The impact of a child's inborn error of metabolism: the parents' perspectives on restrictions, discrimination, family planning, and emergency management.

Autor: Harings T; Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, 04103, Leipzig, Germany., Neininger MP; Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, 04103, Leipzig, Germany., Eisenhofer S; Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, 04103, Leipzig, Germany., Thiele AG; Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstrasse 20a, 04103, Leipzig, Germany., Kiess W; Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstrasse 20a, 04103, Leipzig, Germany., Bertsche A; Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstrasse 20a, 04103, Leipzig, Germany.; Division of Neuropediatrics, University Hospital for Children and Adolescents, Ferdinand-Sauerbruch-Strasse 1, 17475, Greifswald, Germany., Bertsche T; Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, 04103, Leipzig, Germany. thilo.bertsche@uni-leipzig.de., Beblo S; Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstrasse 20a, 04103, Leipzig, Germany.; Center for Rare Diseases, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany.
Jazyk: angličtina
Zdroj: Orphanet journal of rare diseases [Orphanet J Rare Dis] 2024 Aug 26; Vol. 19 (1), pp. 313. Date of Electronic Publication: 2024 Aug 26.
DOI: 10.1186/s13023-024-03315-6
Abstrakt: Background: To investigate the impact of children's inborn error of metabolism (IEMs) on the children's and their parents' lives from the parents' perspective. We focused on disease-related restrictions in various issues of daily life, experienced discrimination, parental family planning, and management of metabolic emergencies.
Methods: We conducted a questionnaire-based survey with 108 parents of 119 children with IEM who attended a metabolic outpatient clinic. The children were categorized into 4 cohorts, based on increasing disease severity (cohort 1: IEMs with lowest severity, cohort 4: IEMs with highest severity), and compared by using Tobit regressions.
Results: The severity of the child's IEM was associated with an increase in the intensity of perceived restrictions from the parents' perspective for themselves and their children in all aspects of life: in general, in contact with friends, in the pursuit of hobbies, in childcare/school/occupation, and due to emotional stress. The highest intensity of restrictions in all cohorts was found for the parents themselves in contact with friends (compared to cohort 1: cohort 2: c. 3.556, p = 0.002; cohort 3: c. 4.159, p = 0.003; cohort 4: c. 7.224, p < 0.001). Parents of 8% of children reported that their children were discriminated against because of IEM, with the highest proportion of affected children (43%) in cohort 4. Parental family planning decisions were influenced in 34% of parents, with fear of recurrence being a predominant aspect. Of the parents of children diagnosed with IEMs associated with metabolic emergencies, 68% stated that they felt well or very well prepared for the occurrence of a metabolic emergency, and 100% of parents were able to name the necessary action steps from memory. Nevertheless, 58% stated that they experienced an occurring emergency as rather or very stressful.
Conclusions: From the parents' perspective, the intensity of restrictions increased with the severity of the child's IEM. The study shows the high impact of IEM on parents of children with IEM and the daily challenges they face. These findings emphasize the importance of comprehensive support for parents of children with IEM.
(© 2024. The Author(s).)
Databáze: MEDLINE
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