Author Identifier
Davina Houghton: http://orcid.org/0000-0001-8943-5278
Date of Award
2026
Keywords
Children, idiopathic constipation, health education, primary healthcare, Perth WA
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Doctor of Philosophy
School
School of Nursing and Midwifery
First Supervisor
Lisa Whitehead
Second Supervisor
Diana Arabiat
Third Supervisor
Deborah Ireson
Fourth Supervisor
Evalotte Mörelius
Abstract
Introduction. Idiopathic childhood constipation (ICC) is a common condition, often associated with childhood life stages that is, weaning, toilet training, or starting school; life events, such as domestic violence; and familial characteristics, such as immediate family members experiencing ICC. While the prevalence of ICC in Australia is unknown, it is thought to affect around one-third of all children worldwide. Furthermore, cases of ICC continue to increase despite online, evidence-based constipation guidelines being available to facilitate diagnosis, treatment, and management. Children and their families experience significant and enduring adverse impacts on their physical, psychological, psycho-emotional, and psychosocial health, which further significantly adversely impacts society, and the economies of Australian and international health services.
Methods. This research study aimed to address three research questions: (1) what health education is provided by Primary Care Providers (PCPs) to families living with ICC and in what format is it delivered?; (2) which aspects of health education are utilised by families living with ICC?; and (3) what do families report as helpful in terms of additional ICC health education resources? The conceptual framework of Child and Family Centred Care, a pragmatic philosophical worldview, and an explanatory sequential design mixed methods approach were used. Sequence 1 collected quantitative data from 15 adult participants using an online questionnaire, and Sequence 2 collected qualitative data through face-to-face interviews with eight adult participants who took part in Sequence 1 and, with consent, six child participants. The results and findings of these two sequences were integrated in tabular form to demonstrate coherence, and discussed. Ethical considerations were addressed according to government and university policies.
Results. Research Question 1: The lack of ICC health education provision by PCPs, and lack of regular and close follow-up, resulted in a failure to achieve optimal outcomes. Health education was predominantly verbal and children were not included in health education conversations. This led to participants presenting to multiple PCPs; fragmented and decreased continuity of care; significant dissatisfaction in the overall management of their child’s ICC; and disengagement from the treatment and management regimens. Mothers and children also did not recognise the development of ICC. Research Question 2: Participants utilised health education when provided. However, the lack of health education resulted in a constant struggle to live with ICC due to misunderstandings, inconsistency, emotional upset, trauma, and burdens associated with trying to manage ICC. Research Question 3: Participants used the internet and social media platforms to gain information and support, and reported on health education resources they considered helpful.
Discussion. The findings demonstrate that while the evidence-base contained all the health education required, this was not accessed due to the lack of PCP ICC knowledge. Consequentially, the verbal and written informational needs of adult and child participants were not met; important pharmacological and non-pharmacological recommendations, strategies, instructions, explanations, and rationales were not provided; families struggled to live with ICC; and dissatisfaction with the overall management of ICC was experienced. Furthermore, this research study identified limitations, and adds to the evidence-base by making six practice and policy recommendations.
Access Note
Access to this thesis is embargoed until 30th April 2028
Recommended Citation
Houghton, D. (2026). Contemporary idiopathic childhood constipation health education within the primary health care setting and its utilisation by families living in Perth, Western Australia: A mixed methods study. Edith Cowan University. https://doi.org/10.25958/bw8e-hg24