Zandbelt Lian M, Gijssel Esther J Bakker-van, Coppens Catelijne H, Draaisma Jos M T, Geelen Joyce M
Department of Paediatrics, Radboud Institute for Health Sciences, Radboud University Medical Centre, Amalia Children's Hospital, Nijmegen, The Netherlands.
Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands.
Eur J Pediatr. 2024 Dec 6;184(1):67. doi: 10.1007/s00431-024-05876-x.
This study aims to investigate and categorize health problems in children with profound intellectual and multiple disabilities (PIMD). We conducted a scoping review in five electronic databases (PubMed, Embase, Medline, PsychInfo, and Web of Science), including peer-reviewed studies that describe health problems in children with PIMD. Articles on PIMD were included when mentioning children with severe or profound intellectual disability (IQ/DQ < 35 or developmental age < 24 months) AND severe/profound motor impairment (GMFCS IV/V, non-ambulatory/not walking without support or gross motor function measure (GMFM-66) score < 40). Health problems were divided into 11 different categories based on literature and the experiences of the authors. Both health problems reported by caregivers and diagnosed by health professionals were included. A data extraction tool was developed using the JBI checklist recommendations. The review included 22 studies, with a total of 894 patients across all the articles. The most reported health problems in children with PIMD were epilepsy, respiratory infections, feeding difficulties, GERD, scoliosis, and visual impairment. There was no uniformity in the definition and terminology of PIMD.
The studies in this review covered a wide range of health problems, with only a few focusing on the entire range. Given the lack of knowledge about children with PIMD, further research is required on the presence of health problems, the age of onset, and appropriate treatments. Awareness, early detection, and treatment of the health problems could optimize the medical care and quality of life of children with PIMD.
• Children with profound intellectual and multiple disabilities (PIMD) have severe intellectual and motor disabilities and various comorbidities. • Children often visit the hospital and provided care is complex and fragmented.
• Children with PIMD develop a wide range of health problems; most reported are epilepsy, respiratory infections, and feeding difficulties. • Little is known about treatment of health problems in children with PIMD.
本研究旨在调查并分类极重度智力和多重残疾(PIMD)儿童的健康问题。我们在五个电子数据库(PubMed、Embase、Medline、PsychInfo和Web of Science)中进行了一项范围综述,纳入描述PIMD儿童健康问题的同行评审研究。当文章提及重度或极重度智力残疾(智商/发育商<35或发育年龄<24个月)且伴有重度/极重度运动障碍(粗大运动功能分类系统IV/V级,无支撑不能行走或总运动功能测量(GMFM - 66)得分<40)的儿童时,将其纳入关于PIMD的文章。根据文献和作者经验,将健康问题分为11个不同类别。纳入了照料者报告的以及健康专业人员诊断出的健康问题。使用JBI核对清单建议开发了数据提取工具。该综述纳入了22项研究,所有文章中的患者总数为894例。PIMD儿童中报告最多的健康问题是癫痫、呼吸道感染、喂养困难、胃食管反流病、脊柱侧弯和视力障碍。PIMD的定义和术语并不统一。
本综述中的研究涵盖了广泛的健康问题,但仅有少数研究关注了全部范围。鉴于对PIMD儿童缺乏了解,需要对健康问题的存在情况、发病年龄和适当治疗进行进一步研究。对这些健康问题的认识、早期发现和治疗可以优化PIMD儿童的医疗护理和生活质量。
• 极重度智力和多重残疾(PIMD)儿童存在严重的智力和运动残疾以及各种合并症。• 这些儿童经常就医,所提供的护理复杂且不连贯。
• PIMD儿童会出现广泛的健康问题;报告最多的是癫痫、呼吸道感染和喂养困难。• 对PIMD儿童健康问题的治疗知之甚少。