title: Quality of life of children with neurological impairment who receive a fundoplication for gastroesophageal reflux disease.
abstract: 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.
authors.affiliation: University of Utah Health Sciences Center, Salt Lake City, Utah 84113, USA. raj.srivastava@hsc.utah.edu
authors.forename: Rajendu
authors.initials: R
authors.lastname: Srivastava
authors.forename: Earl C
authors.initials: EC
authors.lastname: Downey
authors.forename: Peter
authors.initials: P
authors.lastname: Feola
authors.forename: Matthew
authors.initials: M
authors.lastname: Samore
authors.forename: Laurie
authors.initials: L
authors.lastname: Coburn
authors.forename: Richard
authors.initials: R
authors.lastname: Holubkov
authors.forename: Michael
authors.initials: M
authors.lastname: Mundorff
authors.forename: Flory
authors.initials: F
authors.lastname: Nkoy
authors.forename: Dan
authors.initials: D
authors.lastname: Desrochers
authors.forename: Brent C
authors.initials: BC
authors.lastname: James
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenbaum
authors.forename: Paul C
authors.initials: PC
authors.lastname: Young
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Dean
authors.forename: Molly
authors.initials: M
authors.lastname: O'Gorman
mesh_terms: 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