McMaster Pediatric Surgery Research Collaborative, Hamilton, Ontario, Canada.
J Pediatr Surg. 2013 May;48(5):963-70. doi: 10.1016/j.jpedsurg.2013.02.012.
While pediatric surgeons consider gastrostomy to be routine treatment for children with feeding difficulties, the impact on the family is not fully understood. This study focuses on Quality of Life (QoL) of parents of children who require a gastrostomy tube.
A prospective repeated measures cohort study was conducted between November 2009 and March 2012. Demographic, surgical, and QoL data were collected at Baseline, 2 weeks, 3, 6, 9, and 12 months after surgery. At each time-point parents completed three QoL measures: Short Form 36v2 (SF-36), Caregiver Strain Index (CSI), and Parent Experience of Childhood Illness (PECI).
A total of 31 caregivers were recruited with a mean age of 32.6 years (SD=7.0). Overall, a 38% increased risk of depression was seen in the SF-36 when compared to population norms, and a moderate effect was seen in mental health at 12 months (ES=0.56). The CSI demonstrated a decrease in caregiver burden (8.72 to 7.05, p=0.007, 95% CI (0.57-3.18)), while the PECI revealed a decrease in frequency of feelings of guilt, worry, sorrow, anger, and long term uncertainty over 12 months.
Gastrostomy not only improves the child's physical health, but also improves the mental health of the child's caregivers, especially at (or after) one year.
虽然小儿外科医生认为胃造口术是治疗有喂养困难的儿童的常规治疗方法,但对家庭的影响尚未完全了解。本研究重点关注需要胃造口管的儿童的父母的生活质量(QoL)。
这是一项在 2009 年 11 月至 2012 年 3 月之间进行的前瞻性重复测量队列研究。在基线、术后 2 周、3、6、9 和 12 个月收集人口统计学、手术和 QoL 数据。在每个时间点,父母完成了三项 QoL 测量:简短形式 36 项健康调查(SF-36)、照顾者压力指数(CSI)和儿童疾病体验父母评估(PECI)。
共招募了 31 名照顾者,平均年龄为 32.6 岁(SD=7.0)。总体而言,与人群标准相比,SF-36 中抑郁的风险增加了 38%,而心理健康在 12 个月时的影响适中(ES=0.56)。CSI 显示照顾者负担减轻(8.72 降至 7.05,p=0.007,95%CI(0.57-3.18)),而 PECI 则显示在 12 个月内内疚、担忧、悲伤、愤怒和长期不确定性的感觉频率降低。
胃造口术不仅改善了儿童的身体健康,还改善了儿童照顾者的心理健康,尤其是在(或之后)一年。