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Donlau, Marie
Publications (3 of 3) Show all publications
Donlau, M., Mattsson, S. & Glad Mattsson, G. (2013). Children with myelomeningocele and independence in the toilet activity: A pilot study. Scandinavian Journal of Occupational Therapy, 20(1), 64-70
Open this publication in new window or tab >>Children with myelomeningocele and independence in the toilet activity: A pilot study
2013 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 1, p. 64-70Article in journal (Refereed) Published
Abstract [en]

Objective: Regarding adult life and independence the most common obstacles for young adults with myelomeningocele (MMC) are cognitive dysfunction and difficulties in performing toilet activities. A step-by-step method with goal setting for the training of self-care in toilet activities for children with MMC was evaluated. Method: Twenty-two children with MMC and bladder and bowel dysfunction (12 girls, 10 boys) aged 3-17.2 (m 9.1) were included. The toilet activities were observed at home jointly by an occupational therapist and urotherapist. Goal-setting procedures of self-training were promoted. Observation scores before and after intervention were compared, the goal setting being evaluated on a Goal Attainment Scale (GAS). Results: Fifteen children who trained in self-catheterization had a median observation score of 22 before and 37 after the training period (p = 0.002). Another seven trained in trans-rectal irrigation with a median score of 30 before and 49 after (p = 0.02). As a result of GAS all children improved, of whom 17 reached the goal or even more so than expected. Conclusions: In this pilot study mutual goal setting in a step-by-step training programme based on professional observation of the toilet activity at home showed a better outcome than traditionally performed training in a hospital setting or with traditional habilitation support.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
toilet training, spina bifida, self-care, neurogenic bladder and bowel dysfunction
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-87962 (URN)10.3109/11038128.2012.700729 (DOI)000312785300009 ()

Funding Agencies|Medical Research Council of Southeast Sweden||County Council of Ostergotland||Swedish Inheritance Fund||

Available from: 2013-01-28 Created: 2013-01-28 Last updated: 2017-12-06
Gribble, N., Parsons, R., Donlau, M. & Falkmer, T. (2013). Predictors of time to complete toileting for children with spina bifida. Australian Occupational Therapy Journal, 60(5), 343-349
Open this publication in new window or tab >>Predictors of time to complete toileting for children with spina bifida
2013 (English)In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 60, no 5, p. 343-349Article in journal (Refereed) Published
Abstract [en]


Previous research has shown that children with spina bifida use clean intermittent catheterisation for urination, a rather complex procedure that increases the time taken to completion. However, no studies have analysed the factors impacting on the time taken to complete the urination that could inform occupational therapy practice. Therefore, the aim was to identify the variables that predict extended time children with spina bifida take to complete urination.


Fifty children, aged 5–18 years old with spina bifida using clean intermittent catheterisation, were observed while toileting and responding to a set of assessments tools, among them the Canadian Occupational Performance Measure. A logistic regression was used to identify which variables were independently associated with an extended toileting time.


Children with spina bifida do take long time to urinate. More than half of this study's participants required more than five minutes completing urination, but not all required extended times. Ambulant, independent girls were more likely to perform toileting in less than six minutes compared with other children with spina bifida. However, age, IQ, maintained focus on the task, Canadian Occupational Performance Measure, time processing abilities and self-reported ratings of independence appeared to be of no relevance, to predict extended toileting times.


To minimise occupational disruption caused by extended toileting times, occupational therapists should utilise the relevant predictors: gender, independence and ambulation when they prioritise children for relevant interventions.


Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
children, MMC, myelomeningocele, occupational disruption, spina bifida, toileting
National Category
Occupational Therapy
urn:nbn:se:liu:diva-103765 (URN)10.1111/1440-1630.12052 (DOI)000325157200006 ()24089986 (PubMedID)
Available from: 2014-01-27 Created: 2014-01-27 Last updated: 2018-03-17Bibliographically approved
Donlau, M., Imms, C., Glad Mattsson, G., Mattsson, S., Sjörs, A. & Falkmer, T. (2011). Children and youth with myelomeningoceles independence in managing clean intermittent catheterization in familiar settings. ACTA PAEDIATRICA, 100(3), 429-438
Open this publication in new window or tab >>Children and youth with myelomeningoceles independence in managing clean intermittent catheterization in familiar settings
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2011 (English)In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 100, no 3, p. 429-438Article in journal (Refereed) Published
Abstract [en]

Aim: To examine the ability of children and youth with myelomeningocele to independently manage clean intermittent catheterization. Methods: There were 50 participants with myelomeningocele (5-18 years); 13 of them had also participated in a previous hospital-based study. Their abilities and interest in completing the toilet activity were examined at home or in school using an interview and the Canadian Occupational Performance Measure (COPM). Actual performance was observed and rated. Background variables were collected from medical records and KatAD+E tests. Results: In total, 48% were observed to perform the toilet activity independently, in comparison with 74% who self-reported independence. Univariate analyses found KatAD+E could predict who was independent. COPM failed to do so. Ability to remain focused and ambulation were predictors of independence, but age, sex and IQ were not. Multivariable analysis found time to completion to be the strongest predictor of independence. Four children were independent in their familiar environment, but not in the hospital setting, and six of 13 children maintained focus only in their familiar environment. Conclusions: Interviews were not sufficiently accurate to assess independence in the toilet activity. Instead, observations including time to completion are recommended. The execution of the toilet activity is influenced by the environmental context.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011
Catheter intervention, Clean intermittent catheterization, Independence, Neurogenic bladder dysfunction, Spina bifida
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-66906 (URN)10.1111/j.1651-2227.2010.02044.x (DOI)000286837700024 ()
Available from: 2011-03-21 Created: 2011-03-21 Last updated: 2018-03-17

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