Aşırı Düşük Doğum Ağırlıklı Prematüre Çocukların Okul Öncesi Dönemde Dünya Sağlık Örgütü Çocuk ve Ergenlerde Uluslararası İşlevsellik Sınıflamasında Belirlenen Alanlarda Sorun Yaşama Oranları ve Hizmet Gereksinimleri

Yıl 2021, , 102 - 112, 25.08.2021

Berfin Uysal , Sultan Kavuncuoğlu

https://doi.org/10.26650/experimed.2021.927825

Öz

Amaç: Bu çalışmada, 1000 gram ve altında doğan ve 3-5 yaşına gelmiş çocukların, Dünya Sağlık Örgütü Çocuk ve Ergenlerde Uluslararası İşlevsellik Sınıflaması (ICF-CY) sisteminde belirlenen alanlarda sorunla karşılaşma oranları araştırılarak ve hizmet ihtiyaçlarının belirlenmesi amaçlanmıştır.

Gereç ve Yöntem: Elli sekiz çocuğa okul öncesi dönemde fizik muayene ve ayrıntılı nörolojik inceleme yapıldı. Bu çocuklar perinatal ve sosyodemografik özellikler yönünden irdelenerek tüm çocuklara Vineland Uyum ve Davranış Ölçeği uygulanmıştır. Sonuçlar ICF-CY modeline uyarlanmıştır.

Bulgular: Olgularımızın iletişim işlevselliğinde %20,6’sının, günlük yaşam becerilerine katılımında %12,1’inin, sosyalleşme işlevselliğinde %19’unun, hareket işlevselliğinde ise %29,3’ünün ciddi düzeyde sorun yaşadıkları saptanmıştır. Sadece 3 olguda ciddi düzeyde yaşla uyumlu olmayan davranış sorunu tanımlanmıştır. Hareket işlevselliğinin; öz bakım işlevselliğini, ev yaşamı etkinliklerine katılımı, sosyalleşme işlevselliğini, oyun ve boş zaman etkinliklerine katılımı, öğrenme ve problem çözme işlevselliğini anlamlı olarak etkilediği belirlenmiştir. Olgularımızın %22,4’ünün (13 olgu) yüksek seviyede özel eğitim desteğine ihtiyacı olduğu belirlenmiştir.

Tartışma: Günümüzde yaşama şansları oldukça yüksek olan aşırı düşük doğum ağırlıklı prematürelerin işlevsellik, etkinlik, yaşama katılım ve hizmet ihtiyaçlarının saptanabilmesi için uzun dönem izlemleri çok önemlidir ve mutlaka ergenlik dönemine kadar devam ettirilmelidir.

Anahtar Kelimeler

Prematüre, aşırı düşük doğum ağırlıklı, Dünya Sağ-lık Örgütü, Vineland, özel eğitim

Problem Rates and Service Requirements of Extremely Low Birth Weight Preschoolers in Areas Designated in the World Health Organization International Classification of Functioning in Children and Adolescents (ICF-CY ) System

Öz

Objective: Our aim in this study is to determine the problem rates and service requirements according to World Health Organization International Classification of Functioning in Children and Adolescents (ICF-CY) system defining specified areas as body structures, functionality, activity, participation in life and environmental factors in premature children born as <1000 and aged 3 to 5 years during the research process.
Materials and methods: Physical and neurological examination, perinatal and sociodemographic characteristics were examined in 58 premature born preschoolers and they were evaluated in terms of communication, socialization, movement and daily living skills with the Vineland Adaptation and Behavior Scale. Results were adapted to the ICF-CY model.
Results: Functionality problems of our cases were found as 20,6% in communication, 12,1% in participation in daily life skills, 19% in socialization and 29,3% in movement. Severe behavioral problems incompatible with age were identified in only 3 cases. Movement functionality was determined to significantly affect self-care functionality, participation in home life activities, socialization functionality, participation in games and leisure activities, learning and problem solving functionality. It was determined that 22.4% of our cases (13 cases) needed a high level of special education support.
Discussion: Long-term follow-up is very important in determining the functionality, efficiency, participation in life and service needs of extremely low birth weight premature babies whose survival rates are gradually increasing and should be continued with a multidisciplinary approach until adolescence.

Anahtar Kelimeler

Premature, extremely low birth weight, World Health Orga-nization, Vineland, special education

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