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Development of the "JPCC Barriers to Pediatric Colostomy Care Scoring System": A Modified Delphi Study

Giulia Brisighelli1,2, Catterina Bebington2,3, Marion Arnold4

  • 1Department of Pediatric Surgery, Chris Hani Baragwanath Academic Hospital School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

World Journal of Surgery
|September 23, 2025
PubMed

Insights

This study developed a scoring system to identify challenges in pediatric colostomy care in Southern Africa. The JPCC scoring system aims to improve care for children with colostomies in low-resource settings.

Area of Science:

  • Pediatric Surgery
  • Global Health
  • Health Services Research

Background:

  • Pediatric colostomy care in low- and middle-income countries (LMICs) presents significant clinical, social, and economic challenges.
  • These challenges negatively impact patient outcomes and quality of life for children with colostomies.

Purpose of the Study:

  • To identify key barriers affecting pediatric colostomy care in Southern Africa.
  • To develop a validated scoring system for assessing these barriers.

Main Methods:

  • A modified Delphi study involving 23 participants (12 healthcare professionals, 11 caregivers) in Southern Africa.
  • Utilized online REDCap surveys for barrier identification (Round 1) and relevance rating (Round 2).
  • A virtual expert panel refined statements in Round 3 to finalize the scoring system.

Main Results:

  • Consensus was reached on all identified barrier statements by participants.
  • A 36-item JPCC (Joint Pediatric Colostomy Care) barriers to colostomy care scoring system was finalized.
  • The study achieved a 57.5% participation rate in Round 1 and 16 participants completed Round 2.

Conclusions:

  • This research introduces the first scoring system tailored for pediatric colostomy care barriers in Southern Africa.
  • The JPCC scoring system provides a practical tool for research, clinical evaluation, and advocacy.
  • Multicenter validation is recommended to ensure broader applicability of the scoring system.
Abstract

Keywords:
assessmentchallengeschildrencolostomyscoring systemstoma

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