Parental Experience of Anal Dilations: Comparing Hospital Teaching with Home Implementation Using the Adapted AHPEQS-Parent Survey
In brief
Pain and safety scores worsen by half a point after home dilations
In a survey of 53 families, parents reported higher pain scores (increase 0.5) and lower safety/confidence (increase 0.38) when anal dilations shifted from supervised hospital teaching to home care. They also noted more child distress at home. These findings highlight the need for better pain guidance, escalation pathways, and follow-up support for home dilation programs.
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 18 September 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Jessica Taranto, Misel Trajanovska, Helen Nelson, Suzanne Jackson-Fleurus, Fiona Newall, Sebastian K King
- PMID
- 42759840
- DOI
- 10.1016/j.jpedsurg.2026.163467
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 21 September 2026): Parental experience of anal dilations after ARM repair
Abstract
BACKGROUND: Parents of children with anorectal malformations (ARM) are taught to perform anal dilations in hospital and then continue the procedure at home for months. How their experience changes across the transition has not been systematically measured. We adapted the AHPEQS-Parent questionnaire to capture parental experience during both phases of care. METHODS: We conducted a cross-sectional electronic survey of parents of children with ARM who underwent primary repair at a tertiary pediatric centre between 2018 and 2023 and completed both hospital teaching and home implementation of anal dilations. The survey included dilation-specific items and the adapted AHPEQS-Parent, administered separately for the hospital teaching and home implementation phases. Mean scores (1=Always to 5=Never; lower scores indicate better experience) were compared using paired t-tests and Cohen's d; a separate item assessed harm/distress, where higher scores indicate more harm. RESULTS: Of 133 invited families, 53 parents completed both AHPEQS phases (47 unique children). Internal consistency was good to excellent (Cronbach's alpha 0.823 hospital; 0.898 home). Four domains worsened at home: pain control (mean difference +0.51, 95% CI 0.12-0.89), safety and confidence (+0.38, 0.12-0.64), feeling supported (+0.23, 0.06-0.39) and team communication (+0.17, 0.02-0.32). Parents also reported more child harm or emotional distress during home implementation than during hospital teaching (mean 1.26 vs 0.87; mean difference +0.39, 0.09-0.69). Seven domains, including decision involvement and overall quality, remained stable. CONCLUSION: Parental experience of anal dilations deteriorated when care moved from supervised hospital teaching to home, particularly for pain, perceived safety and confidence, support and team communication. These findings support the need for structured pain control advice, clear escalation pathways and proactive follow-up for families performing anal dilations at home.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.