title: Responsiveness and clinical utility of the geriatric self-efficacy index for urinary incontinence.
abstract: OBJECTIVE
  To report on the responsiveness testing and clinical utility of the 12-item Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Six urinary incontinence (UI) outpatient clinics in Quebec, Canada.
  
  
  METHODS
  Community-dwelling incontinent adults aged 65 and older.
  
  
  METHODS
  The abridged 12-item GSE-UI, measuring older adults' level of confidence for preventing urine loss, was administered to all new consecutive incontinent patients 1 week before their initial clinic visit, at baseline, and 3 months posttreatment. At follow-up, a positive rating of improvement in UI was ascertained from patients and their physicians using the Patient's and Clinician's Global Impression of Improvement scales, respectively. Responsiveness of the GSE-UI was calculated using Guyatt's change index. Its clinical utility was determined using receiver operating curves.
  
  
  RESULTS
  Eighty-nine of 228 eligible patients (39.0%) participated (mean age 72.6+5.8, range 65-90). At 3-month follow-up, 22.5% of patients were very much better, and 41.6% were a little or much better. Guyatt's change index was 2.6 for patients who changed by a clinically meaningful amount and 1.5 for patients having experienced any level of improvement. An improvement of 14 points on the 12-item GSE-UI had a sensitivity of 75.1% and a specificity of 78.2% for detecting clinically meaningful changes in UI status. Mean GSE-UI scores varied according to improvement status (P<.001) and correlated with changes in quality-of-life scores (r=0.7, P<.001) and reductions in UI episodes (r=0.4, P=.004).
  
  
  CONCLUSIONS
  The GSE-UI is responsive and clinically useful.
authors.affiliation: Center for Research, Institut Universitaire de Gériatrie de Montréal, Quebec, Canada. cara.tannenbaum@umontreal.ca
authors.forename: Cara
authors.initials: C
authors.lastname: Tannenbaum
authors.forename: Judith
authors.initials: J
authors.lastname: Brouillette
authors.forename: Julie
authors.initials: J
authors.lastname: Michaud
authors.forename: Nicol
authors.initials: N
authors.lastname: Korner-Bitensky
authors.forename: Chantale
authors.initials: C
authors.lastname: Dumoulin
authors.forename: Jacques
authors.initials: J
authors.lastname: Corcos
authors.forename: Le Mai
authors.initials: le M
authors.lastname: Tu
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Lemieux
authors.forename: Stephane
authors.initials: S
authors.lastname: Ouellet
authors.forename: Luc
authors.initials: L
authors.lastname: Valiquette
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D012931:Social Environment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000523:psychology* / Q000534:rehabilitation