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Background Late-onset Pompe Disease (LOPD) is a rare, heterogeneous disease manifested by a range of symptoms varying in severity. Research establishing the frequency of these symptoms and their impact on patients’ daily lives is limited. The objective of this study was to develop a conceptual model that captures the most relevant symptoms and functional limitations experienced by patients with LOPD, to inform the development of new patient-reported outcome (PRO) tools. Methods A preliminary conceptual model was constructed following a literature review and revised through interviews with expert clinicians to identify important and relevant concepts regarding symptoms and impacts of LOPD. This preliminary model informed the development of a qualitative patient interview guide, which was used to gather the patient perspective on symptoms and impacts relating to LOPD or its treatment (including symptom/impact frequency and levels of disturbance). Patient interviews aided further refinement of the conceptual model. The findings from the patient interviews were triangulated with the literature review and clinician interviews to identify the most relevant and significant effects of LOPD from the patient perspective. Results Muscle weakness, fatigue, pain, and breathing difficulties (especially while lying down) were the most common and highly disturbing symptoms experienced by patients. Limitations associated with mobility (e.g., difficulty rising from a sitting position, getting up after bending) and activities of daily living, (e.g., reduced ability to participate in social/family activities or work/study) were the most frequently reported impacts with the highest levels of disturbance on the patient’s daily life. These identified symptoms and impacts were included in the new conceptual model of disease. Conclusions This qualitative patient interview study, also informed by a literature review and clinician interviews, identified the most frequent and relevant symptoms and the functional impact of LOPD on patients. The study interviews also captured the patient-preferred language to describe symptoms and impacts of LOPD. The results from this study can be used to develop future PRO instruments that are tailored to the specific symptoms and impacts experienced by patients with LOPD.

This paper presents findings from an NCCAN-funded study of family functioning in neglecting families and in a comparison group of low-income families with no prior referrals for child neglect. It examines a sub-sample of a larger study of 77 Native American families from two states: Iowa and Oregon. Data were gathered through structured interviews with families and self-report measures completed by the primary caregiver and the children. Two—way analysis of variance was used to test differences between the neglect and comparison groups, controlling for per capita income and tribe. This study found that the family's current situation was more important than the caregiver's history in differentiating neglecting from comparison families. Multiple problems, substance abuse, and a history of criminal charges were strongly related to neglect. The number of fathers in the family was also related to the risk of neglect and regular contact with a father was the only type of social support that reduced the likelihood of neglect. Since this study relied on non-probability sampling, the findings are not generalizable to other populations. However, the results confirm previous research and suggest hypotheses for further testing.