Do parent's global rating of well-being and disease activity of children with juvenile idiopathic arthritis yield different information?

Ullmann, Nicola; Consolaro, Alessandro; Filocamo, G; Verazza, Sara; Dalprà, Sara; Ferrari, Claudia; Caorsi, Roberta; Viola, Stefania; Visconti, Chiara; Martini, Alberto; Ravelli, Angelo

doi:10.1186/1546-0096-6-s1-p103

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“…To our knowledge, there is no study relating the evaluation of differences in the perception of pain and overall well-being by children with JIA, their parents, and physician in the same research. Furthermore, a series of earlier studies that measure the agreement between children, their parents, and physicians in rating pain intensity and overall well-being have shown conflicting results [14,15]. We therefore investigated the difference in pain and overall well-being assessment in JIA between children, their parents, and physician with the determination of the most valuable indicator among the Ukrainian population.…”

Section: Discussionmentioning

confidence: 98%

“…Although joint complaints also have a major influence on the parent's assessment, the parent's perception of the child's health status is largely determined by the ability of the child to cope with arthritis symptoms, namely pain, and by the broad impact of the illness on the child's physical and psychosocial functioning [1,13]. However, previous analyses of the level of agreement between children, their parents and physician, in rating pain intensity and overall well-being, yielded conflicting results [14,15]. To our knowledge, there has not been a study examining the differences in the assessment or perception of pain and overall well-being by children, their parents, and physician among the same group of patients with JIA.…”

Section: Introductionmentioning

confidence: 99%

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The difference in pain and overall well-being assessment between patients with juvenile idiopathic arthritis, their parents, and physicians in Ukraine

Kovalchuk¹,

Pavlyshyn²,

Boyarchuk³

et al. 2018

polp

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Introduction: The purpose of the study is to evaluate the differences in assessment of pain and overall well-being by patients with juvenile idiopathic arthritis (JIA), their parents, and physicians. Material and methods: A total of 120 children were included in the study: 60 patients with JIA, 30 patients with reactive arthritis (ReA), and 30 healthy children within age range of five to 17 years. They were accompanied by their mothers. Patient and mother were asked to rate the intensity of the child's pain using a 10-cm Visual Analogue Scale (VAS). The global assessment of child's overall well-being was made by patient, mother, and physician using the same VAS. Results: The level of agreement between children, parents, and physician in rating the child's present pain and global assessment of the child's overall well-being in JIA patients was good (ICC ≥ 0.75). However, patient-physician agreement in global assessment of overall well-being was much lower compared to patient-parents agreement (ICC = 0.76 vs. ICC = 0.90; p < 0.05). The concordance between pain intensity assessments and overall well-being was defined in more than half of the raters. The present study demonstrated that parents were influenced in the VAS assessment by pain complaints, and physical and psychosocial limitations of their children during daily life activities. The physician's estimation of overall well-being was based on joint counts and the results of laboratory tests. While parent and physician were likely to base their judgment using different factors, this did not affect good agreement between their decisions and child report. The similarity is associated with an interdependence of certain factors-for example, the deterioration of joint counts is always accompanied by pain complaints, and physical and psychosocial limitations of children with JIA. Conclusions: Child's, parent's, and physician's assessment of pain and overall well-being should be considered equally valuable indicators of health status and all of the ratings should be implemented in standard paediatric rheumatology care.

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Section: Discussionmentioning

confidence: 98%