Ayşe Güler EROĞLU, Cenk Eray YILDIZ, Veysel OKTAY, Bülent KOCA, Selman GÖKALP, Oğuzhan ZAHMACIOĞLU, Funda ÖZTUNÇ, Gürkan ÇETİN

Bebeklik döneminde siyanotik kalp hastalığı nedeniyle açık kalp cerrahisi uygulanmış ergenlerde kendilik algısı ve yaşam niteliği

Amaç: Bebeklik döneminde siyanotik kalp hastalığı nedeniyle açık kalp ameliyatı geçiren hastaların, ergenlik dönemindeki yaşam niteliği ölçeğini ebeveynleriyle beraber değerlendirmek ve kendilik algılarıyla birlikte fiziksel olarak sağlıklı kontrol grubuyla karşılaştırmaktır. Gereç ve Yöntem: Bu çalışmaya 1989-1994 yılları arasında İstanbul Üniversitesi Kardiyoloji Enstitüsü’nde doğuştan siyanotik kalp hastalığı nedeniyle ameliyat edilmiş 53 hasta alındı. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Klinik Araştırmalar Etik Kurulu’ndan (Karar numarası: D-005, Tarih: 10-11-2009) onay alınarak, hasta ve yakınları onam formuyla bilgilendirildi. Grup 1 fiziksel olarak sağlıklı kontrol grubu (15 kişi, ort. yaş: 19 yıl, 8 ay), grup 2 Fontan ameliyatı uygulanan tek ventriküllü hastalar (20 hasta, ort. yaş: 19 yıl, 6 ay; 10’unda triküspit atrezisi, beşinde intakt ventriküler septumlu pulmoner atrezi, üçünde çift girişli sol ventrikül, birinde çift çıkışlı sağ ventrikül, birinde ventriküler septal defekt ve pulmoner atrezi), grup 3 ise diğer doğuştan siyanotik kalp hastalığı nedeniyle ameliyat olmuş hastalardı (33 hasta, ort. yaş: 19 yıl, 2 ay; 18’inde büyük arterlerin transpozisyonu, 10’unda Fallot tetralojisi, ikisinde tam atriyoventriküler kanal defekti, pulmoner darlık, ikisinde çift çıkışlı sağ ventrikül, birinde Fallot pentalojisi). Çalışmada yaşam niteliği ve kendilik algısı ölçekleri kullanıldı. Yaşam niteliği ölçeğini hasta ve fiziksel olarak sağlıklı ergenler ile ebeveynleri ayrı ayrı doldurdu. Kendilik algısı ölçeğini sadece hasta ve fiziksel olarak sağlıklı ergenler doldurdu. Yaş ve kendilik algısı puanlarının gruplar arasındaki karşılaştırmaları tek yönlü varyans analizi (ANOVA) ile; çoklu karşılaştırılmaları ise LSD (Least Significant Difference) ile yapıldı. Yaşam niteliği değişkeni normal dağılıma sahip olmadığı için karşılaştırmalar Kruskal-Wallis nonparametrik ANOVA testi ile, çoklu karşılaştırmalar ise Dunn testi ile yapıldı. Bulgular: Yaş ve cinsiyet açısından gruplar arasında anlamlı fark yoktu. Yaşam niteliği ölçeğinde, ilgili sorulara verilen yanıtlarda gruplar arasında ileri derecede anlamlı fark saptandı. Grup 2 ve 3 için yaşam niteliğine yönelik yanıtlar hem ebeveynlerde hem de çocuklarda kontrol grubuna göre çok daha olumsuzdu. Çoklu karşılaştırma testi ile gruplar kıyaslandığında, grup 2 ve 3 arasında anlamlı fark saptanmadı. Ebeveynlerin çocuklarının yaşam niteliği ile ilişkili yanıtları, çocuklarınınkinden istatistiksel olarak daha olumsuzdu (p

Self perception and quality of life of adolescents who had undergone open-heart surgery due to cyanotic congenital heart disease in their infancy

Aim: To assess together with their parents, the quality-of-life of the teenage patients who had undergone open heart surgery because of cyanotic heart disease during their infancy and to compare their self-perception to that of physically healthy control group. Material and Method: This study includes 53 patients who had undergone operation for cyanotic congenital heart disease in Istanbul University, Institute of Cardiology, between 1989-1994. The relatives and the patients were informed with a consent form approved by Istanbul University, Cerrahpaşa Medical Faculty, Clinical Studies, Ethics Commitee (Decree no. D-005, Date: 11-10-2009). Group 1 was the healthy control group (15 patients, median age: 19 years, 8 months), Group 2 included patients with single ventricle who had undergone Fontan procedure (20 patients, median age: 19 years, 6 months; 10 of them had tricuspid atresia, five of them had pulmonary atresia with intact ventricular septum, three of them had double inlet left ventricle, one of them had double outlet right ventricle, one of them had ventricular septal defect and pulmonary atresia), group 3 included patients who had undergone operation for congenital cyanotic heart disease (33 patients, median age: 19 years, 2 months; 18 of them had transposition of the great arteries, 10 of them had tetralogy of Fallot, two of them had complete atrioventricular canal defect and pulmonary stenosis, two of them had double outlet right ventricle, one of them had pentalogy of Fallot). In this study, the quality of life and self perception scales were used. Quality of life scale was filled by patients, healthy adolescents and their parents separately. Self perception scale was only filled by patients and healthy adolescents. The comparison of age and self perception scores between the groups was carried out with unidirectional Analysis of variance (ANOVA) and the multicomparisons with LSD (Least Significant Difference). Since the quality of life variable does not have a normal distribution, the comparions were carried out with Kruskal-Wallis nonparametric ANOVA test and the multicomparisons with Dunn's test. Results: There was not a significant difference between the groups in terms of age and sex. In the quality of life scale (QOLS), for the replies to related questions, a significant difference was determined between the groups. The replies of group 2 and 3 for about quality of life of both children and the parents were far more negative when compared to those of the control group. When the groups were compared via multiple comparison tests, there was no significant difference between group 2 and 3. The replies of the parents regarding their children's quality of life, were statistically more negative than those of their children (p

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