Burgio Kathryn L, Goode Patricia S, Richter Holly E, Locher Julie L, Roth David L
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA.
Neurourol Urodyn. 2006;25(5):411-7. doi: 10.1002/nau.20243.
To test the validity of three patient global ratings, satisfaction, perception of improvement, and estimated percent improvement, for measuring outcomes of behavioral treatment for urinary incontinence.
This report is a secondary analysis of data from three randomized controlled trials testing behavioral interventions for incontinence. Participants were 359 community-dwelling women, aged 40-92 years, with stress, urge, or mixed urinary incontinence. All participants received an 8-week program of clinic-based or self-administered behavioral training. Subjective outcomes included a patient satisfaction question (PSQ), global perception of improvement (GPI), and estimated percent improvement (EPI). Convergent validity was tested by examining the relationship between each measure and reduction of incontinence (bladder diary), change on the incontinence impact questionnaire (IIQ), and desire for another treatment. Discriminant validity was explored by examining the relationship of the global ratings to five measures not expected to be related to outcome (age, race, BMI, education level, and change in perceived pain).
All three patient global ratings were significantly associated with each other (P < 0.0001), with diary measures of reduction of incontinence episodes (P < 0.0001), and change in the IIQ (P < 0.005), and inversely associated with desire for another treatment (P < 0.0001). All three patient ratings were not significantly associated with age, race, BMI, education level, or change in perceived pain.
Patient global ratings of satisfaction, perception of improvement, and estimated percent improvement have acceptable convergent and discriminant validity for measuring outcomes in studies of behavioral treatment for urinary incontinence.
检验三种患者总体评分（满意度、改善感知和估计改善百分比）在测量尿失禁行为治疗效果方面的有效性。
本报告是对三项测试尿失禁行为干预的随机对照试验数据的二次分析。参与者为359名年龄在40 - 92岁之间、患有压力性、急迫性或混合性尿失禁的社区居住女性。所有参与者都接受了为期8周的基于诊所或自我管理的行为训练项目。主观结果包括患者满意度问题（PSQ）、总体改善感知（GPI）和估计改善百分比（EPI）。通过检查每种测量方法与尿失禁减少情况（膀胱日记）、尿失禁影响问卷（IIQ）的变化以及再次治疗意愿之间的关系来测试收敛效度。通过检查总体评分与五项预期与结果无关的测量指标（年龄、种族、体重指数、教育水平和感知疼痛变化）之间的关系来探索区分效度。
所有三项患者总体评分彼此之间均显著相关（P < 0.0001），与尿失禁发作减少的日记测量指标显著相关（P < 0.0001），与IIQ的变化显著相关（P < 0.005），并且与再次治疗意愿呈负相关（P < 0.0001）。所有三项患者评分与年龄、种族、体重指数、教育水平或感知疼痛变化均无显著关联。
患者对满意度、改善感知和估计改善百分比的总体评分在测量尿失禁行为治疗研究的结果方面具有可接受的收敛效度和区分效度。
