tailieunhanh - Fecal Incontinence Diagnosis and Treatment - part 4

Tuy nhiên, điều này lý do tương tự có thể trở thành một điểm yếu. Như tinh chế như quy mô có thể được, họ sẽ luôn luôn được phụ thuộc vào những gì các bệnh nhân báo cáo. - Thái độ của các bệnh nhân đối với không kiểm soát cũng có thể làm thay đổi dấu chấm câu nế | Chapter 8 Clinical Assessment of the Incontinent Patient 93 tress caused by incontinence can only be reported subjectively and therefore it would seem sensible that the patient assign the points. However this same reason can become a weakness. As refined as the scales can be they will always be dependent on what the patient reports. - The attitude of the patient toward incontinence can also alter punctuation if the completely incontinent patient avoids moving far from the toilet. Another controversial issue concerning the use of scoring systems is the method of data collection. Questionnaires fulfilled in the office and defecation diaries given to the patient can be used. In the first instance collection depends on the patient s memory. Concerning the usefulness of the second method which at first seems more consistent it can be argued that studies evaluating similar diaries for pain 14 show how most patients keep the information without reporting at least for 1 day. In that case information would not be of better quality than that obtained by questionnaires. It is difficult to say that summary scales are better than grading scales because studies evaluating reliability and validity of severity scores are scarce 13 . Finally the most popular scale is the CCF-FIS 11 Table 2 . However if assessment of urgency is considered important then the most suitable scale is that by Vaizey et al. 13 Table 3 . It is also interesting to note that population studies that evaluate the use of scores show how they are rarely used except in referral centers 15 . References 1. Leigh RJ Turnberg LA 1982 Faecal incontinence the unvoiced symptom. Lancet 1 8285 1349-1351 2. Hill J Corson RJ Brandon H et al 1994 History and examination in the assessment of patients with idiopathic fecal incontinence. Dis Colon Rectum 37 473-477 3. Hardcastle JD Porter NH 1969 Anal continence. In Morson BC ed. Diseases of the colon rectum and anus. Appleton-Century-Crofts New York p 251 4. Eckhardt VF .