Werner Helene, Buder Kathrin, Landolt Markus A, Neuhaus Thomas J, Laube Guido F, Spartà Giuseppina
Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14, 8051, Zurich, Switzerland.
Pediatr Nephrol. 2017 May;32(5):869-878. doi: 10.1007/s00467-016-3569-0. Epub 2016 Dec 23.
In children after haemolytic-uraemic syndrome (HUS), little is known about long-term health-related quality of life (HRQoL) and psychological adjustment as defined by behavioural problems, depressive symptoms and post-traumatic stress symptoms.
Sixty-two paediatric patients with a history of HUS were included in this study. Medical data of the acute HUS episode were retrieved retrospectively from hospital records. Data on the clinical course at study investigation were assessed by clinical examination and laboratory evaluation. HRQoL and psychological adjustment data were measured by standardised, parent- and self-reported questionnaires.
Haemolytic-uraemic syndrome was diagnosed at a mean of 6.5 years before the initiation of the study (standard deviation 2.9, range 0.1-15.7) years. Among the preschool children, parents reported that their child was less lively and energetic (HRQoL emotional dimension), while no increased behavioural problems were reported. In the school-age children, self- and proxy-reported HRQoL was well within or even above the norms, while increased total behavioural problems were found. The school-age children reported no increased depression scores. Also none of the children met the criteria for full or partial HUS-associated posttraumatic stress disorder.
Healthcare providers should be particularly alert to behavioural problems in school-age children with a history of HUS and to lower HRQoL in preschool children.
在溶血尿毒综合征(HUS)患儿中,对于长期健康相关生活质量(HRQoL)以及由行为问题、抑郁症状和创伤后应激症状所定义的心理调适情况,我们知之甚少。
本研究纳入了62名有HUS病史的儿科患者。急性HUS发作的医学数据通过回顾医院记录进行检索。在研究调查时,通过临床检查和实验室评估来评估临床病程数据。HRQoL和心理调适数据通过标准化的家长报告问卷和自我报告问卷进行测量。
溶血尿毒综合征在研究开始前平均6.5年被诊断(标准差2.9,范围0.1 - 15.7年)。在学龄前儿童中,家长报告他们的孩子活力和精力不如从前(HRQoL情感维度),但未报告行为问题增加。在学龄儿童中,自我报告和家长报告的HRQoL完全处于或甚至高于正常范围,但发现行为问题总数有所增加。学龄儿童报告抑郁得分未增加。此外,没有儿童符合完全或部分HUS相关创伤后应激障碍的标准。
医疗保健提供者应特别警惕有HUS病史的学龄儿童的行为问题以及学龄前儿童较低的HRQoL。