Knowledge, skills, and barriers to management of faecal incontinence in Australian primary care: a cross-sectional study (original) (raw)
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How Much Knowledge and Awareness of Faecal Incontinence Is There in Primary Care?
Surgeries, 2021
Faecal incontinence (FI) is a debilitating symptom with a likely underreported incidence in the general population. Postpartum or postmenopausal women are at increased risk of this. General Practitioners (GPs) have a vital role in screening patient groups with FI. Knowledge of the underlying diseases associated with FI is important for all clinicians who have contact with this patient group. An online questionnaire (Survey MonkeyTM, San Mateo, CA, USA) was sent to GPs in Wales and England through a deanery, social media and GP educational groups. Questions: A total of 250 participants completed the questionnaire—195 GPs and 55 GPSTs. Two-thirds had no coloproctology experience, but 70% had worked in obstetrics and gynaecology. In total, 70% had no formal FI training and 75% felt insufficiently informed about FI. A total of 80% felt that GPs need specific training on FI. A third of respondents used the 6-week postnatal check to assess maternal bowel function and most did not apprecia...
Australian Journal of General Practice, 2019
Background and objectives General practitioners (GPs) often see children with enuresis and daytime urinary incontinence, and adults with persistent enuresis. The aim of this study was to assess Australian community health practitioners' knowledge and experiences with managing these conditions. Methods Health practitioners were surveyed about their knowledge and experience managing urinary incontinence that begins in childhood. Associations between participant characteristics and knowledge/experience were examined using chi-square tests. Results The 1495 participants were mostly female, experienced, GPs who worked in a metropolitan area and/or saw patients with incontinence infrequently, but felt knowledgeable and confident about management of incontinence. Correct survey answers were given by 93% of participants for managing enuresis, 81% for daytime urinary incontinence (with 18% choosing inappropriate and potentially dangerous responses), and 61% for managing enuresis that has persisted into adulthood.
The development and evaluation of an incontinence screening questionnaire for female primary care
Neurourology and Urodynamics, 2000
Although there is a high prevalence of leaking urine among Australian women, there are currently no standardized procedures for screening patients for incontinence in the primary care setting (known in Australia as general practice). In response to this, an incontinence screening questionnaire (ISQ) was developed and evaluated for use in general practice. Eighty-nine women completed an original compilation of 33 items that asked about situations associated with leaking urine, avoidance of leakage, and concern about leakage. Each item was assessed according to its acceptability for the population of female general practice patients, discriminative value, and test-retest reliability. These patients also underwent an objective test of incontinence, the 48-hour pad test, so that the screening items could be validated against an objective classification of incontinence. The study included women who had bladder control problems and those who did not. Eight items on the ISQ were shown to be acceptable to patients, discriminative, reliable, and valid indicators of objective incontinence. Five items were capable of predicting almost 70% of patients who showed objective leakage of urine and misclassified fewer than 15% of these patients. Those five items were selected for inclusion in the (refined) ISQ.
Journal of Evaluation in Clinical Practice, 2008
Background Urinary incontinence is a common problem, affecting quality of life and leading to high costs. There is doubt about the use of clinical practice guidelines on urinary incontinence in primary care. Objective To assess adherence levels and reasons for (non)adherence to the Guideline on Urinary Incontinence of the Dutch College of General Practitioners. Design, setting and participants A postal survey among Dutch general practitioners (GPs). Main outcome measure Adherence of GPs to the guideline. Results We analysed 264 questionnaires. Almost all GPs adhered to the guideline when diagnosing the type of urinary incontinence. A bladder diary is not often used (35%). Adherence to therapeutic procedures was only high for mild/moderate stress urinary incontinence: most GPs (82.6%) used adequate advice on bladder retraining and pelvic floor muscle training. One out of four GPs agreed that adhering to the guideline is difficult, mainly owing to lack of time, staff, diagnostic tools, competences to provide this care and low motivation of patients. Conclusions Dutch GPs follow the guideline only partially: compliance with diagnostic advices is fairly good; compliance with treatment advices is low. Further research should focus on solutions how to support GPs to tackle major barriers to facilitate the adherence to guidelines (substitution of tasks to specialized nurses, reducing the threshold for referral and concentrating expertise in integrated continence care services).
International Urogynecology Journal, 2014
Introduction-To compare physician-recommended treatment options for fecal incontinence to patients' knowledge of treatment options using qualitative methods. Our hypothesis was that physician recommendations were not being communicated well to patients' and that this impaired patients' ability to cope with fecal incontinence. Methods-Cognitive interviews were conducted with physicians who routinely care for women with fecal incontinence. Physicians were asked to describe their typical non-surgical treatment recommendations and counseling for fecal incontinence. Women with bothersome fecal incontinence were recruited to participate in focus groups and asked about personal experience with fecal incontinence symptoms and treatments. For both the physician interviews and patient focus groups, qualitative data analysis was performed using grounded theory methodology. Results-Physicians identified several barriers patients face when seeking treatment: lack of physician interest towards fecal incontinence and patients' embarrassment in discussing fecal
Diseases of the colon and rectum, 2017
A large proportion of Canadians experience fecal incontinence, with no avenue for effective treatments. The Ottawa Hospital has recently started a percutaneous tibial nerve stimulation program for patients who have not improved with conservative efforts. As part of this program implementation, a qualitative needs assessment was undertaken to better define successful outcomes and to identify barriers for program sustainability. This was a cross-sectional, qualitative study involving standardized, semistructured interviews. The study was conducted at a single tertiary care center. Patients experiencing fecal incontinence, as well as nurses, physical therapists, and physicians, were enrolled in the study. Interview questions revolved around success definitions, barriers, and promoters of fecal incontinence care. Transcripts were analyzed to develop themes surrounding fecal incontinence care. Twelve interviews were undertaken raising a total of 17 different themes. Barriers to fecal inc...