Visser-Meily Anne, Post Marcel, Meijer Anne Marie, van de Port Ingrid, Maas Cora, Lindeman Eline
Rehabilitation Center De Hoogstraat, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands.
Stroke. 2005 Nov;36(11):2436-40. doi: 10.1161/01.STR.0000185681.33790.0a. Epub 2005 Oct 6.
The purpose of this research was to describe the clinical course of children's functioning (depression, behavioral problems, and health status) during the first year after parental stroke and to determine which patient-, spouse-, or child-related factors at the start of inpatient rehabilitation can predict children's functioning after parental stroke at 1-year poststroke.
Interviews with 82 children (4 to 18 years of age) and their parents (n=55) shortly after admission to a rehabilitation center, 2 months after discharge from inpatient rehabilitation, and 1 year after stroke. Depression was assessed using the Children Depression Inventory, behavioral problems with the Child Behavior Check List, and health status with the Functional Status II. Potential predictors were gender and age (child), activities of daily living disability and communication ability (patient), and spouse's depression and perception of the marital relationship.
At the start of the stroke patient's rehabilitation, 54% of the children had > or =1 subclinical or clinical problems, which improved to 29% 1 year after stroke. Children's functioning 1 year after stroke could best be predicted by their functioning at the start of rehabilitation. Spouse depression and perception of marital relationship were also significant predictors. A total of 28% to 58% of the variance in children's functioning could be explained.
Children's functioning after parental stroke improved during the first year after stroke. Identifying children at risk for problems 1 year after stroke requires assessment of children's functioning and the healthy spouse's depressive symptoms and perception of the marital relationship at the start of rehabilitation. This demonstrates the need for a family-centered approach in stroke rehabilitation.
本研究旨在描述父母中风后第一年儿童的功能状况（抑郁、行为问题和健康状况），并确定住院康复开始时哪些患者、配偶或儿童相关因素可预测中风后1年父母中风患儿的功能状况。
在康复中心入院后不久、住院康复出院后2个月以及中风后1年，对82名儿童（4至18岁）及其父母（n = 55）进行访谈。使用儿童抑郁量表评估抑郁情况，儿童行为检查表评估行为问题，功能状态II评估健康状况。潜在预测因素包括性别和年龄（儿童）、日常生活活动能力障碍和沟通能力（患者）以及配偶的抑郁情况和对婚姻关系的认知。
在中风患者康复开始时，54%的儿童存在≥1项亚临床或临床问题，中风后1年这一比例降至29%。中风后1年儿童的功能状况最好通过康复开始时的功能状况来预测。配偶的抑郁情况和对婚姻关系的认知也是重要的预测因素。儿童功能状况28%至58%的变异可得到解释。
父母中风后儿童的功能状况在中风后的第一年有所改善。要识别中风后1年有问题风险的儿童，需要在康复开始时评估儿童的功能状况以及健康配偶的抑郁症状和对婚姻关系的认知。这表明中风康复需要以家庭为中心的方法。
