Chronic rhino-sinusitis treatment in children with cystic fibrosis: A cross-sectional survey of pediatric pulmonologists and otolaryngologists

OBJECTIVES Vancomycin is commonly used in patients with cystic fibrosis (CF) to treat acute pulmonary exacerbations, but few guidelines exist to help dose and monitor patients. The objective of this study was to assess vancomycin use and monitoring strategies at Cystic Fibrosis Foundation (CFF)–accredited centers in hopes of developing and implementing vancomycin dosing and monitoring standards. METHODS An anonymous national cross-sectional survey of pharmacists affiliated with CFF-accredited pediatric and/or adult centers was performed by using Surveymonkey.com. The survey consisted of 3 sections: (1) CF Center Demographic Information (10 questions); 2) vancomycin use in pediatric CF patients (31 questions); and 3) vancomycin use in adult CF patients (29 questions); it was administered from March 9, 2015, to April 13, 2015. RESULTS The survey was completed by 31/69 (45%) pharmacists and 28 (90.3%) reported using vancomycin in the pediatric population. The most common initial starting dose for pediatric patients was 15 mg/kg/dose (57.1%) and every 6 hours was the most common dosing frequency (67.9%). The most common monitoring strategy was collection of a trough concentration (92.9%) with 57.7% of pharmacist targeting a range of 15 to 20 mg/L. The most common initial starting vancomycin dose in adults with CF was 15 mg/kg/dose (61.5%), and initial frequency of every 8 hours (73.1%). The most common monitoring strategy was a trough concentration (96.2%) with 83.3% of pharmacists reporting a goal trough range of 15 to 20 mg/L. CONCLUSIONS The most common vancomycin dosing reported was 15 to 20 mg/kg/dose every 6 hours (pediatric) and 15 to 20 mg/kg/dose every 8 to 12 hours (adults). Serum concentrations measured to meet monitoring parameters of trough concentrations of 15 to 20 mg/L, or area under the curve to minimum inhibitory concentration ratio > 400, were the same in both pediatric and adult patients.

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Global and Specific Disease-Related Information Needs of Cystic Fibrosis Patients and Their Families

PEDIATRICS ◽

10.1542/peds.85.6.1015 ◽

1990 ◽

Vol 85 (6) ◽

pp. 1015-1021

Author(s):

Lesley D. Henley ◽

Ivor D. Hill

Keyword(s):

Cystic Fibrosis ◽

Social Life ◽

Information Needs ◽

Medical Information ◽

Family Members ◽

Reproductive Capacity ◽

Specific Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Information Index

A cross-sectional survey of 60 families with a child with cystic fibrosis was undertaken to assess how much family members wanted to be told about the illness, to determine specific information needs concerning selected medical and psychosocial topics, and to determine whether this information had been provided in the past. Self-administered index measures were designed for this purpose. Most family members wanted complete and comprehensive information about cystic fibrosis. A minority of family members claimed they had not received basic medical information. Fathers and siblings wanted more medical information than mothers and patients. The majority of parents and patients wanted a great deal more information on the possible effects of cystic fibrosis on the patient's career, social life, marriage, and reproductive capacity. In general, family members had been given more medical than psychosocial information. Index measures were independent of the effects of patients' age, Shwachman score, and period since diagnosis. Social class was significantly associated with fathers' index measures of their specific information needs and information not given previously.

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Errors, Gaps, and Misconceptions in the Disease-Related Knowledge of Cystic Fibrosis Patients and Their Families

PEDIATRICS ◽

10.1542/peds.85.6.1008 ◽

1990 ◽

Vol 85 (6) ◽

pp. 1008-1014 ◽

Cited By ~ 1

Author(s):

Lesley D. Henley ◽

Ivor D. Hill

Keyword(s):

Cystic Fibrosis ◽

Social Class ◽

Psychometric Properties ◽

Medical Knowledge ◽

Parental Knowledge ◽

Choice Test ◽

Multiple Choice Test ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Poor Knowledge

A cross-sectional survey was conducted among 60 families with a child with cystic fibrosis to assess their medical knowledge of the illness. A 63-item, multiple-choice test with acceptable psychometric properties was administered to 60 mothers, 54 fathers, 29 siblings (aged 10 to 23 years), and 18 patients (aged 9 to 22 years). Parents and patients correctly answered approximately three quarters and siblings two thirds of all items. Family members were most knowledgeable about general cystic fibrosis facts, physiotherapy, gastrointestinal symptomatology and treatment, and anatomy. They were less well-informed about respiratory symptomatology and treatment and nutrition. Parental knowledge of genetics and reproductive risks was mediocre, and that of patients and siblings was poor. Knowledge of terminology was uniformly low. Social class was a significant predictor of parental knowledge. If left uncorrected the misconceptions, gaps, and errors in family members's knowledge of cystic fibrosis identified in this study could result in inadverent noncompliance in treatment of the patient.

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Tobramycin and Beta-Lactam Antibiotic Use in Cystic Fibrosis Exacerbations: A Pharmacist Approach

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-21.3.239 ◽

2016 ◽

Vol 21 (3) ◽

pp. 239-246 ◽

Cited By ~ 1

Author(s):

Jeffery T. Zobell ◽

Kevin Epps ◽

Frederick Kittell ◽

Clarissa Sema ◽

Erin J. McDade ◽

...

Keyword(s):

Cystic Fibrosis ◽

Initial Dosage ◽

Area Under The Curve ◽

Antibiotic Use ◽

Beta Lactam ◽

Beta Lactams ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Maximum Serum ◽

Lactam Antibiotic

OBJECTIVES: Survey suggests that recommended doses and dosage regimens for antipseudomonal antibiotics for the treatment of acute pulmonary exacerbations in cystic fibrosis (CF) patients are not used, and one way to address these disparities is the involvement of pharmacists who are dedicated to CF. This is the first survey specifically designed for pharmacists at Cystic Fibrosis Foundation (CFF)–accredited centers to identify how tobramycin and antipseudomonal beta-lactams are being used. The purpose of this survey is to quantify this information and to promote future study to allow for implementation of tobramycin and beta-lactam dosage and monitoring standardization. METHODS: An anonymous national cross-sectional survey of pharmacists that are affliated with CFF-accredited programs was performed using Qualtrics.com. RESULTS: The survey had a 48.5% response rate. Most pediatric pharmacists (78.6%) report using extended-interval tobramycin dosage. The most common reported starting dosage was 10 mg/kg every 24 hours; most centers aim for a maximum serum concentration (Cmax) between 20 and 40 mg/L (78.6%). A total of 26 adult pharmacists reported using extended-interval dosage (96%), using an initial dosage of 10 mg/kg/day. The most common parameters used to adjust dosage were Cmax and area under the curve (AUC; 31%); the Cmax goal was 20 to 40 mg/L (84.2%). Most respondents (79%) report using beta-lactams in combination with tobramycin. Extended-infusion and continuous-infusion beta-lactams were used more in adults than pediatric patients. CONCLUSIONS: Most CF pharmacists report using extended-interval tobramycin. With the information from this survey, the establishment of future consensus recommendations by pharmacists for optimal and consistent tobramycin and antipseudomonal beta-lactam dosage and monitoring strategies needs to be considered.

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Health related quality of life and disease burden of patients with cystic fibrosis and their caregivers: Results of the European BURQOL-RD survey in Hungary

Orvosi Hetilap ◽

10.1556/oh.2014.30016 ◽

2014 ◽

Vol 155 (42) ◽

pp. 1673-1684 ◽

Cited By ~ 3

Author(s):

Márta Péntek ◽

György Kosztolányi ◽

Béla Melegh ◽

Adrienn Halász ◽

Gábor Pogány ◽

...

Keyword(s):

Quality Of Life ◽

Cystic Fibrosis ◽

Disease Burden ◽

Age Groups ◽

Economic Evaluations ◽

Cross Sectional Survey ◽

Significant Deterioration ◽

Cross Sectional ◽

Assess Quality

Introduction: Data on disease burden of cystic fibrosis in Hungary are scarce. Aim: To assess quality of life and resource utilisations of patients with cystic fibrosis. Method: In a cross-sectional survey (BURQOL-RD project), the EQ-5D-5L questionnaire was applied and healthcare utilisations were retrospectively surveyed. Results: 110 patients participated in the study (age-groups, year: 0–13, N = 48; 14–17, N = 12; ≥18, N = 50), median age at the diagnosis was 1 year. EQ-5D-5L score in age-groups 18–24 and 25–34 was significantly lower than in the general population (p<0.05). 75 patients (68%) attended pulmonology care, 55 patients (50%) were hospitalised in the past 6 and 12 months, respectively, and 57 patients (52%) were taking dornase alpha. Five adult patients (10%) received help from non-professional caregiver. Conclusions: Cystic fibrosis leads to significant deterioration of quality of life. This study is the first from the Central Eastern European region that provides basic inputs for further health economic evaluations of cystic fibrosis care. Orv. Hetil., 2014, 155(42), 1673–1684.

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Depression and coping strategies used among adolescents with cystic fibrosis

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20214531 ◽

2021 ◽

Vol 8 (12) ◽

pp. 1932

Author(s):

Surya Kant Tiwari ◽

Rimple Sharma ◽

Poonam Joshi ◽

Sushil Kumar Kabra

Keyword(s):

Cystic Fibrosis ◽

Coping Strategies ◽

Coping Strategy ◽

Tertiary Care ◽

Care Facility ◽

Severe Depression ◽

Sampling Technique ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tertiary Care Facility

Background: Cystic fibrosis (CF), an autosomal recessive monogenic chronic disorder affects the lungs, pancreas, and other exocrine glands, and manifests as recurrent respiratory infections, malabsorption, and a myriad of complications pertaining to other systems like hepatobiliary, endocrine and reproductive systems. Objectives were to assess the level of depression among adolescents with CF, to assess the coping strategies used by adolescents with CF and to find an association between selected sociodemographic and clinical variables with depression.Methods: In a cross-sectional survey, 30 adolescents with CF in the age group of 12-18 years, attending the specialty clinic of a selected tertiary care facility were enrolled using a purposive sampling technique. Tools consisting of sociodemographic and clinical profile, patient health questionnaire (PHQ)-9, and ways of coping with CF were used for data collection.Results: Most of the adolescents with CF (66.7%) had depression of varying severity with 36.7% having moderate-severe to severe depression. The frequently used coping strategies by the adolescents with CF were hopefulness (76.66±11.29), followed by optimistic acceptance (70.23±13.04). The individual coping strategy with the highest mean score was “having confidence on doctor and treatment” (3.83±0.37), while ‘I cry, eat, drink or take drugs’ had the lowest score (1.6±1.00).Conclusion: Depression is a common problem among adolescents with CF requiring regular screening and referral to experts for enhancing their coping strategy of optimistic acceptance.

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SERVICE EVALUATION OF A CYSTIC FIBROSIS HOME INTRAVENOUS ANTIBIOTIC SERVICE PROVIDED BY A NHS FOUNDATION TRUST

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-311535.71 ◽

2016 ◽

Vol 101 (9) ◽

pp. e2.69-e2 ◽

Cited By ~ 1

Author(s):

Lynn Elsey

Keyword(s):

Cystic Fibrosis ◽

Hospital Pharmacy ◽

Formative Evaluation ◽

Treatment Time ◽

Information Access ◽

Service Evaluation ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Blood Tests ◽

At Home

AimTo evaluate carers' satisfaction with the current service for home reconstitution and administration of intravenous (IV) antibiotics to cystic fibrosis (CF) patients and identify ways of improving this service to reduce treatment burden.MethodsA formative evaluation was conducted of all 17 carers who reconstituted and administered the IV antibiotics at home. This was carried out using a cross-sectional survey. A questionnaire of open and closed questions was sent first class with a pre-paid return envelope to the carers. This was followed by a reminder letter after the set return date.ResultsThirteen carers responded giving a response rate of 76.5%. The carers had a mean of 2 children in the household with all having 1 child under the care of the paediatric CF team. They had been receiving IV antibiotics for a mean of 8 years and 7 months and had been administering them at home for a mean of 6 years and 1 month. The majority had administered the antibiotics in the last 3 months.Over half received their drugs from the hospital pharmacy, but one carer highlighted that they did not always receive a full supply of the treatment.Removing the reconstitution step by providing pre-prepared syringes could reduce treatment time by around 18 minutes. Overall this could mean a daily reduction in treatment time of almost two hours for a patient who is on two antibiotics three times a day. The majority of respondents stated that they would prefer pre-filled syringes.The carers felt that they received enough training and felt confident in reconstituting and administering the antibiotics. The majority felt that they should receive regular updates to their training and it was highlighted that they are reassessed at the start of each course. Most of the carers felt that they had an opportunity to discuss the IV antibiotics in the out-patient clinic with the doctors and the nurses but none of them would contact the pharmacist. They felt that they were appropriately contacted in advance to organise when the course would start and a proportion were contacting the nurses in advance to organise the treatment around their commitments. When they receive the antibiotics and sundries from the hospital pharmacy they are supplied with written directions for reconstitution and administration. However, the carers did not find these easy to understand. It was highlighted by one that they could not access advice at night.Overall the carers had a high level of satisfaction with the service. Some felt that it could be improved by easier access to advice, having blood tests done by community nurses and pre-filled syringes.ConclusionOverall this cohort is satisfied with their current home IV service. Improvements could be made by: ensuring carers always receive 100% of all necessary supplies; better access to advice; easier to understand written information; access to blood tests in community; increased awareness of the pharmacist. The majority of carers would like pre-prepared syringes and these could greatly decrease the treatment time.

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Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽

10.1027/0227-5910/a000604 ◽

2020 ◽

Vol 41 (2) ◽

pp. 82-88 ◽

Cited By ~ 1

Author(s):

Bob Lew ◽

Ksenia Chistopolskaya ◽

Yanzheng Liu ◽

Mansor Abu Talib ◽

Olga Mitina ◽

...

Keyword(s):

Social Support ◽

Suicidal Behavior ◽

Online Survey ◽

Perceived Social Support ◽

Strain Theory ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Psychological Strains ◽

Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conﬂicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

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Fit and Congruency

Journal of Personnel Psychology ◽

10.1027/1866-5888/a000233 ◽

2019 ◽

Vol 18 (3) ◽

pp. 148-156

Author(s):

Mary Hogue ◽

Lee Fox-Cardamone ◽

Deborah Erdos Knapp

Keyword(s):

Role Theory ◽

Social Role ◽

Gender Diversity ◽

Job Fit ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Working Adults ◽

Role Congruity ◽

Self Selection ◽

Selection Of

Abstract. Applicant job pursuit intentions impact the composition of an organization’s applicant pool, thereby influencing selection outcomes. An example is the self-selection of women and men into gender-congruent jobs. Such self-selection contributes to a lack of gender diversity across a variety of occupations. We use person-job fit and the role congruity perspective of social role theory to explore job pursuit intentions. We present research from two cross-sectional survey studies (520 students, 174 working adults) indicating that at different points in their careers women and men choose to pursue gender-congruent jobs. For students, the choice was mediated by value placed on the job’s associated gender-congruent outcomes, but for working adults it was not. We offer suggestions for practitioners and researchers.

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Oscillation between identities and Subjective psychological health objectives among an informed audience in therapeutic patient education

Education thérapeutique du patient - Therapeutic patient education ◽

10.1051/tpe/2018006 ◽

2018 ◽

Vol 10 (1) ◽

pp. 10202

Author(s):

Sandrine Roussel ◽

Alain Deccache ◽

Mariane Frenay

Keyword(s):

Patient Education ◽

Psychological Health ◽

Healthcare Professionals ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Therapeutic Patient Education ◽

French Speaking ◽

Health Objectives ◽

Self Administered Questionnaire

Introduction: The implementation of Therapeutic Patient Education (TPE) remains a challenge. An exploratory study highlighted two tendencies among practitioners of TPE, which could hamper this implementation: an oscillation between identities (as caregivers versus as educators) and an inclination towards subjective psychological health objectives. Objectives: To verify whether these tendencies can be observed among an informed audience in TPE. Next, to explore the variables associated with one or other of these tendencies. Method: A quantitative cross-sectional survey by a self-administered questionnaire was carried out among 90 French-speaking healthcare professionals. Statistical analyses (chi-square, logistic regression) were then conducted. Results: Sixty percent of respondents displayed identity oscillation, which was found to be linked to task oscillation, patient curability, scepticism towards medicine and practising in France. Fifty-six percent pursued subjective psychological health objectives, which was found to be associated with health behaviour objectives and a locus of power in the healthcare relationship distinct from those seen in the pre-existing health models (biomedical, global). This tendency seems to constitute an alternative model of TPE. Discussion & conclusion: Identity oscillation and subjective psychological health objectives can be both observed. This study stresses the need to deliberate on the form(s) of TPE that is/are desired.

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