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暴力性儿童脊髓损伤成年患者的心理社会及健康结局

Psychosocial and Health Outcomes of Adults With Violently Acquired Pediatric Spinal Cord Injury.

作者信息

January Alicia M, Kirk Suzanne, Zebracki Kathy, Chlan Kathleen M, Vogel Lawrence C

机构信息

Shriners Hospitals for Children-Chicago, Illinois.

Purdue University Northwest, Hammond, Indiana.

出版信息

Top Spinal Cord Inj Rehabil. 2018 Fall;24(4):363-370. doi: 10.1310/sci17-00012. Epub 2018 Feb 12.

Abstract

To describe the psychosocial and medical outcomes of individuals with pediatric-onset spinal cord injury (SCI) as a result of violent injuries. This was a cross-sectional study assessing adult outcomes associated with pediatric-onset SCI. Participants completed measures assessing demographics, injury characteristics, secondary conditions, and psychosocial functioning. Participants included 483 adults (ages 19-51 years; = 32.89, = 6.81) who sustained an SCI prior to age 19 (0-18 years; = 14.25, = 4.40). Participants tended to have complete injuries (68%) and tetraplegia (53%) and were predominantly male (63%) and Caucasian (85%). The violent ( = 42) and nonviolent ( = 441) etiology groups tended to be similar in terms of gender. The violent etiology (VE) group, however, was significantly more likely to have paraplegia (χ = 7.45, = .01), identify as an ethnic minority (χ = 5.40, = .02), and have decreased odds of completing a college degree (odds ratio [OR], 0.40; 95% CI, 0.19-0.83). After controlling for significant covariates, individuals in the VE group were more likely to have moderate depression symptoms (OR, 3.73; 95% CI, 1.35-10.30) and significantly lower odds of economic independence (OR, 0.39; 95% CI, 0.19-0.84). The VE group was also 2 times as likely as the nonviolent group to report a pressure injury (OR, 2.04; 95% CI, 1.05-3.94) or activity interfering pain (OR, 2.34; 95% CI, 1.15-4.74). The results of this study reveal significantly greater psychosocial health concerns and more medical complications for individuals with violent SCI than those with nonviolent SCI. Children with an SCI from a violent etiology may warrant additional attention and services aimed at promoting stability and long-term resilience.

摘要

描述因暴力损伤导致儿童期脊髓损伤(SCI)的个体的心理社会和医学结局。这是一项横断面研究,评估与儿童期SCI相关的成人结局。参与者完成了评估人口统计学、损伤特征、继发疾病和心理社会功能的测量。参与者包括483名成年人(年龄19 - 51岁;平均年龄 = 32.89岁,标准差 = 6.81岁),他们在19岁之前(0 - 18岁;平均年龄 = 14.25岁,标准差 = 4.40岁)遭受了SCI。参与者往往有完全性损伤(68%)和四肢瘫(53%),且主要为男性(63%)和白种人(85%)。暴力组(n = 42)和非暴力组(n = 441)在性别方面往往相似。然而,暴力病因(VE)组更有可能患有截瘫(χ² = 7.45,p = .01)、被认定为少数族裔(χ² = 5.40,p = .02),且完成大学学位的几率降低(优势比[OR],0.40;95%置信区间,0.19 - 0.83)。在控制了显著的协变量后,VE组个体更有可能有中度抑郁症状(OR,3.73;95%置信区间,1.35 - 10.30),且经济独立的几率显著更低(OR,0.39;95%置信区间,0.19 -

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