Only those items with CVR values meeting this minimum were retained in the final form of the scale. A total of articles were reviewed. Of these, 81 articles were utilized to identify the domains of activity and participation restrictions and 63 articles were used to formulating open-ended questionnaire. Fifteen subjects were married while five were unmarried. The mean age of the subjects was A total of 98 subjects were recruited for this phase, of which only 56 had participated in the study. Table 1 shows Eigen values of the extracted factors. Eigenvalues with percentage of variance of extracted factors for Incontinence — Activity Participation Scale.
Only 16 items met the criteria of CVR values of more than 0. Content validity ratio of the final version of the Incontinence — Activity Participation Scale.
Practical Urology in Spinal Cord Injury | Keith F. Parsons | Springer
The demographic details of the SCI subjects participated in pilot testing phase are shown in Table 3. The internal consistency of the scale was calculated using R software. The value of ordinal alpha of the scale found to be 0. The ordinal alpha for ADL domain was 0. Urinary incontinence can certainly have profound impact on patient's life. Accurate and reproducible methods of measuring outcomes have been a principle challenge.
During open-ended interviews we found in subjects with SCI urinary incontinence is a major barrier to their participation. Subjects reported difficulty in maintaining personal hygiene and restriction in the choice of clothing due to fear of leakage. In the mobility domain, sit to stand, prone lying and turning were reported to be most affected due to bladder problems as according to them these activities put pressure on bladder.
Patients said that they have to plan everything before going out such as to accommodate for clean intermittent catheterization and they have to come back in 4 hours. This was further supported by study done by Hicken et al. Participation in exercise program was reported to be very difficult for subjects due to their bladder problems. Robberton et al. Sexual domain was also revealed to be severely affected with leakages occurring during sexual intercourse hampered the activity; spoiling the mood of the partner. During the item reduction phase, the initial draft consisting of 77 items was applied to 56 SCI subjects with bladder problems and on CATPCA analysis based on predetermined criteria, only 28 items found to be remaining.
After the quantitative review, 14 items were removed as they did not meet the criteria of CVR value of 0.
In expert's opinion, some of the items were found to be overlapping and thus were removed. Ordinal alpha were 0. Ordinal alpha values for domains of Incontinence — Activity Participation Scale. However, the study had some limitations. It was constructed only for English speaking population and hence the generalizability of the questionnaire was limited. Furthermore, only content validity was established. We are also in the process of establishing other psychometric properties of the questionnaire, in future we suggest that the scale could be used for assessing the impact of bladder problems on activity limitation and participation restrictions in population other than SCI.
The scale could be useful as an outcome tool to assess the effect of an intervention to improve bladder dysfunction. The I-APS Appendix 1 is a valid, comprehensive instrument that measures the activity limitation and participation restrictions due to bladder problems in SCI. We acknowledge Dr. Yadav, Assistant Director, Dr. Tulsi Adhikari, Scientist and Dr.
Jiten Singh, scientist at National Institute of Medical Research for their valuable time and guidance for the statistical analysis. The following 16 questions will assess the physical activity — participation limitation due to bladder problems. Please tick in the square box that best describes your physical activity — participation limitation due to bladder problems. If there is any problem in any question please tick the response which is closest to your situation.
For questions in case not applicable write NA. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest. National Center for Biotechnology Information , U. Journal List Indian J Urol v. Indian J Urol. Author information Article notes Copyright and License information Disclaimer.
Received May 23; Accepted Nov This article has been cited by other articles in PMC. Materials and Methods: The process of development was initiated by formation of open-ended questions after thorough review of literature which were then administered to SCI participants, caretakers, and professionals working with SCI. Results: The I-APS is both health professional and self-administered questionnaire including two domains: Activities of daily living and occupation with 16 items having a content validity of 0.
Conclusion: The I-APS is a valid, comprehensive instrument that measures the activity limitation and participation restrictions due to bladder problems in SCI. Open in a separate window. Figure 1. Step 1: Item generation Stating the purpose of the study The purpose of the scale was specified to understand the impact of bladder problems on activity limitation and participation restriction in SCI subjects. Review of literature A thorough review literature was done to identify the various domains of activity and participation restrictions due to bladder problems.
In depth interviews After the identification of domains of activity limitations and participation restrictions due to bladder problems in SCI, open-ended questions were formulated for a one-to-one interview to gain in-depth knowledge of the construct for which the scale was to be developed. Step 3: Item reduction Item reduction was done to decide which items should be discarded and which should be retained.
Step 4: Validation of scale Face validity Face validity was established by experts who reviewed the scale. Item reduction A total of 98 subjects were recruited for this phase, of which only 56 had participated in the study. Table 1 Eigenvalues with percentage of variance of extracted factors for Incontinence — Activity Participation Scale. Content validity Only 16 items met the criteria of CVR values of more than 0. Table 2 Content validity ratio of the final version of the Incontinence — Activity Participation Scale.
Pilot testing The demographic details of the SCI subjects participated in pilot testing phase are shown in Table 3.
Table 3 Demographic details of spinal cord injury participants during pilot testing phase. Acknowledgments We acknowledge Dr. Appendix 1. Incontinence — Activity Participation Scale I-APS Instructions: The following 16 questions will assess the physical activity — participation limitation due to bladder problems.
Footnotes Financial support and sponsorship: Nil. Participation following traumatic spinal cord injury: An evidence-based review for research. J Spinal Cord Med. Developing core sets for persons with spinal cord injuries based on the international classification of functioning, disability and health as a way to specify functioning. Harry Potter. Popular Features.
Development and validation of Incontinence - Activity Participation Scale for spinal cord injury
New Releases. Description In keeping with the aims of other books in this Series the Editors have concentrated on the practical aspects of management -in this case of the urinary tract in patients with spinal cord injury. It is well accepted that the management of such patients is best done by those with special experience in this field.
Nevertheless, it is essential that urologists should be well informed on matters relating to the neuropathic urinary tract since not all patients will be managed in special centres and, whether their problems are acute or chronic, the wrong clinical decision can lead them into a lifetime of problems. The plan of this book is directed towards examining particular problems and providing definitive answers. Even in this enlightened age of medical progress there are many clinical situations where there is often a choice of treatment.
Readers of this Series will be aware that, despite an apparent abundance of information on a topic, it is sometimes not possible to reach a firm conclusion on a management problem.
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Keith Parsons and John Fitzpatrick are to be congratulated on ensuring that for this subject there are good clear guidelines. The data in the book are up to date and the excellent approach to the subject makes it a valuable addition to Clinical Practice in Urology. Product details Format Paperback pages Dimensions x x 8. Other books in this series. Urinary Diversion G. Add to basket. Chemotherapy and Urological Malignancy A. Bladder Cancer Eduard Zingg. Adenocarcinoma of the Prostate Andrew W.