title: Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale.
abstract: OBJECTIVE
  To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale.
  
  
  METHODS
  Using a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning.
  
  
  METHODS
  Thirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY.
  
  
  METHODS
  Seven hundred fifty-seven adults with traumatic SCI.
  
  
  RESULTS
  The final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI=0.965; RMSEA=0.093; Bowel Management Difficulties CFI=0.955; RMSEA=0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI=0.992, RMSEA=0.050) and were thus retained as a separate scale.
  
  
  CONCLUSIONS
  The SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.
authors.forename: David S
authors.initials: DS
authors.lastname: Tulsky
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Kisala
authors.forename: Denise G
authors.initials: DG
authors.lastname: Tate
authors.forename: Ann M
authors.initials: AM
authors.lastname: Spungen
authors.forename: Steven C
authors.initials: SC
authors.lastname: Kirshblum
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007422:Intestines / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000145:classification / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D001743:Urinary Bladder / Q000502:physiology*
keywords: Neurogenic; Neurogenic bowel; Patient reported outcomes assessment; Psychometrics; Quality of life; Spinal cord injuries; Urinary bladder