Book contents
- Frontmatter
- Contents
- List of contributors
- Acknowledgments
- Preface
- Part I General issues
- 1 Introduction and historical overview
- 2 Principles of outcomes analysis
- 3 Outcomes analysis and systems of children's surgical care
- 4 Perinatal mortality and morbidity: outcome of neonatal intensive care
- 5 Psychological aspects of pediatric surgery
- Part II Head and neck
- Part III Thorax
- Part IV Abdomen
- Part V Urology
- Part VI Oncology
- Part VII Transplantation
- Part VIII Trauma
- Part IX Miscellaneous
- Index
- Plate section
- References
5 - Psychological aspects of pediatric surgery
from Part I - General issues
Published online by Cambridge University Press: 08 January 2010
- Frontmatter
- Contents
- List of contributors
- Acknowledgments
- Preface
- Part I General issues
- 1 Introduction and historical overview
- 2 Principles of outcomes analysis
- 3 Outcomes analysis and systems of children's surgical care
- 4 Perinatal mortality and morbidity: outcome of neonatal intensive care
- 5 Psychological aspects of pediatric surgery
- Part II Head and neck
- Part III Thorax
- Part IV Abdomen
- Part V Urology
- Part VI Oncology
- Part VII Transplantation
- Part VIII Trauma
- Part IX Miscellaneous
- Index
- Plate section
- References
Summary
Introduction
As a result of major advances in all branches of pediatric care there have been considerable improvements in survival and physical health of children following pediatric surgery. Follow-up of pediatric surgical patients has, understandably, concentrated on physical or functional outcome, whereas interest in psychological and social sequelae is relatively recent. Conditions requiring pediatric surgery vary along a continuum from acute short-term problems requiring minor surgery, to those requiring major life-threatening surgery. This chapter is primarily concerned with the long-term psychological and social sequelae of conditions requiring major surgery.
The chapter is divided into four sections. The first focuses briefly on methodological issues in psychological research. The second addresses the effects of hospitalization and children's responses to hospitalization. The third section reviews studies of long-term psychological outcomes and the relationship to chronic health problems. Finally, issues arising from the previous sections are discussed.
Methodological issues
Study design
Good psychosocial adjustment in children has been described as being “reflected in behavior that is age-appropriate, normative and healthy and that follows a trajectory towards positive adult functioning”. The ideal way to assess long-term psychosocial outcomes is by prospective longitudinal studies. They are unique in their ability to determine the best causal relationship between early and later behavior, and they offer the possibility of studying whether specific risk factors lead to different outcomes, whether the effects are immediate or delayed, whether the effects persist over time and whether they are modified by intervening variables.
- Type
- Chapter
- Information
- Pediatric Surgery and UrologyLong-Term Outcomes, pp. 54 - 64Publisher: Cambridge University PressPrint publication year: 2006