Standard compared with mnemonic counseling for fecal incontinence: a randomized controlled trial.
OBJECTIVE
To estimate whether women who underwent mnemonic counseling had better recall of fecal incontinence therapies at 2 months and if mnemonic counseling resulted in greater satisfaction with physician counseling and improvement in quality of life when compared with a group who underwent standard counseling.


METHODS
Counseling-naive women with fecal incontinence were recruited from an academic urogynecology clinic. Women underwent physical examinations, completed the Quality of the Physician-Patient Interaction, recorded fecal incontinence treatment options they recalled, and completed the Fecal Incontinence Severity Index and Manchester Health Questionnaire immediately after counseling and again at 2 months.


RESULTS
Ninety women consented to participate, were randomized, and completed baseline questionnaires. At baseline, women did not differ in age, ethnicity, education, Fecal Incontinence Severity Index, or Manchester Health Questionnaire scores. After counseling, the mnemonic group reported higher satisfaction on Quality of the Physician-Patient Interaction (66.4±6.5 compared with 62.2±10.7, P=.03). Ninety percent (81/90) of women followed up at 2 months. Our primary endpoint, 2-month recall of fecal incontinence treatments, was not different between groups (2.3±1.6 mnemonic counseling compared with 1.8±1.0 standard counseling; P=.08). Secondary endpoints for the mnemonic group reported greater improvement on total Manchester Health Questionnaire (P=.02), emotional (P=.03), sleep (0.045), role limitations (P<.01), and physical limitations (P=.04) when compared with the standard group.


CONCLUSIONS
Fecal incontinence counseling with a mnemonic aid did not improve recall at 2 months but improved patient satisfaction and quality of life at 2 months.
Division of Urogynecology, the Fellowship Program-Female Pelvic Medicine & Reconstructive Surgery, and the Clinical and Translational Science Center, University of New Mexico, Albuquerque, New Mexico.
Sara B
SB
Cichowski
Gena C
GC
Dunivan
Rebecca G
RG
Rogers
Ambroshia M
AM
Murrietta
Yuko M
YM
Komesu
D000328:Adult; D000368:Aged; D003376:Counseling / Q000379:methods*; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D011939:Mental Recall; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life