Luo Wen-Yi, Ni Ping, Chen Lin, Pan Qian-Qian, Zhang Hao, Zhang Ya-Qing
Shanghai Jiao Tong University, School of Nursing, Shanghai, China.
Shanghai Children's Medical Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Front Pediatr. 2022 Jan 27;10:790431. doi: 10.3389/fped.2022.790431. eCollection 2022.
Most children with congenital heart disease (CHD) require surgical repair, and postoperative rehabilitation is an essential step to restore the quality of life. The present study constructs and confirms the International Classification of Functioning, Disability, and Health for Children and Youth core set for children with congenital heart disease 1 year after surgery (ICF-CY-CHDS).
From February 2021 to August 2021, 340 children aged 3-6 years after CHD surgery were evaluated using the ICF-CY-CHDS and analyzed using the Rasch model.
The final ICF-CY-CHDS contained 22 categories; it exhibited a nonsignificant χ test result for the item-trait interaction (χ = 6736.37, = 0.8660, Bonferroni-adjusted = 0.0023). The average severity of children was less than the average difficulty of categories (-2.26 logit <0 logit). The weighted k of all the categories was 0.964 ( < 0.001), and the item separation index was 0.96. The area under the ROC curve of children with a diagnosis result of heart failure was 0.866 (95% CI: 0.801 ~0.931) with good sensitivity (0.875) and specificity (0.759).
The ICF-CY-CHDS presents a preliminary practical direction during early cardiac rehabilitation after pediatric CHD surgery, and thus provides a basis and scope for clinical evaluation and intervention program formulation.
大多数先天性心脏病(CHD)患儿需要进行手术修复,术后康复是恢复生活质量的关键步骤。本研究构建并验证了先天性心脏病患儿术后1年的儿童及青少年国际功能、残疾和健康分类核心集(ICF-CY-CHDS)。
2021年2月至2021年8月,对340例3-6岁先天性心脏病术后患儿采用ICF-CY-CHDS进行评估,并使用Rasch模型进行分析。
最终的ICF-CY-CHDS包含22个类别;项目-特质交互作用的χ检验结果无统计学意义(χ = 6736.37,P = 0.8660,Bonferroni校正P = 0.0023)。患儿的平均严重程度低于类别的平均难度(-2.26对数单位<0对数单位)。所有类别的加权k值为0.964(P < 0.001),项目区分指数为0.96。心力衰竭诊断结果患儿的ROC曲线下面积为0.866(95%CI:0.801~0.931),敏感性(0.875)和特异性(0.759)良好。
ICF-CY-CHDS为小儿先天性心脏病术后早期心脏康复提供了初步的实践指导方向,为临床评估和干预方案制定提供了依据和范围。