4.6 Article

Quality of Life Outcomes in Primary Caregivers of Children with Esophageal Atresia

Journal

JOURNAL OF PEDIATRICS
Volume 238, Issue -, Pages 80-86

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2021.07.055

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Funding

  1. National Health and Medical Research Council Medical Research Postgraduate Scholarship [1168142]
  2. Clifford Family PhD Scholarship
  3. Australian Government Research Training Program Scholarship
  4. Royal Children's Hospital Foundation
  5. Oesophageal Atresia Research Australia
  6. National Health and Medical Research Council of Australia [1168142] Funding Source: NHMRC

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Research has shown that caring for children with esophageal atresia who have previously undergone fundoplication surgery can impact the quality of life of the primary caregivers.
Objective To investigate the quality of life (QoL) impact on primary caregivers of children with esophageal atresia. Study design We used a prospective cohort study design, inviting primary caregivers of children with esophageal atresia to complete the following questionnaires: Parent Experience of Child Illness (PECI), Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, PROMIS Depression, 12-Item Short Form Survey (SF-12), and Pediatric Quality of Life Inventory (PedsQL). The PECI, PROMIS Anxiety and Depression, and SF-12 assessed caregiver QoL, and the PedsQL assessed patient QoL. Patients with Gross type E esophageal atresia served as controls. Results The primary caregivers of 100 patients (64 males, 36 females; median age, 4.6 years; range, 3.5 months to 19.0 years) completed questionnaires. The majority (76 of 100) of patients had Gross type C esophageal atresia. A VACTERL (vertebral anomalies, anorectal malformation, cardiac anomalies, tracheoesophageal fistula, renal anomalies, limb anomalies) association was found in 30, >= 1 esophageal dilatation was performed in 57, and fundoplication was performed in 11/100. When stratified by esophageal atresia types, significant differences were found in 2 PECI subscales (unresolved sorrow/anger, P =.02; uncertainty, P =.02), in PROMIS Anxiety (P =.02), and in SF-12 mental health (P =.02) and mental component summary scores (P =.02). No significant differences were found for VACTERL association, nor esophageal dilatation. Requirement for fundoplication resulted in lower SF-12 general health score, and lower PedsQL social and physical functioning scores. Conclusions We have demonstrated that caring for a child with esophageal atresia and a previous requirement for fundoplication impacts caregiver QoL.

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