The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health.

Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor-Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory-Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire-Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.

The role of animal-assisted programs in physical health improvement of children and adolescents with special education needs - a systematic review.

Programs involving animals in therapeutic programs are becoming increasingly prevalent. These programs can vary greatly in their approach, scope, and objectives, and they can significantly impact the development of healthy children and those with various disorders. In this systematic review, we sought to investigate the psychological ramifications of animal-assisted activities (AAA), therapies (AAT), and interventions (AAI). We searched for relevant studies using the EBSCO Discovery Service search engine across 85 databases, utilising appropriate keywords. Our search generated 262 results, of which 21 were selected for inclusion after title and abstract screening, as well as full-text analysis. Our findings indicate that dogs and horses are animal-assisted programs' most commonly used animals. Additionally, autism, cerebral palsy, and ADHD were found to be overrepresented in these programs. Furthermore, the length of sessions and overall program duration exhibited considerable variation, regardless of patient age or disease type. The principal measures centred on the physiological variables related to the nervous system and motorium-related indicators. The studies were generally of exceptional methodological soundness. Frequently, the studies narrowed their scope to a single segment or just the child or adolescent, but the outcomes lacked contextual interpretation. Expanding the range of studies by comparing psychological and physiological indicators and conducting follow-up analysis with a longitudinal design would be beneficial.

Effect of medically assisted reproduction (MAR) and pregnancy planning on Bayley-III Screening Test subscales in preterm infants at 12 months of corrected age: a cross-sectional study.

BACKGROUND: The association between medically assisted reproduction and pregnancy planning on overall developmental outcomes of infants has been studied in relatively few studies. The availability of accurate tools for the early detection of developmental delays is a major issue. The purpose of this study is describing the average neurodevelopment of preterm infants and assessing the association between medically assisted reproduction, pregnancy planning and neurodevelopmental outcomes among Hungarian preterm infants. METHODS: Cross-sectional study of preterm infants with gestational age < 37 weeks (N = 171) who underwent developmental assessment using Bayley-III Screening Test (Bayley Scales of Infant and Toddler Development Screening Test - Third Edition) in five developmental domains (cognitive, receptive and expressive language, fine and gross motor) at 12 months of corrected age. We examined the developmental pattern of infants and the potential associations between medically assisted reproduction, pregnancy planning and Bayley-III Screening Test subscales. Information on the mode of conception and pregnancy planning was obtained through parental anamnesis. RESULTS: Concerning the risk for developmental delay, the language and motor subscales were the most affected. Examination of the mode of conception and developmental outcomes revealed higher neurodevelopmental skills in infants who were conceived through medically assisted reproduction. Significantly lower cognitive, receptive and expressive language skills were found to be associated with unplanned pregnancies. Multi-way analysis of variance was conducted in order to assess the impact of the mode of conception and pregnancy planning on subscales. CONCLUSIONS: We cannot unambiguously conclude that MAR and pregnancy planning had a solely positive effect on the development of preterm infants at 12 months of corrected age, but our results are vital for the design and implementation of further research.

Perinatal, neonatal, developmental and demographic predictors of intelligence at 4 years of age among low birth weight children: a panel study with a 2-year follow-up.

INTODUCTION: Childhood intelligence is an important predictor of later outcomes in life such as socioeconomic status or health. Hence, a deeper understanding of predictors of child intelligence should suggest points of intervention for children facing adversities. OBJECTIVES: The purpose of this study is to examine the predictive value of demographic, perinatal and neonatal variables after birth and developmental characteristics at age 2 for 4-year intelligence as outcome among low birth weight children. METHODS: We designed a panel study with a 2-year follow-up with 114 child-mother pairs. The outcome variable was IQ intelligence quotient at 4 years of age of LBW low birth weight children measured by the Wechsler Primary and Preschool Scales of Intelligence. Potential predictors were maternal education, family wealth, ethnic identity; sex, twin pregnancy, gestational age, birth weight, Apgar scores, maternal smoking during pregnancy; diagnosis of intravetricular haemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia after birth and cognitive, language and motor development at age 2 measured by one composite score of the three Bayley Scales of Infant and Toddler Development aggregated. RESULTS: Stepwise backward regression was carried out including significant variables from the bivariate analysis. The best model included 4 predictors which accounted for 57% of the variance of the full IQ intelligence at 4-years of age. Maternal higher education was significant positive, below average family wealth and neonatal diagnosis of bronchopulmonary dysplasia were significant negative predictors in the model after birth. 2-year developmental characteristics such as cognitive, motor and language skills were positive predictors of the IQ intelligence at age 4. CONCLUSION: Sociodemographic assessment at birth and developmental assessment at two years of age are of crucial importance to recognize children at high risk for delayed cognitive development. High-risk children should be directed to supportive interventions and their development should be regulary monitored.

A new perspective: Establishing developmental profiles of premature infants based on Bayley-III scores at age 2.

Longitudinal and cross-sectional studies in early childhood generally focus on different developmental areas separately. The aim of this study is to identify the most common developmental profiles regarding cognitive, language and motor skills among low birthweight (LBW) children. Our sample included 208 LBW children examined at 24-28 months. We used cluster analysis to identify developmental profiles based on the scores of the Bayley-III Cognitive, Language and Motor scales. We found three consistent profiles (High, Mildly Delayed and Severely Delayed) and three inconsistent, average profiles (with High Expressive Language, with Mildly Delayed Expressive Language and with Severely Delayed Language). Socioeconomic status, maternal education, in vitro fertilization, plurality and chronic morbidities were significantly related to the clusters. Cluster analysis might be an effective method to identify developmental profiles of preterm (and other at-risk) children, which might result in a more complex understanding of cognitive and psychomotor development in early childhood.

Adaptive Behavioral, Social-Emotional, and Neurodevelopmental Outcomes at 2 Years of Age in Hungarian Preterm Infants Based on Bayley III.

AIM:  This study aimed to assess cognitive, language, and motor development as well as social-emotional and adaptive behavior skills of low birthweight (LBW) children. METHODS: Our cohort contained 305 two-year-old LBW children. Developmental functioning was assessed by the Bayley Scales of Infant and Toddler Development, 3rd Edition. RESULTS: Performance in language, particularly in expressive communication was the poorest. Extremely low birthweight (ELBW) children were found to be at increased risk of developmental delay: 12.73 times in motor (95%CI = 2.8-57.5), 9.81 times in cognitive (95%CI = 3.2-29.6) and 3.91 times in language (95%CI = 1.6-9.4), and social-emotional skills (95%CI = 1.6-9.5). Parents of children with lower birthweight reported poorer social and practical adaptive skills. Self-care domain seemed to be the least developed. CONCLUSION: Additionally, the screening for developmental delays, monitoring the adaptive behavior skills may also be useful - especially among ELBW children - in order to identify the specific areas, situations, and functions that are most in need of interventions. ABBREVIATIONS: AB: Adaptive Behavior; ABAS-II: Adaptive Behavior Assessment System-II; BPD: Bronchopulmonary Dysplasia; BSID-III: Bayley Scales of Infant Development 3rd Edition; BW: Birthweight; CI: Confidence Interval; CS: Composite Score; ELBW: Extremely Low Birthweight; GA: Gestational Age; IVF: In Vitro Fertilization; IVH: Intraventricular Hemorrhage; LBW: Low Birthweight; NEC: Necrotizing Enterocolitis; OR: Odds Ratio; ROP: Retinopathy of Prematurity; SE: Social-Emotional Development; VLBW: Very Low Birthweight.

[The influence of emotional state and coping ability on the outcome of the assisted reproductive technology among infertile couples].

INTRODUCTION: Infertility and its treatment impose significant physical and emotional burden on infertile couples. The most commonly used assisted reproductive technology is the In Vitro Fertilization (IVF). Approximately one third of the treatments results in pregnancy. The aim of our study is to explore psychosocial factors that have an influence on the chance of IVF treatment success. METHODS: 104 infertile couples undergoing IVF treatment participated in our research, of which 49 couples achieved pregnancy after treatment and 55 couples did not. The emotional state was assessed by the Positive and Negative Affect Schedule, the short form of the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory. The coping abilities were measured by the short form of the Ways of Coping Inventory, the Psychological Immune Competence Inventory and the Connor-Davidson Resilience Scale. The negative life events were assessed by the short and revised form of the Paykel's Life Events Scale. Data were collected at three occasions: at the beginning of the treatment (T1), before embryo transfer (T2), and before pregnancy test (T3). RESULTS: According to the most important results of the logistic regression analysis, the outcome of the treatment is negatively influenced by the female (p<0.01) and male age (p<0.05). For women, positive affectivity at T1, the Problem analysis coping strategy, the Sense of self-growth personality trait, the Personal competence and Tolerance of negative affect factors were found to be adaptive in respect of treatment success (p<0.05). For men, the IVF outcome was positively influenced by the lower level of depression at T1, the Problem analysis coping strategy and the Sense of control personality trait (p<0.05). CONCLUSION: Emotional attitudes of couples towards childbearing and treatment and their coping mechanisms have an influence on the treatment outcome. Therefore, assessment and conscious shaping of these factors may increase the chance of successful treatment.

Association between Emotional State Changes in Infertile Couples and Outcome of Fertility Treatment.

Aims Infertility and its treatment are associated with considerable psychological distress for infertile couples. The aim of our study was to explore to what extent positive and negative affectivity and a predisposition to depression and anxiety appear in infertile couples during in vitro fertilization (IVF) treatment. We also aimed to explore how the emotional state of couples changed during IVF in relation to treatment outcomes. Method In our longitudinal study, 174 people (87 couples) were followed up during treatment by means of questionnaires. Their emotional state was assessed with PANAS, BDI-R, and STAI at the beginning of treatment, before embryo transfer, and before taking a pregnancy test. Couples who achieved pregnancy after treatment were included in the successful group (n = 82), while those who did not were included in the unsuccessful group (n = 92). Results We found more favorable emotional states in IVF couples compared to patient populations and the average population. In successful IVF couples, positive affectivity decreased, and negative affectivity increased in women until the time of embryo transfer. This was accompanied by an increase in positive affectivity in men, which remained until the time of the pregnancy test and provided emotional support to their partner. These results were confirmed by changes in the levels of depression. Conclusion Our study suggests the importance of couples' emotional dynamics for having a child and an association between couples' emotional reactions during IVF cycles and treatment success.

[Psychomotor state of development of preterm children concerning chronic neonatal morbidities at the age of 2 years]. / Koraszülöttek kétéves kori pszichomotoros fejlettsége a leggyakoribb krónikus utóbetegségek tekintetében.

Introduction: Over the last few years, in the development of neonatology, the limits to which it is possible to sustain the lives of premature babies have been extended, and thus the proportion of survivors with chronic morbidities has increased. Retinopathy of prematurity (ROP), intraventricular haemorrhage (IVH) and bronchopulmonary dysplasia (BPD), all of which deeply influence the quality of life, life expectancy and social integration, are the most significant morbidities among premature newborns. Aim: Description of psychomotor development of low birth weight (<2500 g) premature infants at the age of 2 years, in relation to the most common chronic morbidities. Method: Psychomotor development (Brunet-Lézine scale, 1980) of low-birth-weight preterm infants at the age of 2 years (n = 200) was measured and the neonatal final reports were analysed retrospectively. Results: After age correction, birth weight positively correlated with the developmental quotient (DQ), while the length of stay in hospital correlated negatively. Grades I/II of neonatal IVH were not significant predictors of lower DQ, while the opposite was true for grades III/IV. We identified a similar relationship with the stages of ROP. According to the result of the homogeneity test, we can consider the independent effects of significant diseases. We also observed that the more diagnoses the premature baby received, the more they are at risk of later developmental delay at the age of 2 years. Conclusions: We recommend the early childhood interventions of the most vulnerable children of ≤1500 g birth weight with severe ROP and IVH - to reduce deficiencies in capabilities and prevent future mental and motor difficulties. Orv Hetil. 2020; 161(5): 183-192.

[Investigation of the adherence of children with diabetes through the validation of the child version of the Diabetes Adherence Questionnaire]. / Cukorbeteg gyermekek együttmuködésének vizsgálata a Diabetes Adherencia Kérdoív gyermekváltozatának validálása során.

Introduction: Most of the adolescents suffering from type 1 diabetes mellitus (T1DM) can be described with HbA1c values below the target level. Several research investigated the impact of diabetes on the quality of life, however, no complex questionnaire has been developed to examine each area of the disease. Aim: The aim of the present study is to create a Hungarian, reliable and valid questionnaire which can cover each aspect of the adherence related to type 1 diabetes mellitus. Method: In the present study, the attention was drawn to the introduction of a new questionnaire related to diabetes adherence which can be applied among children and adolescents as well. To test the questionnaire and to reduce the number of the items and to determine the scales, reliability analysis (Cronbach's α) and factor analysis was applied. Results: The new measurement, which was created through the translation of English language international questionnaires, their pre-test, and its reduction by factor and reliability analysis, containing 9 subscales with 58 items, is stated as reliable regarding the results of the Cronbach's α index. Conclusion: It can be stated that the created Diabetes Adherence Questionnaire can be reliably applied on child and adolescent population and it can be adapted for people suffering from other types of chronic diseases. Orv Hetil. 2019; 160(29): 1136-1142.

[Studying the health behavior of asthmatic children regarding the dimensions of media and internet usage and self-esteem]. / Asztmás gyermekek egészségmagatartásának vizsgálata a média- és internethasználat és az önértékelés dimenziói mentén.

INTRODUCTION: According to the literature, somatic and psychological factors are connected with asthma bronchiale. The health behavior of these patients can be influenced by the virtual world. AIM: We wish to analyze social media and internet usage, self-esteem and sociodemographic data connected to attachment. METHOD: For our research, the Facebook Intensity Scale, the Problematic Internet Usage Questionnaire, the Rosenberg Self-Esteem Scale and a socio-demographic questionnaire were used. We interviewed 175 asthmatic children from the age of 10 to 18 (92 boys, 83 girls). RESULTS: Asthmatic girls, children who went to daycare (under the age of 3) and who were not breastfed use Facebook more than boys, children who stayed at home instead of daycare and who were breastfed (p<0.01). There is no difference in their internet usage. Breastfeeding (even if it only lasted for 1-7 days) can strengthen attachment which is shown in our results regarding social media usage compared with children who were not breastfed (p<0.01). A negative relation with medium strength was found between the number of siblings (ρ = -0.400; p<0.01) and the self-esteem and Facebook usage (ρ = -0.475; p<0.01). There is a positive correlation between Facebook usage and the size of the place the children live in (ρ = 0.492; p<0.01). CONCLUSIONS: Asthmatic youth use social media more frequently which provides social feedback to compensate their self-esteem, especially by girls. As protection factors, we can emphasize the existence of human relationships and the importance of an early mother-child bond. Orv Hetil. 2018; 159(47): 1971-1980.

The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes.

Background Diabetes has previously been linked to mental health problems in children and adolescents, but more recent studies have yielded mixed findings. The aim of the current study was to compare symptoms of mental health problems in children and adolescents with and without type 1 diabetes (T1DM). Methods Life quality, subjective well-being, self-rated health, depression and somatic symptoms in children and adolescents with diabetes (n=130) were measured and compared to the results of a socio-demographically joined control group (n=177) which consists of healthy children and adolescents. Results A significant difference could be observed between the groups in well-being and depressive symptoms as according to the results, the research sample namely the children with T1DM could be described with significantly higher subjective well-being and mood, but with less physical symptoms and lower level of depression as those in the control group. Conclusions These findings suggest that T1DM is not associated with an increased risk of psychosocial problems, and confirm that even a severe disease of a child can lead to personal growth.

[The investigation of attitudes toward health behaviour among high school and university students]. / Egészség-magatartással kapcsolatos attitudök vizsgálata középiskolás és egyetemista fiatalok körében.

INTRODUCTION: Health awareness plays an important role in our life, which contains attitudes as well behavioural components. Social factors influencing health awareness were the basis of many previous investigations, measuring the effect of demographical and psychological factors. However, investigation of these factors usually happened with separated questions. AIM: The aim of the present study is to test a new questionnaire, which measures health behaviour and attitudes related to health awareness. METHOD: In present study, the attention was drawn to the introduction of a new questionnaire related to health behaviour, attitudes toward health awareness and factors influencing those and measured on population in Debrecen (SHTE 2017; n = 256). RESULTS: the new measurement proved to be reliable based on Cronbach α analysis. This was created on the basis of focus content analysis of group conversations with 10 subscales and 35 items. CONCLUSIONS: It can be stated that gender, father's educational level, objective and subjective financial status has a significantly negative effect; while sport, subjective health and fitness as well as subjective religiosity have a significantly positive effect which reflects previous findings and confirm the reliability of our questionnaire. Orv Hetil. 2017; 158(44): 1754-1760.

[The connection between maltreatment and preterm birth - in the light of psychomotor development at 2 years old]. / A bántalmazás és a koraszülés összefüggései a kétéves kori pszichomotoros fejlodés tükrében.

INTRODUCTION: Preterm children' development and harmful affecting factors to development are important aspects of public health, because in our country the number of preterm birth is very high. AIM: Description of psychomotor development of preterm children (Brunet-Lézine; Bayley-III) and connection between psychomotor development and maternal abuse history (own questionnaire). METHOD: Extremely (<1000 g) and very low (1000-1500 g) birth weight preterm children at 23-30 months (n = 35) and their mothers' abuse history were measured. RESULTS: Lower birth weight was associated with lower psychomotor development quotients and higher development risk. Strong associations were found between maternal history of childhood abuse and the development quotients. CONCLUSIONS: We would like to draw attention to the importance of assessing preterm children, as well as to the importance of maltreatment and the severity of its consequences. With the early recognition of necessity for developmental interventions we can prevent problems in the future. Orv Hetil. 2017; 158(25): 976-983.

[Study of stutter originating from the frustrated clinging instinct and its relation to anxiety and self-esteem]. / A dadogással mint a frusztrált megkapaszkodás ösztönével összefüggo szorongás és önértékelés vizsgálata.

INTRODUCTION: The analytic and family therapeutic theories connected to the topic of stutter have to be actualized. AIM: The aim of this work was to point out connections which originate from the instinct of frustrated clinging, however, these can be interpretated in new ways these days. METHOD: Two questionnaires in 48 subjects suffering from stutter were used; Rosenberg's Self-Esteem Scale measured the children's self representation, while the Multidimensional Anxiety Scale for Children measured the degree of their anxiety. At first the subjects had to anwser the questions as themselves, for the second time they had to anwser as an ordinary person without a speech disorder. RESULTS: The hypothesis of the authors was verified: stutterers attributed a significant role to the speech disorder of the subjects in connection with their self-esteem. According to this a significant amount of their anxiety is based on their deficit. An unexpected result was that girls and boys estimated ordinary people's level of anxiety similarly. There was no significant difference between boys and girls regarding the level of other's self-esteem. CONCLUSIONS: Based on the thesis of evolutionary psychology, the adequate use of speech is more important to women who have a connecting role in the family. This results that they see stutter as a major problem.

Coping with infertility: Comparison of coping mechanisms and psychological immune competence in fertile and infertile couples.

This study compared coping strategies and psychological immunity of parents with a child conceived with assisted reproductive technology (n = 84) and parents with a naturally conceived child (n = 84) in a Hungarian fertility-age population. Results showed that in vitro fertilization parents are able to control their emotions in a better way than comparison couples. They interpret trials as challenges and consider themselves more worthy than the members of the control group. Our research confirms that consideration and management of psychological factors in treating infertility have an important preventive role to play.

[International comparative study on health condition of young people]. / Serdülok egészségi állapotának nemzetközi összehasonlító vizsgálata.

INTRODUCTION: The connection between physical condition, coping strategies and emotional intelligence is widely studied in the international literature, but comparative research data collected among Transylvanian and Hungarian adolescents are not available in contemporary psychological literature. AIM: The aim of the authors was to study health indicators, emotional intelligence and coping strategies among adolescents and analyse connections between these factors and physical condition as part of an international research. METHOD: The physical condition, coping strategies and emotional intelligence of 390 individuals, aged between 13 and 19 years living in Debrecen (Hungary) and Érmihályfalva (Romania) were observed. RESULTS: adaptive (i. e. problem-focused) coping strategies used in stressful situations resulted in lower depression rates, as well as better mental well-being than the maladaptive ones such as emotional clearing, self-punishment, distraction of attention. Adolescents showing higher emotional intelligence had lower depression levels and better mental well-being. CONCLUSIONS: Institutionally initiated emotional intelligence and coping strategy development for young people may prove to be an important preventive interventional public health programme. This may serve as a basis to assist health-consciousness and personality formatting.