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      Qualidade de vida de crianças ostomizadas na ótica das crianças e das mães Translated title: Quality of life of children with stomas: the children and mothers' point of view

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          Abstract

          Objetivo: analisar a qualidade de vida de crianças ostomizadas em sua ótica e na de suas mães; comparar os escores de qualidade de vida (QV) obtidos em ambos grupos (crianças e mães), e verificar as associações entre os escores de qualidade de vida e as características sociodemográficas e clínicas das crianças. Métodos: após o cumprimento das exigências éticas, os dados sobre a qualidade de vida foram obtidos através do Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI), em sua versão traduzida para a língua portuguesa, adaptada por Assumpção et al. e validada para este estudo. O questionário foi respondido por 20 crianças ostomizadas, oriundas de um serviço público infantil de referência do Município de São Paulo e por suas respectivas mães. Os dados obtidos foram submetidos ao teste de normalidade de Kolmogorov-Smirnov, coeficientes de correlação ordinal de Spearman e de correlação linear de Pearson, e o teste t de Student. Resultados: dez meninos e 10 meninas, com idades entre 4 e 12 anos, apresentaram idade média de 8,7 anos (DP = 2,64), com predomínio da raça branca (55%) e da escolaridade fundamental (65%). Clinicamente, predominaram os estomas urinários (55%), provenientes, principalmente, das malformações congênitas (60%). Com relação à qualidade de vida, obtiveram-se escores médios totais de 51,95 (DP = 7,90) e 49,60 (DP = 5,60), apontados, respectivamente, pelas crianças e mães. Quanto aos fatores, os escores obtidos pelas crianças foram 8,14; 8,29; 10,27 e 11, 41, respectivamente, para autonomia, lazer, funções e família. Correlações estatisticamente significativas foram verificadas entre a escolaridade e o EQVMãe (r = -0,56) e com o EQVCr (r = -0,63) e entre o EQVMãe e os Fatores Família (r = 0,86), Autonomia (r = 0,60) e Funções (r = 0,59). Conclusões: este estudo vem contribuir para a melhor compreensão sobre a qualidade de vida de crianças com ostomias, bem como alguns desses aspectos na ótica das mães.

          Translated abstract

          Objective: to analyze the quality of life of children with stomas according to the children and mothers' point of view; to compare the results related to quality of life in both groups, and to verify the statistical associations between those aspects and children's demographic and clinical data. Methods: after the fulfilling ethical requirements, the specific data were obtained using the Autoquestionnaire Qualité de Vie Enfant Imagé, adapted and validated for Brazilian culture and also for this study by Assumpção Jr. et al.. It is composed by 26 questions, 18 of them are distributed among four factors: Functions, Family, Autonomy and Leisure. Results: twenty children, aged 4 to 12 years, from a Specialized Outpatient Ostomy Care Center for Children and their respective mothers answered the questionnaire. Ten boys and 10 girls participated, their mean age was 8.7 (SD = 2.64) years, with the predominance of Caucasians (55.0%), and elementary education level (65.0%). Clinical profile shows a predominance of urinary stomas (55.0%) caused by congenital diseases (60.0%). Related to quality of life, the total mean scores were 51.95 (SD = 7.90) and 49.60 (SD = 5.60), respectively for children and mothers, without statistically significant difference. Regarding each factor, the patients' scores were 8.14, 8.29, 10.27 and 11.41, respectively for autonomy, leisure, functions and family. Some statistically significant associations were verified between education level and mothers' quality of life (r = -0.56) and children's quality of life (r = -0.63), and also between mothers' quality of life and family (r = 0.86), autonomy (r = 0.60) and functions (r = 0.59). Conclusions: This study improves the comprehension about quality of life of children with stoma as well as some of these aspects on their mothers' point of view.

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          Most cited references22

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          Definitions of quality of life: a taxonomy.

          Quality of life is of central concern in evaluative research; improved quality of life is probably the most desirable outcome of all health care policies. However, definitions of quality of life are as numerous and inconsistent as the methods of assessing it. Stemming from a larger piece of work looking at the definition and measurement of quality of life, this paper highlights the lack of a consensus definition of quality of life by means of a taxonomy of definitions that emerge from the literature. The paper describes and gives examples of four main types of definition which make up the taxonomy: global (type I); component (type II); focused (type III); and combination definitions (type IV). In addition, an outline of factors influencing the definition of quality of life is given, and an alternative strategy for both defining and measuring the concept (the use of lay definitions) is suggested.
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            Measuring Health: A Review of Quality of Life Measurement Scales

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              The effect of ostomy surgery between the ages of 6 and 12 years on psychosocial development during childhood, adolescence, and young adulthood.

              To investigate the effect of ostomy surgery performed between the ages of 6 and 12 years on psychosocial development during subsequent childhood, adolescence, and young adulthood. Ethnographic. Six women and 4 men (mean age 30.7 years) who responded to a notice in a chapter newsletter of the United Ostomy Association. Spradley's Ethnographic interview format was used for this study. One interview was conducted with each informant over a 4-week period, and a second, more detailed interview was conducted with 2 subjects who were identified as key informants. The interviews were audiotaped and transcribed, and the transcripts were analyzed to detect shared patterns in the informants' language. The Ethnograph computer software program was used as an aid in analyzing the interview transcripts. The informants' subjective experiences during childhood, adolescence, and young adulthood. Nine of the 10 informants adjusted well in the first years after surgery. Key factors in good adjustment were support from family and a perception of "normalcy," including managing one's own ostomy care. All informants reported that their ostomy had a negative impact on their lives during adolescence and that they would have appreciated contact with other teens facing the same dilemma. The age at which an informant underwent ostomy surgery did not influence the difficulties reported during adolescence. Ostomy surgery performed between the ages of 6 and 12 years can have long-term effects on psychosocial development. Nurses should promote normalization, teach self-care of the ostomy as soon as possible after surgery, and refer children and parents to mutual support groups as appropriate.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jped
                Jornal de Pediatria
                J. Pediatr. (Rio J.)
                Sociedade Brasileira de Pediatria (Porto Alegre )
                1678-4782
                February 2003
                : 79
                : 1
                : 55-62
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                Article
                S0021-75572003000100010
                10.1590/S0021-75572003000100010
                515267ac-ee73-4d51-bf92-30605142730c

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0021-7557&lng=en
                Categories
                PEDIATRICS

                Pediatrics
                ostomy care,stomal therapy,pediatric stomas,quality of life,AUQEI,estomaterapia,estomas pediátricos,qualidade de vida

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