Woolery Myra, Carroll Ellen, Fenn Elizabeth, Wieland Holly, Jarosinski Paul, Corey Barbara, Wallen Gwenyth R
Research and Practice Development Service, Nursing and Patient Care Services at the National Institutes of Health, Bethesda, MD 20892-1664, USA.
J Pediatr Oncol Nurs. 2006 Mar-Apr;23(2):65-74. doi: 10.1177/1043454205285874.
Constipation is prevalent in pediatric oncology patients because of treatment with vinca alkaloids and/or narcotics and lifestyle changes secondary to disease process. Sequelae of constipation include anorexia, nausea, vomiting, abdominal pain, emergency department visits, and a decrease in quality of life. There are no reliable instruments to measure constipation in children. A pilot study (N = 21) evaluating the presence and severity of constipation and the reliability and validity of a modified version of the adult Constipation Assessment Scale (CAS) in children with cancer was conducted. Patients receiving weekly vinca alkaloids and/or narcotics = 2 times per day were recruited. Initial bowel function assessments included standardized nursing and nutrition assessments, history/physical review, and baseline CAS score repeated at 1 hour to assess test-retest reliability. Subsequent assessments included CAS administered 3 times per week and daily patient bowel diaries. Test-retest reliability was evident (r = .93; P = .000). Acceptable construct validity was indicated by a difference in mean CAS scores (t = 4.4, P <.001). Patients reported difficulty with CAS questions and response selections. Symptoms asked on CAS were often not viewed as a problem.
便秘在儿科肿瘤患者中很常见，这是由于长春花生物碱和/或麻醉药品的治疗以及疾病过程导致的生活方式改变。便秘的后遗症包括厌食、恶心、呕吐、腹痛、急诊就诊以及生活质量下降。目前尚无可靠的工具来测量儿童便秘情况。开展了一项试点研究（N = 21），评估癌症患儿便秘的存在情况和严重程度，以及成人便秘评估量表（CAS）修改版在儿童中的可靠性和有效性。招募了每周接受长春花生物碱治疗和/或每天使用麻醉药品≥2次的患者。初始肠道功能评估包括标准化护理和营养评估、病史/体格检查回顾，以及在1小时时重复进行的基线CAS评分，以评估重测信度。后续评估包括每周进行3次CAS评估和患者每日排便日记。重测信度明显（r = 0.93；P = 0.000）。平均CAS评分差异表明具有可接受的结构效度（t = 4.4，P <0.001）。患者报告在回答CAS问题和进行反应选择时存在困难。CAS所询问的症状通常不被视为问题。
