Measuring Bladder Health: Development and Cognitive Evaluation of Items for a Novel Bladder Health Instrument

Area of Science:

• Urology
• Health Measurement
• Women's Health

Background:

• Bladder health measurement is complex, with women often unaware of normal function or overlooking infrequent symptoms.
• Self-management strategies are commonly used by women to mitigate the impact of bladder issues on daily activities.

Purpose of the Study:

• To describe the development and cognitive evaluation of the Prevention of Lower Urinary Tract Symptoms Bladder Health Instrument (PLUS-BHI).
• To create a comprehensive instrument for assessing bladder health in women.

Main Methods:

• Item development involved literature reviews, expert input, and focus group analysis.
• Cognitive interviews with 167 women and an online survey of 791 women were conducted for item testing and refinement.
• Iterative modification of items focused on comprehension, language, and response categories.

Main Results:

• Existing measures required adaptation to fully capture bladder health components like storage, emptying, and sensation.
• The concept of "bladder health" was often understood as the absence of severe symptoms, infection, or cancer.
• Incorporating prompts for infrequent symptoms increased symptom reporting across all bladder function areas.

Conclusions:

• Measuring bladder health is challenging due to low awareness of normal function and the tendency to overlook mild symptoms.
• The PLUS-BHI aims to characterize the full spectrum of bladder health in women.
• The PLUS-BHI is intended for validation and use in research settings.