ESPU-Nurses Meeting on Thursday 9, June 2022, 09:20 - 09:50
University Children's Hospital, Neurourology, Zurich, SWITZERLAND
The medical history of children with NBD, obtained during urodynamics in our clinic, indicated that symptomatic but also asymptomatic UTIs were treated both with antibiotics. Additionally, parents felt uncertain about how to prevent UTIs. We addressed the question, whether a specific information leaflet could increase parents' confidence in managing UTIs and reduce the use of antibiotics.
MATERIAL AND METHODS
The leaflet contains compiled evidence-based information about UTIs and clarifies the differences between symptomatic and asymptomatic UTIs. Additionally, a traffic light system indicates the urgency of treatment as well as the appropriate therapeutic measures. The specialized continence nurse explained the leaflet after urodynamic consultations. 94 families were contacted for the evaluation, which was conducted by using SurveyMonkey®.
Of the 56 (52.6%) responding families, 32 (57%) children have been diagnosed with NBD.
24 (43%) of all the children showed one or more UTI. Of these, 14 (58%) had asymptomatic UTIs and 5 (21%) had both forms. Of the 19 children with asymptomatic UTIs, 10 (52%) received unnecessary antibiotics.
The leaflet was used by 33 (56%) families of which 32 (96%) found it easy to understand. The leaflet helped families gain confidence in managing UTIs (65%; N=21) and in working with professionals (37%; N=12).
Managing UTIs remains a challenge. Although, the leaflet proved helpful for families, further prevention of UTIs and unnecessary antibiotics prescription, requires closer follow-ups and creative methods to empower parents to use adequate interventions. Specialized nurses in continence care play a crucial role in patient and family education.
University Children's Hospital, Spina Bifida Center, Zurich, SWITZERLAND
The topic of sex education in children is often underestimated by health care professionals and tends to focus on urogenital function rather than on sexual health. This leads to unanswered questions about sexual development and results in uncertainties regarding the promotion of sexual health, especially concerning children with SB and their families. The aim of this literature review was to raise awareness of the matter and to develop recommendations for people with SB of different age groups, corresponding with the Spina Bifida Association (SBA) guidelines.
MATERIAL AND METHODS
A comprehensive literature search was conducted using Swisscovery, OvidSP, CINAHL, Google scholar and PubMed to identify the challenges young people with SB face regarding sexual activity and their expectations concerning sexual education.
The 19 articles included in this review identify the following main challenges:
Reduced sensitivity in the genital area, decreased sexual function, insufficient sense of privacy and personal space, low awareness of sexual exploitation risks, fear of incontinence accidents, body-image, self-esteem, pubertas praecox, and problems resulting from the close bond between a child and their parents.
Even though the issues are described adequately, most articles are deficit-oriented and do not provide any helpful advice for families.
In order to assist families and health professionals with promoting sexual education in youth with SB, a set of recommendations covering the most important topics regarding their sexual education was created. Further steps will include the development of educational instruments and didactic tools to promote sexual health, sexual satisfaction and quality of life.
Bieke SAMIJN 1, Christine VAN DEN BROECK 1, Frank PLASSCHAERT 2 and Erik VAN LAECKE 2
1) Ghent University, Ghent, BELGIUM - 2) Ghent University Hospital, Ghent, BELGIUM
Lower urinary tract symptoms (LUTS) are common in patients with cerebral palsy (CP). Although recommended in typically developing children, uroflowmetry is not routinely used in children with CP. The objective of the study is to investigate uroflow measurement in children with CP.
MATERIAL AND METHODS
A cross-sectional observational study is conducted including children with CP between five and twelve years old. Children are evaluated using uroflowmetry followed by an automated evaluation of post void residual urine. Two toilet moments with a personally adapted toilet chair are caried out. Data concerning LUTS are collected by means of the validated Dutch Vancouver Symptom Score for Dysfunctional Elimination Syndrome (VSSDES) questionnaire. A power of 0.80 requires a sample size of ninety children.
The study will be conducted between 2021 and 2022. Fourteen children have been included in the study. Eight (57%) were girls and six (43%) followed special education. Some children presented with moderate to severe functional impairment (29%), moderate to severe manual impairment (43 %) or moderate to severe communication impairment (14%). None had moderate to severe drinking and eating impairment. Seven children were dry, three had daytime incontinence, two had enuresis and two had combined daytime incontinence and enuresis. Concerning uroflowmetry, a staccato-shaped and bell-shaped curve most frequently seen and equally present (43 %). Recruitment is ongoing and preliminary statistical results will be present within the next months.
Results could improve the use and interpretation of uroflow measurement in children with CP.