Child Vulnerability Scale Research Articles

Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers

Cancer patients, who face increased foodborne illness susceptibility and severity, are often placed on neutropenic diets (NDs), which eliminate the consumption of fresh produce, among other foods perceived as high-risk. Such diets are clinically disputed because they have never been proven effective in reducing foodborne illness, leading to unstandardized dietary guideline content, format, and delivery methods. To inform a strategic communication approach, this study explored the produce safety handling behavior, barriers, motivators, and beliefs of pediatric cancer patient caretakers using a mixed methods convergent parallel design. A quantitative survey revealed high frequencies (> 60%) for generally recommended produce safety behaviors, such as rinsing produce and washing cutting boards, and more mixed responses for restrictive produce safety behaviors, such as peeling produce and avoiding pre-cut, self-serve, and school cafeteria produce. Total produce safety frequency scores were not significantly affected by demographic factors or Child Vulnerability Scale (CVS) scores. Qualitative interviews established a wide domain of caretaker produce safety experiences and beliefs, finding that eight of seventeen interview participants from different hospitals received produce restrictions typical of the ND. Ultimately, five caretaker archetypes were identified, with common motivators and barriers linked to materials received, child’s health and perceived susceptibility, and self-efficacy beliefs. Finally, response-driven communication strategy improvements were recommended. Although sample sizes in this work were small, and further validation is advised, this work highlights the inconsistent use of the restrictive ND, advances understanding of the drivers of produce safety behaviors in cancer patient caretakers, and supports future endeavors to streamline communication strategy interventions.

Parental Perception of Vulnerability, Child’s Temperament, and Health Locus of Control: Who Made You Boo-Boo?

Background: In Pakistan, where unintentional injuries among toddlers pose a significant public health challenge, understanding the factors that contribute to elevated injury risks is crucial. A two-dimensional approach including parental factors (internal/external health locus of control and perceived vulnerability) and child factors (the child’s temperament) is explored as contributing to the unintentional injury behaviors of toddlers. Method: The study involved 241 parents of toddlers aged 18–36 months from daycare centers in three major Pakistani cities who had observed multiple recent injuries in their children. The comprehensive online assessment, lasting 15–20 minutes, incorporated the child vulnerability scale, injury behavior checklist, parent health locus of control questionnaire, and early childhood behavior questionnaire. Demographic details included child and parent age distributions, with a focus on educational backgrounds. The participants comprised both fathers and mothers, and the data analysis employed Smart-PLS software for structural equation modeling. Result: The results suggested there is no direct relationship between parental health locus of control (internal/external) and injury behaviors in children. However, an indirect and significant path was observed from the parental health locus of control (internal/external) to perceived child vulnerability and injury behaviors through moderation of temperamental characteristics. Conclusion: Our research underscores the indirect link between parental factors, child temperament, and toddler injuries in Pakistan. Culturally sensitive interventions targeting parental awareness can play a pivotal role in safeguarding the well-being of the youngest members of society.

The association between overprotective parenting, parental perceptions of child vulnerability and growth and development of children with congenital heart disease

Abstract Background Congenital Heart Disease (CHD) is the most prevalent childhood birth defect, leading to health concerns in growth and development post-surgery. Parents mostly shoulder the responsibility for post-hospitalization care. The chronic nature of caring for a child with CHD induces significant stress, fostering perceptions of the child as highly vulnerable and resulting in overprotective behaviors. These behaviors could restrict the child's developmental opportunities, affecting overall growth and development. Purpose The purpose was to investigate the association between parental perceptions of child vulnerability, overprotective parenting, and growth and development of children with CHD. Methods The study employed a cross-sectional, comparative design. The total sample included 186 [93 CHD and 93 healthy controls] parents and their child aged 1-5 years. Data on parenting practices were gathered using the Child Vulnerability Scale and Parental Protection Scale. Child development was examined using the Ages and Stages Questionnaire-3. Growth and other clinical variables were gathered from the medical records. Data were analyzed using descriptive statistics, correlational and mediation analyses. Results CHD parents exhibited higher overprotective parenting (p=0.008) and perceived their child as more vulnerable (p<0.001) than healthy controls. In CHD, parental perception of child vulnerability was associated with worse gross motor (p=0.010) and problem-solving development (p=0.011), while among the controls, overprotective parenting was negatively associated with height (p=0.027) and weight (p=0.003). The path analyses revealed direct effects but no mediating or moderating effects of perceived child vulnerability and overprotectiveness on growth and development of the child with CHD. Higher parental perceptions of child vulnerability were associated with lower height (b1= -0.253, 95% CI: -0.397 to -0.087) and weight (a2= -0.098, 95% CI: -0.195 to 0.003). The higher the parental stress, the greater the perceptions of child vulnerability were (d1= 0.108, 95% CI: 0.058 to 0.160) and the worse communication skills of the child (cʹ2= -0.250, 95% CI: -0.422 to 0.091). Higher education level of the parents was associated with less perceptions of child vulnerability (d1= -1.562, 95% CI: -2.753 to -0.623), better fine motor development (c2=6.948, 95% CI: 4.137 to 9.552) and less overprotective parenting (f1=-1.874, 95% CI: -3.186 to -0.499). Higher perceptions of child vulnerability were associated with lower personal-social development (b1= -0.378, 95% CI: -0.803 to 0.046). Top of Form. Conclusion Healthcare providers should consider the diverse parental and child factors identified to initiate interventions aimed at parenting practices, realistic perceptions of their child’s condition, and reducing parental stress to optimize growth and development in children with CHD.

Physical activity in relation to motor performance, exercise capacity, sports participation, parental perceptions, and overprotection in school aged children with a critical congenital heart defect

ObjectiveTo depict objectively measured moderate-to-vigorous physical activity (MVPA), motor performance (MP), cardiorespiratory fitness (CRF), organized sports participation, parental perceptions of vulnerability and parenting style in children with a Critical Congenital Heart Disease (CCHD), and to explore whether these factors are associated with MVPA. Study designA prospective observational cohort study in 62 7–10 years old children with a CCHD. ResultsOn average, children with CCHD spent 64 min on MVPA per day (accelerometry), 61 % met the international WHO physical activity guideline. Only 12 % had >60 min of MVPA daily. Eighteen percent had a motor delay (movement-assessment-battery-for children-II) and 38 % showed a below average CRF (cardiopulmonary exercise test using the Godfrey ramp protocol). Seventy-seven percent participated in organized sports activities at least once a week. Twenty-one percent of the parents are classified as overprotective (parent protection scale) and 7.3 % consider their child as being vulnerable (child vulnerability scale). A significant positive association was found between MVPA and MP (rs = 0.359), CRF(V̇O2peak/ml/kg: rs = 0.472 and Wpeak/kg: rs = 0.396) and sports participation (rs = 0.286). Children who were perceived as vulnerable by their parents showed a significantly lower MVPA (rs = −0.302). No significant associations were found between mean MVPA and parental overprotection. ConclusionEven though the majority of school aged children with a CCHD is sufficiently active, counseling parents regarding the importance of sufficient MVPA and sports participation, especially in parents who consider their child being vulnerable, could be useful. Since motor delays can be detected at an early age, motor development could be an important target to improve exercise capacity and sports participation to prevent inactivity in children with a CCHD.

The predictive role of parental attitudes toward COVID-19 vaccines and child vulnerability: A multi-country study on the relationship between parental vaccine hesitancy and financial well-being.

Recent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents. A predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire. The current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy. The current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children.

Factors That Influence Women’s Symptoms of Postpartum Depression After Discharge of Their Preterm Infants From the NICU

ObjectiveTo examine resourcefulness, perception of child vulnerability, and stress in relation to symptoms of postpartum depression (PPD) in women after discharge of their preterm infants from the NICU. DesignCross-sectional, descriptive, correlational study. SettingAn urban NICU follow-up clinic, a pediatric office in the northeastern United States, and an online NICU parent support group. ParticipantsSeventy-four women who gave birth to preterm infants who were discharged home from the NICU. MethodsThe participants completed a demographic data questionnaire, the Resourcefulness Scale, Child Vulnerability Scale, Perceived Stress Scale, and Edinburgh Postnatal Depression Scale. I examined the relationships among these data using correlational analysis and hierarchical multiple linear regression analysis. ResultsPerception of child vulnerability and stress were predictors of symptoms of PPD; these variables accounted for 9% (p = .001) and 18% (p < .001) of the variation in symptoms of PPD, respectively. Although resourcefulness initially predicted PPD, it was no longer significant when controlling for demographic variables in the final regression analysis. ConclusionsThese results supported previously reported findings on the effects of women’s perceptions of their child’s vulnerability and stress on symptoms of PPD. However, the findings are not consistent with those of previous research regarding the inverse relationship between resourcefulness and symptoms of PPD. Nurses can implement interventions for women regarding perceptions of child vulnerability and stress to decrease symptoms of PPD after their preterm infant’s discharge from the NICU.

Factors affecting motor development of toddlers who received cardiac corrective procedures during infancy

BackgroundA risk adjustment in congenital heart surgery (RACHS-1) method was used for assessing quality of care in children undergoing congenital heart surgery. Children in RACHS-1 categories 1–4 had high survival rates. Little was known about these children and their prognosis of motor development during toddlerhood. AimsTo compare the differences between congenital heart disease (CHD) and healthy toddlers in terms of their characteristics, parental characteristics, parenting attitudes, and motor development, and further examine the influence of these factors on the motor development of the toddler with CHD. Study designA comparison study. SubjectsThere were 48 toddlers in the CHD group and 39 in the healthy toddler group. Outcomes measuresCurrent height and weight, Peabody Developmental Motor Scales second edition (PDMS-2), state-trait anxiety inventory (STAI) and Child Vulnerability Scale (CVS). ResultsCompared to the healthy group, toddlers with CHD had lower birth weight, smaller height-for-age, lower weight-for-age, and more motor developmental delay, but their mothers had lower anxiety. A shorter length of hospitalization and higher weight-for-age z score predicted a better gross motor development, with 40.2% of the variance explained. A higher weight-for-age z score and low RACHS-1 categories predicted better total motor development, with 38.4% of the variance explained. Only low RACHS-1 categories predicted better fine-motor development, with 12% of the variance explained. ConclusionsMany children in RACHS-1 categories 1–4 had growth and motor development below average in their toddlerhood. Therefore, growth and developmental progress should be assessed and mediated early after corrective procedures.

Development of an Instrument to Assess Parents' Excessive Web-Based Searches for Information Pertaining to Their Children's Health: The "Children's Health Internet Research, Parental Inventory" (CHIRPI).

BackgroundPeople often search the internet to obtain health-related information not only for themselves but also for family members and, in particular, their children. However, for a minority of parents, such searches may become excessive and distressing. Little is known about excessive web-based searching by parents for information regarding their children’s health.ObjectiveThis study aimed to develop and validate an instrument designed to assess parents' web-based health information searching behavior, the Children’s Health Internet Research, Parental Inventory (CHIRPI).MethodsA pilot survey was used to establish the instrument (21 items). CHIRPI was validated online in a second sample (372/384, 96.9% mothers; mean age 32.7 years, SD 5.8). Item analyses, an exploratory factor analysis (EFA), and correlations with parents’ perception of their children’s health-related vulnerability (Child Vulnerability Scale, CVS), parental health anxiety (modified short Health Anxiety Inventory, mSHAI), and parental cyberchondria (Cyberchondria Severity Scale, CSS-15) were calculated. A subset of participants (n=73) provided retest data after 4 weeks. CHIRPI scores (total scores and subscale scores) of parents with a chronically ill child and parents who perceived their child to be vulnerable (CVS+; CVS>10) were compared with 2×2 analyses of variances (ANOVAs) with the factors Child’s Health Status (chronically ill vs healthy) and perceived vulnerability (CVS+ vs CVS−).ResultsCHIRPI’s internal consistency was standardized alpha=.89. The EFA identified three subscales: Symptom Focus (standardized alpha=.87), Implementing Advice (standardized alpha=.74) and Distress (standardized alpha=.89). The retest reliability of CHIRPI was measured as rtt=0.78. CHIRPI correlated strongly with CSS-15 (r=0.66) and mSHAI (r=0.39). The ANOVAs comparing the CHIRPI total score and the subscale scores for parents having a chronically ill child and parents perceiving their child as vulnerable revealed the main effects for perceiving one’s child as vulnerable but not for having a chronically ill child. No interactions were found. This pattern was observed for the CHIRPI total score (η2=0.053) and each subscale (Symptom Focus η2=0.012; Distress η2=0.113; and Implementing Advice η2=0.018).ConclusionsThe psychometric properties of CHIRPI are excellent. Correlations with mSHAI and CSS-15 indicate its validity. CHIRPI appears to be differentially sensitive to excessive searches owing to parents perceiving their child’s health to be vulnerable rather than to higher informational needs of parents with chronically ill children. Therefore, it may help to identify parents who search excessively for web-based health information. CHIRPI (and, in particular, the Distress subscale) seems to capture a pattern of factors related to anxious health-related cognitions, emotions, and behaviors of parents, which is also applied to their children.

Correlation between perceived vulnerability and parenting stress in mothers of children with congenital heart disease

Objective To explore the current perceived vulnerability and parenting stress (PS) in mothers of children with congenital heart disease (CHD) and to analyze the correlation between the two. Methods The mothers of 176 children with congenital heart disease admitted in the 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from September 2017 to September 2018 were selected using convenient sampling and investigated with the General Information Questionnaire, Child Vulnerability Scale (CVS) and Parenting Stress Index-Short Form (PSI-SF) . Results Totally 176 questionnaires were distributed and collected, including 168 valid questionnaires, accounting for a recovery rate of 95.45%. The CVS score of the mothers of CHD children averaged (8.77±3.59) ; their PSI-SF scores saveraged (100.74±10.55) ; there was statistically significant difference in PSI-SF scores between mothers with different educational background and single child or not (P<0.05) ; the total CVS score was positively correlated with the total PSI-SF score and the scores of its various dimensions (r=0.262-0.569) ; multivariate stepwise regression analysis showed that mothers with different educational background, single child, and the total score of CVS were factors of parenting stress, except the effect of general information, the total score of CVS can explain 17% of the total variation. Conclusions The perceived vulnerability and PS of the mothers of CHD children stand at high levels. Their perceived vulnerability is positively correlated with their PS. Medical and nursing workers may improve their PS by reducing their perceived vulnerability, thus providing better family care for CHD children. Key words: Heart defects, congenital; Mother; Perceived vulnerability; Parenting stress

The relationship of child executive functions to parenting capacities in childhood acute lymphoblastic leukemia survivors

The current study examined associations between child executive functions and parenting capacities in long-term survivors of childhood acute lymphoblastic leukemia (ALL). Participants included 188 parent-child dyads; children were at least 8 years of age, 5 years postdiagnosis of ALL, and previously treated with chemotherapy only. Parents completed the Parental Protection Scale (PPS), Child Vulnerability Scale (CVS), and Decision-Making Questionnaire (DMQ). Children completed measures of executive functioning and general cognitive abilities. Multivariate multiple regression examined associations between child executive functioning and parenting, while controlling for child age, treatment risk, maternal education, and child intelligence quotient. An exploratory aim identified latent profiles of parenting capacities. Higher child cognitive flexibility (β = -0.16, P = .02) and planning abilities (β = -0.16, P = .049) were related to less parental overprotection. No other neurocognitive measures were related to child autonomy in decision making or perceived child vulnerability. For the exploratory aim, we found (a) a large class defined by normative parenting (94.3%) and (b) a small class characterized by higher levels of child vulnerability and overprotection. Class membership was unrelated to executive functioning, but higher maternal education was related to higher odds of class 2 membership (OR = 0.58, P = .04). Results suggest that parents respond to child executive function difficulties with greater overprotection, which may be adaptive but not conducive to the development of independence. Although most parents report normative levels of child vulnerability and overprotection, a small subset demonstrate parenting practices that may place some survivors at risk for adverse outcomes.

Effect and Process Evaluation of e-Powered Parents, a Web-Based Support Program for Parents of Children With a Chronic Kidney Disease: Feasibility Randomized Controlled Trial.

BackgroundParents of children with chronic kidney disease (CKD) experience high levels of stress in the daily management of their child’s illness. Parents need continuously available support and information, yet online support programs are lacking. e-Powered Parents was developed to fill this gap; it is an online program consisting of (1) medical information, (2) an interactive part, and (3) four training modules (stress management, setting limits, communication, and coping). Prior to a large-scale evaluation, we conducted a feasibility study that consisted of an effect study and a process evaluation.ObjectiveThe objectives of our study were to (1) identify the outcome measures that are most likely to capture the potential benefit, (2) evaluate the potential effectiveness and effect size, and (3) evaluate recruitment, reach, the dose received, and context.MethodsWe conducted a feasibility study with a two-armed, wait-list randomized controlled trial (RCT). Prior to baseline, parents (n=146) were randomly allocated to group 1 or group 2. After completing the baseline questionnaire, parents in group 1 were given access to e-Powered Parents, while those in group 2 received usual care. At the 6-month follow-up (T1), all parents received a questionnaire and parents in group 2 were given access to e-Powered Parents as well. After 1.5 years, through an extra measurement (T2), we evaluated the effect of long-term exposure. Outcomes were the child’s quality of life (Child Vulnerability Scale), parental stress (Pediatric Inventory for Parents) and fatigue (Multidimensional Fatigue Inventory), self-efficacy in communication with health care professionals (Perceived Efficacy in Patient-Physician Interactions, PEPPI-5), and parental perceptions of family management (Family Management Measure). Floor and ceiling effects and percentage of parents showing no change in scores were calculated. We used linear mixed models to evaluate the potential effectiveness and effect sizes using the intention-to-treat and per-protocol analyses. In the process evaluation, we evaluated recruitment, reach, the dose received, and context using a questionnaire sent to the parents, log-in data, and a focus group interview with health care professionals.ResultsAt T1 (n=86) and T2 (n=51), no significant effects were found on any of the five outcomes. The PEPPI-5 showed ceiling effects and high percentages of parents showing no change between the measurement times. The information and interactive part of the intervention were used by 84% (57/68) of the parents in group 1 and 49% (32/65) of the parents in group 2. The information pages were visited most often. Overall, 64% (85/133) of the parents logged in to the training platform and 31% (26/85) actually used the training modules.ConclusionsWe did not observe any significant effect on any of the outcomes. This could possibly be explained by the minimal use of the intervention and by parents’ heterogeneity. For continued participation, we recommend a tailored intervention and further studies to find out whether and how online programs could be used to support parents in the management of their child’s CKD.Trial RegistrationNetherlands Trial Registry NTR4808; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4808 (Archived by WebCite at http://www.webcitation.org/719rCicvW)

Parental perception of child vulnerability in childhood cancer survivors.

Parents' perception of their children's vulnerability to illness following cancer treatment is largely unknown, but is important to understand given known challenges of transitioning survivors to postcancer care. We investigated the frequency of and factors associated with perceived vulnerability by parents of childhood cancer survivors attending a regional survivorship clinic. This cohort study was offered to all parents of pediatric patients (currently≤18years) attending the Yale childhood cancer survivorship clinic January 2010 to October 2016 who were≥1 year postcurative cancer therapy. Participating parents (one per patient) completed the standardized Child Vulnerability Scale at the beginning of the clinic visit (cutoff score≥10 for perceived vulnerability). Patient sociodemographics, cancer history, and posttherapy complications were abstracted from medical records. Overall, 116 parents participated (98% participation rate) consisting of 89% mothers; survivors were 46% female, had a current mean age of 12.7±3.9years, and were a mean of 6.4±3.8years posttherapy. Twenty-eight percent (n=33) of parents perceived their children as vulnerable. Survivor sociodemographics (age, sex, race/ethnicity, family income, insurance, parental marital status, number of siblings), cancer diagnosis, years off-therapy, survivorship visit number, treatment intensity, and late complications (number, type, severity) were not associated with perception of vulnerability. A sizeable proportion of parents continue to perceive their children as vulnerable even years after cancer therapy completion independent of current health status or past cancer history. Our data suggest the need to educate all parents of childhood cancer survivors regarding health risk, including those at lower risk for late complications.

Parental perceptions of child vulnerability in a community-based sample: Association with chronic illness and health-related quality of life.

The study aimed to assess the prevalence of parental perceptions of a child's vulnerability (PPCV) in a Dutch community-based sample and its relationship with children's health and health-related quality of life (HRQoL). Parents completed the Child Vulnerability Scale and a socio-demographic questionnaire. The Pediatric Quality of Life Inventory 4.0 was administered to measure HRQoL. The prevalence of PPCV was assessed in relation to socio-demographic and health-related characteristics. In a three-step multiple hierarchical regression model, the mediational role of PPCV in the association between chronic illness and HRQoL was investigated. Participants were 520 Dutch children aged 5-18 years from nine Dutch schools. In all, 69 (13.3%) had a chronic illness; 1.9% was perceived vulnerable, 3.0% in groups 5-7 and 1.7% in groups 8-12 and 13-18. Younger age of the child, presence of a chronic illness and low HRQoL were associated with PPCV. PPCV partially mediated the negative association between chronic illness and HRQoL. In conclusion, PPCV is associated with adjustment to chronic illness. More research is needed regarding the mechanisms through which PPCV affects HRQoL and to examine whether PPCV can be targeted in parenting interventions.

Quality of life and behavioral functioning in Dutch pediatric patients with hereditary spherocytosis.

The objective of this study was to evaluate health-related quality of life (HRQoL) and behavioral functioning in pediatric patients with hereditary spherocytosis (HS). A cross-sectional study was conducted in 132 Dutch children and adolescents with HS and aged 8-18years of whom 48 underwent splenectomy prior to the study. HRQoL was assessed using the KIDSCREEN-27, and behavioral functioning was evaluated using the strength and difficulties questionnaire (SDQ). Scores of pediatric patients with HS were compared to a Dutch norm population. Additionally, the effects of three factors were assessed: fatigue, self-image, and parents' perceived vulnerability (measured with the checklist individual strength, the self-perception profile for children and adolescents, and the child vulnerability scale). Both unsplenectomised and splenectomised pediatric patients reported lower HRQoL on the domain physical well-being (KIDSCREEN-27) compared to Dutch peers. For behavioral functioning, parents of both groups reported more emotional problems (SDQ) compared to the norm population. Pediatric patients with lower scores on physical well-being experienced more fatigue. The patients' perceived social acceptance and parents' perceived vulnerability appeared as determinants of emotional problems. Pediatric patients in the current study generally report few complaints, and the results suggest that these patients overall have a strong ability to cope with HS. Despite these few complaints, fatigue and parents' perceived vulnerability seem to be important determinants for lower HRQoL and more emotional problems. Therefore, screening on these factors could serve as an addition to the treatment of HS, to help pediatric patients who are at risk for lower HRQoL or more emotional problems.

Health related quality of life and perceptions of child vulnerability among parents of children with a history of Kawasaki disease

Kawasaki disease (KD) is an acute paediatric vasculitis. The psychosocial consequences of this sudden illness for parents are unknown. This study aimed to evaluate health related quality of life (HRQOL) and parental perceptions of child vulnerability (PPCV) in parents of children with KD, and to identify variables associated with PPCV. This cross-sectional study included 288 parents (83% mothers) of KD patients (mean age 8.7years). HRQOL was assessed using the TNO-AZL Questionnaire for Adult's HRQOL (TAAQOL) and PPCV using the Child Vulnerability Scale (CVS). Scores of KD parents were compared with reference groups of Dutch parents. Logistic regression analyses were performed to examine associated variables. The HRQOL of KD parents was comparable to the HRQOL of parents of healthy children. However, KD parents showed significantly higher PPCV, regarding both the median CVS total score and the percentage in the clinical range. No differences were found in CVS outcomes between KD parents and parents of a chronically ill child. None of the studied parental, child and disease characteristics were significantly associated with PPCV. Parents perceived their KD child more vulnerable to illness than healthy children, while in reality the majority had fully recovered from KD.

An Examination of Parenting Capacity Variables and Child Adjustment Outcomes Across Socioeconomic Level in Pediatric Cancer

The objective of this article is to investigate how parenting capacities and child outcomes vary across different indexes of socioeconomic status (SES; e.g., composite vs. single dimension) in a sample of families of children with pediatric cancer. Parents provided demographic information for the Hollingshead Index of Social Position, the Parent Protection Scale (PPS), the Child Vulnerability Scale (CVS), the Parenting Stress Index/Short Form (PSI/SF), and the Behavior Assessment System for Children–Second Edition, Parent Rating Scale. Only the PPS differed by composite social status on the Hollingshead Index. Both the PPS and the PSI/SF varied as a function of lower parent education and family income, whereas the CVS was impacted only by lower parent education level. Child externalizing and internalizing problems were influenced only by lower family income. Results highlight the variability in parent and child adjustment outcomes based on the manner in which SES is measured in families of children with cancer.

부모의 양육태도가 유아 행동평가 척도에 미치는 영향 연구

Objectives The aim of this study was to explore the effect of parental attitude on the behavioral problems in children who visited the traditional Korean pediatrics clinic. Methods The subjects were consist of 190 outpatients (<TEX>$56.6{\pm}12.9$</TEX> months) and their mother. The Behavior problems of children were measured with Korean version of Child Behavior Checklist for Ages 1.5-5 (K-CBCL1.5-5) while parental perception of child vulnerability, parent overprotection, parenting stress were measured by Child Vulnerability Scale (CVS), Parent Protection Scale (PPS), Korean-Parenting Stress Index-Short Form scale (K-PSI-SF), respectively. Correlation and multiple regression were conducted for the analysis. Results Significant correlations between child total problems score and child vulnerability (r=.272, p<.001), parent overprotection (r=.243, p=.001), and parenting stress (r=.597, p<.001) were reported. Multiple regression analysis revealed that the parenting stress (<TEX>${\beta}$</TEX>=.548, p<.001) was a major predictor for the child behavior problems rather than child vulnerability and parent overprotection. Conclusions It was shown that the parenting stress has a significant influence on the emotional and behavioral development of children. These results can be useful for improving clinical diagnosis and treatment in traditional Korean pediatrics.

Parental perceptions of child vulnerability in parents of children with Kawasaki Disease

Abstracts ingediend voor het Amsterdam Kindersymposium 2013 Parental perceptions of child vulnerability in parents of children with Kawasaki Disease Hedy A. van Oers MSc (1), Carline E. Tacke MD (2), Lotte Haverman MSc (1), Heleen Maurice-Stam PhD (1), Taco W. Kuijpers MD PhD (2), Martha A. Grootenhuis PhD (1) (1) Psychosocial Department, Emma Children’s Hospital, AMC.(2) Department of Pediatric Hematology, Immunology and Rheumatology, Emma Children’s Hospital, AMC. INTRODUCTION Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that predominant-ly aff ects children <5 years. 25% of untreated patients develops coronary artery aneurysms (CAA). Studies evaluating the long-term impact of the acute KD episode are scarce. The aim of this abstract is to evaluate parental perceptions of child vulnerability (PPCV) in parents of children with a history of KD. METHODS A cross-sectional study was conducted in parents (82% mothers) of 288 KD patients (mean 8.6 years). PPCV was assessed using the Child Vulnerability Scale (CVS). PPCV scores of KD parents were compared to parents of healthy and chronically ill children (Chi2). PPCV scores of parents of KD patients with and without CAA were compared (Chi2) and the correlation between PPCV and time since KD onset was calculated (Spearman’s rho).

School Attendance in Childhood Cancer Survivors and Their Siblings

To investigate school absenteeism among childhood cancer survivors and their siblings and examine factors related to absenteeism in survivors. A cross-sectional study was conducted among consecutive cancer survivors attending a large pediatric cancer survivor clinic. Absenteeism rates were obtained for survivors and their closest in age sibling from school report cards. Absenteeism was compared with a population control group of 167752 students using 1-sample t tests. The Child Vulnerability Scale, Pediatric Quality of Life Inventory, and Behavior Assessment System for Children were administered to survivors. Univariate and multiple regression analyses assessed variables associated with days absent. One hundred thirty-one survivors (median age at assessment: 13.4 years, range 8.0-19.2; median age at diagnosis: 9.4 years, range 4.3-17.3) and 77 siblings (median age at assessment: 13 years, age range 7-18) participated. Survivors and siblings missed significantly more school days than the population control group (mean ± SD: 9.6 ± 9.2 and 9.9 ± 9.8 vs 5.0 ± 5.6 days, respectively, P < .0001). Among matched survivor-sibling pairs (N = 77), there was no difference in absenteeism (9.6 ± 9.2 vs 9.9 ± 9.8 days, P = .85). Absenteeism in survivors was significantly associated with a low Pediatric Quality of Life Inventory Physical Health Summary Score (P = .01). Parents' perception of their child's vulnerability and emotional and social functioning were not associated with absenteeism. Childhood cancer survivors and siblings miss more school than the general population. The only predictor of absenteeism in survivors is poor physical quality of health. More research should be devoted to school attendance and other outcomes in siblings of childhood cancer survivors.

The Relationship of Father Parenting Capacity Variables to Perceived Uncertainty in Youth With a Chronic Illness

This study examined the relationship between father parenting capacity variables and youth illness uncertainty. Thirty-seven youth (ages 8–18) with a chronic illness and their fathers participated. Fathers completed the Parenting Stress Index–Short Form, the Child Vulnerability Scale, and the Parent Protection Scale, and the youth completed the Children's Uncertainty in Illness Scale. Regression analyses indicated that father-reported parenting stress and child vulnerability was associated with youth-reported illness uncertainty. Paternal overprotection was not related to uncertainty. Results address a gap in the pediatric chronic illness literature, and suggest that the influences of fathers' parenting characteristics are important to understanding youth adjustment to chronic illness.