Friefeld Sharon J, Westmacott Robyn, Macgregor Daune, Deveber Gabrielle A
University of Toronto, Department of Occupational Science and Occupational Therapy, Toronto, Canada.
J Child Neurol. 2011 Sep;26(9):1186-92. doi: 10.1177/0883073811408609.
Predictors of quality of life can define potentially modifiable factors to increase favorable outcomes after pediatric stroke. Quality of life was measured using the Centre for Health Promotion's Quality of Life Profile (CHP-QOL) in 112 children surviving arterial ischemic stroke or cerebral sinovenous thrombosis at mean 3 years after stroke. Overall quality of life was poor in 17.8% children despite mean scores (3.52) in the "adequate" range. Quality of life related to school and play was most problematic and that related to physical and home environment was least problematic. Female gender, cerebral sinovenous thrombosis stroke, and older age at testing predicted reduced overall and domain-specific quality of life (P < .05), whereas neurological outcome and family socioeconomic status did not. Cognitive/behavioral deficit and low Verbal IQ adversely affected socialization and quality of life, especially among older children and females. Altered cognition/behavior has a major impact on quality of life after pediatric stroke. Implementation of ameliorative strategies warrants further study.
生活质量的预测因素可以确定潜在的可改变因素,以提高小儿中风后的良好预后。采用健康促进中心生活质量量表(CHP-QOL)对112例动脉缺血性中风或脑静脉窦血栓形成幸存儿童进行了生活质量评估,这些儿童在中风后平均3年接受评估。尽管平均得分(3.52)处于“良好”范围内,但仍有17.8%的儿童总体生活质量较差。与学校和玩耍相关的生活质量问题最大,而与身体和家庭环境相关的生活质量问题最小。女性、脑静脉窦血栓形成性中风以及测试时年龄较大预示着总体和特定领域的生活质量降低(P <.05),而神经功能结局和家庭社会经济地位则无此影响。认知/行为缺陷和低语言智商对社交和生活质量有不利影响,尤其是在年龄较大的儿童和女性中。认知/行为改变对小儿中风后的生活质量有重大影响。改善策略实施值得进一步研究。