Quality of Life Clinical Trial
Official title:
Health Related Quality of Life of Patients With Abdominal Wall Defects
Examination of the health-related quality of life of patients operated on due to congenital defects of the abdominal wall after birth with the questionnaires KINDL, SDQ and SF-36.
Data of all patients with a congenital abdominal wall defect (CAWD) undergoing surgical
repair between 1996 and 2011 in the Department of Pediatric Surgery of the Clinic for General
Surgery, Visceral, Vascular and Pediatric Surgery of the Saarland University Medical Center
in Homburg were retrieved from surgical health records. Up to 2001 these records were paper
based and later on electronically available (SAP enhancement package 7 for SAP ERP 6.0: 2013,
Walldorf, Germany). Except epidemiological data the type of disease, data concerning birth
details, pre- and postnatal course, treatment, weight and growth development have been
collected electronically.
Gastroschisis or omphalocele can be simple or complex. The investigators defined complex as
involvement of stenosis, atresia, ischemia, volvulus or perforation, closed or vanishing
gastroschisis, and chromosomal anomalies. Giant omphalocele was considered as complex as
well. The type of the primary operative procedure, primary closure of the defect or other
(patch plastic etc.), was also noted. The implementation of silo technique with delayed
primary closure was regarded as primary closure.
A prospective analysis was conducted by a survey with age-related questionnaires to
investigate the patient´s HrQoL. The study protocol was approved by the ethical board of
Aerztekammer of Saarland (Nr. 206/2013). Informed consent was given by all participating
patients or their guardians.
The data collection was carried out by telephone interview, personal interview or by regular
mail. The interview was always conducted by the same person, a medical student (KK). The data
was collected using age related questionnaires. Together with the collection of clinical data
the investigators used the validated questionnaires KINDL, SDQ and SF-36.
The KINDL questionnaire (www.KINDL.org) is a specifically developed questionnaire for
children, which was developed to assess the HrQoL of life of children and adolescents. The
reference values were published as part of the study "The Children and Youth Health Survey
(KIGGS)" by the Robert Koch Institute, Berlin, Germany and covers the health data of 17.641
children and adolescents in Germany aged 0-17 years.
The SDQ (Strengths and Difficulties Questionnaire) is the second questionnaire that was used.
The investigators used the Woerner adjustment of the SDQ as it was transferred to a German
cohort.
Since there are also some adult patients in the patient collective, the investigators have
also integrated the SF-36, which was developed for adolescents and adult patients.
The SF-36 is an internationally recognized and widely used questionnaire for the assessment
of health-related quality of life. It records eight different dimensions (= subscales) of
quality of life: physical functioning, physical role function, pain, general health
perception, vitality, social functioning, emotional role function and psychological
well-being. Additionally, the overall physical sum score and overall psychological sum score
are listed. German reference values are available as a reference for the SF-36.
In addition, disease specific questions were asked. These included somatic and clinical data
about gastrointestinal function, cosmetic aspects and scars, problems during pregnancy of the
child, actual clinical health status and psycho-social development. Answers were given as
precise numbers or rated according to the following LIKERT-scale with these possibilities
"never-seldom-sometimes-often-always".
All data were collected and processed in an Excel spreadsheet (Microsoft® Excel®, Microsoft
Corporation, Redmond, Washington, USA). The statistical analysis was carried out with SPSS
(IBM® SPSS® Statistics, Version 25, International Business Machines Corporation (IBM),
Armonk, New York, USA) and Excel as well.
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