Cognitive development of children with Kawasaki Disease and the parenting stress of their caregivers

2020 ◽  
Author(s):  
Liang-Jen Wang ◽  
Zi-Yu Tsai ◽  
Ling-Sai Chang ◽  
Ho-Chang Kuo
Keyword(s):  
Cognitive Function ◽  
Kawasaki Disease ◽  
Parenting Stress ◽  
Short Form ◽  
Systemic Vasculitis ◽  
Stress Index ◽  
Healthy Children ◽  
Ivig Infusion ◽  
Cross Sectional ◽  
Developmental Index

Abstract Background Kawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multi-systemic vasculitis common in KD patients may influence blood perfusion in the brain, and thus caregivers of KD children may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (CAL). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress. Methods This cross-sectional study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% male) and 85 healthy children (mean age: 6.4 years, 54.1% male). Based on the children’s age, each KD patient and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index-Short Form (PSI). Results We observed no significant differences in any developmental index, cognitive function, or parenting stress between KD patients and controls. Among the KD children, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL (p = 0.019). Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college (p = 0.010) or lower (p = 0.021). Conclusion No significant differences in developmental index, cognitive function or parenting stress between KD patients and controls. In KD patients, neither IVIG response nor CAL appear to have a relationship with development milestones or cognitive function. However, caregivers’ education is associated to parenting stress, and caregivers of KD patients who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfill their parenting roles.

scholarly journals Cognitive development of children with Kawasaki disease and the parenting stress of their caregivers in Taiwan: a case–control study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042996
Author(s):  
Liang-Jen Wang ◽  
Zi-Yu Tsai ◽  
Ling-Sai Chang ◽  
Ho-Chang Kuo
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Parenting Stress ◽  
Case Control Study ◽  
Short Form ◽  
Case Control ◽  
Stress Index ◽  
Secondary Outcome ◽  
Healthy Children ◽  
Control Study

ObjectiveKawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multisystemic vasculitis common in patients with KD may influence blood perfusion in the brain, and thus caregivers of children with KD may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (coronary artery lesion (CAL)). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.DesignA case–control study with consecutive sampling.SettingA medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).ParticipantsThis study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys).Primary and secondary outcome measuresBased on the children’s age, each patient with KD and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form.ResultsWe observed no significant differences in any developmental index, cognitive function or parenting stress between patients with KD and controls. Among the children with KD, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL. Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college or lower.ConclusionCaregivers’ education is associated to parenting stress, and caregivers of patients with KD who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfil their parenting roles.

scholarly journals Caregiver burden and parenting stress among left-behind elderly individuals in rural China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mengjuan Zhao ◽  
Ziqiang Zhu ◽  
Chenchen Kong ◽  
Chunshan Zhao
Keyword(s):  
Parenting Stress ◽  
Caregiver Burden ◽  
Rural Areas ◽  
Short Form ◽  
Public Health Problem ◽  
Stress Index ◽  
Annual Income ◽  
Cross Sectional ◽  
Elderly Individuals ◽  
Left Behind

Abstract Background One public health problem that cannot be ignored is the mental health of left-behind elderly individuals in rural areas. However, the burden of care and parenting stress among left-behind elderly individuals has never been analyzed. The purpose of this study was to explore the level of caregiver burden and parenting stress and their relationship among left-behind elderly individuals. Methods A total of 261 left-behind elderly people responded to the study. The 22-item Zarit Burden Interview and the 36-item Parenting Stress Index-Short Form were used. Results We sent out 300 questionnaires in total. The effective rate was 87% (n = 261). Among the left-behind elderly individuals, most respondents were female (n = 171; 65.5%). The results showed that older age (OR:3.04; 95%CI: 1.307–7.048), an annual income of ¥5000–¥9900 (OR:3.25; 95%CI: 1.192–8.852) and higher parenting stress (OR:1.17; 95%CI: 1.103–1.242) were the risk factors related to higher caregiver burden in the left-behind elderly individuals. The influencing factor for lower caregiver burden in the left-behind elderly was gender (being male) (OR:0.08; 95%CI:0.036–0.178). Age (r = − 0.789; P < 0.001) and gender (r = 0.325; P < 0.001) were significant positively correlated with parenting stress, and annual income (r = − 0.717; P < 0.001) was negatively correlated with parenting stress. Conclusion Parenting stress is a risk factor affecting caregiver burden of left-behind elderly individuals. Healthcare professionals should pay close attention to the caregiver burden and parenting stress of left-behind elderly individuals, especially those who are older, female and have lower income.

scholarly journals Family disability, poverty and parenting stress: Analysis of a cross-sectional study in Kenya

2021 ◽  
Vol 10 ◽  
Author(s):  
Xanthe Hunt ◽  
Christina Laurenzi ◽  
Sarah Skeen ◽  
Leslie Swartz ◽  
Phillip Sundin ◽  
...  
Keyword(s):  
Parenting Stress ◽  
Short Form ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Stress Index ◽  
Disabled Children ◽  
Cross Sectional ◽  
Parenting Stress Index ◽  
The Disabled ◽  
Supportive Interventions

Background: Households with a disabled member, be they a caregiver or a child, are poorer than households not affected by disability. Poverty, caregiving as a person with a disability and being the caregiver of a child with a disability can lead to increased parenting stress.Objectives: The objective of this study was to examine whether parenting stress experienced by caregivers in a household with a disabled member is greater when the disabled member is the caregiver, or the child, and how much of these respective relationships is explained by poverty.Method: We collected cross-sectional data using a demographic survey, the Washington Group Questions on adult disability, the 10 Questions on child disability and the Parenting Stress Index-Short Form, from 465 caregivers enrolled in a non-governmental child development programme in Kenya.Results: Households with a disabled member were poorer than households without a disabled member. Parenting stress of disabled caregivers was higher than parenting stress of non-disabled caregivers; however, this relationship disappeared when socio-economic status was controlled for. Caregivers of disabled children were more stressed than caregivers of non-disabled children, and this effect was not explained by differences in socio-economic status.Conclusion: Our findings highlight the importance of developing a comprehensive understanding of the stressors facing households with a disabled member, particularly if that member is a child, so that supportive interventions can adequately cater to the needs of caregivers, and their children, in the context of poverty.

Abstract 95: Increased Circulating Endothelial Microparticles In The Acute Phase Of Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Hideyuki Nakaoka
Keyword(s):  
Endothelial Dysfunction ◽  
Kawasaki Disease ◽  
Initial Treatment ◽  
Systemic Vasculitis ◽  
Disease Onset ◽  
Ivig Treatment ◽  
Healthy Children ◽  
Ivig Infusion ◽  
Endothelial Microparticles ◽  
Coronary Syndrome

Backgroud: Kawasaki disease (KD) is a typically acute inflammatory syndrome that takes the form of systemic vasculitis. The acute inflammation and subsequent reparative process may lead to lasting changes in arterial structure even in the convalescence of KD including increased endothelial dysfunction. Endothelial microparticles (EMPs) are vesicles formed by the cell membrane after endothelial activation, and their composition can be used to characterize the status of the parent endothelial cell. EMPs were reported in cardiovascular diseases with endothelial dysfunction, such as acute coronary syndrome, pulmonary hypertension, diabetes, and vasculitis. Our aim of this study is to elucidate whether EMPs are involved in vasculitis during acute stage of Kawasaki disease. Method: We enrolled 9 patients (aged 3 months to 14 years, 6 male, 3 female), 7 common febrile children and 5 healthy children. KD patients in the convalescent phase were divided into two subgroups; coronary artery lesion (CAL, n=2) and no coronary lesion (NCAL, n=7). Blood samples were collected at the time of diagnosis before the initiation of IVIG treatment, then immediately after the first IVIG infusion and at 2-4 weeks after disease onset. Samples were measured using flow cytometry. Result: The percentage counts of EMPs were 2.90±1.26% in KD children before initial treatment, which were significantly higher (P<0.005) than those of disease controls (0.12±0.13%) and healthy controls (0.09±0.08%) before initial treatment, and reached normal levels within 4 weeks (0.05±0.05%). The highest percentage count of EMPs (5.47%) was observed in the patient with CAL before initial treatment. Further, prolonged high percentage count of EMPs (3.34%) was recognized in the patient with multiple gaint aneurysms at 2 weeks after onset. Conclusion: The relation between the increased levels of EMPs and the involvement of CAL may suggest that EMPs could serve as a sensitive marker of the severity of endothelial dysfunction and vasculitis in patients with KD. Although the function of EMPs has not been fully elucidated, there is evidence that it plays an important role for distinct inflammatory reactions in endothelium.

scholarly journals Parenting Children With a Cleft Lip With or Without Palate or a Visible Infantile Hemangioma: A Cross-Sectional Study of Distress and Parenting Stress

2021 ◽  
pp. 105566562199329
Author(s):  
M. van Dalen ◽  
W.H. Leemreis ◽  
V. Kraaij ◽  
P.C.J. De Laat ◽  
S.G.M.A. Pasmans ◽  
...  
Keyword(s):  
Parenting Stress ◽  
Behavioral Problems ◽  
Cleft Lip ◽  
Short Form ◽  
Practical Implication ◽  
Infantile Hemangioma ◽  
Cross Sectional Study ◽  
Stress Index ◽  
Sectional Study ◽  
Cross Sectional

Objective: Parents of children with a medical condition and a visible difference can experience challenging situations. We evaluated distress and parenting stress in parents of children with a cleft lip with or without cleft palate (CL±P) or a visible infantile hemangioma (IH). Setting: This cross-sectional study took place in an academic medical hospital in Rotterdam, the Netherlands. Participants: Three-hundred nine parents (mean age = 40.30, 56.00% mothers) of children with CL±P and 91 parents (mean age = 36.40, 58.24% mothers) of children with IH. Main Outcome Measures: The Dutch version of the Parenting Stress Index – Short Form and the subscales Anxiety, Depression, and Hostility of the Symptom Checklist – 90. Results: One sample t tests and mixed linear modeling were used. On average, parents of children with CL±P and of children with IH showed significantly lower parenting stress compared to normative data. Anxiety was significantly lower in parents of children with CL±P than that in the norm group. Visibility of the condition was not related to distress or parenting stress. Child behavioral problems were positively related to parenting stress, depression, and hostility. Conclusions: Parents of children with CL±P and IH report less distress and parenting stress compared to the norm. On average, these parents seem well adjusted. A practical implication is to monitor parents of children with behavioral problems.

Refining the Parenting Stress Index–Short Form (PSI-SF) in Chinese Parents

Assessment ◽  
2019 ◽  
pp. 107319111984775 ◽  
Author(s):  
Jie Luo ◽  
Meng-Cheng Wang ◽  
Yu Gao ◽  
Hong Zeng ◽  
Wendeng Yang ◽  
...  
Keyword(s):  
Parenting Stress ◽  
Short Form ◽  
Stress Index ◽  
Parenting Stress Index ◽  
Chinese Parents

scholarly journals Factorial Structure and Cross-Cultural Invariance of the Parenting Stress Index-Short Form in Hong Kong and Thailand

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaozi Gao ◽  
Kerry Lee
Keyword(s):  
Hong Kong ◽  
Parenting Stress ◽  
Discriminant Validity ◽  
Short Form ◽  
Belief Systems ◽  
Cross Cultural ◽  
Stress Index ◽  
Partial Metric ◽  
Factorial Structure ◽  
Parenting Stress Index

With increasing attention on the role of parenting stress on family functioning and children’s development, one area that has been neglected is how such relations differ across cultures. Although sometimes viewed as homogeneous, Asian countries often have markedly different belief systems. Cross-cultural studies require instruments that have been validated in different socio-cultural contexts. The widely used parenting stress index-short form (PSI-SF) has been used in several locations. However, results regarding its factorial structure have been mixed. Furthermore, there are only a few cross-cultural comparison studies. This study examined the factorial structure of an abridged version of the PSI-SF with data from Hong Kong (N = 258) and Thailand (N = 190). The results from confirmatory factor analyses indicated that, in both cultures, a three-factorial structure provides the best model fit. Furthermore, we found evidence for partial metric invariance, suggesting that the test scores can be compared directly. Tests for convergent and discriminant validity revealed that the three factors were correlated with parent general distress, authoritative, authoritarian, and permissive parenting behaviors, in both cultures. These findings suggest that the abridged PSI-SF can provide a meaningful comparison of parenting stress between Hong Kong and Thailand.

scholarly journals Parenting stress and impact of illness in parents of children with coeliac disease

2013 ◽  
Vol 5 (4) ◽  
pp. 19 ◽  
Author(s):  
Maria Stella Epifanio ◽  
Vitalba Genna ◽  
Maria Grazia Vitello ◽  
Michele Roccella ◽  
Sabina La Grutta
Keyword(s):  
Coeliac Disease ◽  
Parenting Stress ◽  
Stress Index ◽  
Healthy Children ◽  
Critical Areas ◽  
Distress Level ◽  
Parenting Role ◽  
The Impact ◽  
Parenting Distress

Coeliac disease (CD) is a chronic disease which could stress patients and their family. Although, poor attention has been paid to the quality of life in CD children and to the functioning of families with CD children. The study aims to evaluate the parenting perception of the CD impact and the parenting distress level. A group of 74 parents of CD children compiled the Impact Childhood Illness Scale and the Parenting Stress Index which is also compiled by 74 parents of health children. The assessment does not reveal a significant impact of CD on patient’s personal life although some critical areas emerged. Results evidenced an higher level of parenting stress in parents of CD children than parents of healthy children. CD, if suitably managed, has not a critical impact on parenting perception. Although, CD certainly put parents through an higher risk of a distress related to parenting role than parents with health children. A early identification of parenting distress in a pediatric chronic illness could facilitate the adjustment to pathology.

scholarly journals Increased Psychopathology and Maladaptive Personality Traits, But Normal Cognitive Functioning, In Patients after Long-Term Cure of Acromegaly

2010 ◽  
Vol 31 (5) ◽  
pp. 778-779
Author(s):  
Jitske Tiemensma ◽  
Nienke R. Biermasz ◽  
Roos C. van der Mast ◽  
Moniek J. E. Wassenaar ◽  
Huub A. M. Middelkoop ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Personality Traits ◽  
Cognitive Dysfunction ◽  
Short Form ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Personality Changes ◽  
Irreversible Effects

ABSTRACT Objective Active acromegaly is associated with psychopathology, personality changes, and cognitive dysfunction. It is unknown whether, and to what extent, these effects are present after long-term cure of acromegaly. Aim The aim of the study was to assess psychopathology, personality traits, and cognitive function in patients after long-term cure of acromegaly. Design This was a cross-sectional study. Patients and Methods We studied 68 patients after long-term cure (13 ± 1 yr) of acromegaly and 68 matched controls. We compared these data with 60 patients treated for nonfunctioning pituitary macroadenomas (NFMAs) and 60 matched controls. Psychopathology was assessed using the Apathy Scale, Irritability Scale, Hospital Anxiety and Depression Scale, and Mood and Anxiety Symptoms Questionnaire short-form and personality by the Dimensional Assessment of Personality Pathology short-form (DAPP). Cognitive function was assessed by 11 tests. Results Compared with matched controls, patients cured from acromegaly scored significantly worse on virtually all psychopathology questionnaires and on several subscales of the DAPP. Compared with NFMA patients, patients cured from acromegaly scored worse on negative affect (P = 0.050) and somatic arousal (P = 0.009) and seven of 18 subscales of the DAPP (P &lt; 0.05). Cognitive function in patients cured from acromegaly did not differ from matched controls or patients treated for NFMA. Conclusion Patients with long-term cure of acromegaly show a higher prevalence of psychopathology and maladaptive personality traits but not cognitive dysfunction, compared with matched controls and patients treated for NFMA. These results suggest irreversible effects of previous GH excess, rather than effects of pituitary adenomas per se and/or their treatment, on the central nervous system.

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