Kooiman, L.M.P. (2013) Testing a Gastrointestinal module for Quality of Life assessment in Children with Chronic Constipation – A Pilot Study. thesis, Medicine.
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Abstract
Introduction: Constipation is the most common digestive disorder in adults and children. It can be a debilitating problem causing soiling, recurrent faecal impaction, functional and emotional problems for child and family affecting their quality of life (QOL). Paediatric General QOL assessment tools such as PedsQL4.0 have been developed; however, generic tools may not pick up subtle changes caused by treatment within an individual patient with a specific condition such as constipation. Constipation specific QOL questionnaires are available for adults, but not for children. The PedsQL Gastrointestinal Symptom Scale (GISS) has been developed for disease specific QOL assessment in children with irritable bowel syndrome. This pilot study aimed to determine whether the GISS can be a useful tool measuring QOL in children with chronic constipation (CC). Methods: PedsQL4.0 and GISS were distributed to parents and their children with CC at two times with a 4-6 week interval in a nurse-led clinic (n = 8) and a paediatric surgical clinic (n = 10). The 8 children in the nurse-led clinic were disimpacted with polyethelene glycol and sodium picosulphate between the first and second time point; while patients in the surgical clinic were not disimpacted. Data was retrospectively obtained from histories. 18 healthy children and their parents filled in the same questionnaires. Explorative and non-parametric statistical tests were used to interpret the data. Results: Children with constipation had a mean GISS score of 59.4 (SD 23.3), while healthy controls had a significant higher mean score of 86.3 (SD 15.4) (P<0.001). GISS had a good internal consistency (Cronbach’s alpha 0.88), but symptoms described in histories were more severe than the GISS was able to capture. 5 patients with data available before and after disimpaction in the nurse-led clinic had no significant changes in GISS or in PedsQL scores. There were also no significant changes in the surgical clinic within 4-6 weeks. Conclusions: GISS is able to discriminate between children with constipation and healthy children, however it does not reflect the severity of symptoms being described in the patient histories. Recommendations: A proper validation study with larger numbers would be needed to make reliable conclusions, however based on the results in this small pilot study we recommend investigating other measuring tools for constipation specific QOL, such as the relatively new Defecation Disorder List (available in Dutch, not yet published in English).
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Smits, Drs. P. |
| Supervisor name: | Hutson, Professor J.M. and Southwell, Dr. B. and Murdoch Childrens Research Institute and Melbourne, Australia |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/732 |
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