Coloproctology Unit, Clinical Management Unit of General and Gastrointestinal Surgery, Division Seville, Biomedical Research Institute (BIS), University Hospital Virgen del Rocio/CSIC University of Seville, Seville.
Coloproctology Unit, Unit of General and Gastrointestinal Surgery, Division Hospital Nisa 9 de Octubre, Valencia.
J Clin Gastroenterol. 2021 Feb 1;55(2):141-146. doi: 10.1097/MCG.0000000000001342.
The development and validation of a new version of the fecal incontinence (FI) scale "Rapid Assessment Fecal Incontinence Score" (RAFIS) incorporating domains for severity, type of stool loss, and global perception of the effect of incontinence on quality of life (QoL).
FI negatively impacts on QoL. Currently used incontinence questionnaires have outstanding limitations on the global assessment of the impact of the disease on QoL that patients perceive. We developed a new version of RAFIS with a more complete questionnaire.
A 3-phase study was performed to evaluate the applicability and reliability of our questionnaire as a tool for assessing FI. Our score was completed by 98 patients (78 women; mean age: 57±13 y) who presented with FI and who were referred from 4 colorectal surgery centers. The RAFIS was assessed for internal consistency, test-retest reliability, and sensitivity to change. A multivariate analysis was performed. Comparisons were made with the Wexner Cleveland Clinic Incontinence Score and the Fecal Incontinence Quality of Life Scale.
The RAFIS showed good internal consistency and test-retest reliability, differentiating the severity of incontinence but not the etiology. There was a moderate-high correlation between the new scale and the reference scales. Sensitivity to change, compared with the Wexner Score, was moderate. Comparison with established QoL instruments showed a moderate negative correlation. Logistic regression of the RAFIS discriminated between mild and moderate-severe impact on QoL. No correlation was detected with the new score to the presence of an anal sphincter defect or sphincter hypotonia.
The RAFIS scale is easy to administer and compares well with other validated incontinence instruments.
开发和验证一种新的粪便失禁（FI）量表“快速评估粪便失禁评分”（RAFIS）的版本，该量表纳入了严重程度、粪便丢失类型以及失禁对生活质量（QoL）整体影响的评估领域。
FI 对 QoL 有负面影响。目前使用的失禁问卷在评估疾病对患者感知的 QoL 的整体影响方面存在明显的局限性。我们开发了一种新的 RAFIS 版本，具有更完整的问卷。
进行了 3 个阶段的研究，以评估我们的问卷作为评估 FI 工具的适用性和可靠性。我们的评分由 98 名出现 FI 症状并从 4 个结直肠外科中心转诊的患者（78 名女性；平均年龄：57±13 岁）完成。评估 RAFIS 的内部一致性、测试-重测可靠性和对变化的敏感性。进行了多变量分析。与 Wexner 克利夫兰诊所失禁评分和粪便失禁生活质量量表进行了比较。
RAFIS 显示出良好的内部一致性和测试-重测可靠性，可区分失禁的严重程度，但不能区分病因。新量表与参考量表之间存在中度高度相关性。与 Wexner 评分相比，变化的敏感性为中度。与既定的 QoL 工具的比较显示出中度负相关。RAFIS 的逻辑回归可区分对 QoL 的轻度和中度严重影响。与新评分与肛门括约肌缺陷或括约肌张力减退之间无相关性。
RAFIS 量表易于管理，与其他经过验证的失禁量表相比表现良好。
