Health-related quality of life in preschool children in five health conditions

Objective: To test the responsiveness of the Infant/Toddler Quality of Life Questionnaire (ITQOL) to five health conditions. In addition, to evaluate the impact of the child's age and gender on the ITQOL domain scores. Methods: Observational study of 494 Dutch preschool-aged children with five clinical conditions and 410 healthy preschool children randomly sampled from the general population. The clinical conditions included neurofibromatosis type 1, wheezing illness, bronchiolitis, functional abdominal complaints, and burns. Health-related quality of life (HRQoL) was assessed by a mailed parent-completed ITQOL. Mean ITQOL scale scores for all conditions were compared with scores obtained from the reference sample. The effect of patient's age and gender on ITQOL scores was assessed using multi-variable regression analysis. Results: In all health conditions, substantially lower scores were found for several ITQOL scales. The conditions had a variable effect on the type of ITQOL domains and a different magnitude of effect. Scores for 'physical functioning', 'bodily pain', and 'general health perceptions' showed the greatest range. Parental impact scales were equally affected by all conditions. In addition to disease type, the child's age and gender had an impact on HRQoL. Conclusions: The five health conditions (each with a distinct clinical profile) affected the ITQOL scales differently. These results indicate that the ITQOL is sensitive to specific characteristics and symptom expression of the childhood health conditions investigated. This insight into the sensitivity of the ITQOL to health conditions with different symptom expression may help in the interpretation of HRQoL results in future applications

Children's at Home: Pilot Study Assessing Dedicated Social Media for Parents of Adolescents with Neurofibromatosis Type 1.

The aim of this pilot study was to evaluate Children's at Home (C@H), a dedicated social media website for parents of adolescents with neurofibromatosis type 1 (NF1). The interventional study included two phases: (1) creating video intervention/prevention assessment (VIA) visual narratives about having an adolescent with NF1 and (2) interacting on C@H, a secure, medically moderated social media website. C@H was evaluated qualitatively at three time points. At enrollment (T0, N = 17), participants reported needing C@H to break their isolation, connect with other families, and receive accurate information, advice, and support from others facing similar challenges. At T1, after creating VIA during 6 months (N = 13, 145 videos), participants mostly valued the opportunity to speak about the challenges they face with NF1 and their journey since diagnosis. At T2, after interacting on C@H for 7 weeks (N = 10, two sign-ins/week/parent), participants reported connecting with other parents of children with NF1 for the first time, valuing the "real faces" and emotions of other parents with shared experiences providing a sense of normalcy. Qualitative analysis suggested that C@H decreased feelings of isolation, provided relief to talk about NF1 without having to explain it, provided new knowledge about NF1 and the opportunity to address non-medical issues of NF1 never discussed in clinic, and helped participants with putting their lives into perspective. C@H allowed parents of adolescents with NF1 to overcome previous isolation and connect for the first time. Innovative applications of social media dedicated to those who care for children with chronic conditions can provide peer-to-peer support, shared experience, and reliable medical information

The Benefits of Reciprocated Friendships for Treatment-seeking Obese Youth

Objective The current study examined the attributes of the reciprocated friends (RF) of a group of clinically referred obese children and the impact of these friendships on emotional well-being. Methods Classroom visits for 87 obese youth [body mass index (BMI) >95th percentile; 8- to 16-years old) were completed to obtain peer reports of social functioning, including reciprocated friendships, and to identify a demographically similar non-overweight comparison peer (CPO, n = 76). Subsequently, data regarding self-reported emotional well-being were collected from 84 obese children and 74 CPOs. Results Most obese children (68%) had at least one RF in their classroom. RFs were similar socially to CPOs and functioned more adaptively in the peer environment relative to obese children. Among obese youth, having at least one reciprocated friendship moderated the effect of sensitive-isolated behavior on loneliness. Conclusion Friendships may be a source of support for better psychosocial outcomes for obese youth

Psicoterapia de criança com alopecia areata universal: desenvolvendo a resiliência

Este artigo apresenta um estudo de caso de uma criança portadora de alopecia areata universal, vitiligo e transtorno de ansiedade generalizada, atendida em clínica-escola de psicologia de 2002 a 2007. A abordagem terapêutica adotada foi a psicoterapia de orientação psicanalítica infantil e a orientação sistemática aos pais, objetivando a diminuição dos sintomas e o desenvolvimento de habilidades para o enfrentamento da doença crônica. No decorrer do processo, ao longo dos cinco anos de atendimento, a paciente adaptou-se positivamente à doença, ocorrendo a remissão dos sintomas de ansiedade e o desenvolvimento de comportamentos resilientes que indicaram a alta terapêutica