Construction and application of a transitional health management program for children with Hirschsprung disease undergoing colonic irrigation based on the intervention mapping framework

Objective To develop an Intervention Mapping (IM) theory-based transitional health management program for children with Hirschsprung disease (HD) undergoing retrograde enema and evaluate its effectiveness. Methods Guided by IM theory, the intervention was developed through semi-structured interviews, literature review, expert consultation, and a pilot study. From April 2024 to June 2025, 94 children with HD and their primary caregivers were recruited from a tertiary pediatric hospital in Fujian Province and randomly assigned to an intervention group ( n = 47) or control group ( n = 47). The intervention group received multidisciplinary transitional health management based on IM theory, while the control group received routine care. Bowel preparation, enema-related complications, nutritional and growth outcomes, and caregivers’ caregiving ability, anxiety, and depression were assessed. Results Eighty-three participants completed follow-up (intervention, n = 42; control, n = 41). Compared with the control group, the intervention group had better bowel preparation, lower incidences of enterocolitis and overall complications, and more favorable preoperative nutritional and growth outcomes. Caregivers in the intervention group showed significantly greater caregiving ability and greater improvements in anxiety and depression at 1 week and 1 month after discharge (all P < 0.05). No significant differences were observed in enema-related dermatitis or intestinal obstruction ( P > 0.05). Repeated-measures analyses demonstrated significant group-by-time interactions for caregiving ability, anxiety, and depression ( P < 0.05). Conclusion The IM theory-based transitional health management program is feasible and effective in improving clinical and caregiver-related outcomes in children with HD receiving retrograde enema and their families.