Mast T Christopher, DeMuro-Mercon Carla, Kelly Claudia M, Floyd Leigh Ellen, Walter Emmanuel B
Merck Research Laboratories, North Wales, PA, USA.
BMC Pediatr. 2009 Feb 6;9:11. doi: 10.1186/1471-2431-9-11.
Rotavirus is the leading cause of severe diarrhea in young children and causes substantial morbidity and mortality. Although the clinical aspects have been well described, little information is available regarding the emotional, social, and economic impact of rotavirus gastroenteritis on the family of a sick child. The objectives of this study were to: 1) assess the family impact of rotavirus gastroenteritis through qualitative interviews with parents; 2) compare the clinical severity of rotavirus-positive and negative gastroenteritis; 3) test a questionnaire asking parents to rank the importance of various factors associated with a case of rotavirus gastroenteritis.
The study enrolled parents and children (2-36 months of age) brought to one of the study sites (outpatient clinic or ER) if the child experienced > or = 3 watery or looser-than normal stools and/or forceful vomiting within any 24-hour period within the prior 3 days. The clinical severity of each child's illness was rated using a clinical scoring system and stool samples were tested for rotavirus antigen. Parents of rotavirus-positive children were invited to participate in focus group or individual interviews and subsequently completed a questionnaire regarding the impact of their child's illness.
Of 62 enrolled children, 43 stool samples were collected and 63% tested positive for rotavirus. Illness was more severe in children with rotavirus-positive compared to rotavirus-negative gastroenteritis (92% vs. 37.5% rated as moderate/severe). Seventeen parents of rotavirus-positive children participated in the interviews and completed the written questionnaire. Parents were frightened by the severity of vomiting and diarrhea associated with rotavirus gastroenteritis, and noted that family life was impacted in several ways including loss of sleep, missed work, and an inability to complete normal household tasks. They expressed frustration at the lack of a specific medication and the difficulty of treating the illness with oral rehydration solutions, but had a largely positive outlook concerning the prospect of a rotavirus vaccine.
A better understanding of how rotavirus gastroenteritis impacts the family can help healthcare providers ease parental fears and advise them on the characteristics of this illness, practices to prevent infection, and the optimal care of an affected child.
轮状病毒是幼儿严重腹泻的主要病因，会导致大量发病和死亡。尽管临床方面已有详尽描述，但关于轮状病毒肠胃炎对患病儿童家庭的情感、社会和经济影响的信息却很少。本研究的目的是：1）通过对家长进行定性访谈来评估轮状病毒肠胃炎对家庭的影响；2）比较轮状病毒阳性和阴性肠胃炎的临床严重程度；3）测试一份要求家长对与轮状病毒肠胃炎病例相关的各种因素的重要性进行排序的问卷。
如果孩子在过去3天内的任何24小时内出现≥3次水样便或比正常情况更稀的大便和/或剧烈呕吐，研究招募带到其中一个研究地点（门诊诊所或急诊室）的家长和孩子（2至36个月大）。使用临床评分系统对每个孩子的疾病临床严重程度进行评分，并对粪便样本进行轮状病毒抗原检测。邀请轮状病毒阳性孩子的家长参加焦点小组或个人访谈，随后完成一份关于其孩子疾病影响的问卷。
在62名登记的儿童中，收集了43份粪便样本，63%检测出轮状病毒呈阳性。与轮状病毒阴性肠胃炎相比，轮状病毒阳性儿童的病情更严重（分别有92%和37.5%被评为中度/重度）。17名轮状病毒阳性儿童的家长参加了访谈并完成了书面问卷。家长们对与轮状病毒肠胃炎相关的呕吐和腹泻的严重程度感到恐惧，并指出家庭生活在几个方面受到影响，包括睡眠不足、误工以及无法完成正常家务。他们对缺乏特效药物以及使用口服补液溶液治疗疾病的困难表示沮丧，但对轮状病毒疫苗的前景总体持积极态度。
更好地了解轮状病毒肠胃炎如何影响家庭有助于医疗保健提供者减轻家长的恐惧，并就这种疾病的特征、预防感染的措施以及患病儿童的最佳护理向他们提供建议。
