Validation of a questionnaire to assess fecal incontinence and associated risk factors - Fecal incontinence questionnaire

PURPOSE: Although fecal incontinence is a topic of considerable importance, there are no validated self-report measures of fecal incontinence availabl e. The aim of this study was to develop a questionnaire to measure fecal in continence and its risk factors in the community. METHOD: The reliability a nd concurrent validity of the fecal incontinence questionnaire were measure d by test-retest procedures in a population of clinic patients. The questio nnaire was created for a sixth-grade reading level, with large print. Ninet y-four adult patients were surveyed. Thirty-four patients repeated the ques tionnaire through the mail. Forty-one patients were independently retested over the telephone by a physician to assess concurrent validity. Nine patie nts refused retest, and ten patients did not respond to a second contact. R ESULTS: The fecal incontinence questionnaire was well understood and well a ccepted. Reliability (overall median kappa, 0.68; interquartile range, 0.03 -1) and validity (overall median kappa, 0.59; interquartile range, 0.27-1) were acceptable for the mailed retest and the telephone retest, respectivel y. The presence of fecal incontinence as measured by questionnaire was grea tly increased when compared with physician history in clinical records; onl y 3 percent: of patients reported no fecal incontinence on the questionnair e when the clinic chart had documented this problem. CONCLUSION: Our initia l results indicated that this new self-report questionnaire is a useful too l for assessing the presence of fecal incontinence in the population and ha s greater sensitivity compared with a standard physician interview. Specifi c attention should be given to identifying fecal incontinence and associate d symptoms during history taking.