Dorella Scarponi

Background: The transition from pediatric to adult care represents a critical phase for adolescents with chronic kidney disease (CKD), potentially affecting both clinical management and psychological well-being. This study aimed to evaluate anxiety and depressive symptoms in adolescents with CKD undergoing a structured transition program and to identify clinical and demographic predictors of psychological distress. Psychological outcomes were also compared with those of a healthy age- and sex-matched control group. Methods: A cross-sectional monocentric study was conducted at the Pediatric Nephrology and Dialysis Unit of IRCCS Azienda Ospedaliero-Universitaria di Bologna—Policlinico di Sant’Orsola, Bologna, Italy. The study included 93 adolescents and young adults with kidney disorders (mean age 17.4 ± 1.4 years) enrolled in a structured transition program. Psychological assessment was performed using BDI-II and STAI-S and T. A healthy control group ( n = 186) was selected using propensity score matching (1:2 ratio) based on age and sex. Statistical analyses included t-tests, ANOVA, and multivariate linear regression models. Results: Most patients reported minimal depressive symptoms, whereas clinically significant anxiety was observed in approximately one-third of the cohort. Psychological distress was not associated with clinical indicators such as eGFR, disease duration, or clinical complexity. However, higher daily medication dosing frequency and female sex emerged as significant predictors of increased anxiety and depressive symptoms. Unexpectedly, healthy controls reported higher levels of depression and trait anxiety than patients. Conclusions: Medication burden and sex, rather than eGFR, emerged as the primary predictors of psychological distress. Interestingly, patients exhibited lower anxiety and depression levels than their healthy peers, suggesting that intensive family and clinical care support, such as a structured clinical transition program, may act as a protective buffer.

Background/Objectives: Art therapy is a psychotherapeutic technique that involves the creation of tangible visual arts and represents a coping strategy to support children with cancer. Evaluating the effects of such activities on children with cancer is essential for providing evidence of the value that creativity holds within healthcare systems. A dedicated tool for assessing the creative process is the Arts Observational Scale (ArtsObS), focusing on mood and emotional states as key indicators of psychosocial well-being. This study aims to validate a translated version of the ArtsObS in the Italian language. Methods: The translation process followed recommendations for translation and cultural adaptation. The distribution properties of the scores, internal consistency, sensitivity to change, reliability, and convergent validity were assessed through observations conducted by two different evaluators. Results: The ArtsObS in its Italian adaptation is proven to be an adequate tool for capturing changes following an intervention, with good internal consistency and low sensitivity to differences between operators. The analysis supports the reliability of the ArtsObS across different observers. Conclusions: The Italian ArtsObS is a valid and reliable instrument for evaluating the impact of art therapy on pediatric patients’ mood and emotional states. It provides a standardized tool for clinical and research settings to assess creative interventions in pediatric oncology.

Background: Music Therapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients’ physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer. Methods: The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound–musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization. Fifty patients admitted to the Paediatric Oncology and Haematology Unit at Policlinico S. Orsola Hospital in Bologna, Italy, were enrolled, irrespective of their treatment regimen. Data collection occurred on the first day of the MT session between 3 p.m. and 5 p.m., with observations conducted by independent observers. In addition to traditional statistical analysis, network analysis was used to explore the combined interactions of all parameters, effectively discerning the distinctive roles played by each one during therapy sessions and their influence on all others. Results: Network analysis highlighted distinct patterns of interactions among parameters during the various sessions, emphasizing the role of positive emotions and a calm setting, the child’s ability to take the initiative in sessions, their sense of agency, and the parent’s role in guiding them. Significant differences were recorded at each time point between all variables considered. Conclusions: The results of this innovative study may pave the way for future multicenter studies aimed at further exploring the role of MT in children undergoing both curative and palliative treatments for cancer.

Background: Pediatric cancer presents mental and physical challenges for patients and their caregivers. However, parental distress has been understudied despite its negative impact on quality of life, disability, and somatic disorders. Parents of oncopediatric patients experience high levels of suffering with their resilience tested throughout their children’s illness. Identifying at-risk parents and offering specific treatments is crucial and urgent to prevent or alleviate negative outcomes. Methods: This study used statistical and network analyses to examine symptom patterns assessed by the Kellner Symptom Questionnaire in 16 fathers and 23 mothers at different time points: diagnosis, treatment, and discharge. Results: The results indicated significantly higher distress levels in parents of oncopediatric children compared to the control reference population. Gender-specific differences in symptom profiles were observed at each time point, and symptoms showed a gradual but non-significant decrease over time. Conclusions: The network analysis yielded valuable insights that, when applied in clinical practice, can guide the implementation of timely treatments to prevent and manage parental distress, thus addressing long-term, stress-related issues in primary caregivers of children diagnosed and treated for cancer.

Severe acute behavioral and emotional problems represent one of the most serious treatment-related adverse effects for children and adolescents who have cancer. The critical and severe nature of these symptoms often makes necessary the use of psychotropic drugs. A working group composed of experts in multiple disciplines had the task of creating an agreement regarding a management plan for severe acute behavioral and emotional problems (SABEPs) in children and adolescents treated for cancer. To obtain global information on the use of psychotropic drugs in pediatric oncology, the working group first developed and mailed a 15-item questionnaire to many Italian pediatric oncology centers. Overall, an evident lack of knowledge and education regarding the use of psychotropic medications for the treatment of SABEPs was found. Thus, by referring to an adapted version of the Delphi method of consensus and standard methods for the elaboration of clinical questions (PICOs), the working group elaborated evidence-based recommendations for psychotropic drugs in the pediatric oncology setting. Furthermore, based on a thorough multivariate analysis of needs and difficulties, a comprehensive management flow was developed to optimize therapeutic interventions, which allows more accurate and efficient matching of the acute needs of patients while guiding treatment options.

Article: Parental stress in the relationship with children affected by chronic hematological disease - Minerva Pediatrica 2020 Nov 11 - Minerva Medica - Journals

Play therapy to control pain and suffering in paediatric oncology.

The Italian Consensus Conference on clinical management of atopic dermatitis in children reflects the best and most recent scientific evidence, with the aim to provide specialists with a useful tool for managing this common, but complex clinical condition. Thanks to the contribution of experts in the field and members of the Italian Society of Pediatric Allergology and Immunology (SIAIP) and the Italian Society of Pediatric Dermatology (SIDerP), this Consensus statement integrates the basic principles of the most recent guidelines for the management of atopic dermatitis to facilitate a practical approach to the disease. The therapeutical approach should be adapted to the clinical severity and requires a tailored strategy to ensure good compliance by children and their parents. In this Consensus, levels and models of intervention are also enriched by the Italian experience to facilitate a practical approach to the disease.

Résumé Dix années d’animation — d’inspiration psychanalytique — de groupes de parents dont un enfant est atteint de cancer permettent de retracer les différents rôles des animateurs psychologues selon qu’ils étaient internes ou externes à l’institution. Parents « experts » et coleaders (coanimateurs du groupe), groupe saturé en lamentations et perdant toute capacité d’élaboration de la pensée, groupe projectif, excluant le psychologue extérieur à l’institution, rôles des pères et des mères : nous abordons, dans cet article, l’expérience subjective des animateurs et leurs techniques d’animation face aux parents confrontés aux fortes vagues émotionnelles qui tournent autour du thème de la mort de leur enfant.