Çocuk nöroloji polikliniğine başvuran serebral palsi ve epilepsi hastalarının ebeveynlerinde depresyon ve ebeveyn gözünden yaşam kalitesi
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Tarih
2017
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çocukluk çağında görülen nörolojik hastalıklar, bu hastalıkların süreçleri ve tedavileri hem çocukların hem de ebeveynlerin gündelik yaşamını oldukça etkilemektedir. Çocukluk çağı nörolojik hastalıklarından özellikle serebral palsi ve epilepsi dikkati çekmektedir. Yaşam kalitesinin yanısıra ebeveynlerde ve çocuklarda uzun dönemli hastalık bağlantılı etkenler depresif bozukluk ve çeşitli anksiyete ya da uyum bozukluklarına sebep olabilmektedir. Bu çalışmada Trakya Üniversitesi Tıp Fakültesi Çocuk Nöroloji Bilim Dalı tarafından Serebral Palsi veya epilepsi tanılarıyla takip edilen hastalarda yaşam kalitesinin düzeyini belirleme, bunun yanısıra ebeveynlerdeki depresif bozukluk sıklığını tanımlama amaçlanmıştır. Çalışma grubu, 267 epilepsi hastası ve 28 Serebral Palsi ve kontrol grubu 201 sağlıklı çocuktan oluşmuştur. Çalışma ve kontrol grupları arasında cinsiyet, yaş,anne-baba akrabalığı, çoğul gebelik, intauterin büyüme, annede sigara ve alkol kullanımı, gebelik enfeksiyon öyküsü, gebelik esnasında ilaç kullanımı, gebelikte DM ve HT, ailede depresyon öyküsü açısından anlamlı istatiksel bir fark bulunamamıştır. Serebral Palsi grubunda; lise düzeyinde öğrenim gören çocuk sayısı diğer iki gruba göre anlamlı oranda düşük bulunmuşken, özel eğitim gören çocuk sayısı, oksijensiz kalma oranı, yenidoğan nöbet oranı ve Denver testi ile değerlendirilme oranı diğer iki gruba göre anlamlı şekilde yüksek olarak saptanmıştır (p<0,05). Hastaların bakım verenleri depresyon açısından Beck Depresyon Ölçeği ile değerlendirilmiştir. Kontrol grubunun skoru 3,53 ± 1,63, epilepsi grubunun skoru 8,68 ± 3,20 ve SP grubunun skoru 11,92 ± 3,81 idi. Gruplar arasında istatiksel olarak anlamlı farklılık bulunmuştur (p<0,001). SP’li grubun skoru hem kontrol grubuna hem de epilepsi grubuna göre daha yüksek olarak saptanmıştır (p<0,001, p=0,03). Epilepsi, grubunun skoru ise kontrol grubuna göre yüksek olarak bulundu.Yaşam kalitesi skorları ise kontrol grubu, epilepsi ve Serebral Palsi gruplarında sırasıyla 96,34 ± 6,44 , 86,06 ± 11,97 ve 70,74 ± 25.5 idi. Gruplar arasında yaşam kalitesi skoru açısından anlamlı fark saptanmıştır (p<0,001). Serebral Palsi ve epilepsi gruplarındaki skorun kontrol grubuna göre daha düşük olduğu bulunmuştur (p<0,001). Sonuç olarak çalışmamız bu bölgedeki Serebral Palsi ve epilepsi tanılı çocukların yaşam kalitesi ve bakımverenlerin depresif özelliklerini belirlemiştir. Serebral Palsi ve epilepsili çocukları olan ailelerin yaşam kalitesi ve depresyonu düzeltmek açısından desteklenmesi ailelerdeki başetme mekanizmalarını güçlendirecektir. Bu şekilde bir yaklaşım çocukların tedavilerini de olumlu yönden etkileyecektir. Bu yönde yapılacak çalışmalar kronik hastalıklardan olan serebral palsi ve epilepsili çocukların ve ailelerinin yaşadıkları sorunların farkındalığını arttıracak ve yapılacak desteğin artmasına olanak sağlayacaktır.
Neurological diseases seen in childhood, and the processes and treatments of these diseases affect the daily life of both children and their parents. Cerebral palsy and epilepsy are particularly noteworthy among childhood neurological diseases. In addition to affecting quality of life, long-term stress-related stressors can cause depressive disorder and various anxiety or adjustment disorders in parents and children. In the present study, it was aimed to determine the level of quality of life in patients who applied to or were followed up in our pediatric neurology department with the diagnosis of Cerebral Palsy or epilepsy, as well as the frequency of depressive disorder in parents. A total of 496 participants, including 201 control subjects, 267 patients with epilepsy, and 28 patients with cerebral palsy were included in the study. There were no differences between groups in terms of gender, age, parental consanguinity, multiple pregnancy, intrauterine growth, maternal smoking and alcohol use, pregnancy infection history, drug use during pregnancy, DM and HT during pregnancy, and family history of depression. In the Cerebral Palsy group, the number of children at high school level was found to be significantly lower than the other two groups; however, the number of children receiving special education, the rate of oxygen absence, the rate of neonatal seizure, and the rate of evaluation by the Denver test were significantly higher than the other two groups (p<0,05). Caregivers of the patients were assessed with the Beck Depression Scale for depression. The score of the control group was 3,53 ± 1,63, the score of the epilepsy group was 8,68 ± 3,20, and the score of the Cerebral Palsy group was 11,92 ± 3,81. There was a statistically significant difference between the groups (p<0,001). The score of the Cerebral Palsy group was found to be higher than both the control group and the epilepsy group. The score of the epilepsy group was found to be higher than the control group.The scores for quality of life were 96,34 ± 6,44, 86,06 ± 11,97, and 70,74 ± 25.5 respectively in the control group, epilepsy, and Cerebral Palsy groups. There was a significant difference between groups in terms score for quality of life score (p<0,001). The scores in the epilepsy and Cerebral Palsy groups were found to be lower than the control group (p<0,001). This study also contributes to literature by concurrently determining the quality of life of children with Cerebral Palsy and epilepsy and depressive symptoms of the caregivers in this region.This approach will also affect children's treatment positevely.The work to be done in this direction will increase the awereness of the problems of the children with cerebral palsy and epilepsy which are chronic diseases and the problems that the families are experiencing, the support of families with children with cerebral palsy and epilepsy in terms of improving quality of life and depression will strengthen the coping mechanisms in the family.
Neurological diseases seen in childhood, and the processes and treatments of these diseases affect the daily life of both children and their parents. Cerebral palsy and epilepsy are particularly noteworthy among childhood neurological diseases. In addition to affecting quality of life, long-term stress-related stressors can cause depressive disorder and various anxiety or adjustment disorders in parents and children. In the present study, it was aimed to determine the level of quality of life in patients who applied to or were followed up in our pediatric neurology department with the diagnosis of Cerebral Palsy or epilepsy, as well as the frequency of depressive disorder in parents. A total of 496 participants, including 201 control subjects, 267 patients with epilepsy, and 28 patients with cerebral palsy were included in the study. There were no differences between groups in terms of gender, age, parental consanguinity, multiple pregnancy, intrauterine growth, maternal smoking and alcohol use, pregnancy infection history, drug use during pregnancy, DM and HT during pregnancy, and family history of depression. In the Cerebral Palsy group, the number of children at high school level was found to be significantly lower than the other two groups; however, the number of children receiving special education, the rate of oxygen absence, the rate of neonatal seizure, and the rate of evaluation by the Denver test were significantly higher than the other two groups (p<0,05). Caregivers of the patients were assessed with the Beck Depression Scale for depression. The score of the control group was 3,53 ± 1,63, the score of the epilepsy group was 8,68 ± 3,20, and the score of the Cerebral Palsy group was 11,92 ± 3,81. There was a statistically significant difference between the groups (p<0,001). The score of the Cerebral Palsy group was found to be higher than both the control group and the epilepsy group. The score of the epilepsy group was found to be higher than the control group.The scores for quality of life were 96,34 ± 6,44, 86,06 ± 11,97, and 70,74 ± 25.5 respectively in the control group, epilepsy, and Cerebral Palsy groups. There was a significant difference between groups in terms score for quality of life score (p<0,001). The scores in the epilepsy and Cerebral Palsy groups were found to be lower than the control group (p<0,001). This study also contributes to literature by concurrently determining the quality of life of children with Cerebral Palsy and epilepsy and depressive symptoms of the caregivers in this region.This approach will also affect children's treatment positevely.The work to be done in this direction will increase the awereness of the problems of the children with cerebral palsy and epilepsy which are chronic diseases and the problems that the families are experiencing, the support of families with children with cerebral palsy and epilepsy in terms of improving quality of life and depression will strengthen the coping mechanisms in the family.
Açıklama
Anahtar Kelimeler
Serebral Palsi, Epilepsi, Depresyon, Yaşam kalitesi, Cerebral Palsy, Epilepsy, Depression, Quality of Life
