Made available in DSpace on 2019-03-30T00:00:01Z (GMT). No. of bitstreams: 0
Previous issue date: 2014-11-24 / Fecal incontinence (FI) can be defined as the involuntary loss of rectal content (liquid, gas or solid) through the anal canal resulting in a social or hygienic problem, which may have a significant impact on quality of life (QOL). Objective: To assess the QOL of children with FI subjected to the Bowel Management Program (BMP), as well as, correlations with the functional results in FI. Methods: Children with FI secondary to organic and functional causes were consecutive and non-probability refered to the Nucleo Especializado em Tratamento Infantil da Incontinencia Fecal (NETIIF) during the period from February to July 2014 and subjected to the BMP after the parents had signed an informed consent. The data were collected before and after 3 months of the treatment using the QOL instrument (PedsQL 4.0), incontinence scale (IS) and the socioeconomic and demographic records. The PedsQL 4.0 is a generic QOL questionnaire including four domains: physical ability, emotional aspect, social and educational activity. It has two modules: the parental and children fs reporting modules. Results: 43 children were studied (33 male and 10 females) with an average age of 7.7 } 3.1. The majority were from the interior 31/72.1% and 11/25.6% of the capital. In relation to the marital status of the mother 23/53.5% were married and 8/18.6% lived in stable union, corresponding to 31/72% that together lived with their spouses.32/ 74.4% families received between 1 and 2 minimum wages and 6/14% less than 1 salary. 40/93% houses had basic sanitation, the average of 5.2 } 1.4 comados and 4.2 } 1.4 inhabitants. There was no statistical difference (p > 0.05) between the chilren and the parents f reporting modules of the PedsQL 4.0 before treatment. After three months of the BMP could be observed significant improvement in total score as well as in every domains of the PedsQL 4.0 (p < 0.001). In the parents f reporting module the total score increased from 66.9 } 23 to 92.6 } 9 in the and in the children fs one from 73.8 } 19.2 to 93.5 } 6.2. It also noticed an improvement of IS from 14.5 } 3.7 to 2.8 } 2.5 (p < 0.001). Both group 1 (dilated colon) and group 2 (thin colon) were benefited with the treatment reaching significant decrease of the average index of incontinence (p < 0.001). By correlating the rate of II with the domains of the PedsQL 4.0, it was obtained in the total score of the both modules significant positive correlation (p < 0.05). Only in the children fs reporting module there was mild positive correlation in the physical capacity domain (r = -0.46; p = 0.01) and moderate correlation in emotional aspect domain (r = -0.57; p = 0.001). When comparing the delta variation ( ¢) between groups 1 and 2, only in the children fs reporting module there was statistical difference between the two groups in the domain school activity (p < 0.01). Conclusion: It was possible to demonstrate the positive impact of the BMP in all domains of the PedsQL 4.0 and FI.It is necessary to use both parents and children fs module to better assess the QOL of chlildren. The BMP rescued the self-esteem and the freedom to play, skip and play sports. / A incontinencia fecal (IF) pode ser definida como a perda involuntaria do conteudo retal (liquido, gas ou solido), atraves do canal anal, resultando em um problema social ou higienico, podendo ter um significativo impacto na qualidade de vida (QV). Objetivo: Avaliar a QV das criancas com IF submetidas ao Programa Manejo do Colon(PMC), assim como as correlacoes com os resultados funcionais na IF. Metodos: Criancas com IF de 3 a 12 anos secundaria a causas organicas e funcionais foram encaminhadas de forma consecutiva e nao probabilistica ao Nucleo Especializado em Tratamento Infantil da Incontinencia Fecal (NETIIF), no periodo de fevereiro/2014 a julho/2014, e submetidas ao Programa Manejo do Colon, apos os pais terem assinado o termo de consentimento livre e esclarecido. Antes e apos tres meses do tratamento, foram colhidos os dados usando o questionario PedsQL4.0, o indice de incontinencia (II) e a ficha socioeconomica e demografica. O PedsQL 4.0 trata-se de um questionario generico de QV, incluindo quatro dominios: capacidade fisica, aspecto emocional, social e atividade escolar. Possui dois modulos: modulo relato dos pais e modulo relato das criancas. Resultados: Foram estudadas 43 criancas, 33 do sexo masculino e 10 do feminino, com idade media de 7,7 }3,1. A maioria era proveniente do Interior, 31/72, 1% e 11/25,6% da Capital. Em relacao ao estado civil da mae, 23/53,5% eram casadas e 8/18,6% viviam em uniao estavel, correspondendo a 31/72% que coabitavam com seus conjuges.32/74,4% familias recebiam entre 1 e 2 salarios minimos e 6/14%, menos de 1 salario.40 /93% casas tinham saneamento basico com a media de 5,2 }1,4 comodos e 4,2 }1,4 habitantes. Nao houve diferenca estatistica (p>0,05) entre os modulos relato dos pais e das criancas do questionario PedsQL4.0, antes do tratamento. Apos tres meses do PMC, pode-se observar melhora significativa na pontuacao total e nos dominios do questionario PedsQL4.0 (p<0,001). No modulo relato dos pais, a pontuacao total passou de 66,9 }23 para 92,6 }9 e, no relato das criancas, de 73,8 }19,2 para 93,5 }6,2. Notou-se melhora do II, passando de 14,5 }3,7 para 2,8 } 2,5 (p<0,001). Tanto o grupo 1 (colon dilatado) como o grupo 2(colon fino) foram beneficiados com o tratamento, alcancando diminuicao significativa do II (p<0,001). Ao correlacionar o II com os dominios do questionario PedsQL 4.0, obteve-se correlacao positiva significativa na pontuacao total em ambos os modulos(p<0,05). Somente no modulo relato das criancas houve correlacao positiva leve no dominio capacidade fisica (r=-0,46; p=0,01) e correlacao moderada no dominio aspecto emocional (r=-0,57; p=0,001). Ao comparar o delta variacao ( ¢) entre os grupos 1 e 2, somente no modulo relato das criancas houve diferenca estatistica entre os dois grupos, no dominio Atividade Escolar(p<0,01). Conclusao: Foi possivel evidenciar o impacto positivo do PMC em todos os dominios do questionario PedsQL 4.0 e na IF.E necessario utilizar o modulo relato dos pais e o modulo relato da crianca para melhor avaliar a qualidade de vida das criancas. O PMC resgatou a autoestima e a liberdade para brincar, pular e praticar esportes.
| Identifer | oai:union.ndltd.org:IBICT/oai:dspace.unifor.br:tede/93260 |
| Date | 24 November 2014 |
| Creators | Colares, João Henrique Freitas |
| Contributors | Frota, Mirna Albuquerque, Santos, Zélia Maria de Sousa Araújo, Frota, Mirna Albuquerque, Silva, Carlos Antônio Bruno da, Melo Filho, Antônio Aldo |
| Publisher | Universidade de Fortaleza, Mestrado Em Saúde Coletiva, UNIFOR, Brasil, Centro de Ciências da Saúde |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UNIFOR, instname:Universidade de Fortaleza, instacron:UNIFOR |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2850938317121515023, 500, 500, 292441653440865123 |
Page generated in 0.0028 seconds