Quality of Life Aspects Determining The-Bio-Psycho-Social Functioning of Patients in The-Perspective of a Planned Extensive Sphincter's Repair Procedure.

Abstract

Damage to the sphincter, regardless of its pathogenesis, consists in the impossibility to control the physiology, or the so-called faecal incontinence. This implies changes in the whole bio-psycho-social functioning of the patients, and thus affects the satisfaction with their quality of life, conditioned by their health status. The problem affects around 5 to 7% of the population. Often enough, the only hope for those patients are repair procedures of the sphincter mechanism. The aim of the study was to evaluate key aspects of quality of life which determine the psycho-social status of patients with endogenous or iatrogenic sphincter damage in the perspective of a planned extensive sphincter's repair procedure. The study group consisted of 52 people, 26 women and 26 men, aged 19-72. The scale by Rockwood--Fecal Incontinency Quality of Life--was used as the basic research tool which evaluates the quality of life in four aspects: 1/behavioral (Lifestyle) 2/cognitive (Coping) 3/emotional (Depression) 4/overall self-assessment (Embarrasment). The degree of incontinence was determined based on point scales of Jorge Wexner (JW scale) and the Fecal Incontinenece Severity Index (FISI scale). Structured diagnostic interview was also used in the study. The results show that lack of control over the basic physiological functions disintegrates the quality of life in all evaluated aspects related to somatic, psychological and social functioning. FIQL: Lifestyle (LS) - 1.96 pts Coping (C) - 1.67 pts Depression (D) - 2.1 pts Embarrasment (E) - 1.79 pts Conclusions. The FIQL results presented explain the fact that among 52 patients followed, 50 decided to conduct extensive reconstructive procedures, although the results are not statistically optimistic and the risk of complications is relatively high.