ABSTRACT
Childhood ITP is often considered to be a relatively mild haematological disorder, with only a minority of patients requiring treatment for troublesome bleeding. Over recent years, wider effects of the condition have been identified in some adults, particularly relating to fatigue and cognitive impairment. In this study, we sought to investigate such effects in a group of children with ITP and further our understanding of their psychological profile. Children attending routine haematology outpatient clinics and their parents were asked to complete standardised questionnaires designed to assess a range of psychological and cognitive factors. Although the majority of children had some scores within the normal range, a significantly high proportion had difficulties with fatigue (70·6%), emotional and behavioural symptoms (25·7%) or executive functioning (19·4%). Quality of life and subjective evaluation of the illness (appraisal) correlated significantly with each of these domains, but bleeding severity and platelet count did not. Our findings provide valuable insight into the broader impact of childhood ITP, which could aid in providing holistic care, potentially contribute to decisions regarding medical treatment, and guide future research.
Subject(s)
Executive Function/physiology , Fatigue/etiology , Purpura, Thrombocytopenic, Idiopathic/complications , Purpura, Thrombocytopenic, Idiopathic/psychology , Adolescent , Child , Child, Preschool , Female , Humans , MaleABSTRACT
OBJECTIVE: TO explore the factors that predict psychosocial adjustment in young people with a cleft and their parents. DESIGN, PARTICIPANTS, SETTING: The study used a cross-sectional postal questionnaire design involving young people aged between 11 and 16 and their parents from two cleft services. Data are presented for 91 adolescents and their mothers. MAIN OUTCOME MEASURES: Participants completed measures of psychological adjustment, coping, social experiences, satisfaction with appearance, stressful life events, cleft-related factors, and demographic information. RESULTS: Psychosocial adjustment in adolescents was predicted by their social experiences and maternal well-being. Satisfaction with appearance, perceived speech problems, and the use of avoidant coping strategies were also important factors relating to their adjustment. For mothers, adjustment was predicted by use of coping strategies such as self-blame, venting, and acceptance, in addition to perceived problems with their child's hearing and the number of stressful life events experienced. CONCLUSIONS: The findings are discussed in relation to the concepts of adjustment, coping, satisfaction with appearance, and maternal mental health. Directions for future research are outlined, and a number of opportunities and challenges for cleft services regarding the provision of timely interventions for this age group and their families are discussed.
Subject(s)
Adaptation, Psychological , Cleft Lip/psychology , Cleft Palate/psychology , Mothers/psychology , Adolescent , Child , Cross-Sectional Studies , Female , Humans , Life Change Events , Male , Patient Satisfaction , Psychology, Adolescent , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To explore the nature of psychosocial adjustment in young people with a cleft as well as in their parents, within the framework of Lazarus and Folkman's (1984) transactional model of stress and coping. DESIGN, PARTICIPANTS, SETTING: A cross-sectional postal questionnaire design study was used, involving young people aged between 11 and 16 years and their parents. There were 145 families from two cleft services participating in the study. OUTCOME MEASURES: Participants completed measures of psychological adjustment, coping, social experiences, satisfaction with appearance, cleft-related factors, and demographic information. RESULTS: Young people with a cleft and their mothers did not report psychosocial adjustment difficulties above that of the normal population. An insufficient number of fathers were recruited for substantive analysis to be conducted using their data. CONCLUSIONS: The findings show little evidence of significant psychosocial adjustment difficulties for adolescents with a cleft or for their mothers. The concepts of adjustment, coping, satisfaction with appearance, and maternal mental health in this population are discussed. The results highlight the importance of timely interventions and seeking multiple perspectives in clinical management of a cleft. Questions are raised about the completion of self-report measures for future research in this population.
