Mistry Rakesh D, Stevens Molly W, Gorelick Marc H
Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Health Qual Life Outcomes. 2009 Jan 29;7:5. doi: 10.1186/1477-7525-7-5.
We sought to assess the validity and short-term responsiveness of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) for febrile illnesses evaluated in the pediatric emergency department (ED).
Prospective cohort study of children 2-18 years discharged after ED evaluation for fever (>or= 38 degrees C). Self-administered, parent-report of health-related quality of life (HRQOL) was assessed using the PedsQL Acute Version, a validated HRQOL instrument. HRQOL was measured on ED presentation and at 7-10 day follow-up. At follow-up, duration of fever, child functional impairment, missed daycare/school, and disrupted family unit functioning, were assessed.
Of 160 subjects enrolled, 97 (61%) completed the study; mean follow-up was 8.7 days. Mean total HRQOL score on ED presentation was 76.4; mean follow-up score was 86.3. Compared to subjects that returned to baseline, statistically significant differences in HRQOL were noted for those with prolonged fever, child functional impairment, and relapse. Significant correlation was observed between HRQOL at follow-up and days of daycare/school missed (r = -0.35, p = .003) and days of family disruption (r = -0.43, p < .001). Mean change in HRQOL within subjects, from ED visit to follow-up, was +9.8 (95% CI: 5.6-14.6). Effect size was 0.53, indicating moderate responsiveness.
The PedsQL appears to be a valid and responsive indicator of HRQOL for short-term febrile illnesses evaluated in the ED.
我们试图评估儿科急诊部(ED)中对发热性疾病进行评估时,儿童生活质量量表4.0通用核心量表(PedsQL)的有效性和短期反应性。
对2至18岁因发热(≥38摄氏度)在急诊部评估后出院的儿童进行前瞻性队列研究。使用PedsQL急性版(一种经过验证的健康相关生活质量(HRQOL)工具)对与健康相关生活质量进行自我管理的家长报告评估。在急诊部就诊时和7至10天随访时测量HRQOL。在随访时,评估发热持续时间、儿童功能损害、日托/学校缺勤情况以及家庭单位功能中断情况。
在160名登记受试者中,97名(61%)完成了研究;平均随访时间为8.7天。急诊部就诊时HRQOL总平均分是76.4;随访平均分是86.3。与恢复到基线水平的受试者相比,发热持续时间延长、儿童功能损害和复发的受试者在HRQOL方面存在统计学上的显著差异。随访时的HRQOL与日托/学校缺勤天数(r = -0.35,p = 0.003)和家庭干扰天数(r = -0.43,p < 0.001)之间观察到显著相关性。受试者从急诊部就诊到随访时HRQOL的平均变化为+9.8(95%可信区间:5.6 - 14.6)。效应大小为0.53,表明反应性中等。
对于在急诊部评估的短期发热性疾病,PedsQL似乎是HRQOL的有效且有反应性的指标。