Browsing by Author "Martinez, Dailyn"
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Item Impact of Psychological Variables on Health Status Over Time in Adolescents With Inflammatory Bowel Disease(2014-07-25) Martinez, Dailyn; Donewar, Crista W.; Iteld, Lily; Patel, Ashish; Reed, Gabriela; Stewart, Sunita M.The relationship between psychological factors and health outcomes over time in adolescents with Inflammatory Bowel Disease (IBD) is complex. The pediatric IBD literature with respect to these relationships is limited, yet the broader IBD and health psychology literatures offer clues as to the negative impact of alexithymia, depressive symptoms, and stress on health status and health care utilization. Studies have revealed higher rates of alexithymia in adult IBD populations, which in turn has been associated with worse emotional functioning and lower quality of life (QOL). Depression has been associated with worse disease status in children with IBD, but this relationship requires additional exploration, as it remains equivocal. In the adult IBD literature, stress has been associated with disease relapse and avoidant coping. Our study sought to understand the relationship between these psychological factors, health status as determined by disease severity, and health care utilization (i.e., outpatient GI visits, ED visits, nights hospitalized, and time to medical care) over the course of 3 months and 12 months after baseline. Our study revealed correlations between disease severity and age, race, and ethnicity. However, no associations emerged between disease severity and our psychological factors of interest. Conversely, significant associations emerged between our health care utilization variables and psychological factors. For instance, stress was predictive of nights hospitalized over the course of 3 months post-baseline while both alexithymia and depressive symptoms emerged as significantly predictive of number of nights hospitalized over the course of 12 months. Additionally, increasing depressive symptoms were associated with shorter time to hospitalization post-baseline. These results highlight the complex and important relationship between psychological factors and markers of health outcome, and the importance of continuing research efforts to elucidate the mechanisms underlying these relationships. Ultimately, clearer understanding of these dynamics has important implications for pediatric IBD patients and the providers who treat them.Item Longitudinal Analysis of Changes in Facial Asymmetry and Quality of Life in Patients with Cleft Lip and/or Palate(2017-07-28) Hamill, Lillian Clare; Heppner, Celia; Stewart, Sunita M.; Kane, Alex; Martinez, Dailyn; Donewar, Crista W.Previous research has suggested that youth diagnosed with cleft lip and/or palate (CL/P) with more visible facial differences may report lower quality of life than those with less visible facial differences. Three-dimensional imaging has been identified as a reliable and accurate measurement of facial difference; however, use of objective measurement of facial differences in the literature on psychosocial outcomes in the CL/P population is lacking (Mosmuller et al., 2013). This study utilized three-dimensional imaging technology to explore the relationship between nasolabial asymmetry, appearance satisfaction, and patient-rated quality of life cross-sectionally and longitudinally. Data were collected for 120 pediatric patients (74 with follow up visit) with orofacial cleft diagnoses seen in a multidisciplinary craniofacial team clinic between March 2013 and March 2017. Path analyses were conducted to examine the model and results demonstrated that nasolabial asymmetry did not predict appearance satisfaction or quality of life at either time point after controlling for age, sex, and speech therapy status. However, appearance satisfaction was a significant predictor of improvement in quality of life from T1 to T2. Findings suggest that appearance satisfaction may play a major role and may be meaningful in predicting quality of life outcomes, independent of measured facial asymmetry.