Bradbury E T, Kay S P, Hewison J
St James's University Hospital, Leeds, UK.
J Hand Surg Br. 1994 Dec;19(6):689-95. doi: 10.1016/0266-7681(94)90236-4.
This paper is based on a prospective study of microvascular toe transfers which examined psychosocial, functional and aesthetic outcome for children with congenital hand anomalies and their parents. 14 families were assessed both pre-operatively and 2 years post-operatively. There were five boys and nine girls. Their ages ranged from 6 months to 13 years (mean age = 5.08 years). The parents were assessed on the basis of a parental adjustment measure, a detailed semi-structured interview and a measure of anxiety and depression. The children were assessed on the basis of behaviour and social competence, social experience, self-consciousness about the hand and the perceptions of their own functional competence. Both parents and children were asked to rate their satisfaction with the hand. In addition, function and appearance was assessed using an independent professional panel. It was found that parental adjustment to the hand was an important independent variable in determining psychosocial outcome. The children of poorly-adjusted parents had more social and psychological problems prior to surgery, and showed an increase in behavioural problems after surgery. Their parents were less anxious and happier after surgery and it was of particular benefit to them. The children of well-adjusted parents had fewer pre-operative problems and showed a general slight improvement after surgery. For all the children, there was a significant improvement in both function and appearance of the hands after surgery.
本文基于一项关于微血管足趾移植的前瞻性研究，该研究考察了先天性手部畸形患儿及其父母的心理社会、功能和美学方面的结果。对14个家庭在术前和术后2年进行了评估。其中有5名男孩和9名女孩。他们的年龄从6个月到13岁不等（平均年龄=5.08岁）。根据父母适应度量表、详细的半结构化访谈以及焦虑和抑郁量表对父母进行评估。根据行为和社交能力、社交经历、对手部的自我意识以及对自身功能能力的认知对儿童进行评估。父母和孩子都被要求对他们对手部的满意度进行评分。此外，由一个独立的专业小组对手部的功能和外观进行评估。研究发现，父母对手部的适应情况是决定心理社会结果的一个重要独立变量。适应不良的父母的孩子在手术前有更多的社会和心理问题，并且在手术后行为问题有所增加。他们的父母在手术后焦虑减轻，更加幸福，这对他们尤其有益。适应良好的父母的孩子术前问题较少，术后总体略有改善。对所有孩子来说，手术后手部的功能和外观都有显著改善。
