The Influence of Pain: Quality of Life after Pectus excavatum Correction

DOI: 10.4236/ojped.2014.43028   PDF   HTML     3,127 Downloads   3,868 Views   Citations

Abstract

Introduction: The main indication for surgery of thoracic wall deformities (TWD) is psychological due to cosmetic complaints. The assumption is that appearances have a negative effect on self-esteem and quality of life (QoL). Correction should result in improvement. Methods: Prospective trial. QoL was assessed using the CHQ and the WHOQOL-bref. Measurements were taken before surgery (T1) and 6 weeks thereafter (T2). Results: Forty-two patients were included. WHOQOL-bref showed differences between pre-operative and six weeks past surgery on facet body image (p = 0.003). Self-esteem (CHQ) did not show a significant improvement at T2. Concerning the scores on the single step questionnaire (SSQ), 33 patients were “very” to “extremely satisfied” with appearance and increased self-esteem (p < 0.001). Concerning the domain “pain and physical complaints”, CHQ did show a significant change (p < 0.001) with more complaints at T2. Conclusion: Six weeks after surgical correction of a TWD satisfaction with the “new” chest is good; pain seems to be a problem with possible negative influence on self-esteem.

Share and Cite:

Zuidema, W. , Steeg, A. , Oosterhuis, J. , Sleeboom, C. , Heide, S. , Klerk, E. and Heij, H. (2014) The Influence of Pain: Quality of Life after Pectus excavatum Correction. Open Journal of Pediatrics, 4, 216-221. doi: 10.4236/ojped.2014.43028.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Shamberger, R.C. (1996) Congenital Chest Wall Deformities. Current Problems in Surgery, 33, 469-552. http://dx.doi.org/10.1016/S0011-3840(96)80005-0
[2] Lam, M.W.C., Klassen, A.F., Montgomery, C.J., LeBlanc, J.G., Skarsgard, E.D. (2008) Quality-of-Life Outcomes after Surgical Correction of Pectus excavatum: A Comparison of the Ravitch and Nuss procedures. Journal of Pediatric Surgery, 43, 819-825.
http://dx.doi.org/10.1016/j.jpedsurg.2007.12.020
[3] Kelly, R.E., Cash, T.F., Shamberger, R.C., et al. (2008) Surgical Repair of Pectus excavatum Markedly Improves Body Image and Perceived Ability for Physical Activity: Multicenter Study. Pediatrics, 122, 1218-1222. http://dx.doi.org/10.1542/peds.2007-2723
[4] Krasopoulos, G., Dusmet, M., Ladas, G. and Goldstraw, P. (2006) Nuss Procedure Improves the Quality of Life in Young Male Adults with Pectus excavatum Deformity. European Journal Cardio-Thoracic Surgery, 29, 1-5. http://dx.doi.org/10.1016/j.ejcts.2005.09.018
[5] Steinmann, C., Krille, S., Mueller, A., Weber, P., Reingruber, B. and Martin, A. (2011) Pectus excavatum and Pectus Carinatum Patients Suffer from Lower Quality of Life and Impaired Body Image: A Control Group Comparison of Psychological Characteristics Prior to Surgical Correction. European Journal Cardio-Thoracic Surgery, 40, 1138-1145.
[6] WHOQOL Group (1994) Development of the WHOQOL: Rationale and Current Status. International Journal of Mental Health, 23, 24-56.
[7] Densmore, J.C., Peterson, D.B., Stahvic, L.L., et al. (2010) Initial Surgical and Pain Management Outcomes after Nuss Procedure. Journal of Pediatric Surgery, 45, 1767-1771.
[8] Futagawa, K., Suwa, I., Okuda, T., Kamamoto, H., Sugiura, J., Kajikawa, R. and Koga, Y. (2006) Anesthetic Management for the Minimally Invasive Nuss Procedure in 21 Patients with Pectus excavatum. Journal of Anesthesia, 20, 48-50. http://dx.doi.org/10.1007/s00540-005-0367-4
[9] Soliman, I.E., Apuya, J.S., Fertal, K.M., Simpson, P.M. and Tobias, J.D. (2009) Intravenous versus Epidural Analgesia after Surgical Repair of Pectus excavatum. American Journal of Therapeutics, 16, 398-403. http://dx.doi.org/10.1097/MJT.0b013e318187de3e
[10] LaMontagne, L.L., Hepworth, J.T. and Salisbury, M.H. (2001) Anxiety and Post-Operative Pain in Children Who Undergo Major Orthopedic Surgery. Applied Nursing Research, 14, 119-124.
http://dx.doi.org/10.1053/apnr.2001.24410
[11] Palermo, T.M., Drotar, D.D. and Lambert, S. (1998) Psychosocial Predictors of Children’s Postoperative Pain. Clinical Nursing Research, 7, 275-291.
http://dx.doi.org/10.1177/105477389800700305
[12] Palermo, T.M. and Drotar, D. (1996) Prediction of Children’s Postoperative Pain: The Role of Presurgical Expectations and Anticipatory Emotions. Journal of Pediatric Psychology, 21, 683-698.
[13] Nuss, D., Kelly Jr., R.E., Croitoru, D.P. and Katz, M.E. (1998) A 10-Year Review of a Minimally Invasive Technique for the Correction of Pectus excavatum. Journal of Pediatric Surgery, 33, 545-552. http://dx.doi.org/10.1016/S0022-3468(98)90314-1
[14] Landgraf, J.M., Abetz, L. and Ware, J.A. (1996) The CHQ User Manual. The Health Institute, New England Medical Center, Boston.
[15] Raat, H., Landgraf, J.M., Bonsel, G.J., Gemke, R.J. and Essink-Bot, M.L. (2002) Reliability and Validity of the Child Health Questionnaire-Child Form (CHQ-CF87) in a Dutch Adolescent Population. Quality of Life Research, 11, 575- 581. http://dx.doi.org/10.1023/A:1016393311799
[16] WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychological Medicine, 28, 551-558. http://dx.doi.org/10.1017/S0033291798006667
[17] Spielberger, C.D., Gorsuch, R.L. and Lushene, R.E. (1970) The State-Trait Anxiety Inventory Manual. Consulting Psychologists Press, Palo Alto.
[18] Van der Ploeg, H.M., Defares, P.B. and Spielberger, C.D. (1980) ZBV. A Dutch-Language Adaptation of the Spielberger State-Trait Anxiety Inventory. Swets & Zeitlinger, Lisse.
[19] Van der Bij, A.K., de Weerd, S., Cikot, R.J.L.M., Steegers, E.A.P. and Braspenning, J.C.C. (2003) Validation of the Dutch Short Form of the State Scale of the Spielberger State-Trait-Anxiety Inventory: Considerations for Usage in Screening Outcomes. Journal of Community Genetics, 6, 84-87. http://dx.doi.org/10.1159/000073003
[20] Huskisson, E. (1974) Measurement of Pain. The Lancet, 304, 1127-1131.
http://dx.doi.org/10.1016/S0140-6736(74)90884-8
[21] Kain, Z.N., Mayes, L.C., O’Connor, T.Z. and Cicchetti, D.V. (1996) Preoperative Anxiety in Children. Predictors and Outcomes. Archives of Pediatrics and Adolescent Medicine, 150, 1238-1245.
http://dx.doi.org/10.1001/archpedi.1996.02170370016002
[22] Crandall, M., Lammers, C., Senders, C., Braun, J.V. and Savedra, M. (2008) Children’s Pre-Operative Tonsillectomy Pain Education: Clinical Outcomes. International Journal of Pediatric Otorhinolaryngology, 72, 1523-1533. http://dx.doi.org/10.1016/j.ijporl.2008.07.004
[23] Sj?ling, M., Nordahl, G., Olofsson, N. and Asplund, K. (2003) The Impact of Preoperative Information on State Anxiety, Postoperative Pain and Satisfaction with Pain Management. Patient Education and Counseling, 51, 169-176. http://dx.doi.org/10.1016/S0738-3991(02)00191-X
[24] LaMontagne, L.L., Hepworth, J.T., Salisbury, M.S. and Cohen, F. (2003) Effects of Coping Instruction in Reducing Young Adolescents’ Pain after Major Spinal Surgery. Orthopaedic Nursing, 22, 398-403. http://dx.doi.org/10.1097/00006416-200311000-00005

  
comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.