Validation of a bowel dysfunction instrument for adolescents with spina bifida
| Autor: | Georgios D. Sideridis, Rebecca Sherlock, Kathryn L. Johnson, Stuart B. Bauer, Samuel Nurko, Ilina Rosoklija, Greta Kringle, Jennifer Queally, Katherine C. Hubert |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Constipation Adolescent Urology Population Urinary incontinence Quality of life medicine Fecal incontinence Humans education Child Defecation Spinal Dysraphism Retrospective Studies Response rate (survey) education.field_of_study Spina bifida business.industry Reproducibility of Results medicine.disease Cross-Sectional Studies Sample size determination Pediatrics Perinatology and Child Health Physical therapy Quality of Life Female medicine.symptom business Fecal Incontinence |
| Zdroj: | Journal of pediatric urology. 11(4) |
| ISSN: | 1873-4898 |
| Popis: | Introduction Existing survey instruments for bowel dysfunction in the pediatric population are either parent-reported or focus on non-neurogenic bowel dysfunction. Objective The purpose of this study was to develop and validate an adolescent-reported survey to assess the severity of bowel dysfunction in spina bifida patients and examine its impact on quality of life (QOL). Study design We performed a cross-sectional study of patients in our Myelodysplasia Program, aged 11–17 years, with a history of constipation and/or fecal incontinence (FI) from November 2010 to June 2013. Control patients, aged 11–17 years, were recruited from the stone clinic. Exclusion criteria were lack of English fluency, insufficient reading skills, or an incontinent fecal diversion. A 29-item version of the Adolescent Fecal Incontinence and Constipation Symptom Index (A-FICSI) was developed with five domains (Figure). Test re-test reliability and correlation with the total global health-related QOL score from the Parkin survey were measured using the Pearson correlation coefficient. A factor analysis model with four-fold correlations was tested. Results Of the 65 study-eligible individuals approached, 25 (11 boys) completed the A-FICSI (median age 12.6 years, IQR 11.8–14.7 years) and 17 completed another survey on urinary incontinence (64.6% response rate). Twenty-one control patients with nephrolithiasis completed the A-FICSI. Nine of the 25 completed a second administration of the survey. The mean correlation between repeated administrations of the survey was r = 0.43. There was a significant negative correlation between severity of constipation (r = −0.299, p 0.30) in the predicted direction. Unstandardized residuals were 8.7% (95% CI 6.4–10.9%). Item reduction was performed on the 29-item instrument based on results of the factor analysis. The finalized instrument contained 21 items. Discussion This is the first adolescent-reported bowel dysfunction instrument to undergo formal psychometric assessment in the spina bifida population. The instrument demonstrated adequate reliability and the five-factor structure fit the data well. This study highlights the negative impact of bowel dysfunction on the QOL of spina bifida patients. It is limited by the moderate sample size that is a common issue in relatively rare diseases. Conclusion The A-FICSI possesses desirable psychometric properties for the measurement of bowel dysfunction in the spina bifida population. Figure. Conceptual model of the Adolescent Fecal Incontinence and Constipation Symptom Index. Figure options Download full-size image Download high-quality image (276 K) Download as PowerPoint slide |
| Databáze: | OpenAIRE |
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