Urinary incontinence in spina bifida: Initial instrument validation

Area of Science:

• Pediatric Urology
• Clinical Psychology
• Rehabilitation Medicine

Background:

• Adolescents with spina bifida (SB) often experience neuropathic urinary incontinence (UI).
• Accurate assessment of UI symptom severity and impairment is crucial for effective management in this population.
• Existing assessment tools may require validation for specific pediatric cohorts.

Purpose of the Study:

• To psychometrically assess the Incontinence Symptom Index-Pediatric (ISI-P) in adolescents with SB and UI.
• To evaluate the validity and reliability of the ISI-P in this specific patient group.
• To determine if the ISI-P accurately measures symptom severity and functional impairment.

Main Methods:

• The ISI-P, an 11-item self-administered questionnaire, was used.
• Participants included adolescents aged 11-17 with SB and UI, and a control group with nephrolithiasis.
• Psychometric evaluation included internal consistency (Cronbach's alpha), test-retest reliability, and factor analysis.

Main Results:

• The ISI-P demonstrated high internal consistency (Cronbach's alpha = 0.936 for severity, 0.792 for bother).
• Factor analysis supported a two-factor model, indicating excellent fit indices (CFI = 0.969).
• Category information analysis confirmed that each category provided unique measurement information.

Conclusions:

• The Incontinence Symptom Index-Pediatric (ISI-P) exhibits desirable psychometric properties.
• The ISI-P is a valid and reliable instrument for measuring UI symptom severity and impairment in adolescents with SB.
• This validated tool can enhance clinical assessment and management of UI in pediatric SB patients.