School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Live UTI Free Ltd, Sandyford, Dublin, Ireland.
Neurourol Urodyn. 2024 Apr;43(4):902-914. doi: 10.1002/nau.25426. Epub 2024 Feb 22.
Recurrent urinary tract infection (rUTI) has significant negative consequences for a wide variety of quality of life (QoL) domains. Without adequate validation and assessment of the unique insights of people living with rUTI, clinical results cannot be fully understood. The Recurrent UTI Impact Questionnaire (RUTIIQ), a novel patient-reported outcome measure of rUTI psychosocial impact, has been robustly developed with extensive patient and clinician input to facilitate enhanced rUTI management and research. This study aimed to confirm the structural validity of the RUTIIQ, assessing its strength and bifactor model fit.
A sample of 389 adults experiencing rUTI (96.9% female, aged 18-87 years) completed an online cross-sectional survey comprising a demographic questionnaire and the RUTIIQ. A bifactor graded response model was fitted to the data, optimizing the questionnaire structure based on item fit, discrimination capability, local dependence, and differential item functioning.
The final RUTIIQ demonstrated excellent bifactor model fit (RMSEA = 0.054, CFI = 0.99, SRMSR = 0.052), and mean-square fit indices indicated that all included items were productive for measurement (MNSQ = 0.52-1.41). The final questionnaire comprised an 18-item general "rUTI QoL impact" factor, and five subfactor domains measuring "personal wellbeing" (three items), "social wellbeing" (four items), "work and activity interference" (four items), "patient satisfaction" (four items), and "sexual wellbeing" (three items). Together, the general factor and five subfactors explained 81.6% of the common model variance. All factor loadings were greater than 0.30 and communalities greater than 0.60, indicating good model fit and structural validity.
The 18-item RUTIIQ is a robust, patient-tested questionnaire with excellent psychometric properties, which capably assesses the patient experience of rUTI-related impact to QoL and healthcare satisfaction. Facilitating standardized patient monitoring and improved shared decision-making, the RUTIIQ delivers the unique opportunity to improve patient-centered care.
复发性尿路感染（rUTI）对多种生活质量（QoL）领域有显著的负面影响。如果没有充分验证和评估患有 rUTI 患者的独特见解，就无法全面了解临床结果。复发性尿路感染影响问卷（RUTIIQ）是一种新的患者报告 rUTI 心理社会影响的结果测量工具，它在患者和临床医生的广泛参与下得到了稳健的开发，以促进增强 rUTI 的管理和研究。本研究旨在确认 RUTIIQ 的结构有效性，评估其强度和双因素模型拟合度。
389 名患有 rUTI 的成年人（96.9%为女性，年龄 18-87 岁）完成了一项在线横断面调查，包括人口统计学问卷和 RUTIIQ。根据项目拟合度、区分能力、局部依赖性和差异化项目功能，对数据进行了双因素等级反应模型拟合。
最终的 RUTIIQ 显示出优异的双因素模型拟合度（RMSEA=0.054，CFI=0.99，SRMSR=0.052），平均平方拟合指数表明所有包含的项目都对测量有贡献（MNSQ=0.52-1.41）。最终问卷包括一个 18 项的通用“rUTI QoL 影响”因子，以及五个测量“个人幸福感”（三项）、“社会幸福感”（四项）、“工作和活动干扰”（四项）、“患者满意度”（四项）和“性健康”（三项）的子因子域。总的来说，通用因子和五个子因子共同解释了 81.6%的共同模型方差。所有因子负荷都大于 0.30，共同性都大于 0.60，表明模型拟合度和结构有效性良好。
18 项 RUTIIQ 是一种强大的、经过患者测试的问卷，具有良好的心理测量学特性，能够对 rUTI 相关影响对生活质量和医疗保健满意度的患者体验进行评估。RUTIIQ 促进了标准化的患者监测和改进的共同决策，为改善以患者为中心的护理提供了独特的机会。
