OKUL ÖNCESİ SEREBRAL PALSİLİ ÇOCUKLARIN FİZİKSEL AKTİVİTEYİ SÜRDÜREBİLME YETENEĞİ VE YAŞAM KALİTESİ İLE, BAKIM VERENLERİN PSİKOSOSYAL DURUMU ARASINDAKİ İLİŞKİSİ

Öz

Amaç: Bu çalışmanın amacı okul öncesi serebral palsili (SP) çocuklarda fiziksel aktiviteyi sürdürebilme yeteneği ile yaşam kalitesi ve bakım verenlerin psikososyal durumları arasındaki ilişkiyi araştırmaktır. Yöntem: Çalışmaya 55 SP'li çocuk ve bakım verenleri dahil edildi. Fiziksel aktiviteyi sürdürme yeteneği ve yaşam kalitesi sırasıyla Endurans için Erken Aktivite Skalası (EEAS) ve Pediatrik Veri Toplama Aracı (PVTA) ile belirlendi. Bakım verenin psikososyal durumu Aile Etki Ölçeği (AEÖ), Beck Depresyon Ölçeği (BDÖ) ve Durumluk-Sürekli Kaygı Envanteri (DSKE) ile değerlendirildi. Sonuçlar: Çocukların (28K, 27E) ve bakım verenlerin (45K, 10E) yaş ortalaması sırasıyla 46,96±14,66 ay ve 33,81±7,65 yıl idi. EEAS ile PVTA alt parametreleri arasında anlamlı ilişkiler bulundu (p<0,05). Ancak, EEAS ile AEÖ, BDÖ ve DSKE arasında anlamlı ilişkiler bulunmadı (p>0,05). PVTA-mutluluk ile AEÖ (p=0,042, r=-0,293) ve PVTA-transfer/mobilite ile BDÖ (p=0,044, r=-0,273) arasında istatistiksel olarak anlamlı ilişkiler tespit edildi. Tartışma: Bu çalışma, okul öncesi SP'li çocukların fiziksel aktiviteyi sürdürebilme yeteneğinin yaşam kalitesi ile yakından ilişkili olduğunu ve bakım verenlerin psikolojik iyilik hallerinin, hastalığın aile üyeleri üzerindeki etkisinin şiddetinden etkilendiğini düşündürmektedir. Okul öncesi SP'li çocukların yaşam kalitesi, endurans için fiziksel aktivite düzeyini ve bakım verenin psikolojik iyilik halini iyileştirmeyi amaçlayan bütünsel yaklaşımlarla geliştirilebilir.

Anahtar Kelimeler

• Serebral palsi
• fiziksel aktivite
• bakım verenler
• depresyon
• anksiyete

THE ASSOCIATION BETWEEN ABILITY TO SUSTAIN PHYSICAL ACTIVITY AND QUALITY OF LIFE OF PRESCHOOL CHILDREN WITH CEREBRAL PALSY, AND PSYCHOSOCIAL STATUS OF CAREGIVERS

Abstract

Purpose: This study aimed to present the relationship between the ability to maintain physical activity in preschool children with cerebral palsy (CP) and quality of life, and the psychosocial status of caregivers. Methods: Fifty-five children with CP and their caregivers were included in the study. The ability to maintain physical activity and quality of life were determined by the Early Activity Scale for Endurance (EASE) and Pediatric Outcomes Data Collection Instrument (PODCI), respectively. The psychosocial status of caregivers was assessed by Impact on Family Scale (IFS), Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI). Results: The mean age of children (28F, 27M) and their caregivers (45F, 10M) was 46.96±14.66 months and 33.81±7.65 years, respectively. Significant correlations were found between EASE and PODCI sub-parameters (p<0.05). However, there were no significant correlations between EASE and the IFS, BDI and STAI (p>0.05). Statistically significant correlations were detected between PODCI-happiness and IFS (p=0.042, r=-0.293) and PODCI-transfer/mobility and BDI (p=0.044, r=-0.273). Conclusion: This study suggests that the ability of preschool children with CP to maintain physical activity is closely related to their quality of life and the psychological well-being of caregivers is affected from the severity of impact of the disease on family members. The quality of life of preschool children with CP can be improved by holistic approaches aiming to improve the endurance for physical activity and psychological well-being of their caregivers.

Keywords

• Cerebral palsy
• physical activity
• caregivers
• depression
• anxiety

Kaynakça

1. McIntyre S, Goldsmith S, Webb A, Ehlinger V, Hollung SJ, McConnell K, et al. Global prevalence of cerebral palsy: A systematic analysis. Dev Med Child Neurol. 2022;64(12):1494-1506.
2. Keawutan P, Bell KL, Oftedal S, Ware RS, Stevenson RD, Davies PS, Boyd RN. Longitudinal physical activity and sedentary behaviour in preschool‐aged children with cerebral palsy across all functional levels. Dev Med Child Neurol. 2017;59(8),852-857.
3. Lauruschkus K, Hallström I, Westbom L, Tornberg Å, Nordmark E. Participation in physical activities for children with cerebral palsy: feasibility and effectiveness of physical activity on prescription. Arch Physiother. 2017;7:13.
4. Gorter JW, Fehlings D, Ferro MA, Gonzalez A, Green AD, Hopmans SN, et al. Correlates of Mental Health in Adolescents and Young Adults with Cerebral Palsy: A Cross-Sectional Analysis of the MyStory Project. J Clin Med. 2022;11(11):3060.
5. Lavelle G, Noorkoiv M, Theis N, Korff T, Kilbride C, Baltzopoulos V, et al. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy: a cross-sectional study. Physiotherapy. 2020;107:209-15.
6. Wentz EE, Bjornson KF, Kerfeld CI, Cicirello N, Fiss AL. Walking Performance, Physical Activity, and Validity of the Early Activity Scale for Endurance in Young Children with Cerebral Palsy. Phys Occup Ther Pediatr. 2020;40(5):557-70.
7. Fiss AL, Jeffries L, Yocum A, McCoy SW, On Track Study Team. Validity of the early activity scale for endurance and the 6-minute walk test for children with cerebral palsy. Pediatr Phys Ther. 2019;31(2):156-163.
8. FitzGerald TL, Cameron KL, Albesher RA, Mentiplay BF, Lee KJ, Clark RA, et al. Strength, Motor Skills, and Physical Activity in Preschool-Aged Children Born Either at Less Than 30 Weeks of Gestation or at Term. Phys Ther. 2021;101(5): pzab037.

9. Oftedal S, Davies PS, Boyd RN, Stevenson RD, Ware RS, Keawutan P, et al. Body composition, diet, and physical activity: a longitudinal cohort study in preschoolers with cerebral palsy. Am J Clin Nutr. 2017;105(2):369-78.
10. Dere T, Serel Arslan S, Alemdaroğlu-Gürbüz İ. Validity and reliability of the turkish version of the early activity scale for endurance in preschool children with cerebral palsy. Dev Neurorehabil. 2023;26(2),101-108.
11. Akmeşe PP, Kayhan N. An Investigation of Social Support Levels in Mothers of Children with Cerebral Palsy in Early Childhood. SUJE. 2016;6(3):146-61.
12. Guimarães A, Pereira A, Oliveira A, Lopes S, Nunes AR, Zanatta C, et al. Parenting in Cerebral Palsy: Understanding the Perceived Challenges and Needs Faced by Parents of Elementary School Children. Int J Environ Res Public Health. 2023;20(5):3811.
13. Scherer N, Verhey I, Kuper H. Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis. PloS one. 2019;14(7):e0219888.
14. Park EY. Relationship among gross motor function, parenting stress, sense of control, and depression in mothers of children with cerebral palsy. Int J Environ Res Public Health. 2021;18(17):9285.
15. Tseng MH, Chen KL, Shieh JY, Lu L, Huang CY, Simeonsson RJ. Child characteristics, caregiver characteristics, and environmental factors affecting the quality of life of caregivers of children with cerebral palsy. Disabil Rehabil. 2016;38(24):2374-82.
16. Karatekin BD, Icagasioglu A. The effects of the functional levels of children with cerebral palsy on the quality of life of caregivers. J Surg Med. 2022;6(2):191-195.
17. Bjornson KF, Belza B, Kartin D, Logsdon R, McLaughlin J, Thompson EA. The relationship of physical activity to health status and quality of life in cerebral palsy. Pediatr Phys Ther. 2008;20(3):247.
18. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(4):214-23.
19. McCoy SW, Yocum A, Bartlett DJ, Mendoza J, Jeffries L, Chiarello L, et al. Development of the Early Activity Scale for Endurance for children with cerebral palsy. Pediatr Phys Ther. 2012;24(3):232-240.
20. Dilbay NK, Günel MK, Aktan T. Reliability and validity of Turkish version of Pediatric Outcome Data Collection Instrument (PODCI) for people with cerebral palsy. Physiother Rehabil. 2013;24(1):118-26.
21. Daltroy LH, Liang MH, Fossel AH, Goldberg MJ. The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America. J Pediatr Orthop. 1998;18:561–571.
22. Beydemir F, Cavlak U, Yolacan S, Ekici G. Reliability and validity of Turkish version of the impact on family scale: assessment of depressive symptoms and quality of life in mothers with cerebral palsied children. J Med Sci. 2009;9(4):175-184.
23. Stein RE, Riessman CK. The development of an impact-on-family scale: preliminary findings. Med Care. 1980;18(4), 465-472.
24. Hisli N. A reliability and validity study of Beck Depression Inventory in a university student sample. J Psychol. 1989;7(23):3-13.
25. Beck AT, Steer RA, Brown G. Beck depression inventory–II. APA PsycTests. 1996.
26. Oner N, Le Compte A. Manual for the state-trait anxiety inventory. Turkey: Istanbul Boğaziçi University Publications; 1983;1:1-26.
27. Spielberger CD, Gonzalez-Reigosa F, Martinez-Urrutia A, Natalicio LF, Natalicio DS. The state-trait anxiety inventory. Interam J Psychol. 1971;5(3&4):145-158.
28. Pojskic H, McGawley K, Gustafsson A, Behm DG. The reliability and validity of a novel sport-specific balance test to differentiate performance levels in elite curling players. J Sports Sci Med. 2020;19(2):337.
29. Keawutan P, Bell KL, Oftedal S, Davies PS, Ware RS, Boyd RN. Quality of life and habitual physical activity in children with cerebral palsy aged 5 years: a cross-sectional study. Res Dev Disabil. 2018;74:139-45.
30. Tavares Netto AR, Wiesiolek CC, Brito PM, Rocha GAD, Tavares RMF, Lambertz KMF. Functionality, school participation and quality of life of schoolchildren with cerebral palsy. Fisioter em Mov. 2020;33.
31. Badia M, Orgaz MB, Gomez-Vela M, Verdugo MA, Ullan AM, Longo E. Do environmental barriers affect the parent-reported quality of life of children and adolescents with cerebral palsy? Res Dev Disabil. 2016;49:312-21.
32. Şeker Abanoz E, Aslan Keleş Y, Köroğlu F, Uzun N, Kuran Aslan G. Investigation of Quality of Life, Physical Activity and Functional Independence in Ambulatory Children with Cerebral Palsy. IGUSABDER. 2024;22:144–157.
33. Park E-Y, Nam S-J. Time burden of caring and depression among parents of individuals with cerebral palsy. Disabil Rehabil. 2019;41(13):1508-13.
34. Beck AT, Bredemeier K. A unified model of depression: Integrating clinical, cognitive, biological, and evolutionary perspectives. Clin Psychol Sci. 2016;4(4):596-619.
35. Barreto TM, Bento MN, Barreto TM, Jagersbacher JG, Jones NS, Lucena R, et al. Prevalence of depression, anxiety, and substance‐related disorders in parents of children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2020;62(2):163-168.
36. Cejalvo E, Martí-Vilar M, Merino-Soto C, Aguirre-Morales MT. Caregiving Role and Psychosocial and Individual Factors: A Systematic Review. Healthcare (Basel). 2021;9(12):1690.
37. Barreto TM, Bento MN, Barreto TM, Jagersbacher JG, Jones NS, Lucena R, et al. Prevalence of depression, anxiety, and substance‐related disorders in parents of children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2020;62(2):163-8.
38. Ahmadizadeh Z, Mokhlesin M. Factors Which Affect the Depression of Mothers with Cerebral Palsy Child. Iran Rehabil J. 2014;12(4):43-8.
39. Khan SA, Saeed FUR, Ayaz SB. Severity of depression and anxiety among caregivers of children with cerebral palsy and their correlation with functional capabilities of the children. Pak Armed Forces Med J. 2021;71(4):1327-31.
40. Barutcu A, Barutcu S, Kolkiran S, Ozdener F. Evaluation of Anxiety, Depression and Burden on Caregivers of Children with Cerebral Palsy. Dev Neurorehabil. 2021;24(8):555-60.