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PTU-100 Development And Initial Validation Of A New Assessment Tool For Faecal Incontinence In Inflammatory Bowel Disease: The International Consultation On Incontinence Questionnaire- Inflammatory Bowel Disease (iciq-ibd)
  1. L Dibley1,
  2. C Norton1,
  3. N Cotterill2,
  4. P Bassett3
  1. 1Florence Nightingale School of Nursing and Midwifery, King’s College, London, UK
  2. 2British Urological Institute, Bristol
  3. 3Stats Consultancy, Amersham, UK

Abstract

Introduction Faecal incontinence (FI) in IBD is common and under-reported. In a prior study1 an existing questionnaire2 was found unsuitable for assessing FI in IBD due to inability to address fluctuating symptoms and IBD-related concerns. We aimed to develop a new psychometrically robust IBD-specific FI questionnaire.

Methods Participantswere purposefully sampled from a UK IBD charity’s membership. The International Consultation on Incontinence3 Questionnaire development and validation protocol was followed in a two phase study. Phase 1: we progressively developed content, terminology and format of the new tool from feedback in the original study1 and four rounds of cognitive interviews. A modified Delphi survey of clinicians identified important clinical content. Phase 2: participants completed the final version of the ICIQ-IBD and a disease activity index twice, to evaluate validity of the questionnaire and consistency of assessment. A principal exploratory factor analysis identified underlying domains in the questionnaire.

Results 24 respondents (female n = 18, 75%; age: mean 50 yrs) participated in cognitive interviews. Ten clinicians clarified clinical content. 166/188 respondents (88%) returned the first (test) questionnaire. 143 (86% [76% of total sample]) returned the second (retest) questionnaire 2–6 weeks later. Most questions were relevant to most respondents. The new ICIQ-IBD discriminates between patients with and without FI, low and high disease activity, and concern levels.110 respondents returning test and retest data had stable disease – weighted kappa was used to determine stability (test-retest reliability). 36/41 questions (87.8%) showed good or moderate agreement, suggesting the questionnaire is reasonably stable and reliable. Two domains were identified: bowel symptoms and quality of life, with a simple additive score for each domain.

Conclusion The new ICIQ-IBD is valid and reliable. Further psychometric testing to evaluate sensitivity to change will be conducted in a forthcoming intervention study.

References

  1. Norton C, Dibley L, Bassett, P. Faecal incontinence in inflammatory bowel disease (IBD): associations and effect on quality of life. Journal of Crohn’s and Colitis. 2013;7(8):e302–311

  2. Cotterill N, Norton C, Avery K, Abrams P, Donovan J. Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life. The ICIQ-B. Diseases of the Colon and Rectum. 2011;54(10)1235–1250

  3. International Consultation on Incontinence protocol. Available at: http://www.iciq.net/validationprotocol.htm

Disclosure of Interest None Declared.

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