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城市南非脑瘫青少年和成年人的疼痛、健康相关生活质量和心理健康。

Pain, health-related quality of life, and mental health of adolescents and adults with cerebral palsy in urban South Africa.

机构信息

Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

出版信息

Disabil Rehabil. 2022 Aug;44(17):4672-4680. doi: 10.1080/09638288.2021.1916101. Epub 2021 Apr 28.

Abstract

PURPOSE

The aim of this study was to investigate the prevalence and level of disability due to pain, health-related quality of life (HRQoL) and mental health in adolescents and adults with cerebral palsy (CP), living in a low-to-middle income country (LMIC), compared to matched typically developing (TD) peers, and to explore associations with individual characteristics.

MATERIALS AND METHODS

This case-control study included 31 adolescents and 30 adults with CP (gross motor function classification system [GMFCS] Level I-V) and matched TD peers. Assessment tools used were a pain questionnaire, the Oswestry Disability Index (ODI), Short-Form Health Survey (SF-36v2), Hospital Anxiety and Depression Scale (HADS), and General Self Efficacy (GSE) scale.

RESULTS

Both CP cohorts reported more frequent pain in their lower limbs, higher level of disability due to pain (total ODI score) and lower perceived physical HRQoL compared to TD peers, while their mental health (mental HRQoL, HADS, and GSE) was not different.

CONCLUSIONS

Despite the physical challenges faced by adolescents and adults with CP living in urban South Africa, the mental health scores showed no difference compared to TD peers. Care should be taken to maintain this positive mental state during ageing across their lifespan.IMPLICATIONS FOR REHABILITATIONThe prognosis of individuals with cerebral palsy (CP) has improved over the last three decades and CP should therefore be considered as a lifelong condition.Adolescents and adults with CP living in urban South Africa reported a higher level of disability due to pain and lower physical health-related quality of life compared to typically developing peers, while their level of depression, anxiety, and self-esteem was not different.These results were similar to findings of studies conducted in high-income countries, though it cannot be generalised to other low to middle-income countries with different cultural and government systems.In order to promote healthy ageing across their lifespan, intervention programmes should be considered to improve physical well-being, and care should be taken to maintain their positive mental health.

摘要

目的

本研究旨在调查生活在中低收入国家(LMIC)的脑瘫青少年和成年人的疼痛患病率和残疾程度、健康相关生活质量(HRQoL)和心理健康状况,并与匹配的典型发育(TD)同龄人进行比较,并探讨与个体特征的关系。

材料和方法

本病例对照研究纳入了 31 名青少年和 30 名成人脑瘫患者(粗大运动功能分类系统 [GMFCS] 水平 I-V)和匹配的 TD 同龄人。使用的评估工具包括疼痛问卷、Oswestry 残疾指数(ODI)、简明健康调查量表(SF-36v2)、医院焦虑抑郁量表(HADS)和一般自我效能感量表(GSE)。

结果

两组脑瘫患者均报告下肢疼痛更频繁,疼痛导致的残疾程度(总 ODI 评分)更高,感知身体 HRQoL 较低,而心理健康(心理 HRQoL、HADS 和 GSE)则无差异。

结论

尽管南非城市的青少年和成年脑瘫患者面临身体挑战,但与 TD 同龄人相比,他们的心理健康评分没有差异。在他们的整个生命周期中,应注意保持这种积极的心理状态。

对康复的启示

脑瘫患者的预后在过去三十年中有所改善,因此应将 CP 视为一种终身疾病。生活在南非城市的青少年和成年脑瘫患者报告疼痛导致的残疾程度更高,身体相关健康相关生活质量较低,与发育正常的同龄人相比,他们的抑郁、焦虑和自尊水平没有差异。这些结果与在高收入国家进行的研究结果相似,尽管不能将其推广到具有不同文化和政府制度的其他中低收入国家。为了促进他们整个生命周期的健康老龄化,应考虑开展干预计划以改善身体健康,并应注意保持他们的积极心理健康。

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