title: Global ratings of patient satisfaction and perceptions of improvement with treatment for urinary incontinence: validation of three global patient ratings.
abstract: OBJECTIVE
  To test the validity of three patient global ratings, satisfaction, perception of improvement, and estimated percent improvement, for measuring outcomes of behavioral treatment for urinary incontinence.
  
  
  METHODS
  This report is a secondary analysis of data from three randomized controlled trials testing behavioral interventions for incontinence. Participants were 359 community-dwelling women, aged 40-92 years, with stress, urge, or mixed urinary incontinence. All participants received an 8-week program of clinic-based or self-administered behavioral training. Subjective outcomes included a patient satisfaction question (PSQ), global perception of improvement (GPI), and estimated percent improvement (EPI). Convergent validity was tested by examining the relationship between each measure and reduction of incontinence (bladder diary), change on the incontinence impact questionnaire (IIQ), and desire for another treatment. Discriminant validity was explored by examining the relationship of the global ratings to five measures not expected to be related to outcome (age, race, BMI, education level, and change in perceived pain).
  
  
  RESULTS
  All three patient global ratings were significantly associated with each other (P < 0.0001), with diary measures of reduction of incontinence episodes (P < 0.0001), and change in the IIQ (P < 0.005), and inversely associated with desire for another treatment (P < 0.0001). All three patient ratings were not significantly associated with age, race, BMI, education level, or change in perceived pain.
  
  
  CONCLUSIONS
  Patient global ratings of satisfaction, perception of improvement, and estimated percent improvement have acceptable convergent and discriminant validity for measuring outcomes in studies of behavioral treatment for urinary incontinence.
authors.affiliation: Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA. kburgio@aging.uab.edu
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Goode
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Julie L
authors.initials: JL
authors.lastname: Locher
authors.forename: David L
authors.initials: DL
authors.lastname: Roth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000523:psychology* / Q000628:therapy*