Department of Pediatrics, McGill University, Montreal, QC, Canada.
Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
Can J Neurol Sci. 2021 May;48(3):408-414. doi: 10.1017/cjn.2020.188. Epub 2020 Aug 28.
To describe complementary and alternative medicine (CAM) use amongst children with cerebral palsy (CP) in Canada and to identify factors associated with CAM use.
We conducted a cross-sectional study, utilising data from the Canadian CP Registry. We explored the association between CAM use and regional, socioeconomic and CP phenotypic variables, and parental perception of the family-centredness of clinical care using the Measures of Process of Care-56 (MPOC-56). Chi-square analyses were performed, and odds ratios (OR) and 95% confidence intervals (CI) were obtained. Mann-Whitney U tests were used to compare MPOC-56 scores between CAM users and non-CAM users.
The study sample consisted of 313 families of which 27% reported CAM use in the past year. Children with CP using CAM were more likely to reside in Western Canada (OR 3.3, 95% CI 1.6-6.7), live in a two-parent household (OR 3.5, 95% CI 1.5-8.4), have an ataxic/hypotonic or dyskinetic CP subtype (OR 3.0, 95% CI 1.5-6.1) and have a greater motor impairment (OR 2.8, 95% CI 1.7-4.9). MPOC-56 subscale scores were not significantly associated with CAM use.
Physicians need to be aware of existing CAM therapies, the level of evidence supporting their efficacy (beneficence), their associated risks of adverse events (non-maleficence) and enable fair access to care that may be of benefit to each child.
描述加拿大脑瘫(CP)儿童中补充和替代医学(CAM)的使用情况,并确定与 CAM 使用相关的因素。
我们进行了一项横断面研究,利用加拿大 CP 登记处的数据。我们探讨了 CAM 使用与区域、社会经济和 CP 表型变量之间的关联,以及利用护理过程测量-56(MPOC-56)评估的家庭为中心的临床护理感知之间的关联。进行了卡方分析,并获得了比值比(OR)和 95%置信区间(CI)。使用曼-惠特尼 U 检验比较 CAM 用户和非 CAM 用户的 MPOC-56 评分。
研究样本包括 313 个家庭,其中 27%的家庭报告在过去一年中使用过 CAM。使用 CAM 的 CP 儿童更有可能居住在加拿大西部(OR 3.3,95%CI 1.6-6.7),生活在双亲家庭(OR 3.5,95%CI 1.5-8.4),具有共济失调/低张或运动障碍型 CP 亚型(OR 3.0,95%CI 1.5-6.1)和更大的运动障碍(OR 2.8,95%CI 1.7-4.9)。MPOC-56 子量表评分与 CAM 使用无显著相关性。
医生需要了解现有的 CAM 疗法、支持其疗效(有益)的证据水平、其相关不良事件的风险(无害),并确保公平获得可能对每个孩子都有益的治疗。