White-Koning Melanie, Grandjean Hélène, Colver Allan, Arnaud Catherine
INSERM, Unité 558, Toulouse, France.
Dev Med Child Neurol. 2008 Aug;50(8):618-24. doi: 10.1111/j.1469-8749.2008.03026.x.
To examine parent-professional agreement in proxy-reports of child quality of life (QoL) and the factors associated with low child QoL in children with cerebral palsy (CP) and associated intellectual impairment. Professional (teacher, therapist, or residential carer) and parent reports of QoL for 204 children (127 males, 77 females, mean age 10 y 4 mo [SD 1y 6mo]; range 8-12 y) with CP and IQ<or=70 were obtained in 2004 to 2005 in nine European regions, using the KIDSCREEN questionnaire. Parent-professional agreement was studied using correlation and mean differences; multilevel logistic regression was used to determine factors influencing QoL reports and agreement. The mean parent-reported scores of child QoL were significantly higher than the professional reports in the Psychological well-being domain and significantly lower for Social support. The average frequency of disagreement (parent-professional difference >0.5SD of scores) over all domains was 62%. High levels of stress in parenting negatively influenced parent reports of child QoL compared with professional reports, while child pain was associated with professionals rating lower than parents. Proxies do not always agree when reporting the QoL of children with severe disabilities. Parental well-being and child pain should be taken into account in the interpretation of QoL reports in such children.
研究脑瘫(CP)及相关智力障碍儿童生活质量(QoL)代理报告中家长与专业人员的一致性,以及与低儿童QoL相关的因素。2004年至2005年期间,在欧洲九个地区,使用儿童生活质量量表(KIDSCREEN问卷)获取了204名CP且智商≤70的儿童(127名男性,77名女性,平均年龄10岁4个月[标准差1岁6个月];年龄范围8 - 12岁)的生活质量专业人员(教师、治疗师或寄宿照顾者)报告和家长报告。使用相关性和均值差异研究家长与专业人员的一致性;采用多水平逻辑回归确定影响生活质量报告及一致性的因素。在心理健康领域,家长报告的儿童生活质量平均得分显著高于专业人员报告,而在社会支持方面则显著低于专业人员报告。所有领域的分歧平均发生率(家长 - 专业人员得分差异>0.5标准差)为62%。与专业人员报告相比,育儿压力大会对家长报告的儿童生活质量产生负面影响,而儿童疼痛与专业人员给出的评分低于家长有关。在报告重度残疾儿童的生活质量时,代理人并不总是意见一致。在解读此类儿童的生活质量报告时,应考虑家长的幸福感和儿童疼痛情况。