University of Iowa, Departments of Urology, USA.
University of Iowa, Departments of Internal Medicine, USA.
J Pediatr Urol. 2019 Oct;15(5):528.e1-528.e8. doi: 10.1016/j.jpurol.2019.07.016. Epub 2019 Jul 27.
Pediatric bladder and bowel dysfunction (BBD) is a common problem in children. However, the current ability to diagnosis and quantify pediatric BBD is limited as only a few validated instruments exist. In addition, the current questionnaires are limited by their lack of psychometric processing and methods of validation. To address these issues, the authors developed a new questionnaire to objectively diagnose pediatric BBD symptoms. This study aimed to evaluate the performance of this newly devised objective instrument in diagnosing and quantifying the symptomatology of BBD in children.
An 18-item, 5-point questionnaire was developed using both a literature review and expert opinions. The total questionnaire score could range from 0 to 72. Questions were subgrouped into six symptom categories: (1) nocturnal enuresis, (2) lower urinary tract symptoms, (3) urinary holding, (4) infrequent urination, (5) bowel symptoms, and (6) daytime urinary incontinence. The questionnaire also assessed the degree of bother associated with the symptoms. Patients were divided into cases and controls, and these two groups were compared.
DISCUSSION/RESULTS: A total of 1265 new patients (758 cases and 507 controls) completed the new BBD questionnaire. The mean age of the whole study cohort was 9.5 years (range, 3-19 years). The total mean questionnaire score was significantly higher at 23 (3-58) in the cases, compared with 8 (0-35) in the controls (p < 0.001) (Summary Figure). Reliability analysis of the 18-item instrument showed a Cronbach's alpha reliability coefficient of 0.80 for the scale.
This new instrument provides a valid and reliable method for diagnosis of pediatric BBD and classification of patients into subcategories of BBD based on their specific symptoms.
小儿膀胱和肠道功能障碍（BBD）是儿童常见的问题。然而，目前诊断和量化小儿 BBD 的能力有限，因为只有少数经过验证的工具存在。此外，目前的问卷受到其缺乏心理测量处理和验证方法的限制。为了解决这些问题，作者开发了一种新的问卷来客观诊断小儿 BBD 症状。本研究旨在评估这种新设计的客观仪器在诊断和量化儿童 BBD 症状方面的性能。
使用文献回顾和专家意见制定了一个 18 项 5 分制问卷。总问卷得分范围为 0 至 72。问题分为六个症状类别：（1）夜间遗尿，（2）下尿路症状，（3）尿潴留，（4）排尿不频繁，（5）肠道症状，（6）白天尿失禁。问卷还评估了与症状相关的困扰程度。患者分为病例组和对照组，对这两组进行比较。
讨论/结果：共有 1265 名新患者（758 例病例和 507 例对照组）完成了新的 BBD 问卷。整个研究队列的平均年龄为 9.5 岁（范围，3-19 岁）。病例组的总平均问卷得分为 23（3-58），明显高于对照组的 8（0-35）（p <0.001）（总结图）。对 18 项仪器的可靠性分析显示，该量表的克朗巴赫α信度系数为 0.80。
这种新工具为小儿 BBD 的诊断和根据患者的特定症状将其分类为 BBD 的亚类提供了一种有效和可靠的方法。
