Pacey Verity, Tofts Louise, Adams Roger D, Munns Craig F, Nicholson Leslie L
Physiotherapy Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2015 Jul;51(7):689-95. doi: 10.1111/jpc.12826. Epub 2015 Jan 26.
To assess the child- and parent-reported health-related quality of life (HRQOL) of children with joint hypermobility syndrome (JHS), to compare these with other chronic paediatric conditions and to determine whether symptoms experienced by children with JHS can predict their HRQOL.
Eighty-nine children with JHS and one of their parents completed the Pediatric Quality of Life Inventory 4.0 Generic Core Scale, the Multidimensional Fatigue Scale and the Pediatric Pain Questionnaire. Anthropometric measures and reported symptoms were recorded. Child-reported HRQOL scores were compared with parent report, and both child- and parent-reported HRQOL scores of children with JHS were compared with those of children with other chronic conditions. Stepwise multiple regression was undertaken to determine whether any combination of measures could predict HRQOL.
Parent- and child-reported HRQOL scores were strongly correlated (r = 0.6-0.84, all P < 0.001); however, parents of children with JHS perceived lower overall HRQOL (mean difference = 4.44, P = 0.001), physical (mean difference = 7.11, P < 0.0001) and emotional functioning (mean difference = 5.24, P = 0.011) than their children. When considered together with previously reported HRQOL scores for children with other chronic conditions, parent and child scores were similarly strongly correlated (r = 0.93, P = 0.001). Multiple regression revealed that 75% of the variance in child-reported HRQOL scores was accounted for by a child's level of pain and fatigue, and presence of stress incontinence symptoms (P < 0.0001).
Children with JHS experience poor HRQOL and disabling fatigue, with parent scores providing a good proxy. Pain, fatigue and the presence of stress incontinence symptoms have the greatest impact on their HRQOL.
评估关节过度活动综合征(JHS)患儿及其家长报告的健康相关生活质量(HRQOL),将其与其他慢性儿科疾病进行比较,并确定JHS患儿所经历的症状是否能预测其HRQOL。
89名JHS患儿及其一名家长完成了儿童生活质量量表4.0通用核心量表、多维疲劳量表和儿童疼痛问卷。记录人体测量指标和报告的症状。将患儿报告的HRQOL分数与家长报告的分数进行比较,并将JHS患儿及其家长报告的HRQOL分数与其他慢性病患儿的分数进行比较。采用逐步多元回归分析确定是否有任何测量指标组合可以预测HRQOL。
家长和患儿报告的HRQOL分数高度相关(r = 0.6 - 0.84,所有P < 0.001);然而,JHS患儿的家长认为其总体HRQOL(平均差异 = 4.44,P = 0.001)、身体功能(平均差异 = 7.11,P < 0.0001)和情感功能(平均差异 = 5.24,P = 0.011)低于患儿。与之前报告的其他慢性病患儿的HRQOL分数一起考虑时,家长和患儿的分数同样高度相关(r = 0.93,P = 0.001)。多元回归分析显示,患儿报告的HRQOL分数中75%的变异可由患儿的疼痛程度、疲劳程度和压力性尿失禁症状的存在来解释(P < 0.0001)。
JHS患儿的HRQOL较差且存在致残性疲劳,家长的评分可作为一个很好的替代指标。疼痛、疲劳和压力性尿失禁症状的存在对他们的HRQOL影响最大。