Pharmacy Continence Care - Bladder and Bowel Website

measures impact of incontinence on the individual using seven questions. The IIQ was
included as a set of questions within the body of the consumer baseline and follow-up
questionnaires. A four-point rating scale was used in both waves of research to elicit
responses, where 1=Not at all, 2=Slightly, 3=Moderately, 4=Greatly. In order to be
comparable to the IIQ-7 3 , the scores were re-weighted (where 0=Not at all, 1=Slightly,
2=Moderately, 3=Greatly) and an average score was taken and then multiplied by 33 1 /3 to
put the score on a scale of 0 to 100.
The results, presented in Table 2, indicate that the impact of incontinence between baseline
and follow-up increased, in total, across all four key aspects: travel up 20 points; social
activities up 13.4 points; physical activity up 11 points and emotional health up 10 points. In
assessing this outcome, the project team consulted with expert panel members on factors
which may contribute to or explain an increase in the perception of the difficulties caused by
incontinence. The follow-up smaller sample comprised a significant proportion of consumers
who reported an average length of persistence of incontinence 2.6 years greater than the
average for the baseline group. That is, the consumer sample at follow-up comprised a
greater proportion of individuals with long established incontinence.
This group also reported a significantly lower level (40 per cent) of having visited or been
visited by a health care professional about incontinence than did the group in the baseline
survey. This is considered to be the likely explanation of the reported increase in difficulties –
both in the proportion within the sample with long established and limiting incontinence, and
in the impact on the consumer perception of difficulty consequent upon the approach by and
engagement with the pharmacy staff.
Given the follow-up sample included a higher proportion of older individuals, with longer
established incontinence, who had had less contact with health professionals in respect of
their incontinence; the increased perception of difficulty can be considered to reflect a
“Hawthorne effect” – that is, the effect simply of being studied; and potentially of
experimenter effects (Adair 1984). The Hawthorne effect has been held to potentially
describe an experimental effect not in the direction expected, due to the participants’
reactions to the experiment itself, that is, of the subject’s reaction to or new or increased
awareness of the behaviour under study (Parsons 1974).
The expert panel, and the project team, postulate that the follow-up sample of consumers
comprised a higher proportion of consumers with long established and limiting incontinence
than the baseline sample; and, that the follow-up sample had become more aware of the
limiting nature of the incontinence (and perhaps of the potential for improvement) as a
result of the interaction with pharmacy staff and participation in the baseline survey.
Has urine leakage affected your…
Physical Activity
Baseline Survey
Score
Ability to do household chores (cooking, housecleaning, laundry) 1.3 2.3
Physical recreation such as walking, swimming, or other exercise 40.0 50.0
Travel
Entertainment activities (movies, concerts, etc) 33.3 40.0
Ability to travel by car or bus more than 30 minutes from home 30.0 43.3
Follow-up
Survey Score
3 The IIQ-7 provides a single index of life impact associated with urinary incontinence, which subsumes separate domains of
physical activity (items 1 and 2), travel (items 3 and 4), social activities (item 5) and emotional health (items 6 and 7), and is
scored as follows. The assigned values for the item responses are 0 for ‘not at all’, 1 for ‘slightly’, 2 for ‘moderately’ and 3 for
‘greatly’. To account for missing responses, the average score of items responded to is taken, rather than the total number of
responses. The average, which ranges from 0 to 3, is multiplied by 33 1/3 to put scores on a scale of 0 to 100.
Final Report
40
NOVA Public Policy
Pharmacy Continence Care Project