Research program: incontinence measurement

Incontinence is a common health problem estimated to affect almost 4 million Australians. However, because of the personal nature of this problem, we know very little about the best way to measure patient symptoms and treatment outcomes. This research program attempts to redress this imbalance by applying psychometric methods to the assessment of this health condition and social phenomenon. In doing so we are also examining quality of life post-treatment, as well as patient satisfaction with the health services provided. The steps in this research program have involved systematically reviewing and evaluating instruments used internationally for the assessment of incontinence, and then field testing a number of these in an Australian community survey (N=3015). Following an examination of the psychometric properties of the items and scales two new instruments to assess incontinence were developed. These are the Revised Urinary Incontinence Scale and the Revised Faecal Incontinence Scale. The community survey data indicated that both measures have excellent psychometric properties and these measures are currently being trialled and further validated in clinical settings. A number of patient satisfaction measures (both generic and continence specific) were studied in a crosssectional survey of women who had treatment for urinary incontinence (N=184). The psychometric properties of these measures were examined as was their coverage of seven dimensions of patient satisfaction (Donabedian, 1988). The Short Assessment of Patient Satisfaction scale (SAPS; seven items) was developed from consideration of both the psychometric properties of the items and the best fit to the model of patient satisfaction.