Children's experiences of functional constipation: A qualitative reflexive thematic analysis

Area of Science:

• Pediatric Healthcare
• Gastroenterology
• Qualitative Research

Background:

• Childhood functional constipation is a prevalent pediatric health issue requiring medical interventions often managed at home.
• Children's perspectives on constipation and its treatments are under-researched, despite the sensitive and private nature of toileting.
• Stigmatization surrounding bowel habits can impact a child's willingness to discuss their experiences.

Purpose of the Study:

• To explore the lived experiences of children undergoing treatment for functional constipation.
• To understand children's perceptions of oral and rectal medical treatments for constipation.
• To identify factors influencing children's adherence to and feelings about constipation management.

Main Methods:

• A qualitative interview study employing a constructionist epistemology and experiential orientation.
• Individual interviews were conducted in child-friendly settings (home, clinic, university).
• Reflexive thematic analysis of transcribed interviews with 20 children (aged 6-14) with functional constipation.

Main Results:

• Children perceive constipation treatments as both beneficial and burdensome, often delaying toilet visits due to fear of exposure.
• Faecal incontinence is strongly linked to anxiety about being discovered.
• Themes identified include procrastination, dread of vulnerability, the dual nature of enemas (nightmare/relief), and uncertain hope.

Conclusions:

• Healthcare providers should validate and integrate children's perspectives into constipation care discussions.
• Incorporating children's views can improve communication and collaboration among providers, parents, and children.
• Acknowledging the child's viewpoint is essential for effective and empathetic constipation management strategies.