Swipe om te navigeren naar een ander artikel
The Fecal Incontinence Quality of Life Scale (FIQL) is a commonly used patient-reported outcome measure for fecal incontinence, often used in clinical trials, yet has not been validated in English since its initial development. This study uses modern methods to thoroughly evaluate the psychometric characteristics of the FIQL and its potential for differential functioning by gender.
This study analyzed prospectively collected patient-reported outcome data from a sample of patients prior to colorectal surgery. Patients were recruited from 14 general and colorectal surgeons in Vancouver Coastal Health hospitals in Vancouver, Canada. Confirmatory factor analysis was used to assess construct validity. Item response theory was used to evaluate test reliability, describe item-level characteristics, identify local item dependence, and test for differential functioning by gender.
236 patients were included for analysis, with mean age 58 and approximately half female. Factor analysis failed to identify the lifestyle, coping, depression, and embarrassment domains, suggesting lack of construct validity. Items demonstrated low difficulty, indicating that the test has the highest reliability among individuals who have low quality of life. Five items are suggested for removal or replacement. Differential test functioning was minimal.
This study has identified specific improvements that can be made to each domain of the Fecal Incontinence Quality of Life Scale and to the instrument overall. Formatting, scoring, and instructions may be simplified, and items with higher difficulty developed. The lifestyle domain can be used as is. The embarrassment domain should be significantly revised before use.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Bharucha, A. E., Dunivan, G., Goode, P. S., Lukacz, E. S., Markland, A. D., Matthews, C. A., et al. (2015). Epidemiology, pathophysiology, and classification of fecal incontinence: State of the Science Summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Workshop. The American Journal of Gastroenterology, 110(1), 127–136. CrossRefPubMed
Rockwood, T. H., Church, J. M., Fleshman, J. W., Kane, R. L., Mavrantonis, C., Thorson a, G., et al. (2000). Fecal Incontinence Quality of Life Scale: Quality of life instrument for patients with fecal incontinence. Diseases of the Colon & Rectum, 43(1), 9–16. CrossRef
Minguez, M., Garrigues, V., Soria, M. J., Andreu, M., Mearin, F., & Clave, P. (2006). Adaptation to Spanish language and validation of the fecal incontinence quality of life scale. Diseases of the Colon & Rectum, 49, 490–499. CrossRef
Dedeli, O., Fadiloglu, C., & Bor, S. (2009). Validity and reliability of a Turkish version of the Fecal Incontinence Quality of Life Scale. Journal of Wound Ostomy & Continence Nursing, 36(5), 532–538. CrossRef
Hashimoto, H., Shiokawa, H., Funahashi, K., Saito, N., Sawada, T., Shirouzu, K., et al. (2010). Development and validation of a modified fecal incontinence quality of life scale for Japanese patients after intersphincteric resection for very low rectal cancer. Indian Journal of Gastroenterology, 45, 928–935. CrossRef
Ahnis, A., Holzhausen, M., Rockwood, T. H., & Rosemeier, H. P. (2012). FLQAI—A questionnaire on quality of life in fecal incontinence: German translation and validation of Rockwood et al’s (2000) Fecal incontinence quality of life scale (FIQLS). Zeitschrift Fur Gastroenterologie, 50(7), 661–669. CrossRefPubMed
Bols, E. M. J., Hendriks, H. J. M., Berghmans, L. C. M., Baeten, C. G. M. I., & De Bie, R. A. (2013). Responsiveness and interpretability of incontinence severity scores and FIQL in patients with fecal incontinence: A secondary analysis from a randomized controlled trial. International Urogynecology Journal and Pelvic Floor Dysfunction, 24(3), 469–478. CrossRef
Sands, D. R., & Thorsen, A. J. (2016). Common tests for the pelvic floor. In: S. R. Steele, T. L. Hull, T. E. Read, T. J. Saclarides, A. J. Senagore & C. B. Whitlow (Eds.) The ASCRS textbook of colon and rectal surgery (3rd ed., p. 1029). New York: Springer.
Rockwood, T. H., Church, J. M., Fleshman, J. W., Kane, R. L., Mavrantonis, C., Thorson a, G., et al. (1999). Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: The fecal incontinence severity index. Diseases of the Colon & Rectum, 42(12), 1525–1532. CrossRef
Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. CrossRef
Kline, P. (2002). An easy guide to factor analysis. London: Routledge.
Braeken, J., & van Assen, M. A. L. M. (2016). An empirical Kaiser criterion. Psychological Methods, 22(3), 450–66. https://doi.apa.org/getdoi.cfm?doi=10.1037/met0000074.
Samejima, F. (1997). Graded response model. In W. J. van der Linden& R. K. Hambleton (Eds.), Handbook of modern item response theory (pp. 85–100). New York: Springer. CrossRef
Baker, F. B. (2001). The basics of item response theory (2nd ed.). In: C. Boston & L. Rudner (Eds.). College Park: ERIC Clearinghouse on Assessment and Evaluation.
Samejima, F. (1977). A use of the information function in tailored testing. Applied Psychological Measurement, 1(2), 233–247. CrossRef
Hambleton, R. K., & Swaminathan, H. (1985). Item response theory: Principles and applications. Boston: Kluwer Academic Publishers. CrossRef
Chen, W.-H., & Thissen, D. (1997). Local dependence indexes for item pairs using item response theory. Journal of Educational and Behavioral Statistics, 22(3), 265–289. CrossRef
Yau, D. T., Wong, M. C., Lam, K., & McGrath, C. (2015). Evaluation of psychometric properties and differential item functioning of 8-item Child Perceptions Questionnaires using item response theory. BMC Public Health, 15, 1–10. CrossRef
Hospers, J. M. B., Smits, N., Smits, C., Stam, M., Terwee, C. B., & Kramer, S. E. (2016). Reevaluation of the Amsterdam inventory for auditory disability and handicap using item response theory. Journal of Speech, Language, and Hearing Research, 59, 373–383. CrossRef
Kang, T., & Chen, T. T. (2008). Performance of the generalized S-X 2 item fit index for polytomous IRT models. Journal of Educational Measurement, 45(4), 391–406. CrossRef
Lord, F. (1980). Applications of item response theory to practical testing problems. Hillsdale, NJ: Erlbaum.
Kopf, J., Zeileis, A., & Strobl, C. (2015). Anchor selection strategies for DIF analysis: Review, assessment, and new approaches. Educational and Psychological Measurement, 75(1), 22–56. CrossRef
Chalmers, R., Counsell, A., & Flora, D. (2016). It might not make a big DIF: Improved differential test functioning statistics that account for sampling variability. Educational and Psychological Measurement, 76(1), 114–140. CrossRef
Johnson, D. R., & Young, R. (2011). Toward best practices in analyzing datasets with missing data: Comparisons and recommendations. Journal of Marriage and Family, 73(5), 926–945. CrossRef
R Core Team. (2016). R: A language environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. https://www.r-project.org/.
Chalmers, R. P. (2012). mirt: A multidimensional item response theory package for the R environment. Journal of Statistical Software, 48(6), 1–29. CrossRef
Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. CrossRef
Yen, W. M. (1993). Scaling performance assessments: Strategies for managing local item dependence. Journal of Educational Measurement, 30(3), 187–213. CrossRef
Reckase, M. D. (2009). Multidimensional item response theory. New York: Springer. CrossRef
Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4(3), 272–299. CrossRef
Brems, C., Johnson, M. E., Warner, T., & Roberts, L. W. (2016). Survey return rates as a function of priority versus first-class mailing. Psychological Reports, 99(2), 496–501. CrossRef
- Evaluation of the Fecal Incontinence Quality of Life Scale (FIQL) using item response theory reveals limitations and suggests revisions
Alexander C. Peterson
Jason M. Sutherland
R. Trafford Crump
Ahmer A. Karimuddin
- Springer International Publishing