Reasons for non-disclosure of faecal incontinence: a comparison between two survey methods.
OBJECTIVE
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 >or=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.
Faecal Incontinence Research Group School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD, 4811, Australia. Lynne.Bartlett@jcu.edu.au
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005242:Fecal Incontinence / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D012650:Self Disclosure; D011795:Surveys and Questionnaires