Childhood chronic illness

Last updated

Childhood chronic illness refers to conditions in pediatric patients that are usually prolonged in duration, do not resolve on their own, and are associated with impairment or disability. [1] The duration required for an illness to be defined as chronic is generally greater than 12 months, but this can vary, and some organizations define it by limitation of function rather than a length of time. [2] Regardless of the exact length of duration, these types of conditions are different than acute, or short-lived, illnesses which resolve or can be cured. There are many definitions for what counts as a chronic condition. However, children with chronic illnesses will typically experience at least one of the following: limitation of functions relative to their age, disfigurement, dependency on medical technologies or medications, increased medical attention, and a need for modified educational arrangements. [3]

Contents

There are many different diseases affecting children that have a prolonged course and can lead to disability or impairment including asthma, sickle cell anemia, congenital heart disease, obesity, neurodevelopmental conditions, and epilepsy. Owing to improvements in public health and health infrastructure, infant and child mortality especially from infectious causes has decreased in most areas of the world. [4] Therefore, children are living longer with chronic illnesses.

Epidemiology

It is difficult to know the exact number of children who have a chronic illness worldwide. Given that there is no agreement on the definition for a chronic illness and that quality data from every country is not guaranteed, there is a wide range of estimates of prevalence and incidence. In the United States, the American Academy of Pediatrics estimates that between ten and twenty million children and adolescents live with a chronic condition while estimates of the prevalence of chronic conditions among youth more than doubled from 12.8% in 1994 to 26.6% in 2006. [5] [6] One important trend to consider is that the overall number of children with chronic illnesses is increasing. This rise is likely due to decreased infant and child mortality from previously lethal diseases due to innovations in medication and other treatment as well as increased ability to diagnose and therefore discover chronic conditions. [2] Common chronic illnesses in children include asthma, diabetes, cystic fibrosis, obesity and overweight, malnutrition, developmental disabilities and differences, and mental illness. [7] Leading causes of poor outcomes due to childhood chronic illness, however, depend on geographic region.

Common Childhood Chronic Diseases

Chronic diseases in children may have a genetic (hereditary) cause, an environmental (acquired) cause or a combination of both. Early identification and treatment of the disease is key to successful health outcomes. Chronic diseases can affect multiple organ systems and can, therefore, manifest in different ways. Highlighted below are the more common manifestations of chronic childhood disease. [7]

Anemia

Anemia is a condition that involves a reduction in the number of red blood cells circulating in the blood. Red blood cells are packed with a chemical called hemoglobin, which is the main transporter of oxygen in the blood. The decrease in the oxygen-carrying-capacity of the blood will result in children presenting with fatigue, irritability, weakness, frequent napping, and pale skin. A deficiency in iron intake is the main cause of anemia in children and can be managed by eating a balanced diet that includes foods containing iron such as leafy green vegetables, cereals, and red meat. [8] [9]

Asthma

Asthma is a common chronic disease in children that impacts their ability to breathe. The disease is characterized by inflammation of the airways and patients will commonly present with coughing, shortness of breath and wheezing. Asthma in children is typically triggered by environmental antigens, allergies, viral respiratory infections, fumes, obesity, and emotional factors including stress. [10] [11]

Cystic Fibrosis

Cystic fibrosis is an inherited (genetic) disease that can present with symptoms within the first two years of life. The genetic defect results in the production of thick mucus in the lungs, pancreas, liver, small intestine, and reproductive organs. The thick mucus in the lungs moves slower than usual, thereby allowing enough time for bacteria to grow. This predisposes patients with cystic fibrosis to repeated episodes of respiratory infection in the form of pneumonia or bronchitis. [12]

Diabetes

Diabetes is a chronic illness involving the body’s inability to regulate the amount of glucose in the blood. There are two types of Diabetes: Type 1 Diabetes, also known as juvenile-onset diabetes, commonly affects children and is due to an inability of the pancreas to produce insulin. Type 2 diabetes, also known as adult-onset diabetes, commonly affects adults but can also affect children and is due to the body’s inability to respond to insulin appropriately. Both forms lead to elevated blood glucose levels which can lead to the following complications in kids: bed-wetting, significant thirst, weight loss, and increased appetite. [13]

Malnutrition

Malnutrition is particularly common in low and middle-income countries and is the cause of significant morbidity and mortality in children. Risk factors for malnutrition in children include chronic poverty, food insecurity, inadequate maternal and fetal nutritional uptake, and underlying comorbidities.  Severe malnutrition can present in children as muscle wasting, stunted growth, and kwashiorkor. These children will also have an impaired immune system which increases their risk of severe infection and death. [14]

Childhood Overweight and Obesity

Overweight and obesity in children is a chronic illness that has been steadily increasing in prevalence in the US. [15] This disease disproportionately impacts low-income and minority communities. Non-Hispanic Black, Hispanic, and American Indian/Alaskan Native children have a higher burden of disease than white children. [16] Psychosocial risk factors include environmental stressors, food insecurity, chronic stress, and systemic racism.

Management

Taking care of a child with a chronic illness will require a team of providers that may include medical providers, therapists, educators, and other caregivers.

Psychological

Coping with a chronic illness can challenge many aspects of life, and some therapies can help children and their families adjust to their condition.

Psychological Management in Children

Children with chronic illnesses have a higher risk of developing mental health disturbances than their healthy counterparts. Many evidence-based interventions exist to treat children with mental health issues; however, these interventions often have not been validated for children with chronic physical illnesses, and their efficacy on this population is not fully understood. Nevertheless, psychological management in children with chronic diseases should be prioritized similarly to the management of physical symptoms because it can impact the child's quality of life, behavior, and functioning. [17]

Behavior therapy and cognitive behavioral therapy can help children improve their condition and manage the stress associated with a chronic illness. Behavior therapy in the setting of chronic illnesses aims to change problematic learned behaviors using classical conditioning and operant techniques. Some examples of behavioral therapy for children with asthma include stress management techniques and contingency coping exercises. In one study, the asthma patients randomized to such therapies demonstrated fewer behavioral adjustment problems. [18] Additionally, systematic desensitization can be used to decrease children's fear associated with some medical treatments, such as imaging or invasive procedures. [19]

One of the more studied interventions for the psychological management of chronic physical illness in children is Cognitive Behavioral Therapy (CBT). CBT is used to build resilience in children with chronic diseases. It includes breathing exercises, relaxation training, imagery, distraction methods, coping models, cognitive coping skills, reinforcement for compliance, behavioral rehearsal, role-play, and direct coaching. [20] CBT has positive effects in specifically treating anxiety and depression in this population; [17] when treatment includes both parents and child, it can improve physical symptoms associated with the child's condition. [21]

Psychological Management in Parents

Parents of children with chronic conditions often experience higher stress levels, maladaptive behaviors, and mental health issues due to challenges associated with balancing their child's care and other obligations. [21] The adverse effects of chronic childhood illness in parents are critical to address because the child's well-being depends on the parents' ability to deal with the situation and maintain healthy family dynamics. Treatments aim to improve parents' distress, adaptive behaviors, family dynamics, and the sick child's well-being. [21]

Currently, there is a lot of debate about what interventions are the most effective for parents, and often the efficacy of therapy appears to depend on the child's condition. For example, psychotherapy has helped improve parental adaptive behaviors in parents of children with cancer but not in others. [21] Additionally, some therapies may work for some targeted outcomes but not others. Treatments can include psychotherapy, CBT, problem-solving therapy (PST), family therapy (FT), and multi-systemic therapy (MST). Of these, PST has shown to improve parents' adaptive behavior, mental health, and stress level post-treatment. [21]

Diet

Nutrition is a crucial part of managing many chronic conditions in children. Many chronic illnesses increase children's risk of developing growth complications due to increased inflammation and other pathological processes specific to each disease. [22] [23] Inflammation is one of the main drivers of growth failure and malnutrition in children with chronic illnesses because it decreases caloric intake and increases both energy demands and energy losses. [22] [23] Consequently, children can experience food aversion, intolerance, malabsorption, and loss of lean muscle and fat. [22] [23]

The specific management of nutrition varies depending on the patient and their disease. The goal of treatment is to increase energy intake to match the increased energy needs and to supplement nutrient deficiencies. [22] General guidelines for treatment include regular monitoring of growth and development, checking nutritional status, addressing issues with food intake, reviewing medications and supplements, referral to a specialist and assessment of food insecurity. [23] Nutrition management is essential for many children with chronic diseases because poor nutrition is associated with worse treatment responses, development of comorbidities, and lowered survival in some cases. [23]

Transition to Adult Care

The transition from pediatric and family-centered care to adult-centered care is an area of management that has recently gained importance due to the increased prevalence of chronic diseases and lengthened life expectancy in children with chronic conditions. This transition is an ongoing area of research, and better data is still needed to assess the effectiveness of different models of transition. [24]

The transition process is multifactorial and depends on patients' goals, family preferences, cultural differences, and the patient's condition. Guidelines on conducting this process vary amongst countries and healthcare institutions. Most guidelines from countries where western medicine is practiced have similar characteristics. First, early planning is often desirable to allow enough time for the transition and to decrease potential adverse outcomes and the need for acute care. [24] For example, the National Institute of Health and Care Excellence sets transition guidelines in the UK and recommends that planning starts as early as when the child is thirteen or fourteen. [25] Second, a systematic approach that provides good communication between providers, patients, and families is preferred. [24] A dedicated transition coordinator is appointed to manage this process sometimes. [25] Lastly, providers and parents should encourage self-managing of care as the child develops a stronger desire for autonomy and independence. [24] Methods used to achieve self-management will likely depend on the child's capacity and understanding. Plans can include educating the child about their condition, providing different communication tools to reach providers, referring them to peer support or advocacy groups, and encouraging them to be involved in decision-making. [25] [26]

Outcomes

Development

Chronic illness can affect a child's development at any stage. During infancy and childhood chronic illness can be detrimental to the development of secure attachment, interpersonal trust, self-regulation, and/or peer relation skills. During middle adolescence, chronic illness can prevent a child from being in school on a regular basis. This can affect a child's academic and social competence. During adolescence, chronic illness can affect the development of autonomy and self-image. It can also interfere with peer and romantic relationships, and the desire for independence can lead to poor treatment compliance. [20] Stress coping methods significantly influence how well children with chronic illnesses emotionally and behaviorally develop and adjust to their illness. [27] Children with chronic illnesses experience increased absenteeism, poorer school experiences, and poorer educational outcomes than their peers, especially in the case of severe disease, intense treatment regimens, and lower SES. [28] Some research suggests educational outcomes remain poorer in adults who experience childhood chronic illness, but financial outcomes do equalize with proper support. [29] Childhood chronic illnesses are common among school-aged children in the United States, and these illnesses often require management within school settings for a child to safely attend. [30] At any stage, children with chronic illness can have reduced quality of life, especially if the children or their families are of low socioeconomic status. [31] [32] Malnutrition is a greater risk among children with chronic illnesses, and children's physical and cognitive development may be poorly impacted, such as abnormal immune system regulation and decreased IQ scores. [33]

Adulthood

Childhood chronic illnesses and their sequelae persist into adulthood, such as in the case of asthma or diabetes. [34] [35] Despite management of individual diseases, a diagnosis of chronic childhood disease generally does not resolve upon growth into adulthood. Relatedly, experiencing a childhood chronic illness may lead to financial hardships later in life, as shown in childhood cancer survivors. [36]

Society and Culture

Impact on family members and caregivers

The presence of a child with a chronic illness in the home has multiple effects on the family's life as it may affect daily routines. One potential consequence is the physical space inside the home being altered by the need for home health or medical equipment. As such children typically require frequent appointments, caregivers can feel strain to participate in their other children's lives equally and may develop increased levels of stress and family discord. [37] Caregivers report lower physical and psychological quality of life, and coping strategies are important in improving psychological quality of life, just as it is for the ill children themselves. [38] Healthy siblings of children with a chronic illnesses can have negative experiences and emotions, including withdrawal, overwhelm, and isolation even when social support is present. Child life specialists and health professionals must provide additional support to facilitate proper psychosocial adjustment among healthy siblings, as they already do for ill children. [39] The time requirements could also increase social isolation from extended family members. [40] Given the cost associated with the greater need for specialized treatments as well as decreased time to work, these families may also experience economic difficulties. [41]

Societal Impact

Childhood chronic illnesses can have large-scale implications for societies. One to two percent of healthcare budgets in developed countries is spent on asthma, the most common childhood chronic illness. [42] While not specific to childhood disease, the CDC reports that 90% of the U.S. national spending on healthcare goes to chronic diseases broadly. [43]

Related Research Articles

<span class="mw-page-title-main">Kwashiorkor</span> Severe protein malnutrition

Kwashiorkor is a form of severe protein malnutrition characterized by edema and an enlarged liver with fatty infiltrates. It is thought to be caused by sufficient calorie intake, but with insufficient protein consumption, which distinguishes it from marasmus. Recent studies have found that a lack of antioxidant micronutrients such as β-carotene, lycopene, other carotenoids, and vitamin C as well as the presence of aflatoxins may play a role in the development of the disease. However, the exact cause of kwashiorkor is still unknown. Inadequate food supply is correlated with occurrences of kwashiorkor; occurrences in high income countries are rare. It occurs amongst weaning children to ages of about five years old.

<span class="mw-page-title-main">Malnutrition</span> Medical condition

Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues and form. Malnutrition is not receiving the correct amount of nutrition. Malnutrition is increasing in children under the age of five due to providers who cannot afford or do not have access to adequate nutrition.

<span class="mw-page-title-main">Weight loss</span> Reduction of the total body mass

Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat, or lean mass. Weight loss can either occur unintentionally because of malnourishment or an underlying disease, or from a conscious effort to improve an actual or perceived overweight or obese state. "Unexplained" weight loss that is not caused by reduction in calorific intake or increase in exercise is called cachexia and may be a symptom of a serious medical condition.

<span class="mw-page-title-main">Preventive healthcare</span> Prevent and minimize the occurrence of diseases

Preventive healthcare, or prophylaxis is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

<span class="mw-page-title-main">Diseases of affluence</span> Health conditions thought to be a result of increasing wealth in society

Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to so-called "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.

Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.

<span class="mw-page-title-main">Failure to thrive</span> Condition of children whose current weight or rate of weight gain is much lower than expected

Failure to thrive (FTT), also known as weight faltering or faltering growth, indicates insufficient weight gain or absence of appropriate physical growth in children. FTT is usually defined in terms of weight, and can be evaluated either by a low weight for the child's age, or by a low rate of increase in the weight.

A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, chronic obstructive pulmonary disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms.

Diseases of poverty are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviour. Poverty is one of the major social determinants of health. The World Health Report (2002) states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Poverty increases the chances of having these diseases as the deprivation of shelter, safe drinking water, nutritious food, sanitation, and access to health services contributes towards poor health behaviour. At the same time, these diseases act as a barrier for economic growth to affected people and families caring for them which in turn results into increased poverty in the community. These diseases produced in part by poverty are in contrast to diseases of affluence, which are diseases thought to be a result of increasing wealth in a society.

<span class="mw-page-title-main">Protein–energy malnutrition</span> Medical condition

Protein–energy malnutrition (PEM), sometimes called protein-energy undernutrition (PEU), is a form of malnutrition that is defined as a range of conditions arising from coincident lack of dietary protein and/or energy (calories) in varying proportions. The condition has mild, moderate, and severe degrees.

Dysbiosis is characterized by a disruption to the microbiome resulting in an imbalance in the microbiota, changes in their functional composition and metabolic activities, or a shift in their local distribution. For example, a part of the human microbiota such as the skin flora, gut flora, or vaginal flora, can become deranged, with normally dominating species underrepresented and normally outcompeted or contained species increasing to fill the void. Dysbiosis is most commonly reported as a condition in the gastrointestinal tract.

<span class="mw-page-title-main">Non-communicable disease</span> Medical condition

A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, osteoarthritis, osteoporosis, Alzheimer's disease, cataracts, and others. NCDs may be chronic or acute. Most are non-infectious, although there are some non-communicable infectious diseases, such as parasitic diseases in which the parasite's life cycle does not include direct host-to-host transmission.

Despite India's 50% increase in GDP since 2013, more than one third of the world's malnourished children live in India. Among these, half of the children under three years old are underweight.

Clinical nutrition centers on the prevention, diagnosis, and management of nutritional changes in patients linked to chronic diseases and conditions primarily in health care. Clinical in this sense refers to the management of patients, including not only outpatients at clinics and in private practice, but also inpatients in hospitals. It incorporates primarily the scientific fields of nutrition and dietetics. Furthermore, clinical nutrition aims to maintain a healthy energy balance, while also providing sufficient amounts of nutrients such as protein, vitamins, and minerals to patients.

Pediatric psychology is a multidisciplinary field of both scientific research and clinical practice which attempts to address the psychological aspects of illness, injury, and the promotion of health behaviors in children, adolescents, and families in a pediatric health setting. Psychological issues are addressed in a developmental framework and emphasize the dynamic relationships which exist between children, their families, and the health delivery system as a whole.

<span class="mw-page-title-main">Health in Guatemala</span>

Health in Guatemala is focused on many different systems of prevention and care. Guatemala's Constitution states that every citizen has the universal right to health care. However, this right has been hard to guarantee due to limited government resources and other problems regarding access. The health care system in place today developed out of the Civil War in Guatemala. The Civil War prevented social reforms from occurring, especially in the sector of health care.

Developmental Origins of Health and Disease is an approach to medical research factors that can lead to the development of human diseases during early life development. These factors include the role of prenatal and perinatal exposure to environmental factors, such as undernutrition, stress, environmental chemical, etc. This approach includes an emphasis on epigenetic causes of adult chronic non-communicable diseases. As well as physical human disease, the psychopathology of the foetus can also be predicted by epigenetic factors.

<span class="mw-page-title-main">Undernutrition in children</span> Medical condition affecting children

Undernutrition in children, occurs when children do not consume enough calories, protein, or micronutrients to maintain good health. It is common globally and may result in both short and long term irreversible adverse health outcomes. Undernutrition is sometimes used synonymously with malnutrition, however, malnutrition could mean both undernutrition or overnutrition. The World Health Organization (WHO) estimates that malnutrition accounts for 54 percent of child mortality worldwide, which is about 1 million children. Another estimate, also by WHO, states that childhood underweight is the cause for about 35% of all deaths of children under the age of five worldwide.

The taxonomy of the burden of treatment is a visualization created for health care professionals to better comprehend the obstacles that interfere with a patient's health care plan. It was created as a result of a world wide, qualitative-based study that asked adults with chronic conditions to list the personal, environmental, and financial barriers that burden a patient. The purpose of this visualization is to help health care providers develop personalized management strategies that the patient can follow through a narrative paradigm. The goal is to target interventions, achieve an interpersonal doctor-patient relationship, and improve health outcomes.

The first 1000 days describes the period from conception to 24 months of age in child development. This is considered a "critical period" in which sufficient nutrition and environmental factors have life-long effects on a child's overall health. While adequate nutrition can be exceptionally beneficial during this critical period, inadequate nutrition may also be detrimental to the child. This is because children establish many of their lifetime epigenetic characteristics in their first 1000 days. Medical and public health interventions early on in child development during the first 1000 days may have higher rates of success compared to those achieved outside of this period.

References

  1. ↑ Stanton AL, Revenson TA, Tennen H (2007). "Health psychology: psychological adjustment to chronic disease". Annual Review of Psychology. 58: 565–592. doi:10.1146/annurev.psych.58.110405.085615. PMID   16930096.
  2. 1 2 Perrin JM, Bloom SR, Gortmaker SL (June 2007). "The increase of childhood chronic conditions in the United States". JAMA. 297 (24): 2755–2759. doi:10.1001/jama.297.24.2755. PMID   17595277.
  3. ↑ Allen PJ, Vessey JA, Schapiro N (2010). Primary care of the child with a chronic condition (5th ed.). St. Louis: Elsevier/Mosby. ISBN   978-0-323-05877-3. OCLC   373479661.
  4. ↑ Lantto M, Renko M, Uhari M (September 2013). "Changes in infectious disease mortality in children during the past three decades". The Pediatric Infectious Disease Journal. 32 (9): e355–e359. doi:10.1097/INF.0b013e3182930694. PMID   23538525. S2CID   24827747.
  5. ↑ Van Cleave J, Gortmaker SL, Perrin JM (February 2010). "Dynamics of obesity and chronic health conditions among children and youth". JAMA. 303 (7): 623–630. doi: 10.1001/jama.2010.104 . PMID   20159870.
  6. ↑ "Chronic Conditions". HealthyChildren.org. Retrieved 17 September 2022.
  7. 1 2 Torpy JM, Campbell A, Glass RM (February 2010). "JAMA patient page. Chronic diseases of children". JAMA. 303 (7): 682. doi: 10.1001/jama.303.7.682 . PMID   20159879.
  8. ↑ Hercberg S, Galan P (January 1992). "Nutritional anaemias". Baillière's Clinical Haematology. Epidemiology of Haematological Disease: Part I. 5 (1): 143–168. doi:10.1016/S0950-3536(11)80039-9. PMID   1596590.
  9. ↑ "Diabetes in Children". HealthyChildren.org. Retrieved 17 September 2022.
  10. ↑ Hashmi MF, Tariq M, Cataletto ME (2022). "Asthma". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID   28613651 . Retrieved 19 September 2022.
  11. ↑ "Allergies & Asthma". HealthyChildren.org. Retrieved 19 September 2022.
  12. ↑ Shteinberg M, Haq IJ, Polineni D, Davies JC (June 2021). "Cystic fibrosis". The Lancet. 397 (10290): 2195–2211. doi:10.1016/S0140-6736(20)32542-3. PMID   34090606. S2CID   235327978.
  13. ↑ "Diabetes in Children". HealthyChildren.org. Retrieved 19 September 2022.
  14. ↑ Bhutta ZA, Berkley JA, Bandsma RH, Kerac M, Trehan I, Briend A (September 2017). "Severe childhood malnutrition". Nature Reviews. Disease Primers. 3 (1): 17067. doi:10.1038/nrdp.2017.67. PMC   7004825 . PMID   28933421.
  15. ↑ "Childhood Overweight & Obesity | Overweight & Obesity | CDC". www.cdc.gov. 1 April 2022. Retrieved 19 September 2022.
  16. ↑ Browne NT, Hodges EA, Small L, Snethen JA, Frenn M, Irving SY, et al. (May 2022). "Childhood obesity within the lens of racism". Pediatric Obesity. 17 (5): e12878. doi: 10.1111/ijpo.12878 . PMID   34927392.
  17. 1 2 Bennett S, Shafran R, Coughtrey A, Walker S, Heyman I (April 2015). "Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review". Archives of Disease in Childhood. 100 (4): 308–316. doi: 10.1136/archdischild-2014-307474 . PMID   25784736. S2CID   22705399.
  18. ↑ Perrin JM, MacLean WE, Gortmaker SL, Asher KN (August 1992). "Improving the psychological status of children with asthma: a randomized controlled trial". Journal of Developmental and Behavioral Pediatrics. 13 (4): 241–247. doi:10.1097/00004703-199208000-00001. PMID   1506461. S2CID   9618651.
  19. ↑ Harbeck-Weber C (2003). Promoting Coping and Enhancing Adaptation to Illness. The Guilford Press. pp. 99–118. ISBN   978-1572309067.
  20. 1 2 Wenar C, Kerig P (2011). Developmental psychopathology : from infancy through adolescence (5th ed.). Maidenhead, Berkshire: McGraw Hill. ISBN   978-0-07-713745-8. OCLC   756486438.
  21. 1 2 3 4 5 Law, Emily; Fisher, Emma; Eccleston, Christopher; Palermo, Tonya M. (18 March 2019). "Psychological interventions for parents of children and adolescents with chronic illness". The Cochrane Database of Systematic Reviews. 3 (3): CD009660. doi:10.1002/14651858.CD009660.pub4. ISSN   1469-493X. PMC   6450193 . PMID   30883665.
  22. 1 2 3 4 Kyle UG, Shekerdemian LS, Coss-Bu JA (April 2015). "Growth failure and nutrition considerations in chronic childhood wasting diseases". Nutrition in Clinical Practice. 30 (2): 227–238. doi:10.1177/0884533614555234. PMID   25378356.
  23. 1 2 3 4 5 Sevilla WM (August 2017). "Nutritional Considerations in Pediatric Chronic Disease". Pediatrics in Review. 38 (8): 343–352. doi:10.1542/pir.2016-0030. PMID   28765197. S2CID   46832004.
  24. 1 2 3 4 Samarasinghe SC, Medlow S, Ho J, Steinbeck K (1 January 2020). "Chronic illness and transition from paediatric to adult care: a systematic review of illness specific clinical guidelines for transition in chronic illnesses that require specialist to specialist transfer". Journal of Transition Medicine. 2 (1). doi: 10.1515/jtm-2020-0001 . ISSN   2568-2407. S2CID   222005421.
  25. 1 2 3 "Recommendations | Transition from children's to adults' services for young people using health or social care services | Guidance | NICE". www.nice.org.uk. Retrieved 18 September 2022.
  26. ↑ Miller VA (November 2018). "Involving Youth With a Chronic Illness in Decision-making: Highlighting the Role of Providers". Pediatrics. 142 (Suppl 3): S142–S148. doi:10.1542/peds.2018-0516D. PMC   6220652 . PMID   30385620.
  27. ↑ Compas BE, Jaser SS, Dunn MJ, Rodriguez EM (27 April 2012). "Coping with chronic illness in childhood and adolescence". Annual Review of Clinical Psychology. 8 (1): 455–480. doi:10.1146/annurev-clinpsy-032511-143108. PMC   3319320 . PMID   22224836.
  28. ↑ Lum A, Wakefield CE, Donnan B, Burns MA, Fardell JE, Marshall GM (September 2017). "Understanding the school experiences of children and adolescents with serious chronic illness: a systematic meta-review". Child. 43 (5): 645–662. doi:10.1111/cch.12475. PMID   28543609.
  29. ↑ Suris JC, Michaud PA, Viner R (October 2004). "The adolescent with a chronic condition. Part I: developmental issues". Archives of Disease in Childhood. 89 (10): 938–942. doi:10.1136/adc.2003.045369. PMC   1719685 . PMID   15383438.
  30. ↑ "Managing Chronic Health Conditions in Schools | Healthy Schools | CDC". www.cdc.gov. 19 August 2022. Retrieved 15 September 2022.
  31. ↑ Didsbury MS, Kim S, Medway MM, Tong A, McTaggart SJ, Walker AM, et al. (December 2016). "Socio-economic status and quality of life in children with chronic disease: A systematic review". Journal of Paediatrics and Child Health. 52 (12): 1062–1069. doi:10.1111/jpc.13407. hdl: 11343/292196 . PMID   27988995. S2CID   5438951.
  32. ↑ Spencer NJ, Blackburn CM, Read JM (September 2015). "Disabling chronic conditions in childhood and socioeconomic disadvantage: a systematic review and meta-analyses of observational studies". BMJ Open. 5 (9): e007062. doi:10.1136/bmjopen-2014-007062. PMC   4563224 . PMID   26338834.
  33. ↑ Larson-Nath C, Goday P (June 2019). "Malnutrition in Children With Chronic Disease". Nutrition in Clinical Practice. 34 (3): 349–358. doi:10.1002/ncp.10274. PMID   30963628. S2CID   104296610.
  34. ↑ Fuchs O, Bahmer T, Rabe KF, von Mutius E (March 2017). "Asthma transition from childhood into adulthood". The Lancet. Respiratory Medicine. 5 (3): 224–234. doi:10.1016/S2213-2600(16)30187-4. PMID   27666650.
  35. ↑ Monaghan M, Helgeson V, Wiebe D (2015). "Type 1 diabetes in young adulthood". Current Diabetes Reviews. 11 (4): 239–250. doi:10.2174/1573399811666150421114957. PMC   4526384 . PMID   25901502.
  36. ↑ Nathan PC, Henderson TO, Kirchhoff AC, Park ER, Yabroff KR (July 2018). "Financial Hardship and the Economic Effect of Childhood Cancer Survivorship". Journal of Clinical Oncology. 36 (21): 2198–2205. doi:10.1200/JCO.2017.76.4431. PMID   29874136. S2CID   46958943.
  37. ↑ Hartley SL, Barker ET, Seltzer MM, Floyd F, Greenberg J, Orsmond G, Bolt D (August 2010). "The relative risk and timing of divorce in families of children with an autism spectrum disorder". Journal of Family Psychology. 24 (4): 449–457. doi:10.1037/a0019847. PMC   2928572 . PMID   20731491.
  38. ↑ Fairfax A, Brehaut J, Colman I, Sikora L, Kazakova A, Chakraborty P, Potter BK (July 2019). "A systematic review of the association between coping strategies and quality of life among caregivers of children with chronic illness and/or disability". BMC Pediatrics. 19 (1): 215. doi: 10.1186/s12887-019-1587-3 . PMC   6600882 . PMID   31262261.
  39. ↑ Lummer-Aikey S, Goldstein S (May 2021). "Sibling Adjustment to Childhood Chronic Illness: An Integrative Review". Journal of Family Nursing. 27 (2): 136–153. doi:10.1177/1074840720977177. PMID   33305651. S2CID   228101518.
  40. ↑ Thomson J, Shah SS, Simmons JM, Sauers-Ford HS, Brunswick S, Hall D, et al. (May 2016). "Financial and Social Hardships in Families of Children with Medical Complexity". The Journal of Pediatrics. 172: 187–193.e1. doi:10.1016/j.jpeds.2016.01.049. PMC   4846519 . PMID   26897040.
  41. ↑ Kuhlthau K, Hill KS, Yucel R, Perrin JM (June 2005). "Financial burden for families of children with special health care needs". Maternal and Child Health Journal. 9 (2): 207–218. doi:10.1007/s10995-005-4870-x. PMID   15965627. S2CID   9733318.
  42. ↑ Serebrisky D, Wiznia A (January 2019). "Pediatric Asthma: A Global Epidemic". Annals of Global Health. 85 (1): 6. doi: 10.5334/aogh.2416 . PMC   7052318 . PMID   30741507.
  43. ↑ "Health and Economic Costs of Chronic Diseases | CDC". www.cdc.gov. 8 September 2022. Retrieved 15 September 2022.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.