J Korean Acad Community Health Nurs.  2014 Sep;25(3):198-206. 10.12799/jkachn.2014.25.3.198.

A Study on Fecal Incontinence and Depression of Rural Women

• Kim C
• Lee HS
• Kim EM

• KMID: 2292712
• DOI: http://doi.org/10.12799/jkachn.2014.25.3.198

Abstract

PURPOSE
The purposes of this study were to identify the prevalence and influencing factors of fecal incontinence, and to analyze the association between fecal incontinence and depression.
METHODS
The subjects of this study were 233 women living in rural areas, and data were collected using questionnaires from February 24 to May 30, 2012. Fecal incontinence was measured with the Continence Grading Score, and depression with the Geriatric Depression Scale. Collected data were analyzed using SPSS through chi2-test, Fisher's exact test, t-test and ANOVA.
RESULTS
Of the subjects, 16.7% had fecal incontinence. The prevalence of fecal incontinence was higher in older women (chi2=23.55, p<.001), those with vaginal delivery (chi2=4.81, p=.049), those with parity of 4 or more (chi2=13.47, p=.003), and those with urinary incontinence (chi2=26.36, p<.001). The level of depression was significantly higher in older women (F=19.27, p<.001), those with low academic qualification (F=18.17, p<.001), those with urinary incontinence (F=4.15, p=.043), and those with fecal incontinence (F=14.90, p<.001).
CONCLUSION
These results suggest that there should be supports by public health care for fecal incontinence prevention and care programs in order to promote the physical and emotional health of rural women.

Keyword

Fecal incontinence; Depression; Women

MeSH Terms

Depression*
Fecal Incontinence*
Female
Humans
Parity
Prevalence
Public Health
Urinary Incontinence
Surveys and Questionnaires

Reference

1. Mandelstam DA. Fecal incontinence. social and economic factors. In : Henry MM, Swash M, editors. Coloproctology and the pelvic floor. Pathophysiology and management. London: Butterworth;1984. p. 217–222.

2. Bharucha AE, Philips SF. Slow-transit constipation. Curr Treat Options Gastroenterol. 2001; 4(4):309–315.

3. Bartlett L, Nowak M, Ho YH. Reasons for non-disclosure of faecal incontinence: A comparison between two survey methods. Tech coloproctol. 2007; 11(3):251–257.

4. Whitehead WE. Diagnosing and managing fecal incontinence: If you don't ask, they won't tell. Gastroenterology. 2005; 129(1):6.

5. Brown HW, Wexner SD, Lukacz ES. Factors associated with care seeking among women with accidental bowel leakage. Female Pelvic Med Reconstr Surg. 2013; 19(2):66–71. http://dx.doi.org/10.1097/SPV.0b013e31828016d3.

6. Park SH, Kang CB, Jang SY, Kim BY. Effect of kegel exercise to prevent urinary and fecal incontinence in antenatal and postnatal women: Systematic review. J Korean Acad Nurs. 2013; 43(3):420–430.

7. Rohwer K, Bliss DZ, Savik K. Incontinence-associated dermatitis in community-dwelling individuals with fecal incontinence. J Wound Ostomy Continence Nurs. 2013; 40(2):181–184. http://dx.doi.org/10.1097/WON.0b013e31827e8b3d.

8. Toglia MR, DeLancey JO. Anal incontinence and the obstetrician-gynecologist. Obstet Gynecol. 1994; 84(4 Pt 2):731–740.

9. Haadem K, Ohrlander S, Lingman G. Long-term ailments due to anal sphincter rupture caused by delivery-a hidden problem. Eur J Obstet Gynecol Reprod Biol. 1988; 27(1):27–32.

10. Bartlett L, Nowak M, Ho YH. Impact of fecal incontinence on quality of life. World J Gastroenterol. 2009; 15(26):3276–3282. http://dx.doi.org/10.3748/wjg.15.3276.

11. Yip SO, Dick MA, McPencow AM, Martin DK, Ciarleglio MM, Erekson EA. The association between urinary and fecal incontinence and social isolation in older women. Am J Obstet Gynecol. 2013; 208(2):146.e1–146.e7. http://dx.doi.org/10.1016/j.ajog.2012.11.010.

12. Smith TM, Menees SB, Xu X, Saad RJ, Chey WD, Fenner DE. Factors associated with quality of life among women with fecal incontinence. Int Urogynecol J. 2013; 24(3):493–499. http://dx.doi.org/10.1007/s00192-012-1889-6.

13. Halland M, Koloski NA, Jones M, Byles J, Chiarelli P, Forder P, et al. Prevalence correlates and impact of fecal incontinence among older women. Dis Colon Rectum. 2013; 56(9):1080–1086. http://dx.doi.org/10.1097/DCR.0b013e31829203a9.

14. Ditah I, Devaki P, Luma HN, Ditah C, Njei B, Jaiyeoba C, et al. Prevalence, trends, and risk factors for fecal incontinence in United states adults, 2005-2010. Clin Gastroenterol Hepatol. 2014; 12(4):636–643. http://dx.doi.org/10.1016/j.cgh.2013.07.020.

15. Yoon HW, Bae CS. A study female of fecal incontinence: Effects of parity & delivery method. Korean J Obstet Gynecol. 1999; 42(12):2749–2753.

16. Horng SS, Chou YJ, Huang N, Fang YT, Chou P. Fecal incontinence and epidemiology and help seeking among older people in Taiwan. Neurourol Urodyn. 2014; 33(7):1153–1158. http://dx.doi.org/10.1002/nau.22462.

17. Matthews CA, Whitehead WE, Townsend MK, Grodstein F. Risk factors for urinary, fecal, or dual incontinence in the nurses health study. Obstet Gynecol. 2013; 122(3):539–545. http://dx.doi.org/10,1097/AOG.0b013e31829efbff.

18. Mon YJ, Lim HS, Jung JE, Cho HH, Kim MR, Lew YO, et al. Original artides: The effects of the number of normal vaginal deliveries to the function of low urogenital system. Korean J Obstet Gynecol. 2007; 50(4):638–644.

19. Chang TC, Chang SR, Hsiao SM, Hsiao CF, Chen CH, Lin HH. Factors associated with fecal incontinence in women with lower urinary tract symptoms. J Obstet Gynaecol Res. 2013; 39(1):250–255. http://dx.doi.org/10.1111/j.1447-0756.2012.01902.x.

20. Menees SB, Smith TM, Xu X, Saad RJ, Chey WD, Fenner DE. Factors associated with symptoms severity in women presenting with fecal incontinence. Dis Colon Rectum. 2013; 56(1):97–102. http://dx.doi.org/10.1097/DCR.0b013e31826f8773.

21. Kang HW. Prevalence and predictive factors of fecal incontinence [master's thesis]. [Seoul]: Ewha Womens University;2011. 38.

22. Chung SS, Park UC, Kim CK, Seong BG, Shin HJ, Choi YC, et al. Functional investigation with use of anorectal physiology in the patients with fecal incontinence. J Korean Surg Soc. 1999; 57:Suppl. 996–1007.

23. Sheikh JI, Yesavage JA. Geriatric depression scale (GDS): Recent evidence and development of a short version. Clin Gerontol. 1986; 5:165–172.

24. Park SK, Myung SJ. Diagnosis and treatment of fecal incontinence. Korean J Med. 2012; 83(5):580–584. http://dx.doi.org/10.3904/kjm.2012.83.5.580.

25. Berger MB, Delancey JO, Fenner DE. Racial defferences in fecal incontinence in community-dwelling women from the EPI study. Female Pelvic Med Reconstr Surg. 2013; 19(3):169–174. http://dx.doi.org/10,1097/SPV.0b013e3182874709.

26. Joh HK, Seong MK, Oh SW. Fecal Incontinence in Elderly Koreans. J Am Geriatr Soc. 2010; 58(1):116–121. http://dx.doi.org/10.1111/j.1532-5415.2009.02613.x.

27. Hwang JS, Park TH, Kim DK, Kang MA, Kim SM, Bae CS, et al. The prevalence of female urinary and fecal incontinence. Korean J Obstet Gynecol. 1998; 41(6):1552–1559.

28. Goode PS, Burgio KL, Halli AD, Jones RW, Richter HE, Redden DT, et al. Prevalence and correlates of fecal incontinence in community-dwelling older adults. J Am Geriatr Soc. 2005; 53(4):629–635.

29. Wilson M. Living with fecal incontinence: Follow-up to a research project. Br J Nurs. 2013; 22(3):147–150. 152–154. http://dx.doi.org/10.12968/bjon.2013.22.3.147.