Colares João H F, Purcaru Marionescu, da Silva Guilherme P F, Frota Mirna A, da Silva Carlos A B, Melo-Filho Antônio A, Bischoff Andrea, Peña Alberto
Pediatric Surgery Section, Albert Sabin Pediatric Hospital (HIAS), Tertuliano Sales, 544-Vila União, Fortaleza, Ceará, CEP: 60430-230, Brazil.
Nursing Department, Albert Sabin Pediatric Hospital (HIAS), Fortaleza, Ceará, Brazil.
Pediatr Surg Int. 2016 May;32(5):471-6. doi: 10.1007/s00383-016-3874-5. Epub 2016 Feb 13.
Evaluate the impact of implementing Bowel Management Program (BMP) on quality of life (QoL) in children with fecal incontinence (FI).
Children 3-12 years referred to the Children's Treatment Center of FI were included and categorized accordingto the tendency to constipation (dilated colon; group 1) or diarrhea (non-dilated colon; group 2). Evaluations were performed before and after 3 months of BMP implementation. Perceptions from parents and children about QoL were assessed by the instrument PedsQL4.0 and the severity of FI by the fecal incontinence index (FII) of Wexner scale.
43 children (mean age of 7.7 ± 3.1) were studied. 32 (74.4 %) belonged to group 1 and 11 (25.6 %) to group 2. After 3 months of BMP, it was noticed a significant improvement of the FII (14.5 ± 3.7 versus 2.8 ± 2.5; p < 0.001) in both groups. QoL perception by the parents and children increased on PedsQL4.0 evaluation (p < 0.001). There was a medium inverse statistically significant correlation of the FII and the total PedsQL4.0 score among children and parents (r = -0.47, p = 0.009 and r = -0, 39, p = 0.03, respectively).
The BMP applied by a multidisciplinary dedicated team significantly improves the QoL of children with FI in the short-term period.
评估实施肠道管理计划(BMP)对大便失禁(FI)儿童生活质量(QoL)的影响。
纳入3至12岁转诊至儿童大便失禁治疗中心的儿童,并根据便秘倾向(结肠扩张;第1组)或腹泻倾向(结肠未扩张;第2组)进行分类。在实施BMP 3个月前后进行评估。通过PedsQL4.0工具评估家长和儿童对生活质量的认知,并通过韦克斯纳量表的大便失禁指数(FII)评估大便失禁的严重程度。
共研究了43名儿童(平均年龄7.7±3.1岁)。32名(74.4%)属于第1组,11名(25.6%)属于第2组。实施BMP 3个月后,两组的FII均有显著改善(14.5±3.7对2.8±2.5;p<0.001)。在PedsQL4.0评估中,家长和儿童对生活质量的认知有所提高(p<0.001)。儿童和家长中FII与PedsQL4.0总分之间存在中等程度的负相关,且具有统计学意义(r分别为-0.47,p=0.009和r=-0.39,p=0.03)。
由多学科专业团队实施的BMP在短期内可显著提高大便失禁儿童的生活质量。