Revisiting the UDI and IIQ: proposed more stable models

Abstract

Assessing and reviewing a person’s incontinence status is an essential task for nurses. Two clinically‐useful and widely used scales which measure the symptoms and impact of incontinence are the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ). Short forms, more amenable for use in nursing assessments, have been derived from sub‐scales contained within the long forms. The aim of the research was to assess the suitability of the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ) sub‐scales and their short forms for use with a Scottish population. Study participants were 237 females with urinary incontinence from two Scottish regions. Principal Components Analysis, Best Subset Regression, Structural Equation Modelling and Cronbach’s alpha were used to assess reliability and stability. New scales and sub‐scales were generated and tested for goodness‐of‐fit on the Scottish data. Stability was assessed using test‐retest data from the same population. The same structure of sub‐scales previously reported did not emerge, although some overlap was apparent. Different short forms also emerged. Using more flexible modelling methods, sub‐scales with greater stability were developed for the UDI and IIQ. The resulting 11‐item UDI and 11‐item IIQ models had good internal consistency. Cronbach’s alpha was 0.829 and 0.898 respectively. The researchers conclude that internationally robust yet practical measures of incontinence are needed in nursing. Previous reports on the UDI and IIQ sub‐scales and short forms and their associated psychometric properties may not be relevant to populations different to those in which the instruments were developed. Further retrospective and prospective assessment is recommended.

Urinary Incontinence: Its Assessment and Relationship to Depression among Community-Dwelling Multiethnic Older Women

“…In 2008, Sheward et al [ 26 ] tested the two tools on a Scottish population: different short forms emerged, as the author developed subscales for the UDI and IIQ with greater stability, with the resulting 11-item UDI and 11-item IIQ models showing good internal consistency. Short forms of the UDI and IIQ were also generated by Uebersax et al [ 27 ] who reduced the UDI from 19 items to 6 items (UDI-6) and the IIQ from 30 items to 7 items (IIQ-7).…”

A systematic review of utility‐based and disease‐specific quality of life measurement instruments for women with urinary incontinence

“…Five studies investigated measurement properties of the English version of the UDI 47,50,51,53,54 . There was high level evidence for sufficient structural validity and internal consistency.…”

“…Incontinence Impact Questionnaire (IIQ) Six studies evaluated the English version of the IIQ. 44,47,50,51,53,54 There was high quality evidence for sufficient structural validity based on three studies that examined this property using principle component analysis. 50,53,54 Evidence on internal consistency and responsiveness were inconsistent.…”

“…Incontinence Impact Questionnaire (IIQ) Six studies evaluated the English version of the IIQ. 44,47,50,51,53,54 There was high quality evidence for sufficient structural validity based on three studies that All UI; On urodynamics: SUI (133), DI (80), MUI (11), LC (29), UUI (11), normal (14). examined this property using principle component analysis.…”

“…examined this property using principle component analysis. 50,53,54 Evidence on internal consistency and responsiveness were inconsistent. There was moderate insufficient evidence for reliability (κ: 0.732-0.381).…”