Validation of the Childhood Health Assessment Questionnaire in active juvenile systemic lupus erythematosus

Meiorin, Silvia; Pistorio, Angela; Ravelli, Angelo; Iusan, Silvia M.; Filocamo, G; Trail, Lucia; Oliveira, Sheila Knupp Feitosa de; Cuttica, Rubén; Espada, Graciela; Alessio, Maria; Mihaylova, Dimitrina; Cortis, Elisabetta; Martini, Alberto; Ruperto, Nicolino

doi:10.1002/art.23912

Cited by 34 publications

(23 citation statements)

References 20 publications

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“…Pain score was assessed at the time of study visit by participant self-report on a Likert scale of 0 to 10, with higher scores indicating higher pain levels. Physical functioning of SLE and MCTD subjects was also assessed by survey of the parents/legal guardians using the Child Health Assessment Questionnaire (CHAQ), a validated 30-item instrument that measures 8 functional ability domains and calculates a disability index ranging from 0 to 3 (higher index indicates more disability) [37, 38]. …”

Section: Methodsmentioning

confidence: 99%

Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients: a cross-sectional study

et al. 2014

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BackgroundDepression and anxiety adversely affects outcomes in systemic lupus erythematosus (SLE) and healthcare utilization is high for pediatric SLE. We aimed to characterize the prevalence of depression and anxiety in pediatric SLE, and their association with healthcare utilization.MethodsWe conducted a cross-sectional analysis of pediatric SLE and mixed connective tissue disease (MCTD) subjects and healthy controls aged 8 years and above. We used the Patient Health Questionnaire 9 (PHQ-9) and the Screen for Childhood Anxiety Related Disorders (SCARED) to identify depression, suicidal ideation and anxiety symptoms, respectively. We compared symptom prevalence in SLE/MCTD and healthy subjects using logistic regression. For SLE/MCTD subjects, we calculated the rate of annual outpatient visits [rheumatology/nephrology, primary care provider (PCP) and emergency department], hospitalizations and rheumatology/nephrology telephone consultations in the preceding year. We compared these outcomes in those with and without depression and anxiety using negative binomial regression.ResultsWe identified depression symptoms in 10 (20%) SLE/MCTD and 4 (8%) healthy subjects, representing a trend towards increased prevalence in unadjusted analysis (OR = 2.9, 95% CI 0.8-9.9, p = 0.09). Adjusted analysis did not show a significant difference; however, non-white race was a statistically significant independent risk factor for depression symptoms compared to white race (OR = 5.4, 95% CI 1.1-27.2, p = 0.04). We identified anxiety symptoms in 11 (22%) SLE/MCTD and 13 (26%) healthy subjects, which was not statistically different. Suicidal ideation was present in 7 (14%) SLE/MCTD and 2 (4%) healthy subjects, which was a statistically significant difference (OR = 5.4, 95% CI 1.02-28.3, p = 0.047). Of the 34% of SLE/MCTD subjects with any symptoms, only 24% had previous mental health care. Those with depression symptoms had a statistically significant lower rate of visits to the PCP (IRR = 0.38, 95% CI 0.19-0.76, p < 0.001). Anxiety symptoms were not associated with the healthcare utilization outcomes.ConclusionsDepression and anxiety symptoms were prevalent, and suicidal ideation significantly more common in SLE/MCTD than in healthy subjects. Non-white race was an independent risk factor for depression. Despite prevalent symptoms, there were poor rates of prior mental health treatment, and less frequent PCP visits among those with depression symptoms. Further investigation of barriers to mental health care and interventional strategies for symptomatic youth with SLE/MCTD is needed.

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Section: Methodsmentioning

confidence: 99%

Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients: a cross-sectional study

et al. 2014

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“…Responsiveness to change was assessed using standardized response mean (SRM), which has been used in other studies to measure behavioral change (Meiorin et al, 2008; van der Zee, Kap, Rambaran Mishre, Schouten, & Post, 2011). SRM was calculated as the absolute mean change in PA divided by the standard deviation of individuals’ change in score (Cohen, 1977; Meiorin, et al, 2008), as shown in equation (1):

italicSRM = \frac{∣ italicHigh italicintensity - italicLow italicintensity ∣}{S D o f ∣ italicHigh italicintensity - italicLow italicintensity ∣}

…”

Section: Methodsmentioning

confidence: 99%

Evaluating the Responsiveness of Accelerometry to Detect Change in Physical Activity

Montoye¹,

Pfeiffer

Suton

et al. 2014

Measurement in Physical Education and Exercise Science

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The responsiveness to change of the Actical and ActiGraph accelerometers was assessed in children and adolescents. Participants (n=208) aged 6–16 years completed two simulated free-living protocols, one with primarily light-to-moderate physical activities (PA) and one with mostly moderate-to-vigorous PA. Time in sedentary, light, moderate, and vigorous PA was estimated using 8 previously developed cut-points (4 for Actical and 4 for ActiGraph) and 15-s and 30-s epochs. Accelerometer responsiveness for detecting differences in PA between protocols was assessed using standardized response means (SRM). SRM values ≥0.8 represented high responsiveness to change. Both accelerometers showed high responsiveness for all PA intensities (SRMs = 1.2–4.7 for Actical and 1.1–3.3 for ActiGraph). All cut-points and epoch lengths yielded high responsiveness, and choice of cut-points and epoch length had little effect on responsiveness. Thus, both the Actical and ActiGraph can detect change in PA in a simulated free-living setting, irrespective of cut-point selection or epoch length.

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“…The Childhood Health Assessment Questionnaire (CHAQ) was incorporated in the transition pathway. The CHAQ measures functional status and is validated for different juvenile rheumatic conditions (Tennant et al 2001, Meiorin et al 2008.…”

Section: Developing the Clinical Transition Pathwaymentioning

confidence: 99%

Development of a clinical transition pathway for adolescents in the Netherlands

Walter

Hazes

Dolhain

et al. 2017

Nursing Children and Young People

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Aims To explore how young people with juvenile-onset rheumatic and musculoskeletal diseases (jRMDs) and their parent(s) experience care during preparation for the upcoming transfer to adult services, and to develop a clinical transition pathway.Method A survey was conducted with 32 young people aged between 14 and 20 years with jRMDs, and their parents (n=33), treated at the department of paediatric rheumatology in a tertiary care children's hospital in the Netherlands.Results More than 30% of young people would have liked to discuss topics such as educational and vocational choices in a clinic, but did not get the opportunity. Preparation for transition was poor as was training in self-management skills. One third of parents had feelings of anxiety about the upcoming transfer. Results from the survey and evidence-based principles of transitional care were used to develop the clinical transition pathway. The pathway focuses on starting transition early, developing self-management skills, joint consultations and supporting parents in giving young people control of their clinical care.Conclusion Care does not currently meet the needs of young people in the process of transition to adult rheumatology services. The clinical transition pathway developed as a result of the study is a tool that may improve this process.

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Validation of the Childhood Health Assessment Questionnaire in active juvenile systemic lupus erythematosus

Abstract: The C-HAQ showed moderate responsiveness to clinical change, construct validity, good feasibility, internal consistency, and discriminative ability. These findings demonstrate that the C-HAQ represents a good measure to capture disability in patients with active juvenile SLE.

Cited by 34 publications

References 20 publications

Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients: a cross-sectional study

Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients: a cross-sectional study

Evaluating the Responsiveness of Accelerometry to Detect Change in Physical Activity

Development of a clinical transition pathway for adolescents in the Netherlands

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