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The effectiveness of bowel and bladder interventions in children with spina bifida
Author(s) -
Smith Kathryn,
NevilleJan Ann,
Freeman Kurt A,
Adams Elizabeth,
Mizokawa Stacey,
Dudgeon Brian J,
Merkens Mark J,
Walker William O
Publication year - 2016
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13095
Subject(s) - spina bifida , bowel management , urinary continence , medicine , psychological intervention , quality of life (healthcare) , urinary incontinence , international classification of functioning, disability and health , intervention (counseling) , physical therapy , fecal incontinence , pediatrics , rehabilitation , constipation , nursing , urology , surgery , prostate , cancer , prostatectomy
Aim Using the World Health Organization International Classification of Functioning, Disability and Health ( ICF ), the aim of this study was to identify effective strategies for managing urinary and bowel complications resulting from spina bifida. Method Charts of 210 children between 4‐ and 13‐years‐old with spina bifida were reviewed to quantify medical interventions and continence status. Standardized quality of life ( QOL ) questionnaires were administered to a subset of participants; child and parent interviews were carried out to examine the experience of living with bowel and bladder incontinence. Practitioners were also interviewed to understand their perspectives of intervention effectiveness. Results Chart review indicated less than half of children were continent for bowel and bladder. More variability existed in bowel continence programs, and practitioners considered bowel continence more difficult to achieve than bladder continence. No significant associations were found between continence status and QOL measures. Interviews, however, reflected how managing continence at home and school more broadly affects QOL . Among practitioners, some focused primarily on optimizing physical health while others focused on activity and participation. Interpretation While continence is a goal, programs used to achieve this are individualized and outcomes may be affected by differential treatment effects, environmental factors, and/or stigma experienced by children.