Development and psychometric validation of a patient-reported outcome measure of recurrent urinary tract infection impact: the Recurrent UTI Impact Questionnaire

Abigail F Newlands; Lindsey Roberts; Kayleigh Maxwell; Melissa Kramer; Jessica L Price; Katherine A Finlay

doi:10.1007/s11136-023-03348-7

Development and psychometric validation of a patient-reported outcome measure of recurrent urinary tract infection impact: the Recurrent UTI Impact Questionnaire

Qual Life Res. 2023 Jun;32(6):1745-1758. doi: 10.1007/s11136-023-03348-7. Epub 2023 Feb 6.

Authors

Abigail F Newlands¹, Lindsey Roberts², Kayleigh Maxwell³, Melissa Kramer⁴, Jessica L Price⁴, Katherine A Finlay⁵

Affiliations

¹ School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 7BE, UK.
² School of Psychology, University of Buckingham, Buckingham, MK18 1EG, UK.
³ Department of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, FK9 4LA, UK.
⁴ Live UTI Free Ltd, Ardeen House, 10-11 Marine Terrace, Dun Laoghaire, Dublin, Ireland.
⁵ School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 7BE, UK. katherine.finlay@reading.ac.uk.

Abstract

Purpose: Recurrent urinary tract infection (rUTI) is a highly prevalent condition associated with significant poor quality of life outcomes. A patient-reported outcome measure (PROM) of rUTI-associated psychosocial impact is urgently required to supplement clinical evaluation and validate the challenges experienced by patients. This study therefore developed and validated the Recurrent UTI Impact Questionnaire (RUTIIQ).

Methods: A rigorous four-stage methodology was followed: (I) concept elicitation through a qualitative survey of the experiences of people with rUTI (N = 1983); (II) Delphi expert screening of the RUTIIQ with expert rUTI clinicians (N = 15); (III) one-to-one cognitive interviews with people experiencing rUTI (N = 28) to evaluate the comprehensiveness and comprehensibility of the RUTIIQ, and (IV) full pilot testing of the RUTIIQ with people experiencing rUTI (N = 240) to perform final item reduction and psychometric analysis.

Results: Exploratory factor analysis demonstrated a five-factor structure comprising: 'patient satisfaction', 'work and activity interference', 'social wellbeing', 'personal wellbeing', and 'sexual wellbeing', collectively accounting for 73.8% of the total variance in pilot scores. Results from expert clinicians and patients indicated strong item content validity (I-CVI > .75). The internal consistency and test-retest reliability of the RUTIIQ subscales were excellent (Cronbach's α = .81-.96, ICC = .66-.91), and construct validity was strong (Spearman's ρ > .69).

Conclusion: The RUTIIQ is a 30-item questionnaire with excellent psychometric properties, assessing the patient-reported psychosocial impact of living with rUTI symptoms and pain. This new instrument delivers the unique opportunity to enhance patient-centred care through standardised observation and monitoring of rUTI patient outcomes.

Trial registration: This study was pre-registered with ClinicalTrials.gov (identifier: NCT05086900).

Keywords: Chronic pain; Patient-centred care; Patient-reported outcomes; Recurrent urinary tract infection; Urinary tract infection; Women’s health.

MeSH terms

Humans
Patient Reported Outcome Measures
Psychometrics
Quality of Life* / psychology
Reproducibility of Results
Surveys and Questionnaires
Urinary Tract Infections* / drug therapy

Associated data

ClinicalTrials.gov/NCT05086900