Reasons for non-disclosure of faecal incontinence: a comparison between two survey methods

Bartlett, L., Nowak, M., and Ho, Y-H. (2007) Reasons for non-disclosure of faecal incontinence: a comparison between two survey methods. Techniques in Coloproctology, 11 (3). pp. 251-257.

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Abstract

Purpose: We explored reasons for discordance in disclosure of faecal incontinence (FI) between 2 measurement instruments: the Self Administered Faecal Incontinence Questionnaire (SAFIQ) and the Cleveland Clinic Florida Fecal Incontinence Score (CCF-FI)

Methods: Patients ≥18 years attending the urogynaecology (n=135) and colorectal (n=148) outpatient clinics at The Townsville Hospital, a referral centre serving regional North Queensland, Australia, were invited to complete the SAFIQ and answer questions from the CCF-FI asked by their treating doctor. Selected patients undertook semistructured interviews.

Results: 262 patients completed both questionnaires. The prevalence of FI in this population was 25.6% (SAFIQ) and 29.9% (CCF-FI). 24% disclosed FI on both instruments, 3.1% on SAFIQ only and 6.1% on CCF-FI only. Major reasons for non-disclosure were: FI historical but not current; problem not considered as FI by patient; SAFIQ too long; condition embarrassing; doctor considered too busy; patient wanted to focus on primary reason for consultation; and doctor explained that a one-off bout of uncontrollable diarrhoea was not FI. Interviewees reported they would respond to FI questions initiated by their general practitioner (GP) during regular consultations, or in a generic questionnaire in the GP’s surgery.

Conclusions: GPs could identify patients with FI by initiating discussions during routine consultations. Such patients could then be referred to colorectal surgeons for treatment. A more specific definition of FI, which excludes historical data and isolated instances of diarrhoea, is desirable. A measurement instrument suitable for population surveys should contain simple language and acknowledge issues of embarrassment.

Item ID: 2848
Item Type: Article (Research - C1)
ISSN: 1128-045X
Keywords: disclosure; faecal incontinence; general practice; stigma
Date Deposited: 24 Sep 2009 00:38
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111712 Health Promotion @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health @ 60%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920502 Health Related to Ageing @ 20%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920408 Health Status (e.g. Indicators of Well-Being) @ 20%
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