Creation and testing of the Geriatric Self-Efficacy Index for Urinary Incontinence.

OBJECTIVES

To report on the content development, construct validity, and reliability testing of the Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI).

DESIGN

Prospective cohort study.

SETTING

Six UI outpatient clinics in Quebec, Canada.

PARTICIPANTS

Community-dwelling incontinent men and women aged 65 and older.

MEASUREMENTS

Thirty-eight items were generated using a literature search and interdisciplinary panel of experts. Item reduction was achieved through field-testing with 75 older men and women with UI attending an information session. The final 20-item draft, measuring older adults' level of confidence in preventing urine loss, was administered to a new group of consecutive patients 1 week before and at the time of their first visit to the UI clinic to enable evaluation of test-retest reliability. A 3-day voiding diary, quantifying the frequency of UI, and the Incontinence Quality of Life questionnaire were used to test construct validity.

RESULTS

One hundred sixteen of 300 eligible patients (39%) participated (mean age+/-standard deviation 74+/-6, range 65-87). The GSE-UI items showed normal distributions and no ceiling effects. Self-efficacy scores ranged from 16 to 193 (mean 104+/-41, possible range 0-200) and correlated positively with quality of life scores (r=0.7, P<.001) and negatively with UI severity (r=-0.4, P<.001). Internal consistency for the GSE-UI was 0.94 (Cronbach alpha). Initial test-retest reliability of the 20 items using intraclass correlations ranged from 0.50 to 0.86.

CONCLUSION

The GSE-UI will enable measurement of whether a person's confidence in their ability to prevent urine loss is an important mechanism contributing to improvements in UI.