Hanes Julia E, Hlyva Oksana, Rosenbaum Peter, Freeman Matthew, Nguyen Tram, Palisano Robert J, Gorter Jan Willem
CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
School of Rehabilitation Science, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.
Child Care Health Dev. 2019 Sep;45(5):613-622. doi: 10.1111/cch.12705. Epub 2019 Jul 24.
Health for people with cerebral palsy (CP) must extend beyond physical impairments to include social, environmental, and psychological factors that are rarely captured by quantitative research alone. This qualitative study sought to explore the lived experience of young people with CP with their physical, mental, and emotional health in the context of a larger longitudinal Canadian study focusing on brain function, physical and mental health, and well-being.
An integrated research team (including people with CP or other impairments, clinicians, and researchers) was formed to study participant-identified research needs. A purposive sample of 16 people with CP (seven female), aged 17-29, Gross Motor Function Classification System (GMFCS) levels I-V, participated in three focus groups that were conceptualized and analysed using interpretive description methodology.
This study reports the experiences of people with CP across GMFCS levels and identifies some consequences of growing up with the condition: physical and mental health issues, importance of meaningful participation, impact of the environment, and identity formation. Participants shared challenges related to accessibility, healthcare, social/environmental supports, relationships, and sustainable employment.
Body structure and function challenges impact participation in activities of daily living, threatening participants' ability to form positive identities and live meaningful lives. People with CP desire to work but may require additional training, accommodation, and support to do so. Environmental conditions, including relationships, supportive people, and accessibility, shape participants' health, well-being, and social/civic engagement. This study confirms the need for improved care for adults with CP, including multidisciplinary adult health team(s) and community services.
脑瘫患者的健康必须超越身体损伤,纳入社会、环境和心理因素,而这些因素仅凭定量研究很少能涵盖。这项定性研究旨在探讨在一项更大规模的加拿大纵向研究背景下,脑瘫青少年在身体、心理和情感健康方面的生活经历,该研究聚焦于脑功能、身心健康和幸福感。
组建了一个综合研究团队(包括脑瘫患者或其他残障人士、临床医生和研究人员),以研究参与者确定的研究需求。对16名年龄在17 - 29岁、粗大运动功能分类系统(GMFCS)水平为I - V级的脑瘫患者(7名女性)进行了有目的抽样,他们参加了三个焦点小组,采用解释性描述方法进行概念化和分析。
本研究报告了不同GMFCS水平脑瘫患者的经历,并确定了伴随这种疾病成长的一些后果:身心健康问题、有意义参与的重要性、环境的影响以及身份认同的形成。参与者分享了在无障碍环境、医疗保健、社会/环境支持、人际关系和可持续就业方面的挑战。
身体结构和功能方面的挑战影响了对日常生活活动的参与,威胁到参与者形成积极身份认同和过上有意义生活的能力。脑瘫患者渴望工作,但可能需要额外的培训、便利条件和支持才能实现。包括人际关系、支持性的人以及无障碍环境在内的环境条件,塑造了参与者的健康、幸福感以及社会/公民参与度。本研究证实了改善脑瘫成人护理的必要性,包括多学科成人健康团队和社区服务。