Quality of life of children with neurological impairment who receive a fundoplication for gastroesophageal reflux disease.
BACKGROUND
Children with neurological impairment (NI) commonly have gastroesophageal reflux disease (GERD) treated with a fundoplication. The impact of this procedure on quality of life is poorly understood.


OBJECTIVE
To examine the quality of life of children with NI who have received a fundoplication for GERD and of their caregivers.


METHODS
The study was a prospective cohort study of children with NI and GERD who underwent a fundoplication at a children's hospital between January 1, 2005, and July 7, 2006. Quality of life of the children was assessed with the Child Health Questionnaire (CHQ) and of the caregivers with the Short-Form Health Survey Status (SF-36) and Parenting Stress Index (PSI), both at baseline and 1 month after fundoplication. Functional status was assessed using the WeeFIM. Repeated-measures analyses were performed.


RESULTS
Forty-four of the 63 parents (70%) were enrolled. The median WeeFIM score was 31.2 versus the age-normal score of 83 (P = .001). Compared with the baseline scores, mean CHQ scores improved over 1 month in the domains of bodily pain (32.8 vs. 47.5, P = .01), role limitations-physical (30.6 vs. 56.6, P = .01), mental health (62.7 vs. 70.6, P = .01), family limitation of activities (43.3 vs. 55.1, P = .03), and parental time (43.0 vs. 55.3, P = .03). The parental SF-36 domain of vitality improved from baseline over 1 month (41.3 vs. 48.2, P = .001), but there were no changes from baseline in Parenting Stress scores.


CONCLUSIONS
Parents reported that the quality of life of children with NI who receive a fundoplication for GERD was improved from baseline in several domains 1 month after surgery. The quality of life and stress of caregivers did not improve in nearly all domains, at least in the short term.
Srivastava
Rajendu
R
University of Utah Health Sciences Center, Salt Lake City, Utah 84113, USA. raj.srivastava@hsc.utah.edu
Downey
Earl C
EC
Feola
Peter
P
Samore
Matthew
M
Coburn
Laurie
L
Holubkov
Richard
R
Mundorff
Michael
M
Nkoy
Flory
F
Desrochers
Dan
D
James
Brent C
BC
Rosenbaum
Peter
P
Young
Paul C
PC
Dean
Jonathan M
JM
O'Gorman
Molly
M
D017028:Caregivers; D016022:Case-Control Studies; D002675:Child, Preschool; D018662:Fundoplication / Q000009:adverse effects; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D009422:Nervous System Diseases / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological; D014589:Utah