Introduction: Laparoscopic fundoplication is the gold standard operation for treatment of gastroesophageal reflux disease (GERD). It has been suggested that persistent postoperative dysphagia is increased following Nissen fundoplication compared to partial fundoplication. We aimed to determine risk factors for persistent postoperative dysphagia, specifically examining type of fundoplication. Methods: Patients experiencing GERD symptoms who underwent laparoscopic Nissen, Toupet, or Dor fundoplication from 2009-2016 were identified from a single institutional database. A dysphagia score was obtained as part of the GERD-Health Related Quality of Life questionnaire. Persistent dysphagia was defined as a difficulty swallowing score ≥ 1 (noticeable) on a scale from 0-5 at least one year postoperatively. Odds ratios of persistent dysphagia among those who underwent anti-reflux surgery were calculated in a multivariate logistic regression model adjusted for fundoplication type, sex, age, body mass index, and redo operation. Results: Of the 441 patients who met inclusion criteria, 255 had ≥ 1 year of follow-up (57.8%). The median duration of follow-up was 3 years. 45.1% of patients underwent Nissen fundoplication, and 54.9% underwent partial fundoplication. Persistent postoperative dysphagia was present in 25.9% (n=66) of patients. On adjusted analysis, there was no statistically significant
The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers’ mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths’ attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9–16 years to explore their perspectives on maternal depression. All youth had participated in a 12‐week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture‐specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.
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