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SCI-QOL Bladder Management Difficulties
Availability
Please visit this website for more information about the SCI-QOL Bladder Management Difficulties
 
PDF copies of all SCI-QOL item banks and short forms are freely available to the public by contacting SCI-QOL@udel.edu.
Classification
Supplemental: Spinal Cord Injury (SCI)
Short Description of Instrument
The SCI-QoL Bladder Management Difficulties assesses difficulties with neurogenic bladder management in individuals with SCI. Difficulties with bladder management among persons with SCI include incontinence, urinary tract infections (UTIs), pain, pressure, renal failure, and bladder and kidney stones.
 
It is an item response theory (IRT)-calibrated item bank with 15 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 8 item short form. (Tulsky et al., 2015)
Comments/Special Instructions
The Bladder Management Difficulties item bank can be administered as a CAT (PAR-QOL, 2018a) or a 8-item short form (PAR-QOL, 2018b) allowing researchers and clinicians to administer only the most precise and informative items based upon an individual's responses, thus reducing patient burden. (PAR-QOL, 2018a) This may be clinically useful in symptom monitoring and self-management in post-acute care settings.
Scoring and Psychometric Properties
Scoring
 
Item bank of 15 items. With Computer Assisted Technology (CAT), Short-Form with 8 items. Response options in a 5-point scale (Tulsky et al., 2015). CAT- and SF-versions and reference scores available
Assessment through CAT-center.
 
1 = Never/Not at all
 
2 = Rarely / A little bit
 
3 = Somewhat / Sometimes
 
4 = Quite a bit/Often
 
5 = Very much/Always
 
Scoring for CAT 15-item Psychometrics for SCI: Item bank of 15 items. CAT administration (minimum 4 items or minimum 8 items). The complications experienced 'lately' are given a score between 1 (never/not at all) & 5 (always/very much). One item is reverse scored between 1 (always) & 5 (never). Items are summed then converted to a standardized T-metric score with a mean of 50 and a standard deviation of 10. Higher scores indicate higher degree of difficulty. (PAR-QOL, 2018a)
 
Scoring for 8-Item Short Form Psychometrics for SCI: short-form. The complications experienced 'lately' are given a score between 1 (never/not at all) & 5 (always/very much). One item is reverse scored between 1 (always) & 5 (never). Items are summed then converted to a standardized T-metric score with a mean of 50 and a standard deviation of 10. Higher scores indicate higher degree of difficulty. (PAR-QOL, 2018b)
 
Psychometric Properties
 
Reliability: Good test-retest reliability (ICC = 0.76) (Best et al., 2017; Tate et al., 2020; Tulsky et al., 2015)
 
Validity: High internal consistency (0.91). Good fit and no DIF in IRT-analysis. (Best et al., 2017; Tate et al., 2020; Tulsky et al., 2015) Moderate correlation (0.50) with NBSS. Showed significant differences according to type of catheterization. (Myers et al., 2019a) Another study reports significant associations with bladder surgery. (Myers et al., 2019b; Tate et al., 2020)
 
Responsiveness: Not yet reported. (Tate et al., 2020)
 
CAT 15-item Psychometrics for SCI: a=0.91 for internal consistency, correlations (item/total) range from 0.38 to 0.78, Pearson's r is 0.77 (? < 0.01) for test-retest reliability, intra-class correlation coefficient (2.1) is 0.76 (95% CI=0.70 to 0.81), the fit to a unidimensional model is confirmed (CFI=0.965; RMSEA=0.093), the reliability is equivalent to a classical 0.95 (determined with measurement precision in the theta range). (PAR-QOL 2018a; Tulsky et al., 2015)
 
Short Form Psychometrics for SCI: Correlation with full bank score = 0.963. (Tulsky et al., 2015) For the 15 items of the SCI-QoL Bladder Management Difficulties: a=0.91 for internal consistency, correlations (item/total) range from 0.38 to 0.78, Pearson's r is 0.77 (? < 0.01) for test-retest reliability, intra-class correlation coefficient (2.1) is 0.76 (95% CI=0.70 to 0.81), the fit to a unidimensional model is confirmed (CFI=0.965; RMSEA=0.093), the reliability is equivalent to a classical 0.95 (determined with measurement precision in the theta range). (PAR-QOL, 2018b; Tulsky et al., 2015)
Rationale/Justification
Strengths/Weaknesses: The SCI-QoL Bladder Management Difficulties was developed for use in SCI. It is easy to administer using CAT or short forms and reference scores are available.There has been one validation study published (Tulsky et al., 2015); further SCI studies are needed to assess psychometric properties.
References
Key References:
 
Tulsky DS, Kisala PA, Tate DG, Spungen AM, Kirshblum SC. 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. J Spinal Cord Med. 2015;38:288-302.
 
Tulsky DS, Kisala PA, Victorson D, Tate D, Heinemann AW, Amtmann D, Cella D. Developing a contemporary patient-reported outcomes measure for spinal cord injury. Arch Phys Med Rehabil. 2011;92(10 Suppl):S44-S51.
 
Additional References:
 
Best KL, Ethans K, Craven BC, Noreau L, Hitzig SL. Identifying and classifying quality of life tools for neurogenic bladder function after spinal cord injury: a systematic review. J Spinal Cord Med 2017;40:505-529.
 
Dijkers MP. Individualization in quality of life measurement: instruments and approaches. Arch Phys Med Rehabil. 2003;84(4 Suppl 2):S3-S14.
 
Myers JB, Lenherr SM, Stoffel JT, Elliott SP, Presson AP, Zhang C, et al. The effects of augmentation cystoplasty and botulinum toxin injection on patient-reported bladder function and quality of life among individuals with spinal cord injury performing clean intermittent catheterization. Neurourol Urodyn 2019a;38:285-294.
 
Myers JB, Lenherr SM, Stoffel JT, Elliott SP, Presson AP, Zhang C, et al. Patient reported bladder related symptoms and quality of life after spinal cord injury with different bladder management strategies. J Urol 2019b;202(3):574-584.
 
PAR-QoL. (2018a) Spinal Cord Injury-Quality of Life (SCI-QoL) Bladder Management Difficulties. Accessed 01Feb2021 from: https://parqol.com/spinal-cord-injury-quality-of-life-sci-qol-bladder-management-difficulties/.
 
PAR-QoL. (2018b) Spinal Cord Injury-Quality of Life (SCI-QoL) Bladder Management Difficulties-Short Form. Accessed 01Feb2021 from: https://parqol.com/spinal-cord-injury-quality-of-life-sci-qol-bladder-management-difficulties-short-form/.
 
Patel DP, Lenherr SM, Stoffel JT, Elliott SP, Welk B, Presson AP, Jha A, Rosenbluth J, Myers JB; Neurogenic Bladder Research Group. Study protocol: patient reported outcomes for bladder management strategies in spinal cord injury. BMC Urol. 2017;17(1):95.
 
Tate DG, Wheeler T, Lane GI, Forchheimer M, Anderson KD, Biering-Sorensen F, Cameron AP, Santacruz BG, Jakeman LB, Kennelly MJ, Kirshblum S, Krassioukov A, Krogh K, Mulcahey MJ, Noonan VK, Rodriguez GM, Spungen AM, Tulsky D, Post MW. Recommendations for evaluation of neurogenic bladder and bowel dysfunction after spinal cord injury and/or disease. J Spinal Cord Med. 2020;43(2):141-164.
 
Document last updated November 2021