Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Serebral Palsili Çocuklarda Sağlıkla İlgili Yaşam Kalitesi ve Annelerin Depresyon Düzeyi Arasındaki İlişki
Relationship Between Health Related Quality of Life of Children with Cerebral Palsy and Psychological Status of Mothers
Özgün KAYA KARAa, Sedef ŞAHİNb, Hasan Atacan TONAKa, Ahmet GÜLc, Koray KARAd
aAkdeniz Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Antalya, TÜRKİYE
bHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Ergoterapi Bölümü, Ankara, TÜRKİYE
cUfuk Üniversitesi Tıp Fakültesi, Ruh Sağlığı ve Hastalıkları ABD, Ankara, TÜRKİYE
dSağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi, Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Bölümü, Antalya, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2020;5(1):81-90
doi: 10.5336/healthsci.2019-70072
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, serebral palsili (SP) çocuğa sahip annelerin depresyon düzeyi ile çocuğun sağlıkla ilgili yaşam kalitesi arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Kesitsel olarak tasarlanmış olan çalışmamıza 7-16 yaş aralığında 183 çocuk ve anneleri (SP'li grup n=122; sağlıklı grup n=61) dâhil edildi. Çalışmaya alınan sağlıklı ve SP'li çocukların yaşam kalitesini değerlendirmek için Çocuk Sağlık Anketi Ebeveyn Formu (CHQ-PF50) kullanıldı. Annelerin depresyon düzeyleri Beck Depresyon Envanteri (BDE) ile değerlendirildi. Annelerin depresyon düzeyleri normal-minimal depresyon (<17) ve orta-şiddetli depresyon (17 ve üstü) olarak iki gruba ayrıldı. Nicel verilerin karşılaştırılmasında Mann-Whitney U testi; nitel verilerin karşılaştırılmasında ise ki-kare testi kullanıldı. CHQ-PF50 alt parametreleri ve BDE sonuçları arasındaki ilişki Spearman korelasyon testi ile analiz edildi. Bulgular: SP'li çocuğa sahip annelerin depresyon düzeyleri sağlıklı çocuğa sahip annelerin depresyon düzeylerinden yüksekti (p=0,012). SP'li çocuğa sahip annelerin BDE skorları ile CHQ'nun alt bölümlerinden fiziksel sağlık nedeni ile rol/sosyal kısıtlamalar arasında zayıf negatif yönde anlamlı ilişki (p<0,05) varken, ağrı ve rahatsızlık, mental sağlık, genel sağlık algılaması, ebeveyn üzerindeki emosyonel etki, aile aktiviteleri ve aile uyumu alt bölümleri ile arasında orta düzeyde negatif yönde anlamlı ilişki bulundu (p<0,05). Orta-şiddetli depresyon düzeyine sahip annelerin çocuklarının yaşam kalitesi alt bölümlerinden genel sağlık, ağrı ve rahatsızlık, mental sağlık, öz saygı, genel sağlık algılaması, aile aktiviteleri ve aile uyumu normal-minimal depresyon düzeyine sahip annelerin çocuklarından düşük bulundu (p<0,05). Sonuç: SP'li çocuğun ağrı düzeyi, mental ve genel sağlık durumu, öz saygısı ve aile bireylerinin uyumu annenin depresyon düzeyi ile ilişkide olan önemli faktörler arasındadır. Gelecekteki çalışmalar, annenin depresyon düzeyini etkileyebilecek diğer faktörleri araştırmalıdır.

Anahtar Kelimeler: Serebral palsi; yaşam kalitesi; anneler; depresyon; çocuk
ABSTRACT
 Objective: This study was aimed to investigate the relationship between depression level of mothers who had children with cerebral palsy (CP) and health related quality of life of children. Material and Methods: This sectional study was included 183 children at age ranged 7-16 years and their mothers (CP group n=122; health group n=61). Child Health Questionnaire-Parent Form (CHQ-PF50) was used to assess the quality of life of children with CP and health peers who had participated in the study. Depression levels of mothers were assessed with Beck Depression Inventory (BDI). The depression levels of mothers was separated two groups as normal-minimal (<17) and moderate-severe (17 and higher). Mann-Whitney U test was used to compare the quantitative data and ki-square test was used to analyse qualitative data. The correlation between CHQ-PF50 subdimensions and BDI scores was analysed with Spearman correlation. Results: The depression levels of mothers who had children with CP were higher than the mothers who had health children (p=0.012). There was poor significant correlation between BDI scores of mothers who had children with CP and the sub-dimensions of role/social limitations physical (p<0.05) and also moderate negative significant correlation was found in pain, general health perception, parental impact emotional, family activities and family cohesion (p<0.05). The quality of life scores of children with mothers who had moderate-severe depression levels was lower than children with mothers who had normal-minimal depression levels in general health, pain, mental health, self esteem, general health perception, family activities and family cohesion (p<0.05). Conclusion: As a conclusion, the pain level, mental and general health, self esteem and family cohesion of children with CP were the essential related factors with the depression levels of mothers. Future studies should investigate the other factors that affected the depression levels of mothers.

Keywords: Cerebral palsy; quality of life; mothers; depression; child
REFERENCES:
  1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14.
  2. Serdaroglu A, Cansu A, Ozkan S, Tezcan S. Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Dev Med Child Neurol. 2006;48(6):413-6. [Crossref] 
  3. Ribeiro MF, Sousa AL, Vandenberghe L, Porto CC. Parental stress in mothers of children and adolescents with cerebral palsy. Rev Lat Am Enfermagem. 2014;22(3):440-7. [Crossref]  [PubMed]  [PMC] 
  4. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res. 1993;2(2):153-9. [Crossref] 
  5. Fitzpatrick R, Fletcher A, Gore S, Jones D, Spiegelhalter D, Cox D. Quality of life measures in health care. I: applications and issues in assessment. BMJ. 1992;305(6861):1074-7. [Crossref]  [PubMed]  [PMC] 
  6. Mc Manus V, Corcoran P, Perry IJ. Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland. BMC Pediatr. 2008;8:50. [Crossref]  [PubMed]  [PMC] 
  7. Bjornson KF, Belza B, Kartin D, Logsdon RG, McLaughlin J. Self-reported health status and quality of life in youth with cerebral palsy and typically developing youth. Arch Phys Med Rehabil. 2008;89(1):121-7. [Crossref]  [PubMed]  [PMC] 
  8. Wake M, Salmon L, Reddihough D. Health status of Australian children with mild to severe cerebral palsy: cross-sectional survey using the Child Health Questionnaire. Dev Med Child Neurol. 2003;45(3):194-9. [Crossref] 
  9. Makris T, Dorstyn D, Crettenden A. Quality of life in children and adolescents with cerebral palsy: a systematic review with meta-analysis. Disabil Rehabil. 2019:1-10. [Crossref]  [PubMed] 
  10. Tüzün EH, Eker L, Daşkapan A. [An assessment of the impact of cerebral palsy on children's quality of life]. Turk J Physiother Rehabil. 2004;15(1):3-8.
  11. Krstić T, Mihić L, Mihić I. Stress and resolution in mothers of children with cerebral palsy. Res Dev Disabil. 2015;47:135-43. [Crossref]  [PubMed] 
  12. Barnett D, Clements M, Kaplan-Estrin M, Fialka J. Building new dreams: supporting parents' adaptation to their child with special needs. Infants Young Child. 2003;16(3):184-200. [Crossref] 
  13. Khayatzadeh MM, Rostami HR, Amirsalari S, Karimloo M. Investigation of quality of life in mothers of children withcerebral palsy in Iran: association with socio-economic status,marital satisfaction and fatigue. Disabil Rehabil. 2013;35(10):803-8. [Crossref]  [PubMed] 
  14. Bailey DB Jr, Golden RN, Roberts J, Ford A. Maternal depression and developmental disability: research critique. Ment Retard Dev Disabil Res Rev. 2007;13(4):321-9. [Crossref]  [PubMed] 
  15. Türkoğlu S, Bilgiç A, Türkoğlu G, Yilmaz S. Impact of symptoms of maternal anxiety and depression on quality of life of children with cerebral palsy. Noro Psikiyatr Ars. 2016;53(1):49-54. [Crossref]  [PubMed]  [PMC] 
  16. Garip Y, Ozel S, Tuncer OB, Kilinc G, Seckin F, Arasil T. Fatigue in the mothers of children with cerebral palsy. Disabil Rehabil. 2017;39(8):757-62. [Crossref]  [PubMed] 
  17. Kaya K, Unsal-Delialioglu S, Ordu-Gokkaya NK, Ozisler Z, Ergun N, Ozel S, et al. Musculo-skeletal pain, quality of life and depression in mothers of children with cerebral palsy. Disabil Rehabil. 2010;32(20):1666-72. [Crossref]  [PubMed] 
  18. Sajedi F, Alizad V, Malekkhosravi G, Karimlou M, Vameghi R. Depression in mothers of children with cerebral palsy and its relation to severity and type of cerebral palsy. Acta Med Iran. 2010;48(4):250-4.
  19. Unsal-Delialioglu S, Kaya K, Ozel S, Gorgulu G. Depression in mothers of children with cerebral palsy and related factors in Turkey: a controlled study. Int J Rehabil Res. 2009;32(3):199-204. [Crossref]  [PubMed] 
  20. Basaran A, Karadavut KI, Uneri SO, Balbaloglu O, Atasoy N. The effect of having a children with cerebral palsy on quality of life, burn-out, depression and anxiety scores: a comparative study. Eur J Phys Rehabil Med. 2013;49(6):815-22.
  21. Lee MH, Matthews AK, Park C. Determinants of Health-related Quality of Life among mothers of children with cerebral palsy. J Pediatr Nurs. 2019;44:1-8. [Crossref]  [PubMed] 
  22. Koltuniuk A, Rozensztrauch A, Budzińska P, Rosińczuk J. The quality of life of polish children with cerebral palsy and the impact of the disease on the family functioning. J Pediatr Nurs. 2019;S0882-5963(18)30493-7.
  23. Ozkan Y. Child's quality of life and mother's burden in spastic cerebral palsy: a topographical classification perspective. J Int Med Res. 2018;46(8):3131-7. [Crossref]  [PubMed]  [PMC] 
  24. Rosenbaum PL, Palisano RJ, Bartlett DJ, Galuppi BE, Russell DJ. Development of the gross motor function classification system for cerebral palsy. Dev Med Child Neurol. 2008;50(4):249-53. [Crossref]  [PubMed] 
  25. Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Ohrvall AM, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006;48(7):549-54. [Crossref] 
  26. Akpinar P, Tezel CG, Eliasson AC, Icagasioglu A. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabil. 2010;32(23):1910-6. [Crossref]  [PubMed] 
  27. Ozdogan H, Ruperto N, Kasapcopur O, Bakkaloglu A, Arisoy N, Ozen S, et al; Paediatric Rheumatology International Trials Organisation. The Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ). Clin Exp Rheumatol. 2001;19(4 Suppl 23):S158-62.
  28. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71. [Crossref]  [PubMed] 
  29. Hisli N. Validity and relaibility of Beck Depression Scale in university students. J Psyhol. 1989;7(23):3-13.
  30. Altman D. Practical Statistics for Medical Research. 1st ed. London: Chapman and Hall; 1992. p.589.
  31. Power R, King C, Muhit M, Heanoy E, Galea C, Jones C, et al. Health-related quality of life of children and adolescents with cerebral palsy in low- and middle-income countries: a systematic review. Dev Med Child Neurol. 2018;60(5):469-79. [Crossref]  [PubMed] 
  32. Elbasan B, Duzgun I, Oskay D. Is there any difference in health related quality of life, self care and social function in children with different disabilities living in Turkey? Iran J Pediatr. 2013;23(3):281-8.
  33. Resch B, Mühlanger A, Maurer-Fellbaum U, Pichler-Stachl E, Resch E, Urlesberger B. Quality of life of children with cystic periventricular leukomalacia - a prospective analysis with the Child Health Questionnaire-Parent Form 50. Front Pediatr. 2016;4:50. [Crossref]  [PubMed]  [PMC] 

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