Evaluation of osteoporosis and related factors and quality of life of patients with juvenile idiopathic arthritis and burnout status of parents
Osteoporosis, quality of life and burnout syndrome in juvenile idiopathic arthritis
Keywords:
osteoporosis, quality of life, burnout syndrome, juvenile idiopathic arthritisAbstract
Background/Aim: Juvenile idiopathic arthritis (JIA) can negatively influence the lives of children and parents. Because it is a chronic disease, a complete recovery is not expected; additionally, children with JIA and their parents must cope with problems such as chronic pain, physical disability, school absenteeism, and social communication disorders. Children’s quality of life (QoL) may be affected by all these problems. Also, prolonged exposure to stress and failure to cope with stress may cause burnout syndrome in parents. The study aims to evaluate osteoporosis, QoL of children with JIA and the burnout status of caregivers.
Methods: In this prospective, cross-sectional study, 30 patients aged 4–18 years, who were followed up for at least 6 months with the diagnosis of JIA, were included. Demographic, clinical, and laboratory characteristics were recorded retrospectively. Daily dietary calcium intake and daily activity levels were questioned. The patients’ bone mineral densities (BMD) were measured by the Dual Energy X-ray Absorptiometry method. Z scores below -2 were classified as the osteoporosis group, and those above -2 were classified as the non-osteoporosis group. The Turkish Pediatric Quality of Life Inventory validated and reliable in Turkish children was used to evaluate the QoL. Maslach Burnout Inventory was used to evaluate the burnout status of parents.
Results: The mean age of patients was 12.6 (4.3) years. Osteoporosis was detected in 46.7% (n=14) cases. The mean age was higher (14.5 [3.7] in the osteoporosis group and 10.9 [4.1] in the non-osteoporosis group) (P=0.032) and the rate of oligoarticular JIA (7.1%), daily calcium intake (288 [168-456] mg/kg), and duration of activity (3 [2-6] hours) were lower in the osteoporosis group (P=0.039, P=0.043, P<0.001, respectively). Among the QoL indicators, the physical health total score was the lowest. Emotional functionality scores decreased as the age increased (P=0.037) and increased as the BMD z-score increased (P=0.024). Emotional burnout, one of the parental burnout indicators, increased as the duration of illness increased (P=0.003), and the BMD z-score decreased (P=0.003). Depersonalization increased as the age increased (P=0.010) and the duration of the disease prolonged (P<0.001) and increased as daily activity duration (P=0.032) and BMD z-score values decreased (P=0.002). Personal achievement decreased as the age increased (P=0.025) and the duration of illness (P=0.014), and the time spent watching television increased (P=0.030). Emotional exhaustion and depersonalization of the parents increased as the scores in any of the indicators of QoL decreased (P<0.05 for each). The personal success of the parents increased as the scores in any of the indicators of QoL increased (P<0.05 for each). All QoL indicators, except for social functionality and psychosocial health total score, were significantly lower in the group with osteoporosis. In addition, parents of children with osteoporosis had higher emotional burnout and depersonalization scores and lowered personal achievement scores (P<0.05 for each).
Conclusion: In the current study, we observed a decrease in the QoL of the children and burnout syndrome in the parents. It was found that the deterioration in children’s QoL indicators affected the burnout indicators of parents, and the presence of osteoporosis affected both QoL and parental burnout. Awareness of modifiable risk factors in children with JIA is very important. The disease and osteoporosis secondary to this disease can impair children's QoL and cause burnout in parents.
Downloads
References
Giancane G, Alongi A, Ravelli A. Update on the pathogenesis and treatment of juvenile idiopathic arthritis. Curr Opin Rheumatol. 2017;29(5):523-9. DOI: https://doi.org/10.1097/BOR.0000000000000417
Lovell DJ, Athreya B, Emery HM, Gibbas DL, Levinson JE, Lindsleyet CB, et al. School attendance and patterns, special services and special needs in pediatric patients with rheumatic diseases: Results of a multicenter study. Arthritis Care Res. 1990;3(4):196-203. DOI: https://doi.org/10.1002/1529-0131(199012)3:4<196::AID-ANR1790030407>3.0.CO;2-Q
Seid M, Opipari L, Huang B, Brunner HI, Lovell DJ. Disease control and health-related quality of life in JIA. Arthritis Rheum. 2009;61(3):393-9. DOI: https://doi.org/10.1002/art.24477
Ennett ST, DeVellis BM, Earp JA, Kredich D, Warren RW, Wilhelm CL. Disease experience and psychosocial adjustment in children with juvenile rheumatoid arthritis: children's versus mothers' reports. J Pediatr Psychol. 1991;16(5):557-68. DOI: https://doi.org/10.1093/jpepsy/16.5.557
Uneri OS, Memik NC. Concept of quality of life in children and review inventories about quality of life. Turkish Journal of Child and Adolescent Mental Health. 2007;14(1):48-56.
Memik NC, Agaoglu B, Coskun A, Karakaya I. The validity and reliability of Pediatric Quality of Life Inventory in 8–12-year-old Turkish children. Turkish Journal of Child and Adolescent Mental Health. 2008;15(2):87-98.
Memik NC, Agaoglu B, Coskun A, Uneri OS, Karakaya I. The validity and reliability of the Turkish Pediatric Quality of Life Inventory for children 13–18 years old. Turk Psikiyatri Derg. 2007;18(4):353-63.
Akay AP. Psychosocial aspects of children with juvenile idiopathic arthritis. Journal of Dokuz Eylul University Medical Faculty. 2005;19(2):121-6.
Kacmaz N. Burnout syndrome. J Ist Faculty Med. 2005;68(1):29-32.
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory: Third edition. 191-218. In: Zalaquett CP, Wood RJ (Eds). Palo Alto, C: Consulting Psychologists Press, 1996.
Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety. 2009;26(12):1118-26. DOI: https://doi.org/10.1002/da.20631
Gunduz B. Burnout of teachers in basic education. Mersin University Journal of the Faculty of Education. 2005;1(1):152-66.
Norberg AL. Burnout in mothers and fathers of children surviving brain tumour. J Clin Psychol Med Settings. 2007;14(2):130-7. DOI: https://doi.org/10.1007/s10880-007-9063-x
Weiss MJ. Harrdiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. Autism. 2002;6(1):115-30. DOI: https://doi.org/10.1177/1362361302006001009
Roth J, Bechtold S, Borte G, Dressler F, Girschick HJ, Borte M. Osteoporosis in juvenile idiopathic arthritis- a practical approach to diagnosis and therapy. Eur J Pediatr. 2007;166(8):775-84. DOI: https://doi.org/10.1007/s00431-007-0484-1
Cassidy JT, Langman CB, Allen SH, Hillman LS. Bone mineral metabolism in children with juvenile rheumatoid arthritis. Pediatr Clin North Am. 1995;42(5):1017-33. DOI: https://doi.org/10.1016/S0031-3955(16)40051-9
Katzman DK, Bachrach LK, Carter DR, Marcus R. Clinical and anthropometric correlates of bone mineral acquisition in healthy adolescent girls. J Clin Endocrinol Metab. 1991;73(6):1332-9. DOI: https://doi.org/10.1210/jcem-73-6-1332
Stagi S, Cavalli L, Signorini C, Bertini F, Cerinic MM, Brandi ML, et al. Bone mass and quality in patients with juvenile idiopathic arthritis: longitudinal evaluation of bone-mass determinants by using dual-energy x-ray absorptiometry, peripheral quantitative computed tomography, and quantitative ultrasonography. Arthritis Res Ther. 2014;16(2):R83. DOI: https://doi.org/10.1186/ar4525
Roth J, Palm C, Scheunemann I, Ranke MB, Schweizer R, Dannecker GE. Musculoskeletal abnormalities of the forearm in patients with juvenile idiopathic arthritis relate mainly to bone geometry. Arthritis Rheum. 2004;50(4):1277-85. DOI: https://doi.org/10.1002/art.20128
Oliveira S, Ravelli A, Pistorio A, Castell E, Malattia C, Prieur AM, et al. Proxy-reported health-related quality of life of patients with juvenile idiopathic arthritis: the Pediatric Rheumatology International Trials Organization multinational quality of life cohort study. Arthritis Rheum. 2007;57(1):35-43. DOI: https://doi.org/10.1002/art.22473
Lindström C, Aman J, Norberg AL. Increased prevalence of burnout symptoms in parents of chronically ill children. Acta Paediatr. 2010;99(3):427-32. DOI: https://doi.org/10.1111/j.1651-2227.2009.01586.x
Gülbahar S, El O, Altay C, Sahin E, Koroglu F, Berrin Akgün, et al. The relationship between health related quality of life and vertebral fracture in postmenopausal osteoporosis. Turk J Osteoporos. 2007;13(2):23-7.
Downloads
- 229 320
Published
Issue
Section
How to Cite
License
Copyright (c) 2023 Aylin Yücel, Ozlem Aydog, Kıymet Ikbal Karadavut, Sukran Ozden Uneri
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.