PMID- 34083326
OWN - NLM
STAT- MEDLINE
DCOM- 20210618
LR  - 20210619
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 6
DP  - 2021 Jun 3
TI  - Cognitive development of children with Kawasaki disease and the parenting stress 
      of their caregivers in Taiwan: a case-control study.
PG  - e042996
LID - 10.1136/bmjopen-2020-042996 [doi]
LID - e042996
AB  - OBJECTIVE: Kawasaki disease (KD) is an acute form of febrile vasculitis that 
      occurs in early childhood. The multisystemic vasculitis common in patients with 
      KD may influence blood perfusion in the brain, and thus caregivers of children 
      with KD may feel stress with regard to caring for them. Intravenous 
      immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the 
      most serious complication of KD is coronary artery aneurysms (coronary artery 
      lesion (CAL)). This study aimed to investigate the relationships between KD 
      heterogeneity and the risk of patients' cognitive impairment or caregivers' 
      parenting stress. DESIGN: A case-control study with consecutive sampling. 
      SETTING: A medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan). 
      PARTICIPANTS: This study consisted of 176 patients with KD (mean age: 5.5 years, 
      60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys). PRIMARY 
      AND SECONDARY OUTCOME MEASURES: Based on the children's age, each patient with KD 
      and control subject was administered an assessment using the Mullen Scales of 
      Early Learning or the Wechsler Intelligence Scale, and parenting function of 
      their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form. 
      RESULTS: We observed no significant differences in any developmental index, 
      cognitive function or parenting stress between patients with KD and controls. 
      Among the children with KD, IVIG administration nor CAL was associated with 
      children's cognitive scores. However, the caregivers of patients who had CAL 
      suffered from greater PSI total scores than those of patients without CAL. 
      Furthermore, the caregivers who had education levels of a master's degree or 
      above showed less parenting stress than those who had an education level of 
      college or lower. CONCLUSION: Caregivers' education is associated to parenting 
      stress, and caregivers of patients with KD who developed CAL may feel stress 
      about the unpredictable sequela caused by CAL for their children. Such caregivers 
      may require support to fulfil their parenting roles.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Wang, Liang-Jen
AU  - Wang LJ
AUID- ORCID: 0000-0002-5320-1151
AD  - Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial 
      Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, 
      Kaohsiung, Taiwan.
FAU - Tsai, Zi-Yu
AU  - Tsai ZY
AD  - Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Chang, Ling-Sai
AU  - Chang LS
AD  - Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Kuo, Ho-Chang
AU  - Kuo HC
AD  - Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan erickuo48@yahoo.com.tw.
AD  - Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital and 
      Chang Gung University College of Medicine, Kaohsiung, Taiwan.
AD  - Chang Gung University College of Medicine, Kaohsiung, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210603
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Caregivers
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Cognition
MH  - *Coronary Artery Disease
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous
MH  - Male
MH  - *Mucocutaneous Lymph Node Syndrome/complications
MH  - Parenting
MH  - Taiwan/epidemiology
PMC - PMC8183223
OTO - NOTNLM
OT  - community child health
OT  - developmental neurology & neurodisability
OT  - immunology
OT  - paediatric cardiology
COIS- Competing interests: None declared.
EDAT- 2021/06/05 06:00
MHDA- 2021/06/22 06:00
PMCR- 2021/06/03
CRDT- 2021/06/04 06:06
PHST- 2021/06/04 06:06 [entrez]
PHST- 2021/06/05 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2021/06/03 00:00 [pmc-release]
AID - bmjopen-2020-042996 [pii]
AID - 10.1136/bmjopen-2020-042996 [doi]
PST - epublish
SO  - BMJ Open. 2021 Jun 3;11(6):e042996. doi: 10.1136/bmjopen-2020-042996.