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患有小脑缄默症:诊断带来的长期挑战。

Living with the cerebellar mutism syndrome: long-term challenges of the diagnosis.

机构信息

Department of Neurosurgery and Paediatric Department, 2092, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

出版信息

Acta Neurochir (Wien). 2021 May;163(5):1291-1298. doi: 10.1007/s00701-020-04479-3. Epub 2020 Jul 3.

Abstract

BACKGROUND

After posterior fossa tumour surgery, up to 39% of children experience postoperative cerebellar mutism syndrome (CMS) characterized by mutism and other motor and cognitive impairments. There is a lack of knowledge on the patient-reported challenges and long-term needs. Consequently, no specific recommendations exist for rehabilitative and supportive interventions for patients with CMS. The aims of this study were to explore the patients' experiences related to the sequelae of CMS, to identify challenges and needs regarding support and rehabilitation in the period of growing from child to adult and to add perspectives for future developments of supportive care and rehabilitative guidelines.

METHODS

Ten semi-structured interviews were conducted with young adults diagnosed with CMS as children. A thematic analysis identified four themes describing challenges impacting aspects of the participants' lives.

RESULTS

Four main themes were identified and highlight the rehabilitative need for focus on verbal and non-verbal communication skills in addition to the physical impairments. We found that brain tumour survivors with CMS can benefit from social and educational rehabilitation, straightforward and truthful information, support in structuring their everyday lives and increased public knowledge of CMS.

CONCLUSION

Children with CMS face a variety of challenges affecting many aspects of their everyday lives. They should be entitled to the elements of a current rehabilitation initiative for childhood cancer to support patients' social disability and educational decline. Finally, we identified a need for an official information publication.

摘要

背景

在后颅窝肿瘤手术后,多达 39%的儿童会出现术后小脑缄默症(CMS),其特征是缄默和其他运动及认知障碍。目前对于患者报告的挑战和长期需求缺乏了解。因此,对于 CMS 患者的康复和支持干预措施没有具体建议。本研究的目的是探讨患者与 CMS 后遗症相关的经历,确定在从儿童成长为成人的过程中支持和康复方面的挑战和需求,并为支持性护理和康复指南的未来发展提供新视角。

方法

对 10 名曾被诊断为儿童 CMS 的年轻人进行了半结构化访谈。主题分析确定了四个描述影响参与者生活各个方面的挑战的主题。

结果

确定了四个主要主题,强调了除身体障碍外,还需要关注言语和非言语沟通技巧的康复。我们发现,CMS 脑肿瘤幸存者可以从社交和教育康复、直截了当和真实的信息、日常生活结构支持以及提高公众对 CMS 的认识中受益。

结论

患有 CMS 的儿童面临着各种挑战,影响着他们日常生活的许多方面。他们应该有权获得儿童癌症当前康复计划的要素,以支持患者的社交障碍和教育衰退。最后,我们确定了发布官方信息的需求。

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