Evaluation Of Quality Of Life Of Parents Of Children With Anal Atresia After Operation And Affecting Factors Analysis

Objective:(1)Through qualitative interviews,the quality of life of parents of children with anal atresia after operation is deeply understood from a subjective point of view,and the factors that may affect their quality of life are analyzed to lay the foundation for the follow-up quantitative research.(2)Through quantitative study,the quality of life of parents of children with anal atresia after operation is objectively evaluated,and the main affecting factors of their quality of life are analyzed.Methods:(1)The purpose sampling method was used to select 17 parents of children with anal atresia who were reexamined at the Surgery Department,Shanxi Children's Hospital over May to June,2018.The interviews were face-to-face and semi-structured with phenomenological research methods and were recorded.The interviews were analyzed and summarized to extract several themes according to Colaizzi's seven-step analysis method.(2)From July 2018 to January 2019,80 parents of children with anal atresia were investigated and measured at the Surgery Department,Shanxi Children's Hospital with self-made general information questionnaire,World Health Organization Quality of Life Scale(WHOQOL-BREF),Zarit Nursing Burden Scale(ZBI),Self-rating Anxiety Scale(SAS)and Social Support Rating Scale(SSRS).According to the total score of life quality and the average score of other dimensions,the 80 parents were divided into highlife quality group and low life quality group.The main affecting factors were screened by univariate analysis and multivariate logistic regression analysis.Pearson correlation was used to analyze the correlation between each scale score and life quality.P < 0.05 indicates statistically significant difference.Results:(1)In the qualitative study,the subjective experience of parents of children with anal atresia on the life quality was extracted and divided into seven themes: diverse negative emotions,heavy financial burden,great care pressure,weakened social function,sharp increase in family contradictions,insufficient social support,and lack of relevant knowledge.(2)In quantitative research,the results of single sample t-test showed that the scores of physiological domain(t=4.152),psychological domain(t=7.224),social relationship domain(t=6.664),and total life quality score(t=5.218)of the study group were significantly lower than those of the domestic norm,and the differences were statistically significant(P<0.05).There was no significant difference between the environmental domain score of the study group and the domestic norm(t=0.773,P >0.05).Among the ZBI,98.75% of the parents had different levels of care burden;68.7% of the parents had anxiety in the SAS;92.5% of the parents had low and middle levels of social support in the SSRS.Multivariate logistic regression analysis showed that the factors influencing the life quality of parents of AA children in physiological field were: parents' occupation(OR=2.698),anal function(OR=0.313),and current treatment stage(OR=0.234);the factors influencing the life quality in psychological field were: per capita monthly income(OR=18.039),operation method(OR=0.111),current treatment stage(OR=0.078).(OR=0.699);the affecting factors on life quality in the field of social relations were:parents' occupation(OR=6.068),whether only child(OR=0.151),anal function(OR=0.076),subjective support score(OR=1.229);the affecting factors of life quality in the field of environment were: parents' occupation(OR=2.569),number of caregivers(OR=2.603),whether only child(OR=0.362),anal function.(OR=0.165).The affecting factors of total score of life quality were: parents' educational level(OR=3.807),parents' occupation(OR=9.556),degree of anal atresia(OR=0.314),anal function(OR=0.003),current treatment stage(OR=0.003),and number of caregivers(OR=11.375).The life quality of parents increases progressively with careers from unemployed/laid-off/peasants to workers/individuals/others,and then to professional technicians/company employees;the life quality of parents of children with normal anal function is higher than that with abnormal anal function;for the current treatment stage,the life quality decreases gradually from rehabilitation training to anal dilatation to fistula;for the operation method,the life quality of parents of children after anal plasty is higher than that of fistula-anal plasty-fistula closure;the higher the personal burden,the lower the life quality;the life quality of parents with only child is higher than that of parents with more than one child;the higher the score of subjective support,the higher the life quality of parents;the more caregivers,the higher the life quality;the higher the educational level of parents,the higher the life quality;the higher the degree of anal atresia of children,the worse the life quality of parents.Pearson correlation analysis showed that there was a significant negative correlation between the scores of each dimension of care burden,anxiety and life quality(r<0,P<0.05).In social support,there was no significant correlation(P>0.05)between the utilization of support and the psychological dimension and social relationship dimension of life quality,but there was a significant positive correlation(r>0,P<0.05)between other dimensions and the scores of each dimension of life quality.Conclusion:(1)The results of qualitative and quantitative studies showed that the life quality of parents of children with anal atresia after operation is poor.(2)The factors affecting the life quality were: whether the child is the only child,whether the anal function is normal,the degree of anal atresia,the operation method,the stage of treatment,parents' occupation,income,educational level,the number of caregivers,personal burden,subjective social support,etc.(3)The heavier the burden of care and anxiety,the worse the life quality;and the less social support they receive,the worse the life quality.