Families with children diagnosed with JIA are faced with a label of a chronic disease with no cure, that can

have an uncertain course with requirements for numerous medications and procedures. Depending on the resilience of the individual mother or family in these settings, increased stress may be perceived in any of the Fulvestrant order JIA sub-types. In our study, 50% of mothers with children with polyarticular JIA had total stress scores in the clinical range compared with 33% of systemic-onset JIA and 32% of oligoarticular JIA. Ideally this study would have included a sub-group analysis to attempt elucidating whether the level of stress felt by mothers of children with JIA is different among the seven sub-types of JIA. However, the sample size required for such a study INCB024360 manufacturer was three times that of the sample size of the study we conducted. Therefore, we could not retrospectively perform this analysis in an attempt to try answering

this question. It would be very interesting to understand this as it may help direct extra support to those sub-groups with higher levels of stress. When considering the disease severity and maternal stress we have tried to address this by using the CHAQ and measures from the Core set criteria and found there was a significant positive correlation (P < 0.01) between parent global assessments and both the child domain and total PSI scores with Spearman's correlation co-efficient (rs) of 0.4 and 0.39, respectively. There

was also a positive correlation (P < 0.05) between the child domain PSI score and the CHAQ score (rs = 0.31) and the parent global assessment and parent Carnitine palmitoyltransferase II domain PSI score (rs = 0.31). We conclude that disease condition is important but a larger sample may make this clearer. There was a positive correlation between maternal stress and parental global assessment scores in this study. There was also a correlation between the child domain stress score and the CHAQ score. The link between maternal well being and of maternal ratings of children’s physical functioning has previously been highlighted in other chronic diseases of childhood. In JIA specifically, Timko et al.[7] reported that parents had more difficulty when their child had more functional disability when they looked at functioning in 159 married couples at two time-points. This indicates that the child’s physical functioning (measured by parental completion of CHAQ) is a key factor associated with the distress experienced by mothers, perhaps more so than disease activity. It was observed that mothers of children with uveitis had higher stress levels. Five (10%) of the patients had JIA-associated uveitis at the time or prior to the questionnaire being conducted.