小儿功能独立性测量量表（WeeFIM [R]）——一种用于预测小儿烧伤患者长期康复情况的小儿功能独立性测量工具。

The WeeFIM [R] instrument--a paediatric measure of functional independence to predict longitudinal recovery of paediatric burn patients.

作者信息

Serghiou M H, Rose M W, Pidcock F S, Esselman P C, Engrav L H, Kowalske K J, Lezotte D C

机构信息

Rehabilitation and Outpatient Services, Shriners Burns Hospitals for Children, Galveston, TX 77550, USA.

出版信息

Dev Neurorehabil. 2008 Jan-Mar;11(1):39-50. doi: 10.1080/17518420701520644.

DOI:10.1080/17518420701520644

PMID:17943500

Abstract

INTRODUCTION

Burns create a myriad of complications that affect the child's developmental, functional and aesthetic status. The WeeFIM is a standardized measure of functional performance developed for use in children 6-months to 8-years of age but with application through adolescence. It includes 18 domains of performance which are scored on a 7-point scale from 'total assistance' to 'complete independence'. In this study, the WeeFIM was used to evaluate the influence of burn size on functional independence and on time to recovery.

METHODS

Children, 6 months to 16 years of age, with total body surface area (TBSA) bums of 10-100% burn injury were recruited for a 2-year longitudinal study. Due to unstable WeeFIM measurements on children 6 months to 6 years, analyses on normalized WeeFIM scores among subjects 6-16 years are presented. Children were evaluated at discharge from acute care, 6 months, 1 year and 2 years after burn injury.

FINDINGS

In this analysis, 454 WeeFIM evaluations from 249 patients, 6-16 years of age, were reviewed. While mean WeeFIM scores varied significantly at discharge based on the size of burn, there were no significant differences in any of the WeeFIM scales at 24 months post-burn. At 24 months, the mean WeeFIM score for all children, independent of size of their bum, indicated full independence. Hands-on assistance was not required for performing activities of daily living (ADLs). The rates of improvement differed statistically by size of bum. Maximum improvement was attained by 6 months for 10-15% TBSA burns, 12 months for 16-30% burns, 12 months for 31-50% burns and 24 months for 51-100% TBSA.

CONCLUSION

The WeeFIM can be utilized by burn centres to describe diminished functional capacity at discharge from acute care for severely burnt children. The tool can be used to track return to baseline independence after a major burn injury in a paediatric population.

摘要

引言

烧伤会引发众多并发症，影响儿童的发育、功能和美观状况。小儿功能独立性测量量表（WeeFIM）是一种用于评估功能表现的标准化工具，专为6个月至8岁的儿童开发，但也适用于青少年。它包含18个功能领域，评分从“完全依赖”到“完全独立”分为7个等级。在本研究中，WeeFIM用于评估烧伤面积对功能独立性和恢复时间的影响。

方法

招募6个月至16岁、全身烧伤面积（TBSA）为10%-100%的儿童进行为期2年的纵向研究。由于6个月至6岁儿童的WeeFIM测量结果不稳定，因此本文仅呈现6至16岁受试者的标准化WeeFIM评分分析。在急性护理出院时、烧伤后6个月、1年和2年对儿童进行评估。

结果

本分析回顾了249名6至16岁患者的454次WeeFIM评估。虽然出院时的平均WeeFIM评分因烧伤面积不同而有显著差异，但烧伤后24个月时，各WeeFIM量表均无显著差异。在24个月时，所有儿童的平均WeeFIM评分表明他们已完全独立，进行日常生活活动（ADL）时无需他人协助。改善率因烧伤面积不同而有统计学差异。10%-15%TBSA烧伤的儿童在6个月时达到最大改善，16%-30%烧伤的儿童在12个月时达到最大改善，31%-50%烧伤的儿童在12个月时达到最大改善，51%-100%TBSA烧伤的儿童在24个月时达到最大改善。