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青少年慢性疲劳综合征:一项随访研究。

Adolescent chronic fatigue syndrome: a follow-up study.

作者信息

van Geelen Stefan M, Bakker Rob J, Kuis Wietse, van de Putte Elise M

机构信息

Department of Pediatrics, University Medical Center Utrecht, Lundlaan 6, Utrecht, the Netherlands.

出版信息

Arch Pediatr Adolesc Med. 2010 Sep;164(9):810-4. doi: 10.1001/archpediatrics.2010.145.

Abstract

OBJECTIVE

To describe the symptomatic and educational long-term outcomes, health care use, and risk factors of nonrecovery in adolescent chronic fatigue syndrome (CFS).

DESIGN

Follow-up study.

SETTING

Academic pediatric hospital.

PARTICIPANTS

Sixty adolescents with CFS.

INTERVENTIONS

Regular care.

OUTCOME MEASURES

The Checklist Individual Strength, Child Health Questionnaire, and a general questionnaire regarding further symptoms, school attendance, work attendance, and treatment.

RESULTS

Complete measurements were returned for 54 adolescents (90%). At initial assessment, their mean (SD) age was 16.0 (1.5) years and 20.4% were male. The mean follow-up duration was 2.2 years. At follow-up, the mean (SD) age was 18.2 (1.5) years; 28 adolescents (51.9%) had nearly complete improvement of symptoms but 26 (48.1%) did not experience improvement. Adolescents who attended school (n = 41) had missed an average of 33% of classes during the last month. The rest (n = 13) had worked an average of 38.7% of a full-time job during the last month. A total of 66.7% of subjects were treated by a physiotherapist, 38.9% were clinically treated in rehabilitation, 48.1% had received psychological support, and 53.7% had used alternative treatment.

CONCLUSIONS

About half of the adolescents had recovered from CFS at follow-up. The other half was still severely fatigued and physically impaired. Health care use had been high, and school and work attendance were low. Older age at inclusion was a risk factor, and pain, poor mental health, self-esteem, and general health perception at outcome were associated with an unfavorable outcome. Future research should focus on customizing existing treatment and studying additional treatment options.

摘要

目的

描述青少年慢性疲劳综合征(CFS)的症状及教育方面的长期结局、医疗保健利用情况以及未康复的风险因素。

设计

随访研究。

地点

学术性儿科医院。

参与者

60名患有CFS的青少年。

干预措施

常规护理。

结局指标

个人力量清单、儿童健康问卷,以及一份关于进一步症状、上学出勤率、工作出勤率和治疗情况的一般问卷。

结果

54名青少年(90%)返回了完整测量数据。初始评估时,他们的平均(标准差)年龄为16.0(1.5)岁,男性占20.4%。平均随访时长为2.2年。随访时,平均(标准差)年龄为18.2(1.5)岁;28名青少年(51.9%)症状几乎完全改善,但26名(48.1%)未出现改善。上学的青少年(n = 41)在上个月平均缺课33%。其余青少年(n = 13)在上个月平均完成了全职工作的38.7%。共有66.7%的受试者接受了物理治疗师的治疗,38.9%在康复机构接受了临床治疗,48.1%接受了心理支持,53.7%使用了替代疗法。

结论

随访时约一半青少年从CFS中康复。另一半仍严重疲劳且身体受损。医疗保健利用率高,上学和工作出勤率低。纳入时年龄较大是一个风险因素,结局时的疼痛、心理健康状况差、自尊和总体健康认知与不良结局相关。未来研究应专注于定制现有治疗方法并研究其他治疗选择。

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