TY - JOUR
T1 - Development of a Bowel Management Scoring Tool in Pediatric Patients with Constipation
AU - de Bruijn, Clara M. A.
AU - Safder, Shaista
AU - Rolle, Udo
AU - Mosiello, Giovanni
AU - Marshall, David
AU - Christiansen, Albert B.
AU - Benninga, Marc A.
N1 - Funding Information: We thank all the patients and parents who took part in this study. We also thank Henrik Wachmann (Principal Statistician at Larix) for his contributions to and supervision of the statistical analyses, Shaëlla Ons and Carly Zwaan (research assistants at Emma Children's Hospital, Amsterdam University Medical Center) for data processing, and Lia Walhagen and Albert Christiansen (Coloplast) for their contributions to the project. Funding for this study was provided by Coloplast A/S. The funding source had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation of the manuscript. S.S., U.R., G.M., D.M., and A.C. serve as consultants for Coloplast. M.B. serves as a consultant for Shire, Norgine, Danone, Takeda, Allergan, FrieslandCampina, United Pharmaceuticals, HiPP, and Coloplast. The other authors declare no conflicts of interest. Funding Information: Funding for this study was provided by Coloplast A/S. The funding source had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation of the manuscript. S.S., U.R., G.M., D.M., and A.C. serve as consultants for Coloplast. M.B. serves as a consultant for Shire, Norgine, Danone, Takeda, Allergan, FrieslandCampina, United Pharmaceuticals, HiPP, and Coloplast. The other authors declare no conflicts of interest. Publisher Copyright: © 2022 The Author(s)
PY - 2022/5
Y1 - 2022/5
N2 - Objective: To develop a reliable and valid scoring tool, the Pediatric Bowel Management Scoring Tool (PBMST), to better guide management of constipation in pediatric patients. Study design: The project comprised 2 stages, development of the questionnaire and construction of the bowel management score. Two questionnaires were created, one for children aged 8-18 years to self-report and one parent proxy-report for children aged 4-8 years. Questions regarding physical symptoms (n = 6), emotional aspects (n = 2), social activities/school (n = 1), and treatment (n = 1) were included. Patients (or parents of patients) with symptoms of constipation completed the questionnaire. The reproducibility of each question was computed using the Cohen weighted kappa coefficient (κ). A bowel management score was developed using logistic regression analysis, assessing the associations between the questions and impact on self-reported quality of life (QoL). Questions with adequate reproducibility and significantly associated with QoL were incorporated into the score. Results: The questionnaire was completed by 385 patients. Six questions met the inclusion criteria and were incorporated into the score: stool shape (range, 0-3 points), anorectal pain (0-4 points), abdominal pain (0-3 points), frequency of fecal incontinence (0-3 points), assistance of caregivers (0-3 points), and interference with social activities (0-6 points). Differences in bowel management scores among patients reporting no, little, some, or major impact on QoL were statistically significant (P <.001). Conclusions: The newly developed and validated PBMST is a reliable tool for evaluating bowel management strategies in children with constipation.
AB - Objective: To develop a reliable and valid scoring tool, the Pediatric Bowel Management Scoring Tool (PBMST), to better guide management of constipation in pediatric patients. Study design: The project comprised 2 stages, development of the questionnaire and construction of the bowel management score. Two questionnaires were created, one for children aged 8-18 years to self-report and one parent proxy-report for children aged 4-8 years. Questions regarding physical symptoms (n = 6), emotional aspects (n = 2), social activities/school (n = 1), and treatment (n = 1) were included. Patients (or parents of patients) with symptoms of constipation completed the questionnaire. The reproducibility of each question was computed using the Cohen weighted kappa coefficient (κ). A bowel management score was developed using logistic regression analysis, assessing the associations between the questions and impact on self-reported quality of life (QoL). Questions with adequate reproducibility and significantly associated with QoL were incorporated into the score. Results: The questionnaire was completed by 385 patients. Six questions met the inclusion criteria and were incorporated into the score: stool shape (range, 0-3 points), anorectal pain (0-4 points), abdominal pain (0-3 points), frequency of fecal incontinence (0-3 points), assistance of caregivers (0-3 points), and interference with social activities (0-6 points). Differences in bowel management scores among patients reporting no, little, some, or major impact on QoL were statistically significant (P <.001). Conclusions: The newly developed and validated PBMST is a reliable tool for evaluating bowel management strategies in children with constipation.
KW - bowel management
KW - children
KW - constipation
UR - http://www.scopus.com/inward/record.url?scp=85125486560&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpeds.2022.01.036
DO - https://doi.org/10.1016/j.jpeds.2022.01.036
M3 - Article
C2 - 35114289
SN - 0022-3476
VL - 244
SP - 107-114.e1
JO - Journal of pediatrics
JF - Journal of pediatrics
ER -