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父母代理差异组儿童癫痫生活质量。

Parent Proxy Discrepancy Groups of Quality of Life in Childhood Epilepsy.

机构信息

School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada.

Avery Information Services, Orillia, ON, Canada.

出版信息

Value Health. 2019 Jul;22(7):822-828. doi: 10.1016/j.jval.2019.01.019. Epub 2019 May 17.

Abstract

OBJECTIVES

To study the extent to which parents are able to serve as true proxies for their children with epilepsy using a more granular approach than has been found in any study to date.

METHODS

Proxy resemblance to the child was based on discrepancy in z-centered child minus parent scores of matching quality-of-life (QOL) domains for 477 dyads. Latent class mixed models (LCMMs) were built, with child's age as the independent variable for epilepsy-specific and generic QOL. Data were obtained from the QUALITÉ Canadian cohort, which recruited children with epilepsy aged 8 to 14 years at baseline and their parents.

RESULTS

Both epilepsy-specific and generic LCMMs produced latent classes representing proxies that were overly positive, overly negative, or in agreement relative to their children with posterior probabilities of 79% to 84%. The "agreement" classes had N = 411 and N = 349 in the epilepsy-specific and generic LCMMs, respectively. The epilepsy-specific LCMM had a small unique class of N = 5 with a posterior probability of 88% called "growing discrepancy."

CONCLUSIONS

Most parents of children with epilepsy can serve as valid proxies for their children on QOL scales. Poorer parental adaptation is more related to overly negative proxies, whereas low peer support from the child's perspective is more related to overly positive proxies.

摘要

目的

采用比迄今为止任何研究都更细致的方法,研究父母在多大程度上可以作为其患有癫痫的孩子的真正代表。

方法

根据 477 对儿童与父母的匹配生活质量(QOL)域的 z 中心化儿童减去父母得分差异,来评估代理与儿童的相似程度。针对癫痫特异性和通用 QOL,建立了潜在类别混合模型(LCMM),儿童年龄为自变量。该数据来自 QUALITÉ 加拿大队列,该队列在基线时招募了年龄在 8 至 14 岁的患有癫痫的儿童及其父母。

结果

癫痫特异性和通用 LCMM 均产生了潜在类别,代表相对于儿童过度积极、过度消极或一致的代理,后验概率为 79%至 84%。在癫痫特异性和通用 LCMM 中,“一致”类别分别有 N=411 和 N=349。癫痫特异性 LCMM 有一个较小的独特类别,称为“不断扩大的差异”,后验概率为 88%,有 N=5。

结论

大多数癫痫儿童的父母可以作为其 QOL 量表的有效代表。父母适应不良更多地与过度消极的代理相关,而从孩子的角度来看,同伴支持不足则与过度积极的代理相关。

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