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This data is based on a survey that was filled by family medicine physicians and geriatricians. The physicians included in the study are those who reported that they did manage female patients with fecal incontinence. The outcome of interest is whether these physicians never referred or did refer any of these females for specialist care.
Referred: (0) if physician has never referred female patients that present to him with fecal incontinence and (1) if physician did refer
Referred Not Referred Total P-value
Number Proportion N % N %
Total physicians 93 91.18 9 8.82 102 100
PHYSICIAN CHARACTERISTICS
Age of provider (Age) 93 9 0.208
25-35 (0) 24 25.81 3 33.33 27 26.47
36-45 (1) 32 34.41 1 11.11 33 32.35
46-55 (2) 15 16.13 3 33.33 18 17.65
56-65 (3) 19 20.43 1 11.11 20 19.61
>60 (4) 3 3.23 1 11.11 4 3.92
Gender (Gender) 0.466
Male (0) 29 31.18 4 44.44 33 32.35
Female (1) 64 68.82 5 55.56 69 67.65
Specialty (Specialty) 0.011
Family medicine (0) 54 58.06 1 11.11 55 53.92
Geriatrics (1) 39 41.94 8 88.89 47 46.08
PHYSICIAN EXPERIENCE
Level of training (training) 0.401
In Training (0) 19 20.43 3 33.33 22 21.57
In Practice (1) 74 79.57 6 66.67 80 78.43
Number of patients (both males and females) per week – Mean (SD) (Number_of_Pts)
45.80 (36.23)
41.11 (30.29)
45.38 (35.64)
0.709
Percentage of female patients per week (female)
0.657
0 to 50% (0) 16 17.2 2 22.22 18 17.65
More than 50% (1) 77 82.8 7 77.78 84 82.35
Percentage of patients referred (to any specialty) (TotalRef)
0.861
Less than 10% (0) 49 52.69 6 66.67 55 53.92
More than 10% (1) 44 47.31 3 33.33 47 46.08
Number of gynecological exam per week – Mean (SD) (GynExam_weekly)
8.04 (13.03)
1.28(1.66)
7.45 (12.6)
0.124
PHYSICIAN KNOWLEDGE, ATTITUDE AND BELIEF
How does fecal incontinence come up?
Patient complaint (FIHow_PtComplain) (No: 0, Yes: 1) 80 86.02 5 55.56 85 83.33 0.040
Elicited from history (FIHow_PhysicianEli~t) (No: 0, Yes: 1) 46 49.46 5 55.56 51 50 1.000
Physical exam (FIHow_PE) (No: 0, Yes: 1) 18 19.35 2 22.22 20 19.61 1.000
What do you think the prevalence of FI is? (PrevFI)
0.215
Less than 1% (0) 25 26.88 2 22.22 27 26.47
1 – 5 % (1) 47 50.54 3 33.33 50 49.02
5 – 15% (2) 16 17.2 2 22.22 18 17.65
15 – 30% (3) 3 3.23 1 11.11 4 3.92
Don’t Know (4) 2 2.15 1 11.11 3 2.94
Comfort level in managing FI (comfort) 0.728
Comfortable (1) 41 44.09 5 55.56 46 45.1
Uncomfortable (0) 52 55.91 4 44.44 56 54.9
HOSPITAL CHARACTERISTICS
Ease of referral to a specialist for FI (ease) 0.060
Easy (1) 64 68.82 3 33.33 67 65.69
Difficult (0) 29 31.18 6 66.67 35 34.31
Setting (Setting)
1.000
Urban (0) 64 68.82 6 66.67 70 68.63
Not Urban (1) 29 31.18 3 33.33 32 31.37
Practice (practice)
0.716
Academic (0) 63 67.74 7 77.78 70 68.63
Non-academic (1) 30 32.26 2 22.22 32 31.37
Availability of gynecologists in institution
0.355
Yes 79 84.95 9 100 88 86.27
No 14 15.05 0 0 14 13.73
Geographic Region
0.848
Mid-Atlantic 39 41.94 5 55.56 44 43.14
North-East 11 11.83 2 22.22 13 12.75
South 14 15.05 1 11.11 15 14.71
Mid-West 12 12.9 0 0.00 12 11.76
South-West 3 3.23 0 0.00 3 2.94
West 14 15.05 1 11.11 15 14.71
referred Odds Ratio Std. Err. z P>z [95% Conf. Interval]
PrevFI
1 to 5% 2.513507 4.53769 0.51 0.61 0.0730445 86.49139
5 to 15% 0.7663785 1.591936 -0.13 0.898 0.0130711 44.93407
15 to 30% 0.3625486 1.065403 -0.35 0.73 0.0011428 115.0134
Don’t Know 0.1473844 0.5277002 -0.53 0.593 0.0001321 164.4838
ease 52.18946 96.61055 2.14 0.033 1.386374 1964.65
comfort 0.3251792 0.5021416 -0.73 0.467 0.0157651 6.7073
Gender 2.025946 3.0336 0.47 0.637 0.1076614 38.12375
practice 6.658584 13.23788 0.95 0.34 0.135243 327.8302
training 0.911682 1.597096 -0.05 0.958 0.0294237 28.24809
female 3.311432 5.898749 0.67 0.501 0.1008663 108.714
Setting 2.837799 5.849919 0.51 0.613 0.0499219 161.3141
Specialty 0.2557765 0.3407654 -1.02 0.306 0.0187855 3.482552
GynExam_weekly 1.197839 0.3863167 0.56 0.576 0.6366138 2.253827
Number_of_Pts 0.9970729 0.0202015 -0.14 0.885 0.9582545 1.037464
TotalRef 2.629969 3.494612 0.73 0.467 0.1944926 35.56296
Age
36 – 45 yrs 30.4138 64.85385 1.6 0.109 0.4655688 1986.816
46 – 55 yrs 0.95813 1.895747 -0.02 0.983 0.0198265 46.30243
56 – 65 yrs 55.76306 206.4201 1.09 0.277 0.0393934 78934.96
older than 65 yrs 56.07181 174.7047 1.29 0.196 0.1249191 25168.67
FIHow_PtComplain 2.273854 3.378354 0.55 0.58 0.1236229 41.82404
FIHow_PhysicianEli~t 4.84377 7.080369 1.08 0.28 0.2760207 85.00125
FIHow_PE 0.035095 0.0812784 -1.45 0.148 0.0003749 3.285395
_cons 0.1664197 0.9696737 -0.31 0.758 1.83E-06 15166.35
Beneficial Resources Articles from pubmed:
1- Perceptions and practice patterns of general gynecologists regarding urogynecology and pelvic reconstructive surgery.
2- Likelihood of nursing home referral for fecally incontinent elderly patients is influenced by physician views on nursing home care and outpatient management of fecal incontinence.
3- Awareness of investigations and treatment of faecal incontinence among the general practitioners: a postal questionnaire survey
4- Anal incontinence: the role of medical management.
5- Experience with an obstetric perineal clinic.
6- Outcomes and follow-up after obstetric anal sphincter injuries.
7- [Fecal incontinence in community-dwelling elderly: findings from a study of prevalence, consultation of physicians, psychosocial aspects and treatment].
8- Effective and ineffective management of incontinence: issues around illness trajectory and health care.
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