Author(s)

Agneta Simeonsdotter Svensson^1,2, Margaretha Jenholt Nolbris^2,3,4, Gundela Holmdahl⁵, Anna-Lena Hellström^2,4,5*

¹Department of Education, Communication and Learning, University of Gothenburg, Gothenburg, Sweden.
²Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
³Centre for Children’s Right to Health, Queen Silvia Children’s Hospital, Gothenburg, Sweden.
⁴The Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁵Institute of Women and Children’s Health, University of Gothenburg, Pediatric Urology Section, Queen Silvia Children’s Hospital, Gothenburg, Sweden.

Children with urogenital malformation or bowel disturbances are a vulnerable group and are at risk of experiencing ill health. At school they have to face and cope with situations they are unused to and often feel excluded. There is a lack of studies investigating prevention of ill health in this group of children. Objective: The aim of the study was to investigate the health/well-being and self-esteem, before and after a one-year intervention comprising person-centred, web-based learning support, in preschool children born with malformations in the urethra, bladder, genitals and/or bowel. Study design: Nine boys and one girl participated, aged 3 - 7 years (study group) with diagnoses of epispadia, bladder exstrophy, urethra valves and Hirschprung’s disease. Two questionnaires were used, developed to measure index of health/wellbeing and self-esteem in younger children. In the study group, the interviews were repeated after one year. The group was compared with a control group of 20 healthy, age-matched children. Results: Before the intervention, there were no differences in wellbeing (Children condition index) between the study group and the control group. One year after the start of the web-based preschool, wellbeing in the study group had slightly improved, but not significantly compared to before the intervention. No significant difference was found compared to the control group. When measured self-esteem (I think I am) before the intervention, the study group had significantly better self-esteem compared to the control group. One year later, there was a slight improvement in self-esteem, but two children scored worse in the domain Psychological wellbeing. In comparison with the group of healthy children, the self-esteem in the study group was better for total sum (p = 0.0002). Discussion: Wellbeing and self-esteem seem to be good in children aged 3 - 7 years with uro-genital and bowel malformations, according to the findings of this study. This is better than reports concerning older children. Despite high initial values compared to healthy children, continued, but not significant, improvement in wellbeing and self-esteem was shown one year after intervention. Conclusions: The results of the intervention aimed at promoting health, wellbeing and self-esteem are promising but a longer-term follow-up in a larger group of children is needed.

Bladder, Person-Centred Care, Preschool Children, Self-Esteem, Urogenital Malformation, Web-Based Intervention, Wellbeing

Svensson, A. , Nolbris, M. , Holmdahl, G. and Hellström, A. (2016) Health, Wellbeing and Self-Esteem: Web-Based Support in Children with Urogenital or Bowel Malformation. Open Journal of Pediatrics, 6, 82-90. doi: 10.4236/ojped.2016.61014.