Figueiredo Aldvan Alves, Lomazi Elizete Aparecida, Montenegro Maria Augusta, Bellomo-Brandão Maria Angela
UNICAMP, Departamento de Pediatria, Campinas, SP, Brasil.
Arq Gastroenterol. 2020 Jan-Mar;57(1):3-7. doi: 10.1590/S0004-2803.202000000-02.
Cerebral palsy is the most common cause of physical disability in childhood. Caregivers of patients presenting tetraparesis cerebral palsy (TCP) and gastrostomy tube feeding (GTF) were selected for this study because both conditions represent a great demand for their caregivers.
To describe the quality of life related to the state of health of caregivers of patients with TCP who were fed by gastrostomy, to assess the results linked to the mental health of these caregivers, to compare our data with data from other studies on children with cerebral palsy without gastrostomy and to evaluate the possible interference of gastrostomy in the quality of life.
A number of 30 major caregivers were interviewed and assessed. Quality of life and mental health tools applied and analyzed only for caregivers were: Medical Outcomes Study (MOS) 36-item Short Form Health Survey (SF-36), WHOQOL-BREF and Beck scales. Other information (age, gender, marital status, number of residents per household and psychological support) was evaluated. The Spearman's rank correlation coefficient was used to analyze. A 5% significance level was adopted.
Results obtained through questionnaires are as follows: moderate hopelessness in 20% of caregivers (the higher the number of residents per household the higher the level of caregiver's hopelessness); moderate and severe anxiety in 33.33% of the sample studied; moderate and severe depression identified in 46.67% of interviewed caregivers; health-related quality of life of caregivers of patients with TCP were found to be below world averages; no significant figures for suicide potential were noted for the population under this study.
The HRQOL of caregivers of TCP patients who were fed by gastrostomy is below the average of the general population. Our results are very similar to those found in other studies that evaluated caregivers of patients with cerebral palsy with different degrees of neurological impairment and no report of using GTF, suggesting that the presence of gastrostomy did not negatively interfere with the caregiver's HRQOL.
脑瘫是儿童身体残疾的最常见原因。本研究选择了患有四肢瘫脑瘫(TCP)且接受胃造口管饲(GTF)的患者的照顾者,因为这两种情况对其照顾者都有很大需求。
描述接受胃造口喂养的TCP患者照顾者与健康状况相关的生活质量,评估这些照顾者心理健康相关的结果,将我们的数据与其他关于无胃造口脑瘫儿童的研究数据进行比较,并评估胃造口对生活质量的可能影响。
对30名主要照顾者进行了访谈和评估。仅针对照顾者应用和分析的生活质量和心理健康工具包括:医学结局研究(MOS)36项简短健康调查(SF - 36)、世界卫生组织生活质量简表(WHOQOL - BREF)和贝克量表。还评估了其他信息(年龄、性别、婚姻状况、每户居民人数和心理支持)。采用Spearman等级相关系数进行分析。采用5%的显著性水平。
通过问卷调查获得的结果如下:20%的照顾者有中度绝望感(每户居民人数越多,照顾者的绝望程度越高);在研究样本中,33.33%有中度和重度焦虑;在接受访谈的照顾者中,46.67%有中度和重度抑郁;发现接受胃造口喂养的TCP患者照顾者的健康相关生活质量低于世界平均水平;本研究人群未发现自杀倾向的显著数据。
接受胃造口喂养的TCP患者照顾者的健康相关生活质量低于一般人群的平均水平。我们的结果与其他评估不同程度神经损伤且未报告使用GTF的脑瘫患者照顾者的研究结果非常相似,表明胃造口的存在并未对照顾者的健康相关生活质量产生负面影响。