Quality Of Life Of Children With Congenital Hypospadias And Its Influencing Factors

Objective: To evaluate the quality of life(QOL) of children with congenital hypospadias. To analyze the features and influencing factors of hypospadias children’s QOL.Subjects and Method: The case group are from the hospitalized patients who have been diagnosed with hypospadias in Urology Department in Hunan Children’s Hospital and they still don’t have operation between February 2014 to June 2014. The control group have been matched with case group in age. The PedsQLTM has been the assessment tool to evaluate the children’s QOL. The self made generally questionnaire has been used to survey the respondents’ generally situation and possibly influencing factors.Results: 1. Generally information: The case group has 173 children, including 137cases(79.2%)are 2 to 4 years old, 27cases(15.6%) are 5 to 7 years old, 9 cases(5.2%)are 8 to 12 years old. Among them, 95 cases have had the experience of ridicule by others. Rural registration 139 cases(80.3%),urban registration 34 cases(19.7%)。2. The situation and features of QOL in children with hypospadias before operation:(1) The overall parent-proxy QOL score of hypospadias children is 82.74±13.50, the child-self QOL score is 81.82±9.11.(2) The parent-proxy QOL score in physical, emotional, social, role function, overall QOL and child-self QOL score in physical, role function, overall QOL by the case group are lower than the control group(P <0.01).The child-self QOL score of emotional and social function between two group do not have significant differences(P>0.05).(3) The 2 to 4 years old case group has lower child-self QOL score than the control group in emotional, social function and overall QOL(P <0.05), but the QOL score of physical function between two groups do not have significant differences(P>0.05); The 5 to 7 years old case group has lower parent-proxy QOL score than the control group in physical, emotional, role function, overall QOL and lower child-self QOL score than the control group in physical, role function and overall QOL(P <0.01), but the score of parent-proxy QOL in social function and child-self QOL in emotional, social function two group do not have significant differences(P>0.05); The 8 to 12 years old case group has lower parent-proxy QOL score in role function and child-self QOL score in physical function, overall QOL than the control group(P <0.05), but the parent-proxy QOL score in physical, emotional, social function and child-self QOL score in emotional, social and role function two group do not have significant differences(P>0.05).(4) The parent-proxy QOL score in physical, emotional, social, role function and overall QOL between the 2 to 4 years old case group, 5 to 7 years old group and 8 to 12 years old group do not have significant differences(P>0.05).The child-self QOL score between 5 to 7 years old case group and 8 to 12 years old case group in physical, emotional, social, role function and overall QOL also do not have significant differences(P>0.05).(5) The case group has higher parent-proxy QOL score in emotional function than child-self QOL score(P <0.05), but in physical, social, role function and overall QOL two group do not have significant differences(P >0.05).3. The univariate analysis of the influencing factors: “Mainly dependent”, “whether from only child family”, “parents’ educational level”, “the situation of birth time”, “whether has the experience of being ridicule”, “the parents’ confidence of the surgery”, “ the parents’ anxious about child’s future life” are related to child-self QOL score of the children with hypospadias(P <0.05). The type of hypospadias, whether accompanied other malformation, residence, relationship between families, the economic state of the family, the character of the mother, parents’ understanding level of the hypospadias are not related to the QOL score of the children with hypospadias.4. Multiple linear regression analysis: The parent-proxy physiological,social function score and overall QOL score are negatively correlated with "have been teasing", positively correlation with full-term birth. The parent-proxy emotional function score negatively correlated with "have been teasing". The parent-proxy role function is negatively correlated with "have been teasing", positively associated with the parent for the treatment of confidence. The child-self role function and overall QOL score are negatively correlated with parents’ anxiety rates.Conclusion: 1. The QOL of the children with hypospadias is lower than the healthy children. 2. The age, type of hypospadias, whether accompanied other malformation, residence, relationship between families, the economic state of the family, parents’ understanding level of the hypospadias are no obvious correlation with hypospadias children’ QOL. 3.“the experience of being ridicule”, “preterm birth”, “grandparents be the mainly dependent”, “from only child family”, “low educational level of the parents”, “parent’s serious anxious about the surgery” are the negative influencing factors to hypospadias children’ QOL.