Wagner Robert, Linroth Ronna, Gangl Candice, Mitchell Nancy, Hall Michelle, Cady Rhonda, Christenson Matthew
Gillette Children's Specialty Healthcare, St. Paul, MN, USA.
Gillette Children's Specialty Healthcare, St. Paul, MN, USA.
Disabil Health J. 2015 Oct;8(4):492-8. doi: 10.1016/j.dhjo.2015.03.012. Epub 2015 Apr 4.
Spina bifida is a congenital defect of the neural tube resulting in motor and sensory disruption. Persons with spina bifida can also experience executive function impairments. Secondary conditions are physical, medical, cognitive, emotional, or psychosocial consequences to which persons with disabilities are more susceptible. Our experience suggested clinicians underappreciate the presence and impact of secondary conditions in adults with spina bifida because they do not specifically ask for this information.
Describe the presence and impact of secondary conditions on daily life, as perceived by adults with spina bifida.
A clinic-based sample was recruited from the active patient population of an adult specialty center for spina bifida-related care. All subjects were verbally administered a survey developed through literature review and clinical experience of the researchers. The survey measured the presence and perceived impact of secondary conditions. Recruitment and survey data collection occurred over a 6-month period to maximize age representation. Survey data were stratified by age, gender and lesion level for analysis.
Seventy-two respondents completed the survey. Pain was commonly reported, along with pressure ulcers, bowel & bladder concerns, depression, sleep disturbance, and limited social and community participation. No significant relationships were found between the presence or perceived impact of secondary conditions and age, gender or level of lesion.
Secondary conditions in spina bifida are present by early adulthood. Identifying these conditions during clinical encounters requires specific rather than general questions. Future study should evaluate earlier initiation of preventative measures by pediatric providers.
脊柱裂是一种神经管先天性缺陷,会导致运动和感觉功能障碍。脊柱裂患者还可能出现执行功能受损。继发疾病是指残疾人更易患的身体、医学、认知、情感或社会心理方面的后果。我们的经验表明,临床医生并未充分认识到脊柱裂成年患者继发疾病的存在及其影响,因为他们没有专门询问这方面的信息。
描述脊柱裂成年患者所感知的继发疾病对日常生活的存在情况及其影响。
从一家成人脊柱裂相关疾病专科中心的现患患者群体中招募了一个基于门诊的样本。所有受试者均接受了一项通过文献综述和研究人员临床经验制定的口头调查。该调查测量了继发疾病的存在情况及其感知到的影响。招募和调查数据收集历时6个月,以尽量扩大年龄代表性。调查数据按年龄、性别和病变水平分层进行分析。
72名受访者完成了调查。常见的报告症状包括疼痛、压疮、肠道及膀胱问题、抑郁、睡眠障碍以及社会和社区参与受限。继发疾病的存在或感知到的影响与年龄、性别或病变水平之间未发现显著关联。
脊柱裂的继发疾病在成年早期就已存在。在临床问诊过程中识别这些疾病需要提出具体而非一般性的问题。未来的研究应评估儿科医生更早启动预防措施的情况。