Triple P for Parents of Children with Phenylketonuria: A Nonrandomized Trial

Author(s):  
Amy E Mitchell ◽  
Alina Morawska ◽  
Grace Kirby ◽  
James McGill ◽  
David Coman ◽  
...  

Abstract Objective Families of children with phenylketonuria (PKU) report child emotional and behavioral problems, parenting stress, and parenting difficulties, which are associated with worse health-related quality of life. This study aimed to examine acceptability and feasibility of a brief, group-based parenting program (Healthy Living Triple P) for families of children with PKU. Methods An uncontrolled nonrandomized trial design was used. Families of children aged 2–12 years (N = 17) completed questionnaire measures assessing child behavior and impact of PKU on quality of life (primary outcomes), and parenting behavior, self-efficacy and stress, and children’s behavioral and emotional adjustment (secondary outcomes). Routinely collected blood phenylalanine (Phe) levels were obtained from the treating team. Parents selected two child behaviors as targets for change. The intervention comprised two, 2-hr group sessions delivered face-to-face or online. Assessment was repeated at 4-week postintervention (T2) and 4-month follow-up (T3). Results Attrition was low and parent satisfaction with the intervention (face-to-face and online) was high. All families achieved success with one or both child behavior goals, and 75% of families achieved 100% success with both behavior goals by T3; however, there was no change in health-related quality of life. There were moderate improvements in parent-reported ineffective parenting (total score, d = 0.87, 95% CI −1.01 to 2.75) and laxness (d = 0.59, 95% CI −1.27 to 2.46), but no effects on parenting stress or children’s adjustment. Phe levels improved by 6month post-intervention for children with elevated preintervention levels. Conclusions Results support intervention acceptability and feasibility. A randomized controlled trial is warranted to establish intervention efficacy.

2021 ◽  
Author(s):  
Abdullah Ali Gafer ◽  
Nabil Ahmed Al-Rabeei ◽  
Mohammed Sadeg Al-Awar

Abstract Background: Identifying and understanding the variables that influence health-related quality of life (HRQoL) in patients with thalassemia is critical to creating more appropriate clinical, counseling, and social support programs to develop treatment results for these individuals. The purpose of this investigation is to investigate the variables that are related with HRQOL in thalassemic patients in Yemen. Methods: From July to September 2020, a descriptive, cross-sectional investigation was carried out among Thalassemia patients who attended the Yemen Society for Thalassemia. a total of 344 individuals with Thalassemia between the ages of 5 and 18 years old. Data were gathered by utilizing the Pediatric Quality of Life 4.0 as face to face interview with children and their parents. The scale consisted of four domains (Physical, emotional, social, and school functioning) and other related demographic and clinical characteristics of the patients. coefficient tests as appropriate. Two-tailed, p-value <0.05 was regarded statistically considerable.Results:The findings of the investigation displayed that the Thalassemia patients were males with a percentage of (54.9%)Thetotal HRQoL mean score was found to be (50.6±16.5) with the highest mean scores in the social (69.3±20.2) and emotional (55.9±20.7) functioning domains. There was correlation between age, education, residency, and total HRQoL scores, which was statistically significant (P-value<0.05). There was correlation between iron overload complications, pre-transfusion Hb level, received iron chelation, and total HRQoL scores (P-value<0.05).Conclusions:Appropriate programs focused at providing psychological support to thalassemia patients are needed to improve their HRQoL. The results also supported the significance of keeping a pretransfusion hemoglobin level of at least 9-10.5 g/dL prior to the transfusion procedure.


1994 ◽  
Vol 42 (12) ◽  
pp. 1295-1299 ◽  
Author(s):  
Morris Weinberger ◽  
Becky Nagle ◽  
Joseph T. Hanlon ◽  
Gregory P. Samsa ◽  
Kenneth Schmader ◽  
...  

2021 ◽  
pp. 1357633X2098029
Author(s):  
Qingling Wang ◽  
Regina L-T Lee ◽  
Sharyn Hunter ◽  
Sally W-C Chan

Introduction The aim of this review was to systematically evaluate the available evidence on the effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty regarding pain, range of motion, physical function, health-related quality of life, satisfaction, and psychological well-being. Methods This was a systematic review with meta-analysis based on the Cochrane Handbook for Systematic Reviews of Interventions guidelines. Studies published in English or Chinese were searched using defined search periods, databases, and search terms. Two reviewers assessed independently the quality of studies. RevMan 5.3 was used for meta-analysis. Heterogeneity was assessed using the χ2 and I2 statistic. A random effect model and mean difference (MD) with 95% confidence interval (CI) was adopted. Standardised mean difference (SMD) was used if the outcome was measured by different scales. Results Eleven studies with 1020 participants were analysed. Compared to face-to-face rehabilitation, internet-based telerehabilitation showed no significant difference in outcomes of pain (SMD–0.11, 95% CI–0.32 to 0.10), range of motion in flexion (MD 0.65, 95% CI–1.18 to 2.48) and extension (MD–0.38, 95% CI–1.16 to 0.40), patient-reported physical function (SMD 0.01, 95% CI–0.15 to 0.17), health-related quality of life (SMD–0.09, 95% CI–0.26 to 0.07), satisfaction (SMD–0.04, 95% CI–0.21 to 0.14), and psychological well-being (SMD 0.10, 95% CI–0.13 to 0.33). Internet-based telerehabilitation showed better outcomes in physical functional tests (SMD–0.54, 95% CI–1.08 to–0.01). Discussion This review suggests that internet-based telerehabilitation has comparable effectiveness to face-to-face rehabilitation on rehabilitation outcomes among patients after total joint arthroplasty.


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