scholarly journals Fatigue among children with a chronic disease: a cross-sectional study

2021 ◽  
Vol 5 (1) ◽  
pp. e000958
Author(s):  
Merel M Nap-van der Vlist ◽  
Geertje W Dalmeijer ◽  
Martha A Grootenhuis ◽  
Kors van der Ent ◽  
Marry M van den Heuvel-Eibrink ◽  
...  

ObjectiveTo determine: (1) which biological/lifestyle, psychological and/or social factors are associated with fatigue among children with a chronic disease and (2) how much each of these factors contributes to explaining variance in fatigue.Design and settingThis was a cross-sectional study across two children’s hospitals.PatientsWe included children aged 8–18 years who visited the outpatient clinic with cystic fibrosis, an autoimmune disease or postcancer treatment.Main outcome measuresFatigue was assessed using the PedsQL Multidimensional Fatigue Scale. Generic biological/lifestyle, psychological and social factors were assessed using clinical assessment tools and questionnaires. Multiple linear regression analyses were used to test the associations between these factors and fatigue. Finally, a multivariable regression model was used to determine which factor(s) have the strongest effect on fatigue.ResultsA total of 434 out of 902 children were included (48% participation rate), with a median age of 14.5 years; 42% were male. Among these 434 children, 21.8% were severely fatigued. Together, all biopsychosocial factors explained 74.6% of the variance in fatigue. More fatigue was uniquely associated with poorer physical functioning, more depressive symptoms, more pressure at school, poorer social functioning and older age.ConclusionsFatigue among children with a chronic disease is multidimensional. Multiple generic biological/lifestyle, psychological and social factors were strongly associated with fatigue, explaining 58.4%; 65.8% and 50.0% of the variance in fatigue, respectively. Altogether, almost three-quarters of the variance in fatigue was explained by this biopsychosocial model. Thus, when assessing and treating fatigue, a transdiagnostic approach is preferred, taking into account biological, psychological and social factors.

2020 ◽  
Vol 6 (3) ◽  
pp. 00308-2020
Author(s):  
Silvia S. Chiang ◽  
Maria Dolynska ◽  
Natasha R. Rybak ◽  
Andrea T. Cruz ◽  
Omowunmi Aibana ◽  
...  

BackgroundDuring adolescence, childhood and adult forms of tuberculosis (TB) overlap, resulting in diverse disease manifestations. Knowing which patient characteristics are associated with which manifestations may facilitate diagnosis and enhance understanding of TB pathophysiology.MethodsIn this cross-sectional study, we included 10–19-year-olds in Ukraine's national TB registry who started TB treatment between 2015 and 2018. Using multivariable regression, we estimated associations between patient characteristics and four presentations of TB: pleural, extrathoracic, cavitary and rifampicin-resistant (RR). We also described the epidemiology of adolescent TB in Ukraine.ResultsAmong 2491 adolescent TB cases, 88.4% were microbiologically confirmed. RR-TB was confirmed in 16.9% of new and 29.7% of recurrent cases. Of 88 HIV-infected adolescents, 59.1% were not on antiretroviral therapy at TB diagnosis. Among 10–14-year-olds, boys had more pleural disease (adjusted OR (aOR) 2.12, 95% CI: 1.08–4.37). Extrathoracic TB was associated with age 15–19 years (aOR 0.26, 95% CI: 0.18–0.37) and HIV (aOR 3.25, 95% CI: 1.55–6.61 in 10–14-year-olds; aOR 8.18, 95% CI: 3.58–17.31 in 15–19-year-olds). Cavitary TB was more common in migrants (aOR 3.53, 95% CI: 1.66–7.61) and 15–19-year-olds (aOR 4.10, 95% CI: 3.00–5.73); among 15–19-year-olds, it was inversely associated with HIV (aOR 0.32, 95% CI: 0.13–0.70). RR-TB was associated with recurrent disease (aOR 1.87, 95% CI: 1.08–3.13), urban residence (aOR 1.27, 95% CI: 1.01–1.62) and cavitation (aOR 2.98, 95% CI: 2.35–3.78).ConclusionsAge, sex, HIV and social factors impact the presentation of adolescent TB. Preventive, diagnostic and treatment activities should take these factors into consideration.


Breast Care ◽  
2020 ◽  
pp. 1-7
Author(s):  
Elna Kuehnle ◽  
Wulf Siggelkow ◽  
Kristina Luebbe ◽  
Iris Schrader ◽  
Karl-Heinz Noeding ◽  
...  

<b><i>Background:</i></b> Although immigrant health is an important issue in national health policy, there is a serious shortage of data in many countries. Most studies lack information on educational status, which is a major limitation. This prospective cross-sectional study analyzed a real-world breast cancer population on the influence of immigration background and educational status on participation in breast cancer early detection programs in the federal state of Lower Saxony, Germany. <b><i>Methods:</i></b> Data collection was conducted from 2012 to 2016 in six certified breast cancer centers using a standardized questionnaire for patients’ interview and tumor-specific data from the patients’ medical records. <b><i>Results:</i></b> 2,145/3,047 primary breast cancer cases were analyzed. 17.5% of our patients had a history of immigration, including <i>n</i> = 202 first-generation immigrants and <i>n</i> = 168 second-generation immigrants. Most of them were citizens of EU27 member states. No significant difference was seen in age, tumor stage, histology, grading, Ki-67, Her2/neu-status, and hormone receptor status compared to the native cohort. 100% participation rate in the breast cancer early detection programs were seen in patients with no school graduation. With regards to the national mammography screening program, participation decreased significantly with educational status (<i>p</i> = 0.0003). <b><i>Conclusions:</i></b> No tumor biological differences were seen between immigrants and German natives. In first-generation immigrants, early detection programs were well accepted despite sociocultural and language differences. Participation rate decreased significantly with higher education levels irrespective of country of origin. Immigration background does not have a negative effect on the participation in breast cancer screening. This mainly relates to immigrants from EU27 member states.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manee Pinyopornpanish ◽  
Kanokporn Pinyopornpanish ◽  
Atiwat Soontornpun ◽  
Surat Tanprawate ◽  
Angkana Nadsasarn ◽  
...  

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.


2021 ◽  
Vol 9 ◽  
pp. 205031212110400
Author(s):  
Kemal Jemal ◽  
Tinsae Abeya Geleta ◽  
Berhanu Senbeta Deriba ◽  
Mukemil Awol

Objectives: The coronavirus disease 2019 pandemic has caused high morbidity and mortality in older adults over the world. Because the coronavirus disease 2019 pandemic greatly affects older adults who have a preexisting health condition, they are generally susceptible to a high incidence of severe symptoms of anxiety and depression. Therefore, we aimed to assess the prevalence of anxiety and depression symptoms in older adults during the coronavirus disease 2019 pandemic. Methods: Community-based cross-sectional study was completed in August 2020. Standardized and pretested General Anxiety Disorder–7 and Geriatric Depression Scale were used to screen the symptoms of anxiety and depression, respectively. Data were entered into EpiData (version 4.3.2) and transferred to SPSS (version 24) for further analysis. Bivariate and multivariate logistic regression analyses were carried out to determine the significantly associated variables with a 95% confidence interval at p < 0.05. Results: Of the total older adults interviewed, 68.7% had developed symptoms of anxiety and 59.9% had symptoms of depression during the coronavirus disease 2019 pandemic. Female participants, having a chronic disease and poor knowledge of the coronavirus disease 2019 pandemic, were significantly associated with anxiety symptoms. Age category of 81 to 90 and above 90, lack of social support, and having a chronic disease were significantly associated with symptoms of depression. Conclusion: The symptoms of anxiety and depression among older adults in the North Shoa Zone during coronavirus disease 2019 were higher than before the coronavirus disease 2019 happened. The results were evidence points for developing a psychological intervention to tackle the older adults’ mental health needs in the community during and after the coronavirus disease 2019 pandemic.


2020 ◽  
Author(s):  
Clécio Gabriel Souza ◽  
Marcelo Cardoso Souza ◽  
Hugo Jario Silva ◽  
Sanderson Assis ◽  
Diego Sousa Dantas

Abstract Background: Rheumatic diseases are increasingly present in the world population, represented by chronic joint and musculoskeletal pain. Among them, osteoarthritis (OA) is the most prevalent. It is considered the third most prevalent chronic non-communicable disease in the Brazilian population, being responsible for a high rate of physical disability and reduced quality of life. Little has been discussed about the social factors associated with this health condition. This study aimed to analyze the social factors associated with arthritis in the Brazilian population.Methods: This is a cross-sectional study based on data from the 2013 National Health Survey in Brazil with arthritis as its main outcome. Sex, age, body weight, usual activities, physical activity, self-perceived health and diagnosis of depression were analyzed as independent variables. Descriptive and inferential statistics were used. Poisson multiple regression was performed, and the prevalence ratio (PR) and confidence interval (CI) of 95% were calculated using a significance level of 5% (p≤0.05).Results: A total of 60,202 individuals of both sexes took part in this study and the rheumatic diseases or arthrtitis prevalence was 6.4%. The individual factors associated with a higher prevalence of arthritis were female (PR = 2.09; CI = 1.95-2.25), age over 35 years (PR = 2.88; CI = 2.57-3.24) and excess body weight (PR = 1.61; CI = 1.25-2.07). The presence of rhemautic diseases showed an association with lower performance of usual activities (PR = 1.61; CI = 1.50-1.73) and self-perceived health as very poor (PR = 3.96; CI = 3.31-4.72). In addition, it was associated with a higher prevalence of mental illnesses such as depression (PR = 1.77; CI = 1.64-1.90).Conclusion: Social and modifiable factors which are associated with a higher prevalence of arthritis can be controlled through incentive measures such as social participation and physical activity.


2015 ◽  
Vol 9 (2) ◽  
pp. 76-79 ◽  
Author(s):  
Mushtaq Ahmad ◽  
Farial Naima Rahman ◽  
Md Mozaharul Islam ◽  
Md Rakib Uddin Majumder

Self destruction or suicide by pesticide poisoning is a burning problem of Bangladesh. Rapid development in science and rapid growth in agricultural activities has led to the increase in the incidences of poisoning. The objective of this study was to find out the incidences and pattern of poisoning in an urban area, different aspects of poisoning along with demographic pattern, social factors related and other related perimeter, and modality to prevent loss of precious life due to poisoning. This retrospective cross sectional study was conducted among victims of poisoning at Dhaka Medical College, Dhaka Morgue during the period of January 2008-December 2009. Specific identification of poisons was made from Chemical Examiner's report. All the data were later on analyzed. A total of 5114 medico legal post mortems were performed during this study period. Among these 300 (5.87%) cases were suspected poisoning. Out of these cases specific poisons were identified in 131 (43.66%) cases. Among the detected poisoning cases OPC was the commonest agent 103 (78.63%) followed by alcohol/rectified spirit 12 (9.16%) and barbiturate 7 (5.34%). No poison was detected (Negative results) in 116 (38.66%) cases and no reports from chemical examiner were received in 53 (17.66%) cases during the study period. Out of 300 victims 174 (58%) were male and 126 (42%) were female. Highest incidence of poisoning was observed in 21-30 years age group 117 (39%) followed by age group of 31-40 years 84 (28%). Most of the victims were agricultural workers/ farmers 108 (36%) followed by housewives 51 (17%). Among the study subjects 178 (59.33%) were illiterate and 198 (66%) were married. Considering manner of death 274 (91.33%) victims committed suicide by poisoning and rests 26 (8.67%) were due to accidental poisoning. To reduce poisoning cases proper emphasis should be given for safe use of pesticides and consciousness should be created among the population about poisonous compounds. Detail study regarding death due to poisoning is required to be carried out in this country.Faridpur Med. Coll. J. 2014;9(2): 76-79


2020 ◽  
Vol 105 (8) ◽  
pp. 744-748 ◽  
Author(s):  
Laura De Nardi ◽  
Andrea Trombetta ◽  
Sergio Ghirardo ◽  
Maria Rita Lucia Genovese ◽  
Egidio Barbi ◽  
...  

ObjectiveThis study aims to explore the attitude of adolescents with chronic diseases toward social media exposure, focusing in particular on Facebook.DesignCross-sectional study.SettingAn anonymous semistructured survey was distributed to an Italian hospital-based cohort of adolescents with chronic disease to explore the role of Facebook in their daily life.PatientsWe recruited 212 adolescents (aged between 13 and 24 years) with a diagnosis of inflammatory bowel disease, coeliac disease, diabetes mellitus type 1 and cystic fibrosis.ResultsTwo hundred and seven of the 212 (97.6%) expressed the need of sharing their illness experience with friends, 201 out of 212 (94.8%) usually searched information on the internet to find new therapies and to discover their prognosis. One hundred and forty-nine out of 212 adolescents (70.3%) perceived dependence on their parents as the most negative aspect of having a chronic disease, and 200 out of 212 (94.3%) were looking for friends with the same disease on Facebook. Two hundred and ten out of 212 (99.1%) did not want their doctors or nurse on their social media platforms. During the active disease periods, the time spent with social media increased from an average of 5 to 11 hours.ConclusionsThis descriptive analysis focused on the Facebook impact on chronic disease perception among affected adolescents. It showed that they used to spend an increased amount of time on this platform during disease flare-up and highlighted their wish of keeping doctors and nurses away from their social dimension.


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