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.
Dr Ramzi Helewa and colleagues performed a cross-sectional, qualitative study involving standardized, semistructured interviews.
The study was conducted at a single tertiary care center.
The team enrolled patients experiencing fecal incontinence, as well as nurses, physical therapists, and physicians.
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Interview questions revolved around success definitions, barriers, and promoters of fecal incontinence care.
The researchers analyzed transcripts to develop themes surrounding fecal incontinence care.
The team performed 12 interviews raising a total of 17 different themes.
The research team found that barriers to fecal incontinence care included education for both the care provider and patients.
Access issues for treatments were also highlighted.
The team found that promoters of fecal incontinence care were reflected by the impact that it has on quality of life, personal hygiene, psychological burden, and activity and productivity.
The definition of fecal incontinence success was focused on improvements in quality of life rather than a numerical reduction of incontinence episodes.
Dr Helewa's team concludes, "Patient and care provider education surrounding fecal incontinence is lacking."
"Furthermore, access for effective treatments is a real barrier for Canadians experiencing fecal incontinence."
"Programs should focus on improvement of overall quality of life rather than a reduction of incontinence episodes."