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Kvello M, Åvitsland TL, Knatten CK, Fyhn TJ, Malt U, Emblem R, Bjørnland K. Psychologic Distress and Anxiety in Mothers of Children With Gastroesophageal Reflux Undergoing Antireflux Surgery. J Pediatr Gastroenterol Nutr 2019; 68:818-823. [PMID: 31124989 DOI: 10.1097/mpg.0000000000002286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Parents of children with a chronic illness are at risk for impaired psychosocial functioning. Gastroesophageal reflux disease (GERD) is such a disease, and no studies have investigated effects of antireflux surgery on parental psychological distress. The aims of this study were to assess psychological distress and state and trait anxiety in mothers of children with GERD, and to explore possible changes after antireflux surgery. METHODS Mothers of children referred for antireflux surgery were included in this prospective study. Standardized questionnaires were used to evaluate psychological distress and state and trait anxiety before and 12 months after antireflux surgery. RESULTS Of 87 eligible mothers of children with GERD, 62 (71%) agreed to participate. All children had objectively verified GERD by 24-hour pH-monitoring and/or upper gastrointestinal contrast study and unsatisfactory symptom relief of pharmacological treatment. Thirty-one (50%) mothers returned questionnaires postoperatively. Preoperatively, mothers of children undergoing antireflux surgery reported high levels of psychological distress and state anxiety, and 54% had scores indicating clinically significant psychological distress. None of the preoperative child characteristics were found to significantly influence maternal psychological distress or state anxiety. Twelve months postoperatively, both psychological distress and state anxiety were reduced. CONCLUSIONS Mothers of children undergoing antireflux surgery reported reduced levels of psychological distress and state anxiety 12 months after the operation.
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Affiliation(s)
- Morten Kvello
- Institute of Clinical Medicine, University of Oslo.,Department of Gastrointestinal and Pediatric Surgery
| | | | | | | | - Ulrik Malt
- Institute of Clinical Medicine, University of Oslo
| | - Ragnhild Emblem
- Institute of Clinical Medicine, University of Oslo.,Department of Gastrointestinal and Pediatric Surgery
| | - Kristin Bjørnland
- Institute of Clinical Medicine, University of Oslo.,Department of Gastrointestinal and Pediatric Surgery
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Acquadro C, Patrick DL, Eremenco S, Martin ML, Kuliś D, Correia H, Conway K. Emerging good practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) measures. J Patient Rep Outcomes 2018; 2:8. [PMID: 29757337 PMCID: PMC5935017 DOI: 10.1186/s41687-018-0035-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/06/2018] [Indexed: 12/18/2022] Open
Abstract
This paper presents emerging Good Practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) Measures. The ISOQOL Translation and Cultural Adaptation Special Interest Group (TCA-SIG) undertook the review of several TA approaches, with the collaboration of organizations who are involved in conducting TA, and members of the TCA-SIG. The effort led to agreement by the writing group on Good Practices for 1) the terminology to be used in referring to translatability process, 2) the best definition of TA, 3) the methodology that is recommended at each step of the process, 4) the persons involved in TA, 5) the timing of assessment, 6) the review criteria for TA, and 7) the recommendations to be made at the end of the TA process. With input from the TCA-SIG membership and in consultation with experts in the field, these emerging good practices can guide the future use of TA in the development of PROs.
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Affiliation(s)
| | | | | | - Mona L Martin
- Health Research Associates, Mountlake Terrace, WA USA
| | | | - Helena Correia
- 6Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Katrin Conway
- Mapi Research Trust, 27 rue de la Villette, 69003 Lyon, France
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Bardou M, Fortinsky KJ. Safety of medication options for treating pediatric esophagitis. Expert Opin Drug Saf 2015; 14:1087-96. [DOI: 10.1517/14740338.2015.1040389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Lefton-Greif MA, Okelo SO, Wright JM, Collaco JM, McGrath-Morrow SA, Eakin MN. Impact of children's feeding/swallowing problems: validation of a new caregiver instrument. Dysphagia 2014; 29:671-7. [PMID: 25159316 DOI: 10.1007/s00455-014-9560-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 07/11/2014] [Indexed: 11/27/2022]
Abstract
The impact of caring for children with deglutition disorders is poorly understood and tools to measure the unique concerns of these caregivers are lacking. The aims of this investigation were to develop and validate The Feeding/Swallowing Impact Survey (FS-IS) as an instrument designed to measure and improve understanding of caregiver issues. Demographic, economic, and dysphagic data were provided by the primary caregivers of 164 children (median age: 14 months, male: 78, female: 86) presenting for initial outpatient feeding/swallowing evaluations. Caregivers completed the PEDS-QL™ Family Impact Module (PEDS-QL™ FIM) and the FS-IS. A principal component analysis was conducted on the FS-IS to identify appropriate subscales. Concurrent validity was assessed by examining correlations between the FS-IS and PEDS-QL™ FIM. Caring for children with feeding/swallowing problems adversely impacted the Health-Related Quality of Life (HRQoL) of their caregivers. The FS-IS had a strong 3-factor solution to indicate 3 subscales: Daily Activities, Worry, and Feeding Difficulties. All three subscales and total score of the FS-IS correlated with PEDS-QL™ FIM. The FS-IS was validated as an instrument that may help clinicians detect specific factors that influence caregiver HRQoL, identify caregivers who might benefit from additional support, and ultimately improve the care of their children with feeding/swallowing disorders.
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Affiliation(s)
- Maureen A Lefton-Greif
- Department of Pediatrics, Johns Hopkins University School of Medicine, David M. Rubenstein Building, Suite 3017, 200 North Wolfe Street, Baltimore, MD, 21287, USA,
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Khanna P, Agarwal N, Khanna D, Hays RD, Chang L, Bolus R, Melmed G, Whitman CB, Kaplan RM, Ogawa R, Snyder B, Spiegel BM. Development of an online library of patient-reported outcome measures in gastroenterology: the GI-PRO database. Am J Gastroenterol 2014; 109:234-48. [PMID: 24343547 PMCID: PMC4275098 DOI: 10.1038/ajg.2013.401] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 10/22/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Because gastrointestinal (GI) illnesses can cause physical, emotional, and social distress, patient-reported outcomes (PROs) are used to guide clinical decision making, conduct research, and seek drug approval. It is important to develop a mechanism for identifying, categorizing, and evaluating the over 100 GI PROs that exist. Here we describe a new, National Institutes of Health (NIH)-supported, online PRO clearinghouse-the GI-PRO database. METHODS Using a protocol developed by the NIH Patient-Reported Outcome Measurement Information System (PROMIS(®)), we performed a systematic review to identify English-language GI PROs. We abstracted PRO items and developed an online searchable item database. We categorized symptoms into content "bins" to evaluate a framework for GI symptom reporting. Finally, we assigned a score for the methodological quality of each PRO represented in the published literature (0-20 range; higher indicates better). RESULTS We reviewed 15,697 titles (κ>0.6 for title and abstract selection), from which we identified 126 PROs. Review of the PROs revealed eight GI symptom "bins": (i) abdominal pain, (ii) bloat/gas, (iii) diarrhea, (iv) constipation, (v) bowel incontinence/soilage, (vi) heartburn/reflux, (vii) swallowing, and (viii) nausea/vomiting. In addition to these symptoms, the PROs covered four psychosocial domains: (i) behaviors, (ii) cognitions, (iii) emotions, and (iv) psychosocial impact. The quality scores were generally low (mean 8.88 ± 4.19; 0 (min)-20 (max). In addition, 51% did not include patient input in developing the PRO, and 41% provided no information on score interpretation. CONCLUSIONS GI PROs cover a wide range of biopsychosocial symptoms. Although plentiful, GI PROs are limited by low methodological quality. Our online PRO library (www.researchcore.org/gipro/) can help in selecting PROs for clinical and research purposes.
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Affiliation(s)
- Puja Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nikhil Agarwal
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA,Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dinesh Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ron D. Hays
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, and Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA
| | - Lin Chang
- Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Roger Bolus
- Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Gil Melmed
- Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Cynthia B. Whitman
- UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Robert M. Kaplan
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, and Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA
| | - Rikke Ogawa
- Biomedical Library of the Health Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | - Bradley Snyder
- UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Brennan M.R. Spiegel
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA,Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, and Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA,Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
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Bolier EA, Kessing BF, Smout AJ, Bredenoord AJ. Systematic review: questionnaires for assessment of gastroesophageal reflux disease. Dis Esophagus 2013; 28:105-20. [PMID: 24344627 DOI: 10.1111/dote.12163] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality of life of GERD patients. The aim of this review is to develop a complete overview of all available questionnaires, categorized per dimension of the assessment of GERD. A systematic search of the literature up to January 2013 using the Pubmed database and the Embase database, and search of references and conference abstract books were conducted. A total number of 65 questionnaires were extracted and evaluated. Thirty-nine questionnaires were found applicable for the assessment of GERD symptoms, three of which are generic gastrointestinal questionnaires. For the assessment of response to treatment, 14 questionnaires were considered applicable. Seven questionnaires with diagnostic purposes were found. In the assessment of quality of life in GERD patients, 18 questionnaires were found and evaluated. Twenty questionnaires were found to be used for more than one assessment dimension, and eight questionnaires were found for GERD assessment in infants and/or children. A wide variety of GERD questionnaires is available, of which the majority is used for assessment of GERD symptoms. Questionnaires differ in aspects such as design, validation and translations. Also, numerous multidimensional questionnaires are available, of which the Reflux Disease Questionnaire is widely applicable. We provided an overview of GERD questionnaires to aid investigators and clinicians in their search for the most appropriate questionnaire for their specific purposes.
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Affiliation(s)
- E A Bolier
- Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
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Subjective well-being measures for children were developed within the PROMIS project: presentation of first results. J Clin Epidemiol 2013; 67:207-18. [PMID: 24295987 DOI: 10.1016/j.jclinepi.2013.08.018] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 07/25/2013] [Accepted: 08/13/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aims of this Patient Reported Outcome Measurement Information System (PROMIS) study were to (1) conceptualize children's subjective well-being (SWB) and (2) produce item pools with excellent content validity for calibration and use in computerized adaptive testings (CATs). STUDY DESIGN AND SETTING Children's SWB was defined through semistructured interviews with experts, children (aged 8-17 years), parents, and a systematic literature review to identify item concepts comprehensively covering the full spectrum of SWB. Item concepts were transformed into item expressions and evaluated for comprehensibility using cognitive interviews, reading level analysis, and translatability review. RESULTS Children's SWB comprises affective (positive affect) and global evaluation components (life satisfaction). Input from experts, children, parents, and the literature indicated that the eudaimonic dimension of SWB-that is, a sense of meaning and purpose-could be evaluated. Item pools for life satisfaction (56 items), positive affect (53 items), and meaning and purpose (55 items) were produced. Small differences in comprehensibility of some items were observed between children and adolescents. CONCLUSION The SWB measures for children are the first to assess both the hedonic and eudaimonic aspects of SWB. Both children and youth seem to understand the concepts of a meaningful life, optimism, and goal orientation.
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Efficacy and safety of rabeprazole in children (1-11 years) with gastroesophageal reflux disease. J Pediatr Gastroenterol Nutr 2013; 57:798-807. [PMID: 23863328 DOI: 10.1097/mpg.0b013e3182a4e718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Evaluate the efficacy and safety of rabeprazole in children, 1 to 11 years old, with endoscopically/histologically proven gastroesophageal reflux disease (GERD). METHODS Children were randomized to 0.5- or 1.0-mg/kg rabeprazole granule formulation for 12 weeks. The dose was further determined by weight: children 6 to 14.9 kg (low-weight cohort) received 5 or 10 mg and children ≥15 kg (high-weight cohort) received 10 or 20 mg. The primary endpoint was endoscopic/histologic healing at week 12 (defined as grade 0 on the Hetzel-Dent classification scale and/or grade 0 on the Histological Features of Reflux Esophagitis scale). RESULTS Overall, 81% (87/108) achieved endoscopic/histologic healing at week 12 with higher healing in the low-weight cohort (82% [5-mg dose], 94% [10-mg dose]) compared with high-weight cohort (76% [10-mg dose], 78% [20-mg dose]). There was a significant (P < 0.001) decrease in the mean Total GERD Symptoms and Severity score from 19.7 points (baseline) to 8.6 points (week 12), with 26% fewer children reporting GERD symptoms at week 12. The average frequency of symptoms per child decreased from 7.7 (week 1) to 4.7 (week 12). The GERD Symptom Relief score showed that 71% of children felt better, 81% were rated "good to excellent" on the Global Treatment Satisfaction scale by the investigator; 77% were rated "good to excellent" on the Clinical Global Impressions-Improvement scale by the parent/caregiver. The most common (>10%) treatment-emergent adverse events included cough and vomiting (14% each), abdominal pain (12%), and diarrhea (11%). CONCLUSIONS Rabeprazole was effective and safe in 1- to 11-year-old children with GERD.
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Conway K, Acquadro C, Patrick DL. Usefulness of translatability assessment: results from a retrospective study. Qual Life Res 2013; 23:1199-210. [DOI: 10.1007/s11136-013-0572-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2013] [Indexed: 11/24/2022]
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Spiegel BMR. Patient-reported outcomes in gastroenterology: clinical and research applications. J Neurogastroenterol Motil 2013; 19:137-48. [PMID: 23667745 PMCID: PMC3644650 DOI: 10.5056/jnm.2013.19.2.137] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 02/25/2013] [Accepted: 02/26/2013] [Indexed: 12/11/2022] Open
Abstract
Patient-generated reports, also known as Patient-Reported Outcomes (PROs), capture the patients' illness experience in a structured format and may help bridge the gap between patients and providers. PROs measure any aspect of patient-reported health (e.g., physical, emotional or social symptoms) and can help to direct care and improve clinical outcomes. When clinicians systematically collect patient-reported data in the right place at the right time, PRO measurement can effectively aid in detection and management of conditions, improve satisfaction with care and enhance the patient-provider relationship. This review article summarizes the latest approaches to PRO measuring for clinical trials and clinical practice, with a focus on use of PROs in gastroenterology.
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Affiliation(s)
- Brennan M R Spiegel
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System; Division of Digestive Diseases, David Geffen School of Medicine at UCLA; Department of Health Services, UCLA School of Public Health; and UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
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Martigne L, Delaage PH, Thomas-Delecourt F, Bonnelye G, Barthélémy P, Gottrand F. Prevalence and management of gastroesophageal reflux disease in children and adolescents: a nationwide cross-sectional observational study. Eur J Pediatr 2012; 171:1767-73. [PMID: 22903328 DOI: 10.1007/s00431-012-1807-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 07/18/2012] [Accepted: 07/20/2012] [Indexed: 01/10/2023]
Abstract
UNLABELLED This cross-sectional observational study aimed to determine the nationwide prevalence of gastroesophageal reflux disease (GORD) in French children and adolescents. Four hundred four general practitioners and 180 paediatricians compiled a register of all children and adolescents (n = 10,394, aged 0 to 17 years, mean 3.8 ± 5.6 years) who presented over two 3-day periods. For all children who, in the physician's opinion, showed symptoms of gastroesophageal reflux (GOR), a 24-item questionnaire covering the history and management of GOR was completed. Children with symptoms that impaired their daily lives were defined as having GORD, the remainder as having physiological GOR. Of the patients, 15.1 % showed GOR symptoms. Extrapolation to the overall French population yielded a prevalence of 10.3 % for GOR and 6.2 % for GORD. There was a significantly (p < 0.05) greater use of volume reduction or milk thickeners and dorsal positioning among infants with GORD versus physiological GOR. Significantly (p < 0.05) more of the infants and children with GORD received pharmacological therapy. The use of proton pump inhibitors increased with age but was significantly (p < 0.05) higher among those with GORD. CONCLUSIONS Ten percent of French children and adolescents show GOR symptoms and 6 % have GORD. Clinical presentation and treatment vary in different age groups, but those with GORD are more likely to require pharmacological treatment.
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Affiliation(s)
- Léonie Martigne
- Unité Inserm U995, Service de Gastroentérologie, Hépatologie et Nutrition Pédiatrique, Pôle Enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Avenue Eugène Avinée, 59037 Lille Cedex, France
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Mahant S, Pastor AC, Deoliveira L, Nicholas DB, Langer JC. Well-being of children with neurologic impairment after fundoplication and gastrojejunostomy tube feeding. Pediatrics 2011; 128:e395-403. [PMID: 21768323 DOI: 10.1542/peds.2010-1253] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is limited understanding on the impact of fundoplication or gastrojejunostomy tube (GJT) feeding in children with neurologic impairment who have swallowing dysfunction, gastroesophageal reflux disease, and/or dysmotility. OBJECTIVE To explore and understand the well-being of families and their children with neurologic impairment who had either a fundoplication or GJT. METHODS This was a qualitative study using in-depth, individual interviews with parents of children with severe neurologic impairment who had either a fundoplication with gastrostomy or GJT. Parents' perceptions of daily life and QoL were explored in the context of the interventions. Interviews were transcribed, and data were analyzed using qualitative content analysis. RESULTS Children and their parents are profoundly impacted by the health condition of the children. QoL effects were similar across spheres of individual and family experience and well-being. Themes related to QoL were: physical health of the child and the future, intense caregiving needs, social isolation and stigma, pervasive impact on the family, financial strain, and the process of finding meaning. Fundoplication and GJT affected feeding tolerance and times, caregiving, and health care utilization. Parents identified how changes in these factors influenced child, parental, and family QoL. CONCLUSIONS The diverse influences of the underlying condition and the interventions should be addressed in the delivery of health services. Future studies of the effectiveness of fundoplication and GJT feeding should address the well-being of the child and family, the impact on family caregiving, and health care utilization.
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Affiliation(s)
- Sanjay Mahant
- Division of Paediatric Medicine, Paediatric Outcomes Research Team, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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Development of a quality of life instrument for pediatric gastroesophageal reflux disease: qualitative interviews. J Pediatr Gastroenterol Nutr 2010; 50:486-92. [PMID: 20639705 DOI: 10.1097/mpg.0b013e3181b99ca6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Antireflux procedures (ARP) are commonly performed in children and there is no disease-specific quality of life (QOL) instrument for gastroesophageal reflux (GERD) in children. The aim of this study was to identify the relevant domains for developing such an instrument. These domains will be validated in a future study. PATIENTS AND METHODS Parents of 19 patients (age 2 months-18 years) clinically diagnosed with GERD were recruited to complete semistructured interviews. Seven patients with adequate verbal skills were also interviewed. Patients were treated medically (13 patients) or with an ARP (6 patients). The interviews were analyzed using grounded theory. RESULTS GERD affects QOL through the following domains: symptom severity, feeding quality, sleep quality, hygiene, growth and development, social quality, self-image, coping skills, family QOL, health care usage, and impact of ARP. A greater-than-expected effect on parental QOL and remarkable use of accommodation were identified. CONCLUSIONS A pediatric GERD-specific instrument cannot rely on QOL perception alone, but must address broadly the impact of the disease and the effect of coping skills on the child and his or her family in their activities of daily living and interaction with society. We have identified reproducible domains that will serve as the foundation for such an instrument.
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Engelmann C, Gritsa S, Ure BM. Impact of laparoscopic anterior 270 degrees fundoplication on the quality of life and symptoms profile of neurodevelopmentally delayed versus neurologically unimpaired children and their parents. Surg Endosc 2009; 24:1287-95. [PMID: 20033727 DOI: 10.1007/s00464-009-0762-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 10/14/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND This prospective study investigated the therapy-induced changes in the quality of life (QoL) experienced by neurologically healthy and neurodevelopmentally delayed children and their parents after laparoscopic anterior 270 degrees fundoplication (LAF). METHODS In this study, 40 patients (21 impaired) with a mean age of 7.8 years underwent LAF for gastroesophageal reflux disease (GERD) and were evaluated before surgery and then 3 and 6 months afterward using the Gastrointestinal Quality-of-Life Index (GIQLI) supplemented by conventional symptom markers. RESULTS Growth, proton pump inhibitor use, and frequency of supraesophageal/respiratory symptoms improved significantly (p < 0.001) as did feeding parameters (p < 0.05). The global GIQLI score improved by 49 +/- 21% (p < 0.001). The greatest improvement occurred in the symptoms domain (p < 0.001). However, positive alterations also were found in the dimensions of emotions (58%), social functions (37%) and physical functions (27%) (p < 0.001). Comparison of the overall benefit did not show any differences between the subgroups of neurologically fit and impaired children. However, for the child-centered symptoms domain, the benefit increased stepwise with the degree of impairment. This was counterbalanced by an inverse relationship for the parent-centered emotions domain (p < 0.05). CONCLUSIONS Besides the known improvement in symptoms, LAF achieves a significant improvement in QoL for children and their parents. There is no overall difference in the benefit experienced by neurologically impaired and healthy children.
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Affiliation(s)
- Carsten Engelmann
- Department of Pediatric Surgery, Hannover Medical School, 30625 Hannover, Germany.
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Klinnert MD. Psychological Impact of Eosinophilic Esophagitis on Children and Families. Immunol Allergy Clin North Am 2009; 29:99-107, x. [DOI: 10.1016/j.iac.2008.09.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ameen VZ, Pobiner BF, Giguere GC, Carter EG. Ranitidine (Zantac) syrup versus Ranitidine effervescent tablets (Zantac) EFFERdose) in children: a single-center taste preference study. Paediatr Drugs 2006; 8:265-70. [PMID: 16898856 DOI: 10.2165/00148581-200608040-00005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The histamine H(2) receptor antagonist ranitidine is US FDA-approved for the treatment of gastroesophageal reflux disease and healing of erosive esophagitis in children >or=1 month of age. A low-dose strength of ranitidine is now available in a citrus-flavored 25 mg effervescent tablet (dissolved in 5 mL of water); this formulation was developed to facilitate use in infants and smaller children. Ranitidine syrup is available in a peppermint-flavored 15 mg/mL formulation. OBJECTIVE To compare taste preferences for ranitidine (Zantac) syrup and ranitidine effervescent tablets dissolved in water (Zantac EFFERdose) in healthy children aged 4-8 years and their adult caregivers. STUDY DESIGN AND METHODS A randomized, single-blind, crossover, taste test trial was conducted in 102 children and 102 parents/legal guardians. All subjects received a single 45 mg dose of each formulation. After tasting both preparations children were asked: "Now that you have tasted both medicines, which one of these medicines do you think tastes better?" Adults were asked four questions to assess whether they would administer the medication to the children. RESULTS Seventy-one percent (72/102) of the children preferred the taste of the ranitidine effervescent tablets compared with 29% (30/102) who preferred the syrup (p < 0.001). The majority of adults (71%) responded that they would prefer to administer the effervescent formulation based on taste. Adverse events consistent with product labeling were mild and were reported in four children and three adults: headache (n = 3), drowsiness (n = 1), abdominal pain/cramps (n = 2), and bloating/gas (n = 1). CONCLUSION The taste of the ranitidine effervescent formulation dissolved in water is preferred over the ranitidine syrup. Better taste acceptance may facilitate ease of administration and compliance in pediatric patients.
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Affiliation(s)
- Vanessa Z Ameen
- Clinical Pharmacology and Discovery Medicine, Research and Development, GlaxoSmithKline, Research Triangle Park, North Carolina 27709, USA.
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Mattioli G, Pini-Prato A, Gentilino V, Caponcelli E, Avanzini S, Parodi S, Rossi GA, Tuo P, Gandullia P, Vella C, Jasonni V. Esophageal impedance/pH monitoring in pediatric patients: preliminary experience with 50 cases. Dig Dis Sci 2006; 51:2341-7. [PMID: 17120147 DOI: 10.1007/s10620-006-9374-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 04/01/2006] [Indexed: 12/09/2022]
Abstract
This paper describes multiple intraluminal impedance (MII) in 50 children with typical and atypical gastroesophageal reflux (GER) symptoms and discusses the possible clinical significance of objective numeric data provided by MII computed analysis. Patients underwent 24-hr pH/MII monitoring. Reflux parameters were analyzed with relation to age and reported symptoms. Nonacidic MII events occurred as frequently as acidic ones. A Pathologic Bolus Exposure Index associated with a normal pH Reflux Index was detected in 26% of our series. Significant correlations were found regarding acid and bolus clearing times and their ratio. We conclude that the low rate of symptom occurrence in the pediatric population represents a limit on MII evaluation. Our study confirmed that nonacid GER is at least as frequent as acid GER. As MII provides interesting objective data that could be used in clinical practice, we suggest further research to define normal ranges in the pediatric population.
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Affiliation(s)
- Girolamo Mattioli
- Division and Chair of Pediatric Surgery, Giannina Gaslini Institute, University of Genoa, Largo G. Gaslini 5, 16148, Genoa, Italy
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