Health professionals require a greater understanding of the negative impact of OASIS and AI on women's quality of life. This may improve the management, education and clinical care of this condition which may result as a consequence of OASIS.

BackgroundThere is limited research defining the true prevalence of anal incontinence (AI) in women of childbearing age. Understanding the limitations of the current assessment tools in the identification of AI is paramount for identifying the prevalence of AI and improving the care and management for women of childbearing age. The aim of this research was to explore and develop an understanding of women’s experiences in disclosing AI when completing a new bowel-screening questionnaire when compared to two established AI tools.MethodsA phenomenological qualitative research study was undertaken in a maternity setting in a large tertiary hospital. Parous women in the first trimester of a subsequent pregnancy were recruited to complete a specifically designed screening tool (BSQ), St Marks Faecal incontinence score (Vaizey) and Cleveland (Wexner) score. Qualitative semi-structured interviews were utilised to identify experiences in disclosing AI.ResultsWomen (n = 16, 22–42 years) with a history of anal incontinence either following the first birth (n = 12) or the second (n = 4) provided differing responses between the three assessment tools. All women answered the BSQ while the Vaizey and Wexner scores were more difficult to complete due to clinical language and participants level of comprehension. Women identified three major themes that were barriers for disclosing incontinence, which included social expectations, trusted space and confusion.ConclusionThere are barriers for disclosing AI in the pregnant and post-natal population, which can be improved with the use of an easy assessment tool. The BSQ may facilitate discussion on AI between the patient and health professional leading to earlier identification and improvement in short and long-term health outcomes.

Background Anal incontinence (AI) is the involuntary loss of a liquid or solid stool and flatus, resulting in a lifelong profound negative impact on a person's quality of life. One million Australians, half of whom are women, are affected by AI. The aetiology of AI is reported within research literature. Importantly obstetric anal sphincter injury following vaginal delivery is a predominant cause of AI. Factors cited as major risk factors of anal sphincter damage include instrumental delivery, macrosomia and primiparity. The incidence of AI increases with age and with further vaginal delivery. The impact lasts for life. Aim This study aims to identify women's experiences of AI following obstetric anal sphincter injury and their impact on quality of life. Method An extensive online literature search was undertaken within the medical and nursing databases including the Cumulative Index of Nursing and Allied Health Literature, Scopus, PubMed and Medline. Key search terms included AI, faecal incontinence, anal sphincter injuries, obstetric complications, trauma, obstetric, postnatal care, experiences, women's experience and quality of life. The literature search was further refined through fields that included English language only, literature published between 2000 and 2012 and full‐text articles. Findings The review identified a significant amount of research literature that addressed the prevalence and cause of AI. While quality of life questionaries and symptom severity scores have been utilised to assess the impact of AI on a person's life, there are inherent weaknesses in providing the experience of AI on a person's life. Furthermore, there is limited in‐depth research that addresses women's experiences of AI following a history of obstetric anal sphincter injury and the impact on their quality of life. Conclusion Research findings contribute to understanding the prevalence, physical, social and emotional impact of AI. While alterations in clinical practice can improve the identification and management of AI, further research that builds on the state of knowledge and seeks a deeper understanding of the issues for women with AI as a result of obstetric anal sphincter injury is required.

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Patient satisfaction was high for nurse telephone follow-up to replace in-office visits for selected diagnoses. This care strategy deserves further consideration for reimbursement purposes as health care evolves.