Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772315Y.0000000030 · Published: May 1, 2015

Spinal Cord Injury Participation Patient Experience

Simple Explanation

This study describes the development of new questionnaires to measure bladder and bowel issues in people with spinal cord injury (SCI). These questionnaires, called SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks, aim to assess how these issues affect a person's quality of life. The questionnaires were created using feedback from individuals with SCI, SCI clinicians, and statistical analysis. The final versions are available as computer adaptive tests (CATs) or short forms, making them flexible for different needs. The SCI-QOL Bladder Complications scale is a short questionnaire specifically designed to assess urinary tract infections (UTIs) in individuals with SCI. It offers a quick way to measure this common complication.

Study Duration

Not specified

Participants

Seven hundred fifty-seven adults with traumatic SCI.

Evidence Level

Not specified

Key Findings

1
The final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI = 0.965; RMSEA = 0.093; Bowel Management Difficulties CFI = 0.955; RMSEA = 0.078) and acceptable fit to a graded response IRT model.
2
The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items.
3
5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI = 0.992, RMSEA = 0.050) and were thus retained as a separate scale.

Research Summary

The study details the development and testing of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks, along with the SCI-QOL Bladder Complications scale, for individuals with spinal cord injury (SCI). The item banks and scale were created using a mixed-methods design, incorporating feedback from individuals with SCI and clinicians, and employing item response theory (IRT) analytic approaches to ensure psychometric robustness. The resulting SCI-QOL instruments are psychometrically sound and available as computer adaptive tests or short forms, providing clinicians and researchers with valuable tools for assessing bladder and bowel dysfunction and complications in the SCI population.

Practical Implications

Clinical Assessment

Provides clinicians with standardized tools to assess bladder and bowel dysfunction and related complications in SCI patients, leading to more informed treatment plans.

Research Applications

Offers researchers reliable and valid measures for evaluating the impact of interventions and therapies on bladder and bowel management and overall quality of life in SCI.

Symptom Monitoring

Enables consistent tracking of symptoms and complications, facilitating timely adjustments in management strategies and improving patient outcomes in post-acute care settings.

Study Limitations

1
Generalizability may be limited due to the specific population studied (traumatic SCI).
2
The sample size for the Bladder Complications scale was reduced, potentially affecting the stability of the findings.
3
Differential item functioning (DIF) analysis could not be fully performed on the Bladder Complications items due to the reduced sample size.

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