Qualidade de vida de adolescentes nascidos prematuros
| Ano de defesa: | 2017 |
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| Autor(a) principal: | |
| Orientador(a): | |
| Banca de defesa: | |
| Tipo de documento: | Dissertação |
| Tipo de acesso: | Acesso aberto |
| Idioma: | por |
| Instituição de defesa: |
Universidade Federal de São Paulo (UNIFESP)
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| Programa de Pós-Graduação: |
Não Informado pela instituição
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| Departamento: |
Não Informado pela instituição
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| País: |
Não Informado pela instituição
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| Palavras-chave em Português: | |
| Link de acesso: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5199025 http://repositorio.unifesp.br/handle/11600/50365 |
Resumo: | Objectives: To compare the perception of the quality of life of adolescents born prematurely with birth weight <1500g, with the quality of life referred by their caregivers and to analyze factors associated to the quality of life referred by adolescents and caregivers. Methods: A cross-sectional study was carried out from July 2012 to June 2015 using the WHOQOL-bref questionnaire. The study was approved by the Ethic Committe of the Institution, and adolescents and their legal guardians signed the informed consent form. The inclusion criteria were: adolescents aged 10 to 19 years, born before 37 weeks of gestation with birth weight <1500 g and who were in follow-up at the Premature outpatient clinic of the Federal University of São Paulo and their caregivers. Adolescents who were unable to answer the questionnaire due to clinical or neurological impairments or who did not have a caregiver who could report on his quality of life were excluded. The questionnaire applied consisted of 26 questions based on Likert scale from 1 to 5 points over quality of life, covering the physical, psychological, social relations and environmental domains. The scores attributed by the adolescent and his caregiver were compared by student t test and chi-square or Fisher's exact test for categorical variables. Factors associated to the score of quality of life were analyzed by linear regression. SPSS for Win / v.17.0 program (SPSS Statistics, Somers, NY) was used for statistical analysis, considering significant p <0.05. Results: In this study, 73 (80.2%) pairs of adolescent-caregiver were included. Mothers' age was 44.1 ± 7.5 years and 37.0% of them were single. The adolescents aged 13.4 ± 2.7 years and 52.1% were male, born at 30.1 ± 2.4 weeks of gestation, birth weight of 1134 ± 239g. During neonatal period, 47.2% of adolescents presented respiratory distress syndrome, 26.4% persistente ductus arteriosus, 25% bronchopulmonary dysplasia, 41.7% periintraventricular hemorrhage, 12.5% periventricular leukomalacia and 58.3% required mechanical ventilation and were hospitalized for a median of 50.5 days. At study entry, 38.4% of the adolescentes presented chronic diseases, 1.0% motor disorders, 6.8% behavioral changes, 42.5% language disorder, 8.2% hearing disorder, 3% vision impairment, 34.0% learning difficulty, 26.0% school delay, 55.7% needed some support, such as glasses (31.5%), orthodontic appliance (26.0%) or wheelchairs (2.7%) and 12.3% depended on someone to tie shoes, make personal hygiene, to change clothes or to feed themselves. The degree of satisfaction with the quality of life referred by the adolescents and caregivers (p=0.032) was: very dissatisfied (1.4 vs. 4.1%), dissatisfied (20.5 vs. 20.5%), nor satisfied or dissatisfied (56.2 vs. 71.2%), satisfied (21.9 vs. 4.1%). Scores of quality of life attributed by adolescentes and caregivers, respectively, were (4.0 ± 0.7 vs. 3.8 ± 0.6, p=0.032), physical domain (3.6 ± 0.6 vs. 3, 5 ± 0.6, p=0.685), psychological (3.4 ± 0.6 vs. 3.6 ± 0.6, p=0.116), social relationships (3.7 ± 0.7 vs. 3.6 ± 0.8, p=0.371) and environment (3.4 ± 0.7 vs. 3.2 ± 0.6, p=0.037). By multiple linear regression analysis, the caregiver's perception of adolescent’s quality of life, controlled for confounders, was associated to the following variables: mother without partner that reduced the score of quality of life by 0.253 points (p=0.039), the adolescent having had respiratory distress syndrome increased by 0.420 (p=0.001) and each episod of hospitalization during childhood decreased the score of quality of life by 0.031 points (p=0.007). When the quality of life scores were considered on the adolescent's own view, only the presence of periventricular leukomalacia reduced this value by 0.661 points. Conclusions: Despite the high frequency of morbidity due to prematurity, adolescents and their caregivers were satisfied with adolescent's quality of life. Compared to adolescents, caregivers attributed lower quality of life scores. The factors associated to the lower quality of life in the caregivers' perception were: mother without partner, respiratory distress syndrome and number of hospitalizations in the childhood and adolescence. On adolescent’s perception, periventricular leukomalacia was associated with lower quality of life score. |