Depression and Anxiety among Parents of Children with Cystic Fibrosis Related to the Children’s Health Related Quality of Life
Affiliation(s)
1 Stockholm CF Centre, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden. 2 Department of Psychology, M?lardalen University, Eskilstuna, Sweden .
1 Stockholm CF Centre, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden. 2 Department of Psychology, M?lardalen University, Eskilstuna, Sweden .
ABSTRACT
The aim was to examine depression and anxiety among parents of children with Cystic Fibrosis and the association between the parents’ symptoms and the child’s quality of life as rated by the parents. Parents completed HADS (Hospital Anxiety and Depression Scale), and CES-D (Center of Epidemiologic Studies Depression Scale), and assessed the children’s quality of life with CFQ-R (Cystic Fibrosis Questionnaire-Revised). Anxiety amongst the parents was higher than the general population (m = 6.55, SD = 3.54, p < 0.001). The level of depression does not differ from that of the general population. Mothers showed more anxiety symptoms than fathers (p < 0.001). Gender differences were not significant for depression symptoms. There is a strong association between the fathers’ self-rated depression and their rating of their child’s health. Both children and parents should be paid attention to in order to identify mental ill-health and take measures in good time.
The aim was to examine depression and anxiety among parents of children with Cystic Fibrosis and the association between the parents’ symptoms and the child’s quality of life as rated by the parents. Parents completed HADS (Hospital Anxiety and Depression Scale), and CES-D (Center of Epidemiologic Studies Depression Scale), and assessed the children’s quality of life with CFQ-R (Cystic Fibrosis Questionnaire-Revised). Anxiety amongst the parents was higher than the general population (m = 6.55, SD = 3.54, p < 0.001). The level of depression does not differ from that of the general population. Mothers showed more anxiety symptoms than fathers (p < 0.001). Gender differences were not significant for depression symptoms. There is a strong association between the fathers’ self-rated depression and their rating of their child’s health. Both children and parents should be paid attention to in order to identify mental ill-health and take measures in good time.
Cite this paper
Brucefors, A. , Hochwälder, J. , Sjövall, J. and Hjelte, L. (2015) Depression and Anxiety among Parents of Children with Cystic Fibrosis Related to the Children’s Health Related Quality of Life. Open Journal of Nursing, 5, 482-489. doi: 10.4236/ojn.2015.55051.
Brucefors, A. , Hochwälder, J. , Sjövall, J. and Hjelte, L. (2015) Depression and Anxiety among Parents of Children with Cystic Fibrosis Related to the Children’s Health Related Quality of Life. Open Journal of Nursing, 5, 482-489. doi: 10.4236/ojn.2015.55051.
References
[1] Socialstyrelsen (2010) Ovanliga Diagnoser (Unusual Diagnoses). Cystisk Fibros. [2] De Monestrol, I., Klint, Å., Sparén, P. and Hjelte, L. (2010) Age at Diagnosis and Disease. Progression of Cystic Fibrosis in an Area without Newborn Screening. In: Paediatric and Perinatal Epidemiology, Blackwell Publishing Ltd., Hoboken, 1-8. [3] Götz, I. and Götz, M. (2000) Cystic Fibrosis: Psychological Issues. Paediatric Respiratory Reviews, 1, 121-127.
http://dx.doi.org/10.1053/prrv.2000.0033 [4] Driscoll, K.A., Johnson, S.B., Barker, D., Quittner, A.L., Deeb, L.C., Geller, D.E., Gondor, M. and Silverstein, J.H. (2010) Risk Factors Associated with Depressive Symptoms in Caregivers of Children with Type 1 Diabetes or Cystic Fibrosis. Journal of Pediaticr Psychology, 35, 814-822.
http://dx.doi.org/10.1093/jpepsy/jsp138 [5] Hodgkinson, R. and Lester, H. (2002) Stresses and Coping Strategies of Mothers Living with a Child with Cystic Fibrosis: Implications for Nursing Professionals. Journal of Advanced Nursing, 39, 377-383.
http://dx.doi.org/10.1046/j.1365-2648.2002.02299.x [6] Quittner, A.L., Barker, D.H., Snell, C., Grimley, M.E., Marciel, K. and Cruz, I. (2008) Prevalence and Impact of Depression in Cystic Fibrosis. Current Opinion in Pulmonary Medicine, 14, 582-588.
http://dx.doi.org/10.1097/MCP.0b013e3283121cf1 [7] Ylimas, O., Sogut, A., Gulle, S., Can, D., Ertan, P. and Yuksel, H. (2008) Sleep Quality and Depression-Anxiety in Mothers of Children with Two Chronic Respiratory Diseases: Asthma and Cystic Fibrosis. Journal of Cystic Fibrosis, 7, 495-500.
http://dx.doi.org/10.1016/j.jcf.2008.05.002 [8] Downey, G. and Coyne, J.C. (1990) Children of Depressed Parents: An Integrative Review. Psychological Bulletin, 108, 50-76.
http://dx.doi.org/10.1037/0033-2909.108.1.50 [9] Cousino, M.K. and Hazen, R.A. (2013) Parenting Stress among Caregivers of Children with Chronic Illness. A Systematic Review. Journal of Pediatric Psychology, 38, 809-828.
http://dx.doi.org/10.1093/jpepsy/jst049 [10] Wong, M.G. and Heriot, S.A. (2008) Parents of Children with Cystic Fibrosis: How They Hope, Cope, and Despair. Child: Care Health Development, 34, 344-354.
http://dx.doi.org/10.1111/j.1365-2214.2007.00804.x [11] Cruz, I., Marciel, K.K., Quittner, A.L. and Schechter, M.S. (2009) Anxiety and Depression in Cystic Fibrosis. Seminars in Respiratory and Critical Care Medicine, 30, 569-578.
http://dx.doi.org/10.1055/s-0029-1238915 [12] Statistical Database.
www.scb.se/statistikdatabasen [13] Solymar, L., Aronsson, P.H., Bake, B. and Bjure, J. (1980) Nitrogen Single Breath Test, Flow-Volume Curves and Spirometry in Healthy Children, 7 - 18 Years of Age. European Journal of Respiratory Diseases, 61, 275-286. [14] Hankinson, J.L., Odencrantz, J.R. and Fedan, K.B. (1999) Spirometric Reference Values from a Sample of the General U.S. Population. American Journal of Respiratory and Critical Care Medicine, 159, 179-187.
http://dx.doi.org/10.1164/ajrccm.159.1.9712108 [15] Zigmond, A.S. and Snaith, R.P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361-370.
http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x [16] Lisspers, J., Nygren, A. and Söderman, E. (1997) Hospital Anxiety and Depression Scale (HAD): Some Psychometric Data for a Swedish Sample. Acta Psychiatrica Scandinavica, 96, 281-286.
http://dx.doi.org/10.1111/j.1600-0447.1997.tb10164.x [17] Radloff, L. (1997) The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Applied Psychological Measurement, 1, 386-401. [18] Quittner, A.L., Buu, A., Messer, M.A., Modi, A.C. and Watrous, W. (2005) Development and Validation of the Cystic Fibrosis Questionnaire in the United States: A Health-Related Quality-of-Life Measure for Cystic Fibrosis. Chest, 128, 1-13.
http://dx.doi.org/10.1378/chest.128.4.2347 [19] SBU (2005) Behandling av ångestsyndrom, volym 1. En systematisk litteraturöversikt (Treatment of Anxiety Syndromes, Volume 1. A Systematic Literature Overview). Statens beredning för medicinsk utvärdering (SBU), Stockholm, Swedish Council on Health Technology Assessment. [20] Mattisson, C., Bogren, M., Nettelbladt, P., Munk-Jörgensen, P. and Bhugra, D. (2005) First Incidence Depression in the Lundby Study: A Comparison of the Two Time Periods 1947-1972 and 1972-1997. Journal of Affective Disorders, 87, 151-160.
http://dx.doi.org/10.1016/j.jad.2005.04.002 [21] Besier, T., Born, A., Henrich, G., Hinz, A., Quittner, A.L. and Goldbeck, L. (2011) Anxiety, Depression and Life Satisfaction in Parents Caring for Children with Cystic Fibrosis. Pediatric Pulmonology, 46, 672-682.
http://dx.doi.org/10.1002/ppul.21423 [22] Driscoll, K.A., Montag-Leifling, K., Acton, J.D. and Modi, A.C. (2009) Relations between Depressive and Anxious Symptoms and Quality of Life in Caregivers of Children with Cystic Fibrosis. Pediatric Pulmonology, 44, 784-792.
http://dx.doi.org/10.1002/ppul.21057 [23] Quittner, A.L., Barker, D.H., Geller, D., Butt, S. and Gondor, M. (2007) Effects of Maternal Depression on Electronically Monitored Enzyme Adherence and Changes in Weight for Children with CF. Journal of Cystic Fibrosis, 6, S78.
http://dx.doi.org/10.1016/S1569-1993(07)60292-6 [24] Folkhälsorapporten (2009) The National Public Health Report.
http://www.socialstyrelsen.se
[1] Socialstyrelsen (2010) Ovanliga Diagnoser (Unusual Diagnoses). Cystisk Fibros. [2] De Monestrol, I., Klint, Å., Sparén, P. and Hjelte, L. (2010) Age at Diagnosis and Disease. Progression of Cystic Fibrosis in an Area without Newborn Screening. In: Paediatric and Perinatal Epidemiology, Blackwell Publishing Ltd., Hoboken, 1-8. [3] Götz, I. and Götz, M. (2000) Cystic Fibrosis: Psychological Issues. Paediatric Respiratory Reviews, 1, 121-127.
http://dx.doi.org/10.1053/prrv.2000.0033 [4] Driscoll, K.A., Johnson, S.B., Barker, D., Quittner, A.L., Deeb, L.C., Geller, D.E., Gondor, M. and Silverstein, J.H. (2010) Risk Factors Associated with Depressive Symptoms in Caregivers of Children with Type 1 Diabetes or Cystic Fibrosis. Journal of Pediaticr Psychology, 35, 814-822.
http://dx.doi.org/10.1093/jpepsy/jsp138 [5] Hodgkinson, R. and Lester, H. (2002) Stresses and Coping Strategies of Mothers Living with a Child with Cystic Fibrosis: Implications for Nursing Professionals. Journal of Advanced Nursing, 39, 377-383.
http://dx.doi.org/10.1046/j.1365-2648.2002.02299.x [6] Quittner, A.L., Barker, D.H., Snell, C., Grimley, M.E., Marciel, K. and Cruz, I. (2008) Prevalence and Impact of Depression in Cystic Fibrosis. Current Opinion in Pulmonary Medicine, 14, 582-588.
http://dx.doi.org/10.1097/MCP.0b013e3283121cf1 [7] Ylimas, O., Sogut, A., Gulle, S., Can, D., Ertan, P. and Yuksel, H. (2008) Sleep Quality and Depression-Anxiety in Mothers of Children with Two Chronic Respiratory Diseases: Asthma and Cystic Fibrosis. Journal of Cystic Fibrosis, 7, 495-500.
http://dx.doi.org/10.1016/j.jcf.2008.05.002 [8] Downey, G. and Coyne, J.C. (1990) Children of Depressed Parents: An Integrative Review. Psychological Bulletin, 108, 50-76.
http://dx.doi.org/10.1037/0033-2909.108.1.50 [9] Cousino, M.K. and Hazen, R.A. (2013) Parenting Stress among Caregivers of Children with Chronic Illness. A Systematic Review. Journal of Pediatric Psychology, 38, 809-828.
http://dx.doi.org/10.1093/jpepsy/jst049 [10] Wong, M.G. and Heriot, S.A. (2008) Parents of Children with Cystic Fibrosis: How They Hope, Cope, and Despair. Child: Care Health Development, 34, 344-354.
http://dx.doi.org/10.1111/j.1365-2214.2007.00804.x [11] Cruz, I., Marciel, K.K., Quittner, A.L. and Schechter, M.S. (2009) Anxiety and Depression in Cystic Fibrosis. Seminars in Respiratory and Critical Care Medicine, 30, 569-578.
http://dx.doi.org/10.1055/s-0029-1238915 [12] Statistical Database.
www.scb.se/statistikdatabasen [13] Solymar, L., Aronsson, P.H., Bake, B. and Bjure, J. (1980) Nitrogen Single Breath Test, Flow-Volume Curves and Spirometry in Healthy Children, 7 - 18 Years of Age. European Journal of Respiratory Diseases, 61, 275-286. [14] Hankinson, J.L., Odencrantz, J.R. and Fedan, K.B. (1999) Spirometric Reference Values from a Sample of the General U.S. Population. American Journal of Respiratory and Critical Care Medicine, 159, 179-187.
http://dx.doi.org/10.1164/ajrccm.159.1.9712108 [15] Zigmond, A.S. and Snaith, R.P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361-370.
http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x [16] Lisspers, J., Nygren, A. and Söderman, E. (1997) Hospital Anxiety and Depression Scale (HAD): Some Psychometric Data for a Swedish Sample. Acta Psychiatrica Scandinavica, 96, 281-286.
http://dx.doi.org/10.1111/j.1600-0447.1997.tb10164.x [17] Radloff, L. (1997) The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Applied Psychological Measurement, 1, 386-401. [18] Quittner, A.L., Buu, A., Messer, M.A., Modi, A.C. and Watrous, W. (2005) Development and Validation of the Cystic Fibrosis Questionnaire in the United States: A Health-Related Quality-of-Life Measure for Cystic Fibrosis. Chest, 128, 1-13.
http://dx.doi.org/10.1378/chest.128.4.2347 [19] SBU (2005) Behandling av ångestsyndrom, volym 1. En systematisk litteraturöversikt (Treatment of Anxiety Syndromes, Volume 1. A Systematic Literature Overview). Statens beredning för medicinsk utvärdering (SBU), Stockholm, Swedish Council on Health Technology Assessment. [20] Mattisson, C., Bogren, M., Nettelbladt, P., Munk-Jörgensen, P. and Bhugra, D. (2005) First Incidence Depression in the Lundby Study: A Comparison of the Two Time Periods 1947-1972 and 1972-1997. Journal of Affective Disorders, 87, 151-160.
http://dx.doi.org/10.1016/j.jad.2005.04.002 [21] Besier, T., Born, A., Henrich, G., Hinz, A., Quittner, A.L. and Goldbeck, L. (2011) Anxiety, Depression and Life Satisfaction in Parents Caring for Children with Cystic Fibrosis. Pediatric Pulmonology, 46, 672-682.
http://dx.doi.org/10.1002/ppul.21423 [22] Driscoll, K.A., Montag-Leifling, K., Acton, J.D. and Modi, A.C. (2009) Relations between Depressive and Anxious Symptoms and Quality of Life in Caregivers of Children with Cystic Fibrosis. Pediatric Pulmonology, 44, 784-792.
http://dx.doi.org/10.1002/ppul.21057 [23] Quittner, A.L., Barker, D.H., Geller, D., Butt, S. and Gondor, M. (2007) Effects of Maternal Depression on Electronically Monitored Enzyme Adherence and Changes in Weight for Children with CF. Journal of Cystic Fibrosis, 6, S78.
http://dx.doi.org/10.1016/S1569-1993(07)60292-6 [24] Folkhälsorapporten (2009) The National Public Health Report.
http://www.socialstyrelsen.se