目的 观察基于加拿大作业表现量表(COPM)评估结果开展的作业治疗方案对全面性发育迟缓(GDD)儿童作业活动表现、满意度以及日常生活能力的影响,为GDD儿童作业治疗方案的制定提供临床实践参考。方法 选取2021年3月—2022年3月在唐山市妇幼保健院儿童康复科门诊接受康复治疗的GDD儿童69例,采用随机数字表法将其随机分对照组(n=35)和观察组(n=34),对照组给予常规康复治疗,观察组在此基础上将作业治疗替换为基于COPM结果的目标导向性的作业治疗方案,治疗时间持续3个月。分别于治疗前和治疗3个月后采用COPM评估儿童目标任务的作业表现及满意度,儿童功能独立性评定量表(WeeFIM)评估儿童日常生活能力。结果 治疗后,观察组和对照组COPM表现分均较治疗前显著改善,差异有统计学意义(t=21.845、7.533,P＜0.05),且观察组优于对照组(t=2.551,P＜0.05);观察组和对照组COPM满意度分较治疗前显著改善(t=22.240、8.329,P＜0.05),且观察组优于对照组(t=2.300,P＜0.05);观察组较对照组的COPM表现分有效性和满意度分有效性更高,差异均有统计学意义(χ2=4.183、4.284,P＜0.05);治疗后观察组WeeFIM运动功能、认知功能评分及总分均高于对照组 (t=2.132、2.994、2.364,P＜0.05)。结论 基于COPM的作业治疗方案可以提高全面性发育迟缓儿童目标任务的作业表现及满意度,可以显著改善其日常生活能力。
Abstract
Objective To observe the effect of occupational therapy program based on the Canadian Occupational Performance Measure(COPM) on the performance of occupational activities, satisfaction and activities of daily living in children with global developmental delay(GDD), so as to provide reference for clinical practice in the formulation of occupational therapy for children with global developmental delay. Methods A total of 69 children with GDD who received rehabilitation treatment in the outpatient department of Child Rehabilitation of Tangshan Maternal and Child Health Hospital from March 2021 to March 2022 were selected and randomly divided into control group (n=35) and observation group (n=34) by random number table method. The control group received routine rehabilitation therapy. Additionally, the observation group replaced occupational therapy with a goal-oriented occupational therapy program based on COPM results, and the treatment lasted for 3 months. Before treatment and 3 months after treatment, COPM was used to evaluate Children′s performance and satisfaction with target tasks, and Child Functional Independence Measure for Children (WeeFIM) was used to evaluate the Children′s activities of daily living. Results After treatment, the COPM performance scores of the observation group and the control group were significantly improved compared with those before treatment (t=21.845, 7.533, P<0.05), and the improvement of observation group was better than that of the control group (t=2.551, P<0.05). The COPM satisfaction scores of the observation group and the control group were significantly improved compared with those before treatment (t=22.240, 8.329, P<0.05), and the improvement of observation group was better than that of the control group (t=2.300, P<0.05). The effectiveness rates of COPM performance score and satisfaction score in the observation group were significantly higher than those in the control group (χ2=4.183, 4.284, P<0.05). After treatment, scores of motor function, cognitive function and total score of WeeFIM in the observation group were significantly higher than those in the control group (t=2.132, 2.994, 2.364, P<0.05). Conclusion The occupational therapy program based on COPM can improve the occupational performance and satisfaction of the target tasks of children with GDD and can significantly improve the activities of daily living of these children.
关键词
全面性发育迟缓 /
加拿大作业表现量表 /
作业治疗 /
日常生活能力
Key words
global developmental delay /
Canadian Occupational Performance Measure /
occupational therapy /
activities of daily living
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