title: Psychosocial aspects of follow-up of children operated for intermediate anorectal malformations.
abstract: OBJECTIVE
  To determine the degree of stress in parents of children operated for intermediate anorectal malformations, and their quality of life (QOL) at follow-up.
  
  
  METHODS
  Forty-two of the 166 children who had undergone a sacroperineal pullthrough operation for an intermediate type of anorectal malformation, between 1996 and 2005, in the department of paediatric surgery at Christian Medical College, Vellore, responded to follow-up. The psychosocial well-being of the parents and the QOL of the children were assessed by an independent observer.
  
  
  RESULTS
  The main factor which aggravated the stress and caused dissatisfaction with the final outcome was fecal soiling. Mothers bore the brunt of the care of these children, with some help from the fathers and grandparents. The QOL was also significantly affected by soiling, and improvement in soiling resulted in a dramatic improvement in the QOL.
  
  
  CONCLUSIONS
  Managing fecal soiling aggressively in the child with anorectal malformation, and providing social support to the family, are crucial for achieving a better QOL in these children and their families.
authors.affiliation: Department of Paediatric Surgery, Christian Medical College, Vellore 632004, Tamil Nadu, India.
authors.forename: Viju
authors.initials: V
authors.lastname: John
authors.forename: Jacob
authors.initials: J
authors.lastname: Chacko
authors.forename: John
authors.initials: J
authors.lastname: Mathai
authors.forename: Sampath
authors.initials: S
authors.lastname: Karl
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003125:Colostomy / Q000379:methods / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005220:Fathers / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult