alexandra Julia Palacios
- Inborn errors of metabolism Unit, Department of Neurology, Institut de Recerca Sant Joan de Déu and CIBERER-ISCIII, Barcelona, Spain
| | - Jennifer Friedman
- UCSD Departments of Neuroscience and Pediatrics; Rady Children's Hospital Division of Neurology, Rady Children's Institute for Genomic Medicine, San Diego, California, USA
| | - Yılmaz Yıldız
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Pediatric Metabolism, Ankara, Turkey
| | | | - Suet-Na Wong
- Department of Pediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, Hong Kong
| | - Dimitrios I Zafeiriou
- First Department of Pediatrics Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eduardo López-Laso
- Pediatric Neurology Unit, Department of Pediatrics, University Hospital Reina Sofía, IMIBIC and CIBERER, Córdoba, Spain
| | - Roser Pons
- First Department of Pediatrics of the University of Athens, Aghia Sofia Hospital, Athens, Greece
| | - Jan Kulhánek
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Kathrin Jeltsch
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Jesus Serrano-Lomelin
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Sven F Garbade
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
- Dietmar-Hopp Metabolic Center, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Opladen
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Helly Goez
- Department of Pediatrics, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Alberto Burlina
- U.O.C. Malattie Metaboliche Ereditarie, Dipartimento della Salute della Donna e del Bambino, Azienda Ospedaliera Universitaria di Padova - Campus Biomedico Pietro d'Abano, Padova, Italy
| | - Elisenda Cortès-Saladelafont
- Inborn errors of metabolism Unit, Department of Neurology, Institut de Recerca Sant Joan de Déu and CIBERER-ISCIII, Barcelona, Spain
- Inborn Errors of Metabolism and Child Neurology Unit, Department of Pediatrics, Hospital Germans Trias i Pujol, Badalona and Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Angeles García-Cazorla
- Inborn errors of metabolism Unit, Department of Neurology, Institut de Recerca Sant Joan de Déu and CIBERER-ISCIII, Barcelona, Spain
| | - Georg F Hoffmann
- Division of Child Neurology and Metabolic Medicine, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Stacey Tay Kiat Hong
- KTP-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Tomáš Honzík
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ivana Kavecan
- Faculty of Medicine, University of Novi Sad, Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Serbia
| | - Manju A Kurian
- Developmental Neurosciences, UCL Great Ormond Street-Institute of Child Health and Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Vincenzo Leuzzi
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Università degli Studi di Roma La Sapienza, Rome, Italy
| | - Thomas Lücke
- University Children's Hospital, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Francesca Manzoni
- U.O.C. Malattie Metaboliche Ereditarie, Dipartimento della Salute della Donna e del Bambino, Azienda Ospedaliera Universitaria di Padova - Campus Biomedico Pietro d'Abano, Padova, Italy
| | - Mario Mastrangelo
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Università degli Studi di Roma La Sapienza, Rome, Italy
| | - Saadet Mercimek-Andrews
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Genetics, University of Alberta, Women and Children's Health Research Institute, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Pablo Mir
- Unidad de Trastornos del Movimiento Servicio de Neurología y Neurofisiología Clínica Unidad de Gestión Clínica de Neurociencias Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Mari Oppebøen
- Children's Department Division of Child Neurology Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Toni S Pearson
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - H Serap Sivri
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Pediatric Metabolism, Ankara, Turkey
| | - Dora Steel
- Developmental Neurosciences, UCL Great Ormond Street-Institute of Child Health and Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Galina Stevanović
- Clinic of Neurology and Psychiatry for Children and Youth, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Cheuk-Wing Fung
- Department of Pediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, Hong Kong
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10
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Rozensztrauch A, Iwańska M, Bagłaj M. The Quality of Life of Children with Myelomeningocele: A Cross-Sectional Preliminary Study. Int J Environ Res Public Health 2021; 18:ijerph182010756. [PMID: 34682497 PMCID: PMC8535957 DOI: 10.3390/ijerph182010756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
Objectives: To investigate the relationship between the defects and symptoms caused by myelomeningocele (MMC) and quality of life. Design: A cross-sectional questionnaire survey. Methods: The subjects were 52 parents of children with MMC. Structured questionnaires were used: the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQLTM 4.0) and a Study-Specific Questionnaire (SSQ). Results: The overall PedsQLTM 4.0 score was 56.4 (SD ± 14.7). A strong, significant negative correlation was found between the children’s age and emotional functioning. Functioning in this area deteriorated with age by a mean of 1.5 points per year of age. Children with no hydrocephalus functioned significantly better than those with this defect in the physical, social, and school areas (p < 0.05). Foot deformities significantly (p = 0.033) adversely affected the children’s physical functioning. Living in a single-parent family had no statistically significant impact on functioning in any of the areas analyzed (p > 0.05). Conclusion: Understanding the QoL of children with MMC and identifying its determinants may help in planning interventions to minimize the adverse impact of the illness.
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Affiliation(s)
- Anna Rozensztrauch
- Department of Pediatrics, Division of Neonatology, Wroclaw Medical University, 50-367 Wrocław, Poland;
- Correspondence:
| | - Magdalena Iwańska
- Department of Pediatrics, Division of Neonatology, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Maciej Bagłaj
- Department of Pediatrics, Division of Propaedeutic of Pediatrics and Rare Disorders, Wroclaw Medical University, 50-367 Wrocław, Poland;
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Abstract
Quality of Life (QOL) and Health-Related Quality of Life (HRQOL) are important concepts across the life span for those with spina bifida (SB). This article discusses the SB Quality of Life Healthcare Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida. The focus of these QOL Guidelines was to summarize the evidence and expert opinions on how to mitigate factors that negatively impact QOL/HRQOL or enhance the factors positively related to QOL/HRQOL, the measurement of QOL/HRQOL and the gaps that need to be addressed in future research.
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Affiliation(s)
- Kathleen J. Sawin
- Department of Nursing Research and Evidenced-Based Practice, Children’s Wisconsin, Milwaukee, WI, USA
- College of Nursing, University of Wisconsin-Milwaukee Milwaukee, WI, USA
| | - Timothy J. Brei
- Spina Bifida Association, USA
- Department of Pediatrics, Division of Developmental Medicine, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Amy J. Houtrow
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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12
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Papadakis JL, Holmbeck GN. Sociodemographic factors and health-related, neuropsychological, and psychosocial functioning in youth with spina bifida. Rehabil Psychol 2021; 66:286-299. [PMID: 34043409 PMCID: PMC8855727 DOI: 10.1037/rep0000381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Past research suggests that certain sociodemographic factors may put youth with spina bifida (SB) at risk for poor outcomes. The aims of this study were to examine (a) associations between ten sociodemographic factors and health-related, neuropsychological, and psychosocial functioning among youth with SB,(b) cumulative sociodemographic risk as a predictor of youth outcomes as moderated by age, and (c) SB-related family stress as a mediator of longitudinal associations between cumulative sociodemographic risk and youth outcomes. Method: Participants were youth with SB (N = 140 at Time 1; Mage at Time 1 = 11.43, 53.6% female) recruited as part of a larger, longitudinal study. The study included questionnaire (parent-, teacher-, and youth-report), neuropsychological testing, and medical chart data across three time points, spaced 2 years apart. Results: A subset of the sociodemographic factors and their cumulative risk were associated with study outcomes. Specifically, youth characterized by sociodemographic risk had greater pain and lower academic achievement, but also fewer urinary tract infections and fewer attention and executive function problems. Age did not moderate the association between cumulative risk and outcomes. Cumulative risk predicted lower SB-related family stress, which, in turn, predicted several outcomes. Conclusions: Examining a range of sociodemographic factors is warranted. Sociodemographic risk is linked to poorer outcomes for some risk indicators but similar or better outcomes for others. Results have implications for delivering evidence-based, diversity-sensitive clinical care to youth with SB. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jaclyn Lennon Papadakis
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago
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13
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Kawahara T, Sugita Y, Momose H, Szymanski KM, Hida E, Yamazaki A. Development and Validation of the Japanese Version of Quality of Life Assessment of Spina Bifida in Children (QUALAS-C-J). Pediatr Int 2021; 63:423-429. [PMID: 32745355 DOI: 10.1111/ped.14416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND We previously developed the Japanese version of The Quality of Life Assessment of Spina Bifida in Teenagers, a health-related quality-of-life instrument specific to children aged 13-17 years with spina bifida (SB). The Quality of Life Assessment of Spina Bifida in Children is a version of this questionnaire for children aged 8-12 years. The purpose of this study was to develop a Japanese version of the Quality of Life Assessment of Spina Bifida in Children (QUALAS-C-J) and verify its reliability and validity. METHODS Three urologists specializing in SB, 2 nurses, and 1 statistician developed the QUALAS-C-J and conducted a pilot and main survey. Participants included children with SB and non-disabled (ND) children. Participants completed the QUALAS-C-J and the Japanese version of KIDSCREEN-27 (J-KIDSCREEN) without parental help. RESULTS Five children with SB participated in the pilot study and provided face and content validity. Sixty-three children with SB and 40 age- and sex-matched ND children participated in the main survey. The intraclass correlation coefficient in the retest was 0.80, and Cronbach's alpha in each domain was 0.73. The validity was verified by factor analysis, convergent / divergent validity, and known-groups validity. Factor analysis converged to the same two-factor structure as the original version. The correlation between QUALAS-C-J and J-KIDSCREEN-27 was weak (r=-0.06-0.30). The scores of both groups for the two domains of the QUALAS-C-J were significantly lower in SB than ND children. CONCLUSIONS QUALAS-C-J is easy to answer, suitable for Japanese children with SB, reliable, and valid. It can be a communication tool for children with SB, medical staff, families, communities, and school teachers.
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Affiliation(s)
- Tae Kawahara
- Division of Health Sciences, Departments of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yoshifumi Sugita
- Department of Urology, Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Hitoshi Momose
- Department of Urology, Japan Community Health-care Organization Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Akemi Yamazaki
- Division of Health Sciences, Departments of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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14
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Holmbeck GN, Kritikos TK, Stern A, Ridosh M, Friedman CV. The Transition to Adult Health Care in Youth With Spina Bifida: Theory, Measurement, and Interventions. J Nurs Scholarsh 2021; 53:198-207. [PMID: 33482054 DOI: 10.1111/jnu.12626] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE This article focuses on the transition to adult health care in youth with spina bifida (SB) from the perspective of theory, measurement, and interventions. METHODS The purpose of this article is to discuss (a) a theory of linkages between the transfer of medical responsibility from parent to child and the transition from pediatric to adult health care, as mediated by transition readiness; (b) measurement issues in the study of self-management and the transition to adult health care; and (c) U.S.-based and international interventions focused on the transition to adult health care in young adults with SB. FINDINGS Individuals with SB must adhere to a complex multicomponent treatment regimen while at the same time managing a unique array of cognitive and psychosocial challenges and comorbidities that hinder self-management, medical adherence, and the transition to adult health care. Moreover, such youth endure multiple transitions to adult health care (e.g., in the areas of urology, orthopedics, neurosurgery, and primary care) that may unfold across different time frames. Finally, three transition-related constructs need to be assessed, namely, transition readiness, transition completion, and transition success. CONCLUSIONS SB provides an important exemplar that highlights the complexities of conducting research on the transition to adult health care in youth with chronic health conditions. Many transition trajectories are possible, depending on the functioning level of the child and a host of other factors. Also, no single transition pathway is optimal for all patients with SB. CLINICAL RELEVANCE The success of the process by which a child with SB transitions from pediatric to adult health care can have life-sustaining implications for the patient.
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Affiliation(s)
- Grayson N Holmbeck
- Professor, Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Tessa K Kritikos
- Postdoctoral Research Fellow, Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Alexa Stern
- Graduate Student, Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Monique Ridosh
- Assistant Professor, Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Catherine V Friedman
- Research Assistant, Department of Psychology, Loyola University Chicago, Chicago, IL, USA
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15
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Sentenac M, Rapp M, Ehlinger V, Colver A, Thyen U, Arnaud C. Disparity of child/parent-reported quality of life in cerebral palsy persists into adolescence. Dev Med Child Neurol 2021; 63:68-74. [PMID: 32710687 DOI: 10.1111/dmcn.14638] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2020] [Indexed: 01/10/2023]
Abstract
AIM To examine the evolution of child-parent discrepancy in reporting quality of life (QoL) between childhood and adolescence in children with cerebral palsy (CP) and to investigate potential factors associated with such a discrepancy. METHOD We used data from the SPARCLE (Study of PARticipation of Children with CP Living in Europe) study, a population-based cohort study of children with CP, aged 8 to 12 years at baseline (in 2004-2005), in nine European centres, who were followed up at the age of 13 to 17 years. The KIDSCREEN-52 Quality of Life measure was used at baseline and follow-up; 354 child-parent dyads out of 500 eligible dyads were followed up (201 males, 153 females). We used intraclass correlation coefficients (ICCs) to examine agreement between parent proxy-reports and self-reported QoL. We used linear regression to examine factors associated with child-parent discrepancy in QoL reporting. RESULTS Agreement was low to moderate (ICC=0.16-0.48) in childhood and in adolescence across all QoL domains. In four domains (moods and emotions, self-perception, relationship with parents and home life, and social support and peers), the extent of the discrepancy increased significantly between childhood and adolescence. Parenting stress, child pain, and child behaviour problems influenced parent proxy-reports during both childhood and adolescence. INTERPRETATION The points of view of the child and their parents should be treated as complementary to obtain better knowledge regarding the QoL of children and adolescents with CP.
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Affiliation(s)
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | | | - Allan Colver
- Institute of Health and Society, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
| | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Catherine Arnaud
- Inserm U1027, Université Paul Sabatier, Toulouse, France.,Clinical Epidemiology Unit, CHU Purpan, Toulouse, France
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16
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Kayle M, Chu DI, Stern A, Pan W, Holmbeck GN. Predictors of Distinct Trajectories of Medical Responsibility in Youth with Spina Bifida. J Pediatr Psychol 2020; 45:1153-1165. [PMID: 32895710 PMCID: PMC7588101 DOI: 10.1093/jpepsy/jsaa065] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine if there are distinct developmental trajectories of medical responsibility in youth with spina bifida (SB) across ages 8-17 years and to identify condition-related, parental, and family systems predictors of membership in these trajectory groups. METHODS Participants were 140 youth with SB and their parents who participated in four waves of a longitudinal study across 6 years (ages 8-15 years at Time 1). Multi-method (questionnaires and observed family interactions) and multi-respondent assessments were conducted during home visits. RESULTS Findings revealed that there were two distinct developmental trajectories that characterized this sample, with one being labeled "high increasing" (two thirds of the sample) and one labeled "low increasing" (one third of the sample). Most predictor variables were significantly associated with trajectory group membership, with the exception of ethnicity, SES, and measures of conflict. When all significant univariate predictors were included in the same model, only intelligence quotient (IQ), family stress, and gender were retained as significant. CONCLUSIONS Most youth exhibited relatively rapid increases in responsibility over the course of late childhood and adolescence, but there was a smaller portion of the sample that did not exhibit this type of developmental trajectory. The magnitude of the IQ effect on group differentiation appeared to attenuate the effects of most other predictors. It will be important for clinicians working with youth with SB to recognize that the transfer of medical responsibility from parent to child cannot be expected to unfold in the same manner for all families of youth with SB.
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Affiliation(s)
| | - David I Chu
- Division of Pediatric Urology at Ann & Robert H. Lurie Children's Hospital of Chicago
| | | | - Wei Pan
- School of Nursing, Duke University
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17
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Abstract
Spina bifida's (SB) impact on cognitive, physical, and psychosocial functioning places individuals at risk for mental health concerns. This article discusses the SB Mental Health Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida and reviews evidence-based directions with the intention of helping individuals with SB achieve optimal mental health throughout the lifespan. Guidelines address clinical questions pertaining to the psychosocial impact of SB on mental health and adaptation, domains of mental health that are affected in individuals with SB, areas of resilience, common maladaptive behaviors that may impact people with SB, and resources or practices that are helpful in mitigating mental health issues in this population. Gaps in the research and future directions are discussed.
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Affiliation(s)
- Tessa K Kritikos
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Kathryn Smith
- Children's Hospital Los Angeles, Los Angeles, CA, USA
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18
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Kawahara T, Sugita Y, Momose H, Szymanski KM, Hida E, Yamazaki A. Development and validation of the Japanese version of the Quality of Life Assessment of Spina Bifida in Teenagers (QUALAS-T-J). Pediatr Int 2019; 61:1232-1238. [PMID: 31487089 DOI: 10.1111/ped.14003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/03/2019] [Accepted: 08/30/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Spina bifida (SB) is the second-most common birth defect in Japan. In recent years, health-related quality of life measurements have been used to assess the psychosocial status of children with SB. The Quality of Life Assessment of Spina Bifida in Teenagers (QUALAS-T) is a self-reported questionnaire for subjects aged 13-17 years with SB. It focuses particularly on factors related to independence, bladder and bowel. The purpose of this study was to develop and validate a Japanese version of QUALAS-T (QUALAS-T-J). METHODS Three urologists specialized in SB, two nurses, one statistician, and the author of the original version developed the QUALAS-T-J. Subjects with SB completed the QUALAS-T-J and the Japanese version of KIDSCREEN-27 (J-KIDSCREEN-27) independently from their parents. RESULTS A pilot study involving seven adolescents with SB and confirmed face and content validity. Sixty-nine adolescents with SB participated in the main survey. The intraclass correlation coefficient in the retest was 0.77, and Cronbach's alpha in each domain was 0.83 and 0.79. Validity was verified on factor analysis and convergent/divergent validity. Five items converged in the one domain, Bladder and Bowel. The remaining five items converged in the concept of Family and Independence. The correlation between each domain of the QUALAS-T-J and J-KIDSCREEN-27 was low-moderate. CONCLUSION The reliability and validity of the QUALAS-T-J were verified in Japanese adolescents with SB. The QUALAS-T-J would be a useful tool for communication between adolescents with SB and medical staff.
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Affiliation(s)
- Tae Kawahara
- Division of Health Sciences, Department of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yoshifumi Sugita
- Department of Urology, Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Hitoshi Momose
- Department of Urology, Japan Community Health-care Organization Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Akemi Yamazaki
- Division of Health Sciences, Department of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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19
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Murray CB, Palermo TM, Holmbeck GN. A Multimethod, Case-Controlled Study of Sleep-Wake Disturbances in Adolescents With Spina Bifida. J Pediatr Psychol 2019; 43:601-612. [PMID: 29272431 DOI: 10.1093/jpepsy/jsx150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 11/28/2017] [Indexed: 11/13/2022] Open
Abstract
Objective This study aimed to compare sleep-wake disturbances in adolescents with spina bifida (SB) to typically developing (TD) peers. Exploratory analyses examined sex as moderator of disrupted sleep. Methods Adolescents with SB (ages 12-18 years; N = 37) and a demographically matched sample of TD adolescents (N = 37) completed validated sleep questionnaires and underwent 10 days of actigraphy monitoring. Results Adolescents with SB evidenced worse sleep quality, shorter sleep duration, greater sleep maintenance difficulties, and higher levels of fatigue compared with their TD peers. Exploratory analyses revealed females with SB were particularly vulnerable to developing sleep disturbances. Conclusions Adolescents with SB are at risk for nighttime sleep disturbances and daytime fatigue. Additional research will need to identify mechanisms and adverse consequences of poor sleep to develop interventions addressing sleep deficiency. Sex-specific disparities in sleep patterns in pediatric SB is a novel finding that requires assessment of etiological underpinnings to clarify clinical implications.
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Affiliation(s)
- Caitlin B Murray
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA.,Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Mukherjee S, Zebracki K, Wiesenberger L. Community Participation and Transition Outcomes in Youth with Spina Bifida and Other Chronic Health Conditions in an Urban Children’s Hospital Outpatient Clinic. Curr Phys Med Rehabil Rep 2019. [DOI: 10.1007/s40141-019-00217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Stiles-Shields C, Holmbeck GN. Health behaviors and disordered eating in adolescents and young adults with spina bifida: results from a national survey. Disabil Rehabil 2019; 42:2910-2916. [PMID: 30978107 DOI: 10.1080/09638288.2019.1575483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Youth with disabilities are at higher risk for obesity, disordered eating, and poor body image but are often excluded from research on these domains. The current study is the first to characterize health behaviors, body mass index, and disordered eating cognitions and behaviors in a national sample of adolescent and young adult males and females with spina bifida.Methods: Participants were recruited nationally through the support of a national spina bifida-related organization to complete an anonymous survey assessing health behaviors and disordered eating.Results: Participants were primarily Caucasian, had myelomeningocele, and were between 15-24 years of age. Body mass indices ranged from underweight to Class Three obesity. Health behaviors (e.g., healthy food consumption, physical activity) were often subthreshold compared to Centers for Disease Control recommendations made to the general public. Both male and female respondents endorsed higher purging and restricting behaviors than norms established with typically-developing college aged peers.Conclusions: Findings revealed that there are few sex-based differences. Additionally, the need for thorough assessment of disordered eating behaviors in this population is warranted, including those with a lower body mass index who might be overlooked for assessment of unhealthy attempts to lose or maintain their weight.Implications for rehabilitationAdolescents and young adults with spina bifida are often advised to lose weight without clear guidelines on how to do so, putting them at risk for disordered eating.Professionals should expect variable body mass indices in this population, with some health behaviors falling short of recommendations made for the general public by the Centers for Disease Control.Professionals should fully assess disordered eating behaviors in youth with disabilities, even when at a healthy weight.
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Castillo J, Gandy K, Bradko V, Castillo H. Language and Latino immigrants living with spina bifida: Social determinants of health - the missing dimension in quality of life research. J Pediatr Rehabil Med 2019; 12:345-359. [PMID: 31744031 DOI: 10.3233/prm-180586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Aware of the higher birth prevalence of spina bifida (SB) among Hispanics/Latinos, we aimed to appraise the literature as it relates to cultural context through a review of quality of life (QOL) studies conducted among individuals with SB in order to improve care among immigrant families. METHODS A systematic review was conducted consistent with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were: (1) children and adolescents (5-21 years of age) with SB and/or myelomeningocele; (2) quantitative studies; (3) health-related QOL outcome measured by validated instrument determinants; and (4) US-based studies. Articles meeting inclusion criteria were assessed using the focused conceptual framework informing the study (i.e., social determinants of health). RESULTS Eighteen studies met inclusion criteria, with eight different QOL instruments represented. The majority of studies used generic assessments of QOL (72%), two reported the use of both a generic and a SB-specific QOL measure (11%), and three (17%) documented QOL utilizing a SB-specific validated instrument. Only seven (39%) of the studies stated that they included Hispanics/Latinos and only six (33%) reported including Spanish-speaking individuals. CONCLUSIONS QOL in individuals with SB is mediated by a wide-range of interrelated factors. In order to better serve this vulnerable population as they transition across the lifespan, multilingual condition-specific QOL measures need to be further developed and implemented among Hispanic/Latino individuals with SB, especially those who are recent immigrants.
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Affiliation(s)
- Jonathan Castillo
- Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kellen Gandy
- Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Viachaslau Bradko
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Heidi Castillo
- Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Driscoll CFB, Buscemi J, Holmbeck GN. Parental Distress and Stress in Association with Health-Related Quality of Life in Youth with Spina Bifida: A Longitudinal Study. J Dev Behav Pediatr 2018; 39:744-53. [PMID: 30204623 DOI: 10.1097/DBP.0000000000000603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined associations between 3 distinct parent factors (parent personal distress, parenting stress, and spina bifida (SB)-specific parenting stress) and youth and parent proxy reports of youth health-related quality of life (HRQOL) over time. METHOD Participants were recruited as part of a longitudinal study, and data were collected at 3 time points, spaced 2 years apart. Parents and youth completed questionnaires, and youth completed neuropsychological assessment tasks to determine youth intelligence quotient during home visits. RESULTS Analyses revealed that higher levels of maternal SB-specific parenting stress were related to lower levels of youth-reported HRQOL at time 1. Other parent factors were not associated with youth report of HRQOL at the earlier time points, although higher levels of maternal SB-specific parenting stress and paternal parenting stress were associated with lower levels of youth HRQOL at time 3. For mothers and fathers, increased parent personal distress, parenting stress, and SB-specific parenting stress were associated with decreased proxy report of youth HRQOL. Of these three parent factors, SB-specific parenting stress was consistently the most strongly associated with parent proxy-report of youth HRQOL. CONCLUSION Parenting stress and distress are important targets for interventions, and these interventions may improve youth outcomes, especially as youth age. Future research is needed to identify other factors influencing youth HRQOL over time.
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Ólafsdóttir LB, Egilson ST, Árnadóttir U, Hardonk SC. Child and parent perspectives of life quality of children with physical impairments compared with non-disabled peers. Scand J Occup Ther 2018; 26:496-504. [PMID: 30457392 DOI: 10.1080/11038128.2018.1509371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Life quality has become a widely used concept within rehabilitation and occupational therapy practice. AIM This study explored child and parent perspectives of life quality of children with physical impairments compared with a group of non-disabled children. METHOD Data were collected with the Icelandic self- and proxy-reported versions of the KIDSCREEN-27. For children with physical impairments, reports from 34 children and 40 parents were included in the analyses, and in control group reports from 429 children and 450 parents were included. RESULTS Children with physical impairments evaluated their life quality within the average range on four out of five life quality dimensions. The lowest scores were within the physical well-being dimension. Self-reported scores of children with physical impairments were higher than those of their parents on all dimensions except autonomy and parent relations. Thus, the parents considered more environmental and personal factors to negatively influence their child's life quality than children did themselves. CONCLUSION Children with physical impairments experience their life quality similarly to non-disabled children. SIGNIFICANCE Focus on life quality can help occupational therapists to identify what circumstances positively or negatively influence client well-being and to focus more on contextual factors that contribute to disablement.
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Affiliation(s)
- Linda Björk Ólafsdóttir
- a Centre of Disability Studies, School of Social Sciences , University of Iceland , Reykjavík , Iceland
| | - Snaefrídur Thóra Egilson
- a Centre of Disability Studies, School of Social Sciences , University of Iceland , Reykjavík , Iceland
| | - Unnur Árnadóttir
- b The State Diagnostic and Counselling Centre , Kópavogur , Iceland
| | - Stefan C Hardonk
- a Centre of Disability Studies, School of Social Sciences , University of Iceland , Reykjavík , Iceland
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Abstract
PURPOSE Psychometric data are reported for a new Global Family Quality of Life Scale (G-FQOLS) (3-items) evaluating family members, parents and adolescent/young adults (AYA). METHODS Families (N= 209) were interviewed in a study addressing secondary conditions and adaptation in families of AYA with and without spina bifida (SB). Principal component factor analysis with Varimax rotation, Cronbach alpha, and Intraclass correlation (ICC) for parent-AYA agreement of FQOL assessment were conducted. RESULTS A single factor with an eigenvalue greater than 1 was identified. Factor loadings were 0.79-0.94. Internal reliabilities were strong (α= 0.86-0.90). ICC coefficients between parent and AYA ratings were 0.38-0.48. CONCLUSION This study provides preliminary support for the G-FQOLS. This global appraisal of Family Quality of Life (FQOL) reflects a participant's personal weighting of domains important to him/her.
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Affiliation(s)
- Monique M Ridosh
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Kathleen J Sawin
- Self-Management Science Center, College of Nursing, Milwaukee, WI, USA.,Children's Hospital of Wisconsin/UWM, Milwaukee, WI, USA
| | - Timothy J Brei
- Division of Developmental Medicine, Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA, USA
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Cushing CC, Martinez-Leo B, Bischoff A, Hall J, Helmrath M, Dickie BH, Levitt MA, Peña A, Zeller MH, Frischer JS. Health-Related Quality of Life and Parental Stress in Children With Fecal Incontinence: A Normative Comparison. J Pediatr Gastroenterol Nutr 2016; 63:633-6. [PMID: 27027905 DOI: 10.1097/MPG.0000000000001201] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE The aim of the present study was to describe the quality of life and parenting stress associated with a child with fecal incontinence (FI). METHODS Female caregivers (n = 170) of children of 3 to 12 years age with FI completed a broad and general measure of quality of life and a measure of parenting stress. Results were compared with proxy reports for a normative sample of healthy children. RESULTS Caregivers of children with FI reported significantly impaired quality of life for their children and increased parenting stress in all of the respective domains relative to healthy controls. Impairments reported by caregivers were large in magnitude. Similarly, rates of parenting stress were at or greater than the 98th percentile for caregivers of children with FI. CONCLUSIONS Children with fecal incontinence and their families are in need of interventions targeting their quality of life and the stress associated with caregiving. FI appears to be particularly stressful for caregivers who may be in need of support beyond medical management of their child's bowel. Moreover, additional refinements in disease-specific quality of life assessment are needed in this population. Such refinement would allow for more precise measurement of the quality of life processes that are unique to FI.
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Bakaniene I, Prasauskiene A, Vaiciene-Magistris N. Health-related quality of life in children with myelomeningocele: a systematic review of the literature. Child Care Health Dev 2016; 42:625-43. [PMID: 27381478 DOI: 10.1111/cch.12367] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/17/2016] [Accepted: 05/22/2016] [Indexed: 12/16/2022]
Abstract
Myelomeningocele (MMC) is the most complex congenital birth defect compatible with life. To provide the best health care for children with MMC, clinicians and researchers have to understand health and functional status of their patients as well as factors influencing their quality of life (QOL). The objective is to review studies that assess health-related quality of life (HRQOL) and determinants of HRQOL in children with MMC. The data sources include MEDLINE, along with reference lists of relevant reviews and included articles. Study eligibility criteria are quantitative studies that assess HRQOL using validated HRQOL instrument. Participants include children aged 0-18 years with diagnosis of MMC or spina bifida. Risk of bias was assessed using the Hayden system for non-randomized studies. Narrative synthesis and tables of results of HRQOL studies were conducted. Children with MMC have decreased HRQOL compared with normative population. Physical HRQOL is the most exposed aspect of QOL, while discrepancies in psychosocial domains vary by study. Many determinants of QOL have been found, and it is still not clear which determinant can be described as the strongest predictor. Psychosocial factors are the most consistent determinants of HRQOL.Heterogeneous study sample size, study designs, determinant and outcomes measures limited synthesis of findings. The HRQOL in children with MMC is complex and mediated by a number of associated medical problems, together with a variety of psychosocial and environmental factors. Future research is needed (a) on the relation between complex medical problems, functional independence, parent's and clinician's expectation and HRQOL in children and (b) to assess the differences in HRQOL by social environment and healthcare system.
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Affiliation(s)
- I Bakaniene
- Department of Children's Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Prasauskiene
- Department of Children's Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - N Vaiciene-Magistris
- Department of Neurology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Abstract
PURPOSE To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings. METHOD The Uni-Search and five additional databases were searched. Children's health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life. RESULTS Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their children's difficulties in emotional functioning and pain. There were no consistencies in differences between children's and parent's ratings on levels of agreement with respect to the children's health issue, age or gender. CONCLUSIONS Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. Implications for Rehabilitation In general, parents consider their children to have more difficulties - or more extensive difficulties - than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the child´s health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the children's emotional functioning and pain. Clinicians should prioritize obtaining children's views on subjective aspects such as emotional issues as well as on pain.
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Affiliation(s)
- Helena Hemmingsson
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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Loiselle KA, Ramsey RR, Rausch JR, Modi AC. Trajectories of Health-Related Quality of Life Among Children With Newly Diagnosed Epilepsy. J Pediatr Psychol 2016; 41:1011-21. [PMID: 27017987 DOI: 10.1093/jpepsy/jsw019] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/25/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To identify two-year trajectories of health-related quality of life (HRQOL) among children with newly diagnosed epilepsy, and evaluate key predictors of HRQOL trajectories. METHODS This study is part of a prospective study of adherence and HRQOL outcomes in children with epilepsy. Caregivers completed an HRQOL questionnaire at one month post diagnosis and every three months thereafter for two years. Chart review and additional questionnaires were used to collect medical variables and seizure outcomes. RESULTS Participants included 120 children with epilepsy and their caregiver. Unique trajectories for overall HRQOL and PedsQL™ subscales were identified and were predominantly stable. A total side effects score emerged as a consistent predictor of all HRQOL domains. Other variables (i.e., socioeconomic status, seizures, internalizing and externalizing problems) uniquely predicted HRQOL domains. CONCLUSIONS Medical and psychosocial interventions should be implemented soon after treatment initiation to target modifiable factors (e.g., side effects, anxiety symptoms), which could improve HRQOL.
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Affiliation(s)
- Kristin A Loiselle
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and
| | - Rachelle R Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and
| | - Joseph R Rausch
- Center for Biobehavioral Health, Nationwide Children's Hospital
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and
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Yi-Frazier JP, Hilliard ME, Fino NF, Naughton MJ, Liese AD, Hockett CW, Hood KK, Pihoker C, Seid M, Lang W, Lawrence JM. Whose quality of life is it anyway? Discrepancies between youth and parent health-related quality of life ratings in type 1 and type 2 diabetes. Qual Life Res 2015; 25:1113-21. [PMID: 26466834 DOI: 10.1007/s11136-015-1158-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Health-related quality of life (HRQOL) is a critical diabetes outcome, yet differences between youth and parent-proxy ratings can make interpretation difficult. This study aims to explore potential differences between self- and parent-reports of Pediatric Quality of Life Inventory (PedsQL) scores from youth with type 1 (T1D) or type 2 diabetes (T2D) and to evaluate associations between discrepancies, PedsQL scores, and glycemic control (HbA1c). METHODS Youth and parents in the SEARCH for Diabetes in Youth Study (T1D: age 5-18, n = 3402; T2D: age 8-18, n = 353) completed the PedsQL Generic and Diabetes Modules, and youth provided a blood sample to assess HbA1c. Discrepancies (youth minus parent PedsQL ratings) were calculated and examined by age and diabetes type, and associations with youth PedsQL scores and HbA1c were evaluated. RESULTS Discrepancies existed between youth and parent-proxy reports of generic and diabetes PedsQL scores in T1D and T2D (all p values < 0.01). Higher (more favorable) ratings were reported by youth except for those 5-7-years old, where parents' scores were higher. When parent-proxy scores were higher, discrepancies were largest when the child reported low PedsQL scores. Higher HbA1c was associated with larger discrepancies (youth scores higher) for adolescents with T1D. CONCLUSIONS Discrepant PedsQL ratings suggest that parents may often underestimate youths' HRQOL except in the youngest children. Although examining both reports is optimal, the youth report should be prioritized, particularly for young children with T1D and for adolescents with either T1D or T2D.
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Affiliation(s)
- Joyce P Yi-Frazier
- Department of Endocrinology, Seattle Children's Research Institute, Seattle, WA, 98101, USA.
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Nora F Fino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michelle J Naughton
- Division of Population Sciences, The Ohio State University, Columbus, OH, 43201, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Christine W Hockett
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, 80045, USA
| | - Korey K Hood
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94305, USA
| | - Catherine Pihoker
- Department of Endocrinology, Seattle Children's Research Institute, Seattle, WA, 98101, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, 98105, USA
| | - Michael Seid
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Wei Lang
- Division of Population Sciences, The Ohio State University, Columbus, OH, 43201, USA
| | - Jean M Lawrence
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA
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Abstract
Spina bifida is a birth defect in which the vertebral column is open, often with spinal cord involvement. The most clinically significant subtype is myelomeningocele (open spina bifida), which is a condition characterized by failure of the lumbosacral spinal neural tube to close during embryonic development. The exposed neural tissue degenerates in utero, resulting in neurological deficit that varies with the level of the lesion. Occurring in approximately 1 per 1,000 births worldwide, myelomeningocele is one of the most common congenital malformations, but its cause is largely unknown. The genetic component is estimated at 60-70%, but few causative genes have been identified to date, despite much information from mouse models. Non-genetic maternal risk factors include reduced folate intake, anticonvulsant therapy, diabetes mellitus and obesity. Primary prevention by periconceptional supplementation with folic acid has been demonstrated in clinical trials, leading to food fortification programmes in many countries. Prenatal diagnosis is achieved by ultrasonography, enabling women to seek termination of pregnancy. Individuals who survive to birth have their lesions closed surgically, with subsequent management of associated defects, including the Chiari II brain malformation, hydrocephalus, and urological and orthopaedic sequelae. Fetal surgical repair of myelomeningocele has been associated with improved early neurological outcome compared with postnatal operation. Myelomeningocele affects quality of life during childhood, adolescence and adulthood, posing a challenge for individuals, families and society as a whole. For an illustrated summary of this Primer, visit: http://go.nature.com/fK9XNa.
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