评估不同年龄组脑瘫儿童的日常和社交参与情况，重点关注“F”类词汇：功能、家庭、健康、乐趣、朋友和未来。
Evaluation of daily and social participation of children with Cerebral Palsy across different age groups with a focus on the 'F'-words: Function, family, fitness, fun, friends and future.
作者信息
Kerem-Günel Mintaze, Arslan Umut Ece, Seyhan-Bıyık Kübra, Özal Cemil, Numanoğlu-Akbaş Ayşe, Üneş Sefa, Tunçdemir Merve, Çankaya Özge, Özcebe Hilal, Green Dido
机构信息
Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
Department of Health Research, Institue of Public Health, Hacettepe University, Ankara, Turkey.
出版信息
Res Dev Disabil. 2023 Sep;140:104588. doi: 10.1016/j.ridd.2023.104588. Epub 2023 Aug 9.
BACKGROUND
The impact of disability differs across cultures. This study aimed to determine the predictors of participation in children with cerebral palsy (CP) in Turkey, based on the six F-words.
METHODS
Cross-sectional study exploring participation profiles of 450 children with CP, aged between 2 and 18 years. Pediatric Evaluation of Disability Inventory (PEDI) evaluated functional skills, and Assessment of Life Habits (LIFE-H) version 3.0 assessed daily and social participation. Hierarchical linear regression models were done to determine the predictors of participation in daily activities (PDA) and social roles (PSR) in three age groups (2-4, 5-13 and 14-18 years) based on the 6 F-words (mobility of PEDI for 'fitness'; four classification systems and self-care of PEDI for 'functioning'; social functions of PEDI for 'friends'; demographic information by parents for 'family'; the recreation of LIFE-H for 'fun'; and different stages of development for 'future').
RESULTS
The most important predictors for total PDA by age group were: self-care (p = 0.012) of PEDI in 2-4 y; self-care (p = 0.001) and mobility (p = 0.005) of PEDI in 5-13 y; GMFCS (p = 0.006) and mobility (p = 0.002) of PEDI in 14-18 y. Significant predictors for PSR differed by age group: self-care (p = 0.001) of PEDI in 2-4 y; self-care (p = 0.023) and mobility (p = 0.006) of PEDI in 5-13 y; and GMFCS (p = 0.004) and MACS (p = 0.003) in 14-18 y.
CONCLUSIONS
Six F-words of function and fitness focussed on self-care in younger children with an increasing emphasis on mobility and ability levels according to age. Therefore, rehabilitation for different aspects of the functional levels is needed to improve participation in life across the six F-words framework; plus take into consideration context, age-differences, family's expectations, life requirements, environmental needs, and cultural differences.
背景
残疾的影响因文化而异。本研究旨在基于六个“F 字”确定土耳其脑瘫（CP）儿童参与度的预测因素。
方法
横断面研究，探讨 450 名年龄在 2 至 18 岁之间的 CP 儿童的参与情况。儿童残疾评估量表（PEDI）评估功能技能，生活习惯评估量表（LIFE-H）3.0 版评估日常和社会参与度。基于六个“F 字”（PEDI 的移动性对应“健康”；PEDI 的四个分类系统和自我护理对应“功能”；PEDI 的社会功能对应“朋友”；父母提供的人口统计学信息对应“家庭”；LIFE-H 的娱乐对应“乐趣”；不同发育阶段对应“未来”），建立分层线性回归模型，以确定三个年龄组（2 - 4 岁、5 - 13 岁和 14 - 18 岁）日常活动（PDA）和社会角色（PSR）参与度的预测因素。
结果
各年龄组 PDA 总分的最重要预测因素分别为：2 - 4 岁组为 PEDI 的自我护理（p = 0.012）；5 - 13 岁组为 PEDI 的自我护理（p = 0.001）和移动性（p = 0.005）；14 - 18 岁组为 PEDI 的 Gross Motor Function Classification System（GMFCS）（p = 0.006）和移动性（p = 0.002）。PSR 的显著预测因素因年龄组而异：2 - 4 岁组为 PEDI 的自我护理（p = 0.001）；5 - 13 岁组为 PEDI 的自我护理（p = 0.023）和移动性（p = 0.006）；14 - 18 岁组为 GMFCS（p = 0.004）和 Manual Ability Classification System（MACS）（p = 0.003）。
结论
功能和健康的六个“F 字”在年幼儿童中侧重于自我护理，且随着年龄增长对移动性和能力水平的重视程度增加。因此，需要针对功能水平的不同方面进行康复治疗，以改善六个“F 字”框架下的生活参与度；同时要考虑背景、年龄差异、家庭期望、生活需求、环境需求和文化差异。
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