João H F Colares1, Marionescu Purcaru2, Guilherme P F da Silva3, Mirna A Frota4, Carlos A B da Silva4, Antônio A Melo-Filho5,6, Andrea Bischoff7, Alberto Peña7. 1. Pediatric Surgery Section, Albert Sabin Pediatric Hospital (HIAS), Tertuliano Sales, 544-Vila União, Fortaleza, Ceará, CEP: 60430-230, Brazil. jhfcolares@hotmail.com. 2. Nursing Department, Albert Sabin Pediatric Hospital (HIAS), Fortaleza, Ceará, Brazil. 3. University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil. 4. Master's Department in Public Health, University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil. 5. Pediatric Surgery Section, Albert Sabin Pediatric Hospital (HIAS), Tertuliano Sales, 544-Vila União, Fortaleza, Ceará, CEP: 60430-230, Brazil. 6. Department of Surgery, Medical School, Federal University of Ceará (UFC), Fortaleza, Ceará, Brazil. 7. Division of Pediatric Surgery, Colorectal Center for Children, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
Abstract
PURPOSE: Evaluate the impact of implementing Bowel Management Program (BMP) on quality of life (QoL) in children with fecal incontinence (FI). METHODS: Children 3-12 years referred to the Children's Treatment Center of FI were included and categorized accordingto the tendency to constipation (dilated colon; group 1) or diarrhea (non-dilated colon; group 2). Evaluations were performed before and after 3 months of BMP implementation. Perceptions from parents and children about QoL were assessed by the instrument PedsQL4.0 and the severity of FI by the fecal incontinence index (FII) of Wexner scale. RESULTS: 43 children (mean age of 7.7 ± 3.1) were studied. 32 (74.4 %) belonged to group 1 and 11 (25.6 %) to group 2. After 3 months of BMP, it was noticed a significant improvement of the FII (14.5 ± 3.7 versus 2.8 ± 2.5; p < 0.001) in both groups. QoL perception by the parents and children increased on PedsQL4.0 evaluation (p < 0.001). There was a medium inverse statistically significant correlation of the FII and the total PedsQL4.0 score among children and parents (r = -0.47, p = 0.009 and r = -0, 39, p = 0.03, respectively). CONCLUSION: The BMP applied by a multidisciplinary dedicated team significantly improves the QoL of children with FI in the short-term period.
PURPOSE: Evaluate the impact of implementing Bowel Management Program (BMP) on quality of life (QoL) in children with fecal incontinence (FI). METHODS:Children 3-12 years referred to the Children's Treatment Center of FI were included and categorized accordingto the tendency to constipation (dilated colon; group 1) or diarrhea (non-dilated colon; group 2). Evaluations were performed before and after 3 months of BMP implementation. Perceptions from parents and children about QoL were assessed by the instrument PedsQL4.0 and the severity of FI by the fecal incontinence index (FII) of Wexner scale. RESULTS: 43 children (mean age of 7.7 ± 3.1) were studied. 32 (74.4 %) belonged to group 1 and 11 (25.6 %) to group 2. After 3 months of BMP, it was noticed a significant improvement of the FII (14.5 ± 3.7 versus 2.8 ± 2.5; p < 0.001) in both groups. QoL perception by the parents and children increased on PedsQL4.0 evaluation (p < 0.001). There was a medium inverse statistically significant correlation of the FII and the total PedsQL4.0 score among children and parents (r = -0.47, p = 0.009 and r = -0, 39, p = 0.03, respectively). CONCLUSION: The BMP applied by a multidisciplinary dedicated team significantly improves the QoL of children with FI in the short-term period.
Entities:
Keywords:
Bowel management; Children; Fecal incontinence; Quality of life; Treatment
Authors: Katie W Russell; Douglas C Barnhart; Sarah Zobell; Eric R Scaife; Michael D Rollins Journal: J Pediatr Surg Date: 2014-12-06 Impact factor: 2.545
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