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Journal of Pediatric Oncology Nursing
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*Constipation
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A Constipation Assessment Scale for Use in Pediatric Oncology

Myra Woolery, MN, RN

Research and Practice Development Service, Nursing and Patient Care Services at the National Institutes of Health, University of Maryland Baltimore, mwoolery{at}cc.nih.gov

Ellen Carroll, BSN, RN

Inpatient Multi-Institute Pediatric Unit,, Nursing and Patient Care Services, National Institutes of Health

Elizabeth Fenn, BSN, RN

Holly Wieland, MPH, RN

Paul Jarosinski, PharmD

Pediatric Oncology Branch of the National Cancer Institute, United States Public Health Service

Barbara Corey, MSN, RN

National Institutes of Allergy and Infections Disease clinics, Ambulatory Care Services, Nursing and Patient Care Services at the National Institutes of Health

Gwenyth R. Wallen, PhD, RN

Research and Practice Development Service, Nursing and Patient Care Services at the National Institutes of Health, Bethesda, MD

Constipation is prevalent in pediatric oncology patients because of treatment with vinca alkaloids and/or narcotics and lifestyle changes secondary to disease process. Sequelae of constipation include anorexia, nausea, vomiting, abdominal pain, emergency department visits, and a decrease in quality of life. There are no reliable instruments to measure constipation in children. A pilot study (N = 21) evaluating the presence and severity of constipation and the reliability and validity of a modified version of the adult Constipation Assessment Scale (CAS) in children with cancer was conducted. Patients receiving weekly vinca alkaloids and/or narcotics = 2 times per day were recruited. Initial bowel function assessments included standardized nursing and nutrition assessments, history/physical review, and baseline CAS score repeated at 1 hour to assess test-retest reliability. Subsequent assessments included CAS administered 3 times per week and daily patient bowel diaries. Test-retest reliability was evident (r = .93; P = .000). Acceptable construct validity was indicated by a difference in mean CAS scores (t = 4.4, P <.001). Patients reported difficulty with CAS questions and response selections. Symptoms asked on CAS were often not viewed as a problem.

Key Words: constipation • constipation assessment scale • pediatric oncology

Journal of Pediatric Oncology Nursing, Vol. 23, No. 2, 65-74 (2006)
DOI: 10.1177/1043454205285874
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