Institute of Clinical Sciences, Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden; Department of Pediatric Surgery, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Clinical Sciences, Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden; Department of Pediatric Surgery, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
J Pediatr Surg. 2023 Sep;58(9):1646-1655. doi: 10.1016/j.jpedsurg.2022.12.004. Epub 2022 Dec 15.
Children with long-gap esophageal atresia (LGEA) face a high risk of digestive and respiratory morbidity, but their mental health outcomes have not been investigated. We aimed to identify the prevalence of mental health problems in children with LGEA, associated factors and health-related quality of life (HRQOL).
Twenty-six children with LGEA aged 3-17 were recruited nationwide in Sweden. One of their parents and adolescents aged 11-17 completed information on the child's mental health (Strength and Difficulties Questionnaire), generic (PedsQL 4.0) and condition-specific HRQOL (EA-QOL). Parents gave information on current child symptomatology. Mental health level was determined using validated norms; abnormal≥90 percentile/borderline≥80 percentile/normal. Elevated levels were considered borderline/abnormal. Data were analyzed using descriptives, correlation and Mann-Whitney-U test. Significance level was p < 0.05.
Twelve children with LGEA aged 3-17 (46%) had elevated scores of ≥1 mental health domain in parent-reports, whereas 2 adolescents (15%) in self-reports. In parent-reports, 31% of the children had elevated levels of peer relationship problems, with associated factors being child sex male (p = 0.037), airway infections (p = 0.002) and disturbed night sleep (p = 0.025). Similarly, 31% showed elevated levels of hyperactivity/inattention, and associated factors were male sex (p = 0.005), asthma (p = 0.028) and disturbed night sleep (p = 0.036). Elevated levels of emotional symptoms, seen in 20%, were related to swallowing difficulties (p = 0.038) and vomiting problems (p = 0.045). Mental health problems correlated negatively with many HRQOL domains (p < 0.05).
Children with LGEA risk mental health difficulties according to parent-reports, especially peer relationship problems and hyperactivity/inattention, with main risk factors being male sex, airway problems and sleep disturbances. This should be considered in follow-up care and research, particularly since their mental health problems may impair HRQOL.
Prognosis study, LEVEL II.
患有长段食管闭锁（LGEA）的儿童面临较高的消化和呼吸道发病率，但他们的心理健康结果尚未得到调查。本研究旨在确定 LGEA 患儿心理健康问题的患病率、相关因素和健康相关生活质量（HRQOL）。
在瑞典全国范围内招募了 26 名年龄在 3-17 岁的 LGEA 患儿。他们的父母之一和 11-17 岁的青少年完成了儿童心理健康（困难问卷）、通用（PedsQL 4.0）和特定于病情的 HRQOL（EA-QOL）信息。父母提供了当前儿童症状的信息。使用验证的规范确定心理健康水平；异常≥90 百分位/边界≥80 百分位/正常。升高的水平被认为是边界/异常。使用描述性分析、相关性和曼-惠特尼 U 检验进行数据分析。显著性水平为 p<0.05。
12 名 3-17 岁的 LGEA 患儿（46%）在父母报告中出现≥1 个心理健康领域的升高分数，而 2 名青少年（15%）在自我报告中出现升高分数。在父母报告中，31%的儿童存在同伴关系问题，相关因素为男孩（p=0.037）、气道感染（p=0.002）和夜间睡眠障碍（p=0.025）。同样，31%的儿童存在多动/注意力不集中的升高分数，相关因素为男孩（p=0.005）、哮喘（p=0.028）和夜间睡眠障碍（p=0.036）。20%的儿童存在升高的情绪症状，与吞咽困难（p=0.038）和呕吐问题（p=0.045）有关。心理健康问题与许多 HRQOL 领域呈负相关（p<0.05）。
根据父母报告，LGEA 患儿存在心理健康问题的风险，特别是同伴关系问题和多动/注意力不集中，主要危险因素为男孩、气道问题和睡眠障碍。这应在随访护理和研究中加以考虑，特别是因为他们的心理健康问题可能会损害 HRQOL。
预后研究，二级。
