Daily functioning and quality of life in children with sickle cell disease pain: Relationship with family and neighborhood socioeconomic distress
Daily functioning and quality of life in children with sickle cell disease pain: Relationship with family and neighborhood socioeconomic distress
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DOI：
10.1016/j.jpain.2008.04.002
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发表时间：
2008-09-01
期刊：
影响因子：
4
通讯作者：
Mitchell, Brian A.
中科院分区：
文献类型：
--
作者：
Palermo, Tonya M.;Riley, Craig A.;Mitchell, Brian A.
本研究的目的是检查镰状细胞病（SCD）患儿的个人/家庭和社区社会经济窘迫、疼痛和功能结局之间的关系。我们假设个人经济困境和居住在严重经济困境的社区都可以预测儿童的疼痛相关功能残疾水平和健康相关的生活质量（HRQOL）。参与者（平均年龄12.14岁，57%为男性，n = 56）从中西部三级转诊医院的门诊血液学诊所招募。评估疼痛、抑郁、功能障碍和HRQOL的问卷由儿童及其照顾者完成。个人社会经济数据包括父母教育和家庭收入由照顾者报告。社区社会经济困境是根据公开的人口普查区数据确定的，并基于社区贫困、女性户主、男性失业和高中辍学率。多因素回归分析显示，个体/家庭社会经济困境是儿童功能残疾和生理社会心理HRQOL的显著预测因子。社区社会经济困境仅作为身体HRQOL的重要独立预测因子，其中生活在贫困社区预测身体HRQOL降低。研究结果表明，个体社会经济地位和社区经济困境在预测儿童SCD疼痛相关的功能结局方面具有相似但独立的作用。观点：对于个体/家庭或社区社会经济因素对SCD儿童疼痛和功能的影响知之甚少。我们的研究结果表明，在个人水平和社区/社区水平上定义的社会经济窘迫是SCD儿童疼痛相关残疾和HRQOL的重要独立预测因子。(C) 2008年由美国疼痛学会出版。
The aim of this study was to examine the relationship between individual/family and neighborhood socioeconomic distress, pain, and functional outcomes in children with sickle cell disease (SCD). We hypothesized that both individual economic distress as well as residence in neighborhoods of severe economic distress would predict children's level of pain-related functional disability and health-related quality of life (HRQOL). Participants (mean age, 12.14 years; 57% male, n = 56) were recruited from an outpatient hematology clinic at a Midwestern tertiary referral hospital. Questionnaires assessing pain, depression, functional disability, and HRQOL were completed by children and their caregivers. Individual socioeconomic data including parental education and family income were reported by caregivers. Neighborhood socioeconomic distress was identified using publicly available census tract data and was based on neighborhood poverty, female head of household, male unemployment, and high school dropout levels. Multivariate regression analyses revealed that individual/family socioeconomic distress was a significant predictor of children's functional disability and physical and psychosocial HRQOL. Neighborhood socioeconomic distress emerged as a significant independent predictor of physical HRQOL only, where living in a distressed neighborhood predicted diminished physical HRQOL. Findings suggest that individual socioeconomic status and neighborhood economic distress play similar but independent roles in predicting children's functional outcomes related to SCD pain.Perspective: Little is known about the influence of either individual/family or neighborhood socioeconomic factors on pain and functioning in children with SCD. Our findings suggest that socioeconomic distress defined at both the individual level and at the neighborhood/community level are significant independent predictors of pain-related disability and HRQOL in children with SCD. (C) 2008 by the American Pain Society.