Quality of life of children with neurological impairment who receive a fundoplication for gastroesophageal reflux disease

✍ Scribed by Rajendu Srivastava; Earl C. Downey; Peter Feola; Matthew Samore; Laurie Coburn; Richard Holubkov; Michael Mundorff; Flory Nkoy; Dan Desrochers; Brent C. James; Peter Rosenbaum; Paul C. Young; Jonathan M. Dean; Molly O'Gorman

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 439 KB
• Volume: 2
• Category: Article
• ISSN: 1553-5592
• DOI: 10.1002/jhm.167

✦ Synopsis

Abstract

BACKGROUND

Children with neurological impairment (NI) commonly have gastroesophageal reflux disease (GERD) treated with a fundoplication. The impact of this procedure on quality of life is poorly understood.

OBJECTIVES

To examine the quality of life of children with NI who have received a fundoplication for GERD and of their caregivers.

METHODS

The study was a prospective cohort study of children with NI and GERD who underwent a fundoplication at a children's hospital between January 1, 2005, and July 7, 2006. Quality of life of the children was assessed with the Child Health Questionnaire (CHQ) and of the caregivers with the Short‐Form Health Survey Status (SF‐36) and Parenting Stress Index (PSI), both at baseline and 1 month after fundoplication. Functional status was assessed using the WeeFIM®. Repeated‐measures analyses were performed.

RESULTS

Forty‐four of the 63 parents (70%) were enrolled. The median WeeFIM® score was 31.2 versus the age‐normal score of 83 (P = .001). Compared with the baseline scores, mean CHQ scores improved over 1 month in the domains of bodily pain (32.8 vs. 47.5, P = .01), role limitations–physical (30.6 vs. 56.6, P = .01), mental health (62.7 vs. 70.6, P = .01), family limitation of activities (43.3 vs. 55.1, P = .03), and parental time (43.0 vs. 55.3, P = .03). The parental SF‐36 domain of vitality improved from baseline over 1 month (41.3 vs. 48.2, P = .001), but there were no changes from baseline in Parenting Stress scores.

CONCLUSIONS

Parents reported that the quality of life of children with NI who receive a fundoplication for GERD was improved from baseline in several domains 1 month after surgery. The quality of life and stress of caregivers did not improve in nearly all domains, at least in the short term. Journal of Hospital Medicine 2007;2:165–173. © 2007 Society of Hospital Medicine.