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Maternal Psychological Distress and Parenting Stress After Gastrostomy Placement in Children

Åvitsland, Tone Lise*; Faugli, Anne*; Pripp, Are Hugo; Malt, Ulrik Fredrik*; Bjørnland, Kristin; Emblem, Ragnhild*

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e31826078bd
Original Articles: Gastroenterology

Objectives: The aim of the study was to evaluate stress in mothers of children with feeding problems before and after gastrostomy placement, and to identify changes in child health and variables affecting maternal stress.

Methods: Psychological distress and parenting stress in 34 mothers of children referred for gastrostomy were assessed using General Health Questionnaire (GHQ) (overall psychological distress), Impact of Event Scale (IES) (intrusive stress related to child's feeding problems), and Parenting Stress Index (PSI) (stress related to parenting) before, 6, and 18 months after placement of a gastrostomy. Information of child health and long-term gastrostomy complications were recorded. A semistructured interview constructed for the present study explored maternal preoperative expectations and child's quality of life.

Results: Insertion of a gastrostomy did not significantly influence vomiting or the number of children with a low weight-for-height percentile. All of the children experienced peristomal complications. Despite this, mothers’ overall psychological distress was significantly reduced after 6 and 18 months, and the majority of mothers (85%) reported that their preoperative expectations were fulfilled and that the child's quality of life was improved after gastrostomy placement. Maternal concerns for the child's feeding problems, measured as intrusive stress, had effect on maternal overall psychological distress.

Conclusions: Despite frequent stomal complications the gastrostomy significantly reduced the mothers’ psychological distress and improved the child's quality of life as reported by the mother.

Author Information

*Faculty of Medicine, University of Oslo

Unit of Biostatistics and Epidemiology

Department of Pediatric Surgery, Oslo University Hospital, Oslo, Norway.

Address correspondence and reprint requests to Ragnhild Emblem, Department of Pediatric Surgery, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway (e-mail:

Received 23 January, 2012

Accepted 21 May, 2012

T.L.Å. has received research grants from the Centre of Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP). The other authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN