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van Engelenburg-van Lonkhuyzen ML, Bols EMJ, Bastiaenen CHG, de Bie RA. Measurement properties of the childhood bladder and bowel dysfunction questionnaire. J Pediatr Gastroenterol Nutr 2024; 78:592-600. [PMID: 38314913 DOI: 10.1002/jpn3.12152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES The childhood bladder and bowel dysfunction questionnaire (CBBDQ) was previously found feasible, structurally valid, with good internal consistency. The purpose of this study was to evaluate the remaining measurement properties according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). METHODS A prospective cohort study among parents of children aged 5-12 years was conducted. Calculated were the area under the curve (AUC) (criterion validity, responsiveness, interpretability) and intra-class correlation coefficients (ICCagreement ) (construct validity and test-retest reliability). RESULTS One hundred and seventy-two parents were included from March 2019 to April 2021. Correlating the bladder subscales of the CBBDQ with the Vancouver symptom score for dysfunctional elimination (VSSDES) and proxy-reported pediatric incontinence quality of life (p-PinQ) showed convergent validity (ICCsagreement : 0.76 and 0.74). Divergent validity was found when correlating the bowel subscales of the CBBDQ with the VSSDES (ICCagreement : 0.52). Excellent criterion validity (AUC: 0.98); excellent test-retest reliability (ICCagreement : 0.94) and, at 6 months, fair responsiveness (AUC: 0.74) were found. The minimal important change was 4.5, with cut-off value of 11. CONCLUSION The CBBDQ has been developed according to COSMIN standards. The items were defined using the consensus-based ICCS standards and Rome-III criteria. The measurement properties were identified using enough participants. Although interpretability is not considered a measurement property, interpretability aspects are reported here as they refer to what instrument scores mean. The 18-item-CBBDQ met the measurement properties of validity, reliability, and responsiveness, as defined by COSMIN. The CBBDQ is suitable for self-administration by parents, and completion takes little time.
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Affiliation(s)
- Marieke L van Engelenburg-van Lonkhuyzen
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
- Departmentof Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Esther M J Bols
- Research Group Autonomy and Participation for Persons with a Chronic Illness and Academy of Physiotherapy, Zuyd University, Heerlen, The Netherlands
| | - Caroline H G Bastiaenen
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
- Departmentof Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Rob A de Bie
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
- Departmentof Epidemiology, Maastricht University, Maastricht, The Netherlands
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Maffei HVL, Vidolin E, Reis JND, Freitas MD, Cabral BH, Trigo-Rocha F. OCCULT AND SEMI-OCCULT CONSTIPATION IN CHILDREN WITH MONOSYMPTOMATIC OR NON MONOSYMPTOMATIC ENURESIS. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:410-418. [PMID: 38018546 DOI: 10.1590/s0004-2803.230402023-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/04/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Functional constipation and enuresis frequently coexist. Constipation treatment often results in resolution or improvement of the enuresis. However, besides the classical presentation, patients can present with occult constipation (OC) diagnosed in complementary evaluation; in addition, semi-occult constipation (SOC) can be detected by means of a detailed questionnaire. OBJECTIVE To quantify OC and SOC frequency in children with monosymptomatic or non monosymptomatic enuresis (MNE or NMNE). METHODS Otherwise healthy children/adolescents, with enuresis refractory to behavioral therapy and denying constipation after simple questions, answered a structured bowel habit questionnaire and were submitted to a plain abdominal radiological exam. Constipation was classified considering the Boston diagnostic criteria (to allow diagnosis at initial stages), and fecal loading in the X-ray quantified ≥10 by the Barr score. Children with constipation received a standardized treatment (except 26 "pilot" children). RESULTS Out of 81 children, 80 aged 9.34±2.07 years, 52.5% male, were diagnosed with constipation: 30 OC, 50 SOC; 63.75% had MNE, 36.25% NMNE (six NMNE without behavioral therapy). Demographic data and the Barr score were similar for OC and SOC, but SOC children experienced significantly more constipation complications (retentive fecal incontinence and/or recurrent abdominal pain). Not showing the Bristol Stool Scale (BSS) to 24 "pilot" children, or absence of constipation symptoms accompanying BSS predominantly type 3, in 13 children, did not significantly impact the detection of constipation by the Barr score. Children identifying BSS 3 or ≤2 had similar results. Twenty-eight children, with adequate follow-up after treatment, improved or recovered from constipation at 44 of their 52 follow-up visits. CONCLUSION In patients with MNE or NMNE refractory to behavioral therapy, and who initially denied constipation after simple questions, a detailed questionnaire based on the Boston diagnostic criteria detected SOC in 61.7%, and the radiological Barr score revealed fecal loading (OC) in 37.0% of them.
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Affiliation(s)
- Helga Verena L Maffei
- Universidade Estadual Paulista, Faculdade de Medicina, Departamento de Pediatria, Botucatu, SP, Brasil
| | - Eliana Vidolin
- Hospital Municipal Infantil Menino Jesus, São Paulo, SP, Brasil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brasil
| | | | | | | | - Flavio Trigo-Rocha
- Hospital Municipal Infantil Menino Jesus, São Paulo, SP, Brasil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Urologia, São Paulo, SP, Brasil
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Bols E, Beekman E. Clinimetrics: Childhood Bladder and Bowel Dysfunction Questionnaire. J Physiother 2023; 69:193-194. [PMID: 37271694 DOI: 10.1016/j.jphys.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 06/06/2023] Open
Affiliation(s)
- Esther Bols
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, the Netherlands
| | - Emmylou Beekman
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, the Netherlands; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, the Netherlands
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Classen M, Righini-Grunder F, Schumann S, von Gontard A, de Laffolie J. Constipation in Children and Adolescents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:697-708. [PMID: 36261928 PMCID: PMC9830679 DOI: 10.3238/arztebl.m2022.0309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 04/24/2022] [Accepted: 08/16/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND According to a population-based study, approximately 6.8% of children and adolescents in Germany suffer from acute or chronic constipation. It can be of organic or functional origin and may be associated with comorbid disturbances, particularly fecal incontinence. METHODS We selectively searched the PubMed and Google Scholar databases for articles with the keywords "constipation," "children and adolescents," and "incontinence". Recommendations are based on the AWMF guideline on constipation and fecal incontinence and on international guidelines and reviews. RESULTS More than 90% of cases of chronic constipation are of functional origin. Organic causes vary with age and call for targeted differential diagnosis. Invasive tests are only rarely necessary. Functional constipation may be associated with fecal and urinary incontinence, and the relative risk of urinary tract infections is 2.2 to 6.5. There may be associated psychological symptoms and mental disorders in 30-50% of cases. The cornerstone of treatment is patient and parent education, along with laxative medication and toilet training. Instructional programs have been found effective in otherwise refractory cases. CONCLUSION The treatment of constipation in childhood should begin as soon as the differential diagnostic evaluation is completed. The education of parents, follow-up at close intervals, and drug treatment and behavioral therapy that are adapted to the symptoms can improve quality of life.
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Affiliation(s)
| | | | | | - Alexander von Gontard
- Psychiatric Services Graubünden (PDGR), Outpatient Services for Child and Adolescent Psychiatry, Chur, Switzerland; Governor Kremers Centre, Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan de Laffolie
- Department of General Pediatrics and Neonatology, Justus Liebig University Giessen, Standort Giessen,*Kindergastroenterologie, Abt. Allgemeine Pädiatrie und Neonatologie Universitätsklinikum Giessen und Marburg, Standort Giessen Feulgenstr. 12, 35392 Giessen, Germany
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Veriki M, Coomer A, V Simmonds J. Parental perceptions of bladder dysfunction in children with symptomatic joint hypermobility. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2021; 187:586-592. [PMID: 34845822 DOI: 10.1002/ajmg.c.31952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/16/2021] [Indexed: 06/13/2023]
Abstract
Children with symptomatic joint hypermobility (SJH) report chronic pain, fatigue, and joint instability as their main symptoms. Symptoms can extend beyond musculoskeletal and include lower urinary tract dysfunction (LUTD). There are no studies exploring parent-perceived quality of life (QoL) in children with LUTD, or strategies used to manage symptoms in this population. Our online cross-sectional survey assessed parents of 6-18-year-olds via two UK charitable organizations. It included the Pediatric Incontinence Questionnaire (PinQ), the Dysfunctional Voiding Symptom Score, and questions exploring treatments and efficacy. Sixty-seven parental questionnaires were analyzed. The majority of children were white females (95%, n = 64). Urgency (97%, n = 65) and enuresis (41.7%, n = 28) were the most frequently reported symptoms. The PinQ questionnaire showed that children were emotionally distressed by LUTD. Twenty-nine parents (43%, n = 29) reported pharmacotherapy as the most effective treatment. Few had accessed other treatments such as physiotherapy (16%, n = 18). Most parents reported that overall treatment did not meet their expectations. This study highlights that parents perceive LUTD as having a great impact on their child's QoL. There is need for education among clinicians about LUTD and hypermobility-related disorders, and for development and evaluation of treatments.
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Affiliation(s)
- Marianna Veriki
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Children's Physiotherapy, Homerton University Hospital, London, UK
| | - Annette Coomer
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Children's Physiotherapy, Imperial College Healthcare, NHS Trust, London, UK
| | - Jane V Simmonds
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- London Hypermobility Unit, Central Health Physiotherapy, Wellington Hospital, London, UK
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Wang R, Van den Heuvel M, Rickard M, El-Bardisi Y, Mistry N, Koyle M, Farhat W, Santos JD. Neurodevelopmental and psychiatric disorders in pediatric bladder and bowel dysfunction. J Pediatr Urol 2021; 17:450.e1-450.e6. [PMID: 33947637 DOI: 10.1016/j.jpurol.2021.03.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Bladder and bowel dysfunction (BBD) is a common pediatric problem that describes a constellation of lower urinary tract symptoms associated with constipation and/or encopresis. Its association with neurodevelopmental and psychiatric (NDP) problems is not well understood. OBJECTIVES Our primary aim was to identify pre-existing NDP disorders in children with BBD. Secondarily, we aimed to screen for new behavioral problems and evaluate the association between bladder or bowel symptoms and behaviors symptoms. METHODS A cross sectional study was conducted in urology clinics. New patients referred for BBD between 4 and 17 years old were recruited and completed: a demographics survey, Dysfunctional Voiding Score System questionnaire, assessment of bowel movements with the Bristol Stool Scale, and Strength and Difficulties questionnaire (SDQ). Those with known spinal dysraphism were excluded. SDQ scores were evaluated for abnormal screens in different subscales and total difficulties scores. Pearson correlation analyses were conducted for association. RESULTS We included 61 participants (age 9.5 ± 4.1 years), including 33 females and 28 males. One or more pre-existing NDP disorder(s) was reported in 14 (23%) children; most commonly being learning disability (43%) and attention deficit hyperactivity disorder (29%). This cohort had more severe BBD symptoms as reflected in DVSS scores. SDQ scores demonstrated that 12 patients without pre-existing NDP diagnoses scored in the clinical range, with hyperactivity as the most common difficulty (6/12; 50%). CONCLUSIONS A significant proportion of children with BBD have a comorbid NDP disorder and present with more severe symptomatology. The SDQ can be used as a behavioral screening tool this population for the identification of children who may benefit from formal developmental pediatrics assessment.
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Affiliation(s)
- Rebecca Wang
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada; Faculty of Art & Science, University of Toronto, Ontario, Canada
| | - Meta Van den Heuvel
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Mandy Rickard
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Ontario, Canada
| | - Yara El-Bardisi
- Faculty of Art & Science, University of Toronto, Ontario, Canada
| | - Niraj Mistry
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Martin Koyle
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Ontario, Canada
| | - Walid Farhat
- Division of Pediatric Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Joana Dos Santos
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Ontario, Canada.
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Lionarons JM, de Groot IJM, Fock JM, Klinkenberg S, Vrijens DMJ, Vreugdenhil ACE, Medici-van den Herik EG, Cuppen I, Jaeger B, Niks EH, Hoogerhuis R, Platte-van Attekum N, Feron FJM, Faber CG, Hendriksen JGM, Vles JSH. Prevalence of Bladder and Bowel Dysfunction in Duchenne Muscular Dystrophy Using the Childhood Bladder and Bowel Dysfunction Questionnaire. Life (Basel) 2021; 11:life11080772. [PMID: 34440515 PMCID: PMC8399211 DOI: 10.3390/life11080772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 07/27/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction: Lower urinary tract symptoms (LUTS) and gastrointestinal (GI) problems are common in Duchenne muscular dystrophy (DMD), but not systematically assessed in regular care. We aimed to determine the prevalence of bladder and bowel dysfunction (BBD) in DMD patients compared with healthy controls (HC). Methods: The Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ) based on the International Rome III criteria and the International Children’s Continence Society was filled out by 57 DMD patients and 56 HC. Additionally, possible associations of BBD with, for example, medication use or quality of life were evaluated in an additional questionnaire developed by experts. Results: In 74% of patients versus 56% of HC ≥ 1 LUTS (n.s.) were reported, 68% of patients versus 39% of HC reported ≥1 bowel symptom (p = 0.002) and 53% of patients versus 30% of HC reported combined LUTS and bowel symptoms (p = 0.019). A negative impact of BBD on daily life functioning was reported by 42% of patients. Conclusions: These data underscore that standard screening for BBD is needed and that the CBBDQ could be of added value to optimize DMD care.
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Affiliation(s)
- Judith M. Lionarons
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (S.K.); (C.G.F.)
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands;
- Correspondence: ; Tel.: +31-(0)43-3875058
| | - Imelda J. M. de Groot
- Department of Rehabilitation Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
- Duchenne Center Netherlands, 2333 ZA Leiden, The Netherlands; (E.H.N.); (J.G.M.H.)
| | - Johanna M. Fock
- Department of Neurology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Sylvia Klinkenberg
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (S.K.); (C.G.F.)
| | - Desiree M. J. Vrijens
- Department of Urology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
| | - Anita C. E. Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
| | | | - Inge Cuppen
- Department of Neurology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Bregje Jaeger
- Department of Neurology, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands;
| | - Erik H. Niks
- Duchenne Center Netherlands, 2333 ZA Leiden, The Netherlands; (E.H.N.); (J.G.M.H.)
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Rinske Hoogerhuis
- Youth Healthcare Center South Limburg, 6411 TE Heerlen, The Netherlands; (R.H.); (N.P.-v.A.)
| | | | - Frans J. M. Feron
- Department of Social Medicine, Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Catharina G. Faber
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (S.K.); (C.G.F.)
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Jos G. M. Hendriksen
- Duchenne Center Netherlands, 2333 ZA Leiden, The Netherlands; (E.H.N.); (J.G.M.H.)
- Center for Neurological Learning Disabilities, Kempenhaeghe, 5591 VE Heeze, The Netherlands
| | - Johan S. H. Vles
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands;
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Baaleman DF, Malamisura M, Benninga MA, Bali N, Vaz KH, Yacob D, Di Lorenzo C, Lu PL. The not-so-rare absent RAIR: Internal anal sphincter achalasia in a review of 1072 children with constipation undergoing high-resolution anorectal manometry. Neurogastroenterol Motil 2021; 33:e14028. [PMID: 33301220 PMCID: PMC8047870 DOI: 10.1111/nmo.14028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/21/2020] [Accepted: 10/16/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Our objective is to describe the prevalence of patients with internal anal sphincter achalasia (IASA) without Hirschsprung disease (HD) among children undergoing anorectal manometry (ARM) and their clinical characteristics. METHODS We performed a retrospective review of high-resolution ARM studies performed at our institution and identified patients with an absent rectoanal inhibitory reflex (RAIR). Clinical presentation, medical history, treatment outcomes, and results of ARM and other diagnostic tests were collected. We compared data between IASA patients, HD patients, and a matched control group of patients with functional constipation (FC). KEY RESULTS We reviewed 1,072 ARMs and identified 109 patients with an absent RAIR, of whom 28 were diagnosed with IASA. Compared to patients with FC, patients with IASA had an earlier onset of symptoms and were more likely to have abnormal contrast enema studies. Compared to patients with HD, patients with IASA were more likely to have had a normal timing of meconium passage, a later onset of symptoms, and were diagnosed at an older age. At the latest follow-up, the majority of patients diagnosed with IASA (54%) were only using oral laxatives. Over half of patients with IASA had been treated with anal sphincter botulinum toxin injection, and 55% reported a positive response. CONCLUSIONS AND INFERENCES Patients diagnosed with IASA may represent a more severe patient population compared to patients with FC, but have a later onset of symptoms compared to patients with HD. They may require different treatments for their constipation and deserve further study.
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Affiliation(s)
- Desiree F. Baaleman
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
- Department of Pediatric Gastroenterology and NutritionEmma Children’s Hospital, Amsterdam UMCUniversity of Amsterdam & VU UniversityAmsterdamthe Netherlands
- Amsterdam UMCUniversity of Amsterdam, Gastroenterology and HepatologyAmsterdam Gastroenterology Endocrinology MetabolismAmsterdamthe Netherlands
| | - Monica Malamisura
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
- Digestive endoscopy and surgery UnitBambino Gesù Children’s Hospital IRCCSRomeItaly
| | - Marc A. Benninga
- Department of Pediatric Gastroenterology and NutritionEmma Children’s Hospital, Amsterdam UMCUniversity of Amsterdam & VU UniversityAmsterdamthe Netherlands
| | - Neetu Bali
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Karla H. Vaz
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Desale Yacob
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Carlo Di Lorenzo
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Peter L. Lu
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
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Aydın G, van Engelenburg-van Lonkhuyzen ML, Baktır S, Kaya Mutlu E, Mutlu C, de Bie RA. The Turkish version of the childhood bladder and bowel dysfunction questionnaire (CBBDQ): Cross-cultural adaptation, reliability and construct validity. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:482-488. [PMID: 32721920 DOI: 10.5152/tjg.2020.19348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS Bladder and bowel dysfunction (BBD) are both prevalent health problems in pediatric population. The CBBDQ is a parent-reported tool to evaluate and quantitatively assess bladder and bowel dysfunction symptoms in pediatric patients. This study was designed for the translation the CBBDQ into Turkish and the cultural adaptation of CBBDQ for the use among 5-12-year-old children. Moreover, another aim of this study was that the determination of the reliability and construct validity of the Turkish version. The main hypothesis of our study was that the translation and cultural adaptation of the CBBDQ into Turkish language, so that Turkish parents could understand it. Additionally, we estimated that the Turkish version would have eventual internal consistency and test-retest reliability and admissible construct validity. MATERIALS AND METHODS The CBBDQ was guideline driven translated into Turkish language and administered two times to the parents of children with one week interval to assess test-retest reliability. The internal consistency was determined by using Cronbach's α value and the test-retest reliability was calculated by using the inter-rater correlation coefficient. For the estimation of construct validity, the Dysfunctional Voiding and Incontinence Scoring System (DVISS) and Pediatric Quality of Life Inventory (PedsQL) in 5-7, 8-12 years old children were used as the external criterias. RESULTS The participants were parents of 5-12-year-old children. The internal consistency was 0.83 that was the Cronbach's α value which reflects a good result. The Turkish-CBBDQ5-12y and the DVISS showed a satisfactory level correlation (r=0.64 P<0.001). There was not any correlation between the Turkish-CBBDQ5-12y and the PedsQL-General Health and PedsQL-Psychological Health (r=-0.17, P=0.1 and r:0.12 P=0.25, respectively). CONCLUSION The Turkish-CBBDQ5-12y version is a reliable and valid instrument in terms of the content and construction and can be confidently used in clinical practice.
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Affiliation(s)
- Gamze Aydın
- Division of Physiotherapy and Rehabilitation, İstanbul Okan University School of Health Sciences, Istanbul, Turkey;Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Education, Istanbul, Turkey
| | - Marieke L van Engelenburg-van Lonkhuyzen
- Deparment of Epidemiology, Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Seda Baktır
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Education, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Division of Physiotherapy and Rehabilitation, İstanbul University-Cerrahpasa School of Health Sciences, İstanbul, Turkey
| | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Bakirkoy Mazhar Osman Training and Research Hospital, İstanbul, Turkey
| | - Rob A de Bie
- Deparment of Epidemiology, Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
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Nieuwhof-Leppink AJ, Schroeder RPJ, van de Putte EM, de Jong TPVM, Schappin R. Daytime urinary incontinence in children and adolescents. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:492-501. [DOI: 10.1016/s2352-4642(19)30113-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/21/2019] [Accepted: 03/06/2019] [Indexed: 01/21/2023]
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Abstract
OBJECTIVE The aim of the review is to perform a systematic review of the literature examining the prevalence of bladder symptoms in children with functional constipation (FC) and to compare the prevalence of those symptoms between children with and without FC. METHODS In this systematic review 4 databases were searched to July 2018. Studies investigating the prevalence of bladder symptoms in children aged 4 to 17 years with FC were included. There was no language restriction. Two reviewers independently extracted data and assessed study quality. Clinical heterogeneity between studies was investigated. Prevalence rates of bladder symptoms in children with FC were calculated. Relative risks were calculated to compare the prevalence of bladder symptoms between children with and without FC. RESULTS Among 23 studies of children with FC, 22 reported the prevalence bladder symptoms (12,281 children) and 7 reported the prevalence of urinary tract infections (UTIs) (687 children). The prevalence rates of single bladder symptoms, lower urinary tract symptoms (LUTS), and UTI varied between 2% to 47%, 37% to 64%, and 6% to 53%. The relative risks were 1.24 to 6.73 for 20 single bladder symptoms (12 studies) and 2.18 to 6.55 for UTI (2 studies). The 95% confidence intervals indicated significance in 14 of 20 single bladder symptoms. CONCLUSIONS Bladder symptoms seem common in children with FC, but the reported prevalence varies greatly. Children with FC are more likely to have bladder symptoms than children without FC. We recommend that clinicians be aware of concomitant bladder symptoms in children presenting with FC.
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van Summeren JJGT, Holtman GA, Lisman- van Leeuwen Y, Louer LEAM, van Ulsen-Rust AHC, Vermeulen KM, Kollen BJ, Dekker JH, Berger MY. Physiotherapy plus conventional treatment versus conventional treatment only in the treatment of functional constipation in children: design of a randomized controlled trial and cost-effectiveness study in primary care. BMC Pediatr 2018; 18:249. [PMID: 30064408 PMCID: PMC6069950 DOI: 10.1186/s12887-018-1231-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/19/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Our aim was to design a study to evaluate the effectiveness and cost-effectiveness of adding physiotherapy to conventional treatment for children with functional constipation in primary care. Physiotherapy is focusing on improving the coordination between the pelvic floor and abdominal musculature during bowel movement, while conventional treatment is mainly focusing on symptomatic relief of symptoms, therefore, we expect the effects of physiotherapy will be more sustainable than the effects of conventional treatment. In this paper we describe the final study design and how the design was adapted, to overcome recruitment problems. METHODS We designed a randomized controlled trial of children aged 4-17 years with functional constipation diagnosed by a general practitioner or pediatrician. Children in the intervention group received physiotherapy plus conventional treatment, and those in the control group received conventional treatment only. Follow-up measurements took place at 4 and 8 months. The primary outcome was treatment success defined according to the Rome-III criteria as the absence of functional constipation, with no laxative use. Secondary outcomes were absence of functional constipation irrespective of laxative use, quality of life, global perceived effect, and costs. Children were recruited from September 2014 to February 2017. Initially, we aimed to include children with recent symptom onset. However, in the first phase of enrollment we were confronted with an unforeseen recruitment problem: many children and their parents refused randomization because physiotherapy was considered too burdensome for the stage of disease. Therefore, we decided to also include children with a longer duration of symptoms. In total 134 children were included. DISCUSSION The target number of participants is achieved. Therefore, the results may change thinking about the management of functional constipation in children. TRAIL REGISTRATION Netherlands Trial Register ( NTR4797 ), registered 8 September 2014.
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Affiliation(s)
- Jojanneke J. G. T. van Summeren
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gea A. Holtman
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne Lisman- van Leeuwen
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lisa E. A. M. Louer
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Karin M. Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Boudewijn J. Kollen
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Janny H. Dekker
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marjolein Y. Berger
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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