Patient Questionnaires
International Consultation on Incontinence Modular Questionnaires (ICIQ)
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Summary: this short questionnaire can be used by clinicians to screen for incontinence, to obtain a brief yet comprehensive summary of the level, impact and perceived cause of symptoms of incontinence and to facilitate patient-clinician discussions. To read more about the ICIQ-UI click here.
- The ICIQ-UI Short Form scoring system has been shown to exhibit high levels of validity, reliability and responsiveness.
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Time to complete: a few minutes
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Summary: used to evaluate symptoms of anal incontinence (including flatus incontinence) and impact on quality of life. The ICIQ-B provides scores for bowel pattern and control and for the impact on quality of life associated with anal incontinence symptoms. To read more about the ICIQ-B click here.
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The ICIQ-B demonstrates acceptable validity, “good” to “very good” reliability, and reasonable response to changes in symptom and quality of life status following intervention.
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Time to complete: a few minutes
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International Consultation on Incontinence Questionnaire Vaginal Symptoms Module (ICIQ-VS)
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Summary: a measure to assess the impact of vaginal symptoms. Provides scores for vaginal symptoms, sexual matters associated with vaginal symptoms and for impact on quality of life associated with vaginal symptoms. To read more about the ICIQ-VS click here.
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The ICIQ-VS has been shown to demonstrate good validity, reliability and sensitivity to change.
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Time to complete: a few minutes
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*The WHD would like to thank the ICIQ group for providing us with access to the ICIQ resources listed above and for providing permission to our members to use the questionnaires in their clinical practice. We would like to note that the ICIQs are copyright protected and should not be altered in any way. It is not possible to use parts of the questionnaire in isolation in any research studies without the written permission of the ICIQ study group. If you choose to use these questionnaires in research studies please email Dr. Nikki Cotterill to inform her of the details of your study, and any results that you present or publish.
Other questionnaires to consider for use in clinical practice
24-Hour Movement Guidelines
This toolkit is designed to assist physiotherapists in Canada with promoting optimal levels of physical activity, sedentary behaviour and sleep (movement behaviours) in line with the Canadian 24-Hour Movement Guidelines for Adults 18-64 and 65+. Access the toolkit here.