Witvliet Marieke J, Bakx Roel, Zwaveling Sander, van Dijk Tonnis H, van der Steeg Alida F W
Department of Pediatric Surgery, Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Amsterdam, The Netherlands.
Department of Pediatric Surgery, Wilhelmina Children's Hospital UMCU, Utrecht, The Netherlands.
Eur J Pediatr Surg. 2016 Feb;26(1):2-6. doi: 10.1055/s-0035-1559885. Epub 2015 Sep 18.
In 2012, we started the KLANKbord-study. A quality of life (QoL) study that follows patients with an anorectal malformation (ARM) or Hirschsprung disease (HD) and their parents from diagnosis till the age of 18 years. We hypothesized that the diagnosis of ARM or HD initially has a negative influence on QoL and anxiety levels of parents, but that this influence will diminish over time. The aim of this study is to see whether QoL and anxiety levels of parents change within the first year after the diagnosis.
Parents of all children born with ARM or HD, were eligible for this study. Within 3 months after the diagnosis ARM or HD, parents received a set of validated QoL questionnaires (measurement 1). Measurement 2 was 12 months after the first questionnaire.
During measurement 1 mothers (n = 20) scored significantly higher on the social (p value, 0.01; 95% confidence interval [CI], 0.3946-3.1528) and environmental domain (p value, 0.01; 95% CI, 0.4449-2.2851) of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) compared with the known reference values. Fathers (n = 19) scored significantly higher on the physical (p value, 0.01; 95% CI, 0.2964-1.8072), psychological (p value, 0.001; 95% CI, 0.7697-2.4757), and environmental domain (p value, 0.003; 95% CI, 0.5586-2.4214) than the reference values. Comparison of all domains of the WHOQOL-BREF for mothers and fathers between measurements did not show a significant difference. Anxiety levels of mothers were lower during measurement 2 compared with measurement 1. Anxiety levels of fathers were higher during measurement 2 compared with measurement 1. These differences are not significant. Anxiety levels of mothers were significantly higher than anxiety levels of fathers during measurement 1 (p value, 0.002; 95% CI, 0.808-2,956). During measurement 2 this difference in anxiety of mothers versus fathers did not exist (p value, 0.373; 95% CI, -1.157 to 2.922).
A negative influence on the QoL of parents having a child with ARM or HD, compared with the reference population was not seen in this population. QoL did not change significantly during the first year for both fathers and mothers. Anxiety levels of mothers did decline during this first year. The number of parents included in this study is still small, which might influence our results. Therefore, we will continue the KLANKbord-study indefinitely.
2012年,我们启动了KLANKbord研究。这是一项关于生活质量(QoL)的研究,跟踪患有肛门直肠畸形(ARM)或先天性巨结肠病(HD)的患者及其父母,从诊断开始直至18岁。我们假设,ARM或HD的诊断最初会对父母的生活质量和焦虑水平产生负面影响,但这种影响会随着时间的推移而减弱。本研究的目的是观察父母的生活质量和焦虑水平在诊断后的第一年内是否会发生变化。
所有患有ARM或HD的儿童的父母均符合本研究的条件。在诊断出ARM或HD后的3个月内,父母收到一套经过验证的生活质量问卷(测量1)。测量2在第一次问卷之后12个月进行。
在测量1时,母亲(n = 20)在世界卫生组织生活质量简表(WHOQOL - BREF)的社会领域(p值,0.01;95%置信区间[CI],0.3946 - 3.1528)和环境领域(p值,0.01;95% CI,0.4449 - 2.2851)的得分显著高于已知参考值。父亲(n = 19)在身体领域(p值,0.01;95% CI,0.2964 - 1.8072)、心理领域(p值,0.001;95% CI,0.7697 - 2.4757)和环境领域(p值,0.003;95% CI,0.5586 - 2.4214)的得分显著高于参考值。测量期间,母亲和父亲在WHOQOL - BREF所有领域的比较未显示出显著差异。与测量1相比,母亲在测量2时的焦虑水平较低。与测量1相比,父亲在测量2时的焦虑水平较高。这些差异不显著。在测量1时,母亲的焦虑水平显著高于父亲(p值,0.002;95% CI,0.808 - 2.956)。在测量2时,母亲与父亲之间的这种焦虑差异不存在(p值,0.373;95% CI,-1.157至2.922)。
在这一人群中,与参考人群相比,未发现孩子患有ARM或HD对父母生活质量有负面影响。父母的生活质量在第一年中没有显著变化。母亲的焦虑水平在这第一年中确实有所下降。本研究纳入的父母数量仍然较少,这可能会影响我们的结果。因此,我们将无限期继续KLANKbord研究。