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A digital playful bladder and bowel diary for children: Development and content validation
Drielle Fernanda de Arruda1, Gisela Maria Assis2, Camila Girardi Fachin3
1Department of Clinical Surgery, Federal University of Paraná (UFPR), Rua General Carneiro 181, Alto da Glória, Curitiba, PR, 80310-080, Brazil.
Insights
A new digital bladder and bowel diary was developed for children, showing good content validity and initial understanding. This tool aims to improve assessment of bladder and bowel dysfunction (BBD) in pediatric patients.
Area of Science:
- Pediatric urology
- Digital health tools
- Child health assessment
Background:
- Bladder and bowel dysfunction (BBD) is common in children and necessitates structured assessment.
- Current voiding diaries lack child-centered, digital, and playful formats for integrated bladder and bowel data.
Purpose of the Study:
- To develop a digital, playful bladder and bowel diary for children.
- To validate the content of this diary using expert review.
- To conduct an initial assessment of the diary's interface comprehension in children.
Main Methods:
- A two-phase methodological study was performed.
- Phase 1: Expert content validation using the Item-level Content Validity Index (I-CVI) with 15 specialists.
- Phase 2: Interface comprehension assessment with 13 children (aged 6-11) using a digital prototype.
Main Results:
- The diary achieved an initial overall I-CVI of 0.97, with revisions leading to all items meeting the minimum threshold.
- The final validated diary contains 61 items.
- Interface comprehension was high, with over 90% of fields understood by children, though two catheterization fields required improvement.
Conclusions:
- A digitally structured bladder and bowel diary with established content validity has been developed.
- Initial evidence suggests good interface comprehension among child users.
- This represents a foundational step towards a child-centered digital tool for tracking elimination habits.
Introduction:
Bladder and bowel dysfunction (BBD) is frequent in childhood and requires structured assessment strategies. Voiding diaries are commonly used tools; however, child-centered versions integrating bladder and bowel data in a digital and playful format remain limited.
Objective:
To develop and perform content validation of a digital playful bladder and bowel diary for children, including an initial assessment of interface comprehension.
Methods:
This methodological study was conducted in two phases. Phase 1 consisted of expert content validation of the instrument using the Item-level Content Validity Index (I-CVI), with participation of 15 specialists in lower urinary tract dysfunction in children. Phase 2 involved interface comprehension assessment with 13 children aged 6-11 years using a digital prototype.
Results:
The initial overall I-CVI was 0.97. Ten items did not reach the predefined cut-off of 0.80 and were revised according to expert recommendations. After reassessment, all revised items achieved the minimum CVI threshold. The final validated version of the voiding and bowel diary block consisted of 61 items. In Phase 2, 60.7% of interface fields were fully understood, 32.1% showed comprehension rates between 84.62% and 92.31%, and two catheterization-related fields demonstrated comprehension below 80%.
Conclusion:
The study resulted in a digitally structured bladder and bowel diary with established content validity and initial evidence of interface comprehension among children. These findings represent an initial methodological step in the development of a child-centered digital tool for recording elimination habits.
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