Heijting, M. (Max) (2015) Ouder gerapporteerde uitkomstmaten bij kinderen na adenotonsillectomie voor verschillende indicaties in relatie met de ZATT richtlijn. thesis, Medicine.
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Abstract
Introduction: There is a number of indications for an adenotonsillectomy for children younger than 12 years. However, in the literature thus far there is no unanimity about the indications for the operation. The Dutch guideline for health problems involving the adenoid and the tonsils (ZATT) states that there are two indications for the operation: Obstructive sleep apnea syndrome (OSAS) and >7 times a tonsillitis in the last year. For softer indications as rhino sinusitis, upper respiratory tract infection, speech problems, eating disorders and asthma the advice is not to operate. This study approaches this from a different perspective: the patient (in this case: parent) reported outcome measures (PROM). The goal of this study is to determine if the assessment of the operation results by the parents leads to different apprehension of the operation indications than in literature thus far and the Dutch ZATT guideline. Material & methods: For this retrospective PROM, 628 patients who were operated from November 2012 till October 2014 in het Deventer Ziekenhuis were asked to take part in this study. The parents were asked to fill in a survey that was drawn up by us and was not validated. The most important questions concerned an assessment of the morbidity for each symptom that the child presented itself with and an assessment of the result of the operation. Furthermore we asked if they would in hindsight, let the operation be performed again. Results: 328 people responded positively to our request to join this study, this resulted in a response rate of 52.2%. The parents reported a significant improvement for each of the nine symptoms after the operation. On average, parents reported 4.73 symptoms per child that undergoes an adenotonsillectomy. The average rating for the result of the operation was an 8.4 (scale 1-10). Parents who would not let the operation be performed again in hindsight, rated the result of the operation significantly lower (P = 0.004). Parents who felt their child was referred too late to the hospital rated the operation results significantly higher (P = 0.015). 11 of the 318 parents would in hindsight not let the operation be performed again. Conclusion: Despite the fact that the department ENT of het Deventer Ziekenhuis performs more adenotonsillectomies than the Dutch average, the vast majority of parents is satisfied with the results of the operation. Parents report a significant improvement of all symptoms after surgery. Because the parents report several symptoms per child, it is hard to pin down a precise operation indication for each symptom. Complement to the Dutch guideline ZATT we think that the decision to perform an adenotonsillectomy is an assessment of the ENT surgeon of the accumulated morbidity caused by the symptoms.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Laan, T. van der and Deventer Ziekenhuis |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1235 |
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