Parental Quality of Life in the Framework of Paediatric Chronic Gastrointestinal Disease

Chronic gastrointestinal diseases, such as inflammatory bowel disease (IBD) and celiac disease (CD), might have impact not only on the affected child but also on their parents since inside the family framework, a change in each member may have influence on the whole system. The aim of this study was to test the hypothesis that parents whose children have IBD or CD will have a lower quality of life (QoL) compared to parents of healthy children, as well as that lower QoL will be found among parents who perceive lower health related quality of life (HRQOL) of their child. 55 parents of children with IBD, 49 of CD and 53 parents of healthy children were included in the study. Children were aged 7–18 years. In order to measure parental QoL, a Croatian version of the WHOQOL-BREF questionnaire was administered, with four domains: physical health, psychological health, social relationship and environment. The Total QoL was calculated as a sum of all domain items. The parent-proxy report of children’s HRQOL, PedsQLTM 4.0 Generic Core Scales was used.Main result shows that parents of children with IBD report a significantly lower psychological health, compared to parents of other children, and significantly lower physical health compared to parents of healthy children. Among parents of children with CD and parents of healthy children, better parental Total QoL was significantly correlated with better parental report of children’s HRQOL, while for parents of children with IBD those associations were not found. Results of study show association between presence of the disease in offspring with poorer parental QoL, thus highlight the importance of supporting not only children with chronic disease but also involving their parents in psychosocial interventions, as well as supporting the patient’s association groups which gather both children with chronic disease and their parents

Support programmes for emotional and social competencies in children and adolescents

Posljednjih godina raste broj stručnjaka na polju školske psihologije koji, uz akademsko postignuće, naglašavaju važnost razvoja djetetovih socijalnih i emocionalnih vještina kroz školovanje. Rezultati istraživanja idu u prilog tvrdnjama da se socijalne i emocionalne kompetencije mogu naučiti kroz programe integrirane u školski kurikulum (tzv. socijalno i emocionalno učenje, SEU). Takvi programi čine se učinkovitim načinom za smanjenje problematičnih ponašanja učenika i emocionalnih teškoća, dok istovremeno povećavaju socijalnu prilagodbu i potiču akademski uspjeh učenika. Rad donosi opsežan pregled postojećih programa i nekoliko aspekata klasifikacije programa za socijalno i emocionalno učenje (SEU) nastalih i primjenjivanih u svijetu (primarno u američkim školama) u posljednjih 10-ak godina. Budući da je cilj privući interes i povećati razumijevanje stručnjaka s područja obrazovanja i psihologije u svrhu primjene sličnih programa u Hrvatskoj, u radu se kritički razmatraju uvjeti razvoja, primjene i evaluacije efekata SEU programa.During the last decade, a growing number of educational psychology experts, along with academic performance, stress the importance of developing the child\u27s social and emotional skills through schooling. Research indicates that social and emotional competencies can be learned through school-based curriculum activities (Social and Emotional Learning, SEL). Such programs seem to be an effective approach to reducing problem behaviors and emotional distress, while at the same time promoting positive social adjustment and enhancing the academic performance of students. This paper brings a broad overview of existing programs and represents an attempt to classify SEL programs implemented in different countries (primarily in American schools) in the last 10 years. Since the primary goal is to raise interest and increase understanding in experts from education and psychology in order to encourage implementation of such programs in Croatia, the paper gives a critical insight into the conditions in which SEL programs are developed, implemented and evaluated

PARENTAL PSYCHOPATHOLOGY IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE – A PILOT STUDY RESULTS

Background: There are very little literature data available on the prevalence of personality disorder in parents of children and adolescents suffering from inflammatory bowel disease. The purpose of this study was to assess the rate of parents meeting the criteria for a particular personality disorder according to the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Methods: The study included 36 parents of children and adolescents (aged 7-18 years) with inflammatory bowel disease. Results: Half of the parents of children with inflammatory bowel disease scored at or above the threshold of diagnostic criteria for a particular DSM-IV disorder on Axis II, mainly obsessive-compulsive personality disorder. Overall, rigidity and inflexibility about morality were the most frequent obsessive-compulsive personality disorder criteria. Conclusion: Parental personality factors play an important role in the context of pediatric inflammatory bowel disease, although the question remains whether it is influencing or being influenced by the disease. As this study was cross-sectional, we cannot say with certainty if the obsessive-compulsive personality disorder features occur with a high prevalence in parents of children with inflammatory bowel disease as a result of carrying for a child with a chronic disease, or they are a maintaining or even precipitating factor in the frame of pediatric inflammatory bowel disease

Attachment Style in Parents of Children with Chronic Gastrointestinal Disease

Attachment is a point of interest in psychosomatic research since it influences a wide array of biopsychosocial phenomena. Data from literature highlights the role of this concept in the context of Inflammatory Bowel disease (IBD), still, there is a lack of data regarding attachment among parents of children with chronic gastrointestinal diseases. The main hypothesis for the current study is that parents of children with IBD will have a more insecure attachment than parents of children with celiac disease (CD) and parents of healthy children. The second hypothesis is that insecure attachment among parents of sick children will be associated with lower parental quality of life (QoL). 46 parents of children with IBD, 42 parents of children with CD and 43 parents of healthy children completed the validated modification of the Brennan’s Experiences in Close Relationship Inventory. Results were categorized as secure and insecure attachment. In order to assess parental QoL, the WHOQOL-BREF questionnaire was used. The Total QoL was calculated as a sum of all domain items. Secure attachment was found in 45.7% parents of children with IBD, in 35.7% parents of children with CD and in 32.6% parents of healthy children. Surprisingly, the lowest rate of secure attachment was found in parents of healthy children. However, significant differences among groups do not exist. For all groups of parents the attachment style is associated with Total QoL, although only among parents of children with IBD, the secure attachment independently and significantly predicts higher parental Total QoL. According to results, we might say that parental attachment style does not have a role that exclusively belongs in the context of paediatric chronic gastrointestinal diseases. However, parents of children with IBD who have insecure attachment represent target group for psychosocial support in order to improve their QoL

Effects of Ramipril and Valsartan on Proteinuria and Renal Function in Patients with Nondiabetic Proteinuria

The renin-angiotensin system is involved in the progression of chronic renal disease of both diabetic and nondiabetic origin. The angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers have been demonstrated to reduce urinary protein excretion and attenuate the development of renal injury. This prospective, randomized, 12-month study assessed the effects of ramipril (N=23) vs. valsartan (N=22) vs. combination of ramipril and valsartan (N=26) on proteinuria, renal function and metabolic profile in 71 patients with nondiabetic proteinuria with normal or slightly impaired renal function. Monotherapy with ramipril or valsartan and combination of these two drugs significantly reduced proteinuria, serum creatinine, cholesterol and triglycerides as well as systolic and diastolic arterial blood pressure. There was no significant difference among three study groups according to reduction of arterial blood pressure, serum cholesterol and triglycerides. At one year, a significant reduction in serum creatinine was recorded in all three study groups, whereas at 3 and 6 months a statistically significant reduction in serum creatinine was only observed in patients on combination therapy. In addition, at 3 months the reduction of proteinuria was significantly greater in patients on combination therapy than in those on either monotherapy. These results indicated the combination therapy with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to be more efficacious than either monotherapy in reducing proteinuria and serum creatinine level in the first 3 (proteinuria and serum creatinine) or 6 (serum creatinine) months of treatment

Effects of ramipril and valsartan on proteinuria and renal function in patients with nondiabetic proteinuria [Učinci ramiprila i valsartana na proteinuriju i bibrežnu funkciju u bolesnika s nedijabetičkom proteinurijom]

The renin-angiotensin system is involved in the progression of chronic renal disease of both diabetic and nondiabetic origin. The angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers have been demonstrated to reduce urinary protein excretion and attenuate the development of renal injury. This prospective, randomized, 12-month study assessed the effects of ramipril (N = 23) vs. valsartan (N = 22) vs. combination of ramipril and valsartan (N = 26) on proteinuria, renal function and metabolic profile in 71 patients with nondiabetic proteinuria with normal or slightly impaired renal function. Monotherapy with ramipril or valsartan and combination of these two drugs significantly reduced proteinuria, serum creatinine, cholesterol and triglycerides as well as systolic and diastolic arterial blood pressure. There was no significant difference among three study groups according to reduction of arterial blood pressure, serum cholesterol and triglycerides. At one year, a significant reduction in serum creatinine was recorded in all three study groups, whereas at 3 and 6 months a statistically significant reduction in serum creatinine was only observed in patients on combination therapy. In addition, at 3 months the reduction of proteinuria was significantly greater in patients on combination therapy than in those on either monotherapy. These results indicated the combination therapy with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to be more efficacious than either monotherapy in reducing proteinuria and serum creatinine level in the first 3 (proteinuria and serum creatinine) or 6 (serum creatinine) months of treatment

City of Hope Quality of Life-Ostomy Questionnaire Validity and Reliability Assessment on a Croatian Sample

The aim of this study was to validate City of Hope Quality of Life-Ostomy Questionnaire (CoH-QoL-OQ) for assessing the quality of life (QoL) of ostomy patients in the Republic of Croatia. The CoH-QoL-OQ is widely used, but has not been translated or validated so it can be used in the Republic of Croatia. This cross-sectional study encompassed 302 surgery patients with colostomy, ileostomy, or urostomy (182 (60.3%) male and 120 (39.7%) female), whose average age is 59 (M = 59.3, SD = 15.8). The CoH-QoL-OQ was translated into Croatian language using accepted guidelines for translation. Patients were recruited in a telephone conversation, followed by mail containing the CoH-QoL–OQ delivered to the home addresses of the patients who agreed to participate. The collected data were analyzed to verify psychometric properties of the questionnaire on the Croatian sample. All subscales showed high level of internal consistency (Cronbach α = 0.73–0.89). The test-retest reliability indicated a very satisfactory temporal stability (r = 0.99). The Confirmatory Factor Analysis (CFA), showed that the originally established model was not adequate for the data (χ2 = 4237.88, p < 0.01, CFI = 0.540, NNFI = 0.481, RMSEA = 0.113). However, after modification that excluded problematic items, the data showed a better fit with the theoretical model (except for the LR chi-square test that remained statistically significant: χ2 = 1144.28, p < 0.01, CFI = 0.869, NNFI = 0.855 RMSEA = 0.077). We conclude that the CoH-QoL-OQ is a valid, reliable, and reducible instrument for measuring the health-related quality of life (HRQoL) among Croatian patients with ostomy in clinical research and clinical practice