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van de Riet L, Aris AM, Verouden NW, van Rooij T, van Woensel JB, van Karnebeek CD, Alsem MW. Designing eHealth interventions for children with complex care needs requires continuous stakeholder collaboration and co-creation. PEC Innov 2024; 4:100280. [PMID: 38596601 PMCID: PMC11002852 DOI: 10.1016/j.pecinn.2024.100280] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
Objective Hospital-to-home (H2H) transitions challenge families of children with medical complexity (CMC) and healthcare professionals (HCP). This study aimed to gain deeper insights into the H2H transition process and to work towards eHealth interventions for its improvement, by applying an iterative methodology involving both CMC families and HCP as end-users. Methods For 20-weeks, the Dutch Transitional Care Unit consortium collaborated with the Amsterdam University of Applied Sciences, HCP, and CMC families. The agile SCREAM approach was used, merging Design Thinking methods into five iterative sprints to stimulate creativity, ideation, and design. Continuous communication allowed rapid adaptation to new information and the refinement of solutions for subsequent sprints. Results This iterative process revealed three domains of care - care coordination, social wellbeing, and emotional support - that were important to all stakeholders. These domains informed the development of our final prototype, 'Our Care Team', an application tailored to meet the H2H transition needs for CMC families and HCP. Conclusion Complex processes like the H2H transition for CMC families require adaptive interventions that empower all stakeholders in their respective roles, to promote transitional care that is anticipatory, rather than reactive. Innovation A collaborative methodology is needed, that optimizes existing resources and knowledge, fosters innovation through collaboration while using creative digital design principles. This way, we might be able to design eHealth solutions with end-users, not just for them.
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Affiliation(s)
- Liz van de Riet
- Amsterdam UMC, University of Amsterdam, Department of Pediatric Intensive Care, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
- On behalf of the Transitional Care Unit Consortium, the Netherlands
| | - Anna M. Aris
- University of Applied Sciences, Digital Society School, Theo Thijssen Huis, Wibautstraat 2, 1091 GM Amsterdam, the Netherlands
- Athena Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Nick W. Verouden
- University of Applied Sciences, Digital Society School, Theo Thijssen Huis, Wibautstraat 2, 1091 GM Amsterdam, the Netherlands
| | - Tibor van Rooij
- Department of Computer Science, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Job B.M. van Woensel
- Amsterdam UMC, University of Amsterdam, Department of Pediatric Intensive Care, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- On behalf of the Transitional Care Unit Consortium, the Netherlands
| | - Clara D. van Karnebeek
- On behalf of the Transitional Care Unit Consortium, the Netherlands
- Amsterdam UMC, University of Amsterdam, Emma Center for Personalized Medicine, Departments of Pediatrics and Human Genetics, Amsterdam Gastro-Enterology Endocrinology and Metabolism, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Mattijs W. Alsem
- On behalf of the Transitional Care Unit Consortium, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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2
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van de Riet L, Alsem MW, Beijneveld RSI, van Woensel JBM, van Karnebeek CD. Delineating family needs in the transition from hospital to home for children with medical complexity: part 2, a phenomenological study. Orphanet J Rare Dis 2023; 18:387. [PMID: 38082332 PMCID: PMC10714565 DOI: 10.1186/s13023-023-02747-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A systematic literature review on the transition from hospital-to-home (H2H) of families with a child with medical complexity (CMC), resulted in nine overarching themes. These demonstrated common needs and experiences despite the widely differing CMC diagnoses and family characteristics. However, none of the reported studies was conducted in the Netherlands, which hampers the creation of a tailored H2H care pathway, deemed essential for our recently established Transitional Care Unit in the Netherlands: the 'Jeroen Pit Huis'. Therefore, the aim of this study was to gain a deeper understanding of the needs and experiences of Dutch CMC parents on H2H transition and integrate these insights with the literature review into an evidence-based H2H care pathway for CMC and their families. METHODS A descriptive phenomenological approach was applied. Heterogeneous purposeful sampling methods were used to recruit participants according to the following criteria: parents of CMC from various regions in the Netherlands, who spoke Dutch fluently and who had been discharged home from a tertiary hospital within the previous five years. Semi-structured, open-ended interviews were conducted via video call by two researchers, who transcribed the audio recordings verbatim. Thematic analysis methods were used to identify emerging themes from the individual transcripts, involving a third and fourth researcher to reach consensus. RESULTS Between March and August 2021, 14 mothers and 7 fathers participated in 14 interviews. They elaborated on the H2H transition of 14 CMC with a wide range of underlying diseases: 7 male, 7 female, aged 6 months to 10 years. Eight overarching themes, consistent with the results of the systematic review, represent CMC parental needs and experiences during the H2H process in the Netherlands: (1) autonomy, (2) division of tasks and roles, (3) family emotions, (4) impact on family life, (5) communication, (6) coordination of care, (7) support system and (8) adaptation. CONCLUSIONS The H2H needs and experiences reported by the CMC families in this study align with the results of our systematic review. The H2H transition process is not linear but continuous, and should extend beyond the specific medical needs of the CMC to holistic care for the family as a whole. The overarching care needs and experiences, expressed by all CMC families, regardless of underlying symptoms and diagnoses, inform the H2H care pathway and its future evaluation. Our studies highlight the necessity to focus on the family needs rather than on the specific illness of the child, as well as the value of our interdisciplinary care team partnering with parents in the 'Jeroen Pit Huis' towards a safe and sustainable transition home.
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Affiliation(s)
- L van de Riet
- Department of Pediatric Intensive Care, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - M W Alsem
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
| | - R S I Beijneveld
- Department of Pediatric Intensive Care, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
| | - J B M van Woensel
- Department of Pediatric Intensive Care, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - C D van Karnebeek
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands.
- Emma Center for Personalized Medicine, Departments of Pediatrics and Human Genetics, Amsterdam Gastro-Enterology Endocrinology and Metabolism, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands.
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van de Riet L, Alsem MW, van der Leest EC, van Etten-Jamaludin FS, Maaskant JM, van Woensel JBM, van Karnebeek CD. Delineating family needs in the transition from hospital to home for children with medical complexity: part 1, a meta-aggregation of qualitative studies. Orphanet J Rare Dis 2023; 18:386. [PMID: 38082309 PMCID: PMC10714518 DOI: 10.1186/s13023-023-02942-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Advances in diagnostic and therapeutic interventions for rare diseases result in greater survival rates, with on the flipside an expanding group of children with medical complexity (CMC). When CMC leave the protective hospital environment to be cared for at home, their parents face many challenges as they take on a new role, that of caregiver rather than care-recipient. However, an overview of needs and experiences of parents of CMC during transition from hospital-to-home (H2H) is lacking, which hampers the creation of a tailored H2H care pathway. Here we address this unmet medical need by performing a literature review to systematically identify, assess and synthesize all existing qualitative evidence on H2H transition needs of CMC parents. METHODS An extensive search in Medline, PsychINFO and CINAHL (up to September 2022); selection was performed to include all qualitative studies describing parental needs and experiences during H2H transition of CMC. All papers were assessed by two independent investigators for methodological quality before data (study findings) were extracted and pooled. A meta-aggregation method categorized the study findings into categories and formulated overarching synthesized findings, which were assigned a level of confidence, following the ConQual approach. RESULTS The search yielded 1880 papers of which 25 met eligible criteria. A total of 402 study findings were extracted from the included studies and subsequently aggregated into 50 categories and 9 synthesized findings: (1) parental empowerment: shifting from care recipient to caregiver (2) coordination of care (3) communication and information (4) training skills (5) preparation for discharge (6) access to resources and support system (7) emotional experiences: fatigue, fear, isolation and guilt (8) parent-professional relationship (9) changing perspective: finding new routines and practices. The overall ConQual Score was low for 7 synthesized findings and very low for 2 synthesized findings. CONCLUSIONS Despite the variability in CMC symptoms and underlying (rare disease) diagnoses, overarching themes in parental needs during H2H transition emerged. We will augment this new knowledge with an interview study in the Dutch setting to ultimately translate into an evidence-based tailored care pathway for implementation by our interdisciplinary team in the newly established 'Jeroen Pit Huis', an innovative care unit which aims for a safe and sustainable H2H transition for CMC and their families.
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Affiliation(s)
- L van de Riet
- Department of Pediatric Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - M W Alsem
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - E C van der Leest
- Department of Pediatric Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - F S van Etten-Jamaludin
- Medical Library AMC, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J M Maaskant
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J B M van Woensel
- Department of Pediatric Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - C D van Karnebeek
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands.
- Emma Center for Personalized Medicine, Departments of Pediatrics and Human Genetics, Amsterdam Gastro-Enterology Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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4
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Haspels HN, de Lange AA, Alsem MW, Sandbergen B, Dulfer K, de Hoog M, Joosten KFM, van Karnebeek CD, van Woensel JBM, Maaskant JM. Hospital-to-home transitions for children with medical complexity: part 2-a core outcome set. Eur J Pediatr 2023; 182:3833-3843. [PMID: 37338690 PMCID: PMC10570151 DOI: 10.1007/s00431-023-05049-2] [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: 02/21/2023] [Revised: 05/19/2023] [Accepted: 05/31/2023] [Indexed: 06/21/2023]
Abstract
Appropriate outcome measures as part of high-quality intervention trials are critical to advancing hospital-to-home transitions for Children with Medical Complexity (CMC). Our aim was to conduct a Delphi study and focus groups to identify a Core Outcome Set (COS) that healthcare professionals and parents consider essential outcomes for future intervention research. The development process consisted of two phases: (1) a three-round Delphi study in which different professionals rated outcomes, previously described in a systematic review, for inclusion in the COS and (2) focus groups with parents of CMC to validate the results of the Delphi study. Forty-five professionals participated in the Delphi study. The response rates were 55%, 57%, and 58% in the three rounds, respectively. In addition to the 24 outcomes from the literature, the participants suggested 12 additional outcomes. The Delphi rounds resulted in the following core outcomes: (1) disease management, (2) child's quality of life, and (3) impact on the life of families. Two focus groups with seven parents highlighted another core outcome: (4) self-efficacy of parents. Conclusion: An evidence-informed COS has been developed based on consensus among healthcare professionals and parents. These core outcomes could facilitate standard reporting in future CMC hospital to home transition research. This study facilitated the next step of COS development: selecting the appropriate measurement instruments for every outcome. What is Known: • Hospital-to-home transition for Children with Medical Complexity is a challenging process. • The use of core outcome sets could improve the quality and consistency of research reporting, ultimately leading to better outcomes for children and families. What is New: • The Core Outcome Set for transitional care for Children with Medical Complexity includes four outcomes: disease management, children's quality of life, impact on the life of families, and self-efficacy of parents.
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Affiliation(s)
- Heleen N Haspels
- Department of Pediatric Intensive Care Unit, Amsterdam Reproduction and Development, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Pediatric and Neonatal Intensive Care, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, 3015 CN, The Netherlands
| | - Annemieke A de Lange
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Mattijs W Alsem
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | | | - Karolijn Dulfer
- Department of Pediatric and Neonatal Intensive Care, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, 3015 CN, The Netherlands
| | - Matthijs de Hoog
- Department of Pediatric and Neonatal Intensive Care, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, 3015 CN, The Netherlands
| | - Koen F M Joosten
- Department of Pediatric and Neonatal Intensive Care, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, 3015 CN, The Netherlands
| | - Clara D van Karnebeek
- Department of Pediatrics and Human Genetics, Emma Center for Personalized Medicine, Amsterdam Reproduction and Development, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | - Job B M van Woensel
- Department of Pediatric Intensive Care Unit, Amsterdam Reproduction and Development, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jolanda M Maaskant
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
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5
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de Lange A, Alsem MW, Haspels HN, van Karnebeek CDM, van Woensel JBM, Etten-Jamaludin FS, Maaskant JM. Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes. Eur J Pediatr 2023; 182:3805-3831. [PMID: 37318656 PMCID: PMC10570194 DOI: 10.1007/s00431-023-05050-9] [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: 02/21/2023] [Revised: 05/19/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Abstract
Outcome selection to evaluate interventions to support a successful transition from hospital to home of children with medical complexity (CMC) may be difficult due to the variety in available outcomes. To support researchers in outcome selection, this systematic review aimed to summarize and categorize outcomes currently reported in publications evaluating the effectiveness of hospital-to-home transitional care interventions for CMC. We searched the following databases: Medline, Embase, Cochrane library, CINAHL, PsychInfo, and Web of Science for studies published between 1 January 2010 and 15 March 2023. Two reviewers independently screened the articles and extracted the data with a focus on the outcomes. Our research group extensively discussed the outcome list to identify those with similar definitions, wording or meaning. Consensus meetings were organized to discuss disagreements, and to summarize and categorize the data. We identified 50 studies that reported in total 172 outcomes. Consensus was reached on 25 unique outcomes that were assigned to six outcome domains: mortality and survival, physical health, life impact (the impact on functioning, quality of life, delivery of care and personal circumstances), resource use, adverse events, and others. Most frequently studied outcomes reflected life impact and resource use. Apart from the heterogeneity in outcomes, we also found heterogeneity in designs, data sources, and measurement tools used to evaluate the outcomes. Conclusion: This systematic review provides a categorized overview of outcomes that may be used to evaluate interventions to improve hospital-to-home transition for CMC. The results can be used in the development of a core outcome set transitional care for CMC.
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Affiliation(s)
- Annemieke de Lange
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mattijs W Alsem
- Department of Rehabilitation, Amsterdam UMC location University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Heleen N Haspels
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Pediatric and Neonatal Intensive Care, Division of Pediatric Intensive Care, ErasmusMC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Clara D M van Karnebeek
- Department of Pediatrics and Human Genetics, Emma Center for Personalized Medicine, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Amsterdam Reproduction and Development, Meibergdreef 9, Amsterdam, the Netherlands
| | - Job B M van Woensel
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, the Netherlands
| | - Faridi S Etten-Jamaludin
- Medical Library, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jolanda M Maaskant
- Department of Pediatrics, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, the Netherlands.
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Warnink-Kavelaars J, de Koning LE, Rombaut L, Menke LA, Alsem MW, van Oers HA, Buizer AI, Engelbert RHH, Oosterlaan J. Heritable connective tissue disorders in childhood: Decreased health-related quality of life and mental health. Am J Med Genet A 2022; 188:2096-2109. [PMID: 35393672 PMCID: PMC9321696 DOI: 10.1002/ajmg.a.62750] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/23/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
The psychosocial consequences of growing up with Heritable Connective Tissue Disorders (HCTD) are largely unknown. We aimed to assess Health‐Related Quality of Life (HRQoL) and mental health of children and adolescents with HCTD. This observational multicenter study included 126 children, aged 4–18 years, with Marfan syndrome (MFS, n = 74), Loeys–Dietz syndrome (n = 8), molecular confirmed Ehlers–Danlos syndromes (n = 15), and hypermobile Ehlers–Danlos syndrome (hEDS, n = 29). HRQoL and mental health were assessed through the parent and child‐reported Child Health Questionnaires (CHQ‐PF50 and CHQ‐CF45, respectively) and the parent‐reported Strengths and Difficulties Questionnaire. Compared with a representative general population sample, parent‐reported HRQoL of the HCTD‐group showed significantly decreased Physical sum scores (p < 0.001, d = 0.9) and Psychosocial sum scores (p = 0.024, d = 0.2), indicating decreased HRQoL. Similar findings were obtained for child‐reported HRQoL. The parent‐reported mental health of the HCTD‐group showed significantly increased Total difficulties sum scores (p = 0.01, d = 0.3), indicating decreased mental health. While the male and female MFS‐ and hEDS‐subgroups both reported decreased HRQoL, only the hEDS‐subgroup reported decreased mental health. In conclusion, children and adolescents with HCTD report decreased HRQoL and mental health, with most adverse outcomes reported in children with hEDS and least in those with MFS. These findings call for systematic monitoring and tailored interventions.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
| | - Lisanne E de Koning
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, The Netherlands
| | - Lies Rombaut
- Ghent University Hospital, Ghent University, Center for Medical Genetics, Ghent, Belgium
| | - Leonie A Menke
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Amsterdam, The Netherlands
| | - Mattijs W Alsem
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Amsterdam UMC, location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.,Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Raoul H H Engelbert
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.,Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me program & Emma Neuroscience Group, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
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7
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Warnink-Kavelaars J, de Koning LE, Rombaut L, Alsem MW, Menke LA, Oosterlaan J, Buizer AI, Engelbert RHH. Heritable Connective Tissue Disorders in Childhood: Increased Fatigue, Pain, Disability and Decreased General Health. Genes (Basel) 2021; 12:genes12060831. [PMID: 34071423 PMCID: PMC8229209 DOI: 10.3390/genes12060831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022] Open
Abstract
Heritable Connective Tissue Disorders (HCTD) show an overlap in the physical features that can evolve in childhood. It is unclear to what extent children with HCTD experience burden of disease. This study aims to quantify fatigue, pain, disability and general health with standardized validated questionnaires. METHODS This observational, multicenter study included 107 children, aged 4-18 years, with Marfan syndrome (MFS), 58%; Loeys-Dietz syndrome (LDS), 7%; Ehlers-Danlos syndromes (EDS), 8%; and hypermobile Ehlers-Danlos syndrome (hEDS), 27%. The assessments included PROMIS Fatigue Parent-Proxy and Pediatric self-report, pain and general health Visual-Analogue-Scales (VAS) and a Childhood Health Assessment Questionnaire (CHAQ). RESULTS Compared to normative data, the total HCTD-group showed significantly higher parent-rated fatigue T-scores (M = 53 (SD = 12), p = 0.004, d = 0.3), pain VAS scores (M = 2.8 (SD = 3.1), p < 0.001, d = 1.27), general health VAS scores (M = 2.5 (SD = 1.8), p < 0.001, d = 2.04) and CHAQ disability index scores (M = 0.9 (SD = 0.7), p < 0.001, d = 1.23). HCTD-subgroups showed similar results. The most adverse sequels were reported in children with hEDS, whereas the least were reported in those with MFS. Disability showed significant relationships with fatigue (p < 0.001, rs = 0.68), pain (p < 0.001, rs = 0.64) and general health (p < 0.001, rs = 0.59). CONCLUSIONS Compared to normative data, children and adolescents with HCTD reported increased fatigue, pain, disability and decreased general health, with most differences translating into very large-sized effects. This new knowledge calls for systematic monitoring with standardized validated questionnaires, physical assessments and tailored interventions in clinical care.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (M.W.A.); (A.I.B.); (R.H.H.E.)
- Correspondence: ; Tel.: +31(0)2-0566-3345
| | - Lisanne E. de Koning
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, The Netherlands;
| | - Lies Rombaut
- Center of Medical Genetics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium;
| | - Mattijs W. Alsem
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (M.W.A.); (A.I.B.); (R.H.H.E.)
| | - Leonie A. Menke
- Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Jaap Oosterlaan
- Emma Neuroscience Group, Amsterdam Reproduction & Development, Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Annemieke I. Buizer
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (M.W.A.); (A.I.B.); (R.H.H.E.)
- Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Department of Rehabilitation Medicine, Rehabilitation and Development, Amsterdam Movement Sciences Institute, Amsterdam UMC, Vrije University of Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Raoul H. H. Engelbert
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (M.W.A.); (A.I.B.); (R.H.H.E.)
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, The Netherlands;
- Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - on behalf of the Pediatric Heritable Connective Tissue Disorders Study Group
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (M.W.A.); (A.I.B.); (R.H.H.E.)
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, The Netherlands;
- Center of Medical Genetics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium;
- Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Emma Neuroscience Group, Amsterdam Reproduction & Development, Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Department of Rehabilitation Medicine, Rehabilitation and Development, Amsterdam Movement Sciences Institute, Amsterdam UMC, Vrije University of Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
- Center for Human and Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
- Centre of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Physical and Rehabilitation Medicine, Child Rehabilitation, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
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Verkerk GJ, van der Molen-Meulmeester L, Alsem MW. How children and their parents value using the Canadian Occupational Performance Measure (COPM) with children themselves. J Pediatr Rehabil Med 2021; 14:7-17. [PMID: 33104046 PMCID: PMC8075379 DOI: 10.3233/prm-190604] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Although the Canadian Occupational Performance Measure (COPM) is used with children, it is unclear how they and their parents experience this. This study aims to investigate the opinions of children and their parents about the COPM when it is used with children. METHODS Semi-structured interviews were performed with 23 children varying in age between 8 and 18 years. The transcripts of the interviews were analysed using MAXQDA software to discover overarching themes. Parents' responses to an eight-item multiple-choice questionnaire were analysed using SPSS software. RESULTS Five themes extracted from the interviews with the children show: My way of doing the COPM; The COPM shows my own problems and wishes for change; The COPM is important for identifying the support I need; The influence of my parents and my therapist; and The COPM is suitable for me. The children experienced the COPM as a valuable tool for determining and measuring the impact of an intervention. The parents experienced the COPM as suitable for their child and judged that the child's scores were useful for showing the outcome of an intervention. CONCLUSION Both the children and their parents valued the COPM as an outcome measure for intervention.
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Affiliation(s)
- Gijs J.Q. Verkerk
- Corresponding author: Gijs J.Q. Verkerk, Department of Rehabilitation, A-01-414, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Tel.: +31 20 5663345; Fax: +31 20 5669154; E-mail:
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Alsem MW, Berkhout JJ, Buizer AI. Therapy needs and possibilities in paediatric rehabilitation during the COVID-19 lockdown in the Netherlands. Child Care Health Dev 2020; 46:749-750. [PMID: 32692426 PMCID: PMC7404530 DOI: 10.1111/cch.12797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Mattijs W. Alsem
- Department of Rehabilitation, Amsterdam Movement SciencesAmsterdam UMC, University of AmsterdamMeibergdreef 9AmsterdamThe Netherlands,Emma Children's HospitalAmsterdam UMCAmsterdamThe Netherlands
| | - Joris J. Berkhout
- Department of Rehabilitation Medicine, Amsterdam Movement SciencesVrije Universiteit Amsterdam, University of AmsterdamAmsterdamThe Netherlands,Emma Children's HospitalAmsterdam UMCAmsterdamThe Netherlands
| | - Annemieke I. Buizer
- Department of Rehabilitation Medicine, Amsterdam Movement SciencesVrije Universiteit Amsterdam, University of AmsterdamAmsterdamThe Netherlands,Emma Children's HospitalAmsterdam UMCAmsterdamThe Netherlands
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Warnink-Kavelaars J, van Oers HA, Haverman L, Buizer AI, Alsem MW, Engelbert RHH, Menke LA. Parenting a child with Marfan syndrome: Distress and everyday problems. Am J Med Genet A 2020; 185:50-59. [PMID: 33034422 PMCID: PMC7756496 DOI: 10.1002/ajmg.a.61906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/06/2020] [Accepted: 09/20/2020] [Indexed: 12/25/2022]
Abstract
Marfan syndrome (MFS) is a multisystemic, autosomal dominant connective tissue disorder that occurs de novo in 25%. In many families, parent and child(ren) are affected, which may increase distress in parents. To assess distress, 42 mothers (29% MFS) and 25 fathers (60% MFS) of 43 affected children, completed the validated screening‐questionnaire Distress thermometer for parents of a chronically ill child, including questions on overall distress (score 0–10; ≥4 denoting “clinical distress”) and everyday problems (score 0–36). Data were compared to 1,134 control‐group‐parents of healthy children. Mothers reported significantly less overall distress (2, 1–4 vs. 3, 1–6; p = .049; r = −.07) and total everyday problems (3, 0–6 vs. 4, 1–8; p = .03; r = −.08) compared to control‐group‐mothers. Mothers without MFS reported significantly less overall distress compared to mothers with MFS, both of a child with MFS (1, 0–4 vs. 3.5, 2–5; p = .039; r = −.17). No significant differences were found between the father‐groups, nor between the group of healthy parents of an affected child living together with an affected partner compared to control‐group‐parents. No differences in percentages of clinical distress were reported between mothers and control‐group‐mothers (33 vs. 42%); fathers and control‐group‐fathers (28 vs. 32%); nor between the other groups. Distress was not associated with the children's MFS characteristics. Concluding, parents of a child with MFS did not show more clinical distress compared to parents of healthy children. However, clinical distress was reported in approximately one‐third and may increase in case of acute medical complications. We advise monitoring distress in parents of a child with MFS to provide targeted support.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Hedy A van Oers
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mattijs W Alsem
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Raoul H H Engelbert
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Center of Expertise Urban Vitality, University of Applied Sciences, Faculty of Health, Amsterdam, The Netherlands.,Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Leonie A Menke
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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11
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Alsem MW, Verhoef M, Braakman J, van Meeteren KM, Siebes RC, Jongmans MJ, Visser‐Meily JM, Ketelaar M. Parental empowerment in paediatric rehabilitation: Exploring the role of a digital tool to help parents prepare for consultation with a physician. Child Care Health Dev 2019; 45:623-636. [PMID: 31276605 PMCID: PMC7171983 DOI: 10.1111/cch.12700] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 06/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND To explore experiences of parents of children with disabilities using the WWW, roadmap, a tool to support them in exploring needs, finding information, and asking questions of professionals and to explore differences between parents who had used the WWW-roadmap to prepare for consultation with their rehabilitation physician and parents who had not. METHODS In a sequential cohort study, we included 128 parents; 54 used the WWW-roadmap prior to consultation and 74 received care-as-usual. Both groups completed questionnaires after consultation, assessing empowerment, self-efficacy, parent and physician satisfaction, family centredness of care, and experiences using the tool. Additionally, 13 parents were interviewed. RESULTS Parents who used the WWW-roadmap looked up more information on the Internet. No other differences between parents and physicians were found. In the interviews, parents said that the WWW-roadmap was a useful tool for looking up information, exploring and asking questions, and maintaining a comprehensive picture. CONCLUSION Using the WWW-roadmap prior to consultation did not improve self-efficacy, satisfaction, or family centredness of care. Findings suggest positive experiences regarding factors determining empowerment, creating conditions for a more equal parent-physician relationship. The WWW-roadmap is useful for parents to explore their needs and find information, but more is needed to support empowerment in consultations.
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Affiliation(s)
- Mattijs W. Alsem
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands,Department of Rehabilitation MedicineAmsterdam University Medical Centers, location AMCMeibergdreef 9AmsterdamThe Netherlands
| | - Marjolein Verhoef
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands,Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jessica Braakman
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands
| | - Karen M. van Meeteren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands
| | - Renate C. Siebes
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands
| | - Marian J. Jongmans
- Department of Education and Pedagogy, Faculty of Social and Behavioural SciencesUtrecht University, the Netherlands and Department of Neonatology, Wilhelmina Children's hospital, University Medical Center UtrechtUtrechtThe Netherlands
| | - Johanna M.A. Visser‐Meily
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands,Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands
| | - The WWW, roadmap study group
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat RehabilitationUtrecht UniversityUtrechtThe Netherlands,Department of Rehabilitation MedicineAmsterdam University Medical Centers, location AMCMeibergdreef 9AmsterdamThe Netherlands,BOSK Association of persons with congenital physical handicapsUtrechtThe Netherlands,Department of Paediatric RehabilitationRehabilitation Center MeremHuizenThe Netherlands,Department of Paediatric RehabilitationRijndam RehabilitationRotterdamThe Netherlands,Research Center Autonomy and Participation, Faculty of HealthZuyd University of Applied ScienceHeerlenThe Netherlands
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12
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Warnink-Kavelaars J, Beelen A, Goedhart TMHJ, de Koning LE, Nollet F, Alsem MW, Menke LA, Engelbert RHH. Marfan syndrome in adolescence: adolescents' perspectives on (physical) functioning, disability, contextual factors and support needs. Eur J Pediatr 2019; 178:1883-1892. [PMID: 31620888 PMCID: PMC6881250 DOI: 10.1007/s00431-019-03469-7] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 12/11/2022]
Abstract
Although essential for providing optimal adolescent patient support, knowledge of the impact of Marfan syndrome in adolescence is limited. To explore adolescents' perceived impact of Marfan syndrome on (physical) functioning (activities, participation), disability (limitations, restrictions), contextual factors and support needs, we interviewed 19 adolescents with Marfan syndrome. Audio-recordings were transcribed, coded and analysed using thematic analysis. Identified themes were "difficulties in keeping up with peers" and "being and feeling different from peers". Furthermore, an adolescent Marfan syndrome-specific International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) model derived from the data describing the adolescent perceived impact of Marfan syndrome on functioning, disability and its contextual factors. Adolescents perceived problems in keeping up with peers in school, sports, leisure and friendships/relationships, and they could not meet work requirements. Moreover, participants perceived to differ from peers due to their appearance and disability. Contextual factors: coping with Marfan syndrome, self-esteem/image, knowledge about Marfan syndrome, support from family/friends/teachers, ability to express needs and peer-group acceptation acted individually as barrier or facilitator for identified themes.Conclusion: Adolescents with Marfan syndrome perceived limitations and restrictions in (physical) functioning. They perceived problems in keeping up with peers and perceived to differ from peers due to their appearance and disability. This warrants awareness and tailored physical, psychosocial, educational and environmental support programmes to improve (physical) functioning and empowerment of adolescents with Marfan syndrome.What is known:• Marfan syndrome is a hereditary connective tissue disorder.• Marfan syndrome affects multiple systems.What is new:• Adolescents with Marfan syndrome perceive (1) problems in keeping up with peers in school, sports, leisure, friendships/relationships and work (2) to differ from peers due to their appearance and disability.• An adolescent Marfan syndrome-specific International Classification of Functioning, Disability and Health for Children and Youth model derived from the data describing the adolescent perceived impact of Marfan syndrome on functioning, disability and contextual factors.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Amsterdam UMC, University of Amsterdam, Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, PO 22660, 1100 DD, Amsterdam, Netherlands.
| | - Anita Beelen
- grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, PO 22660, 1100 DD Amsterdam, Netherlands ,grid.7692.a0000000090126352Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands ,grid.7692.a0000000090126352Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Tine M. H. J. Goedhart
- grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, PO 22660, 1100 DD Amsterdam, Netherlands
| | - Lisanne E. de Koning
- grid.431204.0ACHIEVE, Center of Applied Research, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, the Netherlands
| | - Frans Nollet
- grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, PO 22660, 1100 DD Amsterdam, Netherlands
| | - Mattijs W. Alsem
- grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, PO 22660, 1100 DD Amsterdam, Netherlands
| | - Leonie A. Menke
- grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Pediatrics, Meibergdreef 9, Amsterdam, Netherlands
| | - Raoul H. H. Engelbert
- grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, PO 22660, 1100 DD Amsterdam, Netherlands ,grid.431204.0ACHIEVE, Center of Applied Research, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, the Netherlands ,grid.7177.60000000084992262Amsterdam UMC, University of Amsterdam, Pediatrics, Meibergdreef 9, Amsterdam, Netherlands
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Terwiel M, Alsem MW, Siebes RC, Bieleman K, Verhoef M, Ketelaar M. Family-centred service: differences in what parents of children with cerebral palsy rate important. Child Care Health Dev 2017; 43:663-669. [PMID: 28326571 DOI: 10.1111/cch.12460] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 12/24/2016] [Revised: 02/24/2017] [Accepted: 02/26/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND A family-centred approach to services of children with disabilities is widely accepted as the foundational approach to service delivery in paediatric health care. The 56 items of the Measure of Processes of Care questionnaire (MPOC-56) all reflect elements of family-centred service. In this study, we investigated which elements of family-centred service are rated important by parents of children with cerebral palsy by adding a question on importance to each item of the MPOC-56 (MPOC-56-I). METHODS In total, 175 parents of children with cerebral palsy completed the MPOC-56-I. For each MPOC item, parents were asked to rate the importance on a 5-point scale ranging from 0 (not important at all) up to and including 4 (very important). We used Spearman's rank correlation coefficient to further explore the variation in parents' importance ratings. RESULTS Parents' importance ratings of the MPOC-56 items varied. The percentage of parents rating an item important (importance rating 3 or 4) varied between 43.8% and 96.8%. The percentage of parents rating an item unimportant (rating 0 or 1) varied between 0.0% and 20.3%, and the percentage of parents rating an item neutral (rating 2) varied between 3.0% and 36.0%. Most diverse importance ratings were found for five items concerning the provision of general information. Three correlations between these items and child and parent characteristics were found. Six items were rated important by almost all (≥95%) parents. These items concern elements of specific information about the child, co-ordinated and comprehensive care for child and family and enabling and partnership. CONCLUSIONS Parents rate the importance of family-centred services for their situation in various ways. These findings endorse that family-centred services should recognize the uniqueness of families and should be tailored to what parents find important.
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Affiliation(s)
- M Terwiel
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - M W Alsem
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - R C Siebes
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - K Bieleman
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Child Rehabilitation, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - M Verhoef
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - M Ketelaar
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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14
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Alsem MW, Ausems F, Verhoef M, Jongmans MJ, Meily-Visser JMA, Ketelaar M. Information seeking by parents of children with physical disabilities: An exploratory qualitative study. Res Dev Disabil 2017; 60:125-134. [PMID: 27914304 DOI: 10.1016/j.ridd.2016.11.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 11/04/2016] [Accepted: 11/20/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Evidence suggests that parents of children with disabilities feel that not all their information needs are being met, but it remains unclear how parents try to fill these information gaps. AIMS The aim of this study is to describe how parents of children with physical disabilities search for and evaluate information. METHODS Qualitative semi-structured interviews were conducted with 15 parents of children with a disability, aged 1.5-21 years. Data were analysed using thematic analysis. RESULTS There was much variation in information needs between parents. Parents used different sources, depending on the type of information needed, the most important being healthcare professionals, peers, and websites. Peers played an important role in information provision and were the preferred source of experience-based knowledge and support. The Internet is a widely used medium to search for information and to access various sources. There was a general preference for closed Internet communities for peer contact. Information was commonly evaluated by comparing sources. CONCLUSIONS AND IMPLICATIONS Parents use different sources for different information needs, and evaluate information by comparing them. Healthcare professionals and parents can support each other in locating and evaluating information including experience-based knowledge. Healthcare professionals should guide parents in their search for information and experience-based knowledge from peers.
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Affiliation(s)
- M W Alsem
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - F Ausems
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M Verhoef
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M J Jongmans
- Department of Child, Family & Education Studies, Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands
| | - J M A Meily-Visser
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
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15
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Alsem MW, Verhoef M, Gorter JW, Langezaal LCM, Visser-Meily JMA, Ketelaar M. Parents' perceptions of the services provided to children with cerebral palsy in the transition from preschool rehabilitation to school-based services. Child Care Health Dev 2016; 42:455-63. [PMID: 27117085 DOI: 10.1111/cch.12341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/10/2015] [Revised: 12/17/2015] [Accepted: 03/04/2016] [Indexed: 11/26/2022]
Abstract
AIM To describe the course of parents' perceptions of the family centredness of rehabilitation services provided to their children with cerebral palsy (CP) before and after the transition from preschool to school-based services. BACKGROUND Parents of 59 children with CP aged 2.5 to 4.5 years filled in the 56-item Measure of Processes of Care (MPOC-56) on three occasions pre (2) and post (1) transition to school-based services. Friedman tests were used to describe changes in parents' perceptions over time. Mann-Whitney U tests were used to describe differences in course of parents' perceptions between regular school and special school or day care. RESULTS Parents' perceptions of preschool services were stable between the ages of 2.5 and 3.5 years, with a decline after transition on four of the five domains of the MPOC (P < 0.05). The domain providing general information was scored lowest (median at baseline 3.56, IQR 2.39) compared with the four other MPOC domains, but remained stable over time. No differences in course of parental perceptions were found for school type. CONCLUSION The transition from preschool to school-based services for children with CP is associated with a decrease in parents' perception of family centredness independent of the type of school. The transition in services has a negative impact on perceived family-centred practices.
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Affiliation(s)
- M W Alsem
- Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - M Verhoef
- Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - J W Gorter
- Department of Pediatrics and CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - L C M Langezaal
- Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - J M A Visser-Meily
- Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - M Ketelaar
- Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Centre Utrecht, Utrecht, The Netherlands
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16
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Alsem MW, Siebes RC, Gorter JW, Jongmans MJ, Nijhuis BGJ, Ketelaar M. Assessment of family needs in children with physical disabilities: development of a family needs inventory. Child Care Health Dev 2014; 40:498-506. [PMID: 24844366 DOI: 10.1111/cch.12093] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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] [Accepted: 06/27/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Valid tools to assess family needs for children with physical disabilities are needed to help tune paediatric rehabilitation care processes to individual needs of these families. To create such a family needs inventory, needs of families of children with a physical disability (age 0-18 years) were identified. We examined differences in the number and type of needs listed by families when asked for by means of an interview compared with using an inventory. METHODS Forty-nine families of children with a wide variety of physical disabilities (mean age 7.7 years; SD 4.6) participated in semi-structured interviews, focusing on family needs. They also checked an inventory of 99 items (based on a previously conducted literature review), regarding their family needs. In addition, individual interviews with healthcare professionals, and panel meetings with healthcare professionals and parents were held to further identify relevant family needs for the inventory. RESULTS The individual parent and healthcare professional interviews raised 41 needs that were not included in the original inventory of 99 items. Moreover, the panel meetings raised a further 49 needs. After restructuring and reformulating several items, a 187-item Family Needs Inventory - Paediatric Rehabilitation (FNI-PR) was created. The parent interviews revealed significantly less family needs (mean number of needs = 10.8; SD = 6.0) compared with using the inventory (mean number of needs = 31.7; SD = 19.7) (P < 0.0001). Most expressed family needs were related to both general and specific information concerning the child's development and treatment, aids and information about legislation and to rules relating to compensation of costs. CONCLUSION Based on responses of parents and healthcare professionals the FNI-PR has been developed, a comprehensive inventory for family needs that can be used in paediatric rehabilitation. An inventory checked by parents resulted in more family needs than a single open-ended question. The inventory may facilitate the implementation of family-centred care.
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Affiliation(s)
- M W Alsem
- Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine Utrecht, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Partner of NetChild, Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands
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