Comparative study of home and community participation among children with and without cerebral palsy.

BACKGROUND: Children with cerebral palsy (CP) are at increased risk of reduced participation. Parental evaluation of child's participation is often the decision-making factor in the process of special education and/or rehabilitation. AIMS: Examine and compare home and community participation of children with CP and typical development (TD) and the associations between their parents' desire for change and participation dimensions in both settings. METHODS AND PROCEDURES: This cross-sectional study included a convenience sample of 110 children with CP (55% males; mean age 12.7 years) and 134 children with TD (49% males; mean age 12.1 years). The Participation and Environment Measure for Children and Youth (PEM-CY) was used. OUTCOMES AND RESULTS: Home and community participation and environmental supportiveness of children with CP were lower compared to children with TD (p < .001, family income controlled). The effect sizes indicated that there may be no clinically important difference in participation frequency. Parents of children with CP desired change if participation was less diverse at home, less frequent in the community, or if involvement was lower in both settings (environmental supportiveness and income controlled). CONCLUSIONS AND IMPLICATIONS: At home, parents expressed a desire for change more intensely through the range of activities, while parents of children with TD emphasized participation frequency. In the community, parents of children with CP equally perceived participation diversity and focused more on frequency and involvement.

Social functioning of elderly persons with malignant diseases.

BACKGROUND/AIM: Malignant disease, its treatment and consequences of treatment can often lead to social marginalization and reduced quality of life. The aim of this research was to determine how elderly patients with malignant diseases function in their social environment. METHODS: Sociodemographic questionnaire and interview were used to investigate a group of 49 elderly persons undergoing adjuvant chemotherapy treatment against early carcinomas (P1), and a group of 51 elderly persons with advanced stages of cancer undergoing systemic chemotherapy (P2). There were two cycles of assessment: one just before the beginning of the first cycle of adjuvant or systemic chemotherapy, and the other three months later. The research paradigm was based on the relation between individual treatment and the impact of the malignant disease on functional and social incompetence. The obtained findings were compared with the group of 50 healthy elderly people (K) who share the same relevant features but do not suffer from malignant diseases. RESULTS: It was found that most healthy older people live in share house, whereas those who suffer from malignant diseases mostly live in separate households. In both groups of patients and healthy group older people are mostly taken care of by their children. Individuals in both groups of patients have been frequently visited by their relatives during initial stages of treatment, unlike the elderly people in the control group. However, the difference did not reach a statistical significance. Three months after the beginning of chemotherapy, there was a statistically relevant difference in favor of the group undergoing adjuvant treatment. Home visits eventually become less frequent, whereas communication by telephone becomes more frequent. It was also found that visits by friends and neighbors are statistically more frequent among subjects who undergo adjuvant treatment, both before the treatment began and three months later when compared to other groups. CONCLUSION: Our research shows that elderly people are subject to social exclusion, especially those with malignant diseases. Special care should be dedicated to monitoring of social functioning during treatment of patients with malignant disease considering the detected trend of deterioration and significance for further recover and cure.

Health Condition and Quality of Life in Persons with Spinal Cord Injury.

BACKGROUND: During the last few decades, focus of rehabilitation outcome has been redirected to the lifetime monitoring of quality of life. The purpose of this study was to investigate the differences in quality of life perceptions between participants with spinal cord injury and participants of typical population. METHODS: This cross-sectional controlled study of 100 adults aged 18-65 years was based on two questionnaires, Short Form-36 Health Survey (SF-36) and Spinal Cord Injury Quality of Life Questionnaire (QL-23), completed by 23 participants with paraplegia, 21 participants with tetraplegia, and 56 participants of typical population. Mann-Whitney U-test for planned comparison between groups and χ(2) test were used to analyze the differences between research groups. RESULTS: Participants from control group perceived their general quality of life at higher level in comparison to participants with spinal cord injury (U=415.000, z=-5.804, P<0.000). Negative influence of spinal cord injury was detected in six domains (physical functioning, physical role, bodily pain, vitality, social functioning, mental health). Statistical differences between participants with paraplegia and participants with tetraplegia only in domain of functional limitations (U=103.000, z=-3.256, P<0.005). CONCLUSION: The participants with spinal cord injury perceived both health-related and general quality of life at a lower level in comparison to controls. However, the injury level only partially determined the estimated quality of life.

Health-related quality of life assessment in Serbian schoolchildren hospitalized for malignant disease.

BACKGROUND/AIM: Although long-term survival of childhood cancer patients is significantly improved, prolonged treatment and hospitalization might have negative impacts on child development. The aim of this study was to verify profile of health-related quality of life parameters in population of schoolchildren during hospitalization and treatment for malignant disease. METHODS: The Serbian version of Pediatric Quality of Life Inventory Version 4.0 (PedsQLTM4.0) Generic Core Scales was applied. A total of 120 schoolchildren were analyzed: 60 patients hospitalized for prolonged malignant disease treatment and 60 healthy schoolchildren from public schools. The study was done at the Institute for Oncology and Radiology of Serbia, as well as in four schools. RESULTS: Generally, schoolchildren hospitalized for cancer treatment demonstrated lower scores on physical, emotional, social and school functioning when compared to healthy schoolchildren from regular public schools. Significant differences were observed for all the 8 items of the Physical Health Scale, in 2 out of 5 items of the Emotional Functioning Scale, in 4 out of 5 items of the Social Functioning Scale, and 3 out of 5 items of the School Functioning Scale. CONCLUSIONS: The Serbian version of PedsQL 4.0 Generic Core Scales could be successfully used to evaluate physical, emotional, social and school functioning of hospitalized children and adolescent. Schoolchildren hospitalized for prolonged tumor treatment have poorer HRQOL scores compared to general healthy population, however the level of remaining physical, emotional and social parameters should provide solid foundation for their potential rehabilitation, education and inclusion.