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Abstracts Des Kongresses Für Kinder- Und Jugendmedizin 2019 Abstracts Monatsschr Kinderheilkd 2019 · 167 (Suppl 4):S197–S278 Abstracts des Kongresses für https:// doi.org/ 10.1007/ s00112- 019- 0759-4 Online publiziert: 19. August 2019 © Springer Medizin Verlag GmbH, ein Teil von Kinder- und Jugendmedizin 2019 Springer Nature 2019 Gemeinsame Jahrestagung der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ), der Deutschen Gesellschaft für Sozialpädiatrie (DGSPJ), der Deutschen Gesellschaft für Kinderchirurgie (DGKCH), des Berufsverbandes Kinderkrankenpfege Deutschland (BeKD) und der Gesellschaft für Neuropädiatrie (GNP) 11. bis 14. September 2019, München Wissenschaftliche Leitung Prof. Dr. Ingeborg Krägeloh-Mann, Kongresspräsidentin DGKJ Prof. Dr. Andreas Neu, Kongresssekretär Dr. Andreas Oberle, Kongresspräsident DGSPJ Prof. Dr. Stephan Kellnar, Kongresspräsident DGKCH Elfriede Zoller, Kongresspräsidentin BeKD Prof. Dr. Martin Staudt, Kongresspräsident GNP Monatsschrift Kinderheilkunde · Suppl 4 · 2019 S197 Abstracts Abstracts der 115. Jahrestagung der Deutschen Gesellschaft für Kinder- und Jugendmedizin e. V. (DGKJ) Wissenschaftliche Leitung Prof. Dr. Ingeborg Krägeloh-Mann, Prof. Dr. Andreas Neu der Mehrzahl der Fälle konnte eine anhaltende Verbesserung des Essver- Freie Vorträge haltens erreicht werden. Die Zufriedenheit ist vor dem Hintergrund der Komplexität und Vielfalt der Komorbiditäten als eher gut zu bezeichnen. Mehrfachbehinderte Kinder/Varia Schlussfolgerung: Die vorliegende Studie zählt zu den bisher umfang- reichsten in diesem Bereich. Die erstmals untersuchten subjektiven Para- meter im Umfeld der Kinder mit frühkindlichen Essstörungen sollten bei DGKJ-FV 01 der therapeutischen Arbeit bedacht werden. Therapiezufriedenheit bei Eltern von Kindern mit frühkindlichen Fütter- und Essstörungen bei multiplen Komorbiditäten DGKJ-FV 02 Lydia Blank1, Ulrike Gaiser2, Rainer Blank2, Georg Friedrich Hofmann3 PalliVac – eine multizentrische Studie zu impfprävalenten 1Heidelberg, Deutschland; 2Kinderzentrum Maulbronn gGmbH, Fachklinik Erkrankungen in der ambulanten Palliativversorgung für Kinderneurologie und Sozialpädiatrie, Maulbronn; 3Universitätsklinikum Holger Hauch1, Irina Tretiakowa2, Peter Brunder3, Astrid Kimmig4, Andrea Heidelberg, Zentrum für Kinder- und Jugendmedizin der Universität Hagenguth5, Mario Scheer6, Vera Vaillant1, Cho-Ming Chao7, Daniel Berthold8, Heidelberg, Klinik I, Heidelberg Jens Kästner9 Fragestellung: Frühkindliche Fütter- und Essstörungen sind bei Klein- 1UKGM Standort Gießen, KinderPalliativTeam Mittelhessen, Gießen, kindern mit somatischen, psychischen und entwicklungsneurologischen Deutschland; 2Klinikum Bad Hersfeld, Klinik für Kinder- und Jugendmedizin, Störungen häufg und können sehr belastend für Bezugspersonen sein. Bad Hersfeld, Deutschland; 3Kinderpalliativteam Saarland, SAPV, Die vorliegende Studie thematisiert die Terapiezufriedenheit von Eltern, Merchweiler; 4Universitätsklinikum Tübingen, Palliativteam, Tübingen; deren Kinder eine stationäre Esstherapie durchliefen. 5Deutsches Rotes Kreuz, Palliativteam, Kiel; 6Kinderhospiz Syke, Material und Methoden: 256 Eltern von zwischen 2011 und 2016 ehemals Palliativteam, Syke; 7UKGM Standort Gießen, Allgemeine Pädiatrie stationär behandelten Kindern (0–7 Jahre) wurden mittels Fragebogen zu und Neonatologie, Gießen, Deutschland; 8UKGM Standort Gießen, ihrer Einschätzung der Terapieverbesserung während und nach dem sta- Klnik für Internistische Onkologie, Gießen; 9Universitätsklinikum Jena, tionären Aufenthalt befragt. Es wurde die Terapiezufriedenheit allgemein Kinderpalliativteam, Jena sowie in den Bereichen Ernährungsverhalten, Oralmotorik, Verhaltens- problematik, Sondenernährung und außerdem die Lebenszufriedenheit Hintergrund: In Deutschland werden Kinder und Jugendliche zunehmend (LiSat-11) sowie die familiäre Belastung ermittelt. häufg durch Teams der spezialisierten ambulanten Palliativversorgung Ergebnisse: Unter den 103 Rückmeldungen (40 %) wiesen 75 % Entwick- (SAPV) im häuslichen Umfeld behandelt. Es handelt sich um Patienten lungsstörungen auf, 55 % waren global retardiert (40 % schwer). 20 % aller Altersklassen mit verschiedenen, teilweise sehr seltenen Krankheits- der Kinder hatten als relevante neurologische Diagnose Zerebralparesen, bildern unklarer Prognose. Bei einem 14 Jahre alten Jugendlichen mit ei- 27 % hatten psychische Störungen, davon ein Drittel autistische Störun- ner ätiologisch unklaren, schweren Entwicklungsverzögerung mit sym- gen. Ätiologisch dominierten Frühgeburtlichkeit (48 %) sowie angebo- ptomatischer Epilepsie, Tetraspastik und zunehmender Skoliose sowie rene Fehlbildungen und Syndrome (49 %). Anamnestisch wurden 60 % eingeschränkter Atemmechanik kam es im Rahmen einer Varizelleninfek- sondenernährt. tion zu einer schweren Pneumonie, zunehmender Dyspnoe und leidvol- Bei einem Katamnesezeitraum von 6 Monaten bis 6 Jahren (m = 3,1; ler Verschlechterung des Allgemeinzustandes. Der Junge war nicht gegen SD = 1,8) waren 61 % der Eltern mit der Terapie zufrieden. Knapp die Varizellen geimpf worden. In einer Literaturanalyse fanden sich bisher Hälfe der Eltern beobachtete während des stationären Aufenthaltes Ver- keine vergleichbaren Fälle. Es stellte sich die Frage, ob impfprävalente Er- besserungen, während eine Einschätzung gemäß der Befundberichte einen krankungen (vaccine preventable diseases, VPD) in der SAPV aufreten Zielerreichungsgrad bei 81 % der Kinder aufwies. Eine langfristige Ver- und ob diese zu leidvollen Symptomen führen. Methodik: In einem ers- besserung gaben 65 % der Eltern an. 77 % der Eltern schilderten, dass ihr ten Schritt erfolgte eine Befragung aller deutschen SAPV Teams für Kin- Kind bis heute kein altersentsprechendes Ernährungsverhalten aufweist. der und Jugendliche sowie aller stationären Kinderhospize. Ergebnisse: Der BMI blieb unverändert. Eltern, deren Kinder rein psychische Komor- 34 Ärzte (32 SAPV- und 2 Hospizärzte) aus 12 Bundesländern beteilig- biditäten aufwiesen, waren häufger unzufrieden als Eltern von Kindern ten sich an der Studie. 25 Patienten mit diagnostizierter VPD (Gruppe 1) mit neurologischen Störungen (65 % vs. 27 %). wurden gemeldet. Es wurden Infektionen mit Infuenza (44 %), Varizel- Diskussion: Die vorliegende Studie weist ein Kollektiv mit unterschied- len (16 %) und anderen (20 % e. g. Diphtherie, Pertussis, Masern, Pneu- lichen Arten von frühkindlichen Fütter- und Essstörungen mit größten- mokken und Meningokokken-Infektion) berichtet. Der Verdacht auf eine teils schweren Komorbiditäten im Langzeit-Outcome auf, was die Ver- VPD (Gruppe 2) wurde bei weiteren 22 Fällen gemeldet (Infuenza 56 %, gleichbarkeit mit anderen Studien limitiert. Erstmals wurde hierbei die Pertussis 14 %, Rotavirus 14 %). Durchschnittsalter beider Gruppen war subjektive Terapie- und Lebenszufriedenheit der Eltern analysiert. Bei 8,8 (± 5,7 SD) Jahre. Verteilung der IMPaCCT Gruppen (1–4) war 5 % (1), 0 % (2), 55 % (3), 40 % (4). Die Diagnose wurde in 64 % klinisch, in S198 Monatsschrift Kinderheilkunde · Suppl 4 · 2019 29 % serologisch und in 59 % mittels PCR gestellt (Mehrfachantworten forschung fehlen. Diese Ergebnisse könnten zunächst als Grundlage für waren möglich). Leidvolle Symptome (min. 1 bis max. 5 Punkte) waren die Versorgungsforschung dienen, es könnten daraus manualisierte In- Dyspnoe (3,4 ± 1,5 SD) und AZ-Verschlechterung (3,8 ± 1,1 SD). Schwere terventionen für spezifsche Neuropädiatrische Krankheitsbilder entwi- Komplikationen waren Aufnahme auf einer Intensivstation (29 %), Beat- ckelt werden. mung (20 %), Tod (6 %) sowie Infektion eines SAPV-Teammitgliedes oder Schlussfolgerung: Die Hypothese, dass in Familien mit Kindern mit Hospiz-Mitarbeiters (20 %). Die befragten Ärzte waren der Meinung, dass schweren z. T. lebensbegrenzenden Hirnschädigungen der Einsatz von es hilfreich sein könnte, VPD bei Palliativpatienten zu verhindern (Mittel- Musik in einem ambulanten musiktherapeutischen Angebot geeignet ist, wert 4,4 ± 1,1 SD; 5 = starke bis 1 = keine Zustimmung). 1.) psychosoziale Prozesse zu unterstützen und 2.) ausgehend von sich er- Diskussion: Impfprävalente Erkrankungen (VPD) kommen auch in der eignenden shared moments dialogische Prozesse anzustoßen und damit Palliativversorgung vor. Überwiegend sind Kinder der IMPaCCT Grup- die Fähigkeiten aller Beteiligten zu erweitern, konnte mit dieser Pilotstu- pe 3 und 4 betrofen. VPD führen zu leidvollen Symptomen bis zur In- die weiter bestätigt werden. tensivbehandlung, Beatmung und Tod. Weitere Untersuchungen scheinen gerechtfertigt zu sein. Der prospektive Arm der Studie PalliVac (DRKS: Literatur 00015045) wurde im Januar 2019 gestartet. 1. Meier-Sprinz B, Sprinz A (2018) Musiktherapie in der neuropädiatrischen Frühr- ehabilitation aus Sicht betrofener Eltern. Musik-, Tanz- und Kunsttherapie. Pabst Literatur Sci Publ 28(2):172–192 1. Koch Institute R (2019) recommended vaccinations in germany. https://www.rki. 2. Meier-Sprinz B (2018) How Do Parents Experience M de/DE/Content/Kommissionen 2. Hauch H et al Klin Paediat. 228(3):145–148 DGKJ-FV 04 Methodik und Ziele der hundegestützten Therapie in der DGKJ-FV 03 stationären Neurorehabilitation von Kindern mit schweren Mobile Musiktherapie zur Versorgung von Kindern mit schweren neurologischen Erkrankungen Hirnschädigungen und ihrer Familien im ländlichen Raum – Ein Friederike Boek1, Julia Sachers1, Gerhard Kluger2, Evelyn Kluger2, Ulrike Praxisprojekt als phänomenologische Pilotstudie Blankenburg2, Martina Schaudeck2, Karin Hediger1 Brigitte Meier-Sprinz 1Universität Basel, Fakultät für Psychologie, Basel, Schweiz;
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