Skip to main content

Advertisement

Log in

Quality of life in patients with anorectal malformation or hirschsprung's disease

Development of a disease-specific questionnaire

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Hirschsprung's disease and anorectal malformation are congenital diseases of the digestive tract with sequelae into adulthood. The quality of life of patients with these diseases is largely unknown. The aim of the study was 1) to construct a self-report disease-specific instrument to assess the quality of life in these patients and 2) to evaluate its psychometric performance. METHODS: An age-specific (6 and 7 years, 8–11 years, 12–16 years, and >17 years) questionnaire called the Hirschsprung's disease/anorectal malformation quality-of-life instrument was constructed. This questionnaire consists of 39 to 42 items, grouped into 10 to 11 scales that cover physical, emotional, and social functions as well as disease-related symptoms. Generic quality-of-life data were obtained in addition. A national sample of 715 patients aged six years and older completed the questionnaire (response rate, 61.9 percent). RESULTS: Multitrait scaling analyses confirmed the hypothesized scale structure with exception of the scales related to diet for the two youngest groups. Cronbach's alpha ranged (with exception of the diet scales) from 0.62 to 0.91 for children (8–11 years), from 0.69 to 0.82 for adolescents (12–16 years) and from 0.57 to 0.91 for adults. Selective scales were able to discriminate between subgroups of adult patients known to differ in disease and disease severity. Relevant scales of the adult version showed substantial correlations (>0.40) with comparable scales of the SF-36. In the two youngest age groups the differences between subgroups of patients were less significant, but in the expected direction. CONCLUSIONS: With the exception of the scales related to diet, the Hirschsprung's disease/anorectal malformation quality-of-life instrument is an instrument with promising reliability and validity, to measure the disease-specific quality of life of patients with anorectal malformation or Hirsch-sprung's disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Pena A. Anorectal malformations. Semin Pediatr Surg 1995;4:35–47.

    PubMed  Google Scholar 

  2. Reding R, de Ville de Goyet J, Gosseye S,et al. Hirschsprung's disease: a 20-year experience. J Pediatr Surg 1997;32:1221–5.

    Article  PubMed  Google Scholar 

  3. Hassink EA, Rieu PN, Brugman AT, Festen C. Quality of life after operatively corrected high anorectal malformation: a long-term follow-up study in patients aged 18 years and older. J Pediatr Surg 1994;29:773–6.

    Article  PubMed  Google Scholar 

  4. Hassink EA, Rieu PN, Severijnen RS, Brugman-Boezeman AT, Festen C. Adults born with high anorectal atresia—how do they manage? Dis Colon Rectum 1996;39:695–9.

    Article  PubMed  Google Scholar 

  5. Erdek MA, Wilt E. Hirschsprung's disease: one institution's ten year experience and long-term follow-up. Am Surg 1994;60:625–8.

    PubMed  Google Scholar 

  6. Heij HA, de Vries X, Bremer I, Ekkelkamp S, Vos A. Long-term anorectal function after Duhamel operation for Hirschsprung's disease. J Pediatr Surg 1995;30:430–2.

    Article  PubMed  Google Scholar 

  7. Rintala R, Mildh L, Lindahl H. Fecal continence and quality of life in adult patients with an operated low anorectal malformation. J Pediatr Surg 1992;7:902–5.

    Article  Google Scholar 

  8. Rintala R, Lindahl H, Marttinen E, Sariola H. Constipation is a major functional complication after internal sphincter-saving posterior sagittal anorectoplasty for high and intermediate anorectal malformation. J Pediatr Surg 1993;28:1054–8.

    PubMed  Google Scholar 

  9. Rintala RJ, Lindahl HG, Rasanen M. Do children with repaired low anorectal malformations have normal bowel function? J Pediatr Surg 1997;32:823–6.

    Article  PubMed  Google Scholar 

  10. Diseth TH, Emblem R. Somatic function, mental health, and psychosocial adjustment of adolescents with anorectal anomalies. J Pediatr Surg 1996;3:638–43.

    Article  Google Scholar 

  11. Diseth TH, Björnland K, Novik TS, Emblem R. Bowel function, mental health, and psychological function in adolescents with Hirschsprung's disease. Arch Dis Childhood 1997;76:100–6.

    Google Scholar 

  12. Diseth TH, Emblem R. Effects of anal invasive treatment and incontinence on mental health and psychosocial functioning of adolescents with Hirschsprung's disease and low anorectal anomalies. J Pediatr Surg 1998;33:468–75.

    Article  PubMed  Google Scholar 

  13. Ditesheim JA, Templeton JM Jr. Short-term v long-term quality of life in children following repair of high imperforate anus. J Pediatr Surg 1987;22:581–7.

    Google Scholar 

  14. World Health Organization. Constitution of the World Health Organization. Geneva: World Health Organization 1948.

    Google Scholar 

  15. Bouman NH, Koot HM, Van Gils AP, Verhulst FC. Development of a health-related quality of life instrument for children: the quality of life questionnaire for children. Psychol Health 1999;14:829–46.

    Google Scholar 

  16. Vogels T, Verrips GH, Verloove-Vanhorick SP,et al. Measuring health-related quality of life in children: the development of the TACQOL parent form. Qual Life Res 1998;7:457–65.

    Article  PubMed  Google Scholar 

  17. Theunissen NC, Vogels T, Koopman H,et al. The proxy problem: child report versus parent report in health related quality of life research. Qual Life Res 1998;7:387–97.

    Article  PubMed  Google Scholar 

  18. Verhulst FC, van der Ende J. Agreement between parents' reports and adolescents' self-reports of problem behavior. J Child Psy 1992;33:1011–23.

    Google Scholar 

  19. Verrips GH, Vogels AG, Verloove-Vanhorick SP,et al. Health-related quality of life measure for children—the TACQOL. J Appl Ther 1997;1:357–60.

    Google Scholar 

  20. Ware JE Jr, Sherbourne CD. The MOS 36-item Short Form Health Survey (SF-36) I. Conceptual framework and item selection. Med Care 1992;32:473–83.

    Google Scholar 

  21. Hays RD, Hayashi T, Carson S,et al. User's guide for the Multitrait Analysis Program (MAP). Santa Monica: Rand Corporation, 1988.

    Google Scholar 

  22. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrica 1951;16:297.

    Google Scholar 

  23. Nunnally JC, Bernstein IH. Psychometric Theory. New York: McGraw-Hill, 1994.

    Google Scholar 

  24. Bland JM, Altman DG. Cronbach's alpha. BMJ 1997;3:314:572.

    Google Scholar 

  25. Saigal S, Feeny D, Rosenbaum P, Furlong W, Burrows E, Stoskopf B. Self-perceived health status and health related quality of life of extremely low-birth-weight infants at adolescence. JAMA 1996;276:453–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Supported by a grant from the Netherlands Digestive Diseases Foundation.

About this article

Cite this article

Hanneman, M.J.G., Sprangers, M.A.G., De Mik, E.L. et al. Quality of life in patients with anorectal malformation or hirschsprung's disease. Dis Colon Rectum 44, 1650–1660 (2001). https://doi.org/10.1007/BF02234386

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02234386

Key words

Navigation