Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
University of Toronto, Toronto, Canada.
Disabil Rehabil. 2022 Dec;44(26):8234-8242. doi: 10.1080/09638288.2021.2008528. Epub 2021 Dec 10.
The quality and length of life for boys with Duchenne muscular dystrophy (DMD) has improved due to medical advancements, but obesity has emerged as and may pose a risk to their physical health. Clinical guidelines recommend attention to weight management, but healthcare professionals (HCPs) find implementing them in clinical care challenging. Little information is available about the perspectives of children with DMD and their families around weight management. This study explored the key priorities of children with DMD, their parents, and HCPs who treat them, around weight management.
Qualitative, individual, semi-structured interviews were conducted and analyzed using a qualitative descriptive approach.
Participants included parents of children with DMD ( = 13), children with DMD ( = 10), and HCPs ( = 14). Theme one: "Competing priorities between healthcare providers, parents, and boys" contained two sub-themes: (i) Body mechanics and function; and (ii) Psychosocial well-being. Theme two: "The realities of living with Duchenne's Muscular Dystrophy," with subthemes: (i) Striving for normality; (ii) The trajectory of DMD; (iii) The labour associated with DMD.
HCPs, parents, and boys have diverging worldviews around weight management, highlighting the importance of integrating the priorities of families into care, even when not aligned with guideline recommendations.IMPLICATIONS FOR REHABILITATIONHCPs must understand the competing priorities in the lives of children with DMD and their families when discussing weight, weight management, and lifestyle changes.Quality of life and living a "normal" life are prioritized by children and families over the surveillance and time demands of lifestyle routines recommended by clinicians for weight management.Weight management recommendations should be based upon the individual needs and priorities of the family.
由于医学的进步,患有杜氏肌营养不良症(DMD)的男孩的生活质量和寿命得到了提高,但肥胖已经出现,可能对他们的身体健康构成威胁。临床指南建议关注体重管理,但医疗保健专业人员(HCP)发现将其纳入临床护理具有挑战性。关于 DMD 儿童及其家庭对体重管理的看法,几乎没有信息。本研究探讨了 DMD 儿童、他们的父母和治疗他们的 HCP 围绕体重管理的关键优先事项。
采用定性、个体、半结构化访谈,采用定性描述方法进行分析。
参与者包括 DMD 儿童的父母( = 13)、DMD 儿童( = 10)和 HCP( = 14)。主题一:“医疗保健提供者、父母和男孩之间的优先事项相互冲突”包含两个子主题:(i)身体力学和功能;(ii)心理社会幸福感。主题二:“与杜氏肌营养不良症一起生活的现实”,包含子主题:(i)追求正常;(ii)DMD 的轨迹;(iii)与 DMD 相关的劳动。
HCP、父母和男孩在体重管理方面存在不同的世界观,这突出了将家庭的优先事项纳入护理的重要性,即使与指南建议不一致也是如此。
对康复的影响 HCP 在讨论体重、体重管理和生活方式改变时,必须了解 DMD 儿童及其家庭生活中的优先事项。儿童和家庭优先考虑生活质量和过“正常”生活,而不是遵循临床医生推荐的用于体重管理的生活方式常规的监测和时间要求。体重管理建议应基于家庭的个人需求和优先事项。