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Use of validated bladder/bowel dysfunction questionnaire in the clinical pediatric urology setting
Beth A Drzewiecki1, John C Thomas, John C Pope
1Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee 37232-9820, USA. beth.a.drzewiecki@vanderbilt.edu
Insights
A validated bladder/bowel dysfunction questionnaire effectively aids pediatric urology assessments. It helps families define symptoms, though some may struggle with completion.
Area of Science:
- Pediatric Urology
- Clinical Assessment Tools
- Patient-Reported Outcomes
Background:
- Pediatric bladder/bowel dysfunction (BBD) assessment tools are emerging research instruments.
- Clinical utility of these questionnaires in busy pediatric urology settings requires evaluation.
Purpose of the Study:
- To assess the effectiveness of a validated BBD questionnaire in a clinical pediatric urology setting.
- To determine if questionnaire scores correlate with physician diagnoses and specific BBD symptoms.
Main Methods:
- A validated BBD questionnaire was administered to new pediatric urology outpatients over age 4.
- Physicians were blinded to questionnaire responses during the study.
- Scores were compared between patients with BBD-related and unrelated diagnoses, and for specific symptoms like urinary incontinence and nocturnal enuresis.
Main Results:
- 267 of 358 (75%) questionnaires were scorable.
- Patients with BBD-related diagnoses had significantly higher overall questionnaire scores (p <0.001).
- Specific symptoms like urinary incontinence, dysuria, and nocturnal enuresis correlated with higher scores on corresponding questionnaire items, but constipation did not.
Conclusions:
- The validated BBD questionnaire is a valuable clinical tool in pediatric urology, correlating with physician assessments.
- It empowers patients and families to articulate BBD symptoms prior to appointments.
- Inconsistent completion by some families was noted, indicating a need for support or alternative methods.
Purpose:
Questionnaires to quantify pediatric bladder/bowel dysfunction have recently been developed as research instruments. We evaluated our use of a bladder/bowel dysfunction questionnaire in a busy clinical setting.
Materials And Methods:
We distributed a validated bladder/bowel dysfunction questionnaire to all new pediatric urology outpatients older than age 4 years from May 1 to July 31, 2010. We instructed families to complete the questionnaire without assistance. Physicians were blinded to responses during the study period. We compared total scores between groups of patients with bladder/bowel dysfunction related and bladder/bowel dysfunction unrelated primary diagnoses. We also compared individual item scores pertaining to urinary incontinence, dysuria, nocturnal enuresis and constipation in patients with those specific primary ICD-9 diagnosis codes to those of other bladder/bowel dysfunction related diagnoses.
Results:
Of 358 questionnaires reviewed 91 (25%) could not be adequately scored. Of the remaining 267 patients 134 had bladder/bowel dysfunction related diagnoses and 133 had bladder/bowel dysfunction unrelated diagnoses. The patients with bladder/bowel dysfunction related diagnoses had a higher score on the validated questionnaire (p <0.001). Patients with primary ICD-9 diagnoses for urinary incontinence (p = 0.0026, p = 0.0164), dysuria (p = 0.008) and nocturnal enuresis (p <0.0001) had higher scores on corresponding items of the questionnaire than those with other bladder/bowel dysfunction related diagnoses. The ICD-9 diagnosis of constipation was not associated with higher scores for constipation related items.
Conclusions:
A validated bladder/bowel dysfunction questionnaire is a useful tool in the pediatric urology clinical setting that correlates well with physician assessment. The questionnaire can help patients and their families better define their bladder/bowel symptoms before their visit. Some families will not be able to fill out the questionnaire appropriately.
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