Abstract
Background
Pectus excavatum is the most common congenital anomaly of the sternum and anterior chest wall, which occurs about 3–4 times more often in boys than girls [1]. Although most patients do not report physical symptoms as cardiovascular and respiratory problems, they show a loss of self-esteem and a poor self-image. There exist very rare data about psychological state before the OP compared with data afterwards.
Objective
This study was conducted to examine psychological changes in body-image, self-concept and mental exposure in patients with pectus excavatum, who had undergone the Nuss procedure.
Methods
Seventeen patients (13 male, 4 female), who underwent 2003 a comprehensive psychological investigation, have been tested again in 2007 by means of the identical questionnaires to get postoperative data: OPE-FB (Wallisch; Operation-Expectation-Questionnaire), FKKS (Deusinger; Frankfurter Body Concept Scales) and SCL-90-R (Derogatis; Symptom Checklist Revised). The mean age at the second time of investigation was 19.6 years (SD = 2.5). The patients were classified into two groups based on a lower (n = 10) and a higher (n = 7) severity index of PE. Parents or a parent person were interviewed about the topics of OPE-FB by a structured interview. Data were analyzed using Mann–Whitney U test and Wilcoxon test. Interview data were evaluated with a content analysis.
Results
Nearly all patient’s expectations in regard to the beneficial effect of the surgical procedure—investigated with the OPE-FB preoperatively—have been confirmed postoperatively. In patients with a lower severity index impairment in general interest in sports and improvements in self-assurance, health, self-acceptance of one’s body and acceptance of one’s body by others can be reported. Data from SCL-90-R, measuring mental exposure, had normal range. Interviews with relatives showed, that the external attribution could emphasize patient’s data from the OPE-FB.
Conclusions
The long-time follow-up can make us sure, that the Nuss procedure as a physical treatment has positive effects on physical as well as psychological aspects of young adults. The patient’s confidence with the cosmetic result was very high, which reflects the excellent effects of the minimal invasive repair according to Nuss.
Similar content being viewed by others
References
Aronson DC, Bosgraaf RP, van der Horst C, Ekkelkamp S (2007) Nuss procedure: pediatric surgical solution for adults with pectus excavatum. World J Surg 31:26–29
Croitoru DP, Kelly RE Jr, Goretsky MJ, Lawson M, Swoveland B, Nuss D (2002) Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients. J Pediatr Surg 37:437–445
Einsiedel E, Clausner A (1999) Funnel chest. Psychological and psychosomatic aspects in children, youngsters, and young adults. J Cardiovasc Surg 40:733–736
Castellani C, Windhaber J, Schober PH, Hoellwarth ME (2010) Exercise performance testing in patients with pectus excavatum before and after Nuss procedure. Pediatr Surg Int 26:659–663
Daunt SW, Cohen J, Miller SF (2004) Age-related normal ranges for the Haller index in children. Pediatr Radiol 34:326–330
Fonkalsrud EW (2003) Current management of pectus excavatum. World J Surg 27:502–508
Metzelder ML, Kübler JF, Leonhardt J, Ure BM, Petersen C (2007) Self and parental assessment after minimally invasive repair of pectus excavatum: lasting satisfaction after bar removal. Ann Thorac Surg 83:1844–1849
Schalamon J, Pokall S, Windhaber J, Hoellwarth ME (2006) Minimally invasive correction of pectus excavatum in adult patients. J Thorac Cardiovasc Surg 132:524–529
Jacobsen EB, Thastum M, Jeppesen JH, Pilegaard HK (2009) Health related quality of life in children and adolescents undergoing surgery for pectus excavatum. Eur J Pediatr Surg 20:85–91
Wallisch A (2004) Operationserwartungen, Körperbild und psychische Belastung im prä- und post-operativen Stadium von Trichterbrustpatientinnen. Diploma thesis, Karl-Franzens-University of Graz, Austria
Hadolt B (2009) Pectus Excavatum—Körperkonzept, Selbstbild und psychische Belastungen im prä- und postoperativen Vergleich bei Patienten mit Trichterbrust. Diploma thesis, Karl-Franzens-University of Graz, Austria
Berk L (2005) Entwicklungspsychologie. Pearson-Studium, München
Resch F, Koch E (1995) Adoleszentenkrisen—Adoleszentenpsychosen. In: Frischenschlager O, Hexel M, Kantner-Rumplmair W, Ringler M, Söllner W, Wisiak UV (eds) Lehrbuch der psychosozialen Medizin. Grundlagen der Medizinischen Psychologie, Psychosomatik, Psychotherapie und Medizinischen Soziologie. Springer, Wien, pp 489–501
Zeltzer L, Kellerman J, Ellenberg L, Dash J, Rigler D (1980) Psychologic effects of illness in adolescence—impact of illness in adolescents—crucial issues and coping styles. J Pediatr 97:132–138
Petermann F (2001) Unterstützende Maßnahmen zur Krankheitsbewältigung. Monatsschrift Kinderheilkunde 149:601–611
Noeker M, Petermann F (1995) Körperlich-chronisch kranke Kinder: Psychosoziale Belastungen und Krankheitsbewältigung. In: Petermann F (ed) Lehrbuch der klinischen Kinderpsychologie. Modelle psychischer Störungen im Kindes- und Jugendalter. Hogrefe, Göttingen, pp 517–554
Egger JW (2002) Zur biopsychosozialen (“ganzheitlichen”) Erfassung von Krankheit. Der Versuch einer Simultandiagnostik in der Verhaltensmedizin. Psychol Med 13(2):13–24
Lienert GA, Raatz U (1998) Testaufbau und Testanalyse. Beltz, Weinheim
Boiché J, Sarrazin PG (2007) Self-determination of contextual motivation, inter-context dynamics and adolescents’ patterns of sport participation over time. Psychol Sport Exerc 8:685–703
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hadolt, B., Wallisch, A., Egger, J.W. et al. Body-image, self-concept and mental exposure in patients with pectus excavatum. Pediatr Surg Int 27, 665–670 (2011). https://doi.org/10.1007/s00383-011-2854-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-011-2854-z