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Symptom outcomes important to women with anal incontinence: a conceptual framework.

Publication ,  Journal Article
Sung, VW; Rogers, RG; Bann, CM; Arya, L; Barber, MD; Lowder, J; Lukacz, ES; Markland, A; Siddiqui, N; Wilmot, A; Meikle, SF ...
Published in: Obstet Gynecol
May 2014

OBJECTIVE: To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. METHODS: A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. RESULTS: Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. CONCLUSION: Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

Duke Scholars

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Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

May 2014

Volume

123

Issue

5

Start / End Page

1023 / 1030

Location

United States

Related Subject Headings

  • Terminology as Topic
  • Patient Care Planning
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Interviews as Topic
  • Hygiene
  • Humans
  • Focus Groups
  • Flatulence
  • Female
 

Citation

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Sung, V. W., Rogers, R. G., Bann, C. M., Arya, L., Barber, M. D., Lowder, J., … Pelvic Floor Disorders Network, . (2014). Symptom outcomes important to women with anal incontinence: a conceptual framework. Obstet Gynecol, 123(5), 1023–1030. https://doi.org/10.1097/AOG.0000000000000236
Sung, Vivian W., Rebecca G. Rogers, Carla M. Bann, Lily Arya, Matthew D. Barber, Jerry Lowder, Emily S. Lukacz, et al. “Symptom outcomes important to women with anal incontinence: a conceptual framework.Obstet Gynecol 123, no. 5 (May 2014): 1023–30. https://doi.org/10.1097/AOG.0000000000000236.
Sung VW, Rogers RG, Bann CM, Arya L, Barber MD, Lowder J, et al. Symptom outcomes important to women with anal incontinence: a conceptual framework. Obstet Gynecol. 2014 May;123(5):1023–30.
Sung, Vivian W., et al. “Symptom outcomes important to women with anal incontinence: a conceptual framework.Obstet Gynecol, vol. 123, no. 5, May 2014, pp. 1023–30. Pubmed, doi:10.1097/AOG.0000000000000236.
Sung VW, Rogers RG, Bann CM, Arya L, Barber MD, Lowder J, Lukacz ES, Markland A, Siddiqui N, Wilmot A, Meikle SF, Pelvic Floor Disorders Network. Symptom outcomes important to women with anal incontinence: a conceptual framework. Obstet Gynecol. 2014 May;123(5):1023–1030.

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

May 2014

Volume

123

Issue

5

Start / End Page

1023 / 1030

Location

United States

Related Subject Headings

  • Terminology as Topic
  • Patient Care Planning
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Interviews as Topic
  • Hygiene
  • Humans
  • Focus Groups
  • Flatulence
  • Female