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Dennis Drotar

Publications and source records attributed to Dennis Drotar.

69 records · Page 4Linked to original sources
PubMed2002

Parental report of health-related quality of life in children with sickle cell disease.

Health-related quality of life (HRQOL) of youths with sickle cell disease (SCD) has not been described, despite the psychosocial and physical consequences associated with the disease. We compared the HRQOL of 58 children with SCD to a demographically similar sample of 120 healthy children and examined predictors of HRQOL. Child HRQOL was assessed using the Child Health Questionnaire--Parent Report Form. Review of medical charts of children with SCD provided data on disease-related complications. Results demonstrated that caregivers of children with SCD reported that their children had more limited physical, psychological, and social well-being than healthy children. Older child age, female gender, and more disease-related complications predicted limitations in the physical health of children with SCD. The findings indicated that SCD significantly affects the HRQOL of youths. Certain subgroups of patients (e.g., children with more disease complications) may benefit from interventions specifically designed to improve their physical functioning.

Adolescent↗
PubMed2002

A prospective study of short- and long-term outcomes after traumatic brain injury in children: behavior and achievement.

Longitudinal behavior and achievement outcomes of traumatic brain injury (TBI) were investigated in 53 children with severe TBI, 56 children with moderate TBI, and 80 children with orthopedic injuries not involving brain insult. Measures of preinjury child and family status and of postinjury achievement skills were administered shortly after injury. Assessments were repeated 3 times across a mean follow-up interval of 4 years. Results from mixed model analysis revealed persisting sequelae of TBI. Recovery of math skills was observed in the severe TBI group but only for children from less stressed families. Social disadvantage in children with TBI predicted more adverse behavioral sequelae and less favorable changes in some outcome measures. The findings suggest that pediatric TBI has long-term effects on behavior and achievement but that postinjury progress is influenced by the family environment.

Achievement↗
PubMed2002

A prospective study of short- and long-term neuropsychological outcomes after traumatic brain injury in children.

Longitudinal neuropsychological outcomes of traumatic brain injury (TBI) were investigated in 53 children with severe TBI, 56 children with moderate TBI, and 80 children with orthopedic injuries only. Neuropsychological functioning was assessed at baseline, at 6- and 12-month follow-ups, and at an extended follow-up (a mean of 4 years postinjury). Mixed model analyses revealed persistent neuropsychological sequelae of TBI that generally did not vary as a function of time postinjury. Some recovery occurred during the first year postinjury, but recovery reached a plateau after that time, and deficits were still apparent at the extended follow-up. Further recovery was uncommon after the first year postinjury. Family factors did not moderate neuropsychological outcomes, despite their demonstrated influence on behavior and academic achievement after childhood TBI.

Brain Injuries↗
PubMed2002

Enhancing reviews of psychological treatments with pediatric populations: thoughts on next steps.

OBJECTIVE: To critique the approach used by the Journal of Pediatric Psychology for reviews of empirical support for psychological treatments and provide recommendations to enhance the scientific review of interventions. METHODS: Application of the Chambless et al. (1996, 1998) criteria to select and describe empirically supported treatments was evaluated from the standpoint of method, theory, and clinical significance. RESULTS: While reviews of treatments based on the Chambless et al. (1996, 1998) criteria have provided valuable information, they are limited by reliance on statistical significance rather than effect sizes and also need to consider systematically the theoretical and clinical significance of intervention findings. CONCLUSIONS: Reviews of psychological treatments conducted with pediatric populations would be enhanced by inclusion of information concerning effect sizes, theory specification, and clinical significance. In addition, broadening the focus of initial reviews to include meta-analyses, clinical significance, and theory-guided interventions would enhance the scientific knowledge base of psychological interventions with pediatric populations.

Adolescent↗
PubMed2002

Race as a moderator of parent and family outcomes following pediatric traumatic brain injury.

OBJECTIVE: To use data from a prospective, longitudinal study to determine whether race moderates parent and family outcomes during the first year following pediatric traumatic brain injuries (TBI). METHOD: Participants included 73 white and 18 black children with moderate to severe TBI and their families, and 32 white and 23 black children with orthopedic injuries only (OI) and their families. Assessments of parent and family functioning occurred shortly after injury (baseline) and at 6- and 12-month follow-ups. RESULTS: Race was a significant moderator of group differences in parental psychological distress and perceived family burden, by and large independent of socioeconomic status. The negative consequences of TBI were relatively less pronounced for parents of black children than for parents of white children at baseline, but became more pronounced at the two follow-ups. Black and white parents differed in preferred coping strategies, which may partially account for their different reactions to their children's injuries. CONCLUSIONS: The sociocultural factors associated with race may moderate the effects of pediatric TBI and OI on parents and families.

Adaptation, Psychological↗
PubMed2002

A prospective study of long-term caregiver and family adaptation following brain injury in children.

OBJECTIVE: We examined long-term differences in family adaptation following traumatic brain injuries (TBI) and orthopedic injuries. DESIGN: Families of children with severe TBI (n = 53), moderate TBI (n = 56), and orthopedic injuries (n = 80) were assessed at baseline, 6 months, and 12 months post injury and at an extended follow-up an average of 4.1 years post injury. Caregiver and family outcomes were examined using mixed model analysis. RESULTS: Patterns of adaptation over time varied across groups but indicated long-standing injury-related stress and burden in the severe TBI group. CONCLUSIONS: Severe TBI results in persistent caregiver stress for a substantial proportion of families.

Adaptation, Psychological↗
PubMed2002

Health-related quality of life of children and adolescents after traumatic brain injury.

OBJECTIVE: Relatively little is known about the longer-term impact of traumatic brain injury (TBI) on children's daily functioning, especially the broader outcome domain referred to as health-related quality of life (HRQL). The objective of the present study was to examine the nature and predictors of HRQL outcomes in children with moderate to severe TBI an average of 4 years postinjury. METHODS: The study used a concurrent cohort-prospective design involving postinjury assessments of 3 groups of traumatically injured children and their families including 42 with severe TBI, 42 with moderate TBI, and 50 with orthopedic injuries only. Parent and child perceptions of HRQL and child adaptive behavior measures were obtained along with parent descriptions of the child's health problems and use of medical and mental health services. Predictors included indices of injury severity, social factors, and ratings of preinjury child behavior problems and school performance. RESULTS: Based on parent report, adolescents who sustained severe TBI had lower HRQL related to overall psychosocial functioning and in the domains of behavior, mental health, general health, and family impact than adolescents who sustained orthopedic injuries only. Communication skills, daily living skills, and general adaptive functioning also were rated lower in the severe TBI group. In contrast to parent reports, adolescents with severe TBI did not rate their HRQL in most domains differently than did adolescents with orthopedic injuries. There were no group differences in frequency of persistent physical limitations. Sixty-seven percent of families of children with severe TBI used mental health counseling at some point after the injury. Risks for poorer HRQL outcomes were related to family social disadvantage and poorer preinjury child behavioral and academic functioning. CONCLUSIONS: Findings underscore the importance of using comprehensive measures of HRQL, along with traditional indicators of functional outcomes, when evaluating the longer-term impact of injuries in children. Identification of predictors suggests the need for close monitoring and intervention of high-risk children.

Adolescent↗
PubMedDate not supplied

Social support, knowledge, and self-efficacy as correlates of osteoporosis preventive behaviors among preadolescent females.

OBJECTIVE: To develop and test a model based on Bandura's social cognitive theory to predict healthy lifestyle behaviors for the prevention of osteoporosis. METHODS: Participants were 354 girls, ages 8-11 years, recruited from area Girl Scout troops. Baseline data from a randomized trial of behavioral interventions are presented. Measures of social support, knowledge, self-efficacy, dietary calcium intake, and weight-bearing physical activity (WBPA) were obtained via interviews and self-administered questionnaires. RESULTS: A structural equation model was tested and fit the data well. Family social support, perceived self-efficacy for eating a calcium-rich diet, and knowledge of WBPA significantly predicted calcium intake. Friend and family support for exercise predicted WBPA. Self-efficacy partially mediated the relationship between family support and calcium intake, as confirmed by Holmbeck's post-hoc probing strategy (2002). CONCLUSIONS: Suggestions are made for primary prevention interventions such as parent and peer involvement, health education, and problem-solving training.

Child↗
PubMedDate not supplied

Association of observed family relationship quality and problem-solving skills with treatment adherence in older children and adolescents with cystic fibrosis.

OBJECTIVE: To examine associations between observations of the quality of family relationships and problem-solving skills and reported adherence to medical treatments for older children and adolescents with cystic fibrosis (CF). METHODS: Reports of adherence were obtained from 96 youth with CF and their parents recruited from six CF centers in the Midwest and southeastern United States. Videotaped observations of family discussions of high conflict issues were used to assess quality of relationships and problem-solving skills. RESULTS: Hierarchical regression analyses indicated that observed family relationship quality (RQ) was related to parent and child reports of adherence to airway clearance and aerosolized medications after controlling for demographic variables and illness severity. Observed family problem solving was not a significant predictor after controlling for RQ. CONCLUSIONS: Older children and adolescents who come from families experiencing unhappy and conflicted relationships may be at greater risk for poor adherence to treatments; thus, family relationships are appropriate targets for interventions aimed at improving adherence.

Adolescent↗
PubMedDate not supplied

Parent-adolescent interactions after traumatic brain injury: their relationship to family adaptation and adolescent adjustment.

OBJECTIVE: To examine changes in parent-adolescent interactions after traumatic brain injury (TBI) and their relationship to parent and adolescent adjustment. DESIGN: Concurrent cohort, cross-sectional study. Analysis of variance was used to examine group differences and regression analysis to assess associations between interactional measures and concurrent adjustment. SETTING: Four hospitals in north-central Ohio. PARTICIPANTS: Adolescents with severe TBI (25), moderate TBI (22), and orthopedic injuries (35) and their parents. MAIN OUTCOME MEASURES: Observer ratings of parent-adolescent interactions, Conflict Behavior Questionnaire (CBQ), Family Burden of Injury Interview (FBII), Brief Symptom Inventory (BSI), Family Assessment Device (FAD), Child Behavior Checklist, Vineland Adaptive Behavior Scale, and Children's Depression Inventory. RESULTS: No group differences were found on ratings of parent-adolescent interaction or the parent or child CBQ. However, observed criticism/coldness and self-rated conflict had stronger associations with the FBII, BSI, and FAD in the severe TBI group than in the orthopedic injury group, suggesting that conflict is more disruptive after TBI. Ratings of criticism/coldness and parent and adolescent CBQ scores were also associated with parent and adolescent adjustment. CONCLUSIONS: Results support the utility of observational measures in assessing dyadic interactions after TBI.

Adaptation, Psychological↗
PubMedDate not supplied

Validating measures of pediatric health status, functional status, and health-related quality of life: key methodological challenges and strategies.

OBJECTIVE: To describe key methodological challenges in the validation of measures of pediatric health status, functional status, and health-related quality of life (HRQOL) and ways to address them. METHODS: Validation strategies of measures of pediatric health status, functional status, and HRQOL were reviewed. RESULTS: Three key challenges were identified: 1) clarifying and testing measurement models; 2) measuring responsiveness to clinically meaningful change; and 3) considering data from multiple respondents. CONCLUSIONS: Research strategies to enhance validity of measures include specifying intended validity and measurement models, documenting sensitivity of measures to clinically meaningful change, and considering data from multiple informants.

Child↗