Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
권호 표지
DOI QR코드

DOI QR Code

Health-Related Quality of Life in the Early Childhood of Premature Children

미숙아로 출생한 유아의 건강 관련 삶의 질 정도와 영향요인

  • Lim, Eun-Hee (Health Insurance Review and Assessment Service) ;
  • Ju, Hyeon-Ok (Department of Nursing, Dong-A University)
  • 임은희 (건강보험심사평가원) ;
  • 주현옥 (동아대학교 의과대학 간호학과)
  • Received : 2014.09.15
  • Accepted : 2014.12.18
  • Published : 2015.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: In this study, a comparison was done of the extent of health-related quality of life (HRQoL) for preterm and fullterm children during early childhood, and factors affecting HRQoL in the early childhood of premature children were analyzed. Methods: Eighty mothers of children born prematurely and 83 mothers of children born at fullterm listed on two Internet cafes were sampled for this study. The major instrument used for the study was the TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire. Results: Total score for HRQoL in the premature group was 80.5 (${\pm}9.9$) and for the full term group, 85.0 (${\pm}8.3$), on a 100-point scale. A comparison of the premature group and full term group showed that the domains which scored relatively lower with respect to HRQoL included the stomach, motor function, anxiety, liveliness and communication. Among the factors that have an impact on HRQoL were 'length of stay in neonatal intensive care unit (${\geq}7$ days)' and 'birth weight (<1,000 gm)'. The explanation power of the model was 17%, which was statistically significant. Conclusion: These findings indicate that a differentiated premature infant follow-up program for children who are hospitalized over 7 days in NICU or weighed under 1,000g at birth is urgently needed.

목적 본 연구는 미숙아로 태어난 유아와 정상아로 태어난 유아의 건강 관련 삶의 질을 비교하고, 미숙아로 태어난 유아의 건강 관련 삶의 질에 영향을 미치는 요인을 파악하여, 이들의 유아기 건강 관련 삶의 질 향상에 기여하기 위하여 시도되었다. 방법 연구 방법은 자가보고식 설문지를 이용하였으며, 연구 대상자는 인터넷 카페에서 미숙아로 출생한 유아의 부모 80명과 정상아 부모 83명이었다. 연구 도구는 TNO-AZL에서 개발한 TAPQOL를 사용하였고, 수집된 자료는 SPSS 20.0을 사용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, 다중회귀분석을 이용하였다. 결과 미숙아로 태어난 유아의 삶의 질 점수는 100점 만점에 80.6점(${\pm}9.9$)이었으며, 정상아로 태어난 유아의 삶의 질 점수는 85.0점(${\pm}8.3$)으로, 미숙아 집단이 정상아 집단에 비해 삶의 질 점수가 4.4점(${\pm}1.4$) 낮았다. 미숙아 집단이 정상아 집단에 비해 삶의 질 점수가 낮은 영역으로는 운동기능, 불안, 긍정적 기분, 활기참 및 의사소통 등이었다. 두 집단간 삶의 질 점수 차이가 가장 큰 영역은 운동기능과 의사소통이었다. 미숙아로 태어난 유아의 건강 관련 삶의 질에 영향을 미치는 변수는 '신생아실 입원기간(7일 이상)'과 '출생체중(1,000 g 미만)'으로 나타났으며, 두 변수의 설명력은 17%였다. 즉, 신생아실 입원기간이 7일 미만이고, 출생 시 체중이 1,000 g 이상인 아동이 그렇지 않은 아동보다 건강 관련 삶의 질 점수가 높았다. 결론 미숙아로 태어난 아동의 건강 관련 삶의 질은 이들의 출생 시 체중 및 신생아실 입원기간 등이 영향을 미치므로 미숙아 추후 프로그램을 개발할 때 출생체중, 재태기간 및 신생아집중치료실 입원기간 등으로 고려해야 할 것이다.

Keywords

References

  1. Arpino, C., Compagnone, E., Montanaro, M. L., Cacciatore, D., De Luca, A., Cerulli, A., et al. (2010). Preterm birth and neurodevelopmental outcome: A review. Child's Nervous System, 26, 1139-1149. http://dx.doi.org/10.1007/s00381-010-1125-y
  2. Bae, Y. M., & Bae, C. W. (2004). The changes in the mortality rates of low birth weight infant and very low birth weight infant in Korea over the past 40 years. Journal of Korean Medical Science, 19, 27-31. http://dx.doi.org/10.5124/jkma.2006.49.11.975
  3. Chang, E. Y., & Oh, J. A. (2008). Concept analysis of the quality of life for the children. The Academic Society of Parent-Child Health, 11(2), 127-137.
  4. Chien, L. Y., Chou, Y. H., Ko, Y. L., & Lee, C. F. (2006). Health-related quality of life among 3-4 year old children born with very low birthweight. Journal of Advanced Nursing, 56(1), 9-16. http://dx.doi.org/10.1111/j.1365-2648.2006.03974.x
  5. Davis, L., Mohay, H., & Edwards, H. (2003). Mothers' involvement in caring for their premature infants: An historical overview. Journal of Advanced Nursing, 42(6), 578-586. http://dx.doi.org/10.1046/j.1365-2648.2003.02661.x
  6. de Kieviet, J. F., Piek, J. P., Aarnoudse-Moens, C. S., & Oosterlaan, J. (2009). Motor development in very preterm and very low-birth-weight children from birth to adolescence: A meta-analysis. JAMA Pediatrics, 302(20), 2235-2242. http://dx.doi.org/10.1001/jama.2009.1708
  7. Fekkes, M., Bruil, J., & Vogels, T. (2004). TAPQOL-manual. Retrieved February 3, 2012, from https://www.tno.nl/content.cfm?context=thema&content=prop_case&laag1=891&laag2=902&laag3=69&item_id=1621&Taal=2
  8. Fekkes, M., Theunissen, N. C., Brugman, E., Veen, S., Verrips, E. G., Koopman, H. M., et al. (2000). Development and psychometric evaluation of the TAPQOL: A health-related quality of life instrument for 1-5 year old children. Quality of Life Research, 9(8), 961-972. https://doi.org/10.1023/A:1008981603178
  9. Janssen, A. J., Akkermans, R. P., Steiner, K., de Haes, O. A., Oostendorp, R. A., Kollee, L. A., et al. (2011). Unstable longitudinal motor performance in preterm infants from 6 to 24 months on the Bayley scales of infant development. Research in Developmental Disabilities, 32, 1902-1909. http://dx.doi.org/10.1016/j.ridd.2011.03.026
  10. Ju, H. O., Park, Y. K., & Kim, D. W. (2013). Predicting factors of developmental delay in infant and early children. Child Health Nursing Research, 19(1), 12-20. http://dx.doi.org/10.5468/CHNR.2013.19.1.12
  11. Kim, C. R. (2004). The limit of viability and care of fetal infants. Korean Journal of Perinatology, 15(4), 341-349.
  12. Klassen, A. F., Lee, S. K., Raina, P., Chan, H., Matthew, D., & Brabyn, D. (2004). Health status and health-related quality of life in a populationbased sample of neonatal intensive care unit graduates. Pediatrics, 113(3), 594-600. https://doi.org/10.1542/peds.113.3.594
  13. Lee, B. H., & Ko, J. Y. (2010). Influential factors for the health related quality of life in children with mental retardation and cerebral palsy. Korean Rehabilitation Science Association, 49(2), 105-126.
  14. Lee, J. W., Han, J. E., & Park, H. R. (2013). Quality of life in children and adolescents with cancer. Journal of Korean Academy of Child Health Nursing, 19(1), 21-28. http://dx.doi.org/10.5468/CHNR.2013.19.1.21
  15. Matza, L. S., Swensen, A. R., Flood, E. M., Secnik, K., & Leidy, N. K. (2004). Assessment of health-related quality of life in children: A review of conceptual, methodological and regulatory issues. Value in Health, 7(1), 79-92. http://dx.doi.org/10.1111/j.1524-4733.2004.71273.x
  16. Ministry of Health and Welfare. (2012). Maternal child health service in 2012. Seoul: Ministry of Health and Welfare.
  17. Park, S. Y., & Kim, Y. S. (2010). A study on the relationship between family environmental characteristics and health related to the quality of life of toddlers. The Korean Association of Human Development, 17(4). 111-125.
  18. Pi, S. Y. (2004). Manual of Neonatal Care (2nd ed.). Seoul: Korean Journal of Pediatrics.
  19. Rajmil, L., Abad, S., Sardon, O., Morera, G., Perez-Yarza, E. G., Moreno, A., et al. (2011). Reliability and validity of the Spanish version of the TAPQOL: A health-related quality of life (HRQOL) instrument for 1 to 5 year-old children. International Journal of Nursing Studies, 48, 549-556. http://dx.doi.org/10.1016/j.ijnurstu.2010.09.004
  20. Rautava, L., Hakkien, U., Korvenranta, E., Andersson, S., Gissler, M., Hallman, M., et al. (2009). Health-related quality of life in 5-year-old very low birth weight infants. The Journal of Pediatrics, 155(3), 338-343. http://dx.doi.org/10.1016/j.jpeds.2009.03.061
  21. Saigal, S., & Tyson, J. (2008). Measurement of quality of life of survivors of neonatal intensive care: Critique and implications. Seminars in Perinatology, 32(1), 59-66. http://dx.doi.org/10.1053/j.semperi.2007.12.007
  22. Shin, H. G., Yoo, I. Yo., & Oh, E. G. (2010). Relationship between quality of life and parenting attitude and parent-child communication patterns of school age children. Journal of Korean Academy of Child Health Nursing, 16(3), 220-229. http://dx.doi.org/10.4094/jkachn.2010.16.3.220
  23. Shin, Y. H. (2003). Current status of Korean premature infant care and its prospective. Korean Journal of Child Health Nursing, 9(1), 96-106.
  24. Shin, Y. H., Kim, M. K., & Kim, T. I. (2006). Resilience and health-related quality of life in children with chronic illness. Journal of Korean Academy of Child Health Nursing, 12(3), 295-303.
  25. Stjernqvist, K., & Svenningsen, N. W. (1995). Extremely low birth weight infants less than 901g: Development and behaviour after 4 years of life. Acta Paediatrics, 84(5), 500-506. http://dx.doi.org/10.1111/j.1651-2227.1995.tb13682.x
  26. The WHOQOL Group. (1995). The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41(10), 1403-1409. http://dx.doi.org/10.1016/0277-9536(95)00112-K
  27. Theunissen, N. C., Veen, S., Fekkes, M., Koopman, H. M., Zwinderman, K. A., Brugman, E., et al. (2001). Quality of life in preschool children born preterm. Developmental Medicine & Child Neurology, 43(7), 460-465. http://dx.doi.org/10.1111/j.1469-8749.2001.tb00743.x
  28. Wielenga, J. M., Smit, B. J., Merkus, M. P., Wolf, M. J., Sonderen, L., & Kok, J. H. (2009). Development and growth in very preterm infants in relation to NIDCAP in a Dutch NICU: Two years of follow-up. Acta Pædiatrica, 98(2), 291-297. http://dx.doi.org/10.1111/j.1651-2227.2008.01038.x
  29. Wood, N. S., Marlow, N., Costeloe, K., Gibson, A. T., & Wilkinson, A. R. (2000). Neurologic and developmental disability after extremely preterm birth. EPICure Group. The New England Journal of Medicine, 343(6), 378-384. http://dx.doi.org/10.1056/NEJM200008103430601

Cited by

  1. The Reliability of the Pediatric Functional Muscle Testing in Children with Developmental Delay vol.27, pp.4, 2015, https://doi.org/10.18857/jkpt.2015.27.4.183
  2. Addressing the Needs of Mothers with Infants in the Neonatal Intensive Care Unit: A Qualitative Secondary Analysis vol.14, pp.5, 2020, https://doi.org/10.1016/j.anr.2020.09.004