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Hamouda S, Hadj IB, Sayari T, Louati A, Messaoud T, Khalsi F, Boussetta K. Impact of illness on mothers of children with cystic fibrosis in Tunisia: A qualitative interview study: Impact of cystic fibrosis on Tunisian mothers. Arch Pediatr 2022; 29:429-433. [PMID: 35705385 DOI: 10.1016/j.arcped.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/09/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Caring for a child with cystic fibrosis (CF) is challenging and stressful and even more so in a country with limited resources. Our aim was to study the impact of CF on the daily life of mothers with children who have CF in Tunisia, emphasizing the difficulties encountered. METHODS Overall, 20 participants were interviewed about their experiences of being caregivers and mothers of children with CF, including their knowledge about the condition, their attitude toward it, the impact of CF on their daily lives, the main difficulties they had faced, and their concerns and wishes about CF management. RESULTS The median age of the interviewees was 39 years. None of the mothers had known about CF before; 14 of them had difficulty accepting it at first, with suicidal thoughts in one case. Six hid the illness from the close family for fear of negative prejudices. Three mothers decided to stop having children despite availability of prenatal screening. CF also influenced the mothers' social activities (n = 13) and interfered with their jobs (n = 5). It was responsible for additional expenses in all cases. Chest physiotherapy represented a daily source of coping for all participants. Hospitalization related to Pseudomonas aeruginosa infection was considered stressful and constraining by 12 mothers. The mothers' main concern was the child's life expectancy (n = 7). Their main wish was to administer a curative treatment (n = 17). CONCLUSION CF was found to have deeply affected the mothers' psychosocial life stressing the need for the involvement of qualified psychologists and social workers together with the medical staff.
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Affiliation(s)
- S Hamouda
- Children's Department B, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia.
| | - I Bel Hadj
- Children's Department B, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia
| | - T Sayari
- Children's Department B, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia
| | - A Louati
- Children's Department B, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia
| | - T Messaoud
- Biochemistry Laboratory, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia
| | - F Khalsi
- Children's Department B, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia
| | - K Boussetta
- Children's Department B, Bechir Hamza Children's Hospital of Tunis, Faculty of Medicine of Tunis, University Al Manar, Tunis 1007, Tunisia
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Cardoso ÉLDS, Santos SRD, Araújo YBD, Neves NTDAT, Nascimento JAD. Factors associated with the quality of life of caregivers of children and adolescents with chronic conditions. Rev Gaucha Enferm 2021; 42:e20190318. [PMID: 34037106 DOI: 10.1590/1983-1447.2021.20190318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/17/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the quality of life and associated factors in caregivers of children and adolescents with chronic conditions. METHOD Cross-sectional study, developed with data from the Children Information System of Adolescents with Chronic Diseases. The sample consisted of 143 caregivers. Data collection took place between August and October 2018. For data analysis, chi-square statistics and Binary Logistic Regression were used. RESULTS Through the study it was possible to identify that the variables that had impact on the low quality of life of the caregiver were: greater number of children with chronic conditions, routine use of medication, and financial limitations, which were considered risk factors. In turn, owning a home and having emotional support were protective factors. CONCLUSION It was observed that the caregivers had low quality of life, and knowledge of the factors that contribute to this may enable an outstanding care to the caregiver.
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Araújo YBD, Santos SRD, Neves NTDAT, Cardoso ÉLDS, Nascimento JA. Predictive model of hospitalization for children and adolescents with chronic disease. Rev Bras Enferm 2020; 73:e20180467. [DOI: 10.1590/0034-7167-2018-0467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/30/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: Describe a predictive model of hospitalization frequency for children and adolescents with chronic disease. Methods: A decision tree-based model was built using a database of 141 children and adolescents with chronic disease admitted to a federal public hospital; 18 variables were included and the frequency of hospitalization was defined as the outcome. Results: The decision tree obtained in this study could properly classify 80.85% of the participants. Model reading provided an understanding that situations of greater vulnerability such as unemployment, low income, and limited or lack of family involvement in care were predictors of a higher frequency of hospitalization. Conclusions: The model suggests that nursing professionals should adopt prevention actions for modifiable factors and authorities should make investments in health promotion for non-modifiable factors. It also enhances the debate about differentiated care to these patients.
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Moreira MCN, Nascimento MAFD, Campos DDS, Albernaz L, Costa ACCD, Barros LBDP, Horovitz DDG, Martins AJ, Madureira AF, Oliveira NVD, Pinto M. Rare diseases and the associative dialogue: resignifications for moral experiences. CIENCIA & SAUDE COLETIVA 2019; 24:3673-3682. [PMID: 31576997 DOI: 10.1590/1413-812320182410.11822019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/05/2019] [Indexed: 11/22/2022] Open
Abstract
This paper aims to discuss the experience of relatives of children and adolescents with rare diseases as a moral experience. Moral experience is characterized by suffering that is socially interpreted as a catastrophic event, mobilizing resources for signification and meaning that allow the reconstruction of identity, the appreciation of itineraries from a rare diagnosis, as well as the search for peers. Thus, the construction of relationships of recognition, alterity, and belonging is fundamental. From a symbolic interactionist perspective, the results show two significant cores: (1) shock as a surprise in the face of an unexpected diagnosis, leading to the search for peers and promotion of social recognition; (2) the cost involved with the course of a rare disease that implies a care work and the acquisition of associative capital as a possibility of strengthening and building the social capital of health care.
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Affiliation(s)
- Martha Cristina Nunes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Marcos Antonio Ferreira do Nascimento
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Daniel de Souza Campos
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Lidianne Albernaz
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Ana Carolina Carioca da Costa
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Letícia Baptista de Paula Barros
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Dafne Dain Gandelman Horovitz
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Antilia Januária Martins
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Adelino Furtado Madureira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | | | - Márcia Pinto
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
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Pinto M, Madureira A, Barros LBDP, Nascimento M, Costa ACCD, Oliveira NVD, Albernaz L, Campos DDS, Horovitz DDG, Martins AJ, Moreira MCN. [Complex care, high cost, and loss of income: frequent issues for families of children and adolescents with rare health conditions]. CAD SAUDE PUBLICA 2019; 35:e00180218. [PMID: 31508699 DOI: 10.1590/0102-311x00180218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 05/16/2019] [Indexed: 11/22/2022] Open
Abstract
Estimates point to more than seven thousand rare diseases already identified, representing 6 to 10% of all diseases. In Brazil, a rare disease is defined as one that affects up to 65 persons per 100,000. The quantification of costs for the families of patients with such conditions and their impact on income provides information capable of supporting public policies for these youngsters. The study aimed to estimate the cost and loss of earnings, viewed from the perspective of families of children and adolescents with cystic fibrosis, mucopolysaccharidosis, and osteogenesis imperfecta. The study included 99 families of patients treated at a national referral hospital for rare diseases in Rio de Janeiro, based on the principal caregiver's report. The descriptive data analysis showed that the median direct nonmedical cost for families was BRL 2,156.56 (USD 570) for cystic fibrosis, BRL 1,060.00 (USD 280) for mucopolysaccharidosis, and BRL 1,908.00 (USD 505) for osteogenesis imperfecta. Loss of earnings exceeded 100% for all three diseases. A total of 54% of families fail to receive any social benefits. The estimate of coping costs indicated that 69% of the families had incurred loans and that 22.5% had sold household assets to cope with the treatment costs. Catastrophic expenditures were observed in families dealing with the three diseases. The results unveil costs that are rarely estimated, and not only in the field of rare diseases. The findings point to a major burden on the families' income. It is important to incorporate such studies in the discussion of financing, the incorporation of new technologies, and the supply of health services.
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Affiliation(s)
- Márcia Pinto
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Adelino Madureira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Letícia Baptista de Paula Barros
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Marcos Nascimento
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Ana Carolina Carioca da Costa
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Nicole Velloso de Oliveira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Lidianne Albernaz
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Daniel de Souza Campos
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Dafne Dain Gandelman Horovitz
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Antilia Januária Martins
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Martha Cristina Nunes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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