Departments of Pediatric Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.
Pediatrics. 2012 Dec;130(6):e1559-66. doi: 10.1542/peds.2012-0858. Epub 2012 Nov 5.
The purpose of this study was to assess health-related quality of life (QoL) in children with Duchenne muscular dystrophy (DMD), including development and field-testing of a DMD-specific module integrated with the core Pediatric Quality of Life Inventory (PedsQL).
The PedsQL 4.0 Generic Core and DMD Module Scales were completed by 203 families, including 200 parents and 117 boys with DMD. Scores on the PedsQL Core Scales were compared with those of matched healthy children. Relationships between PedsQL scores and patient characteristics were examined.
By both parent report and child self-report, mean PedsQL scores for boys with DMD were significantly lower than those for healthy children for physical and psychosocial QoL (P < .0001), with significantly impaired psychosocial QoL scores self-reported by 57%. Psychosocial QoL, by self-report only, tended to be higher in the older boys (13-18 years) than in younger boys (8-12 years; P = .05) and was not significantly associated with use of mobility aids. Although parents reported higher Daily Activities scores in boys receiving steroids (P = .01), boys receiving steroids reported no difference in Daily Activities but significantly less worry (P = .004). Parent-child concordance was generally in the fair to poor range. Internal consistency reliability coefficients for PedsQL DMD module scales ranged from 0.66 to 0.86.
Overall, boys with DMD reported significantly lower QoL than their healthy peers. Despite decreased physical functioning, older boys seem to perceive better psychosocial QoL than perceived by their parents and by younger boys, unrelated to their need for mobility aids.
本研究旨在评估杜氏肌营养不良症(DMD)患儿的健康相关生活质量(QoL),包括开发和现场测试一个与核心儿科生活质量量表(PedsQL)集成的 DMD 专用模块。
203 个家庭,包括 200 名父母和 117 名 DMD 男孩,完成了 PedsQL 4.0 通用核心和 DMD 模块量表。将 PedsQL 核心量表的得分与匹配的健康儿童进行比较。检查了 PedsQL 评分与患者特征之间的关系。
无论是父母报告还是儿童自我报告,DMD 男孩的 PedsQL 得分均明显低于健康儿童的生理和心理社会 QoL(P<0.0001),57%的儿童自我报告心理社会 QoL 明显受损。仅自我报告的心理社会 QoL 在年龄较大的男孩(13-18 岁)中高于年龄较小的男孩(8-12 岁;P=0.05),与使用移动辅助工具无关。尽管父母报告接受类固醇治疗的男孩日常活动得分较高(P=0.01),但接受类固醇治疗的男孩在日常活动方面没有差异,但担忧明显减少(P=0.004)。父母与孩子的一致性通常处于中等至较差范围。PedsQL DMD 模块量表的内部一致性信度系数范围为 0.66 至 0.86。
总体而言,DMD 男孩报告的 QoL 明显低于健康同龄人。尽管身体功能下降,但年龄较大的男孩似乎比他们的父母和年龄较小的男孩感知到更好的心理社会 QoL,与他们对移动辅助工具的需求无关。