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1.
Anxiety sensitivity (AS), or the fear of anxiety sensations, has been shown to independently predict poorer health-related quality of life (HRQOL) in adults with chronic pain. Specifically, AS was found to contribute to decrements in psychological well-being and social functioning but not to decrements in physical functioning. Existing studies have not examined the relationship between AS and HRQOL in children with chronic pain. The present study used multivariate regression analysis to test the association between AS and self-reported HRQOL in 87 children (62 girls; mean age = 14.4 years +/-2.3) presenting for treatment at a tertiary, multidisciplinary clinic specializing in pediatric chronic pain. After controlling for key sociodemographic and pain-related characteristics, higher AS was associated with poorer perceived general and mental health, greater impairment in family activities, lower self-esteem, increased behavior problems, and more social/academic limitations due to emotional problems. AS accounted for 4% to 28% of incremental variance in these HRQOL domains above and beyond the demographic and pain-related variables. However, AS was not significantly associated with physical functioning or with academic/social limitations due to physical health. Additional research is required to delineate possible mechanisms by which AS may influence certain aspects of children's HRQOL but not others. PERSPECTIVE: The present findings support the evaluation of AS in pediatric chronic pain patients as part of a comprehensive assessment battery. The links between AS and multiple HRQOL domains suggest that treatment components aimed at reducing AS may lead to enhanced psychosocial well-being in children with chronic pain.  相似文献   

2.
The purpose of this study was to examine the relationship between pain symptoms, daily functioning, health-related quality of life (HRQOL), and subjectively reported sleep disturbances in adolescents with chronic pain. Depressive symptoms were tested as a general risk factor for increased sleep problems. During routine subspecialty clinic visits, 86 adolescents (mean age, 14.75 years; 67% female) diagnosed with chronic headaches, juvenile idiopathic arthritis, or sickle cell disease completed measures to assess pain, sleep disturbances, functional disability, depression, and HRQOL. Across pain diagnoses, adolescents experienced similar sleep patterns and sleep behaviors with the exception of daytime sleepiness, which was higher in adolescents with headache compared to adolescents with sickle cell disease. Bivariate correlations showed low relationships between pain and sleep and moderate to high relationships between depressive symptoms, daily functioning, HRQOL, and sleep. In multivariate analyses, as hypothesized, depressive symptoms were predictive of the severity of sleep disturbances after controlling for the effect of all other demographic, pain, and functional impact variables. Results suggest that a relationship between the experience of recurrent and chronic pain and sleep disturbances exists for adolescents, and these sleep disturbances are linked to mood disturbances and reductions in daily functioning and quality of life. Sleep disturbances have been described in adult patients with chronic pain, but little is known about sleep in adolescents with chronic pain. This study examined the complex interrelationship between sleep, pain, mood, functioning, and HRQOL. Findings suggest that mood is strongly related to sleep and might share common pathophysiologic or behavioral origins in adolescents with chronic pain.  相似文献   

3.
OBJECTIVE: To describe the health-related quality of life (HRQOL) of a cross-section of children with cerebral palsy (CP) using the Child Health Questionnaire. DESIGN: Survey of the parents or guardians of children with CP. SETTING: Outpatient clinics at a tertiary care children's hospital. PARTICIPANTS: Children (N=177; 98 boys, 79 girls; mean age +/- standard deviation [SD], 8.6+/-4.2y) with CP were enrolled as a convenience sample. Study subjects were stratified by severity of CP using the Gross Motor Function Classification System. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: HRQOL scores, as determined by the Child Health Questionnaire-Parent Form 50. RESULTS: Parents reported reduced HRQOL for their children with CP. In the physical function domain, most children scored over 3 SDs below a normative sample, and scores in parental impact domains were at least 1 SD below the normative sample. Psychosocial domains were less impaired. Most of the effects on physical and parent impact domains were greater in children with more severe CP, although they were significant in most strata of severity. CONCLUSIONS: Children with CP have reduced HRQOL and the degree to which it is reduced is related to the severity of their CP.  相似文献   

4.
目的 探讨朗格尔汉斯细胞组织细胞增多症(Langerhans Cell Histiocytosis,LCH)患儿的生存质量及其影响因素.方法 采用儿童生存质量普适性核心量表(PedsQL4.0)对就诊于北京儿童医院血液中心的74例LCH患儿进行调查.结果 5~7岁患儿在生理功能、心理社会功能和总功能的得分最低.生理功能的影响因素是体重满意程度,社会功能的影响因素是体重满意程度和在京居住;学校功能的影响因素是性别,总功能的影响因素是体重满意程度.自身体重满意者在总功能领域最高(P<0.05),在生理功能领域得分高于认为自己“胖”的患儿(P<0.05),在社会功能领域得分高于认为自己“瘦”的患儿(P<0.05).结论 LCH患儿的生活质量值得关注.  相似文献   

5.
The aim of this study was to examine the relationship between individual/family and neighborhood socioeconomic distress, pain, and functional outcomes in children with sickle cell disease (SCD). We hypothesized that both individual economic distress as well as residence in neighborhoods of severe economic distress would predict children's level of pain-related functional disability and health-related quality of life (HRQOL). Participants (mean age, 12.14 years; 57% male, n = 56) were recruited from an outpatient hematology clinic at a Midwestern tertiary referral hospital. Questionnaires assessing pain, depression, functional disability, and HRQOL were completed by children and their caregivers. Individual socioeconomic data including parental education and family income were reported by caregivers. Neighborhood socioeconomic distress was identified using publicly available census tract data and was based on neighborhood poverty, female head of household, male unemployment, and high school dropout levels. Multivariate regression analyses revealed that individual/family socioeconomic distress was a significant predictor of children's functional disability and physical and psychosocial HRQOL. Neighborhood socioeconomic distress emerged as a significant independent predictor of physical HRQOL only, where living in a distressed neighborhood predicted diminished physical HRQOL. Findings suggest that individual socioeconomic status and neighborhood economic distress play similar but independent roles in predicting children's functional outcomes related to SCD pain.

Perspective

Little is known about the influence of either individual/family or neighborhood socioeconomic factors on pain and functioning in children with SCD. Our findings suggest that socioeconomic distress defined at both the individual level and at the neighborhood/community level are significant independent predictors of pain-related disability and HRQOL in children with SCD.  相似文献   

6.
7.
OBJECTIVES: To investigate the temporal association between symptoms of psychiatric disorder and physical aspects of health-related quality of life (HRQOL) in a sample of HIV-positive adults. METHODS: Sample included 2431 participants at baseline and the first follow-up (FU1; approximately 8 months later). Measures included 4 components of HRQOL (general health, lack of pain, physical functioning, and role functioning), and psychiatric symptoms of depressive and anxiety disorders. Covariates included demographics, and clinical and substance use-related measures. A series of regression equations was estimated to construct the cross-lagged path model. Results depicted the relationships among the 4 HRQOL components and 2 types of psychiatric symptoms over time. This model included stability effects for each measure and cross-lagged effects from both the psychiatric measures at baseline to each of the HRQOL components at FU1 and from each of the 4 HRQOL components at baseline to the psychiatric measures at FU1. RESULTS: After controlling for stability effects and covariates, symptoms of depressive disorder at FU1 were significantly predicted by baseline general health and physical functioning, whereas symptoms of anxiety disorder at FU1 were significantly predicted by baseline general health and lack of pain. Anxiety symptoms at baseline did not significantly predict FU1 HRQOL, but baseline depressive symptoms were significant predictors of general health and lack of pain at FU1. CONCLUSION: Responses from a sample of HIV-positive adults at 2 time points approximately 8 months apart provide evidence for a reciprocal relationship between symptoms of psychiatric disorder and physical aspects of HRQOL.  相似文献   

8.
Pain and fatigue adversely affect the physical and psychosocial functioning of children with Juvenile Rheumatic Diseases (JRDs). Research investigating relations among disease severity and family functioning has produced mixed results. There is scant research examining the relations among illness attitudes and disease severity. Children (50 girls and 32 boys) with a JRD and their parents participated in this study. Parents completed a scale assessing family functioning and children completed information about their experience of pain and fatigue and attitude toward their illness. Regression analyses indicated that children experiencing more pain and fatigue were apt to hold negative attitudes toward their illness, and that parents reported lower family functioning when children were experiencing higher levels of fatigue. Research examining relations among child and reports of family functioning and children’s attitudes toward their illness will provide information for health care teams serving these children and their families.  相似文献   

9.
To identify the impact of multiple symptoms and their co-occurrence on health-related quality of life (HRQOL) dimensions and performance status (PS), 115 outpatients with cancer, who were not receiving active cancer treatment and were recruited from a university hospital in Sao Paulo, Brazil completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, the Beck Depression Inventory, and the Brief Pain Inventory. Karnofsky Performance Status scores also were completed. Application of TwoStep Cluster analysis resulted in two distinct patient subgroups based on 113 patient experiences with pain, depression, fatigue, insomnia, constipation, lack of appetite, dyspnea, nausea, vomiting, and diarrhea. One group had multiple and severe symptom subgroup and another had less symptoms and with lower severity. Multiple and severe symptoms had worse PS, role functioning, and physical, emotional, cognitive, social, and overall HRQOL. Multiple and severe symptom subgroup was also six times as likely as lower severity to have poor role functioning; five times more likely to have poor emotional; four times more likely to have poor PS, physical, and overall HRQOL; and three times as likely to have poor cognitive and social HRQOL, independent of gender, age, level of education, and economic condition. Classification and Regression Tree analyses were undertaken to identify which co-occurring symptoms would best determine reduction in HRQOL and PS. Pain and fatigue were identified as indicators of reduction on physical HRQOL and PS. Fatigue and insomnia were associated with reduction in cognitive; depression and pain in social; and fatigue and constipation in role functioning. Only depression was associated with reduction in overall HRQOL. These data demonstrate that there is a synergic effect among distinct cancer symptoms that result in reduction in HRQOL dimensions and PS.  相似文献   

10.
This study evaluated generic health-related quality of life (HRQOL) among 10 to 12-year-old Icelandic school age children who were either with or without chronic health condition. The children and their parents answered self-report questionnaires. For the 480 children who participated, girls were found to perceive their HRQOL significantly higher than the boys, children who visited the school nurse over a one-week period and children who indicated they were bullied by other children, perceived their HRQOL to be significantly lower than children who did not visit the school nurse over this time period or children who did not indicate they were bullied by other children in school. From the stepwise regression analysis, perception of health, school connectedness, health promotion, bullying victimization, visits to the school nurse and age, significantly predicted 43.8% of the variance of the girls' perception of their HRQOL. However, perception of health, school connectedness, and chronic health condition/illnesses, bullying victimization and after school activities predicted 48.1% of the boys' perception of their HRQOL. Children with chronic health condition or illnesses, reported their HRQOL to be significantly lower than children without chronic health condition. Assessing HRQOL among 10 to 12-year-old children might be helpful to take preventive action early on in children's life and development.  相似文献   

11.
《The journal of pain》2020,21(3-4):418-429
This longitudinal case-control study aims to 1) compare symptoms and functioning in otherwise healthy adolescents with versus without a parent with chronic pain (Parent CP+/Parent CP−) 2) test adolescent sex as a moderator of the relation between parent CP group and child functioning, and 3) determine changes in adolescent pain over 1 year. Adolescents (n = 140; ages 11–15) completed tests of pain responsivity and physical function, as well as self-report measures assessing pain characteristics, somatic symptoms, and physical and psychosocial functioning. Self-reported pain and somatic symptoms were reassessed 1 year later. Adolescents in the Parent CP+ group reported greater pain, somatic symptoms, and worse physical health than Parent CP− youth. Parent CP+ youth performed worse on all tests of physical function. Some observed effects were stronger for girls than boys. There were no differences between groups on pain responsivity. Both groups reported increased pain and somatic symptoms from baseline to 1-year follow-up, with the Parent CP+ group reporting the highest level of symptoms at both time points. This study highlights the potential impact of parental pain status on children, particularly daughters, and is the first to document objective physical functioning differences in youth at risk for developing chronic pain.PerspectiveAdolescents who have a parent with chronic pain demonstrate higher pain and lower physical function than adolescents who have a parent without chronic pain. Group differences in pain and somatic symptoms persist over 1 year. Family based interventions are needed for comprehensive pain prevention and treatment.  相似文献   

12.
OBJECTIVES: To assess the validity of the Protect Scale of the Adult Responses to Children's Symptoms (ARCS) Questionnaire with regard to mothers' responses to their children's abdominal pain. METHODS: Mothers with High (n=32) and Low (n=35) Protect scores on the ARCS questionnaire were recruited from participants in a larger study of family illness behavior. Mothers completed a 28-day diary report of responses to their children's abdominal pain episodes. Records of their children's annual health service utilization and costs were obtained from their health maintenance organization (HMO). RESULTS: Mothers' scores on the ARCS Protect Scale were significantly correlated with their subsequent diary reports of protective responses to their children's abdominal pain. Compared to children of mothers in the Low Protect group, children of mothers in the High Protect group made significantly more health care visits for gastrointestinal symptoms and had significantly higher health care costs. CONCLUSIONS: Results supported the validity of the Protect Scale of the ARCS and demonstrated that mothers' protective responses to children's abdominal pain complaints at home predicted subsequent health service use for gastrointestinal symptoms.  相似文献   

13.
Objectives: The aim of this study was to longitudinally evaluate the epidemiological characteristics of headaches in a school‐based, community setting and to determine the impact of headache symptoms on the health of children. Methods: After institutional review board approval, a prospective cohort study was conducted at two Chicago public schools for a period of 6 months. Members of the research team surveyed both schools weekly for headache and other pain symptoms. The students rated each pain symptom on a 5‐point scale from 0 (“not at all”) to 4 (“a whole lot”). Demographic information was collected at the time of enrollment, and all participants were asked to complete age‐appropriate and validated pediatric surveys to assess the severity of concurrent somatic complaints, anxiety symptoms, functional limitations, and quality of life issues. Results: Of the participating children, 89.5% reported at least one headache during the study period. Females experienced more frequent headaches compared with males (P < 0.05). Children reporting headaches had a significantly increased risk of experiencing other troubling somatic symptoms (P < 0.05). Headache severity showed a moderate correlation with increased feelings of anxiety, functional disability, and a diminished quality of life (P < 0.05). Conclusions: School‐aged children commonly experience headaches. Children experiencing headaches are more likely to report other somatic symptoms, feelings of anxiety, functional limitations, and quality of life impairments.  相似文献   

14.
PURPOSE: To describe the symptom experience of hospitalised Chinese children and adolescents and examine the relationship of symptoms to pre-hospital factors and child behaviour. METHODS: Data were collected at two hospital sites in Hong Kong (HK) and at five hospitals in the Chinese Mainland (CM). A total of 307 hospitalised children and adolescents (ages 2-18) and their primary caregiver (e.g., mother, father or grandparent) participated in the study. Children and adolescents completed an age-appropriate symptom diary on one evening and subsequent morning early in their hospital stay. Parents completed the diary for the children less than 6 years of age. Parents also completed an age-appropriate Chinese version of the Child Behaviour Checklist. RESULTS: Over 50% of the children and adolescents reported some degree of pain, 75% of them reported evening tiredness, and 21% reported gastrointestinal symptoms. The intensity of symptoms varied by age and region and symptoms often co-occurred. Greater symptom burden was predicted by previous surgery, higher level of worst pain prior to hospitalisation, parent report of child behaviour problems, and co-occurrence of other symptoms. CONCLUSIONS: Hospitalised Chinese children manifest symptoms of pain, tiredness, and gastrointestinal distress that vary based on pre-hospital factors and are associated with child behaviour problems. Further research is needed to identify causes and treatments for children's symptoms.  相似文献   

15.
Improving the quality of life of all South Africans has become a major concern to health care practitioners, organisations and politicians. However, the paucity of local information on health-related quality of life (HRQOL) does not allow us to address this public health challenge. In order to rectify this deficiency and complement international research, we undertook a study with 281 Type 2 Black diabetic patients and 437 controls, with no self-reported chronic conditions, to ascertain HRQOL. We used the SF-20 to measure functioning, general health, well-being and bodily pain (HRQOL). It was hypothesised that diabetes mellitus significantly affects functioning, general health and well-being. Multiple analyses of covariance controlled for age, schooling, marital status, employment status and commodity ownership (a socio-economic measure). Patients were significantly more likely to report poorer role functioning, poorer general health and more pain than controls, providing partial support for the hypothesis. Reliability (internal consistency) coefficients on the four multi-item SF-20 sub-scales ranged between 0.79 (well-being), 0.81 (general health), 0.83 (physical functioning) and 0.94 (role functioning) for patients: for controls these coefficients ranged between 0.70 (well-being), 0.78 (general health), 0.80 (physical functioning) and 0.90 (role functioning). Inter-correlations among the sub-scales were significant for patients and controls (p = 0.01). It was concluded that the SF-20 is a reliable instrument for measuring HRQOL in both patient and control samples, and diabetes mellitus has more impact on general health and level of pain than on well-being.  相似文献   

16.
The problem of children's pain is a complex one that requires the careful attention of all health professionals. For years, children's pain has been shrouded in myths and traditions that are inaccurate or inappropriate. Instruments now exist to accurately assess the pain a child is experiencing, but problems still remain within the sphere of what to do for a child who is hurting. Intervention strategies still need to be developed specifically for use with children. Practitioners are faced with children who need relief from their pain. Until a body of knowledge is acquired about effective pain control in children, clinicians must try anything that works and communicate it to others. All children have a right to be free of their pain. Children with cancer have a right to quality in their lives whether they are in remission or exacerbation, and the relief of pain is a key part of quality of life.  相似文献   

17.
《Pain Management Nursing》2021,22(3):252-259
BackgroundNearly 30% of children are affected by chronic pain which puts a significant burden on the child's family and society with estimated cost of over $19.5 billion each year. Children and adolescent's quality of life is often impacted leading to physical disability, low self-esteem, depression, anxiety, school stress or decreased performance, insomnia, and fatigue. The purposes of this paper are to: 1) provide an overview of chronic pain in children and adolescents; 2) describe findings from a quality improvement project that assessed the prevalence of negative mood, quality of life, functional disability, and coping with pain in teens with chronic pain, and 3) discuss screening, assessment and evidence-based management of co-morbid chronic pain and mental health problems in children and teens.FindingsFindings for a quality improvement project indicated that 16.8% of the adolescents scored high risk for depression, which was higher than the national average. Approximately 57% of adolescents were screened as high risk on the Pediatric Quality of Life inventory (PedsQL™). One in four adolescents showed poor functioning on the Functional Disability Inventory and nearly one-third of the adolescents reported poor coping with pain on the Pain Coping Questionnaire. This project indicates that adolescents with chronic pain are at high risk for mental health problems. The outcomes suggest the mental health needs of adolescents with chronic pain need to be identified and addressed to help improve outcomes.DiscussionChildren and youth with chronic pain need to be routinely screened and assessed for mental health problems, especially anxiety and depression. The use of Cognitive Behavioral Therapy (CBT) or CBT-skills building for children and youth with anxiety and depressive disorders has been widely studied and are helpful for children with chronic pain include psychoeducation, which helps the child to learn age and developmental specific information on chronic pain. Evidence-based manualized and internet-based CBT programs should be scaled rapidly to decrease depression and anxiety in children and youth with chronic pain.  相似文献   

18.
Health-related quality of life after stroke: what are we measuring?   总被引:1,自引:0,他引:1  
As there is no single, accepted definition of health-related quality of life (HRQOL), it is assumed to be a broad, multidimensional construct referring to those aspects of people's lives that reasonably relate to their health. Although many scales are used to assess HRQOL, the operationalization of this construct within each tool is unclear. To clarify what each tool is measuring, this study reviewed eight scales commonly used to evaluate HRQOL after stroke. Two reviewers classified scale items from five generic and three stroke-specific scales within an established framework with nine dimensions; physical functioning, symptoms, global judgments of health, psychological well-being, social well-being, cognitive functioning, role activities, personal constructs, and satisfaction with care. All scales reviewed provide multidimensional assessment, but vary in number and combination of dimensions. All include assessment of physical functioning and most incorporate concepts, such as psychological well-being, social well-being, and role activities. One generic (Sickness Impact Profile) and two stroke-specific scales (Stroke Impact Scale and Stroke-Specific Quality of Life Scale) seemed most comprehensive. Evaluated against a common framework of dimensions, scales commonly used in the assessment of HRQOL after stroke provide varying multidimensional assessments of aspects of life function related to health. Whether any of these assessments are sufficient to describe HRQOL in its entirety is unclear.  相似文献   

19.
Research suggests that children of parents with chronic pain might be at risk for a variety of psychological symptoms. This study compared 52 children of parents with recurrent headaches and either low or high levels of accompanying disability with 23 children of parents without recurrent pain on various aspects of psychological and family functioning. Parent reports generally did not indicate any differences between children of parents with headaches and children of parents without recurrent pain, and no group differences were found in terms of children's self-reported psychological or family functioning. This study suggests that children of parents with recurrent headaches might not be at risk for poor functioning compared with children of parents without recurrent pain. Limitations of this study and directions for future research are discussed. PERSPECTIVE: Chronic pain is often believed to be associated with negative impacts on the family. This study included parents with recurrent headaches and their children and examined children's psychological and family adjustment in comparison to children whose parents did not have pain.  相似文献   

20.
PURPOSE: This study aims to examine the association between adolescent health, including physical complaints, mood, and social adjustment, and perceived severity of parental substance abuse. DESIGN AND METHODS: Baseline data from a study of school-based support groups for adolescents with substance-abusing family members (n = 121) were used to examine the relationship between the severity of substance abuse and adolescent health. RESULTS: Participants were divided into three groups on the basis of severity of parental substance abuse. The high-severity group had significantly more medical conditions, physical symptoms, and negative moods than those in the low- or moderate-severity groups (p < .02). PRACTICE IMPLICATIONS: Nurses can use the Children of Alcoholics Screening Tool to assess severity of parental substance abuse and its impact on adolescents' physical and emotional health.  相似文献   

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