Meinds Rob J, Timmerman Marjolijn E W, van Meegdenburg Maxime M, Trzpis Monika, Broens Paul M A
a Department of Surgery, Division of Pediatric Surgery , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
b Department of Surgery, Anorectal Physiology Laboratory , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Scand J Gastroenterol. 2018 Jun-Jul;53(7):790-796. doi: 10.1080/00365521.2018.1465993. Epub 2018 Apr 27.
Current questionnaires on defecation disorders are often brief and fail to include questions considering causative factors. Furthermore, adult and pediatric questionnaires differ, which makes it impossible to monitor defecation disorders during the transition from childhood to adulthood. With these points in mind, we developed the Groningen Defecation and Fecal Continence (DeFeC) questionnaire and its pediatric equivalent, the P-DeFeC. The aim of this paper is to introduce the questionnaires and to assess their feasibility, reproducibility and validity.
Various Rome IV criteria and scoring tools for constipation and fecal incontinence were incorporated, resulting in nine categories. Feasibility and reproducibility were assessed by performing a test-retest survey in 100 adult participants. Concurrent validity was assessed in 27 patients and 18 healthy volunteers by comparing questionnaire-based diagnoses of constipation and fecal incontinence to final diagnoses based on anorectal function tests.
There were no remarks on the understandability of any questions. The Cohen's kappa coefficient of all main questions ranged from 0.26 to 1.00, with an average of 0.57. All but one category showed moderate agreement or higher. The sensitivity of the questionnaire-based diagnosis of constipation was 75%; specificity was 100%. The sensitivity of the questionnaire-based diagnosis of fecal incontinence was 77%; specificity was 94%.
Overall reproducibility of the Groningen DeFeC questionnaire is acceptable and its validity is good. This makes it a feasible screening tool for defecation disorders and, equally important, with these questionnaires defecation disorders can now be monitored during the transition from childhood to adulthood.
目前关于排便障碍的问卷通常较为简短，且未包含考虑致病因素的问题。此外，成人问卷和儿童问卷存在差异，这使得无法在从儿童期到成年期的过渡阶段监测排便障碍。考虑到这些因素，我们开发了格罗宁根排便与大便失禁（DeFeC）问卷及其儿童版P-DeFeC。本文旨在介绍这些问卷，并评估其可行性、可重复性和有效性。
纳入了各种罗马IV标准以及便秘和大便失禁的评分工具，共分为九类。通过对100名成年参与者进行重测调查来评估可行性和可重复性。通过将基于问卷的便秘和大便失禁诊断与基于肛肠功能测试的最终诊断进行比较，对27名患者和18名健康志愿者评估同时效度。
对任何问题的可理解性均无意见。所有主要问题的Cohen's kappa系数范围为0.26至1.00，平均为0.57。除一类外，所有类别均显示出中度一致性或更高。基于问卷的便秘诊断敏感性为75%；特异性为100%。基于问卷的大便失禁诊断敏感性为77%；特异性为94%。
格罗宁根DeFeC问卷的总体可重复性可接受，有效性良好。这使其成为一种可行的排便障碍筛查工具，同样重要的是，通过这些问卷现在可以在从儿童期到成年期的过渡阶段监测排便障碍。
