Ong Lai C, Teh Ching S, Darshinee Joyce, Omar Asma, Ang Hak L
Department of Paediatrics, Faculty of Medicine,University of Malaya,50603 Kuala Lumpur,Malaysia.
Cardiol Young. 2017 Sep;27(7):1306-1313. doi: 10.1017/S1047951117000166. Epub 2017 Mar 6.
The objectives of this study were to compare the quality-of-life scores of Malaysian children with CHD and their healthy siblings, to determine the level of agreement between proxy-reports and child self-reports, and to examine variables that have an impact on quality of life in those with CHD.
Parental-proxy scores of the Pediatric Quality of Life Inventory 4.0 core scales were obtained for 179 children with CHD and 172 siblings. Intra-class coefficients were derived to determine the levels of proxy-child agreement in 66 children aged 8-18 years. Multiple regression analysis was used to determine factors that impacted Pediatric Quality of Life Inventory scores.
Proxy scores were lower in children with CHD than siblings for all scales except physical health. Maximum differences were noted in children aged 5-7 years, whereas there were no significant differences in the 2-4 and 13-18 years age groups. Good levels of proxy-child agreement were found in children aged 8-12 years for total, psychosocial health, social, and school functioning scales (correlation coefficients 0.7-0.8). In children aged 13-18 years, the level of agreement was poor to fair for emotional and social functioning. The need for future surgery and severity of symptoms were associated with lower scores.
Differences in proxy perception of quality of life appear to be age related. The level of proxy-child agreement was higher compared with other reported studies, with lower levels of agreement in teenagers. Facilitating access to surgery and optimising control of symptoms may improve quality of life in this group of children.
本研究的目的是比较患有先天性心脏病(CHD)的马来西亚儿童及其健康兄弟姐妹的生活质量得分,确定代理报告与儿童自我报告之间的一致程度,并研究影响CHD患儿生活质量的变量。
获取了179名CHD患儿和172名其兄弟姐妹的《儿童生活质量量表4.0》核心量表的家长代理评分。计算组内相关系数以确定66名8至18岁儿童的代理-儿童一致程度。采用多元回归分析来确定影响儿童生活质量量表得分的因素。
除身体健康外,CHD患儿在所有量表上的代理评分均低于其兄弟姐妹。在5至7岁儿童中差异最大,而在2至4岁和13至18岁年龄组中无显著差异。在8至12岁儿童的总体、心理社会健康、社交和学校功能量表上发现代理-儿童的一致性良好(相关系数为0.7 - 0.8)。在13至18岁儿童中,情绪和社交功能的一致程度较差至中等。未来手术的需求和症状的严重程度与较低得分相关。
代理对生活质量的认知差异似乎与年龄有关。与其他报道的研究相比,代理-儿童的一致程度较高,青少年中的一致程度较低。促进手术机会并优化症状控制可能会改善这群儿童的生活质量。