Sleep, Behaviour and Health-Related Quality of Life in Preschool-And School-Aged Children with Cerebral Palsy
نام عام مواد
[Thesis]
نام نخستين پديدآور
Horwood, Linda
نام ساير پديدآوران
Israel Shevell, Michael
وضعیت نشر و پخش و غیره
نام ناشر، پخش کننده و غيره
McGill University (Canada)
تاریخ نشرو بخش و غیره
2019
مشخصات ظاهری
نام خاص و کميت اثر
243
یادداشتهای مربوط به پایان نامه ها
جزئيات پايان نامه و نوع درجه آن
Ph.D.
کسي که مدرک را اعطا کرده
McGill University (Canada)
امتياز متن
2019
یادداشتهای مربوط به خلاصه یا چکیده
متن يادداشت
Cerebral Palsy (CP) is a neurodevelopmental disorder of movement and posture resulting from a non-progressive brain lesion during fetal or infant development. In addition to the primary motor impairments, children with CP have a high prevalence of significant comorbidities which also may increase their risk of sleep problems, behavioural difficulties and reduced health-related quality of life (HRQoL) compared to typically developing children. Manuscript 1 of this thesis reports the results of a systematic review and meta-analysis of studies on the prevalence of sleep problems in children with CP. Manuscripts 2, 3 and 4 report on the results of a cross-sectional study of 150 children with CP aged 3-12 years who were prospectively recruited from hospital clinics, a clinical database and the Canadian Cerebral Palsy Registry. Caregivers completed five questionnaires: 1) the Sleep Disturbance Scale for Children (SDSC) to assess overall and specific sleep problems, 2) a questionnaire on sleep-related characteristics to provide additional information on children's sleep, 3) the Strengths and Difficulties Questionnaire (SDQ) to assess children's behavioural difficulties, 4) the Pediatric Quality of Life Inventory (PedsQL) Generic Core Module, to assess children's overall HRQoL and 5) the PedsQL CP Module, to assess children's CP-specific HRQoL. All 23 studies included in our systematic review were cross-sectional and used caregiver-completed sleep measures (SDSC most common in 9 studies); our meta-analysis of these studies found a pooled prevalence of 23.4% (95% CI 18.8-28.4-%) for an abnormal total score and 26.9% (95% CI 21.5-32.7-%) for disorders of initiation and maintenance of sleep (DIMS), the most prevalent sleep problem reported. Our quality assessment revealed that selection, coverage, classification and/or confounding biases were present in all 23 studies. In Manuscript 2 we report that an abnormal total score on the SDSC was found in 20.7% of children with CP aged 3-12 years; 44.0% had ≥1 sleep disorder. The most common sleep problem, DIMS, was found in 26.0% of children. Pain was the strongest predictor of having an abnormal total score and DIMS, with adjusted ORs (95% CIs) of 6.5 (2.2-18.9) and 3.4 (1.3-9.3), respectively. In Manuscript 3 we report that, in a subset of children with CP aged 4-12 years, the prevalence of behavioural difficulties on the SDQ was twice as high in school-aged compared to preschool-aged children. Rates of behavioural difficulties in preschool-aged children with CP were double those previously reported for typically-developing children (~20% vs. 10%). In children with CP, sleep problems and nighttime pain increased the likelihood of behavioural problems by 9- and 4-fold, respectively. Behavioural difficulties were associated mainly with sleep problems relating to DIMS. In Manuscript 4 we report that a large proportion of children with CP aged 3-12 years have impaired HRQoL on the PedsQL. Whereas non-ambulatory status was associated with impaired Physical HRQoL, sleep problems were most strongly associated with impaired Psychosocial HRQoL. Specific sleep problems on the SDSC relating to DIMS increased the odds of impaired emotional functioning (subscale of Psychosocial HRQoL). Pain-related HRQoL was more impaired with a greater number of/more severe sleep problems. More studies examining sleep in children with CP using validated questionnaires in large well-described, broadly-recruited samples are needed. Our cross-sectional study reports that sleep disorders are prevalent in preschool- and school-aged children with CP. Nighttime pain is the most important factor associated with sleep problems. Sleep problems and pain are important risk factors for behavioural difficulties and sleep problems are an important risk factor for impaired HRQoL. Health care professionals should routinely inquire about sleep problems and pain to manage these issues and promote the health of children with CP.
موضوع (اسم عام یاعبارت اسمی عام)
موضوع مستند نشده
Behavioral psychology
موضوع مستند نشده
Developmental psychology
موضوع مستند نشده
Disability studies
موضوع مستند نشده
Health care management
نام شخص به منزله سر شناسه - (مسئولیت معنوی درجه اول )