Symptom and Quality of Life Assessment

BACKGROUND 520 CONTENTS Symptoms of incontinence are common, particularly amongst older people, and, at any age, incontinence can have a severe impact on the quality of life of some individuals. A number of treatments for incontinence are available, most of which aim to reduce the occurrence of incontinent episodes or to limit the impact of the disorder on everyday life. In research and clinical practice it is essential that the symptoms and impact of incontinence can be properly assessed and recorded. Symptoms of incontinence and their impact on patients' quality of life can be assessed in a number of ways, but the only valid way of measuring the patient's perspective of their predicament is through the use of psychometrically robust self-completion questionnaires. In the reports from the First and Second International Consultations on Incontinence, the impact of incontinence on quality of life and methods of measuring these factors were described, and a number of questionnaires with acceptable levels of psychometric testing were recommended for use in research and clinical practice. [1] [2] This chapter will summarise the major findings from those reviews, extend these with an updated systematic review of the literature, and provide new recommendations for questionnaires developed for use in clinical practice and research. In addition, the ICIQ modular questionnaires (supported by the International Consultation) are presented in detail and their use evaluated. A number of different electronic databases were searched, limited to adults over the age of 18 years and human studies from January 2001 to June 2004, including Pub-Med, Medline, PsychInfo, the LOCA-TORplus database for books, serial titles and audio-visuals, the Cochrane Library for randomised controlled trials, and the NLM Gateway database. The following keywords were used separately and/or in combination: " urinary incontinence " , " incontinence " , " questionnaire " , " epidemiology " , " prostate " , " prolapse " , " fecal " , " faecal " , " bowel " , " anal " and " quality of life " , " sexual " and " health utilities ". Questionnaires identified in previous ICI reports were also searched in PubMed and Medline. A systematic Medline search from 1966 – April 2003 using the keywords " faecal " , " fecal " , " anal " or " bowel " with " questionnaire " , " instrument " , " quality of life " , or " measure " found …