Characterizing Decisional Conflict for Caregivers of Children With Obstructive Sleep Apnea Without Tonsillar Hypertrophy
Characterizing Decisional Conflict for Caregivers of Children With Obstructive Sleep Apnea Without Tonsillar Hypertrophy
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DOI：
10.5664/jcsm.7122
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发表时间：
2018-01-01
影响因子：
4.3
通讯作者：
Ishman, Stacey L.
中科院分区：
文献类型：
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作者：
Manning, Amy M.;Duggins, Angela L.;Ishman, Stacey L.
研究目的：本研究的目的是（1）评估无扁桃体肥大的阻塞性睡眠呼吸暂停（OSA）儿童的照顾者所经历的决策冲突（DC）的程度;（2）描述DC、生活质量（QOL）和OSA严重程度之间的关系。这项研究包括从12月起在辛辛那提儿童医院医学中心多学科上呼吸道中心评估的儿童。2014年至2016年5月。要求护理人员在诊所访视期间完成调查（儿科生活质量量表4.0 [PedsQL]、OSA-18、埃普沃思嗜睡量表、家庭影响问卷、决策冲突量表、CollaboRATE量表和SURE问卷）。收集多导睡眠图数据。分析包括Kruskal-Wallis，Wilcoxon秩和，回归testing.Results：照顾者的76名儿童参加; 16（21.1%）有高DC。低DC组和高DC组的人口统计学差异无统计学意义;低DC组的阻塞性呼吸暂停低通气指数较高（13.2 vs 12.3事件/h：P = 0.013）。除PedsQL身体亚类外，OSA严重程度的总体和疾病特异性QOL、嗜睡、家庭影响评分和DC无差异（P = 0.02）。在单变量回归中，DC与总PedsQL相关（P= 0.043）;然而，在控制人口统计学变量后，这并不持续（P = 0.61）。在整个分析过程中，DC评分与CollaboRATE和SURE相关性良好（P < .001）。结论：患有OSA但没有扁桃体肥大的儿童的照顾者中，有21.1%的人在孩子的治疗方面经历了高水平的DC。DC和OSA的严重程度与OSA儿童的生活质量无关。简短的SURE或CollaboRATE量表是测量这些儿童DC的适当工具。
Study Objectives: The goals of this study were to (1) evaluate the degree of decisional conflict (DC) experienced by caregivers of children with obstructive sleep apnea (OSA) without tonsillar hypertrophy: and (2) describe the association between DC, quality of life (QOL), and OSA severity.Methods: This study comprised children evaluated in the multidisciplinary upper airway center at the Cincinnati Children's Hospital Medical Center from December 2014 to May 2016. Caregivers were asked to complete surveys (Pediatric Quality of Life Inventory 4.0 [PedsQL], OSA-18, Epworth Sleepiness Scale, Family Impact Questionnaire, Decisional Conflict Scale, CollaboRATE scale, and SURE questionnaire) during a clinic visit. Polysomnography data were collected. Analysis included Kruskal-Wallis, Wilcoxon rank-sum, and regression testing.Results: Caregivers of 76 children participated; 16 (21.1%) had high DC. There were no significant differences in demographics between those with low and high DC; the low DC group had a higher obstructive apnea-hypopnea index (13.2 versus 12.3 events/h: P = .013). Overall and disease-specific QOL, sleepiness, family impact scores, and DC did not differ by OSA severity except for the PedsQL physical subcategory (P = .02). DC was associated with the total PedsQL (P= .043) on univariate regression; however, this did not persist (P = .61) after controlling for demographic variables. DC scores correlated well with CollaboRATE and SURE throughout the analysis (P < .001).Conclusions: The proportion of caregivers of children with OSA without tonsillar hypertrophy who experienced a high level of DC regarding their child's treatment was 21.1%. Neither DC nor OSA severity was related to QOL in children with OSA. The briefer SURE or CollaboRATE scales were adequate tools to measure DC in these children.