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Background <p>While traditional disease-management regarding fecal incontinence (FI) primarily focuses on symptom-control and health-related quality of life (HrQoL) outcomes, patients often prioritize broader aspects of health, like well-being. This study evaluates the psychometric performance of ICEpop CAPability measure for Adults (ICECAP-A), a capability-based well-being instrument, alongside two established HrQoL-instruments, EQ-5D-5L and the FI quality of life (FIQL) questionnaire, in an outpatient-population with FI.</p> Methods <p>Data were obtained from patients with FI recruited from a randomized-controlled trial evaluating the efficacy of anal plugs for FI ((The CONFIDEnCE trial, NCT04657588). Psychometric evaluation of ICECAP-A involved the assessment of the convergent validity, known-group validity (examined across predefined subgroups), acceptability, and floor and ceiling effects.</p> Results <p>Among 72 participants (mean age 67.3years; 83.3% female), the mean ICECAP-A capability score (0.86, scale 0–1) exceeded the mean EQ-5D-5L utility (0.71, scale − 0.446–1) and the FIQL score (2.34, scale 1–5). ICECAP-A showed good convergent validity (76.6% predefined hypotheses confirmed). Known-group validity was comparable across instruments; ICECAP-A demonstrating significant differences by EQ-VAS, anxiety, and education level, but not outperforming EQ-5D-5L or FIQL. EQ-5D-5L showed stronger effect sizes for anxiety (<i>p &lt;</i> 0.001), depression and symptom severity (non-significant), while FIQL was stronger for education level (<i>p</i> = 0.002). Questionnaire completion was 84.7% overall, reflecting trial dropout only (100% among completers) with no substantial floor or ceiling effects.</p> Conclusions <p>In patients with FI, ICECAP-A showed psychometric performance comparable to EQ-5D-5L and FIQL, despite its broader conceptual scope. Well-being appeared less influenced by symptom severity, possibly reflecting coping or adaptation. Further research is warranted evaluating ICECAP-A’s psychometric advantage over traditional HrQoL-instruments in this clinical context.</p> Trial registration <p>Not applicable.</p>

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Measuring health-related quality of life and well-being in adults with fecal incontinence: a comparative psychometric evaluation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Sylvester R. Groen,
  • Daniel Keszthelyi,
  • Zsa Zsa R. M. Weerts,
  • Sadé L. Assmann,
  • Stéphanie O. Breukink,
  • Brigitte A. B. Essers

摘要

Background

While traditional disease-management regarding fecal incontinence (FI) primarily focuses on symptom-control and health-related quality of life (HrQoL) outcomes, patients often prioritize broader aspects of health, like well-being. This study evaluates the psychometric performance of ICEpop CAPability measure for Adults (ICECAP-A), a capability-based well-being instrument, alongside two established HrQoL-instruments, EQ-5D-5L and the FI quality of life (FIQL) questionnaire, in an outpatient-population with FI.

Methods

Data were obtained from patients with FI recruited from a randomized-controlled trial evaluating the efficacy of anal plugs for FI ((The CONFIDEnCE trial, NCT04657588). Psychometric evaluation of ICECAP-A involved the assessment of the convergent validity, known-group validity (examined across predefined subgroups), acceptability, and floor and ceiling effects.

Results

Among 72 participants (mean age 67.3years; 83.3% female), the mean ICECAP-A capability score (0.86, scale 0–1) exceeded the mean EQ-5D-5L utility (0.71, scale − 0.446–1) and the FIQL score (2.34, scale 1–5). ICECAP-A showed good convergent validity (76.6% predefined hypotheses confirmed). Known-group validity was comparable across instruments; ICECAP-A demonstrating significant differences by EQ-VAS, anxiety, and education level, but not outperforming EQ-5D-5L or FIQL. EQ-5D-5L showed stronger effect sizes for anxiety (p < 0.001), depression and symptom severity (non-significant), while FIQL was stronger for education level (p = 0.002). Questionnaire completion was 84.7% overall, reflecting trial dropout only (100% among completers) with no substantial floor or ceiling effects.

Conclusions

In patients with FI, ICECAP-A showed psychometric performance comparable to EQ-5D-5L and FIQL, despite its broader conceptual scope. Well-being appeared less influenced by symptom severity, possibly reflecting coping or adaptation. Further research is warranted evaluating ICECAP-A’s psychometric advantage over traditional HrQoL-instruments in this clinical context.

Trial registration

Not applicable.