{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:23:41Z","timestamp":1760059421197,"version":"build-2065373602"},"reference-count":52,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:00:00Z","timestamp":1749945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The Distress Thermometer for Parents represents an excellent tool for the rapid assessment of emotional distress in parents of children with a variety of chronic diseases. This study aimed to evaluate the efficacy of the Distress Thermometer for Parents in assessing emotional distress in parents and caregivers of children with feeding and swallowing difficulties feeding swallowing disorders or, dysphagia, in the Greek Cypriot community. Methods: It involved 200 Greek Cypriot participants: 100 parents\/caregivers of children with FSD and 100 parents\/caregivers of children without such difficulties. Demographic and clinical data were collected and test\u2013retest reliability was evaluated. Results: The DT-P demonstrated excellent reliability (Cronbach\u2019s \u03b1 = 0.928) and strong test\u2013retest consistency (r = 1.00, p &lt; 0.001). ROC analysis showed strong discrimination for detecting distress, with an AUC of 0.76 for parents of children under 24 months and 0.77 for parents of children over 2 years (p &lt; 0.01). Parents reported a medium level of distress (M = 3.67, SD = 2.89), with \u201cEmotional Problems\u201d (M = 2.03, SD = 2.28) and \u201cPractical Problems\u201d (M = 1.79, SD = 2.12) contributing most significantly. Independent t-tests revealed significantly higher distress levels in parents in the clinical group compared to the parents in the typical group (p &lt; 0.001), confirming the DT-P\u2019s sensitivity and validity. Conclusions: The Greek version of the DT-P is a reliable and valid tool assessing distress in parents of children with PFD. This study highlights significantly higher distress levels in these parents compared to those of typically developing children, emphasizing the need for targeted support.<\/jats:p>","DOI":"10.3390\/jcm14124260","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T06:40:27Z","timestamp":1750056027000},"page":"4260","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Greek Version of the Distress Thermometer for Parents of Children with Dysphagia: A Validation Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Andri","family":"Papaleontiou","sequence":"first","affiliation":[{"name":"Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8002-8825","authenticated-orcid":false,"given":"Vassiliki","family":"Siafaka","sequence":"additional","affiliation":[{"name":"Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3754-2466","authenticated-orcid":false,"given":"Louiza","family":"Voniati","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Speech and Language Therapy, European University, 2404 Nicosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0563-0282","authenticated-orcid":false,"given":"Alexandros","family":"Gryparis","sequence":"additional","affiliation":[{"name":"Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafaella","family":"Georgiou","sequence":"additional","affiliation":[{"name":"Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7317-4106","authenticated-orcid":false,"given":"Dionysios","family":"Tafiadis","sequence":"additional","affiliation":[{"name":"Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2616","DOI":"10.1001\/jama.291.21.2616","article-title":"The global burden of chronic diseases: Overcoming impediments to prevention and control","volume":"291","author":"Yach","year":"2004","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1163\/1569150042036747","article-title":"Globalization of risks for chronic diseases demands global solutions","volume":"3","author":"Yach","year":"2004","journal-title":"Perspect. Glob. Dev. Technol."},{"key":"ref_3","first-page":"373","article-title":"Disease, illness and health: Theoretical models of the disablement process","volume":"70","author":"Minaire","year":"1992","journal-title":"Bull. World Health Organ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2741","DOI":"10.1001\/jama.297.24.2741","article-title":"Definitions and measurement of chronic health conditions in childhood: A systematic review","volume":"297","author":"Mokkink","year":"2007","journal-title":"JAMA"},{"key":"ref_5","first-page":"1","article-title":"What is chronic illness?","volume":"1","author":"Dowrick","year":"2005","journal-title":"Chronic Illn."},{"key":"ref_6","first-page":"183","article-title":"Chronic diseases in the paediatric population: Comorbidities and use of primary care services","volume":"93","author":"Cortes","year":"2020","journal-title":"An. Pediatr. (Engl. Ed.)"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s11136-016-1405-4","article-title":"Dutch normative data and psychometric properties for the Distress Thermometer for Parents","volume":"26","author":"Schepers","year":"2017","journal-title":"Qual. Life Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e20190811","DOI":"10.1542\/peds.2019-0811","article-title":"Prevalence and trends of developmental disabilities among children in the United States: 2009\u20132017","volume":"144","author":"Zablotsky","year":"2019","journal-title":"Pediatrics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.pedn.2014.10.011","article-title":"Children with chronic conditions: Perspectives on condition management","volume":"30","author":"Beacham","year":"2015","journal-title":"J. Pediatr. Nurs."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1001\/jama.2010.130","article-title":"Evolving notions of childhood chronic illness","volume":"303","author":"Halfon","year":"2010","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.12968\/bjcn.2013.18.Sup5.S14","article-title":"Dysphagia and quality of life","volume":"18","author":"Vesey","year":"2013","journal-title":"Br. J. Community Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bourin, P.F., Puech, M., and Woisard, V. (2017). Pediatric aspect of dysphagia. Dysphagia: Diagnosis and Treatment, Springer.","DOI":"10.1007\/174_2017_138"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1001\/jamaoto.2019.3622","article-title":"Diagnosis and management of pediatric dysphagia: A review","volume":"146","author":"Lawlor","year":"2020","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_14","first-page":"CD004303","article-title":"Interventions for dysphagia in long-term, progressive muscle disease","volume":"2016","author":"Jones","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1002\/pon.4038","article-title":"Validity, specificity, feasibility, and acceptability of a brief pediatric distress thermometer in outpatient clinics","volume":"26","author":"Wiener","year":"2017","journal-title":"Psychooncology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s00455-018-9884-9","article-title":"Temporal trends of pediatric dysphagia in hospitalized patients","volume":"33","author":"Horton","year":"2018","journal-title":"Dysphagia"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/ddrr.12","article-title":"The neurobiology of swallowing and dysphagia","volume":"14","author":"Miller","year":"2008","journal-title":"Dev. Disabil. Res. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Platis, C., Papagianni, A., Stergiannis, P., Messaropoulos, P., and Intas, G. (2021). Attitudes of the general population regarding patient information for a chronic and life-threatening disease: A cross-sectional study. GeNeDis 2020: Geriatrics, Springer.","DOI":"10.1007\/978-3-030-78771-4_20"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1002\/ddrr.17","article-title":"Assessment of pediatric dysphagia and feeding disorders: Clinical and instrumental approaches","volume":"14","author":"Arvedson","year":"2008","journal-title":"Dev. Disabil. Res. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/MPG.0000000000002188","article-title":"Pediatric feeding disorder: Consensus definition and conceptual framework","volume":"68","author":"Goday","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Murphy Salem, S., and Graham, R.J. (2021). Chronic illness in pediatric critical care. Front. Pediatr., 9.","DOI":"10.3389\/fped.2021.686206"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1046\/j.1365-2788.2003.00484.x","article-title":"Pre-school children with and without developmental delay: Behaviour problems and parenting stress over time","volume":"47","author":"Baker","year":"2003","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1111\/j.1469-8749.2011.04014.x","article-title":"Parenting stress and children with cerebral palsy: A European cross-sectional survey","volume":"53","author":"Parkes","year":"2011","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4071","DOI":"10.1007\/s10826-018-1219-9","article-title":"Parenting stress and emotion dysregulation among children with developmental delays: The role of parenting behaviors","volume":"27","author":"Chan","year":"2018","journal-title":"J. Child Fam. Stud."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1111\/jar.12594","article-title":"Comparing parental stress of children with neurodevelopmental disorders: The case of Williams syndrome, Down syndrome and autism spectrum disorders","volume":"32","author":"Ashworth","year":"2019","journal-title":"J. Appl. Res. Intellect. Disabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1192\/bjo.2023.55","article-title":"Measuring parental stress, illness perceptions, coping and quality of life in families of children newly diagnosed with autism spectrum disorder","volume":"9","author":"Papadopoulos","year":"2023","journal-title":"BJPsych Open"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Papadopoulos, A., Fouska, S., Tafiadis, D., Trimmis, N., Plotas, P., and Siafaka, V. (2023). Psychometric properties of the Greek version of the Autism Parenting Stress Index (APSI) among parents of children with autism spectrum disorder. Diagnostics, 13.","DOI":"10.3390\/diagnostics13203259"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1007\/s10803-007-0512-z","article-title":"Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics","volume":"38","author":"Davis","year":"2008","journal-title":"J. Autism Dev. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.braindev.2012.10.004","article-title":"Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders","volume":"35","author":"Estes","year":"2013","journal-title":"Brain Dev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1007\/s10803-013-2000-y","article-title":"Impacts of autistic behaviors, emotional and behavioral problems on parenting stress in caregivers of children with autism","volume":"44","author":"Huang","year":"2014","journal-title":"J. Autism Dev. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.ridd.2015.08.006","article-title":"Behavioral and emotional profile and parental stress in preschool children with autism spectrum disorder","volume":"45","author":"Giovagnoli","year":"2015","journal-title":"Res. Dev. Disabil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/0143034320971675","article-title":"Parenting styles, parenting stress, and behavioral outcomes in children with autism","volume":"42","author":"Clauser","year":"2021","journal-title":"Sch. Psychol. Int."},{"key":"ref_33","unstructured":"Lazarus, R.S., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1002\/cncr.23622","article-title":"Screening and referral for psychosocial distress in oncologic practice: Use of the Distress Thermometer","volume":"113","author":"Tuinman","year":"2008","journal-title":"Cancer"},{"key":"ref_35","unstructured":"Abidin, R., Flens, J.R., and Austin, W.G. (2006). The Parenting Stress Index, Lawrence Erlbaum Associates Publishers."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Berry, J.O., and Jones, W.H. (1995). Parental Stress Scale (PSS), American Psychological Association (APA).","DOI":"10.1037\/t02440-000"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1365-2214.2012.01396.x","article-title":"Predictors of psychological adjustment, experienced parenting burden and chronic sorrow symptoms in parents of children with cerebral palsy","volume":"39","author":"Whittingham","year":"2013","journal-title":"Child Care Health Dev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1093\/geronj\/38.3.344","article-title":"Validation of a caregiver strain index","volume":"38","author":"Robinson","year":"1983","journal-title":"J. Gerontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/00005650-200108000-00006","article-title":"PedsQL\u2122 4.0: Reliability and validity of the Pediatric Quality of Life Inventory\u2122 Version 4.0 Generic Core Scales in healthy and patient populations","volume":"39","author":"Varni","year":"2001","journal-title":"Med. Care"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s11136-005-1388-z","article-title":"The PedsQL TM 4.0 as a school population health measure: Feasibility, reliability, and validity","volume":"15","author":"Varni","year":"2006","journal-title":"Qual. Life Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med. Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/psyg.12087","article-title":"Caregiving across the lifespan: Comparing caregiver burden, mental health, and quality of life","volume":"15","author":"Neto","year":"2015","journal-title":"Psychogeriatrics"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"De Courten, M., de Courten, B., Egger, G., and Sagner, M. (2017). The epidemiology of chronic disease. Lifestyle Medicine, Academic Press.","DOI":"10.1016\/B978-0-12-810401-9.00002-4"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"436","DOI":"10.2307\/585750","article-title":"Family strengths in the care of handicapped children: Targets for intervention","volume":"38","author":"McCubbin","year":"1989","journal-title":"Fam. Relat."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.jpeds.2013.06.011","article-title":"Development and validation of the distress thermometer for parents of a chronically ill child","volume":"163","author":"Haverman","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_46","unstructured":"Papaleontiou, A., Siafaka, V., Voniati, L., Georgiou, R., and Tafiadis, D. (2023, June 15). Psychometric Properties of the \u201cDistress Thermometer for Parents (DT-P)\u201d Questionnaire in Greek-Cypriot Parents: A Pilot Study. Poster Presented at the 8th Congress on Neurobiology, Psychopharmacology & Treatment Guidance, Thessaloniki, Greece, 17\u201319 February 2023. Available online: https:\/\/psychiatry.gr\/8icnpepatg\/images\/final.pdf."},{"key":"ref_47","unstructured":"IBM Corp (2023, June 15). IBM SPSS Statistics for Windows, Version 29.0. Armonk, NY. IBM Corp; 2023. The jamovi Project (2023). jamovi (Version 2.4) [Computer Software]. Available online: https:\/\/www.jamovi.org."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Kyranou, M., Varvara, C., Papathanasiou, M., Diakogiannis, I., Zafeiropoulos, K., Apostolidis, M., Papandreou, C., and Syngelakis, M. (2020). Validation of the Greek version of the distress thermometer compared to the clinical interview for depression. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02926-0"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/0269216320967593","article-title":"The support needs of parent caregivers of children with a life-limiting illness and approaches used to meet their needs: A scoping review","volume":"35","author":"Gill","year":"2021","journal-title":"Palliat. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e050208","DOI":"10.1136\/bmjopen-2021-050208","article-title":"Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: A scoping review","volume":"11","author":"Hamilton","year":"2021","journal-title":"BMJ Open"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Koch, K.D., and Jones, B.L. (2018). Supporting parent caregivers of children with life-limiting illness. Children, 5.","DOI":"10.3390\/children5070085"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.pcl.2022.04.002","article-title":"Advances in supporting parents in interventions for autism spectrum disorder","volume":"69","author":"Bradshaw","year":"2022","journal-title":"Pediatr. Clin. N. Am."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4260\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:29Z","timestamp":1760032349000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,15]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14124260"],"URL":"https:\/\/doi.org\/10.3390\/jcm14124260","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,6,15]]}}}