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Pinto FNCS, de Bessa J, Bastos JM, Dias GCM, Vasconcelos MMDA, Lima EM, Almeida TDS, Silva ACSE, Mrad FCDC. Validation of the Vancouver Symptom Score Questionnaire for bladder and bowel dysfunction for Brazilian children and adolescents. Int Braz J Urol 2022; 49:110-122. [PMID: 36512459 PMCID: PMC9881813 DOI: 10.1590/s1677-5538.ibju.2022.0495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/28/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to translate, and perform a cross-cultural adaptation, and validation of the Vancouver Symptom Score (VSS) for bladder and bowel dysfunction (BBD) for Brazilian children and adolescents Materials and Methods: Six steps were performed for the translation and cross-cultural adaptation: (1) translation, (2) synthesis of translations, (3) back-translation, (4) pre-final version of the translated instrument, (5) pilot test and degree of comprehensibility and (6) elaboration of the Brazilian version of the VSS. For validation, the Brazilian Dysfunctional Voiding Score (DVSS) questionnaire was used. RESULTS Validation was performed on a sample of 107 children and adolescents with a mean age of 9.2 ± 2.84 years, presenting BBD and 107 without BBD (control group-CG). There was a positive correlation (r = 0.91, 95% CI 0.88 to 0.93, p < 0.0001) between total VSS score and total DVSS score. VSS was higher in patients with BBD (p < 0.0001). The internal consistency estimated by Cronbach's alpha was 0.87 for patients with BBD. The VSS showed excellent diagnostic accuracy in detecting cases, with an area under the ROC curve of 98% (95% CI 0.96 to 0.99, p < 0.001). A cut-off value of >11 points produced a sensitivity of 100% (95% CI 96.4% to 100%) and a specificity of 91.8% (95% CI 85.1% to 95.6%). CONCLUSION The translated, cross-culturally adapted, and validated VSS for the Brazilian population is a reliable and valid tool to identify symptoms of BBD in children and adolescents aged five to 16 years, whose first language is Brazilian Portuguese.
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Affiliation(s)
- Fernanda Nunes Coelho Siqueira Pinto
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - José de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de UrologiaFeira de SantanaBABrasilDepartamento de Urologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - José Murillo Bastos
- Universidade Federal de Juiz de ForaFaculdade de MedicinaDepartamento de UrologiaJuiz de ForaMGBrasilDepartamento de Urologia, Faculdade de Medicina, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil,Faculdade de Ciências Médicas de Juiz de Fora e Maternidade Therezinha de JesusDepartamento de UrologiaJuiz de ForaMGBrasilDepartamento de Urologia, Faculdade de Ciências Médicas de Juiz de Fora e Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brasil
| | - Gláucia Cristina Medeiros Dias
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Mônica Maria de Almeida Vasconcelos
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Eleonora Moreira Lima
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Tailly de Souza Almeida
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil,Universidade Federal de Minas GeraisLaboratório Interdisciplinar de Investigação MédicaBelo HorizonteMGBrasilLaboratório Interdisciplinar de Investigação Médica, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Flávia Cristina de Carvalho Mrad
- Universidade Federal de Minas GeraisFaculdade de MedicinaUnidade de Nefrologia PediátricaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil,Correspondence address: Flávia Cristina de Carvalho Mrad, MD, Departamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Alfredo Balena 190. sala 267, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brasil. E-mail:
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Sumboonnanonda A, Sawangsuk P, Sungkabuth P, Muangsampao J, Farhat WA, Piyaphanee N. Screening and management of bladder and bowel dysfunction in general pediatric outpatient clinic: a prospective observational study. BMC Pediatr 2022; 22:288. [PMID: 35581653 PMCID: PMC9110931 DOI: 10.1186/s12887-022-03360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/16/2022] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Bladder and bowel dysfunction (BBD) is a common disorder in children that is often associated with psychosocial and behavioral problems. Data specific to BBD in Asian children are comparatively scarce. Accordingly, this study aimed to investigate the prevalence of BBD and the response to standard urotherapy among Thai children attending the general pediatric outpatient clinic of Siriraj Hospital - Thailand's largest national tertiary referral center. METHODS: Children aged 4-12 years were recruited to complete the Dysfunctional Voiding Symptom Score (DVSS) questionnaire to screen for BBD during 2018 to 2020. Standard urotherapy, which consists of education and behavior management, was prescribed to those with a DVSS score that suggests the presence of BBD. Enrolled children and their caregivers were followed-up at 3 and 6 months. The Strengths and Difficulties Questionnaire (SDQ) was completed at baseline. DVSS scores at baseline, and at 3 months and 6 months after standard urotherapy were compared using repeated measures analysis of variance (ANOVA). RESULTS A total of 1,042 children completed the DVSS during the study period, and 90 (8.6%) were deemed to have BBD. The mean age of BBD children was 6.9 ± 2.2 years, and the female to male ratio was 2.9:1. The most common symptoms were defecation frequency (80.0%), difficult defecation (80.0%), curtsying (74.4%), urgency (68.9%), infrequent voiding (43.3%), and daytime incontinence (32.2%). Forty-one BBD children completed the SDQ, and 32.5% had scores suggestive of hyperactivity problems. Among the 24 BBD patients who were followed-up after 3 and 6 months of standard urotherapy, there was a significant improvement in DVSS results (9.5 ± 3.1 at baseline vs. 6.9 ± 3.4 at 3 months vs. 4.4 ± 3.9 at 6 months; p < 0.01). Nine of 12 patients with urinary incontinence showed complete response at 6 months. The overall Bristol stool score significantly improved from 2.6 ± 0.7 at baseline to 3.2 ± 1.0 at 6 months (p = 0.03). CONCLUSIONS BBD is a prevalent condition among Thai children that is often associated with emotional and behavioral problems. Standard urotherapy prescribed in a general pediatric outpatient clinic setting yielded favorable outcomes in Thai children with BBD.
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Affiliation(s)
- Achra Sumboonnanonda
- Division of Nephrology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Punnarat Sawangsuk
- Division of Nephrology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Patharawan Sungkabuth
- Pediatric Nursing Division, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Janpen Muangsampao
- Pediatric Nursing Division, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Walid A Farhat
- Department of Urology, University of Wisconsin, Madison, WI, USA
| | - Nuntawan Piyaphanee
- Division of Nephrology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
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