Johaningsmeir Sarah A, Colby Holly, Krauthoefer Mary, Simpson Pippa, Conceição Simone C O, Gordon John B
Medical College of Wisconsin, Milwaukee, WI, USA.
Children's Hospital of Wisconsin, Milwaukee, WI, USA.
J Pediatr Rehabil Med. 2015;8(2):75-82. doi: 10.3233/PRM-150321.
This study examined the impact of caring for children with medical complexity (CMC) and high resource use on family quality of life (QoL).
Families of CMC enrolled in a complex care program completed the PedsQL Family Impact module (PedsQL FIM) and Healthcare Satisfaction module (PedsQL HCS) at enrollment then 1 and 2 years after enrollment. Tertiary center resource utilization and staff care coordination time were collected for the two years.
PedsQL FIM scores were low at enrollment and did not improve over time. Social Functioning, Worry, and Daily Activities were the lowest domains. PedsQL HCS scores were higher at enrollment, but also failed to improve over the two years. Changes in resource use were not associated with changes in PedsQL FIM or HCS scores. Staff care coordination time was highest for patients with ≥ 10 hospital days per year.
CMC families' low QoL did not appear to be related to healthcare satisfaction or a shift from inpatient to outpatient resource use. Less staff support for families of CMC who spent more time at home may have contributed to their continued low QoL. Further study is required to identify causes of and strategies for improving the low QoL of families of CMC.
本研究探讨了照顾患有复杂疾病的儿童(CMC)以及高资源消耗对家庭生活质量(QoL)的影响。
参与复杂护理项目的CMC患儿家庭在入组时、入组后1年和2年完成了儿童生活质量量表家庭影响模块(PedsQL FIM)和医疗保健满意度模块(PedsQL HCS)。收集了两年内三级中心的资源利用情况和工作人员护理协调时间。
PedsQL FIM评分在入组时较低,且未随时间改善。社会功能、担忧和日常活动是得分最低的领域。PedsQL HCS评分在入组时较高,但在两年内也未改善。资源利用的变化与PedsQL FIM或HCS评分的变化无关。每年住院天数≥10天的患者,工作人员护理协调时间最长。
CMC患儿家庭的低生活质量似乎与医疗保健满意度或从住院资源利用向门诊资源利用的转变无关。在家中花费更多时间的CMC患儿家庭获得的工作人员支持较少,这可能导致了他们持续的低生活质量。需要进一步研究以确定导致CMC患儿家庭低生活质量的原因及改善策略。