Development of an ICF-based questionnaire for urinary and/or fecal incontinence (ICF-IAF): The female patients' perspective using focus groups (subproject).

AIMS: The aim of this study was to identify the problems and resources of women with urinary or fecal incontinence based on the International Classification of Function and Health (ICF) framework and detecting the impact on the personal environment and quality of life. This study forms part of a project with an overall goal to enable standardized planning and evaluation of interventions in multi-professional settings. METHODS: To answer the study question a mixed-method sequential design with a priority to the quantitative approach was considered appropriate. Regarding methods, focus groups were chosen to collect data. Transcripts were analyzed with content analysis and identified concepts linked to the corresponding ICF categories by two different raters. Cohen's kappa was calculated for interrater reliability. RESULTS: Thirteen women with a mean age of 69.9 years were recruited. Four focus groups were conducted, whereas saturation was reached after two focus groups. Overall transcripts 99 defined ICF categories at second level could be linked (body functions = 31, body structures = 5, activities and participation = 33, and environmental factors = 30) whereas 4 categories were not sufficiently covered by the ICF (3 = personal factors, 1 = not covered). CONCLUSIONS: This study has determined 103 resources and problems based on the ICF model of women with urinary and/or fecal incontinence. In spite of these results, it was shown that four concepts are not fully covered by the ICF framework. The current data highlight the importance of an extension of the ICF model, especially towards the personal factors of patients.

Development of an ICF-based questionnaire for urinary and/or fecal incontinence (ICF-IAF): The male patients' perspective using focus groups.

AIMS: This study seeks to explore barriers faced by and resources available to male patients with urinary (UI) and/or fecal incontinence (FI) based on the ICF framework. As a result, this study contributes to the development of the ICF-Incontinence Assessment Form (ICF-IAF), which is designed to be a standardized planning and evaluation tool for interventions in a multidisciplinary setting. METHODS: A mixed-method sequential design that places emphasis on the quantitative approach was considered appropriate for this study. Focus group interviews (FG) were chosen to collect data. Data were analysed with deductive content analysis and themes identified during FG were linked to the most corresponding ICF categories by two raters. Cohen's κ was calculated to determine interrater reliability. RESULTS: Four FG were conducted with a total of 13 male participants. The mean age of the participants was 74.7 years. A total of 73 barriers and resources on the second ICF level (body functions 26, body structures five, activities and participation 26 and environmental factors 16), whereby four categories were not sufficiently covered by the ICF, could be identified. The κ score for the two raters was 0.82. CONCLUSIONS: While barriers are fundamental factors affecting patients, this study found that resources are as important and should not be overlooked in the conventional treatment in both UI and FI-specific assessments.

Development and validation of the ICF-Incontinence Assessment Form (ICF-IAF) to identify problems and resources for planning and evaluation of interventions using the Classification of Functioning, Disability and Health of the World Health Organization: Preliminary study.

AIMS: Current level-A recommended questionnaires that provide a valid assessment of urinary incontinence (UI) and/or faecal incontinence (FI), but do not cover all aspects of the burden of the disease in the sense of the bio-psycho-social model of the World Health Organization's International Classification of Functioning, Disability and Health (ICF). Therefore, an ICF oriented questionnaire for patients with UI and/or FI to assess treatment barriers (problems) as well as positive influencing factors (resources), the "ICF-Incontinence Assessment Form" will be developed. The aim of this preliminary study was (a) to identify problems and resources of UI and/or FI in current level-A recommended questionnaires and (b) to evaluate problems and resources of patients with UI and/or FI from the perspective of experienced physiotherapists. METHODS: (a) Current level-A recommended questionnaires for UI and/or FI were analyzed. Questions were linked to the ICF categories. (b) A 3-round Delphi technique survey among 262 physiotherapists from five German-speaking countries was used to evaluate patients' problems and resources relevant to physiotherapy. RESULTS: (a) A total of 27 identified questionnaires were linked to 110 ICF categories. No positive influencing factors could be identified. (b) After Delphi-round 3, 110 categories of problems and 71 resources were identified. CONCLUSION: Since there is a lack of resource items in the present validated questionnaires, there is a need for a short, practical questionnaire to assess and monitor both, problems and resources of patients with UI and/or FI.