Group Treatment of Fecal Incontinence: A Description of an Interdisciplinary Intervention
| Autor: | Kelsey Gonring, Theresa Lauer Kapke, Alan H. Silverman, Manu R. Sood, Bridget K. Dolan, Andrea M. Begotka |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty MEDLINE Affect (psychology) Medical Records 03 medical and health sciences 0302 clinical medicine Behavior Therapy 030225 pediatrics Intervention (counseling) medicine Fecal incontinence Humans Family Child Retrospective Studies Patient Care Team Interdisciplinary treatment business.industry Medical record Gastroenterology Retrospective cohort study Group treatment Laxatives Child Preschool Pediatrics Perinatology and Child Health Physical therapy Patient Compliance 030211 gastroenterology & hepatology Female medicine.symptom business Fecal Incontinence |
| Zdroj: | Journal of pediatric gastroenterology and nutrition. 69(3) |
| ISSN: | 1536-4801 |
| Popis: | Introduction Approximately 5% of children in the United States have chronic fecal incontinence. Unfortunately, standard medical management of fecal incontinence fails in 20% to 60% of cases. A combined medical-behavioral model is often recommended in these cases. The purpose of this pilot study was to describe an interdisciplinary group-based treatment for fecal incontinence in school-aged children, and to present a description of changes in treatment adherence rates that affect clinical effectiveness. Method Poop group employed a developmentally appropriate model of care in which caregivers and children participated in separate but simultaneously held therapy groups. This interdisciplinary 6-week protocol is designed to increase appropriate stooling, decrease soiling events, and increase medication adherence pre- to post-treatment. Group sessions focus on the GI system, medication, toilet sitting posture, hydration, fiber, and behavior contracts. In addition, participant families consult with an Advanced Nurse Practitioner privately at each session discussing symptoms and making medication modifications as needed. Results Nineteen families completed the 6-week protocol. Appropriate stool frequency was improved (P ≤ 0.01), and soiling was reduced (P ≤ 0.00). Medication adherence was also improved (P ≤ 0.04). Treatment results were maintained at 1-month follow-up. Discussion A developmentally targeted intervention and interdisciplinary focus of treatment likely account for treatment successes. Conclusion Poop group may be an effective interdisciplinary treatment option for families of children who fail traditional outpatient treatment. |
| Databáze: | OpenAIRE |
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