Дотримання режиму лікування і причини його порушення в дітей, хворих на муковісцидоз

Abstract

Medical dietary therapy (MDT) is aimed at preventing complications related to both the chronic disease itself and complications that may develop into separate nosological forms as a result of non-compliance with such recommendations. At the same time, adherence to MDT recommendations among children is quite low, despite the adverse consequences of non-adherence to therapy. These difficulties determine the need for additional counseling by behavioral pediatricians and psychologists. Purpose - to study the degree of adherence to dietary recommendations and pancreatic enzyme replacement therapy in children with cystic fibrosis (CF) in Kyiv and the Kyiv region, and the impact on anthropometric indicators, length of hospitalization, and the probability of respiratory tract colonization by Ps. aeruginosa. Materials and methods. Interviews were conducted with 17 children with cystic CF aged 5 to 17 years, as well as their parents. Children and parents were asked to fill out the EAT-26 food attitude questionnaire. All interviewed patients were assessed for nutritional status and sputum culture. Patients were divided into 3 groups depending on the completeness of compliance with the recommendations. Results. According to the general results of the survey, only 47% of all patients are sure that they fully followed the recommendations. Children with CF who did not regularly or substandardly consume specialized food mixtures had a higher percentage of respiratory tract colonization by Ps. aeruginosa, stayed longer in the hospital, and some of them had nutritional disorders. According to the EAT-26 questionnaire and a face-to-face interview, it was established that children with CF form their attitude to eating through the prism of the perception of the diagnosis. The daily “burden of the disease” and the additional responsibilities associated with it are reflected in the patients’ answers. Conclusions. An important component of the work with children with CF is the determination of reduced adherence to diet therapy. EAT-26 testing can be useful for identifying the most significant factors that require correction in a specific child by members of a multidisciplinary team (pediatrician, nutritionist, psychologist). The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child’s parents was obtained for the research. No conflict of interests was declared by the authors.