Written versus oral disclosure of fecal and urinary incontinence in women with dual incontinence

Cichowski, Sara; Komesu, Yuko M.; Dunivan, Gena C.; Qualls, Clifford; Rogers, Rebecca G.

doi:10.1007/s00192-014-2393-y

Cited by 11 publications

(7 citation statements)

References 22 publications

(28 reference statements)

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“…After careful evaluation of full‐text papers 27 studies were excluded: 15 studies 23–37 did not evaluate FI assessment, six manuscripts 38–43 were just protocols, five were paediatric studies, 44–48 and one trial 49 had an inappropriate study design. Finally, 328 studies were included in our review: 306 studies…”

Section: Resultsmentioning

confidence: 99%

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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Background Fecal incontinence is a disabling condition affecting up to 20% of women. Objective We investigated fecal incontinence assessment in both inflammatory bowel disease and non-inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials. Methods We searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non-inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019. Results In total, 328 studies were included; 306 studies enrolled non-inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non-inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies. Conclusion Based on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.

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Section: Resultsmentioning

confidence: 99%

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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“…20 In prior qualitative studies, women with FI describe written inquiry as a more comfortable way to broach an uncomfortable topic, 15 and women with dual incontinence seeking care are more likely to verbally disclose urinary than fecal symptoms. 22 Similarly, adults in Ireland are more likely to disclose the use of incontinence aids on an anonymous written survey than they are when asked in face-to-face interviews. 23 Use of a previsit electronic pelvic floor health questionnaire, results of which were provided to both patients and their PCPs, improved provider-initiated discussion of incontinence in a randomized trial of women aged 40 years or older presenting to an internal medicine clinic for a well-woman examination.…”

Section: Discussionmentioning

confidence: 99%

If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers

Brown¹,

Guan²,

Schmuhl³

et al. 2018

J Am Board Fam Med

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Background: More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers’ (PCPs’) screening for UI and FI. Methods: We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs’ beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment. Results: Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%;P < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI (P < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9–26.0; P < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2–90.0; P =.01); screening verbally (OR, 3.9; 95% CI, 1.9–8.0; P < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8–7.4; P < .001); using the term, “accidental bowel leakage” (OR, 2.9; 95% CI, 1.2–6.7; P =.02) or “bowel control issues” (OR, 2.2; 95% CI, 1.1–4.5; P =.03); and being a resident (OR, 0.37; 95% CI, 0.16–0.82; P = .02). PCPs reported high interest in patient and provider educational materials about UI and FI. Conclusions: Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment. (J Am Board Fam Med 2018; 31:774–782.)

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“…While effective clinical treatments exist for both [2–5], more than 50 % of women with UI and 70 % with ABL do not seek treatment [6]. Further, women with both UI and ABL who seek clinical care are more likely to do so for their urinary symptoms and often do not mention their ABL to a healthcare provider [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Barriers to seeking care for accidental bowel leakage: a qualitative study

2016

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Introduction and hypothesis Fewer than 50 % of women with urinary incontinence (UI) and 30 % of women with accidental bowel leakage (ABL) seek care. We sought to describe barriers to care seeking for ABL to inform development of an instrument to measure these barriers. Methods We recruited women with ABL with varied prior care-seeking experiences to participate in focus groups and cognitive interviews so we could understand factors that may have prevented or delayed care seeking. Focus groups continued until thematic saturation was reached using conventional content analysis. Final themes were established and characterized by comparing within and across the focus groups and with previously described UI and ABL care-seeking barriers. Cognitive interviews were confirmatory. Results Thirty-nine women (aged 46–85) participated in six focus groups and ten cognitive interviews; 89 % were white, 8 % African American, and 3 % Latina. We identified 12 barriers to seeking care for ABL: (1) Lack of knowledge about the condition; (2) Lack of knowledge about treatment; (3) Fear of testing/treatment; (4) Normative thinking; (5) Avoidance/ denial; (6) Life impact; (7) Embarrassment/shame; (8) Self-blame; (9) Stigma; (10) Isolation; (11) Provider barriers; (12) Access limitations. These 12 barriers encompassed three overarching themes: the internalized self in relation to ABL; perceptions about ABL and its treatments; and interaction with the healthcare system. Conclusions ABL care-seeking barriers are similar to those described for UI, with the notable addition of lack of knowledge that ABL is a medical condition experienced by others. Interventions to promote access to effective treatments for ABL should include information about prevalence and treatability.

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Written versus oral disclosure of fecal and urinary incontinence in women with dual incontinence

Cited by 11 publications

References 22 publications

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers

Barriers to seeking care for accidental bowel leakage: a qualitative study

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