New approach to assess quality of life in neonatal surgical cases: medical providers' subjective assessment of disease- and condition-related factors, using the linear analogue scale.
A new questionnaire survey of pediatric surgeons and nurses, using the linear analogue scale, was used to determine subjective assessments of patients' quality of life (QOL) with regard to neonatal surgical diseases and conditions, including those involving anal and urinary functions. The results were analyzed according to the medical providers' years of professional experience. For six neonatal surgical diseases, QOL was assessed more favorably by less experienced surgeons and nurses. The result was similar for adulthood diseases. The development of medical technology can be attributed to this trend; however, QOL for patients with diaphragmatic hernia was assessed less favorably by less experienced surgeons (as 66.1%) than by more experienced surgeons (as 81.6%). Current technology has enabled the survival of neonatal surgical patients who are born prematurely and/or who have serious diseases or anomalies. Consequently this leads to poorer assessment of the surviving patients' QOL. QOL for patients with imperforate anus and spina bifida remained less favorably assessed. That of patients with conditions related to anal and urinary dysfunctions also scaled in the same manner. Anal dysfunction was less favorably assessed by less experienced surgeons (as 40.0%) than by more experienced surgeons (as 49.4%). In part, this discrepancy could be attributed to (1) better adjustment by the patients to their condition over time, and (2) greater focus on QOL issues in recent years. With regard to anal function, low QOL assessment correlated strongly with imperforate anus, Hirshsprung's disease, and spina bifida (P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Pediatric Surgery, Juntendo University, Tokyo, Japan.
K
K
Takayanagi
K
K
Suruga
D000328:Adult; D001003:Anal Canal / Q000503:physiopathology; D001006:Anus, Imperforate / Q000601:surgery; D000013:Congenital Abnormalities / Q000601:surgery*; D013502:General Surgery; D006548:Hernia, Diaphragmatic / Q000601:surgery; D006554:Hernia, Umbilical / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006627:Hirschsprung Disease / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000601:surgery; D008722:Methods; D009726:Nurses; D010372:Pediatrics; D011361:Professional Competence; D011788:Quality of Life; D016135:Spinal Dysraphism / Q000601:surgery; D011795:Surveys and Questionnaires; D014551:Urinary Tract / Q000503:physiopathology