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Ayupe KMA, Galvão ÉRVP, Cazeiro APM, Anaby D, Teplicky R, Lopes PB, Massetti T, de Oliveira AKC, de Campos AC, Longo E. Participation and environment measure - children and youth: PEM-CY Brazil measurements properties. Braz J Phys Ther 2024; 28:101103. [PMID: 39094214 PMCID: PMC11345649 DOI: 10.1016/j.bjpt.2024.101103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/04/2024] [Accepted: 07/11/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Participation of children with disabilities is an indicator of social inclusion, health, and well-being, and its evaluation needs to be included in the clinical practice of rehabilitation professionals. OBJECTIVES To investigate the measurement properties of the Participation and Environment Measure - Children and Youth Brazilian version (PEM-CY Brazil). METHODS We used the PEM-CY to evaluate participation and environment of children with and without disabilities in the home, school, and community settings. Based on COSMIN guidelines, we analyzed two measurement properties: internal consistency for all domains using Cronbach's alpha; and construct (known-groups) validity, i.e., the degree to which instrument scores identify differences between groups. T-tests, Mann-Whitney, or Chi-square tests compared children with and without disabilities. RESULTS 101 Brazilian children (mean age=9.31 years) with (n = 62) and without (n = 39) disabilities were included. Internal consistency ranged from appropriate (0.70) to excellent (0.95) for all domains in all settings, except for Resources in the environment of the home setting (0.53). Regarding construct validity, PEM-CY participation scores were significantly different between groups in most domains. Children with disabilities were significantly less involved and participated in a smaller number of activities in all settings, in comparison to those without disabilities. The PEM-CY scores in all settings of the environment were significantly higher in the group of children without disabilities. CONCLUSION Preliminary support was provided for the internal consistency and construct (known-groups) validity of the PEM-CY Brazil to measure participation and the environment in the Brazilian context. The PEM-CY can therefore be used by rehabilitation professionals in Brazil.
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Affiliation(s)
- Kennea Martins Almeida Ayupe
- Department of Integrated Health Education, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
| | | | | | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Rachel Teplicky
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | | | - Thais Massetti
- Centro Universitário São Camilo - Campus Ipiranga, São Paulo, SP, Brazil
| | | | - Ana Carolina de Campos
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Egmar Longo
- Department of Physical Therapy, Health Sciences Center, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
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Kumar DS, Perez G, Friel KM. Adults with Cerebral Palsy: Navigating the Complexities of Aging. Brain Sci 2023; 13:1296. [PMID: 37759897 PMCID: PMC10526900 DOI: 10.3390/brainsci13091296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/30/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
The goal of this narrative review is to highlight the healthcare challenges faced by adults with cerebral palsy, including the management of long-term motor deficits, difficulty finding clinicians with expertise in these long-term impairments, and scarcity of rehabilitation options. Additionally, this narrative review seeks to examine potential methods for maintaining functional independence, promoting social integration, and community participation. Although the brain lesion that causes the movement disorder is non-progressive, the neurodevelopmental disorder worsens from secondary complications of existing sensory, motor, and cognitive impairments. Therefore, maintaining the continuum of care across one's lifespan is of utmost importance. Advancements in healthcare services over the past decade have resulted in lower mortality rates and increased the average life expectancy of people with cerebral palsy. However, once they transition from adolescence to adulthood, limited federal and community resources, and health care professionals' lack of expertise present significant obstacles to achieving quality healthcare and long-term benefits. This paper highlights the common impairments seen in adults with cerebral palsy. Additionally, it underscores the critical role of long-term healthcare and management to prevent functional decline and enhance quality of life across physical, cognitive, and social domains.
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Affiliation(s)
- Devina S. Kumar
- Burke Neurological Institute, White Plains, NY 10605, USA; (D.S.K.); (G.P.)
| | - Gabriel Perez
- Burke Neurological Institute, White Plains, NY 10605, USA; (D.S.K.); (G.P.)
| | - Kathleen M. Friel
- Burke Neurological Institute, White Plains, NY 10605, USA; (D.S.K.); (G.P.)
- Feil Family Brain & Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA
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Blasco M, García-Galant M, Laporta-Hoyos O, Ballester-Plané J, Jorba-Bertran A, Caldú X, Miralbell J, Alonso X, Meléndez-Plumed M, Toro-Tamargo E, Gimeno F, Pueyo R. Factors Related to Quality of Life in Children With Cerebral Palsy. Pediatr Neurol 2023; 141:101-108. [PMID: 36805966 DOI: 10.1016/j.pediatrneurol.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND We investigated the influence of relevant demographic, clinical, neuropsychological, and psychosocial variables on the proxy-reported quality of life (QOL) of children with cerebral palsy (CP). METHODS The proxy-reported Cerebral Palsy Quality of Life-Child questionnaire (CP QOL-Child) was completed by 58 children with CP (mean age 10.22 years, SD 1.67). Relationships between QOL scores and demographic, clinical, neuropsychological, and psychosocial variables were assessed. CP QOL scores and other variables that correlated significantly were introduced into a multiple linear regression model. RESULTS Executive functioning and motor functional status were explanatory variables for the CP QOL total score. Executive functions explained three specific QOL domains: Social Wellbeing and Acceptance, Feelings about Functioning, and Emotional Wellbeing and Self-esteem. Parental stress also explained Social Wellbeing and Acceptance. Motor functional status and visual perception were explanatory variables for the Access to Services domain. Finally, autism spectrum disorder (ASD) traits were an explanatory variable for the Participation and Physical Health domain. CONCLUSION Executive functioning and motor functional status importantly influence QOL of children with CP. Visual perception, ASD symptoms, and parental stress variables are related with specific QOL domains. These findings demonstrate that interventions targeting cognitive functions in children with CP may positively influence QOL.
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Affiliation(s)
- Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Anna Jorba-Bertran
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mar Meléndez-Plumed
- Servei de Rehabilitació i Medicina Física, Hospital Vall d'Hebron, Barcelona, Spain
| | - Esther Toro-Tamargo
- Servei de Rehabilitació i Medicina Física, Hospital Vall d'Hebron, Barcelona, Spain
| | - Francisca Gimeno
- Serveis de Salut i Rehabilitació, Associació de la Paràlisi Cerebral (ASPACE), Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
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García-Puello F, Herazo-Beltrán Y, Pinillos-Patiño Y, Suarez-Palacio D, Longo E. Restrictions on persons with disabilities for participating in family and community activities. Rev Salud Publica (Bogota) 2023; 22:62-68. [PMID: 36753141 DOI: 10.15446/rsap.v22n1.80515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/29/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To identify the influence of functional impairments and limitations activities for persons with disabilities to particípate in family and community activities. METHODS This is a cross-sectional study with 4 044 persons with disabilities, selected using probabilistic sampling and a door-to-door active search model in 5 towns in the District of Barranquilla. The data were processed with univariate analysis and bivariate analysis to determine the relationship between the study variables. RESULTS 55.9% of the population were males, 41.6% were between 15 and 44 years of age, and 92.9% belonged to the lower socioeconomic stratum. 82.9% reported mobility limitations and 99% reported barriers to access non-formal learning activities, 98.6% to access public activities, and 97.5% to access productive activities. Individuals with that a lower limitation in exercising the power of reason, particularly thinking, can increase participation in activities with family and friends (OR, 0.8; 95% CI, 0.6-0.9), with the community (OR, 0.7; 95% CI, 0.6-0.9), religious or spiritual activities (OR, 0.8; 95% CI, 0.7-0.9). CONCLUSIONS There is a directly proportional relationship between structural impairment with the development of dependency and limited family, social, and work participation in the persons with disabilities.
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Affiliation(s)
| | - Yaneth Herazo-Beltrán
- YH: Fisioterapeuta, M. Sc. Salud Pública. Universidad Simón Bolívar. Barranquilla, Colombia.
| | - Yisel Pinillos-Patiño
- YP: Fisioterapeuta. M. Sc. Salud Pública. Universidad Simón Bolívar. Barranquilla, Colombia.
| | - Damaris Suarez-Palacio
- DS: Fisioterapeuta, M. Sc. Salud Pública. Universidad Simón Bolívar. Barranquilla, Colombia.
| | - Egmar Longo
- EL: Fisioterapeuta. M. Sc. Salud Pública. Ph. D. Discapacidad, Universidad Federal de Rio Grande do Norte-UFRN. Facisa, Brasil.
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Almasri NA, Alquaqzeh FA. Determinants of Quality of Life of Children and Adolescents with Cerebral Palsy: A Systematic Review. Phys Occup Ther Pediatr 2023:1-22. [PMID: 36588347 DOI: 10.1080/01942638.2022.2162358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To summarize research findings on the determinants of Quality of Life (QoL) in children with cerebral palsy based on the International Classification of Functioning, Disability, and Health (ICF). METHODS The protocol of the review was registered in the International Prospective Register of The Systematic Reviews PROSPERO (CRD42021261966). A PubMed, Web of Science, MEDLINE complete, and CINAHL Plus search was conducted between January 2020 and October 2021 to identify studies that examined determinants of QoL. Inclusion criteria for the studies were children between the ages of birth and 20 years with cerebral palsy. The data extraction and quality evaluation of studies were carried out independently by two reviewers. RESULTS A total of 664 studies were identified in the search, of which 23 studies were included in the review. The majority of the studies were conducted in high-income countries. According to the ICF, 48% of the studies examined body function determinants, 52% examined activities determinants, and 26% examined environmental determinants. In contrast, 13% of the studies examined determinants related to participation and 13% examined determinants related to personal factors. CONCLUSIONS Based on our findings, most of the determinants identified in the literature are related sequentially to functional activities, body functions and structures, and environmental factors. Researchers should focus on assessing the determinants of QoL related to participation and personal characteristics for children with cerebral palsy in order to improve their QoL.
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Affiliation(s)
- Nihad A Almasri
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Fatima Alzahra Alquaqzeh
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
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Milićević M. Functional and environmental predictors of health-related quality of life of school-age children with cerebral palsy: A cross-sectional study of caregiver perspectives. Child Care Health Dev 2023; 49:62-72. [PMID: 35305043 DOI: 10.1111/cch.13007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/01/2022] [Accepted: 03/14/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Caregivers' reports often serve as a decision-making guide in the treatment and rehabilitation of children with cerebral palsy (CP). This study identified predictors of the caregiver-reported health-related quality of life (HRQoL) of school-age children with CP. METHODS A cross-sectional study was conducted using the convenience sample of 108 children with CP (60 males; aged 7-18 years; mean age 12 years 8 months [SD 3 years 5 months]). Caregivers reported their child's HRQoL using KIDSCREEN-27. Standard multiple regression analyses were conducted to test if the child characteristics (gender, age, Gross Motor Function Classification System-Expanded & Revised [GMFCS-E&R], Manual Ability Classification System [MACS], intellectual disability, health problems, communication, social skills, behavioural difficulties); family characteristics (income, type, home adaptation); physical, social and attitudinal barriers; environmental features; and family-centeredness of service delivery significantly predicted HRQoL. RESULTS Fine manual abilities, home adaptation and the magnitude of barriers predicted physical well-being. The child's challenging behaviour, the magnitude of barriers and the barriers related to different policies predicted psychological well-being. The home adaptation level and provision of general information about the child's disability and available types of services predicted HRQoL domain related to interactions and relationships with parents. Children with behavioural difficulties and more severe limitations in communication had less social support from friends and peers. The social skills and intellectual functioning combined with the parental ratings of the child's behaviour, other people's attitudes towards the child and the lack of support predicted HRQoL in the School Environment domain. The magnitude and frequency of barriers were the strongest predictors of general HRQoL. CONCLUSION From the caregivers' perspective, home adaptation, supportive laws and policies and family-centred rehabilitation care that meets the family needs may promote children's HRQoL. Specific interventions addressing modifiable environmental features and continuous support to children in improving their fine motor abilities, communication and social skills and families in managing behavioural difficulties may be relevant for HRQoL of school-age children with CP.
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Affiliation(s)
- Milena Milićević
- Institute of Criminological and Sociological Research, Belgrade, Serbia
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Kim K, Kadirov R. Parental Stress and Bringing up a Child with Cerebral Palsy: A Foreign Studies Review. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
<p style="text-align: justify;">Raising a child with cerebral palsy contains difficult stress, which negatively affects everyone who is involved in this process. In native psychology, this problem is described by I.U. Levchenko, V.V. Tkacheva, V.A. Vishnevsky, T.N. Volkovskaya. However, there is a lack of research on stress for people, who are raising a child with cerebral palsy. The purpose of this review is to learn about foreign studies on stress for people, who are raising children with cerebral palsy. The article describes R. Abidin's current leading model for parental stress. The connection between raising a child with cerebral palsy and parental stress is considered based on R. Abidin's model. Particularly, the results of studies describe specific aspects of parental stress: lack of knowledge on special child care, not an equal assignment for parental responsibilities, separation anxiety, parent's health problems, social isolation, and guilt. Based on the analysis, we can conclude that raising a child with cerebral palsy is associated with a higher level of stress than raising children without disabilities. This information can be used both in similar studies for a domestic sample and in active programs to reduce parental stress.</p>
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Yoon MJ, Choi H, Kim JS, Lim SH, Yoo YJ, Hong BY. Physical activity, quality of life and parenting stress in children with cerebral palsy. Pediatr Int 2022; 64:e15295. [PMID: 36112040 DOI: 10.1111/ped.15295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/13/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with cerebral palsy (CP) are less physically active than their typically developing peers. The effects of decreased physical activity on children's quality of life (QOL) or caregiver's lives are not well understood. This study aimed to investigate the association between physical activity, QOL, and parenting stress in children with CP. METHODS A prospective cross-sectional study was done in children with CP. Daily physical activity was measured over 7 days using an accelerometer (ActiGraph™). Caregivers completed the Child Health Questionnaire - Parent Form 50 and Parenting Stress Index - Short Form. Multiple regression analysis was used. RESULTS In total, data from 65 children with Gross Motor Function Classification System (GMFCS) levels I-V, aged 4-13 years, were analyzed. Non-ambulatory (GMFCS IV-V) children had significantly lower activity counts and moderate to vigorous physical activity (MVPA) in comparison with ambulatory (GMFCS I-II) and marginally ambulatory (GMFCS III) children. The ambulatory group had better physical QOL than the non-ambulatory group. Caregivers of the non-ambulatory or marginally ambulatory children with CP reported higher parenting stress levels than those of the ambulatory group. Time spent in MVPA and activity counts were positively associated with physical QOL in children with CP. Low activity counts and low amounts of MVPA of children with CP were significant predictors of high parenting stress. CONCLUSIONS Physical activity in children with CP is associated with children's QOL and parenting stress. These results suggest that clinicians should conduct physical activity assessment and counseling to promote physical activity.
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Affiliation(s)
- Mi-Jeong Yoon
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Hyehoon Choi
- Department of Rehabilitation Medicine, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea
| | - Joon-Sung Kim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Yeun-Jie Yoo
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Bo Young Hong
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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Ruan Y, Chen W, Zhuang C, Lin H. Health-Related Perceptions of Older Adults/Patients with Degenerative Lumbar Diseases (ODLs) are associated with their Quality of Life: a Mixed-Methods Study. Patient Prefer Adherence 2021; 15:2303-2311. [PMID: 34675494 PMCID: PMC8518139 DOI: 10.2147/ppa.s328532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to elucidate the quality of life of older adults/patients with degenerative lumbar diseases (ODLs) and analyse its association with some of their health-related perceptions. MATERIALS AND METHODS This mixed-methods study consisted of a questionnaire survey and an in-depth interview, which was designed within this study. ODLs were recruited from January 12, 2017 to June 27, 2018. The independent sample t-test and grounded theory coding method were employed for data analysis. RESULTS Of the 125 participants who returned valid questionnaires, 18 were included in the in-depth interviews. ODLs' quality of life was associated with the following health-related perceptions: "life barriers", "subjective health status", and "treatment outcomes" across the domains of physiology, psychology, social relations, and environment. CONCLUSION Our findings indicate that ODLs' quality of life is associated with their health-related perceptions. Thus, to improve older adults' quality of life, more attention should be paid to enhancing non-medical factors such as their health-related perceptions.
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Affiliation(s)
- Yuhui Ruan
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Weisin Chen
- Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Chenyang Zhuang
- Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Hong Lin
- Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- Institute of Medical Science Popularization, Fudan University, Shanghai, People’s Republic of China
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Rezaei A, Raji P, Mousavi ST, Mahmoodian M, Baghestani AR. Study of environmental factors and quality of life in children with cerebral palsy based on international classification of functioning, disability and health. Br J Occup Ther 2021. [DOI: 10.1177/03080226211008724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Identification of environmental barriers is an important factor for improving quality of life. The aim was to investigate the relationship between environmental factors and quality of life of children with cerebral palsy and to prioritize environmental factors affecting the quality of life. Method In this cross-sectional study, participants were children with cerebral palsy ( n = 67) 8–12 years. The European Child Environment Questionnaire and cerebral palsy quality of life questionnaire were used. In order to prioritize environmental codes, each of the items in the European Child Environment Questionnaire was linked to environmental codes of the cerebral palsy ICF Core Set. Data were analyzed using SPSS and Pearson correlation and regression tests. Results There was a significant negative relationship between quality of life and environmental barriers ( p < 0.05, r = −0.36). The European Child Environment Questionnaire covered 75% of the environmental codes of cerebral palsy ICF Core Set. Also, e5 (services, systems and policies) was identified as the main priority of environmental factors affecting the quality of life. Conclusion Occupational Therapists should devote part of the interventional plan to reduce environmental barriers. On the other hand, decision-making organizations have to make supportive laws to improve the physical environment of the home, community, school, and work.
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Affiliation(s)
- Amin Rezaei
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Department of Occupational Therapy, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parvin Raji
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Tahmineh Mousavi
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mahmoodian
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Baghestani
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Pérez-Ardanaz B, Morales-Asencio JM, León-Campos Á, Kaknani-Uttumchandani S, López-Leiva I, Garcia-Piñero JM, Martí-García C, García-Mayor S. Quality of Life and Health Services Utilization for Spanish Children With Cerebral Palsy. J Pediatr Nurs 2020; 53:e121-e128. [PMID: 32201113 DOI: 10.1016/j.pedn.2020.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To examine the health-related quality of life of children with cerebral palsy and its relationship with their use of health resources, taking into account sociodemographic factors concerning the family context. DESIGN AND METHODS Cross-sectional study of children with cerebral palsy in Granada (Spain). Quality of life was evaluated with PedsQL questionnaire. RESULTS A total of 75 children were analysed (mean age 7.41 years; SD 4.37; 50.7% male). They made an average of 22.80 visits (SD 12.43) per year; greater use was made of resources by children who had been diagnosed with cerebral palsy for <45 months (36.00 vs. 26.93 visits per year, p < 0.0001). Older children suffered more fatigue and pain. Children aged 2-4 years who presented with fatigue had more hospitalizations (r = -0.35; p = 0.20), whereas those >4 years who had a higher quality of life for daily activities had made more visits to hospital A&E (r = 0.35, p = 0.043). Among the children studied, there was no significant association between HRQOL and the parents' education or occupation. CONCLUSION These findings highlight variables that may influence children's quality of life and their use of health resources, identifying certain profiles of children who might need individualized interventions. PRACTICE IMPLICATIONS These findings could inform services provided by paediatric nurses to children with cerebral palsy, to individualize interventions and improve patient centred care.
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Affiliation(s)
| | - José Miguel Morales-Asencio
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain.
| | - Álvaro León-Campos
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - Shakira Kaknani-Uttumchandani
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - Inmaculada López-Leiva
- Universidad de Málaga, Faculty of Health Sciences, Spain; Hospital Materno-Infantil de Málaga, Spain
| | - José Miguel Garcia-Piñero
- Universidad de Málaga, Faculty of Health Sciences, Spain; Hospital Materno-Infantil de Málaga, Spain
| | | | - Silvia García-Mayor
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
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I Want to Play: Children With Cerebral Palsy Talk About Their Experiences on Barriers and Facilitators to Participation in Leisure Activities. Pediatr Phys Ther 2020; 32:190-200. [PMID: 32604358 DOI: 10.1097/pep.0000000000000719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore how children with cerebral palsy (CP) experience participation in leisure activities and to describe the environmental barriers and facilitators. METHODS Sixteen children with cerebral palsy aged 7 to 17 years participated in 3 focus groups. Data were analyzed thematically by 3 researchers on the basis of the International Classification of Functioning, Disability and Health. RESULTS A total of 38 International Classification of Functioning, Disability and Health categories were identified (4 linked to Body functions; 2 linked to Body structures; 8 linked to Activities & Participation, and 24 to Environmental factors: 10 facilitators and 14 barriers). The most mentioned categories were Voluntary movement control functions, Functions related to gait pattern, Structure of upper arm, Recreation and leisure, Nuclear family and finally, and Individual attitudes of acquaintances. CONCLUSIONS The main barriers identified by children with cerebral palsy highlight aspects of the physical, social, and attitudinal environment that could be modified to enhance participation in leisure activities.
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Prajakta P, John S, Bellur R. Parental Perspectives on Quality of Life in Adolescents with Cerebral Palsy. Indian J Psychol Med 2020; 42:256-261. [PMID: 32612330 PMCID: PMC7320728 DOI: 10.4103/ijpsym.ijpsym_300_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/06/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Quality of life (QoL) is an important outcome variable while evaluating intervention effectiveness during adolescence. Limited studies have addressed the issues that affect the QoL in adolescents with cerebral palsy. The present study explores the parent-reported QoL in adolescents with cerebral palsy. MATERIALS AND METHODS Using a cross-sectional study design, parental perspectives on QoL were investigated among 35 parents of adolescents with cerebral palsy, aged between 13 and 18 years. Performance on seven domains of QoL across age and gender were explored. RESULTS While the maximum QoL was seen in the domain of social well-being, the least QoL was noted for feelings about functioning. Across age, the early adolescence group (13-15 years) had a poorer quality of life in comparison to the late adolescence group (16-18 years). With respect to the gender, though females had a lower QoL scores, a statistically significant difference was observed only for the domain of general well-being and participation. CONCLUSIONS From a parental perspective, the major issues of concern in adolescents with cerebral palsy were feelings about functioning, general well-being and participation, and access to services. This information will be useful when establishing management options or assessment protocols to improve their overall QoL.
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Affiliation(s)
- Prabhu Prajakta
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sunila John
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajashekhar Bellur
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Bolaños-Roldán AM. Calidad de vida relacionada con características sociodemográficas y clínicas en niños con parálisis cerebral. DUAZARY 2020. [DOI: 10.21676/2389783x.3230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La parálisis cerebral (PC) es la causa más frecuente de discapacidad en la infancia. El objetivo fue determinar la calidad de vida relacionada con la salud (CVRS) de niños y niñas entre 8 y 12 años con PC y relacionarlo con características sociodemográficas y clínicas. Estudio descriptivo correlacional; se aplicó cuestionario con información sociodemográfica y clínica y el Kidscreen 27 a una población de 100 niños con PC o a sus cuidadores principales, para el caso de aquellos con dificultades cognitivas o comunicativas. La dimensión de entorno escolar y estado de ánimo y sentimientos fueron mejor percibidas. En los niños más pequeños (8 a 9 años) se encontró una mejor percepción sobre la actividad física y la vida familiar y el tiempo libre, mientras que los niños mayores (10 a 12 años) en el dominio de apoyo social y amigos. Los niños de estrato socioeconómico alto dieron mayor puntuación en todos los dominios de calidad de vida al igual que los niños menos comprometidos en su función motora gruesa. El más alto nivel educativo de los cuidadores, estrato socioeconómico alto y menor severidad en el compromiso motor en los niños con PC, se relaciona con una mejor calidad de vida.
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Dehghanizadeh M, Khalafbeigi M, Akbarfahimi M, Yazdani F, Zareiyan A. Exploring the contributing factors that influence the volition of adolescents with cerebral palsy: A directed content analysis. Scand J Occup Ther 2020; 28:553-563. [PMID: 32089013 DOI: 10.1080/11038128.2020.1723686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Communication, behavioural disturbances and low motivation influence the functional potential and the effectiveness of interventions in adolescents with cerebral palsy (CP). While the model of human occupation (MOHO) is a conceptual model in occupational therapy, no research on the volition of adolescents with CP in daily activities has been undertaken. AIM To explore the elements contributing to the volition of adolescents with CP based on their own experience. METHODS A qualitative approach using directed content analysis with volition of MOHO as a framework was applied. Semi-structured in-depth interviews were carried out with five adolescents with CP and five parents of the same adolescents. RESULTS In this study primary codes were categorized into eight categories: family and community-related values, individual values, individual perceptions of ability level, sense of control over conditions, enjoying performing activities, enjoying interpersonal relationships, physical context features and social context features. CONCLUSIONS Personal causation in interaction with environmental features is strongly influenced by adolescents' motivation. SIGNIFICANCE Occupational therapists could improve the motivation of adolescents with CP in interaction with the individual's volition with focussing on self-efficacy for promoting personal causation. Adapting to the physical environment and changing the attitudes of others to these adolescents is necessary.
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Affiliation(s)
- Moslem Dehghanizadeh
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Khalafbeigi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Malahat Akbarfahimi
- Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Yazdani
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Armin Zareiyan
- Department of Public Health Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
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Tavares Netto AR, Wiesiolek CC, Brito PM, Rocha GAD, Tavares RMF, Lambertz KMF. Functionality, school participation and quality of life of schoolchildren with cerebral palsy. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The quality of life (QoL) of schoolchildren with cerebral palsy (CP) should be evaluated considering the functional variability of the child with CP with an extended view on functionality in the school context and the determinants of QoL. Objective: to evaluate the school participation and the QoL of schoolchildren with CP in Recife's municipal public network, as well as to analyze the influence of GMFCS levels and motor performance on these variables in the study population. Method: This is an exploratory observational study whose evaluation model was structured based on the International Classification of Functioning, Disability and Health (CIF). Children with CP were classified in the Gross Motor Function Classification System (GMFCS) and evaluated according to Gross Motor Function Measure-88 (GMFM-88). The School Function Assessment (SFA) and the Quality of Life Questionnaire for Cerebral Palsy (CPQOL-Caregiver) were answered by teachers and mothers, respectively. Results: In the study population, the higher the GMFCS level, the lower the participation and the lower the independence in school activities, aspects that add to the QoL construct, mainly with less functionality, less emotional well-being and self-esteem, and lower family health. Conclusion: GMFCS levels and motor performance of schoolchildren with CP can affect school participation and QoL, and it is important to consider each child's individual and contextual factors. These results can help the development of functional, care, inclusion and pedagogical strategies for students with CP.
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Raji P, Mehraban AH, Ahmadi M, Schiariti V. Assessment priorities in cerebral palsy using ICF core set by Iranian occupational therapists. The Canadian Journal of Occupational Therapy 2019; 86:289-298. [PMID: 31046435 DOI: 10.1177/0008417419833400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND. International Classification of Functioning, Disability and Health (ICF) core set for cerebral palsy allows for the description of the levels of functioning in cerebral palsy. It is not exactly clear which of these levels is more important for evaluation from the perspective of occupational therapists in Iran. By identifying these priorities, we can establish a better plan for intervention. PURPOSE. This study defines assessment priorities in children with cerebral palsy (<6 years). METHOD. Sixty-two Iranian occupational therapists studied the priorities of assessment based on the Iranian ICF core set. The therapists were asked to rate the code categories from 1 to 3. The results are presented as mean values. FINDINGS. Occupational therapists first focus on body functions assessment, then activities/participation, and ultimately, environmental factors. IMPLICATIONS. Occupational therapists in Iran have a bottom-up approach toward clients with cerebral palsy. It may be necessary to revise the educational curriculum, prepare a training course, and provide more supervision for practising occupational therapists.
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Ferreira HNC, Schiariti V, Regalado ICR, Sousa KG, Pereira SA, Fechine CPNDS, Longo E. Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1107. [PMID: 29844290 PMCID: PMC6025082 DOI: 10.3390/ijerph15061107] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. OBJECTIVE Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. METHODS This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. RESULTS A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. CONCLUSION This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.
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Affiliation(s)
- Haryelle Náryma Confessor Ferreira
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
| | - Veronica Schiariti
- Division of Medical Sciences, University of Victoria, BC V8W 2Y2, Canada.
| | | | - Klayton Galante Sousa
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
| | - Silvana Alves Pereira
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
| | | | - Egmar Longo
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
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Keawutan P, Bell KL, Oftedal S, Davies PSW, Ware RS, Boyd RN. Quality of life and habitual physical activity in children with cerebral palsy aged 5 years: A cross-sectional study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 74:139-145. [PMID: 29413428 DOI: 10.1016/j.ridd.2018.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/29/2017] [Accepted: 01/17/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To compare quality of life (QOL) according to ambulatory status and to investigate association with habitual physical activity (HPA) in children with cerebral palsy (CP) aged 5 years. METHODS Fifty-eight participants were classified using Gross Motor Function Classification System (GMFCS) as level I = 33, II = 8, III = 6, IV = 3 and V = 8 and assessed for motor function using 66-item Gross Motor Function Measure (GMFM-66). Participants wore an ActiGraph® triaxial accelerometer for 3 days to measure HPA. Parents completed the parent proxy Cerebral Palsy Quality of Life questionnaire for Children (CP QOL-Child). Linear regression analyses were performed. RESULTS Ambulant children with CP (GMFCS I-III) had better parent-reported QOL than non-ambulant children (GMFCS IV-V) in domains of feelings about functioning (mean difference (MD) = 20.0; 95% confidence interval (CI) = 11.7, 28.2), participation and physical health (MD = 14.5; 95%CI = 4.7, 24.4), and emotional well-being and self-esteem (MD = 12.5; 95%CI = 4.8, 20.1). HPA was not associated with QOL domains after controlling for motor function. GMFM scores accounted for 39% of variation for feelings about functioning domain (MD = 0.4; 95%CI = 0.2, 0.6). CONCLUSIONS In children with CP aged 5 years, HPA was not associated with parent-reported QOL. Gross motor function contributed to QOL domains of feelings about functioning.
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Affiliation(s)
- Piyapa Keawutan
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia; Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand.
| | - Kristie L Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia; Dietetics and Food Services, Lady Cilento Children's Hospital, Children's Health Queensland, South Brisbane, Australia
| | - Stina Oftedal
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia; Children's Nutrition Research Centre, The University of Queensland, Brisbane, Australia
| | - Peter S W Davies
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia
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Longo E, Badia M, Begoña Orgaz M, Gómez-Vela M. Comparing parent and child reports of health-related quality of life and their relationship with leisure participation in children and adolescents with Cerebral Palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:214-222. [PMID: 29055241 DOI: 10.1016/j.ridd.2017.09.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 08/10/2017] [Accepted: 09/28/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to examine the level of agreement between reports of health-related quality of life (HR-QoL) obtained from children and adolescents with cerebral palsy (CP) and their parents. We also examined the relationships between child and parent perception of the different domains of HR-QoL and participation dimensions. Sixty-nine children and adolescents with CP and their parents separately completed parallel forms of the KIDSCREEN questionnaire. The Spanish version of the Children's Assessment of Participation and Enjoyment (CAPE) was completed by the child/adolescent. Concordance between the children's and the parents' HR-QoL scores was analyzed via Pearson and intraclass correlations. Differences in means were tested using paired Student's t-tests. Chi-square tests were using to assess the incidence of personal variables in the agreement and disagreement of children-parents' responses. The relationships between HR-QoL and leisure participation was confirmed with Pearson's correlation coefficients. Correlations between child and parent HR-QoL scores were small in 7 domains, medium in 2 and large in the Social Support & Peers domain. Children reported significantly better HR-QoL than their parents did. Participation was positively associated with specific domains of HR-QoL, but only weakly, and there were discrepancies between parent and child reports of HR-QoL. These findings provide interesting information about the importance of hearing the voices of children and adolescents with CP to promote HR-QoL and leisure participation.
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Affiliation(s)
- Egmar Longo
- Federal University of Rio Grande do Norte/FACISA, Brazil.
| | - Marta Badia
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - M Begoña Orgaz
- Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - María Gómez-Vela
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
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