Bladder and Bowel Dysfunction in Korean Children with Down Syndrome and Parental Quality of Life

J Pediatr Nurs. 2019 Nov-Dec:49:e74-e80. doi: 10.1016/j.pedn.2019.09.016. Epub 2019 Oct 31.

Abstract

Purpose: Children with Down syndrome (DS) are more likely to experience bladder bowel dysfunction (BBD) than typically developing children, which could in turn have a serious effect on children with DS and on their parents and other family members. This study aimed to explore the prevalence of BBD in Korean children with DS and its effect on parental quality of life (QOL).

Design and methods: To assess BBD and parental QOL, we used self-administered questionnaires (Dysfunctional Voiding Symptom Score [DVSS], Rome IV criteria, and World Health Organization Quality of Life scale [WHOQOL-BREF]) for parents of children with DS. We collected data from 86 parents between September and October 2017 through an online community website.

Results: DVSS was elevated in 26.7% of the children with DS. Specifically, 14% had daytime urinary incontinence, and 33.7% had functional constipation. Moreover, 18.6% of children had BBD according to the DVSS and Rome IV criteria. The sensitivity and specificity of DVSS to functional constipation was 55.17% and 87.72%, respectively. The BBD score and total parental QOL score were statistically correlated (r = 0.291, p = 0.007).

Conclusions: Although children with DS are a high-risk group for BBD, their BBD symptoms are often overlooked because of their intellectual disability. Consequently, this could negatively affect children's and family's health and QOL in the long term.

Practice implications: Health-care providers should reconsider a routine check-up of BBD in children with DS. If a child has BBD, health-care providers should consult a urologist to determine the appropriate diagnosis and intervention.

Keywords: Bladder bowel dysfunction; Children; Down syndrome; Parent; Quality of life.

MeSH terms

  • Adolescent
  • Age Factors
  • Caregivers / psychology*
  • Child
  • Child, Preschool
  • Confidence Intervals
  • Constipation / epidemiology
  • Constipation / etiology
  • Constipation / nursing
  • Cross-Sectional Studies
  • Down Syndrome / complications*
  • Down Syndrome / diagnosis
  • Fecal Incontinence / epidemiology
  • Fecal Incontinence / etiology*
  • Fecal Incontinence / nursing
  • Female
  • Humans
  • Male
  • Odds Ratio
  • Parenting / psychology*
  • Prevalence
  • Prognosis
  • Quality of Life*
  • Republic of Korea
  • Risk Assessment
  • Sex Factors
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires
  • Urination Disorders / epidemiology
  • Urination Disorders / etiology*
  • Urination Disorders / nursing