Bharucha A E, Locke G R, Seide B M, Zinsmeister A R
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Aliment Pharmacol Ther. 2004 Aug 1;20(3):355-64. doi: 10.1111/j.1365-2036.2004.02028.x.
The prevalence, severity and risk factors of faecal incontinence in women in the community are incompletely characterized.
To develop and validate a self-report questionnaire (faecal incontinence and constipation assessment) to address these issues.
Eighty-three women completed the instrument; 20 randomly selected patients answered the faecal incontinence and constipation assessment again 6 weeks later. A gastroenterologist also completed the faecal incontinence and constipation assessment in all 83 subjects after a detailed clinical assessment. Concurrent validity was evaluated by comparing the patient's self-report to a doctor interview for every question. Reproducibility was evaluated by a test-retest approach for every question. The severity of faecal incontinence was rated by incorporating the frequency and type of faecal incontinence, rectal urgency and use of sanitary devices.
The questionnaire was well-understood. Reproducibility [median kappa statistic, 0.80 (interquartile range: 0.66-0.90)]; and concurrent validity [0.59 (0.47-0.67)] were acceptable. For the index question on faecal incontinence, the kappa for reproducibility and concurrent validity was 0.90 and 0.95, respectively. The faecal incontinence severity score was also valid (kappa = 0.5).
The faecal incontinence and constipation assessment has excellent reproducibility and reasonable validity for assessing the presence, risk factors and severity of faecal incontinence and associated bowel disorders in women when compared against clinical assessment.
社区女性大便失禁的患病率、严重程度及风险因素尚未完全明确。
开发并验证一份自我报告问卷(大便失禁与便秘评估问卷)以解决这些问题。
83名女性完成了该问卷;20名随机选取的患者在6周后再次回答了大便失禁与便秘评估问卷。一名胃肠病学家在对所有83名受试者进行详细临床评估后也完成了大便失禁与便秘评估问卷。通过将患者的自我报告与医生针对每个问题的访谈结果进行比较来评估同时效度。通过对每个问题采用重测法来评估可重复性。大便失禁的严重程度通过纳入大便失禁的频率和类型、直肠紧迫感以及卫生用品的使用情况来进行评分。
该问卷易于理解。可重复性[中位数kappa统计量为0.80(四分位间距:0.66 - 0.90)];同时效度[0.59(0.47 - 0.67)]可接受。对于大便失禁的指标问题,可重复性和同时效度的kappa值分别为0.90和0.95。大便失禁严重程度评分也有效(kappa = 0.5)。
与临床评估相比,大便失禁与便秘评估问卷在评估女性大便失禁及相关肠道疾病的存在情况、风险因素和严重程度方面具有出色的可重复性和合理的效度。