Maria Cristina Murano1, Matthew M Feldt2, John D Lantos3. 1. Bioethics Center, Children's Mercy Kansas City, Kansas City, MO. Electronic address: maricri88@gmail.com. 2. Endocrinology and Diabetes Clinic, Children's Mercy Kansas City, Kansas City, MO; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO. 3. Bioethics Center, Children's Mercy Kansas City, Kansas City, MO; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
Abstract
OBJECTIVES: To compare parental attitudes about short stature over time and determine possible factors that predict changes in attitudes. STUDY DESIGN: At baseline (1993-1994), we surveyed parents about their attitudes regarding their children's height. We compared parents of children (aged 4-15 years) referred to endocrinologists (referred, 154) with those of children with heights <10th percentile seen by pediatricians during regular visits (control, 240). At follow-up (2008-2009), 103 control and 98 referred parents completed a similar survey. We then made a logistic regression analysis to observe changes in perception. Primary variables included self-esteem, treatment by peers, and ability to cope with current height. RESULTS: At baseline, referred parents perceived a worse impact of short stature on their children than did controls. At follow-up, instead, referred parents were 3.8 times more likely to report improvement in self-esteem, 2.4 times more likely to report improved treatment from peers, and 5.7 times more likely to report overall ability to cope with height than were unreferred parents. Perception of psychosocial improvement was greater in the referred than the control group. Referral was a stronger predictor of an improved follow-up response than patients' current height or change in height. CONCLUSIONS: While incorporating parental attitudes into management decisions, clinicians should be aware that parental perceptions may change over time and that referral itself may lead parents to perceive psychosocial improvements over time.
OBJECTIVES: To compare parental attitudes about short stature over time and determine possible factors that predict changes in attitudes. STUDY DESIGN: At baseline (1993-1994), we surveyed parents about their attitudes regarding their children's height. We compared parents of children (aged 4-15 years) referred to endocrinologists (referred, 154) with those of children with heights <10th percentile seen by pediatricians during regular visits (control, 240). At follow-up (2008-2009), 103 control and 98 referred parents completed a similar survey. We then made a logistic regression analysis to observe changes in perception. Primary variables included self-esteem, treatment by peers, and ability to cope with current height. RESULTS: At baseline, referred parents perceived a worse impact of short stature on their children than did controls. At follow-up, instead, referred parents were 3.8 times more likely to report improvement in self-esteem, 2.4 times more likely to report improved treatment from peers, and 5.7 times more likely to report overall ability to cope with height than were unreferred parents. Perception of psychosocial improvement was greater in the referred than the control group. Referral was a stronger predictor of an improved follow-up response than patients' current height or change in height. CONCLUSIONS: While incorporating parental attitudes into management decisions, clinicians should be aware that parental perceptions may change over time and that referral itself may lead parents to perceive psychosocial improvements over time.
Authors: Adda Grimberg; Sara A DiVall; Constantin Polychronakos; David B Allen; Laurie E Cohen; Jose Bernardo Quintos; Wilma C Rossi; Chris Feudtner; Mohammad Hassan Murad Journal: Horm Res Paediatr Date: 2016-11-25 Impact factor: 2.852
Authors: Leona Cuttler; Detelina Marinova; Mary Beth Mercer; Alfred Connors; Rebecca Meehan; J B Silvers Journal: Med Care Date: 2009-08 Impact factor: 2.983