Kathy Zebracki

Outcome Expectancy and Self-Efficacy in Adolescent Asthma Self-Management

The relation of outcome expectancy and perceived self-efficacy for asthma prevention and management in adolescents to asthma self-management, adherence to treatment, and asthma morbidity was studied. Participants included 77 adolescents, 11 to 17 years old, and their caregivers. A high outcome expectancy was associated with greater asthma morbidity but was unrelated to self-management or treatment adherence. Self-efficacy was associated with adherence to treatment but was unrelated to self-management and asthma morbidity. The social cognitive theory and health belief models may not be generalizable to adolescents with asthma because psychological factors (e.g., internal beliefs and expectations) may still be developing in adolescence.

Health-related quality of life of children with primary immunodeficiency disease: a comparison study

BACKGROUNDnMany symptoms of primary immunodeficiency (PI) disease can be successfully managed with intravenous immunoglobulin infusion. Although survival rates and prognosis have greatly improved, children with PI disease are still at risk for physical, social, and psychological problems owing to their chronic health condition. However, to our knowledge, there are no empirical data concerning health-related quality of life (HRQOL) in children with PI disease receiving intravenous immunoglobulin infusion.nnnOBJECTIVEnTo compare parental reports of HRQOL of children with PI disease receiving intravenous immunoglobulin infusion with children with juvenile idiopathic arthritis (JIA) and a healthy sample.nnnMETHODSnDemographic, illness, and HRQOL data were collected from parents of 4- to 18-year-old children with PI disease (n = 36), children with JIA (n = 36), and healthy children (n = 36). The HRQOL was evaluated using the Child Health Questionnaire-Parent Report version.nnnRESULTSnCompared with children with JIA, children with PI disease were similar in many aspects of their HRQOL. However, parents of children with PI disease reported greater limitations in their personal time, poorer general health of their children, greater limitations in their childrens physical functioning and family activities, and less bodily pain than children with JIA. In contrast, children with PI disease scored lower on most HRQOL domains compared with healthy children.nnnCONCLUSIONnChildren with PI disease experience similar HRQOL to children with JIA and poorer HRQOL than healthy children, indicating potential areas to be addressed by future medical and psychosocial interventions.

Summary of Issues and Challenges in the Use of New Technologies in Clinical Care and With Children and Adolescents With Chronic Illness

New technologies such as telehealth and Internet-based interventions provide powerful methods of clinical intervention and research with pediatric populations, especially children with chronic health conditions. Barriers to utilization of these technologies include the experiences and attitudes of professionals and families, ethical concerns about privacy and confidentiality resources, and control. The utilization of new technologies will be promoted by addressing resistance toward and discomfort of new technology, enhancing ways of providing information via technology, and facilitating education efforts within the general population. Recommendations to advance research concerning new technologies include the following: (a) develop benchmarks for evaluations, (b) use quantitative and qualitative approaches, (c) conduct theory-guided research, (d) study the cost benefits of different technologies, (e) document the impact of technologies on comprehensive outcomes, and (f) facilitate multisite research collaboration.