1
|
Simpson TS, Grande LA, Kenny JJ, Wilson PE, Peterson RL. Child, Parent, and Family Adjustment for Patients Followed in a Multidisciplinary Spina Bifida Clinic. Top Spinal Cord Inj Rehabil 2022; 28:41-58. [PMID: 36017123 DOI: 10.46292/sci21-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives To characterize child, parent, and family adjustment for patients followed in a multidisciplinary spina bifida (SB) clinic. Methods Participants were drawn from clinical cases seen through a multidisciplinary outpatient SB clinic at a children's hospital between 2017 and 2019. Participants included 209 youth under 19 years old who were diagnosed with SB and their parents. Self-reported internalizing symptoms were measured in youth in grade 3 through 12 using the 25-item Revised Children's Anxiety and Depression Scale-25 (RCADS-25). Self- and parent-reported quality of life and family functioning were obtained using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and Family Impact Modules. Results A total of 45.7% of children and adolescents reported at-risk psychosocial functioning on the PedsQL. In contrast, only 5% of patients reported clinically elevated internalizing symptoms on the RCADS. Parents' quality of life and family functioning in the study were higher than in most studies of parents of children with other chronic health conditions, children with attention deficit-hyperactivity disorder, and healthy control samples. Conclusion Our findings indicate that children and adolescents with SB are at risk for poor health-related quality of life (HRQOL); however, poorer HRQOL may not necessarily be associated with more severe psychiatric symptoms in this population. Examining resilience factors that may help to buffer against challenges to HRQOL will be important in informing future interventions.
Collapse
Affiliation(s)
- Tess S Simpson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Leah A Grande
- Department of Psychology, University of Denver, Denver, Colorado
| | - Jessica J Kenny
- Department of Psychiatry, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Pamela E Wilson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Robin L Peterson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| |
Collapse
|
2
|
Needs and Research Priorities for Young People with Spinal Cord Lesion or Spina Bifida and Their Caregivers: A National Survey in Switzerland within the PEPSCI Collaboration. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030318. [PMID: 35327690 PMCID: PMC8947533 DOI: 10.3390/children9030318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to describe the needs and research priorities of Swiss children/adolescents and young adults (from here, “young people”) with spinal cord injury/disorder (SCI/D) or spina bifida (SB) and their parents in the health and life domains as part of the international Pan-European Pediatric Spinal Cord Injury (PEPSCI) collaboration. Surveys included queries about the satisfaction, importance, research priorities, quality of life (QoL), and characteristics of the young people. Fifty-three surveys with corresponding parent-proxy reports were collected between April and November 2019. The self-report QoL sum scores from young people with SCI/D and SB were 77% and 73%, respectively. Parent-proxy report QoL sum scores were lower, with 70% scores for parents of young people with SCI/D and 64% scores for parents of young people with SB. “Having fun”, “relation to family members”, and “physical functioning” were found to be highly important for all young people. “Physical functioning”, “prevention of pressure injuries”, “general health”, and “bowel management” received the highest scores for research priority in at least one of the subgroups. As parents tend to underestimate the QoL of their children and young people prioritized research topics differently, both young peoples’ and caregivers’ perspectives should be included in the selection of research topics.
Collapse
|
3
|
Kawahara T, Sugita Y, Momose H, Szymanski KM, Hida E, Yamazaki A. Development and Validation of the Japanese Version of Quality of Life Assessment of Spina Bifida in Children (QUALAS-C-J). Pediatr Int 2021; 63:423-429. [PMID: 32745355 DOI: 10.1111/ped.14416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND We previously developed the Japanese version of The Quality of Life Assessment of Spina Bifida in Teenagers, a health-related quality-of-life instrument specific to children aged 13-17 years with spina bifida (SB). The Quality of Life Assessment of Spina Bifida in Children is a version of this questionnaire for children aged 8-12 years. The purpose of this study was to develop a Japanese version of the Quality of Life Assessment of Spina Bifida in Children (QUALAS-C-J) and verify its reliability and validity. METHODS Three urologists specializing in SB, 2 nurses, and 1 statistician developed the QUALAS-C-J and conducted a pilot and main survey. Participants included children with SB and non-disabled (ND) children. Participants completed the QUALAS-C-J and the Japanese version of KIDSCREEN-27 (J-KIDSCREEN) without parental help. RESULTS Five children with SB participated in the pilot study and provided face and content validity. Sixty-three children with SB and 40 age- and sex-matched ND children participated in the main survey. The intraclass correlation coefficient in the retest was 0.80, and Cronbach's alpha in each domain was 0.73. The validity was verified by factor analysis, convergent / divergent validity, and known-groups validity. Factor analysis converged to the same two-factor structure as the original version. The correlation between QUALAS-C-J and J-KIDSCREEN-27 was weak (r=-0.06-0.30). The scores of both groups for the two domains of the QUALAS-C-J were significantly lower in SB than ND children. CONCLUSIONS QUALAS-C-J is easy to answer, suitable for Japanese children with SB, reliable, and valid. It can be a communication tool for children with SB, medical staff, families, communities, and school teachers.
Collapse
Affiliation(s)
- Tae Kawahara
- Division of Health Sciences, Departments of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yoshifumi Sugita
- Department of Urology, Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Hitoshi Momose
- Department of Urology, Japan Community Health-care Organization Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Akemi Yamazaki
- Division of Health Sciences, Departments of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| |
Collapse
|
4
|
Kawahara T, Sugita Y, Momose H, Szymanski KM, Hida E, Yamazaki A. Development and validation of the Japanese version of the Quality of Life Assessment of Spina Bifida in Teenagers (QUALAS-T-J). Pediatr Int 2019; 61:1232-1238. [PMID: 31487089 DOI: 10.1111/ped.14003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/03/2019] [Accepted: 08/30/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Spina bifida (SB) is the second-most common birth defect in Japan. In recent years, health-related quality of life measurements have been used to assess the psychosocial status of children with SB. The Quality of Life Assessment of Spina Bifida in Teenagers (QUALAS-T) is a self-reported questionnaire for subjects aged 13-17 years with SB. It focuses particularly on factors related to independence, bladder and bowel. The purpose of this study was to develop and validate a Japanese version of QUALAS-T (QUALAS-T-J). METHODS Three urologists specialized in SB, two nurses, one statistician, and the author of the original version developed the QUALAS-T-J. Subjects with SB completed the QUALAS-T-J and the Japanese version of KIDSCREEN-27 (J-KIDSCREEN-27) independently from their parents. RESULTS A pilot study involving seven adolescents with SB and confirmed face and content validity. Sixty-nine adolescents with SB participated in the main survey. The intraclass correlation coefficient in the retest was 0.77, and Cronbach's alpha in each domain was 0.83 and 0.79. Validity was verified on factor analysis and convergent/divergent validity. Five items converged in the one domain, Bladder and Bowel. The remaining five items converged in the concept of Family and Independence. The correlation between each domain of the QUALAS-T-J and J-KIDSCREEN-27 was low-moderate. CONCLUSION The reliability and validity of the QUALAS-T-J were verified in Japanese adolescents with SB. The QUALAS-T-J would be a useful tool for communication between adolescents with SB and medical staff.
Collapse
Affiliation(s)
- Tae Kawahara
- Division of Health Sciences, Department of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yoshifumi Sugita
- Department of Urology, Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Hitoshi Momose
- Department of Urology, Japan Community Health-care Organization Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Akemi Yamazaki
- Division of Health Sciences, Department of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| |
Collapse
|
5
|
Castillo J, Gandy K, Bradko V, Castillo H. Language and Latino immigrants living with spina bifida: Social determinants of health - the missing dimension in quality of life research. J Pediatr Rehabil Med 2019; 12:345-359. [PMID: 31744031 DOI: 10.3233/prm-180586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Aware of the higher birth prevalence of spina bifida (SB) among Hispanics/Latinos, we aimed to appraise the literature as it relates to cultural context through a review of quality of life (QOL) studies conducted among individuals with SB in order to improve care among immigrant families. METHODS A systematic review was conducted consistent with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were: (1) children and adolescents (5-21 years of age) with SB and/or myelomeningocele; (2) quantitative studies; (3) health-related QOL outcome measured by validated instrument determinants; and (4) US-based studies. Articles meeting inclusion criteria were assessed using the focused conceptual framework informing the study (i.e., social determinants of health). RESULTS Eighteen studies met inclusion criteria, with eight different QOL instruments represented. The majority of studies used generic assessments of QOL (72%), two reported the use of both a generic and a SB-specific QOL measure (11%), and three (17%) documented QOL utilizing a SB-specific validated instrument. Only seven (39%) of the studies stated that they included Hispanics/Latinos and only six (33%) reported including Spanish-speaking individuals. CONCLUSIONS QOL in individuals with SB is mediated by a wide-range of interrelated factors. In order to better serve this vulnerable population as they transition across the lifespan, multilingual condition-specific QOL measures need to be further developed and implemented among Hispanic/Latino individuals with SB, especially those who are recent immigrants.
Collapse
Affiliation(s)
- Jonathan Castillo
- Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kellen Gandy
- Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Viachaslau Bradko
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Heidi Castillo
- Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
6
|
Efficacy and safety of mirabegron, a β3-adrenoceptor agonist, for treating neurogenic bladder in pediatric patients with spina bifida: a retrospective pilot study. World J Urol 2018; 37:1665-1670. [DOI: 10.1007/s00345-018-2576-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/22/2018] [Indexed: 12/27/2022] Open
|
7
|
Karmur BS, Kulkarni AV. Medical and socioeconomic predictors of quality of life in myelomeningocele patients with shunted hydrocephalus. Childs Nerv Syst 2018; 34:741-747. [PMID: 29249073 DOI: 10.1007/s00381-017-3691-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 12/04/2017] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Children with myelomeningocele (MMC) often develop hydrocephalus, and the combination of these conditions can lead to psychosocial, cognitive, and physical health issues that decrease their health-related quality of life (HRQOL). The goal of the present study was to understand the QOL in patients with MMC and shunted hydrocephalus. METHODS Data from the Toronto Hydrocephalus QOL Database was acquired between 2004 and 2009 using parent-completed questionnaires and, when appropriate, child-completed questionnaires: Hydrocephalus Outcome Questionnaire (HOQ) and the Health Utilities Index. We identified several medical and socioeconomic factors potentially relevant to the outcome measure (e.g., level of myelomeningocele, length of stay in hospital, and shunt-related hospital admissions; family functioning, income, parental education, employment status, etc.). Linear regression models were used to examine associations between potential predictor variables and HRQOL, with P < 0.05 in the multivariate model suggesting significance. RESULTS The analysis consisted of 131 patients (mean age = 12.6, SD = 3.7). The mean HUI score was 0.51, and the mean HOQ overall health score was 0.67. There was a significant association between lower age and higher HOQ social-emotional health (P = 0.03) and HUI scores (P = 0.03), lower anatomical level of myelomeningocele and higher HUI scores (P = 0.01), better family functioning and higher HOQ overall health scores (P = 0.004), and higher family income and higher HOQ overall health, physical health, and HUI scores (P = 0.001, P = 0.003, and P = 0.02, respectively). CONCLUSION Myelomeningocele patients with shunted hydrocephalus can have a poor health-related quality of life. Our results indicate a strong association of income and family functioning on quality of life, along with younger age and lower level of myelomeningocele.
Collapse
Affiliation(s)
- Brij S Karmur
- Division of Neurosurgery, Hospital for Sick Children, Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Abhaya V Kulkarni
- Division of Neurosurgery, Hospital for Sick Children, Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| |
Collapse
|
8
|
Guillot-Tantay C, Chartier-Kastler E, Perrouin-Verbe MA, Denys P, Léon P, Phé V. Complications of non-continent cutaneous urinary diversion in adults with spinal cord injury: a retrospective study. Spinal Cord 2018. [DOI: 10.1038/s41393-018-0083-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
9
|
A cross sectional single institution study of quality of life in adult patients with spina bifida. Neurourol Urodyn 2018; 37:1757-1763. [DOI: 10.1002/nau.23511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/02/2018] [Indexed: 01/23/2023]
|
10
|
Canaz H, Canaz G, Dogan I, Alatas I. Health-related quality of life in non-paraplegic (ambulatory) children with myelomeningocele. Childs Nerv Syst 2017; 33:1997-2002. [PMID: 28656385 DOI: 10.1007/s00381-017-3494-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/13/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Evaluation of the effects of ventriculoperitoenal shunt and incontinence presence on health-related quality of life of ambulatory myelomeningocele patients. METHODS The study group included 35 myelomeningocele patients, between 5 and 18 years old (mean age = 9.6), who were neonatally operated. All patients were ambulatory. The Child Edition of the Child Health and Illness Profile (CHIP-CE) used to evaluate the patient group. Seventeen patients were using clean intermittent catheterization and nine patients had ventriculoperitoneal shunt. RESULTS The CHIP-CE has five domains, and in satisfaction, resilience and achievement domains, significant lower scores were obtained from our study group. In terms of clean intermittent catheterization use, we got significantly lower scores on satisfaction, resilience and achievement domains (p < 0.05). According to the presence of ventriculoperitoneal shunt, we found lower scores in satisfaction, resilience, risk avoidance and achievement domains but the differences were not significant (p > 0.05). No significant difference was spotted according to gender and age. CONCLUSIONS Continence problems have important effects on life quality of myelomeningocele patients. Incontinency should always be considered as a major variable in health-related quality of life evaluations.
Collapse
Affiliation(s)
- Huseyin Canaz
- Department of Neurosurgery, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Gokhan Canaz
- Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, 34147, Istanbul, Turkey.
| | - Irem Dogan
- Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey
| | - Ibrahim Alatas
- Department of Neurosurgery, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| |
Collapse
|
11
|
Doyle S, Carter B, Bray L, Sanders C. Bladder augmentation in children and young adults: a review of published literature. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Sarah Doyle
- Alder Hey Children's NHS Foundation Trust and Lecturer; Edge Hill University; Liverpool UK
| | - Bernie Carter
- University of Central Lancashire & Alder Hey Children's NHS Foundation Trust; Preston & Liverpool UK
| | - Lucy Bray
- Children's Nursing Research Unit, Alder Hey Children's NHS Foundation Trust and Evidence-based Practice Research Centre; Edge Hill University; Liverpool UK
| | | |
Collapse
|
12
|
Quantity, Not Frequency, Predicts Bother with Urinary Incontinence and its Impact on Quality of Life in Adults with Spina Bifida. J Urol 2016; 195:1263-9. [DOI: 10.1016/j.juro.2015.07.108] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2015] [Indexed: 11/22/2022]
|
13
|
Szymanski KM, Misseri R, Whittam B, Yang DY, Raposo SM, King SJ, Kaefer M, Rink RC, Cain MP. Quality of Life Assessment in Spina Bifida for Children (QUALAS-C): Development and Validation of a Novel Health-related Quality of Life Instrument. Urology 2016; 87:178-84. [DOI: 10.1016/j.urology.2015.09.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/16/2015] [Accepted: 09/21/2015] [Indexed: 10/22/2022]
|
14
|
Strine AC, Misseri R, Szymanski KM, Kaefer M, Rhee AC, Hillier K, Rink RC, Cain MP. Assessing Health Related Benefit after Reconstruction for Urinary and Fecal Incontinence in Children: A Parental Perspective. J Urol 2015; 193:2073-8. [DOI: 10.1016/j.juro.2014.12.089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Andrew C. Strine
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Rosalia Misseri
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Konrad M. Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Martin Kaefer
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Audrey C. Rhee
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Kate Hillier
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Richard C. Rink
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Mark P. Cain
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
15
|
QUAlity of Life Assessment in Spina bifida for Adults (QUALAS-A): development and international validation of a novel health-related quality of life instrument. Qual Life Res 2015; 24:2355-64. [DOI: 10.1007/s11136-015-0988-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
|
16
|
Liu JS, Dong C, Casey JT, Greiman A, Mukherjee S, Kielb SJ. Quality of life related to urinary continence in adult spina bifida patients. Cent European J Urol 2015; 68:61-7. [PMID: 25914840 PMCID: PMC4408393 DOI: 10.5173/ceju.2015.01.494] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/12/2014] [Accepted: 12/21/2014] [Indexed: 01/07/2023] Open
Abstract
Introduction To analyze the correlations of bladder management technique, ambulatory status and urologic reconstruction on quality of life (QOL) as affected by urinary symptoms in adult spina bifida (SB) patients. Material and methods Sixty–six adult SB patients completed the RAND 36–Item Health Survey (mSF–36) and Incontinence Quality of Life (I–QOL). Demographic information, history of urinary reconstruction, and bladder management techniques were reviewed and analyzed with respect to survey scores. Results Mean age of patients was 32.3 (SD ±7.2) years and 44 patients (66.7%) were female. Forty–five patients (68.2%) were mainly ambulatory, 21 (31.8%) use a wheelchair and 10 (15.2%) had urologic reconstruction, while 56 (83.3%) did not. Twelve patients (18.2%) void, 42 (63.6%) perform clean intermittent catheterization (CIC), 4 (6.1%) use an indwelling catheter, 3 (4.5%) have an ileal conduit (IC) and 5 (7.6%) mainly use diapers. Mean mSF–36 General Health score was 56.5 (SD ±22.9) and mean I–QOL Sum score was 50.9 (SD ±21.7), where lower scores reflect lower QOL. mSF–36 and I–QOL scores did not significantly correlate with bladder management technique, ambulatory status or urologic reconstruction. A correlation was noted between I–QOL scales and most mSF–36 scales (all p <0.02). Conclusions In our cohort study of adult SB patients, bladder management technique and urologic reconstruction did not correlate with urinary (I–QOL) or general health (mSF–36) domains, although I–QOL and mSF–36 scores correlated closely, suggesting urinary continence is significantly related to general QOL. However, we are unable to identify a single factor that improves either urinary or general QOL.
Collapse
Affiliation(s)
- Joceline S Liu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Caroline Dong
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Jessica T Casey
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Alyssa Greiman
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Shubhra Mukherjee
- Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Stephanie J Kielb
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, USA
| |
Collapse
|
17
|
Murray CB, Holmbeck GN, Ros AM, Flores DM, Mir SA, Varni JW. A longitudinal examination of health-related quality of life in children and adolescents with spina bifida. J Pediatr Psychol 2014; 40:419-30. [PMID: 25434043 DOI: 10.1093/jpepsy/jsu098] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 10/19/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The current study examined (1) spina bifida (SB) youths' health-related quality of life (HRQOL) compared with nonclinical and chronic health condition (CHC) samples, (2) parent-child agreement regarding HRQOL, and (3) prospective changes in HRQOL. METHODS Child and parent-proxy reports of Pediatric Quality of Life were collected at two time waves (Time 1: N = 134, ages 8-15 years; Time 2: N = 109, ages 10-17 years) as part of a larger longitudinal study. RESULTS SB youth had statistically and clinically reduced physical HRQOL compared with the nonclinical and CHC samples at both time points. There were significant discrepancies between youth and parent-proxy reports of HRQOL; youth reported higher levels of physical and social HRQOL than parents. The majority of parent- and child-reported HRQOL domains remained stable, yet youth-reported social HRQOL increased over time. CONCLUSIONS Youth with SB are at risk for poor HRQOL. Examining modifiable condition and social-environmental predictors of youth HRQOL will be important in informing future interventions.
Collapse
Affiliation(s)
- Caitlin B Murray
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Grayson N Holmbeck
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Anna M Ros
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Donna M Flores
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Sophie A Mir
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - James W Varni
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| |
Collapse
|
18
|
Wide P, Glad Mattsson G, Drott P, Mattsson S. Independence does not come with the method--treatment of neurogenic bowel dysfunction in children with myelomeningocele. Acta Paediatr 2014; 103:1159-64. [PMID: 25048689 DOI: 10.1111/apa.12756] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 05/18/2014] [Accepted: 07/17/2014] [Indexed: 12/22/2022]
Abstract
AIM The aim was to evaluate and compare different bowel regimes with regard to satisfaction, faecal incontinence and independence, and the relationship to quality of life among children with myelomeningocele (MMC). METHODS A questionnaire, including the health-related quality of life instrument PedsQL 4.0™, was sent to all children aged seven to 16 years (n = 172) with MMC, treated at two centres in Sweden and one in Norway. The three centres cover a third of the population in the two countries. The response rate was 62%. RESULTS Parents of children (30%) using antegrade colonic enemas (ACE) reported higher satisfaction (p = 0.01) than the parents of those (47%) using transanal irrigation (TAI). The children reported no significant difference. Children and parents in the ACE group reported more complete evacuation of the bowels than the TAI group. No significant difference was found in faecal incontinence or independent toileting. The children (40%) who emptied their bowels independently reported a higher quality of life. Children using TAI or ACE spent around one hour on the toilet at every bowel emptying. CONCLUSION TAI and ACE are effective treatments, but time-consuming and difficult to perform independently. Higher parental satisfaction is obtained with ACE. Irrespective of method the children who can use the toilet independently report a higher quality of life, which makes efforts to support independence valuable.
Collapse
Affiliation(s)
- Peter Wide
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Gunilla Glad Mattsson
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Peder Drott
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Sven Mattsson
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| |
Collapse
|
19
|
Health-related quality of life is compromised in individuals with spina bifida: results from qualitative and quantitative studies. Eur J Obstet Gynecol Reprod Biol 2014; 181:214-22. [DOI: 10.1016/j.ejogrb.2014.07.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 01/30/2014] [Accepted: 07/30/2014] [Indexed: 11/17/2022]
|
20
|
Rofail D, Maguire L, Kissner M, Colligs A, Abetz-Webb L. A review of the social, psychological, and economic burdens experienced by people with spina bifida and their caregivers. Neurol Ther 2013; 2:1-12. [PMID: 26000212 PMCID: PMC4389032 DOI: 10.1007/s40120-013-0007-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Despite measures to reduce the incidence of neural tube defects (NTDs), the rate of decline has not been as dramatic as expected. At least 300,000 newborns worldwide are known to be affected by NTDs each year. This comprehensive literature review summarizes the human and economic burden of NTDs to patients and caregivers, with particular focus on spina bifida (SB). METHODS PubMed, PsycINFO, and Embase were searched for studies from January 1976 to November 2010 that included clinical terms, such as NTD, and at least one patient-reported outcome or cost term. A conceptual model was also developed. RESULTS Areas of peoples' lives affected by SB included physical and role functioning, activities of daily living, bodily pain, vitality, emotional functioning, mental health, self-esteem, self-image, social functioning, relationships, and sexual functioning. Areas of caregivers' lives affected included activities of daily living, work impact, time consumption, parental responsibilities (including responsibilities to other children), confidence, feelings and emotions, mental health, stress, social impact, psychological adjustment, relationships (with SB child, siblings, other family members), social support, coping strategies, and termination decisions. Cost burdens on patients and caregivers also include out-of-pocket costs, lost wages, or household production due to increased morbidity and mortality, transportation and other nonmedical costs. CONCLUSIONS This review highlights the need to provide care and support to individuals with SB and their caregivers. Results also emphasize the importance of effective long-term public health campaigns and/or newer strategies to prevent NTDs, such as SB.
Collapse
Affiliation(s)
- Diana Rofail
- Adelphi Values Ltd, Grimshaw Lane, Bollington, Cheshire SK10 5JB UK
| | - Laura Maguire
- Adelphi Values Ltd, Grimshaw Lane, Bollington, Cheshire SK10 5JB UK
| | | | - Antje Colligs
- Bayer Healthcare, Müllerstr. 178, 13353 Berlin, Germany
| | - Linda Abetz-Webb
- Adelphi Values Ltd, Grimshaw Lane, Bollington, Cheshire SK10 5JB UK
| |
Collapse
|
21
|
Ramachandra P, Palazzi KL, Skalsky AJ, Marietti S, Chiang G. Shunted Hydrocephalus Has a Significant Impact on Quality of Life in Children With Spina Bifida. PM R 2013; 5:825-31. [DOI: 10.1016/j.pmrj.2013.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 05/09/2013] [Accepted: 05/17/2013] [Indexed: 11/28/2022]
|
22
|
Vaidyanathan S, Selmi F, Soni B, Hughes P, Singh G, Pulya K, Oo T. Pyonephrosis and urosepsis in a 41-year old patient with spina bifida: Case report of a preventable death. Patient Saf Surg 2012; 6:10. [PMID: 22613462 PMCID: PMC3407709 DOI: 10.1186/1754-9493-6-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 05/21/2012] [Indexed: 11/29/2022] Open
Abstract
Background Urological complications are the major cause of ill health in patients with spina bifida. Urinary sepsis accounted for the majority of admissions in patients with spina bifida. As the patient grows older, changes occur in the adult bladder, leading to increases in storage pressure and consequent risk of deterioration of renal function, which may occur insidiously. Case presentation A 34-year-old male spinal bifida patient had been managing neuropathic bladder by penile sheath. Intravenous urography revealed normal kidneys. This patient was advised intermittent catheterisations. But self-catheterisation was not possible because of long, overhanging prepuce and marked spinal curvature. This patient developed repeated urine infections. Five years later, ultrasound examination of urinary tract revealed hydronephrotic right kidney with echogenic debris within the collecting system. There was no evidence of dilatation of the ureter near the vesicoureteric junction. The left kidney appeared normal. There was no evidence of calculus disease seen in either kidney. Indwelling urethral catheter drainage was established. Two years later, MAG-3 renogram revealed normal uptake and excretion by left kidney. The right kidney showed little functioning tissue. Following a routine change of urethral catheter this patient became unwell. Ultrasound examination revealed hydronephrotic right kidney containing thick hyper-echoic internal septations and debris in the right renal pelvis suspicious of pyonephrosis. Under both ultrasound and fluoroscopic guidance, an 8 French pig tail catheter was inserted into the right renal collecting system. 150 ml of turbid urine was aspirated immediately. This patient developed large left pleural effusion, collapse/consolidation of the left lower lobe, a large fluid collection in the abdomen extending into the pelvis and expired twenty days later because of sepsis and respiratory failure. Conclusion Although penile sheath drainage may be convenient for a spina bifida patient and the carers, hydronephrosis can occur insidiously. With recurrent urine infections, hydronephrotic kidney can become pyonephrosis, which is life-threatening. Therefore, every effort should be made to carry out intermittent catheterisations along with antimuscarinic drug therapy.
Collapse
Affiliation(s)
- Subramanian Vaidyanathan
- Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Town Lane, Southport, PR8 6PN, UK.
| | | | | | | | | | | | | |
Collapse
|
23
|
Guillotreau J, Castel-Lacanal E, Roumiguié M, Bordier B, Doumerc N, De Boissezon X, Malavaud B, Marque P, Rischmann P, Gamé X. Prospective study of the impact on quality of life of cystectomy with ileal conduit urinary diversion for neurogenic bladder dysfunction. Neurourol Urodyn 2011; 30:1503-6. [DOI: 10.1002/nau.21121] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 03/07/2011] [Indexed: 01/09/2023]
|
24
|
Yao DF, Weinberg AC, Penna FJ, Huang L, Freilich DA, Minnillo BJ, Shoag J, Retik AB, Nguyen HT. Quality of life in children with vesicoureteral reflux as perceived by children and parents. J Pediatr Urol 2011; 7:261-5. [PMID: 21527212 DOI: 10.1016/j.jpurol.2011.02.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Significant research has been dedicated to the management of vesicoureteral reflux (VUR). However, few studies have been published to evaluate the impact of this disease on quality of life. The aim of this study was a prospective examination of the health-related quality of life (HRQoL) in children with VUR who have either been treated medically (antibiotics or surveillance) or by ureteral reimplant (UR) using a validated patient satisfaction survey. MATERIALS AND METHODS A prospective, longitudinal study was conducted using a validated HRQoL questionnaire, the Pediatric Quality of Life Inventory (PedsQL™ 4.0 Generic Core). 353 children or parents of children with VUR, age 2-18 years, completed the survey. Statistical analysis was performed with significance set at p-value ≤ 0.05. RESULTS Children and parents of children with VUR did not score lower on total or subscale domains of HRQoL when compared to a historical healthy control. On univariate analysis, patients who underwent UR scored lower on total as well as physical, social, and school subscale HRQoL domains, compared to patients managed medically. When controlling for gender, ethnicity, age, reflux grade, and antibiotic use, there was no difference in total HRQoL between patients who underwent UR compared to those managed medically. CONCLUSIONS In terms of HRQoL, VUR is a benign clinical entity and neither antibiotic use nor UR is associated with lower HRQoL. Disease-specific quality of life surveys are needed to accurately evaluate patient and parent satisfaction in the management of VUR.
Collapse
Affiliation(s)
- David F Yao
- Department of Urology, Children's Hospital, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Étude prospective de l’impact sur la qualité de vie de la réalisation d’une dérivation urinaire cutanée transiléale non continente pour troubles vésicosphinctériens d’origine neurologique. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s11608-010-0334-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
26
|
Freilich DA, Penna FJ, Nelson CP, Retik AB, Nguyen HT. Parental Satisfaction After Open Versus Robot Assisted Laparoscopic Pyeloplasty: Results From Modified Glasgow Children's Benefit Inventory Survey. J Urol 2010; 183:704-8. [DOI: 10.1016/j.juro.2009.10.040] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Indexed: 11/25/2022]
Affiliation(s)
- Drew A. Freilich
- Robotic Surgery, Research and Training Center, Department of Urology, Children's Hospital, Boston, Massachusetts
| | - Frank J. Penna
- Robotic Surgery, Research and Training Center, Department of Urology, Children's Hospital, Boston, Massachusetts
| | - Caleb P. Nelson
- Robotic Surgery, Research and Training Center, Department of Urology, Children's Hospital, Boston, Massachusetts
| | - Alan B. Retik
- Robotic Surgery, Research and Training Center, Department of Urology, Children's Hospital, Boston, Massachusetts
| | - Hiep T. Nguyen
- Robotic Surgery, Research and Training Center, Department of Urology, Children's Hospital, Boston, Massachusetts
| |
Collapse
|
27
|
Sawin KJ, Bellin MH. Quality of life in individuals with spina bifida: A research update. ACTA ACUST UNITED AC 2010; 16:47-59. [DOI: 10.1002/ddrr.96] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
28
|
Health Related Quality of Life in Patients With Spina Bifida: A Prospective Assessment Before and After Lower Urinary Tract Reconstruction. J Urol 2009; 182:1984-91. [DOI: 10.1016/j.juro.2009.02.060] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Indexed: 11/15/2022]
|
29
|
Snodgrass W, Keefover-Hicks A, Prieto J, Bush N, Adams R. Comparing Outcomes of Slings With Versus Without Enterocystoplasty for Neurogenic Urinary Incontinence. J Urol 2009; 181:2709-14; discussion 2714-6. [DOI: 10.1016/j.juro.2009.02.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Indexed: 10/20/2022]
Affiliation(s)
- Warren Snodgrass
- Pediatric Urology Section, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center, Dallas, Texas
| | - Amy Keefover-Hicks
- Spina Bifida Program, Texas Scottish Rite Hospital for Children, Dallas, Texas
| | - Juan Prieto
- Pediatric Urology Section, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center, Dallas, Texas
| | - Nicol Bush
- Pediatric Urology Section, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center, Dallas, Texas
| | - Richard Adams
- Spina Bifida Program, Texas Scottish Rite Hospital for Children, Dallas, Texas
| |
Collapse
|
30
|
Nanigian DK, Nguyen T, Tanaka ST, Cambio A, DiGrande A, Kurzrock EA. Development and Validation of the Fecal Incontinence and Constipation Quality of Life Measure in Children With Spina Bifida. J Urol 2008; 180:1770-3; discussion 1773. [DOI: 10.1016/j.juro.2008.03.103] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Indexed: 10/21/2022]
Affiliation(s)
- Dana K. Nanigian
- Department of Urology, University of California-Davis, Davis Children's Hospital, Department of Statistics, University of California-Davis, Davis and Shriners Hospitals for Children-Northern California, Sacramento, California
| | - Thuan Nguyen
- Department of Urology, University of California-Davis, Davis Children's Hospital, Department of Statistics, University of California-Davis, Davis and Shriners Hospitals for Children-Northern California, Sacramento, California
| | - Stacy T. Tanaka
- Department of Urology, University of California-Davis, Davis Children's Hospital, Department of Statistics, University of California-Davis, Davis and Shriners Hospitals for Children-Northern California, Sacramento, California
| | - Angelo Cambio
- Department of Urology, University of California-Davis, Davis Children's Hospital, Department of Statistics, University of California-Davis, Davis and Shriners Hospitals for Children-Northern California, Sacramento, California
| | - Angela DiGrande
- Department of Urology, University of California-Davis, Davis Children's Hospital, Department of Statistics, University of California-Davis, Davis and Shriners Hospitals for Children-Northern California, Sacramento, California
| | - Eric A. Kurzrock
- Department of Urology, University of California-Davis, Davis Children's Hospital, Department of Statistics, University of California-Davis, Davis and Shriners Hospitals for Children-Northern California, Sacramento, California
| |
Collapse
|
31
|
Abresch RT, McDonald DA, Widman LM, McGinnis K, Hickey KJ. Impact of spinal cord dysfunction and obesity on the health-related quality of life of children and adolescents. J Spinal Cord Med 2007; 30 Suppl 1:S112-8. [PMID: 17874696 PMCID: PMC2031984 DOI: 10.1080/10790268.2007.11754614] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Accepted: 02/09/2007] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The objectives of this study were: (1) to compare the health-related quality of life (HRQOL) of children and adolescents with mobility impairments due to spinal cord injury (SCI) and spina bifida (SB) to the HRQOL of children and adolescent controls without mobility impairments (CTRL); and (2) to examine the impact of of obesity on the HRQOL of these subjects. METHODS The Pediatric Quality of Life Inventory (PedsQL) was administered to 42 SB, 71 SCI and 60 able-bodied subjects who were 8-20 years of age. Subjects were categorized as obese if their BMI exceeded the 95th percentile for age. Twenty-one CTRL, 26 SB and 26 SCI subjects were obese. RESULTS The SCI and SB subjects had significantly lower subscores than the control subjects on the physical (p < 0.001), emotional (p < .01), social (p < .001), and school (p < .001) domains of the PedsQL. The obese (CTRL) group had lower subscores on the physical (p < 0.001), social (p < 0.001), and psychosocial (p < 0.001) domains of the PedsQL as compared to the non-obese CTRL group, while there were no significant differences in subscores from the emotional and school domains. In contrast to the subjects without mobility impairment, there were no significant differences between the sub-scores of the obese and non-obese subjects with spinal cord dysfunction secondary to SCI or SB. The mean total PedsQL score of the non-obese control group (87.7 +/- 2.1) was significantly higher than the obese control group (75.2 +/- 3.4, p < 0.02), which in turn was significantly higher than the SCI group (63.7 +/- 2.2, p < 0.02), and the SB group (63.0 +/- 2.2, p < 0.02). CONCLUSION Patients with SCI and SB have significantly lower HRQOL than children and adolescents without mobility impairments. Whereas obesity significantly reduces the quality of life scores of adolescents without mobility impairments, it has no significant incremental effect on subjects with SCI or SB.
Collapse
Affiliation(s)
- Richard Ted Abresch
- University of California Davis School of Medicine, Davis, California 95616, USA.
| | | | | | | | | |
Collapse
|