{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:00:25Z","timestamp":1783436425332,"version":"3.54.6"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T00:00:00Z","timestamp":1517875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T00:00:00Z","timestamp":1517875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An early observation after chest wall correction is direct inspection from the PE patient of their \u201cnew\u201d thorax. Changes in self\u2010perception may give raise to other psychological adaptations. The aim of this study was to evaluate the early changes in the fields of self\u2010esteem, body image and QoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational longitudinal multicenter cohort study. Self\u2010esteem, emotional limitations and general health were assessed using the Child Health Questionnaire (CHQ) in patients under 18 and the World Health Organization Quality of Life Questionnaire\u2010bref (WHOQOL\u2010bref) was used for body image, psychological domain and overall QoL in patients over 16 years of age. Measurements were taken before surgery (T1) and 6 weeks (T2), and 6\u00a0months thereafter (T3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Scores on post\u2010operative self\u2010esteem were significantly higher compared with scores pre\u2010operatively (<jats:italic>p<\/jats:italic> &lt; 0.007). Also body image, psychological domain and emotional limitations showed significant improvement, respectively <jats:italic>p<\/jats:italic> &lt; 0.001, <jats:italic>p<\/jats:italic> &lt; 0.001, and <jats:italic>p<\/jats:italic> &lt; 0.016. Significant improvement in the first three components was mainly achieved in the first 6 weeks post\u2010operative. In emotional limitation, however, the largest change was between 6 weeks and 6\u00a0months. Overall quality of life in the WHOQOL\u2010bref and general health domain in the CHQ showed no significant improvement in relation to the pre\u2010operative scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Post\u2010operative PE patients after Nuss procedure showed an improved body image, increased self\u2010esteem and increased psychological resilience in the first 6\u00a0months, with the most marked change in the first 6 weeks. Also emotional limitations changed significantly over time. The changes were not large enough to influence general QoL or general health significantly.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4526-9","type":"journal-article","created":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T18:35:00Z","timestamp":1517942100000},"page":"2502-2506","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Early Consequences of Pectus Excavatum Surgery on Self\u2010Esteem and General Quality of Life"],"prefix":"10.1002","volume":"42","author":[{"given":"W. P.","family":"Zuidema","sequence":"first","affiliation":[{"name":"Pediatric Surgical Center Amsterdam, Emma Children\u2019s Hospital AMC VU\u2010University Medical Center De Boelelaan 1117 1081 HV Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W. A.","family":"Oosterhuis","sequence":"additional","affiliation":[{"name":"Department of Surgery Haaglanden Medical Center The Hague The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. W.","family":"Zijp","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Juliana Children\u2019s Hospital\/Haga\u2010Hospital The Hague The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"van der Heide","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. F. W.","family":"van der Steeg","sequence":"additional","affiliation":[{"name":"Pediatric Surgical Center Amsterdam, Emma Children\u2019s Hospital AMC VU\u2010University Medical Center De Boelelaan 1117 1081 HV Amsterdam The Netherlands"},{"name":"Center of Research on Psychology in Somatic Disease (CoRPS) Tilburg University Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. W. E.","family":"van Heurn","sequence":"additional","affiliation":[{"name":"Pediatric Surgical Center Amsterdam, Emma Children\u2019s Hospital AMC VU\u2010University Medical Center De Boelelaan 1117 1081 HV Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,6]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0011\u20103840(96)80005\u20100"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.12.020"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007\u20102723"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2005.09.018"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezr170"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.03.034"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt473"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2003.50112"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2016.09.03"},{"key":"e_1_2_6_11_2","first-page":"1138","article-title":"Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction","volume":"40","author":"Steinmann C","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2010.02.090234"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/00207411.1994.11449286"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.4236\/ojped.2014.43028"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20103468(98)90314\u20101"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291798006667"},{"key":"e_1_2_6_17_2","volume-title":"The CHQ user manual","author":"Landgraf JM","year":"1996"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1016393311799"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010011\u20101111\u2010x"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010017\u20100827\u2010x"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215114001662"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181881fb0"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.7182\/prtr.1.6.1.q52347756145h374"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103046.2006.00648.x"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-018-4526-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4526-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4526-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-018-4526-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T19:32:37Z","timestamp":1703619157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-018-4526-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,6]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1007\/s00268-018-4526-9"],"URL":"https:\/\/doi.org\/10.1007\/s00268-018-4526-9","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,6]]},"assertion":[{"value":"6 February 2018","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors have no conflict of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}