189 PARENTING STRESS IN BLADDER AND BOWEL DYSFUNCTION

INTRODUCTION AND OBJECTIVES: Parents of children with medical conditions are at increased risk for maladaptive outcomes, such as higher levels of parenting stress. Additionally, elevated levels of parenting stress have been linked to higher levels of caregiver anxiety and depression, and can negatively affect medical decisionmaking and compliance with treatment recommendations. The current study sought to evaluate levels of stress in parents of children with bladder and bowel dysfunction. METHODS: Participants included 72 parents (56 mothers, 16 fathers) of children seen for bladder and/or bowel dysfunction in either the Pediatric Urology or Pediatric Gastroenterology outpatient clinics in an urban Children’s Hospital (Table 1). Parents completed the Parenting Stress Index ? Short Form (PSI), a 36-item, validated, self-report measure that assesses level of parental stress. Additionally, parents and their children completed the Dysfunctional Voiding Scoring System (DVSS), a 10-item, validated measure that assesses severity of voiding dysfunction. RESULTS: Level of parenting stress was not significantly associated with any demographic variables (e.g., parent age, gender, or level of education, child age or gender, Urology or GI clinic, and annual household income). Bivariate correlations revealed significant relationships between level of parenting stress, and DVSS items #8 (i.e., ?child has to push to pee?, r(72) .27, p .020), #10 (i.e., ?child has experienced something stressful over last month?, r(72) .33, p .004) and Total Score (r(72) .32, p .006). Additionally, 15.3% (11/72) of the parents met the established cut-off for having a clinically significant level of stress, which is consistent with percentages reported in other pediatric illness groups (e.g., cancer, diabetes). CONCLUSIONS: For parents of children with bladder and bowel dysfunction, level of parenting stress is related to the severity of the child’s voiding problems. Given the system-wide effect of elimination dysfunction on the child’s family, it is important that interventions be family-based. Early identification of significantly distressed families, and a program of inclusive therapy may yield better outcomes in the management of dysfunctional elimination disorders.