Continence Outcome Measures - Validation and Clinical Translation Project
The National Continence Management Strategy (NCMS) has funded a number of major research studies relevant to the outcomes evaluation of continence conditions. This work built on research undertaken for the project Refining Continence Measurement Tools (Sansoni et al., 2006). The Revised Urinary Incontinence Scale (RUIS) and the Revised Faecal Incontinence Scale (RFIS) were found to have excellent internal consistency reliability (RUIS 0.91, RFIS 0.89) in a large community sample.
However, a limitation of community survey data is its derivation from subjective reports of incontinence symptoms collected in face to face interviews, rather than from confirmed clinical diagnoses. This restricts the range of responses to incontinence items, particularly for the more severe levels of symptoms. Therefore it was necessary to trial the revised continence measures in a range of clinical settings in follow-up field trials. This 2010 study was designed to address this issue by field testing the revised scales in eleven clinical settings across Australia.
The relationships between the revised instruments, type of treatment, clinical feedback and patient satisfaction were examined. Additional reliability data were collected from post-test patients in order to examine the test-retest reliability of the instruments over a two week period. Data analyses indicated that the RUIS and the RFIS have excellent psychometric properties. The RUIS and the RFIS performed well in clinical settings demonstrating good evidence that these instruments were sensitive to changes in continence status as a result of treatment, making them suitable for outcome evaluation.
The use of such measures can provide effective feedback to clinicians concerning the effectiveness of their treatments, can facilitate the systematic review and monitoring of patients, and assist in identifying ways to improve practice.