Abstract

BackgroundTo investigate the factor structure, dimensionality and construct validity of the (5-item) PRAFAB questionnaire score in women with stress urinary incontinence (stress UI).MethodsA cross validation study design was used in a cohort of 279 patients who were randomly divided into Sample A or B. Sample A was used for preliminary exploratory factor analyses with promax rotation. Sample B provided an independent sample for confirming the premeditated and proposed factor structure and item retention. Internal consistency, item-total and subscale correlations were determined to assess the dimensionality. Construct validity was assessed by comparing factor-based scale means by clinical characteristics based on known relationships.ResultsFactor analyses resulted in a two-factor structure or subscales: items related to 'leakage severity' (protection, amount and frequency) and items related to its 'perceived symptom impact' or consequences of stress UI on the patient's life (adjustment and body (or self) image). The patterns of the factor loadings were fairly identical for both study samples. The two constructed subscales demonstrated adequate internal consistency with Cronbach's alphas in a range of 0.78 and 0.84 respectively. Scale scores differed by clinical characteristics according to the expectations and supported the construct validity of the scales.ConclusionThe findings suggest a two-factorial structure of the PRAFAB questionnaire. Furthermore the results confirmed the internal consistency and construct validity as demonstrated in our previous study. The best description of the factorial structure of the PRAFAB questionnaire was given by a two-factor solution, measuring the stress UI leakage severity items and the perceived symptom impact items. Future research will be necessary to replicate these findings in different settings, type of UI and non-white women and men.

Highlights

  • To investigate the factor structure, dimensionality and construct validity of the (5item) PRAFAB questionnaire score in women with stress urinary incontinence

  • Study population Data were derived from a prognostic cohort study of 279 mainly Caucasian women (96%) with a primary or recurrent episode of stress Urinary incontinence (UI) referred for physiotherapy treatment by GPs or urogynaecologists

  • There were no significant differences between Sample A and Sample B

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Summary

Introduction

To investigate the factor structure, dimensionality and construct validity of the (5item) PRAFAB questionnaire score in women with stress urinary incontinence (stress UI). Urinary incontinence (UI) is a common condition that affects approximately five to seven percent of adults in the Netherlands [1,2] increasing in the elderly to nine percent for men and 29% for women [3]. These estimates of prevalence are strongly influenced by the definition of UI. Valid and responsive outcome measures that combine UI leakage symptoms and the subjective impact on a patient's life are needed in clinical practice [7]. The PRAFAB questionnaire combines relevant objective and subjective aspects of UI severity, is quick and easy to administer and has the additional value of including the subjective aspects of UI [8,9]

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