Dahan-Oliel N, Oliel S, Tsimicalis A, Montpetit K, Rauch F, Dogba M J
Shriners Hospital for Children, Canada.
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University.
Am J Med Genet A. 2016 Jan;170A(1):62-76. doi: 10.1002/ajmg.a.37377. Epub 2015 Sep 14.
Clinical interventions and research have mostly focused on the orthopedic, genetic, and pharmacological outcomes of individuals with osteogenesis imperfecta (OI), and although quality of life (QoL) has gained recognition as an important patient-outcome, it has received little attention in individuals with OI. This mixed-methods systematic review of the literature included five search engines and identified a total of 212 articles. Once study eligibility was reviewed, 10 studies met the inclusion criteria and were included in this mixed-methods review (9 quantitative and 1 qualitative). Among the 10 included QoL studies, six reported on children with OI, three on adults with OI, and one on the parents of children with OI. Physical QoL in children and adults with OI appears to be less than that of the general population, with individuals with more severe OI types reporting worse QoL. On the other hand, mental and psychosocial QoL is the same or better in individuals with OI than that of the general population. Pain, scoliosis activity limitations and participation restrictions due to decreased function are associated with lower levels of physical QoL. Researchers must agree on a definition of QoL as it relates to OI and use validated measures appropriate for evaluating QoL in OI. Pediatric studies should consider both the child and the parent's QOL perceptions as these may differ. QoL in the adult population should not be dismissed in order to offer proper client-centered interventions throughout the lifespan.
临床干预和研究大多集中在成骨不全症(OI)患者的骨科、遗传学和药理学结果上。尽管生活质量(QoL)已被公认为一项重要的患者结局指标,但在OI患者中却很少受到关注。这项混合方法的文献系统综述使用了五个搜索引擎,共识别出212篇文章。在审查研究的纳入资格后,有10项研究符合纳入标准,并被纳入这项混合方法综述(9项定量研究和1项定性研究)。在纳入的10项生活质量研究中,6项报告了OI患儿的情况,3项报告了OI成人患者的情况,1项报告了OI患儿父母的情况。OI患儿和成人的身体生活质量似乎低于一般人群,OI类型越严重的个体报告的生活质量越差。另一方面,OI患者的心理和社会心理生活质量与一般人群相同或更好。疼痛、脊柱侧弯、因功能下降导致的活动受限和参与限制与身体生活质量水平较低有关。研究人员必须就与OI相关的生活质量定义达成一致,并使用适用于评估OI患者生活质量的经过验证的测量方法。儿科研究应考虑儿童和父母对生活质量的看法,因为这些看法可能不同。为了在整个生命周期中提供适当的以患者为中心的干预措施,不应忽视成年人群的生活质量。