Department of Pediatrics, Division of Pediatric Rehabilitation and Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA.
To explore the performance of the Physical Functioning (PF) subscale of the Child Health Questionnaire (CHQ) in children with cerebral palsy (CP).
Parents of 177 children and adolescents (age 3 to 18 years) with CP completed the CHQ -Parent Form 50. Severity of CP was assessed using the 5-level Gross Motor Function Classification System (GMFCS), in which higher levels reflect more severe impairment.
PF scores were negatively correlated with GMFCS classification (R = -0.62) and were distributed bimodally in subjects with severe motor impairment. For GMFCS classifications IV and V (n = 59), PF scores were very low (means, 9 to 28; medians, 0 to 8); however, 12% of these subjects had excellent PF scores (> 88) despite being nonambulatory.
Although the CHQ PF subscale correlated well with the GMFCS, the CHQ questions on physical functioning resulted in unexpected responses in approximately 1 in 8 subjects with severe CP. These unanticipated responses to the PF subscale questions may be due to ambiguity in the questions (which do not differentiate between health problems and disability) or to alternative parental interpretation of physical functioning. Confusion in differentiating health status and functional status may make the CHQ less useful in children with significant disabilities.
[Show abstract][Hide abstract] ABSTRACT: The health of children with cerebral palsy and stress in their parents.
This paper is a report of a study conducted to describe the health of children with cerebral palsy and investigate predictors of stress in their parents.
Children with severe cerebral palsy tend to have poorer health than their able-bodied peers, and their parents are more likely to be stressed and have poorer health.
A cross-sectional survey with home visits using standard questionnaires was administered to parents in 2004-05. A total of 102/199 (51%) children and parents participated. The children were compared with a normative sample.
Children with cerebral palsy had poorer physical health, and 79% of parents reported that their child had moderate to severe pain. Their poorer health, in comparison with the normal sample and measured by the Child Health Questionnaire, was related to feeding problems and seizures, general health perceptions to intellectual and feeding impairment, and family activities with severe motor, intellectual and feeding impairment. Poorer psychological well-being on the hyperactivity domain of the Strengths & Difficulties Questionnaire was related to feeding difficulties, on the prosocial domain to more severe forms of all child impairments, and on the social impairment scale to intellectual impairment. Children with psychological problems had statistically significantly increased odds (OR = 7.2, 95% CIs 2.6-20.3) of having parents with high stress.
Children with cerebral palsy and associated impairments are at higher risk of poorer health and family well-being. A family-centred approach to the care of children with cerebral palsy and their families is essential to ensure both receive adequate care and support.
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