Quality of life assessment

There are many validated questionnaires available although all have the same structure, consisting of a series of sections (domains) designed to gather information regarding particular aspects of health (Table 49.2). There are two types of QoL questionnaires, generic and disease, or condition-specific.

More recently the International Consultation on Incontinence (ICI) has published levels of recommendation for both generic and disease-specific questionnaires [31] (Table 49.3).

Generic QoL questionnaires

Generic questionnaires are designed as general measures of QoL and are therefore applicable to a wide range of populations and clinical conditions. Many different validated

Table 49.2 Quality of life domains

Domains of quality of life

Physical function, e.g. mobility, self-care, exercise Emotional function, e.g. depression, anxiety, worry Social function, e.g. intimacy, social support, social contact leisure activities Role performance, e.g. work, housework, shopping Pain

Sleep/nausea Disease-specific symptoms Severity measures

Table 49.3 Criteria for the recommendation of questionnaires

Grade of recommendation Evidence required

Grade A

Highly recommended

Grade B

Recommended

Grade C With potential

Published data indicating that it is valid, reliable and responsive to change on psychometric testing

Published data indicating that it is valid and reliable on psychometric testing

Published data (including abstracts) indicating that it is valid or reliable or responsive on psychometric testing

Table 49.4 Generic quality of life questionnaires

Generic quality of life questionnaires (Grade A) Short form 36 (SF-36) [32]

Generic quality of life questionnaires (Grade B) Sickness impact profile [33] Nottingham health profile [34] Goteborg quality of life [35]

Table 49.5 Disease-specific quality of life questionnaires

Disease-specific quality of life questionnaires (Grade A) Urogenital distress inventory (UDI) [36] Urogenital distress inventory - 6 (UDI-6) [37] Urge UDI [38]

Incontinence severity index [39] Quality of life in persons with urinary incontinence (I-QoL) [40] King's health questionnaire [22] Incontinence impact questionnaire (IIQ) [41]

generic questionnaires have been developed although not all are suitable for the assessment of lower urinary tract problems Table 49.4. They are not specific to a particular disease, treatment or age group and hence allow broad comparisons to be made. Consequently they lack sensitivity when applied to women with lower urinary tract symptoms and may be unable to detect clinically important improvement.

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