Association Between Participation in Life Situations of Children With Cerebral Palsy and Their Physical, Social, and Attitudinal Environment: A Cross-Sectional Multicenter European Study

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• 作者：Allan Colver ; MD^a ; ^{allan.colver@ncl.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; Ute Thyen ; MD^b ; Catherine Arnaud ; MD^c ; Eva Beckung ; PhD^d ; Jerome Fauconnier ; MD^e ; Marco Marcelli ; MD^f ; Vicki McManus ; MSc^g ; Susan I. Michelsen ; MD^h ; Jackie Parkes ; PhDⁱ ; Kathryn Parkinson ; PhD^a ; Heather O. Dickinson ; PhD^a
• 关键词：Cerebral palsy ; Child ; Environment ; Models ; statistical ; Rehabilitation ; Social participation
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：93
• 期：12
• 页码：2154-2164
• 全文大小：400 K

文摘

Colver A, Thyen U, Arnaud C, Beckung E, Fauconnier J, Marcelli M, McManus V, Michelsen SI, Parkes J, Parkinson K, Dickinson HO. Association between participation in life situations of children with cerebral palsy and their physical, social, and attitudinal environment: a cross-sectional multicenter European study. Arch Phys Med Rehabil 2012;93:2154-64.

Objective

To evaluate how participation of children with cerebral palsy (CP) varied with their environment.

Design

Home visits to children. Administration of Assessment of Life Habits and European Child Environment Questionnaires. Structural equation modeling of putative associations between specific domains of participation and environment, while allowing for severity of child's impairments and pain.

Setting

European regions with population-based registries of children with CP.

Participants

Children (n=1174) aged 8 to 12 years were randomly selected from 8 population-based registries of children with CP in 6 European countries. Of these, 743 (63%) agreed to participate; 1 further region recruited 75 children from multiple sources. Thus, there were 818 children in the study.

Interventions

Not applicable.

Main Outcome Measure

Participation in life situations.

Results

For the hypothesized associations, the models confirmed that higher participation was associated with better availability of environmental items. Higher participation in daily activities—mealtimes, health hygiene, personal care, and home life—was significantly associated with a better physical environment at home (P<.01). Mobility was associated with transport and physical environment in the community. Participation in social roles (responsibilities, relationships, recreation) was associated with attitudes of classmates and social support at home. School participation was associated with attitudes of teachers and therapists. Environment explained between 14% and 52% of the variation in participation.

Conclusions

The findings confirmed the social model of disability. The physical, social, and attitudinal environment of disabled children influences their participation in everyday activities and social roles.