Srivastava Rajendu, Downey Earl C, Feola Peter, Samore Matthew, Coburn Laurie, Holubkov Richard, Mundorff Michael, Nkoy Flory, Desrochers Dan, James Brent C, Rosenbaum Peter, Young Paul C, Dean Jonathan M, O'Gorman Molly
University of Utah Health Sciences Center, Salt Lake City, Utah 84113, USA.
J Hosp Med. 2007 May;2(3):165-73. doi: 10.1002/jhm.167.
Children with neurological impairment (NI) commonly have gastroesophageal reflux disease (GERD) treated with a fundoplication. The impact of this procedure on quality of life is poorly understood.
To examine the quality of life of children with NI who have received a fundoplication for GERD and of their caregivers.
The study was a prospective cohort study of children with NI and GERD who underwent a fundoplication at a children's hospital between January 1, 2005, and July 7, 2006. Quality of life of the children was assessed with the Child Health Questionnaire (CHQ) and of the caregivers with the Short-Form Health Survey Status (SF-36) and Parenting Stress Index (PSI), both at baseline and 1 month after fundoplication. Functional status was assessed using the WeeFIM. Repeated-measures analyses were performed.
Forty-four of the 63 parents (70%) were enrolled. The median WeeFIM score was 31.2 versus the age-normal score of 83 (P = .001). Compared with the baseline scores, mean CHQ scores improved over 1 month in the domains of bodily pain (32.8 vs. 47.5, P = .01), role limitations-physical (30.6 vs. 56.6, P = .01), mental health (62.7 vs. 70.6, P = .01), family limitation of activities (43.3 vs. 55.1, P = .03), and parental time (43.0 vs. 55.3, P = .03). The parental SF-36 domain of vitality improved from baseline over 1 month (41.3 vs. 48.2, P = .001), but there were no changes from baseline in Parenting Stress scores.
Parents reported that the quality of life of children with NI who receive a fundoplication for GERD was improved from baseline in several domains 1 month after surgery. The quality of life and stress of caregivers did not improve in nearly all domains, at least in the short term.
患有神经功能障碍（NI）的儿童通常患有胃食管反流病（GERD），需接受胃底折叠术治疗。人们对该手术对生活质量的影响了解甚少。
研究接受GERD胃底折叠术的NI儿童及其照料者的生活质量。
本研究是一项前瞻性队列研究，研究对象为2005年1月1日至2006年7月7日期间在一家儿童医院接受胃底折叠术的NI合并GERD儿童。分别在基线期和胃底折叠术后1个月，使用儿童健康问卷（CHQ）评估儿童的生活质量，使用简明健康调查量表（SF-36）和育儿压力指数（PSI）评估照料者的生活质量。使用儿童功能独立性测量量表（WeeFIM）评估功能状态。进行重复测量分析。
63名家长中有44名（70%）参与研究。WeeFIM评分中位数为31.2，而年龄正常评分是83（P = 0.001）。与基线评分相比，术后1个月，儿童CHQ评分在身体疼痛（32.8对47.5，P = 0.01）、身体角色限制（30.6对56.6，P = 0.01）、心理健康（62.7对70.6，P = 0.01）、家庭活动限制（43.3对55.1，P = 0.03）和家长时间（43.0对55.3，P = 0.03）等领域有所改善。照料者SF-36量表中的活力领域评分术后1个月较基线期有所提高（41.
