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Prevalence of mental health problems, associated factors, and health-related quality of life in children with long-gap esophageal atresia in Sweden

Dellenmark-Blom, Michaela ; Ax, Sofie Örnö ; Lilja, Helene Engstrand ; Reilly, Colin ; Svensson, Jan F. ; Kassa, Ann Marie ; Jönsson, Linus ; Abrahamsson, Kate ; Gatzinsky, Vladimir and Omling, Erik LU orcid , et al. (2023) In Journal of Pediatric Surgery 58(9). p.1646-1655
Abstract

Background: Children with long-gap esophageal atresia (LGEA) face a high risk of digestive and respiratory morbidity, but their mental health outcomes have not been investigated. We aimed to identify the prevalence of mental health problems in children with LGEA, associated factors and health-related quality of life (HRQOL). Methods: Twenty-six children with LGEA aged 3–17 were recruited nationwide in Sweden. One of their parents and adolescents aged 11–17 completed information on the child's mental health (Strength and Difficulties Questionnaire), generic (PedsQL 4.0) and condition-specific HRQOL (EA-QOL). Parents gave information on current child symptomatology. Mental health level was determined using validated norms; abnormal≥90... (More)

Background: Children with long-gap esophageal atresia (LGEA) face a high risk of digestive and respiratory morbidity, but their mental health outcomes have not been investigated. We aimed to identify the prevalence of mental health problems in children with LGEA, associated factors and health-related quality of life (HRQOL). Methods: Twenty-six children with LGEA aged 3–17 were recruited nationwide in Sweden. One of their parents and adolescents aged 11–17 completed information on the child's mental health (Strength and Difficulties Questionnaire), generic (PedsQL 4.0) and condition-specific HRQOL (EA-QOL). Parents gave information on current child symptomatology. Mental health level was determined using validated norms; abnormal≥90 percentile/borderline≥80 percentile/normal. Elevated levels were considered borderline/abnormal. Data were analyzed using descriptives, correlation and Mann-Whitney-U test. Significance level was p < 0.05. Results: Twelve children with LGEA aged 3–17 (46%) had elevated scores of ≥1 mental health domain in parent-reports, whereas 2 adolescents (15%) in self-reports. In parent-reports, 31% of the children had elevated levels of peer relationship problems, with associated factors being child sex male (p = 0.037), airway infections (p = 0.002) and disturbed night sleep (p = 0.025). Similarly, 31% showed elevated levels of hyperactivity/inattention, and associated factors were male sex (p = 0.005), asthma (p = 0.028) and disturbed night sleep (p = 0.036). Elevated levels of emotional symptoms, seen in 20%, were related to swallowing difficulties (p = 0.038) and vomiting problems (p = 0.045). Mental health problems correlated negatively with many HRQOL domains (p < 0.05). Conclusions: Children with LGEA risk mental health difficulties according to parent-reports, especially peer relationship problems and hyperactivity/inattention, with main risk factors being male sex, airway problems and sleep disturbances. This should be considered in follow-up care and research, particularly since their mental health problems may impair HRQOL. Levels of evidence: Prognosis study, LEVEL II.

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organization
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Contribution to journal
publication status
published
subject
keywords
Congenital malformation, Esophageal atresia, Health-related quality of life, Mental health, Pediatric surgery, Rare disease
in
Journal of Pediatric Surgery
volume
58
issue
9
pages
1646 - 1655
publisher
Elsevier
external identifiers
  • pmid:36635161
  • scopus:85146134004
ISSN
0022-3468
DOI
10.1016/j.jpedsurg.2022.12.004
language
English
LU publication?
yes
id
e25bc106-1df2-4db1-8620-74c8309e2e61
date added to LUP
2023-02-16 14:39:19
date last changed
2024-06-09 09:51:23
@article{e25bc106-1df2-4db1-8620-74c8309e2e61,
  abstract     = {{<p>Background: Children with long-gap esophageal atresia (LGEA) face a high risk of digestive and respiratory morbidity, but their mental health outcomes have not been investigated. We aimed to identify the prevalence of mental health problems in children with LGEA, associated factors and health-related quality of life (HRQOL). Methods: Twenty-six children with LGEA aged 3–17 were recruited nationwide in Sweden. One of their parents and adolescents aged 11–17 completed information on the child's mental health (Strength and Difficulties Questionnaire), generic (PedsQL 4.0) and condition-specific HRQOL (EA-QOL). Parents gave information on current child symptomatology. Mental health level was determined using validated norms; abnormal≥90 percentile/borderline≥80 percentile/normal. Elevated levels were considered borderline/abnormal. Data were analyzed using descriptives, correlation and Mann-Whitney-U test. Significance level was p &lt; 0.05. Results: Twelve children with LGEA aged 3–17 (46%) had elevated scores of ≥1 mental health domain in parent-reports, whereas 2 adolescents (15%) in self-reports. In parent-reports, 31% of the children had elevated levels of peer relationship problems, with associated factors being child sex male (p = 0.037), airway infections (p = 0.002) and disturbed night sleep (p = 0.025). Similarly, 31% showed elevated levels of hyperactivity/inattention, and associated factors were male sex (p = 0.005), asthma (p = 0.028) and disturbed night sleep (p = 0.036). Elevated levels of emotional symptoms, seen in 20%, were related to swallowing difficulties (p = 0.038) and vomiting problems (p = 0.045). Mental health problems correlated negatively with many HRQOL domains (p &lt; 0.05). Conclusions: Children with LGEA risk mental health difficulties according to parent-reports, especially peer relationship problems and hyperactivity/inattention, with main risk factors being male sex, airway problems and sleep disturbances. This should be considered in follow-up care and research, particularly since their mental health problems may impair HRQOL. Levels of evidence: Prognosis study, LEVEL II.</p>}},
  author       = {{Dellenmark-Blom, Michaela and Ax, Sofie Örnö and Lilja, Helene Engstrand and Reilly, Colin and Svensson, Jan F. and Kassa, Ann Marie and Jönsson, Linus and Abrahamsson, Kate and Gatzinsky, Vladimir and Omling, Erik and Tollne, Anna Maria and Stenström, Pernilla and Öst, Elin}},
  issn         = {{0022-3468}},
  keywords     = {{Congenital malformation; Esophageal atresia; Health-related quality of life; Mental health; Pediatric surgery; Rare disease}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1646--1655}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pediatric Surgery}},
  title        = {{Prevalence of mental health problems, associated factors, and health-related quality of life in children with long-gap esophageal atresia in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.jpedsurg.2022.12.004}},
  doi          = {{10.1016/j.jpedsurg.2022.12.004}},
  volume       = {{58}},
  year         = {{2023}},
}