INTRODUCTION AND HYPOTHESIS: Using qualitative methods, we compared physician-recommended treatment options for fecal incontinence to patient knowledge of treatment options. 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 nonsurgical 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 treatment options. For both 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 toward fecal incontinence, and patient embarrassment in discussing fecal incontinence. Physicians universally recommended fiber and pelvic floor exercise; they felt the majority (approximately 70-80 %) of patients will improve with these therapies. Collectively, patients were able to identify all treatment recommendations given by physicians, although many had discovered these treatments through personal experience. Three concepts emerged regarding treatment options that physicians did not identify but that patients felt were important in their treatment: hope for improvement, personal effort to control symptoms, and encouragement to go on living life fully. CONCLUSIONS: Whereas physicians had treatment to offer women with fecal incontinence, women had already found the best treatments through personal research and effort. Women want to hear a message of hope and encouragement and perceive personal effort from providers.
INTRODUCTION AND HYPOTHESIS: Using qualitative methods, we compared physician-recommended treatment options for fecal incontinence to patient knowledge of treatment options. 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 nonsurgical 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 treatment options. For both 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 toward fecal incontinence, and patient embarrassment in discussing fecal incontinence. Physicians universally recommended fiber and pelvic floor exercise; they felt the majority (approximately 70-80 %) of patients will improve with these therapies. Collectively, patients were able to identify all treatment recommendations given by physicians, although many had discovered these treatments through personal experience. Three concepts emerged regarding treatment options that physicians did not identify but that patients felt were important in their treatment: hope for improvement, personal effort to control symptoms, and encouragement to go on living life fully. CONCLUSIONS: Whereas physicians had treatment to offer women with fecal incontinence, women had already found the best treatments through personal research and effort. Women want to hear a message of hope and encouragement and perceive personal effort from providers.
Authors: Adil E Bharucha; Alan R Zinsmeister; G Richard Locke; Barbara M Seide; Kimberly McKeon; Cathy D Schleck; L Joseph Melton Journal: Gastroenterology Date: 2005-07 Impact factor: 22.682
Authors: Muriel K Boreham; Holly E Richter; Kimberly S Kenton; Charles W Nager; W Thomas Gregory; Michael P Aronson; Val Y Vogt; Don D McIntire; Joseph I Schaffer Journal: Am J Obstet Gynecol Date: 2005-05 Impact factor: 8.661
Authors: Gena C Dunivan; Steve Heymen; Olafur S Palsson; Michael von Korff; Marsha J Turner; Jennifer L Melville; William E Whitehead Journal: Am J Obstet Gynecol Date: 2010-03-12 Impact factor: 8.661
Authors: Vivian W Sung; Michelle L Rogers; Deborah L Myers; Homayoon M Akbari; Melissa A Clark Journal: Am J Obstet Gynecol Date: 2007-12 Impact factor: 8.661
Authors: Sadé L Assmann; Daniel Keszthelyi; Jos Kleijnen; Foteini Anastasiou; Elissa Bradshaw; Ann E Brannigan; Emma V Carrington; Giuseppe Chiarioni; Liora D A Ebben; Marc A Gladman; Yasuko Maeda; Jarno Melenhorst; Giovanni Milito; Jean W M Muris; Julius Orhalmi; Daniel Pohl; Yvonne Tillotson; Mona Rydningen; Saulius Svagzdys; Carolynne J Vaizey; Stephanie O Breukink Journal: United European Gastroenterol J Date: 2022-03-18 Impact factor: 6.866