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      Quality of life of adolescents with cerebral palsy: agreement between self-report and caregiver’s report* Translated title: Qualidade de vida de adolescentes com paralisia cerebral: concordância entre autorrelato e relato do cuidador Translated title: Calidad de vida de adolescentes con parálisis cerebral: concordancia entre el autorrelato e el relato del cuidador

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          Objective:

          to assess the quality of life (QOL) of adolescents with cerebral palsy (CP) by self-report and by the caregiver’s report, and to analyze the agreement between these reports.

          Method:

          cross-sectional study conducted with 101 adolescents with CP and 101 caregivers. Both answered the Pediatric Quality of Life Inventory (PedsQL), module 4.0 - Generic (PedsQL 4.0) and module 3.0 - PC (PedsQL 3.0). Agreement between reports was analyzed using the Mann-Whitney test and the intra-class correlation coefficient (ICC) (p<0.05).

          Results:

          the lowest scores were in physical health, school activities and fatigue in the self-report. The lowest scores were in physical health and daily activities, in the caregivers’ report. Perceptions among adolescents and caregivers differed in physical health, movement and equilibrium, daily and school activities, with a lower score for caregivers in all of them. The agreement between the self-report and the caregivers’ report was poor (ICC<0.44) and in both instruments, the caregivers’ report was less optimistic.

          Conclusion:

          physical health is the most impaired domain of the QOL of adolescents with CP, both in the self-report and in the caregivers’ report. However, there is poor agreement between these reports, emphasizing that the use of the caregivers’ report should be cautious.

          Objetivo:

          avaliar a qualidade de vida (QV) de adolescentes com paralisia cerebral (PC) pelo autorrelato e pelo relato do cuidador, e analisar a concordância entre estes relatos.

          Método:

          estudo transversal conduzido com 101 adolescentes com PC e 101 cuidadores. Ambos responderam o Pediatric Quality of Life Inventory (PedsQL), módulo 4.0 - Genérico (PedsQL 4.0) e módulo 3.0 - PC (PedsQL 3.0). A concordância entre os relatos foi analisada pelo teste de Mann-Whitney e pelo coeficiente de correlação intra classe (ICC) (p<0.05).

          Resultados:

          no autorrelato os menores escores foram em saúde física, atividades escolares e fadiga. No relato dos cuidadores as menores pontuações foram em saúde física e atividades cotidianas. As percepções entre adolescentes e cuidadores divergiram em saúde física, movimento e equilíbrio, atividades cotidianas e escolares, com menor escore dos cuidadores em todos eles. A concordância entre o autorrelato e o relato dos cuidadores foi pobre (ICC<0.44), e em ambos instrumentos o relato dos cuidadores foi menos otimista.

          Conclusão:

          a saúde física é o domínio mais prejudicado da QV de adolescentes com PC, tanto no autorrelato quanto no relato dos cuidadores. Porém há pobre concordância entre estes relatos, ressaltando que o uso do relato dos cuidadores deve ser cauteloso.

          Objetivo:

          evaluar la calidad de vida (CV) de adolescentes con parálisis cerebral (PC) a partir del autorrelato y del relato del cuidador, y analizar la concordancia entre esos relatos.

          Método:

          estudio transversal, llevado a cabo con 101 adolescentes con PC y 101 cuidadores. Ambos contestaron el Pediatric Quality of Life Inventory (PedsQL), módulo 4.0 - Genérico (PedsQL 4.0) e módulo 3.0 - PC (PedsQL 3.0). La concordancia entre los relatos se analiz ó por el test de Mann-Whitney e por el coeficiente de correlación intra clase (ICC) (p<0.05).

          Resultados:

          en el autorrelato, los puntajes más bajos se dieron en salud física, actividades escolares y fatiga. En el relato de los cuidadores, los puntajes más bajos se dieron en salud física y actividades cotidianas. Las percepciones de los adolescentes y los cuidadores fueron divergentes en salud física, movimiento y equilibrio, actividades cotidianas y escolares, con un puntaje más bajo por parte de los cuidadores en todos esos rubros. La concordancia entre el autorrelato y el relato de los cuidadores fue pobre (ICC<0.44), y en ambos instrumentos el relato de los cuidadores fue menos optimista.

          Conclusión:

          la salud física es el dominio más perjudicado de la CV de los adolescentes con PC, tanto en el autorrelato como en el relato de los cuidadores. Sin embargo, la concordancia entre los dos relatos es deficiente, razón por la cual, el relato de los cuidadores debe realizarse con cautela.

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          Most cited references29

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          A report: the definition and classification of cerebral palsy April 2006.

          For a variety of reasons, the definition and the classification of cerebral palsy (CP) need to be reconsidered. Modern brain imaging techniques have shed new light on the nature of the underlying brain injury and studies on the neurobiology of and pathology associated with brain development have further explored etiologic mechanisms. It is now recognized that assessing the extent of activity restriction is part of CP evaluation and that people without activity restriction should not be included in the CP rubric. Also, previous definitions have not given sufficient prominence to the non-motor neurodevelopmental disabilities of performance and behaviour that commonly accompany CP, nor to the progression of musculoskeletal difficulties that often occurs with advancing age. In order to explore this information, pertinent material was reviewed on July 11-13, 2004 at an international workshop in Bethesda, MD (USA) organized by an Executive Committee and participated in by selected leaders in the preclinical and clinical sciences. At the workshop, it was agreed that the concept 'cerebral palsy' should be retained. Suggestions were made about the content of a revised definition and classification of CP that would meet the needs of clinicians, investigators, health officials, families and the public and would provide a common language for improved communication. Panels organized by the Executive Committee used this information and additional comments from the international community to generate a report on the Definition and Classification of Cerebral Palsy, April 2006. The Executive Committee presents this report with the intent of providing a common conceptualization of CP for use by a broad international audience.
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            Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy.

            In a representative series of 176 children with cerebral palsy (CP), aged 5 to 8 years, associations were studied between additional neuroimpairments, activity limitations, and participation restrictions in the domains of mobility, education, and social relations as proposed in the International Classification of Functioning Disability and Health (ICF). Learning disability occurred in 40%, epilepsy in 35%, visual impairment in 20%, and infantile hydrocephalus in 9% of the children. Additional neuroimpairments were most frequently seen in children with tetraplegia and dystonic CP and in those with antecedents of brain malformations or severe perinatal compromise. Activity limitations were studied with the Gross Motor Function Classification System (GMFCS) and a system for grading bimanual fine motor function (BFMF) was developed. There was a strong correlation of 0.74 between the GMFCS and BFMF (p<0.001). Learning disability, activity limitations, and participation restrictions were all clinically strongly associated with each other (p<0.001). Restriction in mobility was best predicted by the GMFCS, learning disability, and the BFMF; in education by learning disability and the GFMCS; and in social relations by learning disability, the GMFCS, and BFMF. Motor function and learning disability were important predictors for participation restrictions in children with CP. The ICF has the capacity to be a model to help plan interventions for specific functional goals and to ascertain the child's participation in society.
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              The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the Generic Core Scales and Cerebral Palsy Module.

              This investigation determined the measurement properties of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cerebral Palsy (CP) Module. PedsQL 4.0 Generic Core Scales and 3.0 CP Module were administered to 245 families. Mean age of the 134 males and 107 females was 8 years 1 month (SD 4y 4mo; range 2-18y). The sample included children with hemiplegia (n=55), diplegia (n=84), and quadriplegia (n=85). Twenty eight children had a Gross Motor Function Classification System classification at Level I, 40 at Level II, 86 at Level III, 43 at Level IV, and 37 at Level V. Reliability was demonstrated for the PedsQL 4.0 (alpha=0.86 child, 0.89 parent) and CP Module (alpha=0.79 child, 0.91 parent). The PedsQL 4.0 distinguished between healthy children and children with CP. Construct validity of the CP Module was supported. Sensitivity of the PedsQL was demonstrated among children with different diagnostic categories and gross motor function.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                01 July 2020
                2020
                : 28
                : e3300
                Affiliations
                [1 ]Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, GO, Brazil.
                [2 ]Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.
                [3 ]Pontifícia Universidade Católica de Goiás, Escola de Ciências Sociais e da Saúde, Goiânia, GO, Brazil.
                Author notes
                Corresponding author: Mariana Ceravolo Ferreira E-mail: mari_ceravolo@ 123456hotmail.com

                Associate Editor: Regina Aparecida Garcia De Lima

                Author information
                http://orcid.org/0000-0003-2204-2124
                http://orcid.org/0000-0002-8006-7584
                http://orcid.org/0000-0001-6499-3011
                http://orcid.org/0000-0002-7871-6987
                Article
                00357
                10.1590/1518-8345.3928.3300
                7332252
                32609264
                a940c178-37c6-4a5f-97ed-57db7e3357f8
                Copyright © 2020 Revista Latino-Americana de Enfermagem

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 August 2019
                : 14 March 2020
                Categories
                Original Article

                quality of life,cerebral palsy,adolescent,young adult,child,caregivers,qualidade de vida,paralisia cerebral,adolescente,adulto jovem,criança,cuidadores,calidad de vida,parálisis cerebral,adulto joven,niño

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