Discrepancies between mothers and clinicians in assessing functional capabilities and performance of children with cerebral palsy
Discrepancies between mothers and clinicians in assessing functional capabilities and performance of children with cerebral palsy
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DOI：
10.1016/j.ridd.2013.07.036
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发表时间：
2013-11-01
影响因子：
3.1
通讯作者：
Brezner, Amichai
中科院分区：
文献类型：
--
作者：
Elad, Dina;Barak, Sharon;Brezner, Amichai
目前的研究是一项横断面研究，旨在调查卫生保健专业人员（HCP）和母亲之间的一致性评价能力和表现的脑瘫（CP）的儿童，和CP粗大运动严重程度的一致性的影响。73名患有轻度至重度CP的儿童（平均年龄8.8 ± 2.10岁）及其母亲参加了这项研究。儿科评估残疾量表（FED！）的两种模式使用的管理：母亲的社会工作者和HCP的实际评估访谈。通过配对t检验和组内相关系数（ICC）评估评分员之间的差异。一致性定义为平均绝对差小于或等于6分。结果表明，尽管PEDI的整体ICC非常好（ICC > 0.8），但在所有PEDI子领域中观察到评分者之间的不一致：功能技能-移动性、功能技能-自我护理、护理人员辅助-移动性（CA-MO）和护理人员辅助-自我护理（CA-SC）的不一致率分别为38%、56%、72%和59%。在CA-SC和CA-MO分歧主要包括母亲评价自己的孩子比HCP的性能较低。CP严重程度影响的协议主要是在中度CP严重程度的儿童。这些结果的影响是，评分员认为儿童的活动不同，从而揭示隐藏的残疾的看法，与预期的干预措施的显着后果。(C)2013爱思唯尔有限公司保留所有权利。
The current study is a cross-sectional study that aimed to investigate the concordance between health care professionals (HCPs) and mothers in rating capabilities and performance of children with cerebral palsy (CP), and the impact of CP gross motor severity on concordance. Seventy-three children with mild-to-severe CP (mean age 8.8 +/- 2.10 years) and their mothers participated in this study. Two modes of Pediatric Evaluation Disability Inventory (FED!) administration were used: mothers' interview by a social worker and HCPs' actual evaluation. Differences between raters were assessed by paired t-tests and intra-class correlation coefficients (ICCs). Agreement was defined as mean absolute difference of less than or equal to six points. The results indicated that in spite of excellent overall ICCs in PEDI (ICC > 0.8), disagreement between raters was observed in all PEDI sub-domains: 38%, 56%, 72% and 59% disagreement in Functional Skills-Mobility, Functional Skills-Self Care, Caregiver Assistance-Mobility (CA-MO) and Caregiver Assistance-Self Care (CA-SC), respectively. In CA-SC and CA-MO disagreement mainly consisted of mothers rating their children lower in performance than HCPs. CP severity effected the agreement mostly in children with moderate CP severity. The implications of these results are that raters perceive child's activity differently, hence revealing hidden disability perceptions, with significant consequences for intended interventions. (C) 2013 Elsevier Ltd. All rights reserved.