Sunnye Mayes

An Evaluation of Psychosocial Outcomes for Children and Adolescents Attending a Summer Camp for Youth With Chronic Illness

This study evaluated health-related quality of life (HRQOL) and hope in youth after participation in a summer camping program for children with chronic medical conditions. A total of 102 youth (mean age = 13.10 years, SD = 2.37) with various medical diagnoses (e.g., cancer, 36.9%; kidney disease, 21.4%) participated in the study. Findings from the Childrens Hope Scale indicated that from pre- to post-camp, youth were more confident in their ability to identify strategies to accomplish goals. Additionally, findings from this scale suggested that the identification and development of personal goals is associated with enhancement of perceived HRQOL at the post-camp assessment. No significant differences emerged in HRQOL from pre- to post-camp. Overall, the results are consistent with previous studies of positive benefits of the camp experience; this study indicates that youth participation in chronic illness camps facilitates increased hope and goal-directed behaviors, which contributes to improvements in psychosocial functioning.

Illness Uncertainty, Global Psychological Distress, and Posttraumatic Stress in Pediatric Cancer: A Preliminary Examination Using a Path Analysis Approach

OBJECTIVE To investigate the relationship of illness uncertainty (IU) to global psychological distress (GPD) and posttraumatic stress symptomatology (PTSS) using a path analysis approach. METHODS Participants were 105 caregivers (MAge = 36.9 years, standard deviation [SD] = 8.7) of children (MAge = 8.6 years, SD = 5.0) with newly diagnosed cancer. A path analysis model examined the indirect and direct effects of each IU subscale on PTSS through GPD.  RESULTS  The final model accounted for 47.30% of the variance in PTSS, and the ambiguity facet of IU had a significant indirect effect on PTSS through GPD. Lack of clarity and unpredictability were not significant predictors.  CONCLUSIONS Ambiguity experienced by parents may be salient in the development of PTSS. Future research should examine these relationships longitudinally in larger samples to better understand adjustment in parents of children with cancer.

Risk for household safety hazards: Socioeconomic and sociodemographic factors.

INTRODUCTION Many unintentional injuries to young children occur in the home. The current study examines the relation between family socioeconomic and sociodemographic factors and risk factors for home injury. METHODS Presence of household hazards was examined in 80 families with toddler-aged children. Parental ability to identify household hazards in pictures was also assessed. ANOVAs and Pearson product-moment correlations examined the relationship between presence of household hazards, knowledge to identify hazards, and factors of yearly family income, parental age, parental education, parental marital status, child ethnicity, and the number of children living in the home. RESULTS A greater number of hazards were found in the homes of both the lowest and highest income families, but poorer knowledge to identify household hazards was found only among parents of the lowest income families and younger parents. Across family socioeconomic status, parent knowledge of hazards was related to observed household hazards. CONCLUSIONS The relationship between family income and risk for injury is complex, and children of both lower and higher SES families may be at risk for injury. PRACTICAL APPLICATIONS While historically particular focus has been placed on risk for injury among children in low income families, injury prevention efforts should target reducing presence of household hazards in both high and low SES families.

Posttraumatic Growth and Hope in Parents of Children with Cancer

Posttraumatic growth (PTG), a positive change in values and major life goals experienced as a result of the struggle with a highly challenging life circumstance, has been shown to be related to the construct of hope, the belief that goals can be met. To date, no studies have examined the relationship between PTG and hope in parents of children with cancer. Participants were parents (N = 85) of children and adolescents (ages 2–18 years, M = 7.72 years) receiving treatment for cancer. Parents completed a demographic questionnaire, the Posttraumatic Growth Inventory (PTGI), and Hope Scale (HS). Hope was found to be related to PTG in parents of children with cancer, with higher levels of hope associated with greater PTG. Exploratory analyses on the subscales of the PTGI revealed that hope was also related to higher scores on the Relating to Others, New Possibilities, Personal Strength, and Appreciation of Life subscales. Spiritual change was not related to hope in parents. Conclusions: Findings suggest that experiencing hope during the pediatric cancer experience may facilitate posttraumatic growth in parents. The construct of hope may be an important target of intervention for promoting positive adjustment in this population.

Children's Knowledge of Household Safety Rules

We examined child temperamental characteristics and family environment characteristics as predictors of the level of parent-child agreement on household safety rules. Fifty children (ages 4-7) and their parents participated. Linear regression analysis indicated that child temperamental characteristics and family characteristics predicted parent-child rule agreement. Child activity level and family orientation toward social and recreational activities were significant predictors. The findings of this study highlight the importance of not relying only on household rules as a method of keeping children safe.

Psychoeducational Screening in Pediatric Sickle Cell Disease: An Evaluation of Academic and Health Concerns in the School Environment

This study examined parent-reported psychoeducational concerns among families of children and adolescents with sickle cell disease (SCD). A chart review was conducted to obtain psychoeducational information and associated medical data collected during routine SCD clinic visits. Analyses revealed that 45% of parents in the sample expressed significant concerns about their childs education and disease-related school accommodations. Medical variables including lower average hemoglobin level, greater disease severity, and longer hospitalizations were associated with greater educational concerns. These results highlight the need for continued attention to the educational needs of this population and provision of appropriate school accommodations.

Preliminary exploration of secondhand smoke exposure in youth with Sickle Cell Disease: biochemical verification, pulmonary functioning, and health care utilization

ABSTRACT Exposure to secondhand smoke (SHSe) can compound an already challenging set of health problems for youth with Sickle Cell Disease (SCD). Exposure to electronic cigarettes may also impact SCD symptomology and respiratory functioning. This study built on these previous findings by a) utilizing two objective measures of SHSe, salivary cotinine and exhaled carbon monoxide and b) examining the association of SHSe with emergency department utilization, physician-reported sickle cell crises, and pulmonary functioning. Caregivers (N = 31 dyads; Mage = 37.6 years; SD = 8.5 years) of youth with SCD (Mage = 9.0 years; SD = 4.5 years) completed self-report measures of tobacco/nicotine use. Youth provided a saliva sample to assess cotinine levels, and performed pulmonary function tests. Dyads provided breath samples for measurement of eCO. A chart review was conducted to obtain medical history and utilization. Majority of youth (88%) were exposed to SHS via salivary cotinine. Interestingly, no significant associations were observed between youth cotinine levels and emergency department utilization, physician-reported sickle cell crises, or pulmonary functioning. Present findings indicate a need to assess for SHSe using objective assessment measures. Future research should investigate which specific factors contribute to increase SHSe/SHVe in youth with SCD.

The relationship between barriers to care, caregiver distress, and child health-related quality of life in caregivers of children with cancer: A structural equation modeling approach

ABSTRACT The current study examined the relationship between demographic variables, treatment factors, and perceived barriers to care to both caregiver distress and caregiver-reported child health-related quality of life in caregivers of children diagnosed with cancer utilizing path analysis. Parental distress is examined as a potential mediator between barriers to care and income, as well as child age and caregiver-reported health-related quality of life (HRQOL). The final model demonstrated close fit to the data. Family income and perceived barriers to care demonstrated direct effects on caregiver distress. Child age, treatment intensity, severity of illness, and caregiver distress also demonstrated direct effects on caregiver-reported HRQOL. These results suggest a significant relationship between burden of care, caregiver functioning, and caregiver-reported child outcomes and support the transactional relationship between caregiver and child functioning.

Posttraumatic stress symptomology in parents of children with cancer: Implications related to criterion changes in DSM-IV-TR to DSM-5

ABSTRACT Objective: This preliminary study compared a DSM-IV-TR screening tool for posttraumatic stress symptoms (PTSS) with a modified DSM-5 version for parents of children diagnosed with cancer. Methods: Caregivers (n = 101) completed the Brief Symptom Inventory (BSI) and Impact of Event Scale-Revised (IES-R). Five BSI items were added to the IES-R to assess whether caregivers met DSM-5 specific posttraumatic stress disorder criteria. Results: Chi-square analysis revealed three groups: caregivers who (1) did not meet screening criteria for DSM-IV-TR or DSM-5; (2) only met DSM-IV-TR criteria; and (3) met criteria for DSM-IV-TR and DSM-5, X2(1, n = 101) = 64.47, p < 0.001. Subgroup 2 had lower overall PTSS than subgroup 3 (p < 0.001), but more than Subgroup 1 (p < 0.001). Conclusions: A “gap group” evidenced elevated PTSS but did not meet DSM-5 screening criteria. Further research is needed to clarify the prevalence and composition of PTSS among caregivers, and evaluate the clinical implications of the changes in diagnostic criteria.

Enhancing Coping and Resilience Among Families of Individuals with Sickle Cell Disease

Sickle cell disease (SCD) is an inherited illness that is accompanied by lifelong medical complications. There are several genotypes of SCD, with varying medical complications, including increased susceptibility to infection, painful vasoocclusive episodes, priapism, and osteonecrosis. Coping with a potentially debilitating chronic illness yields numerous challenges, although many individuals with SCD establish successful coping strategies and manage their illnesses in an adaptive manner. Management of lifelong illness poses potential difficulties to all family members, including those who do not directly have the illness.