Faculty of Medicine, University of Oslo, Norway.
J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):562-6. doi: 10.1097/MPG.0b013e31826078bd.
The aim of the study was to evaluate stress in mothers of children with feeding problems before and after gastrostomy placement, and to identify changes in child health and variables affecting maternal stress.
Psychological distress and parenting stress in 34 mothers of children referred for gastrostomy were assessed using general health questionnaire (GHQ) (overall psychological distress), impact of event scale (IES) (intrusive stress related to child's feeding problems), and parenting stress index (PSI) (stress related to parenting) before, 6, and 18 months after placement of a gastrostomy. Information of child health and long-term gastrostomy complications were recorded. A semistructured interview constructed for the present study explored maternal preoperative expectations and child's quality of life.
Insertion of a gastrostomy did not significantly influence vomiting or the number of children with a low weight-for-height percentile. All of the children experienced peristomal complications. Despite this, mothers' overall psychological distress was significantly reduced after 6 and 18 months, and the majority of mothers (85%) reported that their preoperative expectations were fulfilled and that the child's quality of life was improved after gastrostomy placement. Maternal concerns for the child's feeding problems, measured as intrusive stress, had effect on maternal overall psychological distress.
Despite frequent stomal complications the gastrostomy significantly reduced the mothers' psychological distress and improved the child's quality of life as reported by the mother.
本研究旨在评估喂养问题儿童的母亲在胃造口术前后的压力,并确定儿童健康状况的变化和影响母亲压力的因素。
使用一般健康问卷(GHQ)(整体心理困扰)、事件影响量表(IES)(与儿童喂养问题相关的侵入性压力)和父母压力指数(PSI)(与育儿相关的压力)评估 34 名接受胃造口术的儿童的母亲的心理困扰和育儿压力,在胃造口术之前、6 个月和 18 个月后进行评估。记录儿童健康状况和长期胃造口并发症的信息。为本次研究构建的半结构化访谈探讨了母亲术前的期望和孩子的生活质量。
胃造口术的插入并没有显著影响呕吐或体重身高百分位数低的儿童数量。所有的孩子都经历了造口周围的并发症。尽管如此,母亲的整体心理困扰在 6 个月和 18 个月后显著减轻,大多数母亲(85%)报告说她们的术前期望得到了满足,孩子的生活质量在胃造口术后得到了改善。母亲对孩子喂养问题的担忧,表现为侵入性压力,对母亲的整体心理困扰有影响。
尽管造口周围经常出现并发症,但胃造口术显著减轻了母亲的心理困扰,并如母亲所报告的那样提高了孩子的生活质量。