Çocuk Ürolojisinde 4-18 Yaş Arası Yapılan Cerrahi Tedavinin Yaşam Kalitesi ve Psikolojik İyilik Hali ile İlişkisi
Özet
Most of the studies conducted in pediatric urology investigate the clinical results. However, very few studies explore the relationship between surgery and quality of life and psychosocial well-being in pediatric urology practice. Especially after surgery, It was observed that the studies evaluating the mental effects of the surgical method and the quality of life were essential. The current study investigated the psychological factors of child and parent, sociodemographic, medical and surgical factors that may affect the quality of life and psychological well-being of patients aged 4-18 years who were hospitalized and operated in the pediatric urology clinic. For this purpose, patients and parents were evaluated in the preoperative period and at the 7th month postoperatively. Before the surgery, a patient diagnosed with an active psychiatric disorder in the psychiatric interview using the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version ( K- SADS- PL) were excluded from the study. The study was conducted with 98 patients who met the inclusion criteria in the preoperative period and 63 patients in the postoperative period. Of all the parents included in the study to evaluate the psychiatric symptom areas two times, preoperatively and postoperatively; Pediatric Quality of Life Inventory- Parent report, Strengths and Difficulties Questionnaire- Parent report (SDQ); in relation to themselves Beck Anxiety Inventory, Beck Depression Inventory, Symptom Checklist (SCL-90-R), Orientation to Problems Experienced (COPE) inventory was requested to fill. Children and adolescents also filled in the Children's Depression Inventory (CDI), the Pediatric Quality of Life Inventory- self-report, and the State-Trait Anxiety Inventory for Children (STAI-CH). The surgeries of the patients evaluated within the scope of the study were examined in two different groups as open surgery/endourological surgery and major surgery/minor surgery. In the linear regression analysis, the variables that most predicted both the total score of quality of life reported by parents (p<0,001, adjusted R2: 0,304) and the total score of quality of life reported by children (p<0,001, adjusted R2: 0,304) after surgery were found to be parental SCL-90 total score, number of previous surgeries, and female gender. Preoperative depression scores and SCL-90 general symptom level scores of the minor surgery group's parents were significantly lower than those in the major surgery group (p: 0,023 and p: 0,010, respectively). In addition, the preoperative self-report quality of life physical score was higher in the minor surgery group (p: 0,036), while the post-surgical self-report quality of life total score increased statistically in this group (p: 0,037). Major surgery/minor surgery grouping was associated with both the child and parent's preoperative and postoperative mental well-being and the child's quality of life. However, the same significance was not seen in the open surgery/endourologic surgery grouping. This situation is clinically significant, and it was thought that factors related to the underlying preoperative psychological and medical disease rather than the type of surgical method affect the child and parents. In the future, following the forms of the surgical method in larger and homogeneous samples, with longer and more frequent psychosocial follow-ups, may shed light on surgeons when deciding on clinical applications in the future.
