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胃造口术和智力残疾儿童的生活质量:一项定性研究。

Gastrostomy and quality of life in children with intellectual disability: a qualitative study.

机构信息

Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Nedlands, Western Australia, Australia.

Medical School, The University of Western Australia, Perth, Western Australia, Australia.

出版信息

Arch Dis Child. 2020 Oct;105(10):969-974. doi: 10.1136/archdischild-2020-318796. Epub 2020 Apr 8.

Abstract

OBJECTIVE

Children with intellectual disability and marked feeding difficulties may undergo gastrostomy insertion to assist with their nutritional and medication needs. Use has increased recently for younger children, and it is intended to provide long-term support. This study explored the perceived value of gastrostomy for the quality of life (QOL) of children with intellectual disabilities and their families.

METHODS

Twenty-one primary caregivers of children with intellectual disability aged 2-18 years participated in semistructured telephone interviews. Data were analysed using directed content analysis, and data were coded to existing QOL domains relevant to children with intellectual disability and their families.

RESULTS

Benefits in each of the child and family QOL domains were represented in the interview data. For children, the impacts of gastrostomy for the physical health domain were predominant, supplemented by experiences of value for emotional well-being, social interactions, leisure activities and independence. For families, gastrostomy was integrated into multiple aspects of QOL relating to family interactions, parenting, resources and supports, health and safety, and advocacy support for disability. Shortcomings related to difficulties with equipment and complications.

CONCLUSIONS

Our comprehensive overview of the value of gastrostomy for children with intellectual disability and their families was classified within a QOL framework. Gastrostomy was mainly supportive over long time periods across many QOL domains. Findings will be of use to patient counselling and education and the development of family support resources.

摘要

目的

智力残疾且存在明显进食困难的儿童可能需要进行胃造口术来满足其营养和药物需求。近年来,该手术在年龄更小的儿童中使用有所增加,目的是提供长期支持。本研究旨在探讨胃造口术对智力残疾儿童及其家庭生活质量(QOL)的感知价值。

方法

21 名 2-18 岁智力残疾儿童的主要照顾者参与了半结构化电话访谈。使用定向内容分析法分析数据,并对与智力残疾儿童及其家庭相关的现有 QOL 领域进行编码。

结果

访谈数据中体现了儿童和家庭 QOL 各个领域的益处。对于儿童而言,胃造口术对身体健康领域的影响最为显著,同时也有情感幸福感、社交互动、休闲活动和独立性方面的价值体验。对于家庭而言,胃造口术融入了与家庭互动、育儿、资源和支持、健康和安全以及残疾倡导支持相关的多个 QOL 方面。不足之处与设备问题和并发症有关。

结论

我们全面概述了胃造口术对智力残疾儿童及其家庭的价值,将其归入 QOL 框架内。胃造口术在许多 QOL 领域长期支持儿童。研究结果将有助于患者咨询和教育以及家庭支持资源的开发。

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