Department of Surgery, McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada.
J Pediatr Surg. 2012 May;47(5):999-1004. doi: 10.1016/j.jpedsurg.2012.01.058.
High-quality prospective cohort studies are needed to answer research questions focused on prognosis. To determine the feasibility of conducting this type of research, a prospective cohort study focused on investigating health-related quality of life (HRQoL) of caregivers of children who require a gastrostomy (G) tube at the McMaster Children's Hospital was piloted from November 2009 to May 2011.
Recruitment began after research ethics board approval. Feasibility data were collected on all caregivers of patients assessed for G tube placement by a pediatric surgeon including recruitment status, protocol compliance, and HRQoL. Data were collected at 1 month and 2 weeks before surgery and 2 weeks and 3, 6, 9, and 12 months after surgery. Health-related quality of life measures included the Short Form 36v2, the Caregiver Strain Index, and the Parent Experience of Childhood Illness.
A total of 117 G procedures were conducted, and 39 caregivers met eligibility criteria. Thirty-one caregivers were enrolled (79.5% recruitment rate), 8 parents were not interested, and 26 were missed. Protocol adherence to the follow-up schedule is high (91.3%).
Conducting high-level research with long-term follow-up in pediatric surgery is challenging. Factors including low prevalence of patients and competing priorities for busy clinicians indicate that multicenter collaboration is essential to research success in this field.
需要高质量的前瞻性队列研究来回答关注预后的研究问题。为了确定开展此类研究的可行性,一项前瞻性队列研究于 2009 年 11 月至 2011 年 5 月在麦克马斯特儿童医院试点,旨在调查需要胃造口术(G)管的儿童照顾者的健康相关生活质量(HRQoL)。
在获得研究伦理委员会批准后开始招募。对接受小儿外科医生评估的所有患者的照顾者收集可行性数据,包括招募情况、方案依从性和 HRQoL。数据在手术前 1 个月和 2 周、手术后 2 周和 3 周、6 周、9 周和 12 周收集。健康相关生活质量的测量包括简短形式 36 版 2(Short Form 36v2)、照顾者压力指数和父母对儿童疾病的体验。
共进行了 117 次 G 手术,有 39 名照顾者符合入选标准。共招募了 31 名照顾者(招募率为 79.5%),8 名家长不感兴趣,26 名家长未联系上。对随访计划的方案依从性很高(91.3%)。
在小儿外科进行高水平的长期随访研究具有挑战性。包括患者患病率低和忙碌的临床医生的竞争优先级在内的因素表明,多中心合作对于该领域的研究成功至关重要。