{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:51:49Z","timestamp":1791823909674,"version":"4.3.4"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Background: Postoperative anal dilations (PAD) are the standard of care for patients after a posterior sagittal anorectoplasty (PSARP) for anorectal malformation (ARM) or a transanal pull-through (TP) procedure for Hirschsprung disease (HD). This study assessed the psychosocial impact of PAD among caregivers of children with ARM or HD, which may inform postoperative care strategies. Methods: Caregivers of patients with ARM and HD who underwent PSARP or TP within five years participated in the online survey. Questions included demographics, patient and caregiver experiences with PAD, and baseline psychosocial functioning. Quantitative results were reported descriptively, while qualitative responses were summarized as major themes. Results: The survey indicated a response rate of 26% caregivers, with most being female (91%) and biological mothers (85%). Patients were mostly male (65%), born with ARM (74%), and were five months old on average when PAD began. Caregivers reported that during PAD, children experienced distress (56%), pain (44%), and fear (41%), while a third noted no negative reactions. Over time, their child\u2019s ability to cope with PAD got easier (38%) or stayed the same (41%). Caregivers reported worry\/anxiety (88%), guilt (71%), stress (62%), and frustration (35%), noting that additional coping strategies to manage the emotional and logistical challenges of daily PAD would be helpful. Conclusion: Although PAD is necessary, it can be highly stressful for the patients and their caregivers. Key findings emphasized the need for additional coping strategies and highlighted the importance of integrating psychosocial support into the postoperative care regimen.<\/jats:p>","DOI":"10.3390\/bs14050379","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T09:50:07Z","timestamp":1714470607000},"page":"379","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["\u201cTake It One Dilation at a Time\u201d: Caregiver Perspectives of Postoperative Anal Dilations in Pediatric Patients with Colorectal Conditions"],"prefix":"10.3390","volume":"14","author":[{"given":"Lea A.","family":"Wehrli","sequence":"first","affiliation":[{"name":"International Center for Colorectal and Urogenital Care, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merlin","family":"Ariefdjohan","sequence":"additional","affiliation":[{"name":"Child and Adolescent Mental Health Division, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Ketzer","sequence":"additional","affiliation":[{"name":"International Center for Colorectal and Urogenital Care, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Matkins","sequence":"additional","affiliation":[{"name":"International Center for Colorectal and Urogenital Care, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"De la Torre","sequence":"additional","affiliation":[{"name":"International Center for Colorectal and Urogenital Care, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bischoff","sequence":"additional","affiliation":[{"name":"International Center for Colorectal and Urogenital Care, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Judd-Glossy","sequence":"additional","affiliation":[{"name":"International Center for Colorectal and Urogenital Care, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"},{"name":"Child and Adolescent Mental Health Division, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"},{"name":"Pediatric Mental Health Institute, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1055\/s-0035-1570755","article-title":"The Practice of Anal Dilations Following Anorectal Reconstruction in Patients with Anorectal Malformations: An International Survey","volume":"26","author":"Brisighelli","year":"2016","journal-title":"Eur. 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Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1055\/s-0033-1333635","article-title":"Are Routine Dilatations Necessary Post Pull-through Surgery for Hirschsprung Disease?","volume":"23","author":"Aworanti","year":"2013","journal-title":"Eur. J. Pediatr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1007\/s00383-022-05219-7","article-title":"Stricture Rate in Patients after the Repair of Anorectal Malformation Following a Standardized Dilation Protocol","volume":"38","author":"Wehrli","year":"2022","journal-title":"Pediatr. Surg. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1017\/S0954579406060135","article-title":"Dissociation Following Traumatic Medical Treatment Procedures in Childhood: A Longitudinal Follow-Up","volume":"18","author":"Diseth","year":"2006","journal-title":"Dev. 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Int."}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/14\/5\/379\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:37:25Z","timestamp":1760107045000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/14\/5\/379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,30]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["bs14050379"],"URL":"https:\/\/doi.org\/10.3390\/bs14050379","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,30]]}}}