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Development and psychometric evaluation of the ICIQ-LTCqol: A self-report quality of life questionnaire for long-term
Nikki Cotterill1, Sarah Fowler1, Miriam Avery2
1Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom.
Insights
A new questionnaire, the ICIQ-Long Term Catheter quality of life (ICIQ-LTCqol), has been developed to assess the quality of life for individuals using long-term urinary catheters. This tool provides a reliable method for evaluating patient well-being and catheter impact.
Area of Science:
- Urology
- Quality of Life Research
- Health Outcomes Measurement
Background:
- Long-term indwelling catheterization can negatively impact health-related quality of life.
- Existing clinical assessment and monitoring methods lack validated measures for catheter users.
- Standardized assessment tools are needed to capture the experiences of individuals with long-term catheters.
Purpose of the Study:
- To develop and validate the ICIQ-Long Term Catheter quality of life (ICIQ-LTCqol) questionnaire.
- To create a standardized module within the International Consultation on Incontinence Questionnaire (ICIQ) series.
- To provide a robust measure for assessing quality of life in long-term catheter users.
Main Methods:
- Qualitative interviews with 27 catheter users and 4 carers.
- Cognitive debriefing with 31 catheter users and clinical experts.
- Psychometric evaluation of a 44-item draft questionnaire with 893 participants, followed by factor analysis to create a 16-item final version.
- Validation of the final questionnaire with 438 long-term catheter users.
Main Results:
- The final ICIQ-LTCqol questionnaire comprises 16 items across two scored domains: catheter function/concern (9 items) and lifestyle impact (3 items), plus four standalone items.
- The questionnaire demonstrates good content validity, test-retest reliability, and internal consistency (Cronbach's alpha 0.76 and 0.74).
- Low missing data rates (mean 3.6%) indicate good participant engagement and data quality.
Conclusions:
- The ICIQ-LTCqol is a psychometrically sound, self-report questionnaire.
- It is suitable for the clinical assessment and evaluation of health-related quality of life in long-term catheter users.
- This tool addresses the need for validated measures in this patient population.
Aims:
Long-term indwelling catheterisation may affect health related quality of life, but clinical assessment and monitoring of people with indwelling catheters is poorly recorded because there are no validated measures to capture these criteria. In this paper, we describe the development of the ICIQ-Long Term Catheter quality of life (ICIQ-LTCqol), one of the modules of the ICIQ series, an international project to standardise assessment of lower pelvic dysfunction: www.iciq.net.
Methods:
In-depth interviews were conducted with 27 catheter-users and 4 informal carers and cognitive debriefing with a further 31 catheter-users and clinical experts to evaluate clarity and comprehensiveness. The draft 44 item questionnaire was then sent by post to 893 long-term catheter-users; the 370 completed questionnaires were used to test content validity, test re-test reliability and internal consistency (Cronbach α coefficient). Factor analysis alongside expert opinion was used to formulate the final questionnaire of 16 items. This was then sent by post to another 438 long-term catheter-users to evaluate domain scores.
Results:
The final questionnaire consists of two scored domains: catheter function and concern (9 items) and lifestyle impact (3 items) and four standalone items, relating to pads, pain, sexual activity and bladder spasm. Levels of missing data are good (mean 3.6%) with moderate to good agreement and acceptable internal consistency (Cronbach's alpha 0.76 and 0.74 for each domain respectively), suggesting acceptability and stability of the questionnaire.
Conclusion:
The ICIQ-LTCqol is a psychometrically robust self-report questionnaire for the clinical assessment and evaluation of health related quality of life for long-term catheter users.
