Rainey Linda, van Nispen Ruth, van Rens Ger
Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
Acta Ophthalmol. 2014 Nov;92(7):689-96. doi: 10.1111/aos.12319. Epub 2013 Dec 24.
To gain qualitative insight into the rehabilitation goals of visually impaired children and how these goals relate to the structure of the International Classification of Functioning, Disability and Health (ICF) and patient characteristics.
A patient record study was conducted, analysing rehabilitation goals and characteristics of children with a suspected visual impairment in the Netherlands (<18 years) who applied for multidisciplinary services in 2012 (N = 289). Chi-square analyses for trend in rehabilitation content across age bands and additional analyses were performed.
The three most common diagnoses were nystagmus (21.2%), cerebral visual impairment (16.2%) and albinism (6.1%). Rehabilitation goals for children aged <7 years were mostly aimed at 'physical (visual) functioning' (36.7%) and 'environmental factors' (36.7%). For children ≥7 years, significantly more goals were identified on activity and participation (A&P) domains (52.2%). Three A and P domains presented a significant linear trend on the number of rehabilitation goals across age bands: (1) 'Learning and applying knowledge' (13.042, p < 0.001), (4) 'Mobility' (31.340, p < 0.001) and (8) 'Major life areas' (5.925, p = 0.015). Regression analysis showed that both age and visual acuity significantly contributed to the number of A and P goals.
Although analyses were based on a selection of patient records, the number and nature of rehabilitation goals differ significantly with age. Many A and P goals seem underrepresented at the intake procedure, for example: communication, peer interaction and participating in leisure activities. A systematic, standardized procedure is required to catalogue all existing goals and to be able to evaluate progress and potential new or other important goals.
深入了解视力受损儿童的康复目标，以及这些目标与《国际功能、残疾和健康分类》（ICF）结构和患者特征之间的关系。
进行了一项患者记录研究，分析了2012年在荷兰申请多学科服务的疑似视力受损儿童（<18岁）的康复目标和特征（N = 289）。对各年龄组康复内容的趋势进行了卡方分析及其他分析。
三种最常见的诊断为眼球震颤（21.2%）、脑性视力障碍（16.2%）和白化病（6.1%）。7岁以下儿童的康复目标主要针对“身体（视觉）功能”（36.7%）和“环境因素”（36.7%）。对于7岁及以上儿童，在活动和参与（A&P）领域确定的目标明显更多（52.2%）。三个A&P领域在各年龄组的康复目标数量上呈现出显著的线性趋势：（1）“学习与应用知识”（13.042，p < 0.001），（4）“移动性”（31.340，p < 0.001）和（8）“主要生活领域”（5.925，p = 0.015）。回归分析表明，年龄和视力均对A&P目标的数量有显著影响。
尽管分析基于部分患者记录，但康复目标的数量和性质随年龄有显著差异。许多A&P目标在入院程序中似乎未得到充分体现，例如：沟通、同伴互动和参与休闲活动。需要一个系统、标准化的程序来梳理所有现有目标，并能够评估进展以及潜在的新目标或其他重要目标。
