大便失禁儿童的生活质量评估
Quality-of-life assessment in children with fecal incontinence.
作者信息
Filho Humberto S, Mastroti Roberto A, Klug Wilmar A
机构信息
1 Department Pediatric of Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil 2 Department Pediatric of Santa Casa de São Paulo Medical School, São Paulo, Brazil 3 Department of Surgery of Santa Casa de São Paulo Medical School, São Paulo, Brazil.
出版信息
Dis Colon Rectum. 2015 Apr;58(4):463-8. doi: 10.1097/DCR.0000000000000324.
BACKGROUND
Fecal incontinence is a clinical condition that causes embarrassment and changes the perception of quality of life. The absence of a specific tool for assessing fecal incontinence in children led us to adapt an instrument originally developed for adults, which has already been validated into Portuguese.
OBJECTIVE
The purpose of this work was to evaluate the quality of life of children with fecal incontinence.
DESIGN
This is a single-center, prospective study based on the application of survey. The Fecal Incontinence Quality of Life questionnaire was modified by eliminating 2 questions related to sexuality and by substituting the word "depressed" with "sad" in the statement, "I feel depressed."
SETTING
The study took place at a tertiary academic medical center.
PATIENTS
Forty-one children >5 years of age, with incontinence of organic etiology and preserved cognition but without stomy, were interviewed with the use of the Fecal Incontinence Quality of Life modified questionnaire. To evaluate the discrimination validity, 28 healthy children were interviewed as control subjects.
MAIN OUTCOME MEASURES
As to reproducibility, a test/retest was performed, involving 25 children. For construct validation, the Fecal Incontinence Quality of Life modified was correlated with the generic instrument Autoquestionnaire Qualité de Vie Enfant Imagé with the continence index São Paulo Score of Continence.
RESULTS
The average values by scale included lifestyle, 3.1; emotional, 2.8; behavior, 2.3; and embarrassment, 1.6. The average values for the control group included lifestyle, 3.7; emotional, 4.0; behavior, 3.6; and embarrassment, 3.6. The instrument showed a general reliability of 0.78, measured by the Cronbach α. Reproducibility was also >0.90 according to the Cronbach α.
LIMITATIONS
The intrinsic characteristics of children include their constant growth, and this presented a challenge in our search for an instrument that permitted us to identify and measure these variations.
CONCLUSIONS
The experiment showed a reduction in all of the scale values, particularly for embarrassment in children with fecal incontinence.
背景
大便失禁是一种会导致尴尬并改变生活质量认知的临床病症。由于缺乏评估儿童大便失禁的特定工具，我们对最初为成人开发的一种工具进行了改编，该工具已被验证可用于葡萄牙语环境。
目的
本研究旨在评估大便失禁儿童的生活质量。
设计
这是一项基于问卷调查应用的单中心前瞻性研究。对大便失禁生活质量问卷进行了修改，删除了2个与性相关的问题，并将陈述“我感到沮丧”中的“沮丧”一词替换为“悲伤”。
地点
研究在一家三级学术医疗中心进行。
患者
41名5岁以上因器质性病因导致失禁且认知功能正常但无造口的儿童，使用修改后的大便失禁生活质量问卷进行访谈。为评估区分效度，选取28名健康儿童作为对照进行访谈。
主要观察指标
关于可重复性，对25名儿童进行了重测。为进行结构效度验证，将修改后的大便失禁生活质量问卷与通用工具《儿童形象化生活质量自填问卷》以及圣保罗失禁指数进行相关性分析。
结果
各量表的平均值如下：生活方式方面为3.1；情绪方面为2.8；行为方面为2.3；尴尬方面为1.6。对照组的平均值如下：生活方式方面为3.7；情绪方面为4.0；行为方面为3.6；尴尬方面为3.6。该工具通过克朗巴赫α系数测量的总体信度为0.78。根据克朗巴赫α系数，重测信度也>0.90。
局限性
儿童的内在特点包括持续生长，这给我们寻找一种能够识别和测量这些变化的工具带来了挑战。
结论
实验表明，所有量表值均有所降低，尤其是大便失禁儿童的尴尬量表值。
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