Increasing Daily Water Intake and Fluid Adherence in Children Receiving Treatment for Retentive Encopresis

Department of Psychology, Eastern Michigan University, USA.
Journal of Pediatric Psychology (Impact Factor: 2.91). 05/2010; 35(10):1144-51. DOI: 10.1093/jpepsy/jsq033
Source: PubMed


To examine the efficacy of an enhanced intervention (EI) compared to standard care (SC) in increasing daily water intake and fluid goal adherence in children seeking treatment for retentive encopresis.
Changes in beverage intake patterns and fluid adherence were examined by comparing 7-week diet diary data collected during participation in the EI to achieved data for families who had previously completed the SC.
Compared to children in SC (n = 19), children in the EI (n = 18) demonstrated a significantly greater increase in daily water intake from baseline to the conclusion of treatment ( p ≤ .001), and were four and six times more likely to meet fluid targets in Phases 1 (Weeks 3-4) and 2 (Weeks 5-6) of fluid intervention, respectively (both p ≤ .001).
Enhanced education and behavioral strategies were efficacious in increasing children's intake of water and improving fluid adherence. Future research should replicate the findings in a prospective randomized clinical trial to discern their effectiveness.

Full-text preview

Available from:
  • [Show abstract] [Hide abstract]
    ABSTRACT: We determined factors influencing the behavior of patients with kidney stones in the prevention of recurrent stones. Patients with stones from an academic and a community practice were recruited for key informant interviews and focus groups. Groups were guided based on the framework of the health belief model. Content analysis was done on transcriptions using qualitative data analysis software. Key informant interviews were completed with 16 patients and with a total of 29 subjects in 5 focus groups. Content analysis revealed that patients were highly motivated to prevent stones. The minimum level of perceived benefit for adopting the behavior change varied among patients and the behaviors proposed. An important strategy to increase fluid intake was insuring availability with containers. Patients were more consistently confident in the ability to increase fluid, in contrast to ingesting medicine or changing the diet. While barriers to increasing fluid were multifactorial among individuals, the barriers aligned into 3 progressive stages that were associated with distinct patient characteristics. Stage 1 barriers included not knowing the benefits of fluid or not remembering to drink. Stage 2 barriers included disliking the taste of water, lack of thirst and lack of availability. Stage 3 barriers included the need to void frequently and related workplace disruptions. Patients with kidney stones are highly motivated to prevent recurrence and were more amenable to fluid intake change than to another dietary or pharmaceutical intervention. Barriers preventing fluid intake success aligned into 3 progressive stages. Tailoring fluid intake counseling based on patient stage may improve fluid intake behavior.
    No preview · Article · Feb 2012 · The Journal of urology
  • [Show abstract] [Hide abstract]
    ABSTRACT: To elucidate our experience and outcome in the management of childhood encopresis, and to emphasize the factors that may predict successful management. This prospective study was carried out between September 2003 and September 2011 in the Department of Pediatric Surgery, Al-Thoura Teaching Hospital, Al-Beida and Al-Butnan Medical Teaching Center, Tobruk, Libya. One hundred and thirty-two patients (117 male, 15 female) took part of the study. The male and female ratio was 7.8:1. The participants were patients aged 4-9 years. There were 30 (22.7%) patients between 4-5 years, 61 (46.2%) between 6-7 years, and 41 (31%) between 8-9 years. Nonretentive encopresis patients were 36 (27.2%) (Group I) and 96 (72.8%) patients had retentive encopresis (Group II). Patients with low fluid intake were 87 (65.9%) and low fiber diet were 91 (68.9%). Patients with delayed toilet training were 99 (75%). The total rate of successful conservative treatment was 70.5%. The rate of successful treatment in Group I was 94.4% and in Group II was 61.5%. We observed 18.2% of the patients had recurrence of encopresis. The factors found to predict good resolution rate after medical treatment included: cooperation of the parent and patient, female gender, ages above 5 years, and non-retentive encopresis. Encopresis remains a problem for the parents and the patients. Clinical evaluation is indispensable. Good outcome can be achieved effectively. Cooperative parents and patient, female gender, age above 5 years, and nonretentive encopresis are predictors for good response to medical treatment.
    No preview · Article · Jun 2012 · Saudi medical journal