Uzark Karen, Jones Karen, Slusher Joyce, Limbers Christine A, Burwinkle Tasha M, Varni James W
Department of Pediatric Cardiology, Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
Pediatrics. 2008 May;121(5):e1060-7. doi: 10.1542/peds.2006-3778.
The aims of this study were to evaluate and compare the parent-reported and self-reported quality of life of children who have cardiovascular disease with the healthy pediatric population across age groups and to determine the relationship between perceived quality of life and severity of cardiovascular disease.
The Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales and Cardiac Module were administered to 475 families including 347 children with cardiovascular disease during a pediatric cardiology outpatient visit. The PedsQL scores reported by children with cardiovascular disease and their parents were compared with pediatric population norms. The relationship between Pediatric Quality of Life Inventory scores and patient characteristics was examined.
By self-report, mean PedsQL scores for children with cardiovascular disease were significantly lower than healthy child norms for physical and psychosocial functioning. Psychosocial quality of life scores were classified as significantly impaired as reported by 21% of children > or = 8 years of age. Even among children with less severe cardiovascular disease, 19.2% reported significantly impaired psychosocial quality of life. By parental report, overall PedsQL scores were not significantly different from healthy children except in the teenage group, and both the 8- to 12-year-old and teenage groups had lower mean psychosocial quality of life scores than healthy peers. Parent-reported mean PedsQL scores for both physical and psychosocial quality of life were significantly lower in children with more severe cardiovascular disease. Children with more severe cardiovascular disease reported lower mean scores for physical functioning, but smaller differences in psychosocial quality of life scores were observed related to disease severity.
Overall, children with cardiovascular disease perceived lower quality of life than healthy children across all age groups. As perceived by parents, overall quality of life was not significantly different in young children with cardiovascular disease, but children with more severe cardiovascular disease have worse physical and psychosocial quality of life. One in 5 children with cardiovascular disease perceives impaired psychosocial functioning, including children with mild disease severity.
本研究旨在评估和比较患有心血管疾病儿童的父母报告的和自我报告的生活质量与各年龄组健康儿童群体的生活质量,并确定感知生活质量与心血管疾病严重程度之间的关系。
在儿科心脏病门诊就诊期间,对475个家庭(包括347名患有心血管疾病的儿童)进行了儿童生活质量量表(PedsQL)通用核心量表和心脏模块的测评。将患有心血管疾病儿童及其父母报告的PedsQL分数与儿科人群常模进行比较。研究了儿童生活质量量表分数与患者特征之间的关系。
通过自我报告,患有心血管疾病儿童的PedsQL平均分数在身体和心理社会功能方面显著低于健康儿童常模。21%年龄大于或等于8岁的儿童报告心理社会生活质量分数显著受损。即使在心血管疾病不太严重的儿童中,19.2%的儿童报告心理社会生活质量显著受损。根据父母报告,除青少年组外,总体PedsQL分数与健康儿童无显著差异,8至12岁组和青少年组的心理社会生活质量平均分数均低于健康同龄人。心血管疾病更严重的儿童,其父母报告的身体和心理社会生活质量的PedsQL平均分数显著更低。心血管疾病更严重的儿童身体功能平均分数更低,但在心理社会生活质量分数方面,与疾病严重程度相关的差异较小。
总体而言,患有心血管疾病的儿童在所有年龄组中感知到的生活质量均低于健康儿童。父母认为,患有心血管疾病的幼儿总体生活质量无显著差异,但心血管疾病更严重的儿童身体和心理社会生活质量更差。五分之一患有心血管疾病的儿童感知到心理社会功能受损,包括疾病严重程度较轻的儿童。