Quality-of-life assessment in children with fecal incontinence.
BACKGROUND
Fecal incontinence is a clinical condition that causes embarrassment and changes the perception of quality of life. The absence of a specific tool for assessing fecal incontinence in children led us to adapt an instrument originally developed for adults, which has already been validated into Portuguese.


OBJECTIVE
The purpose of this work was to evaluate the quality of life of children with fecal incontinence.


METHODS
This is a single-center, prospective study based on the application of survey. The Fecal Incontinence Quality of Life questionnaire was modified by eliminating 2 questions related to sexuality and by substituting the word "depressed" with "sad" in the statement, "I feel depressed."


METHODS
The study took place at a tertiary academic medical center.


METHODS
Forty-one children >5 years of age, with incontinence of organic etiology and preserved cognition but without stomy, were interviewed with the use of the Fecal Incontinence Quality of Life modified questionnaire. To evaluate the discrimination validity, 28 healthy children were interviewed as control subjects.


METHODS
As to reproducibility, a test/retest was performed, involving 25 children. For construct validation, the Fecal Incontinence Quality of Life modified was correlated with the generic instrument Autoquestionnaire Qualité de Vie Enfant Imagé with the continence index São Paulo Score of Continence.


RESULTS
The average values by scale included lifestyle, 3.1; emotional, 2.8; behavior, 2.3; and embarrassment, 1.6. The average values for the control group included lifestyle, 3.7; emotional, 4.0; behavior, 3.6; and embarrassment, 3.6. The instrument showed a general reliability of 0.78, measured by the Cronbach α. Reproducibility was also >0.90 according to the Cronbach α.


CONCLUSIONS
The intrinsic characteristics of children include their constant growth, and this presented a challenge in our search for an instrument that permitted us to identify and measure these variations.


CONCLUSIONS
The experiment showed a reduction in all of the scale values, particularly for embarrassment in children with fecal incontinence.
1 Department Pediatric of Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil 2 Department Pediatric of Santa Casa de São Paulo Medical School, São Paulo, Brazil 3 Department of Surgery of Santa Casa de São Paulo Medical School, São Paulo, Brazil.
Humberto S
HS
Filho
Roberto A
RA
Mastroti
Wilmar A
WA
Klug
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005242:Fecal Incontinence / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires