A systematic review of psychometric evidence and expert opinion regarding the assessment of faecal incontinence in older community-dwelling adults

Article


Fallon, Anthony Bruce, Westaway, Julie and Moloney, Clint. 2008. "A systematic review of psychometric evidence and expert opinion regarding the assessment of faecal incontinence in older community-dwelling adults." International Journal of Evidence-Based Healthcare. 6 (2), pp. 225-259.
Article Title

A systematic review of psychometric evidence and expert opinion regarding the assessment of faecal incontinence in older community-dwelling adults

ERA Journal ID40007
Article CategoryArticle
AuthorsFallon, Anthony Bruce (Author), Westaway, Julie (Author) and Moloney, Clint (Author)
Journal TitleInternational Journal of Evidence-Based Healthcare
Journal Citation6 (2), pp. 225-259
Number of Pages35
Year2008
Place of PublicationAdelaide, Australia
ISSN1744-1595
1744-1609
Web Address (URL)http://www3.interscience.wiley.com/cgi-bin/fulltext/120089993/PDFSTART
Abstract

[Abstract]:

Objectives: This review had two objectives: (i) to determine what is required in an assessment of faecal incontinence issues for older community-dwelling adults; and (ii) to determine the psychometric tools most effective for assessment of faecal incontinence in older community-dwelling adults.

Inclusion criteria: For the review of psychometric tools, studies were included if they were concerned with
people living in the community, included a significant proportion of the sample aged 65 years or over, and either
examined psychometric properties of assessment tools or assessed sensitivity of assessment tools to non-surgical
interventions available in the community setting. For the review of expert opinion, the search was limited to expert
opinion provided by an expert in faecal incontinence that related to community-based assessment. Only articles
published in English were eligible for inclusion and no limits were placed on publication dates.

Search strategy: An initial search of Medline and CINAHL databases identified terminology frequently used in the
literature with regard to assessment of faecal incontinence. An extensive search was then undertaken using all identified key words and index terms. The third step involved a search of reference lists and bibliographies of all relevant articles.

Methodological quality: All identified studies that met the inclusion criteria were assessed for methodological
validity in the case of studies considered for inclusion in the psychometric review. Validity of expert text was also assessed prior to it being included in the review.

Results: The final search strategy identified approximately 7000 references. Full-text versions of 144 references were critically appraised for inclusion in the review. Of these, 25 sources were included in the review of expert opinion and 16 in the review of psychometric properties. In the review of expert opinion, 254 conclusions were extracted for synthesis. The 31 thematic categories were organised under five major themes: History-taking, bowel assessment, psychosocial aspects, physical examination and specialist referral. From the sources that survived critical appraisal, 52 conclusions relating to psychometric properties of assessment tools were derived. There was limited, if any, analysis of psychometric properties for the majority of assessment tools. The Wexner and Vaizey symptom severity scales demonstrated acceptable test–retest reliability and convergent validity. The Fecal Incontinence Quality of Life Scale (FIQLS) demonstrated reasonable reliability and good convergent and criterion-related validity. There
was, however, some evidence questioning its discriminant validity.

Conclusions: This systematic review represents an important first stage in developing guidelines for assessment of faecal incontinence in community-dwelling older people. Assessment should be comprehensive in nature. Gaps in expert opinion are evident regarding issues such as assessment of cognitive decline and specialist referral. Continence advisors need to be appropriately trained in using and interpreting results from assessment tools and conducting physical examinations. Although studies in the review of psychometric properties suffer from limitations such as inadequate sample sizes, the Vaizey and Wexner scales would appear to be the tools of choice. The FIQLS is clearly the tool of choice at this stage for measuring faecal incontinence quality of life. Further validation of tests used in faecal incontinence assessments is required.

Keywordsaged, expert opinion, faecal incontinence, psychometrics, review, systematic
ANZSRC Field of Research 2020420502. Aged care nursing
Public Notes

© 2008 The Authors. Deposited in accordance with the copyright policy of the publisher (Blackwell) The definitive version is available at www.blackwell-synergy.com

Byline AffiliationsAustralian Centre for Rural and Remote Evidence Based Practice
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The Toowoomba infant feeding support service project: Report on phase 1 - a longitudinal needs analysis of breastfeeding behaviours and supports in the Toowoomba region
Fallon, Anthony Bruce, O'Brien, Maxine, Plank, Ashley, Doolan, Jackie, Brodribb, Wendy, Hennessy, Jane, Laurent, Kathy and Baker, Sandra F.. 2003. The Toowoomba infant feeding support service project: Report on phase 1 - a longitudinal needs analysis of breastfeeding behaviours and supports in the Toowoomba region. Toowoomba, Australia. University of Southern Queensland.
Aged care nursing in Queensland - the nurses' view
Eley, Robert, Hegney, Desley, Buikstra, Elizabeth, Fallon, Anthony Bruce, Plank, Ashley and Parker, Victoria. 2007. "Aged care nursing in Queensland - the nurses' view ." Journal of Clinical Nursing. 16 (5), pp. 860-872. https://doi.org/10.1111/j.1365-2702.2006.01696.x
Key issues in rural health: perspectives of health service providers in Queensland
Eley, Robert, Fallon, Anthony Bruce, Gorman, Don, Fahey, Paul P., Rogers-Clark, Cath and Hegney, Desley. 2006. Key issues in rural health: perspectives of health service providers in Queensland. Toowoomba, Australia. University of Southern Queensland.
A stock-take of existing aged care clinical placements for undergraduate nursing students in Australia
Neville, Christine C., Yuginovich, Trudy, Fallon, Anthony Bruce, Soar, Jeffrey, Boyes, Joanne and Grasby, David. 2006. A stock-take of existing aged care clinical placements for undergraduate nursing students in Australia. Toowoomba, Australia. University of Southern Queensland.
To what extent will the annual number of episodes of acute confusion within a medical unit be reduced following the introduction of high risk indicators and early intervention strategies
Moloney, Clint. 2005. To what extent will the annual number of episodes of acute confusion within a medical unit be reduced following the introduction of high risk indicators and early intervention strategies. Masters Thesis Master of Health Science. University of Southern Queensland.
SEAM: improving the quality of palliative care in regional Toowoomba, Australia - lessons learned
Buikstra, Elizabeth, Pearce, Susanne, Hegney, Desley and Fallon, Tony. 2006. "SEAM: improving the quality of palliative care in regional Toowoomba, Australia - lessons learned ." Rural and Remote Health. 6 (1), pp. 1-10.
Challenges for implementing wireless hand-held technology in health care: views from selected Queensland nurses
Gururajan, Raj, Moloney, Clint and Soar, Jeffrey. 2005. "Challenges for implementing wireless hand-held technology in health care: views from selected Queensland nurses." Journal of Telemedicine and Telecare. 11 (2 (Supplement)), pp. 37-38. https://doi.org/10.1258/135763305775124849
Lexicality and phonological similarity: a challenge for the retrieval-based account of serial recall?
Fallon, Anthony B., Mak, Eva, Tehan, Gerald and Daly, Charmaine. 2005. "Lexicality and phonological similarity: a challenge for the retrieval-based account of serial recall?" Memory. 13 (3/4), pp. 349-356. https://doi.org/10.1080/09658210344000215
Out patient orthopaedic consultations via telehealth: a qualitative study
Gururajan, Raj, Gururajan, Vijaya, Moloney, Clint and Scott, Annette. 2005. "Out patient orthopaedic consultations via telehealth: a qualitative study." Beekhuyzen, Jenine, Von Hellens, Lisa, Guest, Karen, Morley, Morley and Collier, Toni (ed.) 2005 QualIT Challenges for Qualitative Research. Brisbane, Australia 23 - 25 Nov 2005 Brisbane, Australia.
Facilitators and inhibitors for wireless handheld technology: views from Queensland nurses
Gururajan, Raj and Moloney, Clint. 2005. "Facilitators and inhibitors for wireless handheld technology: views from Queensland nurses." Beekhuyzen, Jenine, Von Hellens, Lisa, Guest, Karen, Morley, Morley and Collier, Toni (ed.) 2005 QualIT Challenges for Qualitative Research. Brisbane, Australia 23 - 25 Nov 2005 Brisbane, Australia.
Adoption of wireless handheld technology: a case of Queensland healthcare
Gururajan, Raj, Hafeez-Baig, Abdul and Moloney, Clint. 2005. "Adoption of wireless handheld technology: a case of Queensland healthcare." Yeung, Jeff (ed.) 5th International Conference on Electronic Business: Enhancing Logistics & Supply Chain Competence Through E-Business (ICEB 2005). Hong Kong, China 05 - 09 Dec 2005 Hong Kong, China.
The baby-friendly hospital initiative and breastfeeding duration: relating the evidence to the Australian context
Fallon, Anthony Bruce, Crepinsek, Maree, Hegney, Desley and O'Brien, Maxine. 2005. "The baby-friendly hospital initiative and breastfeeding duration: relating the evidence to the Australian context." Birth Issues. 14 (3), pp. 90-95.
Drivers for wireless handheld technology: views from Queensland nurses
Gururajan, Raj, Moloney, Clint and Kerr, Don. 2005. "Drivers for wireless handheld technology: views from Queensland nurses." Shehadie, Elias (ed.) Australasian Business and Behavioural Sciences Association Conference 2005 (ABBSA 2005). Cairns, Australia 05 - 07 Aug 2005 Australia.
An investigation into the factors of adoption of wireless applications for data management by nurses
Gururajan, Raj, Kerr, Don, Moloney, Clint and Houghton, Luke. 2005. "An investigation into the factors of adoption of wireless applications for data management by nurses." Eldon, Li (ed.) APDSI 2005. Taipei, Taiwan 28 Jun - 02 Jul 2005 Taipei, Taiwan.
Attitudes of Australian nurses to information technology in the workplace: A national survey
Eley, Robert, Soar, Jeffrey, Buikstra, Elizabeth, Fallon, Tony and Hegney, Desley. 2009. "Attitudes of Australian nurses to information technology in the workplace: A national survey." CIN: Computers, Informatics, Nursing. 27 (2), pp. 114-121. https://doi.org/10.1097/NCN.0b013e318197557e