title: Management of childhood constipation: parents' experiences.
abstract: BACKGROUND
  Constipation in childhood is common and places a burden on child health services. Whilst constipation can have a variety of causes, for most children it is usually non-organic and requires limited intervention. It has been suggested that health professionals can resent consultations for such a common problem, believing them to be inappropriate. However, they can underestimate the impact of this condition, leading to adverse clinical effects, as well as parental dissatisfaction. Little research has explored parents' experiences of consulting health professionals about the management of childhood constipation.
  
  
  OBJECTIVE
  To explore parents' experiences of consulting health professionals about management of childhood constipation and to use the findings to inform more effective therapeutic encounters when responding to parental concerns.
  
  
  METHODS
  A phenomenological approach was adopted, using in-depth interviews with parents of 14 children receiving health interventions for constipation.
  
  
  RESULTS
  Six themes emerged from analysis including: 'enduring and extreme constipation', which reflected the substantial and sustained impact of the child's constipation; 'dismissed and fobbed off', which captured parents' feelings that their concerns were frequently dismissed by health professionals; 'asserting the need for action', a perception that they had reached a point at which they had to demand some intervention; and 'validation and acknowledgement', which reflected acknowledgment that, finally, their concerns for their child had been taken seriously and acted on.
  
  
  CONCLUSIONS
  The findings indicate a failure by some health professionals to appreciate fully the significance of childhood constipation, thereby appearing to be unconcerned and insensitive to the needs of child and family. The impact of this is a potential loss of trust in health professionals by parents, which can then have implications for how they perceive and access health services for management of this common childhood problem. The findings offer an insight into parental experiences and indicate the need for a more sensitive approach during health consultations.
authors.affiliation: Formerly Lecturer/Practitioner, Alder Hey - Royal Liverpool Children's NHS Trust and Department of Nursing, University of Liverpool, Liverpool, UK. mike.farrell@clwdc.nhs.uk
authors.forename: Mike
authors.initials: M
authors.lastname: Farrell
authors.forename: Gill
authors.initials: G
authors.lastname: Holmes
authors.forename: Pat
authors.initials: P
authors.lastname: Coldicutt
authors.forename: Matthew
authors.initials: M
authors.lastname: Peak
mesh_terms: D000223:Adaptation, Psychological; D001294:Attitude to Health; D002675:Child, Preschool; D003248:Constipation / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D024802:Nurse's Role; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations