Katarzyna Zinken

How to Train Families to Cope with Lifelong Health Problems

From the Department of Medical Psychology, Hannover Medical School, Hannover, 2 3 E P A A significant proportion of children and adolescents in industrialized countries suffer from chronic health problems requiring special care. The diagnosis of a long-term disease brings about a dramatic change in the life of families with increased requirements for disease management. This often leads to more stress, anxiety, and depression, as well as reduced health-related quality of life (hrQoL) and impaired everyday life for the whole family. The quality of medical and psychosocial care after diagnosis is crucial for the future course of disease. The main challenge of pediatric health education is transforming medical theory into daily practice. Standards of health care after the diagnosis of a long-term disease differs dramatically across Europe. Taking the example of children with type 1 diabetes, the time spent with a diabetes educator after the diagnosis during in-patient care varies widely. After the onset of diabetes, German children and adolescents together with their parents receive 2 weeks of individualized education and psychological treatment from a multidisciplinary diabetes team affiliated with the hospital. In the United Kingdom, families go home after 2 days of inpatient care and education, equipped with a pile of brochures and a telephone number that they can call with diabetes management queries. Testimonials from patients and their parents collected within the European-Certified Diabetes Educator Course project show that parents of children with type 1 diabetes in the United Kingdom gain knowledge mostly from other parents and from online parent forums. Both sources have great value for families. Whereas a multidisciplinary team provides a robust basis for diabetes management, there is no doubt that much can be learned from other parents. Recent comparison studies of national registries have shown clear differences in the quality of diabetes control across countries; for example, the average hemoglobin A1c value for children and adolescence with type 1 diabetes was 7.9 in Germany, 8.5 in the US, and 9 in the United Kingdom. The prevalence of diabetes ketoacidosis was lowest in the German and Austrian registry. It is known from the Diabetes Control and Complications Trial that a lower hemoglobin A1c value substantially reduces the risk of late complications. Standard diabetes care in Germany incorporates ongoing long-term health education. All children and adolescents with

Pediatric diabetes training for healthcare professionals in Europe: Time for change

Training for healthcare professionals (HCPs) in Europe who care for children and young people (CYP) with type 1 diabetes and their families is variable depending on the country. Building on the work of SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) and using the German Certified Diabetes Educators (CDEs) curriculum, a European collaboration of pediatric diabetes experts aimed to (1) establish current core elements that should be included in a pediatric diabetes education training course and (2) create a template for a European CDEs training curriculum.

WHO-5 well-being index as screening instrument for psychological comorbidity in patients with temporomandibular disorder

Abstract Objectives: The aim of the study was to compare the WHO-Five Well-Being Index (WHO-5) with the Oral Health Impact Profile-49 (OHIP-49) questionnaire as screening tools to detect psychological comorbidity in TMDs. Methods: A TMD group (92 patients, 42.8 ± 17.1 yrs) and a control group (90 patients of the Department of Prosthetic Dentistry, 38.9 ± 10.1 yrs) completed the WHO-5 and the OHIP-49 questionnaire. Results: The patients with TMD reported significantly greater OHIP-49 sum scores than controls (47.5 ± 34.7 vs. 7.7 ± 12.1; p < 0.001). The mean raw score of the WHO-5 was significantly less, with 45.6 ± 20.6 points for patients with TMD than the 73.2 ± 15.6 points found for controls (p < 0.001). The OHIP sum score and the WHO-5 raw score were significantly associated (r = 0.705, p < 0.001). Both instruments exhibited excellent internal consistency (Cronbach’s α = 0.967 and 0.883, respectively). Conclusions: WHO-5 proved to be an effective and economic screening instrument to detect psychological comorbidity in TMDs. Implementing WHO-5 in standard care could contribute to more individualized interdisciplinary psychotherapy and/or functional therapy.