Quality of Life Concepts

Secondary Health Conditions

Cleveland Clinic Incontinence (CCI) Score

Description: The CCI Score takes into account the frequency of incontinence and the extent to which it alters a person’s life [1].

Format: 5 questions assessing type of incontinence (solid, liquid, gas, wears pad, lifestyle alteration).

Scoring: The frequency with which each type of incontinence occurs is rated on a scale from 0 (never) to 4 (always or to 1/day). The sum of the frequencies is added to yield a total score that can range from 0 to 20, with higher scores indicating higher levels of incontinence.

Administration and Burden: Interviewer-administered; Self-administered. It only takes a few minutes to complete.

Psychometrics for SCI: Not available.

Languages: English.

QoL Concept: The CCI is a Health-Related Quality of Life measure, which corresponds to Box C (achievements) of Dijker’s Model.

Permissions/Where to Obtain: Not available.

References:

  1. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993;36:77-97.

CLICK ON THE LISTED SECONDARY HEALTH CONDITIONS ON THE LEFT TO READ HOW THE CCI SCORE HAS BEEN USED WITH A PARTICULAR CONDITION


Bowel Dysfunction SCI Studies: One controlled, descriptive, and comparative questionnaire study and one longitudinal study.

1. Lynch AC, Wong C, Anthony A, Dobbs BR, Frizelle FA. Bowel dysfunction following spinal cord injury: a description of bowel function in a spinal cord-injured population and comparison with age and gender matched controls. Spinal Cord 2000;38:717-23.

2. Krogh K, Christensen P, Sabroe S, Laurberg S. Neurogenic bowel dysfunction score. Spinal Cord 2006;44: 625-31.

Sensitivity to Impact: Lynch et al. (2000) showed that compared to controls (N = 668), patients with SCI (N = 467) are more severely affected by incontinence (as measured by the CCI) in everyday activities. However, the definition of quality of life (QoL) and the areas and activities affected were not well described.

Krogh et al. (2006) found that the impact on QoL increased with the severity of symptoms both in terms of the Neurogenic Bowel Dysfunction (NBD) Score and the CCI.

Suggestions for Use: A noted limitation of the CCI is that the patient’s coping mechanisms are not taken into account. For instance, if the patient remains constantly on the toilet, a score of 4 would be assigned on alteration to lifestyle, but the patient would not necessarily receive a high score overall, even though the degree of incontinence in this case would merit a significantly higher score. In addition, definitions of QoL and areas or activities affected were not well-described. One recommendation may therefore be to administer the CCI along with other measures of health status as it relates to QoL, such as the Short-Form 36 (SF-36).

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