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Childhood Bladder and Bowel Dysfunction Questionnaire: Development, Feasibility, and Aspects of Validity and
Marieke L van Engelenburg-van Lonkhuyzen1, Esther M J Bols, Caroline H G Bastiaenen
1*Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht †Department of Paediatric Gastroenterology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Insights
A new 18-item questionnaire, the Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ), effectively assesses symptom frequency in children aged 5-12. It is a feasible, valid, and reliable tool for evaluating childhood bladder and bowel dysfunctions.
Area of Science:
- Pediatrics
- Urology
- Gastroenterology
Background:
- Childhood bladder and bowel dysfunctions (CBBDs) are common and can significantly impact a child's quality of life.
- Concomitant CBBDs are prevalent, affecting a majority of children with these conditions.
- There is a need for reliable and valid instruments to track symptom frequency over time.
Purpose of the Study:
- To develop and validate the Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ).
- To assess the frequency of symptoms related to CBBDs in children aged 5 to 12 years.
- To evaluate the feasibility, validity, and reliability of the CBBDQ.
Main Methods:
- The CBBDQ was developed in phases following COSMIN standards, involving item selection (Delphi method), content validity (pilot testing), feasibility (interviews), and structural validity/internal consistency (field testing).
- The study included parents of 1333 children aged 5 to 12 years.
- Psychometric properties were evaluated using Cronbach's alpha for internal consistency and other statistical measures for validity and reliability.
Main Results:
- The final 18-item CBBDQ demonstrated satisfactory feasibility, content validity, structural validity, and internal consistency (Cronbach's α = 0.74 for bladder, 0.71 for bowel subscales).
- Prevalence data indicated urinary incontinence (35.9%), enuresis (29.7%), and constipation/fecal incontinence (30.1%) as common symptoms.
- Concomitant CBBDs were observed in 74.2% of children.
Conclusions:
- The 18-item CBBDQ is a feasible, valid, and reliable evaluative tool for assessing childhood bladder and bowel dysfunction symptoms.
- The Dutch and English versions of the CBBDQ are ready for clinical introduction and further psychometric evaluation.
- This questionnaire will aid in the clinical management and research of CBBDs.
Objectives:
The aim of the study was to develop a questionnaire evaluating the frequency of symptoms over time of concomitant childhood bladder and bowel dysfunctions (CBBDs) in 5- to 12-year-old children and to assess its feasibility and aspects of validity and reliability.
Methods:
The Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ) was developed in phases according to COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) in cooperation with epidemiologists, pediatricians, physiotherapists (phases 1 and 5), and professional translators (phase 5): selection of items (Delphi-method), content validity (pilot), feasibility (interviews), structural validity and internal consistency (field testing), and guideline-based translation (Dutch-English). Participants were parents of children, ages 5 to 12 years (phases 2-4).
Results:
Parents of 1333 children (mean age 7.8 years [standard deviation 2.1]) were included. Most common were urinary incontinence (35.9%), enuresis (29.7%), and constipation/fecal incontinence (30.1%). Concomitant CBBD was seen in 74.2% of 1229 children. Originally, a 27-item CBBDQ was developed. After the pilot (48 parents) a 23-item version remained for evaluation of feasibility aspects by interviewing 56 parents. Based on 1229 completed questionnaires during field testing, the CBBDQ reduced to 18 items. Cronbach α values were 0.74 and 0.71 for bladder and bowel subscales, respectively. Feasibility and aspects of validity and reliability were satisfactory. A definitive and accepted English version of the CBBDQ is available.
Conclusions:
When completed by parents, the 18-item evaluative CBBDQ appears feasible, content, and structurally valid with good internal consistency for the bladder and bowel subscales. The Dutch and English versions will be introduced clinically and subjected to further psychometric evaluation.
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