1
|
Perret C, Alvarelhão JJM, Pennington L, Ehlinger V, Duffaut C, Arnaud C, Vidart d'Egurbide Bagazgoïtia N. Assessing the Adequacy of the Physical, Social, and Attitudinal Environment to the Specific Needs of Young Adults With Cerebral Palsy: The European Adult Environment Questionnaire. Arch Phys Med Rehabil 2024; 105:906-920. [PMID: 38206241 DOI: 10.1016/j.apmr.2023.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/17/2023] [Accepted: 11/26/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES To present the development of the European Adult Environment Questionnaire (EAEQ), to assess to what extent it covers the International Classification of Functioning, Disability and Health (ICF), and to describe the adequacy of the physical, social, and attitudinal environment to the specific needs of young adults with cerebral palsy (CP). DESIGN Cross-sectional. SETTING Administrative regions in France, Germany, Italy, Portugal, and Sweden. PARTICIPANTS Young adults with CP (N=357), with varying severity profiles, aged 19-28 years at time of interview (2018-20). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) Physical, social, and attitudinal environment unmet needs. RESULTS Relevant environmental factors (EFs) for young adults with CP were identified during focus groups in England and Portugal. EFs were mapped to the ICF environmental classification and the EAEQ analytical structure resulted from this linking procedure. It comprised 61 items, linked to 31 ICF environmental classification categories, and covered 4 of its 5 chapters. Content validity assessed with the bandwidth index (percentage coverage of ICF Core Sets for adults with CP) was satisfactory (79.3%). A descriptive analysis was carried out. Participants had a mean age of 24 years, 56% were men, 38% had severely limited mobility. Less than 16% reported unmet needs for EFs relating to home, college/work/day placement, and communication in the Products and technology chapter. Unmet needs were higher (>20%) for the other items in the Public use and Land development categories. Social support, attitudes, and understanding of relatives were often adequate to the participants' needs. The proportion of unmet needs varied by sex (women were more often concerned) and raised with increasing gross motor impairment. CONCLUSION The EAEQ describes in detail the adequacy of the environment to the specific needs of young adults with CP. Its ICF-based structure opens up possibilities for use in a universal conceptual framework.
Collapse
Affiliation(s)
- Célia Perret
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | | | - Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Virginie Ehlinger
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | - Carine Duffaut
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | - Catherine Arnaud
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France; Clinical Epidemiology Unit, University Hospital, Toulouse, France
| | | |
Collapse
|
2
|
Muehlan H, Alvarelhao J, Arnaud C, Cytera C, Fauconnier J, Himmelmann K, Marcelli M, Markwart H, Rapp M, Schmidt S, Thyen U. Satisfaction with health care services in young people with cerebral palsy in the transition period: results from a European multicenter study. Front Med (Lausanne) 2024; 11:1306504. [PMID: 38352143 PMCID: PMC10862483 DOI: 10.3389/fmed.2024.1306504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Background Young people with chronic health conditions and disabilities rely on the healthcare system to maintain their best possible health. The appropriate delivery and utilization of healthcare services are key to improve their autonomy, self-efficacy and employment outcomes. The research question of our study is directed toward investigating if poor availability and accessibility of healthcare services in general, as identified by unmet needs in healthcare, are associated with dissatisfaction with healthcare. Methods Within a European multicenter observational study, 357 young adults with cerebral palsy aged 19-28 were included. We assessed special healthcare needs, utilization of healthcare services, and satisfaction with healthcare applying the short-form of the YHC-SUN-SF, environmental and social variables (EAEQ) as well as indicators for severity of condition and functionality (e.g., GMFCS) of these participants based on a self-, assisted self- or proxy-reports. We used correlation analyses to explore associations between satisfaction with healthcare and respective indicators related to availability and accessibility of healthcare services as well as severity of the condition. In addition, we included reference values for satisfaction with heath care from young adults with various chronic conditions assessed within population-based surveys from some of the European countries included in the study. Results We identified several unmet healthcare needs, especially for widely used and established services (e.g., physical therapy). Satisfaction with healthcare (YHC-SUN-SF general and subscale scores) was moderate to high and almost consistently better for the sample of young adults with cerebral palsy as compared to reference values for young adults with various chronic conditions assessed within general population surveys). Correlation coefficients between satisfaction with healthcare and utilization of services and (unmet) healthcare needs were low, also with different indicators for severity of the condition or functionality. Conclusion Young adults with cerebral palsy reports of unmet healthcare needs varied largely but showed substantial deficits in some aspects. This seems to have no impact on the satisfaction with healthcare those patients currently receive. We conclude that these are two different constructs and somewhat independent indicators to evaluate the quality of healthcare. Clinicians and other practitioners should consider this distinction when monitoring patient needs in their daily practice.
Collapse
Affiliation(s)
- Holger Muehlan
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | | | - Catherine Arnaud
- UMR 1295 CERPOP Centre for Epidemiology and Research in POPulation Health, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
- Clinical Epidemiology Unit, University Hospital, Toulouse, France
| | - Chirine Cytera
- Hospital for Child and Adolescent Medicine, University of Luebeck, Luebeck, Germany
| | - Jerome Fauconnier
- Laboratoire TIMC-IMAG Equipe ThEMAS, Pavillon Taillefer, Université Joseph Fournier, Grenoble, France
| | - Kate Himmelmann
- Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marco Marcelli
- Azienda Sanitaria Locale Viterbo, Child and Adolescent Neuropsychiatric Unit—Adult Disability Unit, Viterbo, Italy
| | - Henriette Markwart
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marion Rapp
- Hospital for Child and Adolescent Medicine, University of Luebeck, Luebeck, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Ute Thyen
- Hospital for Child and Adolescent Medicine, University of Luebeck, Luebeck, Germany
| |
Collapse
|
3
|
De Clercq LE, Soenens B, Dieleman LM, Prinzie P, Van der Kaap-Deeder J, Beyers W, De Pauw SSW. Parenting and Child Personality as Modifiers of the Psychosocial Development of Youth with Cerebral Palsy. Child Psychiatry Hum Dev 2022; 53:137-155. [PMID: 33405025 DOI: 10.1007/s10578-020-01106-1] [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] [Accepted: 12/05/2020] [Indexed: 11/26/2022]
Abstract
This two-year longitudinal study addressed the joint contribution of parent-rated parenting behaviors and child personality on psychosocial outcomes in 118 families of children with Cerebral Palsy (M age Time 1 = 10.9 years old, 64.4% boys). Latent change modeling revealed intra-individual changes in children's psychosocial development as internalizing and externalizing behaviors increased from the first to the second assessment and psychosocial strengths increased from the second to the third assessment, whereas externally controlling and autonomy-supportive parenting behavior remained stable over time. Externally controlling parenting related to higher levels of, and increases in behavioral problems, with these associations being most pronounced among children low on Extraversion, Conscientiousness, or Imagination. Autonomy-supportive parenting related to higher levels of psychosocial strengths, with this association being most pronounced among children high on Emotional Stability.
Collapse
Affiliation(s)
- Lana E De Clercq
- Department of Special Needs Education, Ghent University, Henri Dunantlaan 1, 9000, Ghent, Belgium.
| | - Bart Soenens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Lisa M Dieleman
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Peter Prinzie
- Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Wim Beyers
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sarah S W De Pauw
- Department of Special Needs Education, Ghent University, Henri Dunantlaan 1, 9000, Ghent, Belgium
| |
Collapse
|
4
|
Arnaud C, Duffaut C, Fauconnier J, Schmidt S, Himmelmann K, Marcelli M, Pennington L, Alvarelhão J, Cytera C, Rapp M, Ehlinger V, Thyen U. Determinants of participation and quality of life of young adults with cerebral palsy: longitudinal approach and comparison with the general population - SPARCLE 3 study protocol. BMC Neurol 2021; 21:254. [PMID: 34193065 PMCID: PMC8244176 DOI: 10.1186/s12883-021-02263-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/02/2021] [Indexed: 12/20/2022] Open
Abstract
Background Effective inclusion in society for young people with disabilities is increasingly seen as generating opportunities for self-development, and improving well-being. However, significant barriers remain in the vast majority of activities meaningful for young adults. Research argues that various personal (disabilities, health) and environmental (access to the resources needed, accessible environment, discrimination, lack of personal economic independence) factors contribute to limited participation. However, previous studies conducted in young people with cerebral palsy (CP) mainly investigated the transition period to adulthood, and did not fully consider the whole range of impairment severity profiles or environmental barriers. In this study, we will use the follow-up of the SPARCLE cohort and a comparison group from the general population (1) to investigate the impact of the environment on participation and quality of life of young adults with CP, (2) to determine predictors of a successful young adulthood in educational, professional, health and social fields, (3) to compare quality of life and frequency of participation in social, work and recreational activities with the general population, (4) to document on participation and quality of life in those with severe disabilities. Methods The SPARCLE3 study has a combined longitudinal and cross-sectional design. Young adults with CP aged 22 to 27 years in 6 European regions previously enrolled in the SPARCLE cohort or newly recruited will be invited to self-complete a comprehensive set of questionnaires exploring participation (daily life and discretionary activities), health-related quality of life, body function, personal factors (health, personal resources), and contextual factors (availability of needed environmental items, family environment, services provision) during home visits supervised by trained researchers. Proxy-reports or adapted questionnaires will be used for those with the most severe impairments. The recruitment of a large group from the general population (online survey) will enable to identify life areas where the discrepancies between young people with CP and their able-bodied peers are the most significant. Discussion This study will help identify to what extent disabilities and barriers in environment negatively affect participation and quality of life, and how previous valued experiences during childhood or adolescence might modulate these effects.
Collapse
Affiliation(s)
- Catherine Arnaud
- UMR 1027 Inserm, Toulouse3 University, team Sphere, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France. .,Clinical Epidemiology Unit, University Hospital, F-31059, Toulouse, France.
| | - Carine Duffaut
- UMR 1027 Inserm, Toulouse3 University, team Sphere, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France
| | - Jérôme Fauconnier
- Laboratoire TIMC-IMAG Equipe ThEMAS, Grenoble Alpes University, Pavillon Taillefer CHU Grenoble CS10217, F-338043, Grenoble, France
| | - Silke Schmidt
- University of Greifswald, Institute of Psychology, Robert-Blum-Str. 13, 17489, Greifswald, Germany
| | - Kate Himmelmann
- Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Marco Marcelli
- Azienda Sanitaria Locale Viterbo, Child and Adolescent Neuropsychiatric Unit - Adult Disability Unit, Via Enrico Fermi 15, 01100, Viterbo, Italy
| | - Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Joaquim Alvarelhão
- School of Health Sciences, University of Aveiro, Campo Universitário de Santiago, Aveiro, Portugal
| | - Chirine Cytera
- University of Greifswald, Institute of Psychology, Robert-Blum-Str. 13, 17489, Greifswald, Germany.,Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Marion Rapp
- Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Virginie Ehlinger
- UMR 1027 Inserm, Toulouse3 University, team Sphere, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France
| | - Ute Thyen
- Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| |
Collapse
|
5
|
Sentenac M, Rapp M, Ehlinger V, Colver A, Thyen U, Arnaud C. Disparity of child/parent-reported quality of life in cerebral palsy persists into adolescence. Dev Med Child Neurol 2021; 63:68-74. [PMID: 32710687 DOI: 10.1111/dmcn.14638] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2020] [Indexed: 01/10/2023]
Abstract
AIM To examine the evolution of child-parent discrepancy in reporting quality of life (QoL) between childhood and adolescence in children with cerebral palsy (CP) and to investigate potential factors associated with such a discrepancy. METHOD We used data from the SPARCLE (Study of PARticipation of Children with CP Living in Europe) study, a population-based cohort study of children with CP, aged 8 to 12 years at baseline (in 2004-2005), in nine European centres, who were followed up at the age of 13 to 17 years. The KIDSCREEN-52 Quality of Life measure was used at baseline and follow-up; 354 child-parent dyads out of 500 eligible dyads were followed up (201 males, 153 females). We used intraclass correlation coefficients (ICCs) to examine agreement between parent proxy-reports and self-reported QoL. We used linear regression to examine factors associated with child-parent discrepancy in QoL reporting. RESULTS Agreement was low to moderate (ICC=0.16-0.48) in childhood and in adolescence across all QoL domains. In four domains (moods and emotions, self-perception, relationship with parents and home life, and social support and peers), the extent of the discrepancy increased significantly between childhood and adolescence. Parenting stress, child pain, and child behaviour problems influenced parent proxy-reports during both childhood and adolescence. INTERPRETATION The points of view of the child and their parents should be treated as complementary to obtain better knowledge regarding the QoL of children and adolescents with CP.
Collapse
Affiliation(s)
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | | | - Allan Colver
- Institute of Health and Society, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
| | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Catherine Arnaud
- Inserm U1027, Université Paul Sabatier, Toulouse, France.,Clinical Epidemiology Unit, CHU Purpan, Toulouse, France
| |
Collapse
|
6
|
Dada S, Bastable K, Halder S. The Role of Social Support in Participation Perspectives of Caregivers of Children with Intellectual Disabilities in India and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6644. [PMID: 32933056 PMCID: PMC7558089 DOI: 10.3390/ijerph17186644] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022]
Abstract
Caregivers are an intrinsic component of the environment of children with intellectual disabilities. However, caregivers' capacity to support children's participation may be linked to the social support that they, as caregivers, receive. Social support may increase participation, educational, psychological, medical and financial opportunities. However, there is a lack of information on social support in middle-income countries. The current study described and compared the social support of caregivers of children with intellectual disabilities by using the Family Support Survey (FSS) in India and South Africa. The different types of social support were subsequently considered in relation to participation, using the Children's Assessment of Participation and Enjoyment (CAPE). One hundred caregiver-child dyads from India and 123 from South Africa participated in this study. The data were analysed using non-parametric measures. Indian caregivers reported greater availability of more helpful support than did the South African caregivers. Social support was associated with children's participation diversity (India) and intensity (South Africa). The child-/caregiver-reported participation data showed different associations with participation. Results from this study suggest that perceived social support of caregivers differs between countries and is associated with their child's participation. These factors need to be considered when generalising results from different countries.
Collapse
Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, Humanities Faculty, University of Pretoria, Pretoria 0002, South Africa;
| | - Kirsty Bastable
- Centre for Augmentative and Alternative Communication, Humanities Faculty, University of Pretoria, Pretoria 0002, South Africa;
| | - Santoshi Halder
- Department of Education, University of Calcutta, Alipore Campus, 1 Reformatory St., Kolkata 700027, India;
| |
Collapse
|
7
|
Srinivasaraghavan R, Koshy B, Devarajan C, Beulah R, Glory L, Manoharan M. The Impact of Autism Spectrum Disorder in Comparison with Other Neuro-Developmental Disorders in Children on the Family: Single Centre Experience. Indian J Psychol Med 2020; 42:233-237. [PMID: 32612327 PMCID: PMC7320731 DOI: 10.4103/ijpsym.ijpsym_376_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/19/2019] [Accepted: 03/12/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDD), especially autism spectrum disorder (ASD), have a substantial impact on the family, with a consequent decrease in the quality of life. The current study was undertaken to understand if having ASD contributed to a higher impact on families compared to other NDD and to understand additional factors impacting families of children with either disorder in a low-middle income country (LMIC) setting. METHODS Impact of ASD and other NDD along with sociodemographic factors was examined, by a retrospective analysis, among 540 children in a tertiary care center in South India. RESULTS Both ASD and NDD had high, but comparable, impact on the family. Being a girl child, having seizures, and having sleep problems predicted a higher impact. CONCLUSIONS In children with NDD, managing co-morbidities such as achieving better seizure control and addressing sleep-related problems may improve the impact of NDD on the family. Gender disparity in disability needs to be studied within the local cultural context.
Collapse
Affiliation(s)
- Rangan Srinivasaraghavan
- Developmental Pediatrics unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Beena Koshy
- Developmental Pediatrics unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Chitra Devarajan
- Developmental Pediatrics unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Rachael Beulah
- Developmental Pediatrics unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Lincy Glory
- Developmental Pediatrics unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Margaret Manoharan
- Developmental Pediatrics unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| |
Collapse
|
8
|
Boldyreva U, Streiner DL, Rosenbaum PL, Ronen GM. Quality of life in adolescents with epilepsy, cerebral palsy, and population norms. Dev Med Child Neurol 2020; 62:609-614. [PMID: 31898321 DOI: 10.1111/dmcn.14450] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2019] [Indexed: 12/18/2022]
Abstract
AIM To compare: (1) self- and proxy-reported quality of life (QoL) in adolescents with epilepsy, cerebral palsy (CP), both epilepsy and CP, and a representative general population sample; and (2) parental stress between parents of adolescents with epilepsy, CP, or both epilepsy and CP. METHOD This was a cross-sectional observational study with 496 adolescents with epilepsy, 699 with CP, 192 with both CP and epilepsy, and 15 396 from the general population, assessed with the KIDSCREEN-52 and Parenting Stress Index (PSI). RESULTS All KIDSCREEN-52 domains showed statistically significant differences across groups. The epilepsy population showed clinically better scores for 'school environment' than the general population (Cohen's d=0.62). Parents scored adolescents with CP lower than adolescents with epilepsy or general populations on 'physical health' (d=0.57, d=0.55) and 'social-support and peers' (d=0.82, d=0.91). Parents of adolescents with CP scored them lower than parents of the epilepsy group on 'autonomy' (d=0.62). Parents of adolescents with epilepsy scored them lower on 'mood and emotions' (d=0.52) and 'social acceptance' (d=0.66) than the general population. PSI scores were better for parents of adolescents with CP than for parents of adolescents with epilepsy (d=2.12, d=2.70, d=3.35, d=1.67). INTERPRETATION Adolescents with epilepsy or CP self-report equal or better QoL than the general adolescent population, which should comfort families and allow clinicians to address parental concerns. WHAT THIS PAPER ADDS Adolescents with epilepsy, with or without cerebral palsy (CP), self-reported better school environment than adolescents in the general population. Proxy quality of life (QoL) results showed clinically important differences across groups in 6 out of 10 domains of the KIDSCREEN-52. Proxy-reported results showed poorer QoL scores for adolescents with epilepsy or CP than the general population. Parental stress level was lower in parents of children with CP or both CP and epilepsy, than in those with only epilepsy.
Collapse
Affiliation(s)
- Uliana Boldyreva
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Gabriel M Ronen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
9
|
Withers JW, Muzzolon SB, Zonta MB. Influence of adapted hip-hop dancing on quality of life and social participation among children/adolescents with cerebral palsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:712-722. [PMID: 31664347 DOI: 10.1590/0004-282x20190124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 07/21/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe the influence of adapted hip-hop dancing on the quality of life (QoL) and biopsychosocial profile of children/adolescents with cerebral palsy (CP). METHODS Pilot study including 18 children/adolescents with CP and Gross Motor Function Classification System levels I and II. Nine participants took part in an adapted hip-hop dance practice (study group; SG), and nine others served as the control group (CG). All participants were assessed with the Pediatric Outcomes Data Collection Instrument and the Child Behavior Checklist at baseline and after at least three months of dance practice and a public performance (SG) or a similar period without intervention (CG). RESULTS Improvement in QoL was observed in the SG in the domains of transfer and basic mobility (p = 0.00*), sporting and physical function (p = 0.04*), and global function and symptoms (p = 0.01*). In the SG, there was a reduction in emotional and behavioral problems and an increase in social competence in the biopsychosocial profile. Greater participation in adapted hip-hop dancing was associated with a greater gain in the transfer and basic mobility domains (p = 0.05*) of the Pediatric Outcomes Data Collection Instrument and in the activities (p = 0.05*) and social (p = 0.04*) scales of the Child Behavior Checklist. CONCLUSIONS Children/adolescents with CP participating in adapted hip-hop dance practice showed improvement in QoL and biopsychosocial profile scores.
Collapse
Affiliation(s)
- Joseana Wendling Withers
- Universidade Federal do Paraná, Setor de Ciências da Saúde, Pós-graduação em Saúde da Criança e do Adolescente, Curitiba PR, Brasil
| | - Sandra Baggio Muzzolon
- Universidade Federal do Paraná, Hospital de Clínicas, Serviço de Psicologia, Curitiba PR, Brasil
| | - Marise Bueno Zonta
- Universidade Federal do Paraná, Hospital de Clínicas, Serviço de Reabilitação, Curitiba PR, Brasil
| |
Collapse
|
10
|
Park EY, Won-Ho K. Participation restriction of stroke survivors: Verification of the moderating effects of demographic characteristics. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1674090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Eun-Young Park
- Professor of the Department of Secondary Special Education, College of Education, Jeonju University, 303 Cheonjam-ro, Wansan-gu 55069, South Korea
| | - Kim Won-Ho
- Professor of the Department of Physical Therapy, Ulsan College, 101 Bong su-ro, Dong-gu 44022, South Korea
| |
Collapse
|
11
|
Effect of Mirror Therapy on Dexterity and Hand Grasp in Children Aged 9-14 Years with Hemiplegic Cerebral Palsy. IRANIAN JOURNAL OF CHILD NEUROLOGY 2019; 13:135-142. [PMID: 31645873 PMCID: PMC6789091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/22/2018] [Accepted: 07/29/2018] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Mirror therapy using visual feedback is one of the non-invasive methods along with other commonly used rehabilitation treatments for neurological patients which therapeutic effects on the affected upper limb of children with hemiplegic cerebral palsy have also been studied. We aimed to examine the effect of mirror therapy on improving the dexterity and grasp of children with hemiplegic cerebral palsy. MATERIALS & METHODS In this single-blind clinical trial, 30 children with hemiplegic cerebral palsy in rehabilitation centers and special schools of Tabriz, northwest of Iran were randomly divided into two intervention and control groups in 2017. The children of the intervention group were under mirror therapy for 6 weeks. Occupational therapy exercise was done routinely for both groups. The grasp with dynamometer and the dexterity with box and block was measured. Data were analyzed using independent t-test and paired t-test. RESULTS The mean scores of the two groups in dexterity were significantly different after the intervention (P=0.008). However, there was no significant difference between the two groups in grasp. CONCLUSION Mirror therapy in hemiplegic children is useful in improving the dexterity but not in improving of the grasp.
Collapse
|
12
|
Heräjärvi N, Leskinen M, Pirttimaa R, Jokinen K. Subjective quality of life among youth with severe physical disabilities during the transition to adulthood in Finland. Disabil Rehabil 2018; 42:918-926. [DOI: 10.1080/09638288.2018.1511756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Nina Heräjärvi
- Department of Education, Special Education, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Leskinen
- Department of Education, Special Education, University of Jyväskylä, Jyväskylä, Finland
| | - Raija Pirttimaa
- Department of Education, Special Education, University of Jyväskylä, Jyväskylä, Finland
| | - Kimmo Jokinen
- Department of Social Sciences and Philosophy, Family Research Centre, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
13
|
Self-reported upper limb functioning of pupils with cerebral palsy by the International Classification of Functioning, Disability, and Health. Int J Rehabil Res 2018; 41:262-266. [PMID: 29664754 DOI: 10.1097/mrr.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
International Classification of Functioning, Disability, and Health: Children and Youth Version has shown an increasing role in the assessment of children with cerebral palsy (CP), but just a few researchers use it for individuals' self-assessment. In this study, we present the self-assessment of functioning of students with CP and changes by the end of a school year. Thirty-seven pupils with spastic CP involving upper limbs, 24 pupils with typical development, and 20 pupils with speech and language disorders were studied by International Classification of Functioning, Disability, and Health core sets for CP. The CP group reported limitations in sensory functions (P<0.05), movement-related functions (P<0.001), and mobility (P<0.001) as well as products and technology and support and relationships as supportive (P<0.05). Correlation between expert and self-evaluation was weak to moderate. The CP core set may appropriately serve in the self-assessment of pupils' functioning in longitudinal studies.
Collapse
|
14
|
Espín-Tello SM, Colver A. How available to European children and young people with cerebral palsy are features of their environment that they need? RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:1-10. [PMID: 28987966 PMCID: PMC5679358 DOI: 10.1016/j.ridd.2017.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/16/2017] [Accepted: 09/27/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The UN Convention on the Rights of Persons with Disabilities requires accessibility to the physical and social environments. However, individuals with cerebral palsy (CP) have many difficulties in accessing the environment they need for functional independence and social inclusion. AIMS To examine the availability of environmental features which children with CP need for optimal participation, and whether availability changed for them between ages 8-12 and 13-17 years. METHODS The sample is the 594 children with CP, born 31/07/1991-01/04/1997, who took part in the SPARCLE study at age 8-12 (SPARCLE 1) and again at 13-17 years (SPARCLE 2). Participants were randomly sampled from population registers of children with CP in eight European regions; one further region recruited from multiple sources. Data about environment were captured with the European Child Environment Questionnaire (60 items). Differences in availability of environmental features between childhood and adolescence were assessed using McNemar's test; differences between regions were assessed by ranking regions. Differences in availability between regions were assessed by ranking regions. RESULTS For seven environmental features significantly (p<0.01) fewer individuals needed the feature in SPARCLE 2 than in SPARCLE 1, whilst for two features more individuals needed the feature. Nine features in SPARCLE 1 and six features in SPARCLE 2 were available to less than half the participants who needed them. Eight features showed significantly (p<0.01) higher availability in SPARCLE 2 than in SPARCLE 1 (enlarged rooms, adapted toilet, modified kitchen and hoists at home, adapted toilets and lifts at school, an adequate vehicle, grants for home modifications) while none showed significantly lower availability. The relative rankings of the better and less good regions persisted from the age 8-12year age group to the 13-17year age group. CONCLUSIONS Needed environmental features are unavailable to many children at ages 8-12 and 13-17 years. This lack of availability is more pronounced in some regions than others, which probably results from their policy, legislative and statutory frameworks.
Collapse
Affiliation(s)
| | - Allan Colver
- Institute of Health and Society, Newcastle University, UK
| |
Collapse
|
15
|
Adolfsson M, Johnson E, Nilsson S. Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches. Disabil Rehabil 2017; 40:2152-2162. [DOI: 10.1080/09638288.2017.1327987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Margareta Adolfsson
- CHILD, Jönköping University, Jönköping, Sweden
- School of Education and Communication, Jönköping University, Jönköping, Sweden
- Swedish Institute of Disability Research, Jönköping University, Jönköping, Sweden
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Stefan Nilsson
- CHILD, Jönköping University, Jönköping, Sweden
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
16
|
Rapp M, Eisemann N, Arnaud C, Ehlinger V, Fauconnier J, Marcelli M, Michelsen SI, Nystrand M, Colver A, Thyen U. Predictors of parent-reported quality of life of adolescents with cerebral palsy: A longitudinal study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 62:259-270. [PMID: 28110883 DOI: 10.1016/j.ridd.2016.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/14/2016] [Accepted: 12/18/2016] [Indexed: 06/06/2023]
Abstract
AIM Parent-reporting is needed to examine Quality of Life (QoL) of children with cerebral palsy (CP) across all severities. This study examines whether QoL changes between childhood and adolescence, and what predicts adolescent QoL. METHOD SPARCLE is a European cohort study of children with CP, randomly sampled from population databases. Of 818 8-12-year-olds joining the study, 594 (73%) were revisited as 13-17-year-olds. The subject of this report is the 551 (316 boys, 235 girls) where the same parent reported QoL on both occasions using KIDSCREEN-52 (transformed Rasch scale, mean 50, SD 10 per domain). Associations were assessed using linear regression. RESULTS Between childhood and adolescence, average QoL reduced in six domains (1.3-3.8 points, p<0.01) and was stable in three (Physical wellbeing, Autonomy, Social acceptance). Socio-demographic factors had little predictive value. Childhood QoL was a strong predictor of all domains of adolescent QoL. Severe impairments of motor function, IQ or communication predicted higher adolescent QoL on some domains; except that severe motor impairment predicted lower adolescent QoL on the Autonomy domain. More psychological problems and higher parenting stress in childhood and their worsening by adolescence predicted lower QoL in five and eight domains respectively; contemporaneous pain in seven domains. The final model explained 30%-40% of variance in QoL, depending on domain. INTERPRETATION In general, impairment severity and socio-demographic factors were not predictors of lower adolescent QoL. However, pain, psychological problems and parenting stress were predictors of lower adolescent QoL in most domains. These are modifiable factors and addressing them may improve adolescent QoL.
Collapse
Affiliation(s)
- Marion Rapp
- Department of Pediatrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, Purpan, Clinical Epidemiology Unit, Toulouse, France.
| | | | - Jérôme Fauconnier
- UJF-Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France.
| | | | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Malin Nystrand
- Gothenburg University, The Queen Silvia Children's Hospital, S-41685 Gothenburg, Sweden.
| | - Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Ute Thyen
- Department of Pediatrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| |
Collapse
|
17
|
Ramstad K, Jahnsen R, Diseth TH. Associations between recurrent musculoskeletal pain and visits to the family doctor (GP) and specialist multi-professional team in 74 Norwegian youth with cerebral palsy. Child Care Health Dev 2016; 42:735-41. [PMID: 27283955 DOI: 10.1111/cch.12366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 05/07/2016] [Accepted: 05/12/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Musculoskeletal pain in cerebral palsy (CP) is common, but probably undertreated. The aim of the study was to explore if recurrent musculoskeletal pain (RMP) related to the CP condition was associated with visits to the family doctor [general practitioner (GP)] and specialist habilitation centre in youth with CP. METHODS Seventy-four youth with CP (mean age 16.5 years, 40 boys) from the same geographical area were assessed by clinical examination, semi-structured interview on pain (adolescent and parent together), the two questions on pain from the Child Health Questionnaire (parents only) and a structured interview on health care services. Gross Motor Function Classification System was level I 39%, level II 23%, level III 8% and levels IV and V 30%. RESULTS Thirty-five participants (47%) had visited their GP last year, and 49 (66%) had visited the specialist habilitation centre. The presence of RMP (n = 58; 78%) was not significantly associated with having visited the GP or the specialist habilitation centre. Still, in participants with RMP, increasing pain severity was associated with having visited the GP. Rest, massage, change of position and oral drugs were the most common measures taken to relieve RMP. Three adolescents with RMP did not take any measures to relieve pain. CONCLUSION Youth with RMP do take measures to relieve pain, but usually not in the direction of consulting the health care services available unless the pain is severe. Both youth with CP and their caregivers should be encouraged to discuss RMP with their professional network of care.
Collapse
Affiliation(s)
- K Ramstad
- Department of Clinical Neuroscience, Division of Women and Children, Oslo University Hospital, Oslo, Norway
| | - R Jahnsen
- Department of Clinical Neuroscience, Division of Women and Children, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo University College, Oslo, Norway
| | - T H Diseth
- Department of Clinical Neuroscience, Division of Women and Children, Oslo University Hospital, Oslo, Norway.,University of Oslo, Oslo, Norway
| |
Collapse
|
18
|
Pons C, Brochard S, Gallien P, Nicolas B, Duruflé A, Roquet M, Rémy-Néris O, Garlantezec R. Medication, rehabilitation and health care consumption in adults with cerebral palsy: a population based study. Clin Rehabil 2016; 31:957-965. [DOI: 10.1177/0269215516663286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To evaluate medication, rehabilitation and healthcare consumption in adults with CP as a function of Gross Motor Function Classification System (GMFCS) level. Design: Questionnaire-based cross-sectional study. Setting: Brittany, a French county. Subjects: Adults with cerebral palsy. Interventions: Questionnaires relating to drugs, orthotic devices, mobility aids, rehabilitation and medical input were sent to 435 members of a unique regional French network dedicated to adults with cerebral palsy. The questionnaire was completed by the participant or a helper if necessary. Results: Of the 282 responders, 7.8% had a GMFCS level of I, 14.2% II, 17.7% III, 29.1% IV and 31.2% V. Participants consumed a large amount of healthcare. Almost three-quarters took orally administered drugs, of which antispastic and antiepileptic drugs were among the most frequent. Nearly all patients had at least one type of rehabilitation, 87.2% had physiotherapy, 78% used at least one mobility aid and 69.5% used at least one orthotic device. The frequency of numerous inputs increased with GMFCS level. Specificities were found for each GMFCS level, e.g. participants with GMFCS level IV and V had a high level of medical input and a greater use of trunk-supporting devices, antireflux and laxative. Profiles could be established based on GMFCS levels. Conclusions: Adults with cerebral palsy use a large amount of drugs, mobility aids, orthotic devices, rehabilitation and medical input. Healthcare is targeted at cerebral palsy-related issues. GMFCS is a determinant of healthcare consumption and thus a useful tool for clinical practice to target care appropriately.
Collapse
Affiliation(s)
- Christelle Pons
- Physical medicine and rehabilitation, CHRU Brest, France
- Fondation ILDYS, Brest, France
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l’Information Médicale, Brest, France
| | - Sylvain Brochard
- Physical medicine and rehabilitation, CHRU Brest, France
- Fondation ILDYS, Brest, France
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l’Information Médicale, Brest, France
| | - Philippe Gallien
- Physical medicine and rehabilitation, Pôle MPR Saint Hélier, Rennes, France
| | - Benoit Nicolas
- Physical medicine and rehabilitation, Pôle MPR Saint Hélier, Rennes, France
| | - Aurélie Duruflé
- Physical medicine and rehabilitation, Pôle MPR Saint Hélier, Rennes, France
| | - Marion Roquet
- Physical medicine and rehabilitation, CHRU Brest, France
| | - Olivier Rémy-Néris
- Physical medicine and rehabilitation, CHRU Brest, France
- Université de Bretagne Occidentale, Brest, France
- Laboratoire de Traitement de l’Information Médicale, Brest, France
| | - Ronan Garlantezec
- Public Health departement, CHU Rennes, University Rennes 1 Rennes, France
| |
Collapse
|
19
|
Abstract
Selective dorsal rhizotomy is a valuable surgical option to manage spasticity in children with bilateral cerebral palsy with the objective of improving function. Choosing the correct patient for rhizotomy requires considerable effort and a comprehensive evaluation. Instrumented three-dimensional gait analysis provides supporting evidence in the selection of the ideal child for SDR as well as enabling quantitative monitoring of outcome and post-operative management up to skeletal maturity.
Collapse
Affiliation(s)
- Andrew Roberts
- Orthotic Research and Locomotor Assessment Unit, Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG, United Kingdom.
| | - Caroline Stewart
- Orthotic Research and Locomotor Assessment Unit, Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG, United Kingdom
| | - Robert Freeman
- Orthotic Research and Locomotor Assessment Unit, Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG, United Kingdom
| |
Collapse
|
20
|
Colver A, Rapp M, Eisemann N, Ehlinger V, Thyen U, Dickinson HO, Parkes J, Parkinson K, Nystrand M, Fauconnier J, Marcelli M, Michelsen SI, Arnaud C. Self-reported quality of life of adolescents with cerebral palsy: a cross-sectional and longitudinal analysis. Lancet 2015; 385:705-16. [PMID: 25301503 PMCID: PMC4606972 DOI: 10.1016/s0140-6736(14)61229-0] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Children with cerebral palsy who can self-report have similar quality of life (QoL) to their able-bodied peers. Is this similarity also found in adolescence? We examined how self-reported QoL of adolescents with cerebral palsy varies with impairment and compares with the general population, and how factors in childhood predict adolescent QoL. METHODS We report QoL outcomes in a longitudinal follow-up and cross-sectional analysis of individuals included in the SPARCLE1 (childhood) and SPARCLE2 (adolescent) studies. In 2004 (SPARCLE1), a cohort of 818 children aged 8-12 years were randomly selected from population-based cerebral palsy registers in nine European regions. We gathered data from 500 participants about QoL with KIDSCREEN (ten domains); frequency of pain; child psychological problems (Strengths and Difficulties Questionnaire); and parenting stress (Parenting Stress Index). At follow-up in 2009 (SPARCLE2), 355 (71%) adolescents aged 13-17 years remained in the study and self-reported QoL (longitudinal sample). 76 additional adolescents self-reported QoL in 2009, providing data for 431 adolescents in the cross-sectional sample. Researchers gathered data at home visits. We compared QoL against matched controls in the general population. We used multivariable regression to relate QoL of adolescents with cerebral palsy to impairments (cross-sectional analysis) and to childhood QoL, pain, psychological problems, and parenting stress (longitudinal analysis). FINDINGS Severity of impairment was significantly associated (p<0·01) with reduced adolescent QoL on only three domains (Moods and emotions, Autonomy, and Social support and peers); average differences in QoL between the least and most able groups were generally less than 0·5 SD. Adolescents with cerebral palsy had significantly lower QoL than did those in the general population in only one domain (Social support and peers; mean difference -2·7 [0·25 SD], 95% CI -4·3 to -1·4). Pain in childhood or adolescence was strongly associated with low adolescent QoL on eight domains. Childhood QoL was a consistent predictor of adolescent QoL. Child psychological problems and parenting stress in childhood or their worsening between childhood and adolescence predicted only small reductions in adolescent QoL. INTERPRETATION Individual and societal attitudes should be affected by the similarity of the QoL of adolescents with and without cerebral palsy. Adolescents with cerebral palsy need particular help to maintain and develop peer relationships. Interventions in childhood to alleviate psychological difficulties, parenting stress, and especially pain, are justified for their intrinsic value and for their longer term effect on adolescent QoL. FUNDING SPARCLE1 was funded by the European Union Research Framework 5 Program (grant number QLG5-CT-2002-00636), the German Ministry of Health GRR-58640-2/14, and the German Foundation for the Disabled Child. SPARCLE2 was funded by: Wellcome Trust WT086315 A1A (UK and Ireland); Medical Faculty of the University of Lübeck E40-2009 and E26-2010 (Germany); CNSA, INSERM, MiRe-DREES, and IRESP (France); Ludvig and Sara Elsass Foundation, The Spastics Society and Vanforefonden (Denmark); Cooperativa Sociale "Gli Anni in Tasca" and Fondazione Carivit, Viterbo (Italy); Göteborg University-Riksforbundet for Rorelsehindrade Barn och Ungdomar and the Folke Bernadotte Foundation (Sweden).
Collapse
Affiliation(s)
- Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institute of Cancer Epidemiology, Universität Lübeck, Lübeck, Germany
| | | | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität Lübeck, Lübeck, Germany
| | - Heather O Dickinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Jackie Parkes
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, UK
| | - Kathryn Parkinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Malin Nystrand
- Göteborg University, The Queen Silvia Children's Hospital, Sweden
| | - Jérôme Fauconnier
- UJF-Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, France
| | | | | | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, Toulouse, France; Purpan, Clinical Epidemiology Unit, Toulouse, France
| |
Collapse
|
21
|
Dang VM, Colver A, Dickinson HO, Marcelli M, Michelsen SI, Parkes J, Parkinson K, Rapp M, Arnaud C, Nystrand M, Fauconnier J. Predictors of participation of adolescents with cerebral palsy: A European multi-centre longitudinal study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:551-564. [PMID: 25462516 PMCID: PMC4265728 DOI: 10.1016/j.ridd.2014.10.043] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/24/2014] [Indexed: 06/01/2023]
Abstract
We investigated whether childhood factors that are amenable to intervention (parenting stress, child psychological problems and pain) predicted participation in daily activities and social roles of adolescents with cerebral palsy (CP). We randomly selected 1174 children aged 8-12 years from eight population-based registers of children with CP in six European countries; 743 (63%) agreed to participate. One further region recruited 75 children from multiple sources. These 818 children were visited at home at age 8-12 years, 594 (73%) agreed to follow-up at age 13-17 years. We used the following measures: parent reported stress (Parenting Stress Index Short Form), their child's psychological difficulties (Strength and Difficulties Questionnaire) and frequency and severity of pain; either child or parent reported the child's participation (LIFE Habits questionnaire). We fitted a structural equation model to each of the participation domains, regressing participation in childhood and adolescence on parenting stress, child psychological problems and pain, and regressing adolescent factors on the corresponding childhood factors; models were adjusted for impairment, region, age and gender. Pain in childhood predicted restricted adolescent participation in all domains except Mealtimes and Communication (standardized total indirect effects β -0.05 to -0.18, 0.01
Collapse
Affiliation(s)
- Van Mô Dang
- UJF Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France.
| | - Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Heather O Dickinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Marco Marcelli
- AUSL Viterbo, Via Enrico Fermi 15, 01100 Viterbo, Italy.
| | - Susan I Michelsen
- National Institute of Public Health, Oster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Jackie Parkes
- School of Nursing & Midwifery, Queen's University Belfast, 21 Stranmillis Road, Belfast BT9 5AF, UK.
| | - Kathryn Parkinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
| | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, Toulouse, France; Purpan, Clinical Epidemiology Unit, Toulouse, France.
| | - Malin Nystrand
- Göteborg University, The Queen Silvia Children's Hospital, S-41685 Göteborg, Sweden.
| | - Jérôme Fauconnier
- UJF Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France.
| |
Collapse
|
22
|
Nystrand M, Beckung E, Dickinson H, Colver A. Stability of motor function and associated impairments between childhood and adolescence in young people with cerebral palsy in Europe. Dev Med Child Neurol 2014; 56:833-8. [PMID: 24641712 PMCID: PMC4132119 DOI: 10.1111/dmcn.12435] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2014] [Indexed: 11/26/2022]
Abstract
AIM The aim of the study was to investigate whether impairments associated with cerebral palsy were stable between childhood and adolescence. METHOD The Study of Participation of Children with Cerebral Palsy Living in Europe (SPARCLE) longitudinal study was conducted in nine European regions. In total, 818 children aged 8 to 12 years were randomly selected from population-based registers; 594 (73%) were followed up at the age of 13 to 17 years (344 males, 250 females; median age 10 y 4 mo) Research associates visited them in their homes and recorded their motor function and additional impairments. Stability of impairment was assessed using the weighted kappa coefficient. RESULTS The proportion of participants whose level of impairment remained unchanged varied from 63% for fine motor function to 98% for hearing. For gross motor function, communication, and cognitive level, the kappa and the lower bound of its 95% confidence interval (CI) were above 0.75, indicating stability between childhood and adolescence; for fine motor function and feeding, the kappa was above 0.75 but the lower bound of the 95% CI was below 0.75, indicating probable stability; for seizures and vision, the kappa was below 0.75, although the upper bound of the 95% CI was above 0.75, indicating possible change; for hearing the kappa and its entire CI were below 0.75, indicating change. Overall, 81% of participants had no seizures in childhood, of whom 93% were seizure-free in adolescence. INTERPRETATION Motor function and additional impairments were generally stable between childhood and adolescence.
Collapse
Affiliation(s)
- Malin Nystrand
- The Institute of Clinical Sciences, Göteborg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | | |
Collapse
|
23
|
Shikako-Thomas K, Kolehmainen N, Ketelaar M, Bult M, Law M. Promoting leisure participation as part of health and well-being in children and youth with cerebral palsy. J Child Neurol 2014; 29:1125-33. [PMID: 24907136 DOI: 10.1177/0883073814533422] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/15/2022]
Abstract
Participation in leisure is a human right and is central to the health of children and youth. The World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth supported a change in thinking about what outcomes are most relevant in the context of children's health and places participation as one of the constituent elements of health. Participation is also a fundamental rehabilitation and health promotion outcome for children with cerebral palsy as identified by youth, parents, and health professionals. Several studies have identified individual and environmental factors related to participation in leisure; new studies are now determining the best interventions to promote participation. This article summarizes recent findings and proposes important topics for neurologists to consider in exploring leisure pursuits with children with cerebral palsy and their families and in working with rehabilitation professionals to promote engagement in leisure opportunities as part of integrated care.
Collapse
Affiliation(s)
- Keiko Shikako-Thomas
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Niina Kolehmainen
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, United Kingdom
| | - Marjolijn Ketelaar
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands Partner of NetChild, Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands
| | - Maureen Bult
- Utrecht University, Faculty of Social Sciences, Department of Pedagogical and Educational Sciences, Utrecht, the Netherlands
| | - Mary Law
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| |
Collapse
|
24
|
Michelsen SI, Flachs EM, Damsgaard MT, Parkes J, Parkinson K, Rapp M, Arnaud C, Nystrand M, Colver A, Fauconnier J, Dickinson HO, Marcelli M, Uldall P. European study of frequency of participation of adolescents with and without cerebral palsy. Eur J Paediatr Neurol 2014; 18:282-94. [PMID: 24412031 PMCID: PMC4096654 DOI: 10.1016/j.ejpn.2013.12.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 12/09/2013] [Accepted: 12/10/2013] [Indexed: 11/17/2022]
Abstract
Children with cerebral palsy participate less in everyday activities than children in the general populations. During adolescence, rapid physical and psychological changes occur which may be more difficult for adolescents with impairments. Within the European SPARCLE project we measured frequency of participation of adolescents with cerebral palsy by administering the Questionnaire of Young People's Participation to 667 adolescents with cerebral palsy or their parents from nine European regions and to 4666 adolescents from the corresponding general populations. Domains and single items were analysed using respectively linear and logistic regression. Adolescents with cerebral palsy spent less time with friends and had less autonomy in their daily life than adolescents in the general populations. Adolescents with cerebral palsy participated much less in sport but played electronic games at least as often as adolescents in the general populations. Severity of motor and intellectual impairment had a significant impact on frequency of participation, the more severely impaired being more disadvantaged. Adolescents with an only slight impairment participated in some domains as often as adolescents in the general populations. Regional variation existed. For example adolescents with cerebral palsy in central Italy were most disadvantaged according to decisional autonomy, while adolescents with cerebral palsy in east Denmark and northern England played sports as often as their general populations. Participation is an important health outcome. Personal and environmental predictors of participation of adolescents with cerebral palsy need to be identified in order to design interventions directed to such predictors; and in order to inform the content of services.
Collapse
Affiliation(s)
- Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5A, 1353 Copenhagen, Denmark.
| | - Esben M Flachs
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Mogens T Damsgaard
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Jacqueline Parkes
- School of Nursing & Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 5BN, Ireland
| | - Kathryn Parkinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, Lübeck 23538, Germany
| | | | - Malin Nystrand
- The Queen Silvia Children's Hospital, Göteborg University, Göteborg S-41685, Sweden
| | - Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Jerome Fauconnier
- SIIM-Pole Exploitation, Université Joseph Fournier, CHU de Grenoble BP 217, Grenoble cedex 9 38043, France
| | - Heather O Dickinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Marco Marcelli
- Azienda Sanitaria Locale Viterbo, Vi Enrico Ferri 15, Viterbo 01100, Italy
| | - Peter Uldall
- Peter Uldall, Copenhagen University Hospital, Pediatric Clinic 1, Blegdamsvej 9, 2100 Copenhagen, Denmark
| |
Collapse
|
25
|
Himmelmann K, Lindh K, Hidecker MJC. Communication ability in cerebral palsy: a study from the CP register of western Sweden. Eur J Paediatr Neurol 2013; 17:568-74. [PMID: 23672835 DOI: 10.1016/j.ejpn.2013.04.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 04/05/2013] [Accepted: 04/17/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Communication is often impaired in cerebral palsy (CP). Tools are needed to describe this complex function, in order to provide effective support. AIM To study communication ability and the relationship between the Communication Function Classification System (CFCS) and CP subtype, gross motor function, manual ability, cognitive function and neuroimaging findings in the CP register of western Sweden. METHODS Sixty-eight children (29 girls), 14 with unilateral spastic CP, 35 with bilateral spastic CP and 19 with dyskinetic CP, participated. The CFCS, Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels, cognitive impairment and neuroimaging findings were recorded. RESULTS Half the children used speech, 32% used communication boards/books and 16% relied on body movements, eye gaze and sounds. Twenty-eight per cent were at the most functional CFCS level I, 13% at level II, 21% at level III, 10% at level IV and 28% at level V. CFCS levels I-II were found in 71% of children with unilateral spastic CP, 46% in bilateral spastic CP and 11% in dyskinetic CP (p = 0.03). CFCS correlated with the GMFCS, MACS and cognitive function (p < 0.01). Periventricular lesions were associated with speech and more functional CFCS levels, while cortical/subcortical and basal ganglia lesions were associated with the absence of speech and less functional CFCS levels (p < 0.01). CONCLUSION Communication function profiles in CP can be derived from the CFCS, which correlates to gross and fine motor and cognitive function. Good communication ability is associated with lesions acquired early, rather than late, in the third trimester.
Collapse
Affiliation(s)
- Kate Himmelmann
- Department of Paediatrics, Institute of Clinical Sciences, Queen Silvia Children's Hospital, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
| | | | | |
Collapse
|
26
|
Lower limb functioning and its impact on quality of life in ambulatory children with cerebral palsy. Eur J Paediatr Neurol 2013; 17:561-7. [PMID: 23755939 DOI: 10.1016/j.ejpn.2013.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 03/07/2013] [Accepted: 04/13/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Children with cerebral palsy (CP) are confronted on a daily basis with their motor problems affecting gait, which might impact on their quality of life (QOL). AIM The goal of this study was to evaluate the impact of gross motor and gait function on QOL in ambulatory children with CP attending regular school. METHODS A condition-specific questionnaire (CP QOL-Child), including a parent/proxy and child self-report, was used to assess the relation between patient characteristics, lower limb impairments and functioning, and the different aspects of the child's QOL. Data on therapy management, lower limb impairments, and gross motor and gait function was collected for 81 children with CP (10.5 ± 3.0 years). CP QOL-Child questionnaires were completed by a parent/proxy for all 81 children and by 39 of the children over 9 years. RESULTS The mean self-reported QOL score (78.2 ± 9.6) was significantly higher than the mean parent/proxy reported score (73.9 ± 10.2). Lower limb spasticity and higher frequency of BTX-A injections correlated with worse scores for the pain and impact of disability domain. Results further showed the adverse impact of the severity of gait pathology on QOL perception for the parents/proxy and the child self-report. Gait speed was an important factor for the parents/proxy, though correlated less with self-perceived QOL for the children. CONCLUSIONS Children and parents identified similar factors that adversely affect QOL, whereby the amount of gait pathology was shown to play a crucial role. Only gait speed seemed to be of higher importance for the parents compared to the children.
Collapse
|
27
|
Tuffrey C, Bateman BJ, Colver AC. The Questionnaire of Young People's Participation (QYPP): a new measure of participation frequency for disabled young people. Child Care Health Dev 2013; 39:500-11. [PMID: 23763251 DOI: 10.1111/cch.12060] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The concept of participation was introduced by the World Health Organisation in the International Classification of Functioning, Disability and Health, 2001. Instruments to measure participation have been developed for children and adults, but none specifically for adolescents. Adolescence is a life stage with distinct patterns of participation, and previous research has shown that young people with disabilities have poorer participation than the general population. The aim of this study was to develop a measure of participation frequency, covering all major domains, for young people with cerebral palsy (CP). CP was chosen as an exemplar because it is a significant cause of disability in young people, with affected individuals experiencing a range of different impairments of varying severity. METHODS A pool of 88 items was developed using the published literature, existing measures and qualitative data from young people. The item pool was revised following expert review by 17 experts. Cognitive interviews on the items were carried out with 12 young people and 12 carers; field-testing was then undertaken with 107 young people with CP aged 13-21 years, and 540 young people from the general population to enable item reduction and to examine reliability and construct validity. RESULTS The content review resulted in a 92-item draft questionnaire, content validity index of 93%. Cognitive interviews led to further wording changes. Following field-testing, the questionnaire was shortened to 45 items. Known-groups validity was demonstrated by correlation with impairment severity. Test-retest reliability was satisfactory for all domains. Internal consistency varied between domains. CONCLUSION This is the first instrument developed specifically to measure frequency of participation across multiple domains for young people with disability. Use of the questionnaire in research and clinical work will enable its properties to be better understood and its generalizability to wider groups to be clearer.
Collapse
Affiliation(s)
- C Tuffrey
- Solent NHS Trust, Child Health Services, Alpha Court, Segensworth Business Centre, Fareham, UK.
| | | | | |
Collapse
|
28
|
Parkinson KN, Dickinson HO, Arnaud C, Lyons A, Colver A. Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study. Arch Dis Child 2013; 98:434-40. [PMID: 23606716 PMCID: PMC3664388 DOI: 10.1136/archdischild-2012-303482] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the prevalence and associations of self- and parent-reported pain in young people with cerebral palsy (CP). DESIGN AND SETTING Cross-sectional questionnaire survey conducted at home visits in nine regions in seven European countries. Participants were 13 to 17-year-olds (n=667) drawn from population CP registers in eight regions and from multiple sources in one region. 429 could self-report; parent-reports were obtained for 657. Data were collected on: severity, frequency, site and circumstances of pain in previous week; severity of pain associated with therapy in previous year. RESULTS The estimated population prevalence of any pain in previous week was 74% (95% CI 69% to 79%) for self-reported pain and 77% (95% CI 73% to 81%) for parent-reported pain. 40% experienced leg pains, 34% reported headaches and 45% of those who received physiotherapy experienced pain during therapy. Girls reported more pain than boys (OR=2.1, 95% CI 1.5 to 3.0) and young people reported more pain if they had emotional difficulties (comparing highest and lowest quartiles: OR=3.1, 95% CI 1.7 to 5.6). Parents reported more pain in children with emotional difficulties (OR=4.2, 95% CI 2.7 to 6.6), or with more impaired walking ability. CONCLUSIONS Pain in young people with CP is highly prevalent. Because pain causes immediate distress and is associated with lower subjective well-being and reduced participation, clinicians should routinely assess pain. Clinical interventions to reduce pain should be implemented and evaluated. The efficacy of medical and therapeutic interventions causing pain should be re-examined to establish if their benefit justifies the pain and fear of pain that accompany them.
Collapse
Affiliation(s)
- Kathryn N Parkinson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Heather O Dickinson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Arnaud
- INSERM, UMR1027, Université Paul-Sabatier, CHU Purpan, Service d'Epidémiologie Clinique, Toulouse, France
| | - Alan Lyons
- Enable Ireland, Lavanagh Centre, Ballintemple, Cork, Ireland
| | - Allan Colver
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | | |
Collapse
|
29
|
Guyard A, Michelsen SI, Arnaud C, Lyons A, Cans C, Fauconnier J. Measuring the concept of impact of childhood disability on parents: validation of a multidimensional measurement in a cerebral palsy population. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1594-1604. [PMID: 22534397 DOI: 10.1016/j.ridd.2012.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 03/30/2012] [Accepted: 03/30/2012] [Indexed: 05/31/2023]
Abstract
Living with a child with a disability can affect family life in various domains. Impacts on time, expenses, work, relationships within the family, social relationships and physical and psychological health can be observed. The Family Impact of Childhood Disability (FICD) is a specific instrument designed to assess this situation. Used in a cross-sectional survey, this questionnaire was extended to consider two missing aspects: impact on work and health (FICD+4). This paper addresses the psychometric qualities of the FICD in Europe among parents living with an adolescent with cerebral palsy. Expecting the FICD+4 could assess detailed impact dimensions, an exploratory analysis was conducted. We interviewed 242 families of 13- to 17-year-old adolescents with cerebral palsy living in Europe. Good psychometric properties were found in negative and positive FICD scales and in six underlying factors extracted from exploratory factor analysis on FICD+4. These results support the psychometric validity of the FICD in the assessment of the impact of disability in European families who live with an adolescent with cerebral palsy. They also highlight the multifaceted aspects of the impact of childhood disability on the family and suggest that the FICD+4 is a good tool for assessing specific negative impacts on time, finances, work, social relationships and positive impacts on parental feeling and family attitude. This scale needs further validation and could be helpful for research and clinical interventions.
Collapse
Affiliation(s)
- Audrey Guyard
- ThEMAS TIMC-IMAG, UMR CNRS 5525, Joseph Fourier University, Grenoble F-38041, France.
| | | | | | | | | | | |
Collapse
|
30
|
Dickinson HO, Rapp M, Arnaud C, Carlsson M, Colver AF, Fauconnier J, Lyons A, Marcelli M, Michelsen SI, Parkes J, Parkinson K. Predictors of drop-out in a multi-centre longitudinal study of participation and quality of life of children with cerebral palsy. BMC Res Notes 2012; 5:300. [PMID: 22704327 PMCID: PMC3502092 DOI: 10.1186/1756-0500-5-300] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 05/08/2012] [Indexed: 11/23/2022] Open
Abstract
Background SPARCLE is a study across nine European regions which examines the predictors of participation and quality of life of children with cerebral palsy. Children and their families were initially interviewed in 2004/2005 when the children were aged 8–12 years (SPARCLE1); they were approached again in 2009/2010 at age 13–17 years (SPARCLE2). The objective of this report is to assess potential for bias due to family non-response in SPARCLE2. Logistic regression was used to assess whether socio-demographic factors, parental stress and child impairment were related to non-response, both overall and by category (failure to trace families, death of child, traced families declining to participate). Results Of the 818 families who participated in SPARCLE1, 224/818 (27%) did not participate in SPARCLE2. 51/818 (6%) were not traced. Among the 767 traced families, 32/767 (4%) children with cerebral palsy had died, seven children had been incorrectly diagnosed as having cerebral palsy, thirteen families had moved out of the region and one family had language problems. Of the remaining 714 families, 120/714 (17%) declined to participate. Drop-out between SPARCLE1 and SPARCLE2 varied significantly between regions; families were more difficult to trace and more likely to decline to participate if the parents’ educational qualifications, as recorded in SPARCLE1, were lower; they were also more likely to decline to participate if SPARCLE1 recorded that they were more stressed or if they had not completed a SPARCLE1 stress questionnaire. Conclusions To reduce the risk of bias, all SPARCLE2 analyses should allow for factors (region and walking ability) which determined the sampling strategy, either by adjusting for these factors or by using sampling weights. Further analyses should be performed, adjusting for additional factors that were associated with non-response: parents' educational qualifications, family structure and parental stress. To allow for differential non-response in studies which sample from population registers, such registers should routinely record socio-demographic information.
Collapse
Affiliation(s)
- Heather O Dickinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Tsybina I, Kingsnorth S, Maxwell J, Bayley M, Lindsay S, McKeever P, Colantonio A, Hamdani Y, Healy H, Macarthur C. Longitudinal Evaluation of Transition Services ("LETS Study"): protocol for outcome evaluation. BMC Pediatr 2012; 12:51. [PMID: 22587415 PMCID: PMC3496583 DOI: 10.1186/1471-2431-12-51] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 04/24/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Because of advances in medical treatment, most children with physical disabilities can expect to achieve near normal life spans. Typically, coordinated teams of health care providers in specialized pediatric settings care for these children. As these children reach adulthood, however, the availability of services and expertise changes because the adult health care system has different processes designed to meet their specialized needs. Gaps in continuity of care during the transition from pediatric to adult services, and associated poor health outcomes are well documented. In response, new models of care are being introduced to address the complex process of health care transition. This paper describes a study protocol of a client-centred, prospective, longitudinal, mixed-method evaluation of linked model of health care across the lifespan (the LIFEspan Model), offered by a pediatric rehabilitation centre and an adult rehabilitation centre. METHOD This project will include a process and an outcome evaluation of the LIFEspan Model. The process evaluation will detail the specific service delivery that occurs with respect to preparation for transition and transfer of care through chart audits of pediatric medical records and qualitative interviews with LIFEspan staff. The outcome evaluation will measure the effect of the model on: 1) maintaining continuity within the health care system from pediatric to adult care; and 2) secondary outcomes related to health, well-being, social participation, transition readiness, and health care utilization of youth with cerebral palsy and acquired brain injury. Standardized instruments will include Health Utilities Inventory, Assessment of Life Habits, Arc's Self-Determination, Assessment of Health-Related Quality of Life, Partners in Health Questionnaire, Social Support Questionnaire, and Self-Efficacy for Managing Chronic Disease. DISCUSSION The LETS study will be original in its undertaking of a prospective examination of outcomes 1-year post-transition, use of multiple comparison groups, and absence of disability-related exclusion criteria ensuring that the transition experiences of varied populations of young people and their families will be represented. TRIAL REGISTRATION http://www.clinicaltrials.gov, ID NCT00975338.
Collapse
Affiliation(s)
| | | | - Joanne Maxwell
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Toronto Rehabilitation Institute, Toronto, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute, Toronto, Canada
| | | | | | | | - Yani Hamdani
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Helen Healy
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | | |
Collapse
|
32
|
Simkiss DE, Blackburn CM, Mukoro FO, Read JM, Spencer NJ. Childhood disability and socio-economic circumstances in low and middle income countries: systematic review. BMC Pediatr 2011; 11:119. [PMID: 22188700 PMCID: PMC3259053 DOI: 10.1186/1471-2431-11-119] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 12/21/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The majority of children with disability live in low and middle income (LAMI) countries. Although a number of important reviews of childhood disability in LAMI countries have been published, these have not, to our knowledge, addressed the association between childhood disability and the home socio-economic circumstances (SEC). The objective of this study is to establish the current state of knowledge on the SECs of children with disability and their households in LAMI countries through a systematic review and quality assessment of existing research. METHODS Electronic databases (MEDLINE; EMBASE; PUBMED; Web of Knowledge; PsycInfo; ASSIA; Virtual Health Library; POPLINE; Google scholar) were searched using terms specific to childhood disability and SECs in LAMI countries. Publications from organisations including the World Bank, UNICEF, International Monetary Fund were searched for. Primary studies and reviews from 1990 onwards were included. Studies were assessed for inclusion, categorisation and quality by 2 researchers. RESULTS 24 primary studies and 13 reviews were identified. Evidence from the available literature on the association between childhood disability and SECs was inconsistent and inconclusive. Potential mechanisms by which poverty and low household SEC may be both a cause and consequence of disability are outlined in the reviews and the qualitative studies. The association of poor SECs with learning disability and behaviour problems was the most consistent finding and these studies had low/medium risk of bias. Where overall disability was the outcome of interest, findings were divergent and many studies had a high/medium risk of bias. Qualitative studies were methodologically weak. CONCLUSIONS This review indicates that, despite socially and biologically plausible mechanisms underlying the association of low household SEC with childhood disability in LAMI countries, the empirical evidence from quantitative studies is inconsistent and contradictory. There is evidence for a bidirectional association of low household SEC and disability and longitudinal data is needed to clarify the nature of this association.
Collapse
Affiliation(s)
- Douglas E Simkiss
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, (Gibbet Hill Road), Coventry, (CV4 7AL), UK
| | - Clare M Blackburn
- School of Health and Social Studies, University of Warwick, (Gibbet Hill Road), Coventry, (CV47 1GN), UK
| | - Felix O Mukoro
- NHS Kidney Care, New Croft House, (Market Street East), Newcastle upon Tyne, (NE1 6ND), UK
| | - Janet M Read
- School of Health and Social Studies, University of Warwick, (Gibbet Hill Road), Coventry, (CV47 1GN), UK
| | - Nicholas J Spencer
- School of Health and Social Studies, University of Warwick, (Gibbet Hill Road), Coventry, (CV47 1GN), UK
| |
Collapse
|
33
|
Hurley DS, Sukal-Moulton T, Msall ME, Gaebler-Spira D, Krosschell KJ, Dewald JP. The cerebral palsy research registry: development and progress toward national collaboration in the United States. J Child Neurol 2011; 26:1534-41. [PMID: 21677201 PMCID: PMC3223319 DOI: 10.1177/0883073811408903] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cerebral palsy is the most common neurodevelopmental motor disability in children. The condition requires medical, educational, social, and rehabilitative resources throughout the life span. Several countries have developed population-based registries that serve the purpose of prospective longitudinal collection of etiologic, demographic, and functional severity. The United States has not created a comprehensive program to develop such a registry. Barriers have been large population size, poor interinstitution collaboration, and decentralized medical and social systems. The Cerebral Palsy Research Registry was created to fill the gap between population and clinical-based cerebral palsy registries and promote research in the field. This is accomplished by connecting persons with cerebral palsy, as well as their families, to a network of regional researchers. This article describes the development of an expandable cerebral palsy research registry, its current status, and the potential it has to affect families and persons with cerebral palsy in the United States and abroad.
Collapse
Affiliation(s)
- Donna S. Hurley
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Biomedical Engineering, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Michael E. Msall
- Section of Developmental and Behavioral Pediatrics, University of Chicago, Chicago, IL, USA, Comer and La Rabida Children's Hospitals, Chicago, IL, USA, Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Rehabilitation Institute of Chicago, Chicago, IL, USA, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Kristin J. Krosschell
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Julius P. Dewald
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Biomedical Engineering, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| |
Collapse
|
34
|
Okurowska-Zawada B, Kułak W, Otapowicz D, Sienkiewicz D, Paszko-Patej G, Wojtkowski J. Quality of life in children and adolescents with cerebral palsy and myelomeningocele. Pediatr Neurol 2011; 45:163-8. [PMID: 21824563 DOI: 10.1016/j.pediatrneurol.2011.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 04/18/2011] [Indexed: 10/17/2022]
Abstract
The aim of this study was to compare health-related quality of life in children with cerebral palsy and with myelomeningocele. Fifty-seven children with spastic cerebral palsy and 34 patients with myelomeningocele aged 5-16 years were included in the study. Their mothers completed standardized measures on the Revidierter Kinder Lebensqualitätsfragebogen (KINDL-R) parent questionnaire. The 2 groups were demographically comparable. The children with cerebral palsy were classified more frequently into levels II (n = 24) and III (n = 18) of the Gross Motor Function Classification System. Other patients were classified into levels IV (n = 5) and V (n = 10). Three patients with myelomeningocele were community walkers, 10 could walk with assistive devices, and 21 used a wheelchair. Lesion level was thoracic in 13 patients, lumbar in 17, and sacral in 4. Twenty-nine patients (85.3%) with myelomeningocele had hydrocephalus, and 27 had a shunt. Parents in the both studied groups reported similar overall quality of life of their children in the dimensions of physical and emotional well-being, self-esteem, family, friends, and school. No significant correlations between the quality-of-life scores and age, walking ability, and mental development of the studied groups were found.
Collapse
|
35
|
Pragmatic measures in paediatric psychopharmacology--are we getting it right? Eur Neuropsychopharmacol 2011; 21:571-83. [PMID: 21194897 DOI: 10.1016/j.euroneuro.2010.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 09/27/2010] [Accepted: 11/18/2010] [Indexed: 11/23/2022]
Abstract
Recent changes in legislation have stimulated a new wave of interest and activity in paediatric psychopharmacology. This increased activity has coincided with a recognition that pragmatic measures of outcome such as those that tap into impairment and health related quality of life (HRQOL) have the potential to add considerably to the traditional symptom based measures of outcome. There are however considerable methodological issues associated with these types of measure, and these are made more complex when they are applied in mental health and paediatric settings. There is a clear need for the continued development of valid and reliable measures of HRQOL and impairment that are fit for purpose for use in clinical trials. Other more specific issues that need to be considered, and which all require further investigation include those relating to; age, self versus proxy ratings, contextual issues, generic versus disorder specific measures and definitions of clinically meaningful change. Most of the child and adolescent mental health trials that have included pragmatic measures have been conducted in ADHD samples, have been industry sponsored, use only parent ratings and focus on one drug (atomoxetine). Taken together they do however suggest that pharmacological treatments can impact positively on impairment and HRQOL, although with smaller effect sizes than is seen for symptom reduction. Further studies, across a wider range of disorders and treatments with multiple measures and multiple raters, are to be encouraged. In addition to reporting the basic outcomes from these studies researchers should use these data to improve the measurement models and refine both the measures and the trial designs.
Collapse
|
36
|
Mohamadian H, Eftekhar H, Rahimi A, Mohamad HT, Shojaiezade D, Montazeri A. Predicting health-related quality of life by using a health promotion model among Iranian adolescent girls: a structural equation modeling approach. Nurs Health Sci 2011; 13:141-8. [PMID: 21595808 DOI: 10.1111/j.1442-2018.2011.00591.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Predicting the significant determinants of health-related quality of life through the application of structural equation modeling in adolescents has received little attention in the health education and health promotion literature. The purpose of this study was to investigate the relationships between self-efficacy, barriers, social support, health-promoting lifestyle, and health-related quality of life among Iranian adolescent girls. Pender's health promotion model guided this study. This was a cross-sectional survey of 500 students who were recruited in Kashan, Iran. Their health-related quality of life was measured by using the Short Form Health Survey. A path analysis was conducted to predict the health-related quality of life determinants. The results indicated that 71% of the variance in health-related quality of life could be predicted by the variables. The results affirmed that self-efficacy was the most significant predictor of the students' health-related quality of life. It was concluded that interventions that are aimed at improving self-efficacy can lead to the enhancement of health-related quality of life among adolescent girls in the developing country of Iran.
Collapse
Affiliation(s)
- Hashem Mohamadian
- Department of Health Education Promotion, Tehran University of Medical Sciences, Iran
| | | | | | | | | | | |
Collapse
|
37
|
McDougall J, Wright V, Schmidt J, Miller L, Lowry K. Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions. Dev Neurorehabil 2010; 14:41-53. [PMID: 21034288 PMCID: PMC4245180 DOI: 10.3109/17518423.2010.521795] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 09/03/2010] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. METHOD This article will describe the study's aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used--and expanded upon--to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths' QoL. CONCLUSIONS Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals' perceptions of their QoL.
Collapse
|