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针对近期被诊断为幼年特发性关节炎的儿童及其父母的幼年关节炎支持项目(JASP - 1)的益处。

Benefits of a Juvenile Arthritis Support Program (JASP-1) for children recently diagnosed with Juvenile Idiopathic Arthritis and their parents.

作者信息

Mördrup Karina, Jungner Johanna Granhagen, Broström Eva, Palmblad Karin, Bartholdson Cecilia

机构信息

Department of Women´s and Children´s Health, Karolinska Institutet Neuropediatric Unit, Karolinska vägen 37 A, Solna, 171 64, Sweden.

Highly Specialized Pediatric Medicine and Orthopedics, Astrid Lindgren Children´s Hospital, Karolinska University Hospital, Stockholm, Sweden.

出版信息

BMC Rheumatol. 2024 Aug 15;8(1):35. doi: 10.1186/s41927-024-00404-8.

Abstract

BACKGROUND

Medical treatment for children with Juvenile Idiopathic Arthritis (JIA) has improved radically since the development of biological disease-modifying antirheumatic drugs. However, children suffer from pain and anxiety, and parents often experience loneliness and lack of support. Some parents reported that information provided at the time their child was diagnosed could be difficult to assimilate. Therefore, the aim of this study was to develop a Juvenile Arthritis Support Program (JASP-1) for children recently diagnosed with JIA and their parents. Moreover, the aim was to explore patients´ and parents´ experiences with JASP-1 and its potential impact on patients´ physical health.

METHODS

JASP-1 included seven patient- and family-centered clinical visit from time of diagnose and one year ahead. Data were collected from a study-specific questionnaire answered by children and their parents after participation in JASP-1 and from the pediatric rheumatology register. The study-specific questionnaire explored participants´ experience with the care they received during their first year with JIA. Registry and questionnaire data from the intervention (JASP-1) group was compared to a control group.

RESULTS

The analysis revealed that children and parents who completed JASP-1 were more satisfied with the care they had received during their first year with JIA than the control group. The results also showed that children who completed JASP-1 were assessed as having better overall health after 12 months, than children in the control group (JASP-1 = mean 4.33, 95% Confidence Interval (CI) 4.17 - 4.46), (Control = mean 3.68, 95% CI 3.29 - 4.06), (p = 0.002). Moreover, children in the JASP-1 group had less disease impact on daily life (JASP-1 = mean 0.15, 95% CI 0.07 - 0.24) (Control = mean 0.40, 95% CI 0.13 - 0.67), (p = 0.017) and less active joints than the control group (JASP-1 = mean 0.62, 95% CI 0.35 - 1.58), (Control = mean 0.87, 95% CI 0.18 - 1.56), (p = 0.054).

CONCLUSION

A support program like JASP-1 could be an effective way of not only supporting children newly diagnosed with JIA and their parents psychologically but may also increase children's overall physical health and improve quality of care within pediatric rheumatology.

TRIAL REGISTRATION

Retrospectively registered in ClinicalTrials.gov, the 13th of February with ID NCT06284616.

摘要

背景

自从生物性改善病情抗风湿药物问世以来,幼年特发性关节炎(JIA)患儿的医学治疗有了根本性改善。然而,患儿遭受疼痛和焦虑之苦,家长则常常感到孤独且缺乏支持。一些家长报告称,孩子确诊时所提供的信息可能难以理解。因此,本研究的目的是为近期确诊JIA的患儿及其家长制定一项幼年关节炎支持计划(JASP - 1)。此外,目的还在于探索患者及其家长对JASP - 1的体验以及该计划对患者身体健康的潜在影响。

方法

JASP - 1包括从确诊之时起至未来一年的七次以患者和家庭为中心的临床就诊。数据收集自患儿及其家长在参与JASP - 1后填写的一份针对该研究的问卷,以及儿科风湿病登记处的数据。该针对研究的问卷探讨了参与者在患JIA的第一年所接受护理的体验。将干预组(JASP - 1)的登记处和问卷数据与对照组进行比较。

结果

分析显示,完成JASP - 1的患儿及其家长对患JIA第一年所接受的护理比对照组更满意。结果还表明,完成JASP - 1的患儿在12个月后被评估为总体健康状况优于对照组(JASP - 1 = 平均4.33,95%置信区间(CI)4.17 - 4.46),(对照组 = 平均3.68,95% CI 3.29 - 4.06),(p = 0.002)。此外,JASP - 1组患儿的疾病对日常生活的影响较小(JASP - 1 = 平均0.15,95% CI 0.07 - 0.24)(对照组 = 平均0.40,95% CI 0.13 - 0.67),(p = 0.017),且活动关节比对照组少(JASP - 1 = 平均0.62,95% CI 0.35 - 1.58),(对照组 = 平均0.87,95% CI 0.18 - 1.56),(p = 0.054)。

结论

像JASP - 1这样的支持计划不仅可能是在心理上支持新确诊JIA的患儿及其家长的有效方式,还可能提高患儿的总体身体健康水平,并改善儿科风湿病的护理质量。

试验注册

于2月13日在ClinicalTrials.gov上进行回顾性注册,识别号为NCT06284616。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/11325655/80371140e3af/41927_2024_404_Fig1_HTML.jpg

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