新诊断小儿乳糜泻患者的健康相关生活质量

Mary Shull, Tracy R. Ediger, I. Hill, R. L. Schroedl
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引用次数: 12

摘要

目的乳糜泻(CD)是一种常见的慢性疾病,对患病儿童有潜在的不良生理和心理影响。本研究的目的是使用PedsQL™4.0通用核心量表,对大量新诊断为乳糜泻的儿科患者的健康相关生活质量(HRQOL)进行表征,并使用历史数据将其与健康儿童和非乳糜泻胃肠道疾病儿童的健康相关生活质量进行比较。方法:对159名新诊断为乳糜泻的儿童及其父母在诊断性食管胃十二指肠镜检查时或在他们最初预约营养师进行无谷蛋白饮食教学之前给予PedsQL™。计算父母报告和自我报告PedsQL™总结和子量表得分的平均值,然后使用单样本t检验将健康儿童样本和非乳糜泻胃肠道症状儿童样本的公布平均值进行比较。结果与健康儿童相比,新诊断乳糜泻患儿父母报告总分、身体健康、心理社会健康、情绪功能和学校功能得分较低(p < 0.008),自我报告得分相近。在CD样本中,55.9%的学校功能、62.7%的身体健康、54.4%的情感功能、43.7%的社会功能和49%的总分得分具有临床意义。结论新诊断为乳糜泻的儿童和青少年的HRQOL低于健康儿童,与非乳糜泻胃肠道疾病患者的HRQOL相似。在学业或情感功能等领域有缺陷的患者可能会从早期干预中受益,包括504条款计划或与心理学家或社会工作者会面。
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Health-related Quality of Life in Newly Diagnosed Pediatric Celiac Disease Patients.
OBJECTIVES Celiac disease (CD) is a common chronic condition with potential adverse physical and psychosocial implications for affected children. The study purpose was to characterize health-related quality of life (HRQOL) in a large sample of pediatric patients with newly diagnosed CD using the PedsQL™ 4.0 Generic Core Scales, and compare it to that of healthy children and children with non-celiac GI conditions using historic data. METHODS The PedsQL™ was administered to 159 children with newly diagnosed CD and their parents at either the time of diagnostic esophagogastroduodenoscopy or prior to their initial dietitian appointment for gluten-free diet teaching. Mean parent-report and self-report PedsQL™ summary and subscale scores were calculated, then compared to published means from a sample of healthy children and a sample of children with non-celiac GI symptoms using one-sample t-tests. RESULTS Compared to the healthy children, those with newly diagnosed CD had lower Total Scores, Physical Health, Psychosocial Health, Emotional Functioning, and School Functioning on parent-report (p < 0.008) with similar findings on self-report. Within the CD sample, clinically significant scores were found in 55.9% for School Functioning, 62.7% for Physical Health, 54.4% for Emotional Functioning, 43.7% for Social Functioning, and 49% for Total Score. CONCLUSIONS Children and adolescents with newly diagnosed CD had lower HRQOL than healthy children and similar HRQOL to that of patients with non-celiac GI conditions. Patients with deficits in domains such as school or emotional functioning may benefit from early interventions including a Section 504 plan or meeting with a psychologist or social worker.
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