Kuhn M1,2, Gass S3, Koenig I3, Radlinger L3, Koehler B1,2
1ZHAW Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Winterthur, Switzerland, 2Stadtspital Triemli, Zurich, Switzerland, 3Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
Background: Urinary and fecal incontinence (UI, FI) are physically debilitating disorders, both types of incontinence mainly result in psycho-social stress, which has a negative impact on the quality of affected people's lives. For the treatment of incontinent patients the entire spectrum of the disease should be considered. To address the entire spectrum of the disease, our study group is currently developing the ICF Incontinence Assessment Form (ICF-IAF). Therefore, this subproject involved deductively investigating barriers faced by and resources available to incontinent adults and linking those to the ICF. These barriers and resources assigned to the ICF categories are expected to support the development of the ICF-IAF.
Purpose: The aim of this study was to explore barriers and resources in patients with urinary or fecal incontinence using focus group interviews. The answers should be translated in the standardized language of the International Classification of Functioning, Disability and Health (ICF) as part of the development of the ICF-IAF for international use in multi-professional settings.
Methods: The qualitative design of focus group interviews was appropriate. The semi-structured topic guide was based on the ICF chapters body functions, body structures, activities and participation, environmental, and personal factors. The interviews were transcribed and the textual data was explored inductively using content analysis to generate codes. In the next step all generated codes were linked to the most corresponding ICF-Barrusing established linking-rules. The linking to the ICF was done by two researchers independently. To assess the inter-rater agreement, Cohen's Kappa was calculated for the second level categories. Saturation was given if no more than 5 new ICF-categories in two consecutive focus groups could be identified.
Results: Four focus groups were conducted with 13 participants. The mean age was 74.7 years. Personal data as well as established health related and disease specific questionnaires were included. A total of 73 2nd level ICF categories could be linked, of those 63 referred to barriers and 42 denoted resources. The most often mentioned barriers were handling stress and other psychological demands (d240), urination and defecation functions (b620 resp. b525) and temperament and personality functions (b126). Regarding resources most often mentioned were products and technology for personal use in daily life (e115), temperament and personality functions (b126) and handling stress and other psychological demands (d240).
Conclusion(s): Barriers and resources in all chapters of the ICF were found in contrast to preliminary subprojects of the development of the ICF-IAF. This functioning profile is useful to represent the perspective of patients with UI or FI in the population of this study.
Implications: The results of all preliminary studies were included in a consensus conference in late 2017 developing the first version of the ICF-IAF. The international and multi-professional validation will result in the final version of the ICF-IAF in 2018.
Used in a multidisciplinary team, the ICF-IAF can be seen as a common platform from which the different professionals start their assessments, plan interventions, and evaluate the treatment, as well as its implication in future research.
Keywords: assessment, patient outcomes, health holistic
Funding acknowledgements: none
Purpose: The aim of this study was to explore barriers and resources in patients with urinary or fecal incontinence using focus group interviews. The answers should be translated in the standardized language of the International Classification of Functioning, Disability and Health (ICF) as part of the development of the ICF-IAF for international use in multi-professional settings.
Methods: The qualitative design of focus group interviews was appropriate. The semi-structured topic guide was based on the ICF chapters body functions, body structures, activities and participation, environmental, and personal factors. The interviews were transcribed and the textual data was explored inductively using content analysis to generate codes. In the next step all generated codes were linked to the most corresponding ICF-Barrusing established linking-rules. The linking to the ICF was done by two researchers independently. To assess the inter-rater agreement, Cohen's Kappa was calculated for the second level categories. Saturation was given if no more than 5 new ICF-categories in two consecutive focus groups could be identified.
Results: Four focus groups were conducted with 13 participants. The mean age was 74.7 years. Personal data as well as established health related and disease specific questionnaires were included. A total of 73 2nd level ICF categories could be linked, of those 63 referred to barriers and 42 denoted resources. The most often mentioned barriers were handling stress and other psychological demands (d240), urination and defecation functions (b620 resp. b525) and temperament and personality functions (b126). Regarding resources most often mentioned were products and technology for personal use in daily life (e115), temperament and personality functions (b126) and handling stress and other psychological demands (d240).
Conclusion(s): Barriers and resources in all chapters of the ICF were found in contrast to preliminary subprojects of the development of the ICF-IAF. This functioning profile is useful to represent the perspective of patients with UI or FI in the population of this study.
Implications: The results of all preliminary studies were included in a consensus conference in late 2017 developing the first version of the ICF-IAF. The international and multi-professional validation will result in the final version of the ICF-IAF in 2018.
Used in a multidisciplinary team, the ICF-IAF can be seen as a common platform from which the different professionals start their assessments, plan interventions, and evaluate the treatment, as well as its implication in future research.
Keywords: assessment, patient outcomes, health holistic
Funding acknowledgements: none
Topic: Women's & men's pelvic health
Ethics approval required: Yes
Institution: Kantonale Ethikkommission Zürich
Ethics committee: Kantonale Ethikkommission Zürich
Ethics number: KEK-ZH-Nr. 2015-0257
All authors, affiliations and abstracts have been published as submitted.
