vedrana vejzovic going through a colonoscopy and living with inflammatory bowel disease

115 Pages·2016·2.31 MB·English

VEDRANA VEJZOVIC
GOING THROUGH A
COLONOSCOPY AND LIVING
WITH INFLAMMATORY BOWEL
DISEASE
Children’s and parents’ experiences and evaluation of the
bowel cleansing quality prior to colonoscopy
M A L M Ö U N I V E R S I T Y H E A L T H A N D S O C I E T Y D O C T O R A L D I S S E R T A T I O N 2 0 16 : 5
V E D R A N A V E J Z O V I C G O I N G T H R O U G H A C O L O N O S C O P Y A N D L I V I N G W I T H I N F L A M M A T O R Y B O W E L D I S E A S E M A L M Ö U N I V E R S I T Y 2 0 16
GO I N G T H R O U G H A C O L O N O S C O P Y A N D L I V I N G W I T H
I N F L A M M A T O R Y B O W E L D I S E A S E
Malmö University
Health and Society, Doctoral Dissertation 2016:5
© Vedrana Vejzovic 2016
ISBN: 978-91-7104-681-9 (print)
ISBN: 978-91-7104-682-2 (pdf)
ISSN: 1653-5383
Holmbergs, Malmö 2016
VEDRANA VEJZOVIC
GOING THROUGH A
COLONOSCOPY AND LIVING
WITH INFLAMMATORY BOWEL
DISEASE
Children’s and parents’ experiences and evaluation of the bowel
cleansing quality prior to colonoscopy
Malmö University, 2016
Faculty of Health and Society
This publication is also available at:
www.mah.se/muep
In memory of my son Dino, and to my family and all others who believed in me!
CONTENTS
ABSTRACT ......................................................................... 9
LIST OF PUBLICATIONS I-IV ............................................... 12
ABBREVIATIONS ............................................................... 13
INTRODUCTION ............................................................... 15
BACKGROUND ................................................................ 17
Inflammatory bowel disease in children ....................................... 17
Incidence of paediatric IBD ......................................................... 17
Diagnosis and treatment ............................................................. 18
Colonoscopy in children ............................................................. 18
Preparation prior to colonoscopy............................................ 19
Bowel cleansing prior to colonoscopy ..................................... 20
Children (10-18) with IBD ........................................................... 20
Parents’ role in paediatric care.................................................... 22
The child and the child’s perspective ............................................ 24
Rationale ................................................................................... 26
AIMS ............................................................................... 27
METHOD ......................................................................... 28
Settings ..................................................................................... 30
Participants ................................................................................ 30
Procedures (I-IV) ........................................................................ 31
Data collection ........................................................................... 34
Interviews (I, II, & IV) ............................................................. 34
Bowel cleansing quality ......................................................... 35
Questionnaires ...................................................................... 36
DATA ANALYSIS ....................................................................... 36
Qualitative method ..................................................................... 36
Quantitative method ................................................................... 38
Pre-understanding ...................................................................... 39
ETHICAL CONSIDERATIONS ............................................... 41
FINDINGS ........................................................................ 43
Children’s experiences of colonoscopy (I & III) .............................. 43
The parents’ experiences when their child undergoes a
colonoscopy (II & III) ................................................................... 49
Bowel cleansing quality with PEG or NaPico (III) ........................... 50
The meaning of the children’s lived experience of IBD (IV) ............. 53
METHODOLOGICAL DISCUSSION ....................................... 55
Participants................................................................................ 56
Interviews .................................................................................. 57
Trustworthiness .......................................................................... 58
Reliability and validity ................................................................ 59
GENERAL DISCUSSION OF FINDINGS ................................. 60
CONCLUSION .................................................................. 66
CLINICAL IMPLICATIONS .................................................... 67
FURTHER RESEARCH .......................................................... 69
SVENSK SAMMANFATTNING ............................................. 70
ACKNOWLEDGEMENTS ..................................................... 73
REFERENCES ..................................................................... 76
APPENDICES ..................................................................... 87
Appendix I ................................................................................ 88
Appendix II ............................................................................... 89
PAPERS I -- IV .................................................................... 91