Assessment of Health Related Quality Of Life in Children with Inflammatory Bowel Disease
May Abd ElTawab Ahmed Abu El-Ma’atti;
Abstract
IBD is characterized by an unpredictable illness course and includes symptoms of abdominal pain, diarrhea, nausea, fatigue, delayed puberty, and weight loss. These symptoms, in addition to treatment (including surgery, corticosteroids, and having a stoma), can be embarrassing, socially limiting, and can lead to changes in physical appearance. This may have a negative effect on body image, self-esteem, and mood. The social constraints of the disease, in addition to the considerable amount of school often missed because of illness and hospital appointments, may therefore have effect on social functioning. This could result in the children having fewer opportunities to develop autonomy as they grow older.
Aim: This study aimed to measure HRQL of patients with IBD in relation to disease parameters (type of disease, duration of disease, number of bowel motions, number of relapses), patients’ parameters (age, sex) and type of treatment.
Patients and methods: Forty children & adolescent suffering from IBD and 40 of their parents were recruited from Gastroenterology Clinic, Ain Shams University Children’s Hospital, Cairo, Egypt. Full history & clinical assessment of IBD was taken from all patients. The IMPACT III was used to measure HRQOL of the participants.
Results: Our result revealed that patients were frequently bothered by their parents’ excessive fears, how much rules imposed on their activities & food. Also they reported teasing by peers due to their bathroom urge. They reported fears of having tests especially endoscopy.
Child/proxy report scores were significantly lower in the domain of tests &treatment (t=2.058, P=0.047) as regards the effect of patients’ sex on QOL, however patient’s age turned to have no effect on QOL neither does the duration of the disease.
Patient weight was positively correlated to child/proxy report scores (r=0.326, P=0.040) and was significantly lower concerning the domain of systemic impairment.
The numbers of bowel motions were negatively correlated to child/proxy report scores in all domains except for the domain of tests & treatment denoting a worse QOL (r= -0.627, P=<0.01/ r= -0.638, P=<0.01/ r= -0.512, P=<0.01/ r= -0.613, P=<0.01/ r= -0.542, P=<0.01).
The type of disease significantly affect the QOL scores in all domains, with Crohn’s disease being worse than UC. (t=3.747, P=<0.01 / t=3.693, P=<0.01/ t=3.029, P=<0.01/ t=4.487, P=<0.01/ t=3.831, P=<0.01/ t=2.547, p=.015).
The use of infliximab turns to affect the QOL scores significantly as regards all domains except for the domain of tests & treatment. The current study revealed that the use of infliximab worsens the QOL but this result could be biased due to the small sample size.(t= 3.584, P=<0.01 / t=3.161, P=<0.01/ t=2.862, P=<0.01/ t=4.440, P=<0.01/ t=3.000, P=<0.01). On the other hand the use of steroids turns to have no effect on QOL of patients.
Surgery significantly affect the QOL scores in all domains except for the score of tests & treatment with those who underwent surgery having worse QOL. (t=3.584, P=<0.01/ t=4.207, P=<0.01/ t=2.862, p=<0.01 / t=3.863, P=<0.01 / t=3.430, P=<0.01). However this result could be biased due to the small sample size.
The use of antidepressants showed a worse QOL in those who used it with the affection of all domains except for the domain of tests & treatment. However this result could be biased due to small sample size. (t=3.825, p=<0.01/ t=4.838, P=<0.01 / t=4.209, P=<0.01/ t=4.289, P=<0.01 / t=3.000, P=<0.01).
The number of relapses turn to affect the QOL in patients who experienced it in the domain of emotional impairment (P=0.04) with those who experienced two times or more relapses being more affected.
The presence of extra-intestinal manifestations seems to affect the QOL of patients in the domains of bowel symptoms & systemic impairment leading to worse QOL (t=2.256. P=.030/ t=2.133, P=.039).
The presence of other medical conditions appears to affect the QOL of patients in the domains of bowel symptoms, emotional impairment, social impairment and body image.
Aim: This study aimed to measure HRQL of patients with IBD in relation to disease parameters (type of disease, duration of disease, number of bowel motions, number of relapses), patients’ parameters (age, sex) and type of treatment.
Patients and methods: Forty children & adolescent suffering from IBD and 40 of their parents were recruited from Gastroenterology Clinic, Ain Shams University Children’s Hospital, Cairo, Egypt. Full history & clinical assessment of IBD was taken from all patients. The IMPACT III was used to measure HRQOL of the participants.
Results: Our result revealed that patients were frequently bothered by their parents’ excessive fears, how much rules imposed on their activities & food. Also they reported teasing by peers due to their bathroom urge. They reported fears of having tests especially endoscopy.
Child/proxy report scores were significantly lower in the domain of tests &treatment (t=2.058, P=0.047) as regards the effect of patients’ sex on QOL, however patient’s age turned to have no effect on QOL neither does the duration of the disease.
Patient weight was positively correlated to child/proxy report scores (r=0.326, P=0.040) and was significantly lower concerning the domain of systemic impairment.
The numbers of bowel motions were negatively correlated to child/proxy report scores in all domains except for the domain of tests & treatment denoting a worse QOL (r= -0.627, P=<0.01/ r= -0.638, P=<0.01/ r= -0.512, P=<0.01/ r= -0.613, P=<0.01/ r= -0.542, P=<0.01).
The type of disease significantly affect the QOL scores in all domains, with Crohn’s disease being worse than UC. (t=3.747, P=<0.01 / t=3.693, P=<0.01/ t=3.029, P=<0.01/ t=4.487, P=<0.01/ t=3.831, P=<0.01/ t=2.547, p=.015).
The use of infliximab turns to affect the QOL scores significantly as regards all domains except for the domain of tests & treatment. The current study revealed that the use of infliximab worsens the QOL but this result could be biased due to the small sample size.(t= 3.584, P=<0.01 / t=3.161, P=<0.01/ t=2.862, P=<0.01/ t=4.440, P=<0.01/ t=3.000, P=<0.01). On the other hand the use of steroids turns to have no effect on QOL of patients.
Surgery significantly affect the QOL scores in all domains except for the score of tests & treatment with those who underwent surgery having worse QOL. (t=3.584, P=<0.01/ t=4.207, P=<0.01/ t=2.862, p=<0.01 / t=3.863, P=<0.01 / t=3.430, P=<0.01). However this result could be biased due to the small sample size.
The use of antidepressants showed a worse QOL in those who used it with the affection of all domains except for the domain of tests & treatment. However this result could be biased due to small sample size. (t=3.825, p=<0.01/ t=4.838, P=<0.01 / t=4.209, P=<0.01/ t=4.289, P=<0.01 / t=3.000, P=<0.01).
The number of relapses turn to affect the QOL in patients who experienced it in the domain of emotional impairment (P=0.04) with those who experienced two times or more relapses being more affected.
The presence of extra-intestinal manifestations seems to affect the QOL of patients in the domains of bowel symptoms & systemic impairment leading to worse QOL (t=2.256. P=.030/ t=2.133, P=.039).
The presence of other medical conditions appears to affect the QOL of patients in the domains of bowel symptoms, emotional impairment, social impairment and body image.
Other data
| Title | Assessment of Health Related Quality Of Life in Children with Inflammatory Bowel Disease | Other Titles | دراسة جودة الحياة في الأطفال المصابين بالتهاب الأمعاء المناعي | Authors | May Abd ElTawab Ahmed Abu El-Ma’atti | Issue Date | 2014 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.