Gertrude A. Huster

Adolescents with active or inactive epilepsy or asthma : A comparison of quality of life

Summary: Purpose: We compared quality of life (QOL) in youth with inactive or active epilepsy with that of a similar sample of youth with asthma. We explored 19 different dimensions in three domains (psychological, social, and school) and also determined differences related to illness severity and gender.

Academic achievement in children with epilepsy or asthma

The purposes of the study were to compare academic achievement between children with epilepsy and those with asthma and to identify child perception, school adaptive functioning, and condition severity factors related to academic achievement. Subjects were 225 children (117 with epilepsy and 108 with asthma) aged between 8 and 12 years. Academic achievement was measured using school‐administered group tests. Self‐report questionnaires were used to measure child attitudes and school self‐concept. Teachers rated school adaptive functioning. Data were analyzed using ANCOVA and multiple regression. Children with epilepsy had significantly lower achievement scores than children with asthma. Boys with severe epilepsy were most at risk for underachievement. Factors related to poor academic achievement in both samples were: high condition severity, negative attitudes, and lower school adaptive functioning scores. Less variance was accounted for in the model for epilepsy (R2=0.25) than for asthma (R2=0.36). Boys with high seizure severity were most at risk for achievement‐related problems. Future research in epilepsy should consider additional factors in the model predicting academic achievement.

Effect of interventions on stage of mammography adoption

Mammography has been found significantly to impact mortality in women; however, compliance is still problematic. A theoretical model which combined Health Belief Model (HBM) constructs with stage of mammography adoption was used to investigate the effect of an individualized belief and/or informational intervention on mammography compliance. A control group and three intervention groups (belief, information, and belief and information) were used. A probability sample of 405 women ages 40–88 years without a prior history of breast cancer was randomly assigned to groups. Subjects in the intervention group received individually tailored messages to alter beliefs or provider information related to mammography screening. Women in the combined belief/information group were over two times more likely to have been compliant with mammography 1 year postintervention than those in the control. In addition, groups who received the belief intervention had significantly more women that went from a lower to a higher stage of mammography adoption.

Childhood Epilepsy and Asthma: Changes in Behavior Problems Related to Gender and Change in Condition Severity

Summary: Purpose: We conducted a 4‐year follow‐up study of behavior problems in children with either epilepsy (n = 115) or asthma (n = 105) to identify changes in behavior problems as they were related to gender and change in condition severity. All children were between ages 8 and 13 years and had been diagnosed with their respective conditions for 1 year at entry into the study.

Does academic achievement in children with epilepsy change over time

A 4‐year follow‐up study of academic achievement in children aged between 11 and 17 years with epilepsy or asthma was carried out to identify differences between the two samples and to identify change in achievement over time. Differences based on sex and seizure severity also were explored. There were 98 subjects in the group with epilepsy and 96 subjects in the group with asthma. Academic achievement in five areas (Composite, Reading, Mathematics, Language, and Vocabulary) was measured using school‐administered group test scores. To explore change over time in condition severity, each child was categorized as having a low or high condition severity at baseline (time I) and again 4 years later, resulting in four groups: low–low, low–high, high–low, and high–high. There were too few cases in the low–high group to be included in the analyses. Data were processed using analysis of covariance (ANCOVA), intraclass correlation coefficients, and paired t tests. At follow‐up the children with epilepsy continued to perform significantly worse in all five achievement areas than the children with asthma. Children with either inactive or low‐severity epilepsy had mean scores comparable to national norms; those with high seizure severity had mean scores ranging from 3 to 5 points below national norms. No changes were found in academic achievement over time for either sample, even among those whose conditions improved. Although boys with high‐severity epilepsy continued to have the lowest achievement scores, there was no trend for them to decline in achievement over time.

QUALITY OF LIFE IN WOMEN WITH HEART FAILURE

Persons with heart failure (HF) experience impaired quality of life (QOL). However, the majority of research conducted on QOL in persons with HF has been with men. The purpose of this descriptive pilot study was to describe the impact of symptoms of HF and examine the relationships among symptom impact, perceived health status, perceived social support, and overall QOL in 30 women who had recently been hospitalized for HF. The women reported high physical symptom impact, poor perceived physical health status, and impaired QOL. Physical symptom impact, perceived physical health status, and QOL were moderately to highly correlated with one another. Perceived social support was significantly, though not strongly, correlated with physical symptom impact. Emotional symptom impact and mental health status were significantly and negatively correlated with each other but were not significantly correlated with QOL. In this group of 30 chronically ill women, QOL was lower in those women who reported greater physical symptom impact and poorer perceptions of their physical health status.

Reliability and validity of preverbal pain assessment tools.

Pain assessments using three different observational pain assessment tools--the Post Operative Pain Score (POPS), the Nursing Assessment of Pain Intensity (NAPI), and the Pain Rating Scale (PRS)--were made on 98 preverbal children following surgery in an attempt to establish the reliability and validity of the three tools. Two observers (raters) scored pain intensity using each of the three instruments before and after administration of an analgesic. Interrater agreements were satisfactory on all three tools, with Interclass Correlations (ICC) ranging from .71 to .85. T tests supported the discriminant validity of all three tools at the p < .0001 level. The POPS and NAPI had internal consistency reliability alphas ranging from .79 to .88 for the POPS and .59 to .77 for the NAPI. Item analyses suggested specific revisions of the tools that might increase their reliability.

Risk factors for nonelective hospital readmissions

We previously reported a predictive model that identified potentially modifiable risk factors for nonelective readmission to a county hospital. The objectives of this study were to determine if those risk factors were generalizable to a different population. We found that the previously reported risk factors were generalizable, and other potentially modifiable risk factors were identified in this population of veterans. However, further research is needed to establish whether or not the risk factors can be modified and whether or not modification improves outcomes.