Validity and Reliability of a Turkish Version of the Fecal Incontinence Quality of Life Scale

PURPOSE: Anorectal disorders, including fecal incontinence, are a significant healthcare problem that produce bothersome symptoms and adversely affect quality of life. We sought to establish the validity and reliability of a Turkish language version of the Fecal Incontinence Quality of Life Scale (FIQOLS). SUBJECTS AND SETTING: Data were collected at the Fecal Incontinence-Constipation-Biofeedback Clinic, located in the Gastroenterology Department at Ege University School of Medicine Hospital in Izmir, Turkey. The study sample comprised patients with fecal incontinence who attended the clinical assessment and agreed to participate in the study. INSTRUMENTS: A sociodemographic questionnaire form, the 29-item FIQOLS, and the Fecal Incontinence Severity Index (FISI), as well as the 36-Item Short Form Health Survey (SF-36) were administered to subjects. Both the FIQOLS and FISI were translated from English to Turkish by using a back-translation technique. METHODS: Subjects initially completed the FIQOLS, FISI, and the SF-36 at baseline and again after a 2-week interval to allow test-retest reliability measurement. Internal consistency was also measured, using the Cronbach alpha and Spearman-Brown split-half coefficients. Test-retest reliability was evaluated using interclass correlation coefficient testing. The validity of FIQOLS with respect to the SF-36 and FISI was analyzed using Pearson correlation coefficients. RESULTS: Fifty subjects with fecal incontinence participated in the study; their mean age (SD) was 57.1 (+/-15.7) years. Almost two-thirds (66%) were female, and 38% did not complete primary school education. Test-retest reliability analysis revealed an intraclass correlation of r value higher than 0.70 (P < .05). The overall Cronbach alpha coefficient of instrument was .88; the Spearman-Brown split-half value was 0.84 for the first half of the tool and 0.76 for the second half. The Cronbach alpha coefficient for subfactors varied from .56 to .82. The FIQOLS score was found to have a statistically significant (P < .05) correlation with both the FISI and SF-36. CONCLUSION: These findings support the Turkish language version of the FIQOLS as a valid and reliable instrument.