Objective:The major goal of incontinence treatment is to reduce symptom burden and ensure that patients’ resources are supported as helpful as possible. This goal requires standardized assessment that will represent the typical spectrum of functioning problems, limitations in activity and participation, as well as environmental and personal factors to describe positive and negative influencing factors of patients with urinary (UI) or faecal incontinence (FI). There is need for a validated short, simple instrument to quantify UI and FI impact to aid health status assessment and communication between patients and the involved health professionals (1). Current level-A recommended questionnaires provide valid assessment of UI and FI, but do not cover all aspects of the burden of the disease in the sense of the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF) of the WHO, which limits the value of the assessments (2).

To address this problem the study group of Barbara Koehler is developing the evidence-based, reliable and valid ICF-based Incontinence Assessment Form (ICF-IAF).

This aims to: 1. identify problems and resources using qualitative and quantitative methods, 2. assess the impact of UI and FI on health status in a holistic sense and 3. develop a standardized assessment for multidisciplinary planning and evaluation of interventions.

Sub-projects of the ICF-IAF:

• Systematic analysis of level-A disease-specific questionnaires, finished (2).
• 3-round Delphi technique survey with 262 experienced German speaking physiotherapists from Austria, Germany, Liechtenstein, Luxembourg and Switzerland, finished (3).
• Patients’ reports using focus groups (finished), responses to be translated (‘’linked’’) into ICF language using standardized rules (1).
• Personal patient interviews to ask about problems, resources and aspects of the environment relevant to their disease using the list developed by the Delphi technique survey (ongoing).
• Consensus-Conference: After training in the use of the ICF-IAF, and based on the preliminary studies, relevant ICF categories will be identified, and a formal consensus agreed by experts from 3 German-speaking countries (17th November 2017).
• International and multiprofessional validation using the Delphi process incorporating all relevant health professionals (2018-2022), under construction.

The ICF-IAF will be a short, simple questionnaire for assessing and monitoring UI and FI. The current more than 200 translations of the ICF and the coding system allows world-wide use and will help to standardize therapy and research protocols.

1. Köhler B, Kirchberger I, Glässel Andrea, Kool J, Stucki G, Alarcos C. Validation of the International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Sets for Osteoporosis: The Perspective of Physical Therapists. J Geriatr Phys Ther 2011;34:117-130.

2. Koehler B, Brand P, Isler M, Passweg D, Radlinger L. The development of the ICF-Incontinence Assessment Form to identify problems and resources for planning and evaluation of interventions (ICF-IAF). Physiotherapy 2015 May;101:e774.

3. Koehler B, Koenig I, Isler M, Passweg D, Radlinger L. Development ot the ICF-Incontinence Assessment Form to identify problems and resources in male and female patients with urinary and / or faecal incontinence (ICF-IAF): Subproject Delphi technique survey among 262 physiotherapists in 5 German speaking countries. Neurourol Urodyn 2015;3:314-315.

4. Köhler B, Marks D. Die ICF und der Einsatz von Core Sets in der klinischen Praxis, in: Wirz M, Köhler B, Marks D, Kool J, Sattelmayer M, Oesch P, Hilfiker R, Rogan S, Schädler S, Verra M, Lüthi H. Lehrbuch Assessments in der Rehabilitation. Hans Huber, Bern 2014;59-85.

KEYWORDS: Urinary incontinence, fecal incontinence, bio-psycho-social model, ICF, questionnaire, problems, resources.