Penilaian Kualitas Hidup pada Anak dengan Penyakit Jantung Bawaan Asianosis dan Sianosis

Abstract

Latar belakang. Setiap tahun seribu bayi lahir dengan penyakit jantung bawaan (PJB). Terapi bertujuan mengurangi gejala klinis, mencegah gagal jantung, penutupan defek, dan meningkatkan kualitas hidup. Evaluasi terhadap kualitas hidup menjadi penting karena dengan tata laksana yang baik sekarang ini, anak dengan PJB memiliki harapan hidup yang lebih lama.Tujuan. Menilai perbedaan kualitas hidup anak penderita PJB asianosis dengan sianosis.Metode. Penelitian menggunakan studi potong lintang telah dilakukan dari bulan Maret sampai dengan Juli 2012 di RSUP H. Adam Malik, Medan. Sampel terdiri dari anak usia 5 sampai dengan 18 tahun yang menderita PJB asianosis dan sianosis yang belum dikoreksi dan sudah dikoreksi. Anak dan orangtua mengisi kuesioner PedsQL modul kardio versi 3.0. Penilaian kualitas hidup dilihat dari enam domain yaitu menggunakan T-test independen dengan p<0,05 dan interval kepercayaan 95%.Hasil. Terdapat 52 anak penderita PJB, 17 anak sianosis dan 37 anak asianosis. Kualitas hidup anak PJB asianosis lebih baik daripada anak sianosis dalam empat domain yaitu masalah jantung dan terapi, penampilan fisik, cemas terhadap tindakan terapi dan masalah kognitif.Kesimpulan. Kualitas hidup anak penderita PJB asianosis lebih baik dibandingkan penderita PJB sianosis.

Growth, Development, and Quality of Life in Children with Congenital Heart Disease Children

“…Consistent with the previous study on the developmental outcome of children with CHD, our study also found that nutritional problem [3], [10], [15], cognitive delay [3], [5], [9], and lower quality of life [8], [14] are common problems in CHD children [10]. In nutritional assessment, both groups showed the same proportion of severely underweight 50.0%.…”

“…It also appropriates with a study in Cairo which found that malnutrition, stunting, and wasting proportion were significantly higher among cyanotics (62.8%, 74.4%, and 25.6%) compared with acyanotics (49.5%, 63.3%, and 18.3%) [12]. In addition, cyanotic heart defect was known to have a correlation with the decrement of insulin growth factor-1 level (r = 0.402, p < 0.05) [14], which is in agreement with Eren et al who stated chronic hypoxia had a negative effect on nutrition and growth hormone, by decreasing insulin growth factor-1 (somatomedin) level that is produced in the liver and regulated by the binding of growth hormone to growth hormone receptors. These findings indicated that chronic hypoxemia might serve as the underlying cause by decreasing the production of insulin growth factor-1 which induced growth failure in patients with cyanotic CHD [11], [16], [17].…”

“…As these children reach adulthood those morbidities can limit educational achievements, employability, insurability, and can particularly affect the child's overall health-related quality of life [7]. As shown by several studies children with cyanotic heart defect have a lower score in quality of life compared with healthy peers in the same age group [14]. In effort to improve the outcome, we aimed to study the nutritional status, cognitive function, and quality of life in children with cyanotic and acyanotic CHD.…”

“…The comparison quality of life from 17 cyanotic children with 37 acyanotic children showed that quality of life-based on parental report was significant lower in cyanotic group in the following segments including heart problem and therapy (53.3 ± 9.26 vs. 71.4 ± 7.75; p = 0.007), physical appearance (67.5 ± 20.57 vs. 90.2 ± 4.89; p = 0.033), treatment anxiety (57.3 ± 11.34 vs. 83.6 ± 14.28; p = 0.001), and cognitive problem (53.3 ± 5.16 vs. 78.3 ± 4.85; p = 0.001) [14]. Based on that, the composite of standard deviation using the formula for unpaired analytic categories and numeric we got the biggest sample size was 21 children per group.…”