CHICAGO, IL USA (UroToday.com) - The topic of stigma associated with urinary incontinence has received scant attention in the research literature although UI is associated with stigma. This poster presented a review of existing UI intervention outcome measures (questionnaires) for relevance to UI stigmatization. The population of interest was individuals age 65+ with UI. The intervention of interest included any form of UI measurement tool. Several different databases were searched and UI-related questionnaires were scrutinized for content relating to:
- Felt or perceived-stigma - internalize negative perceptions regarding oneself
- Self-stigma - harsh or unjustified beliefs about oneself
- Enacted stigma – discrimination that takes place at an institution or from a group
Eleven questionnaires were identified and it was determined that none of them fully accessed UI stigma. Questionnaires reviewed included:
- Bristol Female Lower Urinary Tract Symptoms questionnaire (Bristol FLUTS)
- Urogenital Distress Inventory (UDI)
- Incontinence Impact Questionnaire (IIQ)
- Incontinence Outcome Questionnaire (IOQ)
- Incontinence Quality of Life Questionnaire (I-QOL)
- King’s Health Questionnaire (KHQ)
- Stamey Urinary Incontinence Scale (SUIS)
- Incontinence Severity Index (ISI)
- Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI)
- International Consultation on Incontinence Questionnaire - Urinary Incontinence-Short Form (ICIQ-UI-SF)
- Male Urogenital Distress Inventory and Male Urinary Symptom Impact Questionnaire (MUDI-MUSIQ)
The reviewers noted that more than half (6: UDI, ICIQ-UI-SF, SUIS, GSE-UI, ISI) of the measures do not have any stigma content. Four of the measures addressed perceived stigma (IIQ, I-QOL, KHQ, MUDI-MUSIQ), five measures (IIQ, IOQ, I-QOL, KHQ, MUDI-MUSIQ) addressed self-stigma, and only one (B-FLUTS) recommends conducting interviews to assess previously stigmatizing events. Four measures (IIQ, UDI, MUSIQ, MUDI) are gender specific, but the subscales of these measures appeared quite similar, which raises the question on the manifestations of stigma across gender.
The authors’ conclusion was that most measures are unable to assess how stigma may influence utilization of management products and ultimately how stigma influenced intervention outcomes.
References:
Bjelic-Radisic V, Dorfer M, Tamussino K, Frudinger A, Kern P, Winter R, Greimel E. The Incontinence Outcome Questionnaire: an instrument for assessing patient-reported outcomes after surgery for stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2007 Oct;18(10):1139-49. Epub 2007 Feb 17. PMID:17308862
Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P. The Bristol Female Lower Urinary Tract Symptoms questionnaire: development and psychometric testing. Br J Urol. 1996 Jun;77(6):805-12. PMID: 8705212
Kelleher CJ, Cardozo LD, Khullar V, Salvatore S.A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997 Dec;104(12):1374-9. PMID: 9422015
Robinson JP, Avi-Itzhak T, McCorkle R. Psychometric properties of the Male Urogenital Distress Inventory (MUDI) and Male Urinary Symptom Impact Questionnaire (MUSIQ) in patients following radical prostatectomy. Urol Nurs. 2007 Dec;27(6):512-8. PMID: 18217534
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Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA. Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group. Qual Life Res. 1994 Oct;3(5):291-306. PMID: 7841963
Tannenbaum C, Brouillette J, Korner-Bitensky N, Dumoulin C, Corcos J, Tu le M, Lemieux MC, Ouellet S, Valiquette L. Creation and testing of the Geriatric Self-Efficacy Index for Urinary Incontinence. J Am Geriatr Soc. 2008 Mar;56(3):542-7. doi: 10.1111/j.1532-5415.2007.01572.x. Epub 2008 Jan 2. PMID: 18179504
Wagner TH, Patrick DL, Bavendam TG, Martin ML, Buesching DP. Quality of life of persons with urinary incontinence: development of a new measure. Urology. 1996 Jan;47(1):67-71; discussion 71-2. PMID: 8560665
Presented by K Southall, JW Jutai, and E van den Heuvel at the Simon Foundation for Continence's Innovating for Continence Conference Series - April 12 - 13, 2013 - Chicago, Illinois USA
Reported for UroToday.com by Diane K. Newman, DNP, ANP-BC, FAAN
About the Conference Series
The Innovating for Continence Conference Series is a unique, international, biennial conference for engineers, physicians, nurses, people with incontinence and their caregivers, academics, industry executives, and those with a passion for increased development of creative and efficacious products for the management of incontinence.
The multi-disciplinary meetings attract speakers from a wide range of disciplines and is organized and hosted by The Simon Foundation for Continence (Chicago, IL USA). It is made possible through generous support from individual and industry sponsors.
Professor Alan Cottenden is the ongoing chair for the conference series. He is Professor of Incontinence Technology at University College London, England. Professor Cottenden is the Chair of the Organizing Committee for the biennial conference "Incontinence: The Engineering Challenge" hosted by the UK Institution of Mechanical Engineers along with the committee on Management Using Continence Products of the International Consultation on Incontinence (ICI). He has been involved in continence technology for almost 30 years, working on clinical and basic science aspects as well as product development and international standards work (ISO).
