Abstract
Aims: To examine short term and long term health related quality of life (HRQoL) of survivors of congenital anorectal malformations (ARM) and congenital diaphragmatic hernia (CDH), and to compare these patients' HRQoL with that of the general population.
Methods: HRQoL was measured in 286 ARM patients and 111 CDH patients. All patients were administered a symptom checklist and a generic HRQoL measure. For the youngest children (aged 1–4) the TAIQOL (a preliminary version of the TAPQOL) was used, for the other children (aged 5–15) the TACQOL questionnaire, and for adults (aged >16) the SF-36.
Results: As appeared from the symptom checklists, many patients remained symptomatic into adulthood. In the youngest ARM patients (aged 1–4 years), generic HRQoL was severely affected, but the older ARM patients showed better HRQoL. In the CDH patients, the influence of symptoms on HRQoL seemed less profound. The instruments we used revealed little difference between adults treated for ARM or CDH and the general population.
Conclusions: These results show that for two neonatal surgical procedures, improved survival does not come at the expense of poor HRQoL in adults. Even though there is considerable suffering in terms of both morbidity and mortality in the youngest group, the ultimate prognosis of survivors of the two studied congenital malformations is favourable. This finding can be used to reassure parents of patients in need of neonatal surgery for one of these conditions about the prospects for their child.
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- Aaronson N. K., Muller M., Cohen P. D., Essink-Bot M. L., Fekkes M., Sanderman R., Sprangers M. A., te Velde A., Verrips E. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998 Nov;51(11):1055–1068. doi: 10.1016/s0895-4356(98)00097-3. [DOI] [PubMed] [Google Scholar]
- Aneci Rosa C. S., Borba E. S., Ebrahim G. J. The street children of Recife: a study of their background. J Trop Pediatr. 1992 Feb;38(1):34–40. doi: 10.1093/tropej/38.1.34. [DOI] [PubMed] [Google Scholar]
- Aptekar L. Characteristics of the street children of Colombia. Child Abuse Negl. 1989;13(3):427–437. doi: 10.1016/0145-2134(89)90083-5. [DOI] [PubMed] [Google Scholar]
- Barr R. D., Chalmers D., De Pauw S., Furlong W., Weitzman S., Feeny D. Health-related quality of life in survivors of Wilms' tumor and advanced neuroblastoma: aA cross-sectional study. J Clin Oncol. 2000 Sep 15;18(18):3280–3287. doi: 10.1200/JCO.2000.18.18.3280. [DOI] [PubMed] [Google Scholar]
- Beyene Y., Berhane Y. Characteristics of street children in Nazareth, Ethiopia. East Afr Med J. 1997 Feb;74(2):85–88. [PubMed] [Google Scholar]
- Bouman N. H., Koot H. M., Tibboel D., Hazebroek F. W. Children with congenital diaphragmatic hernia are at risk for lower levels of cognitive functioning and increased emotional and behavioral problems. Eur J Pediatr Surg. 2000 Feb;10(1):3–7. doi: 10.1055/s-2008-1072314. [DOI] [PubMed] [Google Scholar]
- Canning E. H., Hanser S. B., Shade K. A., Boyce W. T. Mental disorders in chronically ill children: parent-child discrepancy and physician identification. Pediatrics. 1992 Nov;90(5):692–696. [PubMed] [Google Scholar]
- Chetcuti P., Myers N. A., Phelan P. D., Beasley S. W. Adults who survived repair of congenital oesophageal atresia and tracheo-oesophageal fistula. BMJ. 1988 Jul 30;297(6644):344–346. doi: 10.1136/bmj.297.6644.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coons S. J., Rao S., Keininger D. L., Hays R. D. A comparative review of generic quality-of-life instruments. Pharmacoeconomics. 2000 Jan;17(1):13–35. doi: 10.2165/00019053-200017010-00002. [DOI] [PubMed] [Google Scholar]
- Ennett S. T., DeVellis B. M., Earp J. A., Kredich D., Warren R. W., Wilhelm C. L. Disease experience and psychosocial adjustment in children with juvenile rheumatoid arthritis: children's versus mothers' reports. J Pediatr Psychol. 1991 Oct;16(5):557–568. doi: 10.1093/jpepsy/16.5.557. [DOI] [PubMed] [Google Scholar]
- Fekkes M., Theunissen N. C., Brugman E., Veen S., Verrips E. G., Koopman H. M., Vogels T., Wit J. M., Verloove-Vanhorick S. P. Development and psychometric evaluation of the TAPQOL: a health-related quality of life instrument for 1-5-year-old children. Qual Life Res. 2000;9(8):961–972. doi: 10.1023/a:1008981603178. [DOI] [PubMed] [Google Scholar]
- Glaser A. W., Davies K., Walker D., Brazier D. Influence of proxy respondents and mode of administration on health status assessment following central nervous system tumours in childhood. Qual Life Res. 1997 Jan;6(1):43–53. doi: 10.1023/a:1026465411669. [DOI] [PubMed] [Google Scholar]
- Hassink E. A., Rieu P. N., Brugman A. T., Festen C. Quality of life after operatively corrected high anorectal malformation: a long-term follow-up study of patients aged 18 years and older. J Pediatr Surg. 1994 Jun;29(6):773–776. doi: 10.1016/0022-3468(94)90367-0. [DOI] [PubMed] [Google Scholar]
- Hazebroek F. W., Bouman N. H., Tibboel D. The neonate with major malformations: experiences in a university children's hospital in the Netherlands. Semin Pediatr Surg. 2001 Nov;10(4):222–229. doi: 10.1053/spsu.2001.26846. [DOI] [PubMed] [Google Scholar]
- Hazebroek F. W., Tibboel D., Leendertse-Verloop K., Bos A. P., Madern G. C., Molenaar J. C. Evaluation of mortality in surgical neonates over a 10-year period: nonpreventable, permissible, and preventable death. J Pediatr Surg. 1991 Sep;26(9):1058–1063. doi: 10.1016/0022-3468(91)90673-h. [DOI] [PubMed] [Google Scholar]
- Ijsselstijn H., Tibboel D., Hop W. J., Molenaar J. C., de Jongste J. C. Long-term pulmonary sequelae in children with congenital diaphragmatic hernia. Am J Respir Crit Care Med. 1997 Jan;155(1):174–180. doi: 10.1164/ajrccm.155.1.9001308. [DOI] [PubMed] [Google Scholar]
- Inciardi J. A., Surratt H. L. Children in the streets of Brazil: drug use, crime, violence, and HIV risks. Subst Use Misuse. 1998 Jun;33(7):1461–1480. doi: 10.3109/10826089809069809. [DOI] [PubMed] [Google Scholar]
- Kim E. S., Stolar C. J. ECMO in the newborn. Am J Perinatol. 2000;17(7):345–356. doi: 10.1055/s-2000-13449. [DOI] [PubMed] [Google Scholar]
- Koot V. C., Bergmeijer J. H., Bos A. P., Molenaar J. C. Incidence and management of gastroesophageal reflux after repair of congenital diaphragmatic hernia. J Pediatr Surg. 1993 Jan;28(1):48–52. doi: 10.1016/s0022-3468(05)80353-7. [DOI] [PubMed] [Google Scholar]
- Lalor K. J. Street children: a comparative perspective. Child Abuse Negl. 1999 Aug;23(8):759–770. doi: 10.1016/s0145-2134(99)00047-2. [DOI] [PubMed] [Google Scholar]
- Levi R. B., Drotar D. Health-related quality of life in childhood cancer: discrepancy in parent-child reports. Int J Cancer Suppl. 1999;12:58–64. doi: 10.1002/(sici)1097-0215(1999)83:12+<58::aid-ijc11>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
- Limerick S. R., Bacon C. J. Terminology used by pathologists in reporting on sudden infant deaths. J Clin Pathol. 2004 Mar;57(3):309–311. doi: 10.1136/jcp.2003.013052. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ludman L., Spitz L. Psychosocial adjustment of children treated for anorectal anomalies. J Pediatr Surg. 1995 Mar;30(3):495–499. doi: 10.1016/0022-3468(95)90065-9. [DOI] [PubMed] [Google Scholar]
- Martins S. B., Ebrahim G. J. The female street children of Rio de Janeiro: a qualitative study of their backgrounds. J Trop Pediatr. 1995 Feb;41(1):43–46. doi: 10.1093/tropej/41.1.43. [DOI] [PubMed] [Google Scholar]
- Nobuhara K. K., Lund D. P., Mitchell J., Kharasch V., Wilson J. M. Long-term outlook for survivors of congenital diaphragmatic hernia. Clin Perinatol. 1996 Dec;23(4):873–887. [PubMed] [Google Scholar]
- Parsons S. K., Barlow S. E., Levy S. L., Supran S. E., Kaplan S. H. Health-related quality of life in pediatric bone marrow transplant survivors: according to whom? Int J Cancer Suppl. 1999;12:46–51. doi: 10.1002/(sici)1097-0215(1999)83:12+<46::aid-ijc9>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
- Peña A. Anorectal malformations. Semin Pediatr Surg. 1995 Feb;4(1):35–47. [PubMed] [Google Scholar]
- Poley M. J., Stolk E. A., Langemeijer R. A., Molenaar J. C., Busschbach J. J. The cost-effectiveness of neonatal surgery and subsequent treatment for congenital anorectal malformations. J Pediatr Surg. 2001 Oct;36(10):1471–1478. doi: 10.1053/jpsu.2001.27025. [DOI] [PubMed] [Google Scholar]
- Poley Marten J., Stolk Elly A., Tibboel Dick, Molenaar Jan C., Busschbach Jan J. v. The cost-effectiveness of treatment for congenital diaphragmatic hernia. J Pediatr Surg. 2002 Sep;37(9):1245–1252. doi: 10.1053/jpsu.2002.34973. [DOI] [PubMed] [Google Scholar]
- Ravitch M. M., Barton B. A. The need for pediatric surgeons as determined by the volume of work and the mode of delivery of surgical care. Surgery. 1974 Nov;76(5):754–763. [PubMed] [Google Scholar]
- Rintala R., Mildh L., Lindahl H. Fecal continence and quality of life for adult patients with an operated high or intermediate anorectal malformation. J Pediatr Surg. 1994 Jun;29(6):777–780. doi: 10.1016/0022-3468(94)90368-9. [DOI] [PubMed] [Google Scholar]
- Stolk E. A., Post H. A., Rutten F. F., Molenaar J. C., Busschbach J. J. Cost-effectiveness of neonatal surgery: a review. J Pediatr Surg. 2000 Apr;35(4):588–592. doi: 10.1053/jpsu.2000.0350588. [DOI] [PubMed] [Google Scholar]
- Theunissen N. C., Vogels T. G., Koopman H. M., Verrips G. H., Zwinderman K. A., Verloove-Vanhorick S. P., Wit J. M. The proxy problem: child report versus parent report in health-related quality of life research. Qual Life Res. 1998 Jul;7(5):387–397. doi: 10.1023/a:1008801802877. [DOI] [PubMed] [Google Scholar]
- UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation. UK Collaborative ECMO Trail Group. Lancet. 1996 Jul 13;348(9020):75–82. [PubMed] [Google Scholar]
- Vance Y. H., Morse R. C., Jenney M. E., Eiser C. Issues in measuring quality of life in childhood cancer: measures, proxies, and parental mental health. J Child Psychol Psychiatry. 2001 Jul;42(5):661–667. [PubMed] [Google Scholar]
- Vogels T., Verrips G. H., Verloove-Vanhorick S. P., Fekkes M., Kamphuis R. P., Koopman H. M., Theunissen N. C., Wit J. M. Measuring health-related quality of life in children: the development of the TACQOL parent form. Qual Life Res. 1998 Jul;7(5):457–465. doi: 10.1023/a:1008848218806. [DOI] [PubMed] [Google Scholar]
- Ware J. E., Jr SF-36 health survey update. Spine (Phila Pa 1976) 2000 Dec 15;25(24):3130–3139. doi: 10.1097/00007632-200012150-00008. [DOI] [PubMed] [Google Scholar]
- Waters E., Doyle J., Wolfe R., Wright M., Wake M., Salmon L. Influence of parental gender and self-reported health and illness on parent-reported child health. Pediatrics. 2000 Dec;106(6):1422–1428. doi: 10.1542/peds.106.6.1422. [DOI] [PubMed] [Google Scholar]
- Wilson I. B., Cleary P. D. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995 Jan 4;273(1):59–65. [PubMed] [Google Scholar]
- Wright J. D., Kaminsky D., Wittig M. Health and social conditions of street children in Honduras. Am J Dis Child. 1993 Mar;147(3):279–283. doi: 10.1001/archpedi.1993.02160270041015. [DOI] [PubMed] [Google Scholar]
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