Stewart Kirsty, Tavender Emma, Rice James, Harvey Adrienne
Kids Rehab, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Murdoch Childrens Research Institute, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2018 Apr;54(4):432-438. doi: 10.1111/jpc.13749. Epub 2017 Oct 31.
The aims of this study were to investigate clinicians' knowledge, and barriers they perceive exist, relating to the identification and measurement of dyskinesia (dystonia/choreoathetosis) in children with cerebral palsy (CP) and to explore educational needs regarding improving identification and assessment of dyskinesia.
This was a cross-sectional online survey of clinicians working with children with CP. Data analysis was descriptive, with qualitative analysis of unstructured questions.
In total, 163 completed surveys from Australian clinicians were analysed. Respondents were allied health (n = 140) followed by medical doctors (n = 18) working mainly in tertiary hospitals and not-for-profit organisations. Hypertonia subtypes and movement disorders seen in children with CP appear to be identified by clinicians, although limited knowledge about dyskinesia and access to training were reported as significant barriers to accurate identification. Despite knowledge of available measurement scales, only a small percentage were used clinically and reported to be only somewhat useful or not useful at all. Barriers identified for use of scales included limited training opportunities and knowledge of scales and lack of confidence in their use.
A lack of confidence in identifying and measuring movement disorders in children with CP was reported by Australian clinicians. It was identified that a greater understanding of dyskinetic CP and the tools available to identify and measure it would be valuable in clinical practice. The results of this survey will inform the development of a 'Toolbox' to help identify, classify and measure dyskinetic CP and its impact on activity and participation using the framework of the International Classification of Functioning, Disability and Health.
本研究旨在调查临床医生对于脑瘫（CP）患儿运动障碍（肌张力障碍/舞蹈徐动症）的识别与测量方面的知识以及他们所察觉到的障碍，并探索在改善运动障碍识别与评估方面的教育需求。
这是一项针对治疗CP患儿的临床医生的横断面在线调查。数据分析采用描述性分析，并对开放式问题进行定性分析。
共分析了来自澳大利亚临床医生的163份完整调查问卷。受访者主要是专职医疗人员（n = 140），其次是医生（n = 18），他们主要在三级医院和非营利组织工作。虽然临床医生似乎能够识别CP患儿中出现的高张力亚型和运动障碍，但据报告，关于运动障碍的知识有限以及缺乏培训机会是准确识别的重大障碍。尽管了解现有的测量量表，但临床上仅使用了一小部分，并且报告称这些量表仅在一定程度上有用或根本没用。使用量表的障碍包括培训机会有限、对量表的了解不足以及对其使用缺乏信心。
澳大利亚临床医生报告称，他们在识别和测量CP患儿的运动障碍方面缺乏信心。研究发现，更好地了解运动障碍型CP以及用于识别和测量它的工具在临床实践中具有重要价值。本次调查结果将为开发一个“工具箱”提供参考，该工具箱将利用《国际功能、残疾和健康分类》框架来帮助识别、分类和测量运动障碍型CP及其对活动和参与的影响。
