Title Dugoročna kakvoća života bolesnika liječenih u jedinici intenzivnog liječenja djece Title (english) Long-term quality of life of patients treated in the pediatric intensive care unit Author Branka Polić Mentor Julije Meštrović (mentor)Committee member Vjekoslav Krželj (predsjednik povjerenstva)Committee member Marijan Saraga (član povjerenstva)Committee member Antun Bačić (član povjerenstva)Granter University of Split Defense date and country 2010, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616 - Pathology. Clinical medicine Abstract Preživljavanje nakon teške bolesti ili ozljede je važno, ali funkcionalno zdravlje i kakvoća života ovisna o zdravlju najvažnija su mjerila ishoda i bolesnikove dobrobiti. Ispitali smo promjenu dugoročne kakvoće života djece šest i 12 mjeseci nakon otpusta iz JILD-a. U prospektivno istraživanje u razdoblju od jedne i pol godine uključeno je 200 djece, u dobi 10 do 18 godina, liječene u JILD-u, 159 djece bez kroničnih bolesti i 41 dijete s kroničnim bolestima. Kontrolnu skupinu djece istovrsnih demografskih obilježja prikupili smo u ambulantama. Djeca su razvrstana prema dijagnostičkom kazalu ANZPIC Registry koji se koristi u JILD-u. Za procjenu dugoročne kakvoće života djece upotrijebili smo RAHC MOF bodovni sustav. Ispitali smo koja od sljedećih mjerila ishoda utječu na promjenu dugoročne kakvoće života: prisutnost kronične bolesti, dani strojne ventilacije, dani boravka u JILD-u i težina bolesti. Težina bolesti procijenjena je predviđenim rizikom smrtnosti (PIM 2), a težina ozljede bodovnim sustavima GCS i ISS. Ispitali smo promjenu kakvoće života kronično bolesne djece nakon šest i 12 mjeseci od otpusta iz JILD-a u odnosu na djecu u ambulantama. Dokazali smo da se kakvoća života nakon otpusta iz JILD-a početno pogoršava. Međutim, dugoročno se broj djece s pogoršanjem kakvoće života smanjuje pa je u 70% djece kakvoća života dobra. Na pogoršanje dugoročne kakvoće života šest mjeseci od otpusta iz JILD-a utječu: prisutnost kronične bolesti, ozljede, više dana strojne ventilacije, dulji boravak u JILD-u i više vrijednosti PIM-a. Nakon 12 mjeseci na pogoršanje dugoročne kakvoće života utječe prisutnost kronične bolesti i dulji boravak u JILD-u. Kod djece s kroničnim bolestima 12 mjeseci nakon otpusta iz JILD-a došlo je do pogoršanja kakvoće života, u odnosu na ambulantnu djecu s kroničnim bolestima. Zaključili smo da je dugoročno praćenje djece liječene u JILD-u potrebno kako bismo procijenili: tjelesne posljedice i njihov utjecaj na rast i razvoj, psihološke posljedice, te njihov utjecaj na kakvoću života bolesnika kao i potrebu za liječenjem i potporom nakon otpusta. Važno je znati koji čimbenici utječu na promjenu kakvoće života te nastojati poboljšati medicinsku skrb. Promicanje razvoja optimalnog zdravlja za svu djecu zahtijeva veliku pozornost društva, a mjerenje kakvoće života ovisne o zdravlju ključno je u tom procesu.
Abstract (english) Survival after a critical illness and injury is important, but functional health and Health Related Quality of Life (HRQoL) are the most important outcome measures and measures of patient's well being. In our study, we investigated the change in quality of life in children six and 12 months after treatment in PICU. 200 children, aged 10 to 18, treated in PICU during the period of 18 months, 159 of them without chronic diseases and 41 with chronic diseases, were included in this prospective study. The control group of children with the same demographic characteristics was collected in outpatient clinics. The children were classified according ANZPIC Registry diagnostic codes used in PICU. RAHC MOF score system was used for evaluating long-term quality of life in children. We investigated which of the following outcome measures influence the change in long-term quality of life: chronic disease, number of ventilation days, length of stay in PICU and severity of illness. The severity of illness was evaluated by PIM 2. GCS and ISS score systems were used to evaluate the severity of injury. Furthermore, we investigated the change in quality of life in chronically ill children six and 12 months after discharge from PICU in relation to the children from outpatient clinics. We confirmed that quality of life worsens after treatment in PICU. However, on the long term, the number of children with a decreased quality of life is reduced and in 70% of children the long-term quality of life is good. Chronic disease, injury, days of mechanical ventilation, length of stay and higher values of PIM 2 negatively affect the quality of life six months after discharge from PICU. Chronic disease and longer stay in PICU negatively affect the quality of life 12 months after the discharge. In children with chronic disease quality of life worsened 12 months after discharge from PICU in relation to the children from outpatient clinics. Our study revealed that a long-term follow-up research of paediatric intensive care survivors is needed to evaluate: physical sequelae and their impact during growth and development, psychological sequelae and their impact on the QoL of patients and the need for treatment and support after discharge. It is important to determine the factors which influence the change in quality of life and to try to improve medical care. Promoting the development of optimum health for all children requires greater public attention, and measuring HRQoL is a key element in that process.
Keywords
kvaliteta života
pedijatrijske jedinice intenzivnog liječenja
Keywords (english)
Quality of Life
Pediatric Intensive Care Units
Language croatian URN:NBN urn:nbn:hr:171:164052 Study programme Title: Basic and clinical medical sciences Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-05-06 08:42:20
