Buran Constance F, Sawin Kathleen J, Brei Timothy J, Fastenau Philip S
Ambulatory Administration, Riley Hospital for Children, Indianapolis, IN 46202, USA.
Dev Med Child Neurol. 2004 Apr;46(4):244-52. doi: 10.1017/s0012162204000404.
The Carnegie Council on Adolescent Development, USA has identified activities, beliefs, and perceptions critical for healthy development. The aim of this study was to measure the activities, beliefs and expectations, and perceived outcomes of adolescents with myelomeningocele. In this descriptive study, 66 adolescents with myelomeningocele, aged 12 to 21 years and functioning at grade level, completed a structured interview. Thirty-eight (58%) of the participants were female. The level of lesion was distributed as follows: 30% had thoracic level lesions, 32% had lumbar level lesions, 15% had lumbosacral level lesions, and 23% of the sample had sacral level lesions. Instruments used had both established reliability and validity (WeeFIM, Harter's Self-Perception Profile, Austin's Child Attitude Toward Illness Scale, and Snyder's Hope Scale, Adolescent Decision-Making Inventory, Adolescent Coping Scale) or were scales developed for this study (Adolescent Activities Inventory, Future Expectations Scale, Communication Efficacy, and Adolescent Self-Management and Independence Scale). Scale reliabilities ranged from 0.70 to 0.88. These participants, though hopeful and positive in their attitudes toward myelomeningocele and generally able to perform activities of daily living independently, are not engaging in the full range of adolescent activities (decision making, friendship activities, and household responsibilities) and achieving positive outcomes (self-management and job) necessary to make a successful transition to adulthood. This might explain why so many individuals with myelomeningocele are underemployed and are not living independently as young adults.
美国卡内基青少年发展委员会已确定了对健康发展至关重要的活动、信念和认知。本研究的目的是衡量患有脊髓脊膜膨出症青少年的活动、信念和期望,以及感知到的结果。在这项描述性研究中,66名年龄在12至21岁且功能处于年级水平的脊髓脊膜膨出症青少年完成了一次结构化访谈。38名(58%)参与者为女性。病变水平分布如下:30%有胸段病变,32%有腰段病变,15%有腰骶段病变,23%的样本有骶段病变。所使用的工具既有已确立可靠性和有效性的(WeeFIM、哈特自我认知量表、奥斯汀儿童对疾病的态度量表、斯奈德希望量表、青少年决策量表、青少年应对量表),也有为本研究开发的量表(青少年活动量表、未来期望量表、沟通效能量表以及青少年自我管理与独立量表)。量表的信度范围为0.70至0.88。这些参与者虽然对脊髓脊膜膨出症持乐观积极态度,并且总体上能够独立进行日常生活活动,但并未参与青少年的全部活动(决策、交友活动和家务责任),也未取得成功过渡到成年所需的积极成果(自我管理和工作)。这或许可以解释为什么如此多的脊髓脊膜膨出症患者就业不足,且成年后无法独立生活。