Influence of gait analysis on decision-marketing for lower extremity surgery

Does the health status of caregivers influence their perception of the health-related quality of life of children with severe non-ambulatory cerebral palsy?

U G NARAYANAN MBBS FRCSC MSC A,B, S WEIR BSC MSC A,
D L FEHLINGS MD MSC FRCPC B

  1. 1. Divisions of Orthopaedics and Child Health Evaluative Sciences, The Hospital for Sick Children;
  2. 2. Bloorview Kids Rehabilitation, Toronto, ON, Canada

Background: The Caregiver Priorities and Child Heralth Index of Life with Disabilities (CPCHILD) is a proxy measure of the health status, functional limitations, and well-being of children with severe, non-ambulatory cerebral palsy (CP). Caregivers’ perceptions about their children’s health-related quality of life (HRQL) might be influenced by caregivers’ own quality of life.

Objectives: The purpose of this study is to assess the relationship of caregivers’ health status (Health Survey [SF-36v2]) with their perception of their children’s HRQL (CPCHILD).

Design: Cross-sectional survey.

Setting: A tertiary children’s hospital and three children’s rehabilitation centres.

Participants: A purposeful sample of primary caregivers (n=30) of children (5-18y) with severe non-ambulatory CP, categorized by the Gross Motor Function Classification System (GMFCS).

Method: Thirty caregivers of children with severe, non-ambulatory CP (GMFCS Levels IV and V) completed the self-administered CPCHILD as well as the SF-36v2 questionnaires. Demographics of the caregivers and their children were recorded at the time of recruitment. The caregivers’ physical and mental summary scores of the SF-36v2 were compared with the CPCHILD Total and Domain Scores using Spearman’s correlation coefficients.

Results: Twenty-seven primary caregivers were female; mean age was 42y 6mo (SD 8y 4mo). Twenty-seven children were male; mean age of the children was 11y 6mo (SD 4y 3mo). Twelve children were categorized at GMFCS Level IV and 18 children categorized at GMFCS Level V. The mean CPCHILD score for children was 5046 (SD 14.27; range 21.73-77.76). Mean CPCHILD scores decreased with increasing GMFCS level and were 60.97 (Level IV) and 43.03 (Level V) respectively (p<0.0001). The mean SF-36v2 physical and mental summary scores of the primary caregivers were 50.04 (SD 9.16; range 23.49-63.30) and 47.37 (SD 14.07; range 15.30-70.34) respectively. Spearman’s correlation coefficient indicated that the CPCHILD scores were not significantly correlated with the physical (r=-0.318) and mental (r=0.143) summary scores of the SF-36v2.

Conclusions: Despite the wide range of self-reported health status of the caregivers in this sample, the health status of the caregivers does not seem to influence their perceptions of the HRQL of their children as measured by the CPCHILD. Although caring for children with severe disabilities may have an impact on the health status and quality of life of caregivers, caregivers seem to be able to report on the HRQL of their children independent of their own health status.

 
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