Tijdschrift voor kindergeneeskunde

, Volume 71, Issue 3, pp 173–182 | Cite as

Leer- en gedragsproblemen en kwaliteit van leven van kinderen na bacteriële meningitis: waakzaamheid geboden

  • I. Koomen
  • H. Raat
  • A. Jennekens-Schinkel
  • D.E. Grobbee
  • J. J. Roord
  • A. M. van Furth
Artikelen
  • 61 Downloads

samenvatting

Achtergrond: Leer- en gedragsproblemen worden de laatste jaren frequent gerapporteerd bij kinderen die van bacteriële meningitis zijn genezen.

Doel: Inventariseren van leer- en gedragsproblemen en de gezondheidsgerelateerde kwaliteit van leven van postmeningitis kinderen in Nederland.

Methoden: Uit een cohort van 674 postmeningitis kinderen werden 182 kinderen (leeftijd gemiddeld 10 jaar; range 5-14) geselecteerd voor onderzoek. Deze kinderen hadden geen meningitis met ‘complex begin’, noch preëxistent afwijkende cognitie of gedrag, noch ernstige restverschijnselen. Het interval tussen ziekte en onderzoek was gemiddeld 7 (range 4-10) jaar. Bij de kinderen werd een Schoolvaardigheden Onderzoek afgenomen, de ouders vulden de Child Behavior Checklist in. Gezondheidsgerelateerde kwaliteit van leven werd bij de ouders geïnventariseerd door middel van de Child Health Questionnaire en de Health Utility Index. De kinderen vulden zelf de Competentie Belevingsschaal in.

Resultaten: De cumulatieve incidentie van leer- en/of gedragsproblemen was 32%. De ouders van de gehele postmeningitisgroep namen zowel in het fysieke als in het psychosociale functioneren een verminderde gezondheidsgerelateerde kwaliteit van leven waar ten opzichte van normgegevens. Vooral wat betreft het psychosociale functioneren werd dit verschil veroorzaakt door een significante vermindering in kwaliteit van leven in de subgroep van kinderen met leer- en/of gedragsproblemen na bacteriële meningitis. De zelfbelevingsschalen suggereerden dat de kinderen zelf weinig problemen ervoeren.

Conclusie: Na genezing van bacteriële meningitis heeft op de lange termijn ongeveer eenderde van de kinderen leer- en/of gedragsproblemen. Juist voor deze subgroep is ook de gezondheidsgerelateerde kwaliteit van leven verminderd. Met deze bevindingen dient rekening gehouden te worden bij de nazorg van postmeningitis kinderen.

Summary

Background: Learning and behavioural problems are frequently reported in recent studies on long-term adverse outcome of childhood bacterial meningitis.

Objective: To investigate school achievement, behaviour, and health-related quality of life of postmeningitic children in The Netherlands.

Methods: 182 children (mean age 10 years; range 5-14) were selected from a cohort of 674 postmeningitic children on average 7 (range 4-10) years after meningitis. These children had neither meningitis with ‘complex onset’, nor prior cognitive or behavioural problems, nor severe disease sequelae. The children were evaluated with an ‘Academic Achievement Test’ and the parents filled in the Child Behaviour Checklist. Furthermore, parents completed two questionnaires on health-related quality of life (Child Health Questionnaire and Health Utility Index) and the children filled in the Perceived Competence Scale for Children.

Results: The cumulative incidence of academic and/or behavioural problems was 32%. Parents' perception of health-related quality of life of the postmeningitic children, particularly in the dimensions of physical and psychosocial functioning, was decreased in comparison to that of a normal reference group. Decreased quality of life with respect to the psychosocial functioning was attributable to the subgroup of postmeningitic children with academic and/or behavioural problems. The self-perceptions of the postmeningitic children did not reveal significant problems.

Conclusion: One-third of the postmeningitic children has long-term academic and/or behavioural problems. The health-related quality of life of postmeningitic children is decreased, particularly of those with academic and/or behavioural problems. It is important to bear in mind these risks when taking care of children who survived bacterial meningitis.

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Copyright information

© Bohn Stafleu van Loghum 2003

Authors and Affiliations

  • I. Koomen
    • 1
  • H. Raat
  • A. Jennekens-Schinkel
  • D.E. Grobbee
  • J. J. Roord
  • A. M. van Furth
  1. 1.

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