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An instrument for assessing quality of life in persons with neurogenic lower urinary tract dysfunction: validation of the German short-form Qualiveen questionnaire

Spinal Cord volume 60, pages 306–311 (2022)Cite this article

Subjects

Abstract

Study design

Prospective validation study.

Objectives

To validate and evaluate the measurement properties of the German Qualiveen short-form (SF) questionnaire in individuals with chronic neurogenic lower urinary tract dysfunction (NLUTD) resulting from spinal cord injury (SCI).

Setting

Tertiary neuro-urologic referral center in Switzerland.

Methods

Fifty individuals with chronic (>12 months) NLUTD resulting from SCI presenting for a urodynamic follow-up examination were enrolled to complete both the full version Qualiveen and the SF-Qualiveen questionnaires twice within three weeks. The criterion validity and test-retest reliability were evaluated by calculating the interclass correlation coefficients. Internal consistency was evaluated by calculating Cronbach’s alpha. Finally, the cross-sectional construct validity was evaluated using Spearman’s rank correlations between the scores of the two questionnaires for bladder evacuation, urinary continence, and urinary tract infection sub-groups.

Results

The mean age of the evaluated individuals was 53 years. The median duration of NLUTD was 14.9 years. The SF-Qualiveen showed good to excellent criterion validity with correlation coefficients greater than 0.8. Internal consistency was good overall and in the domains “bother with limitations” as well as “feelings” (>0.75). However, internal consistency in the domains “frequency of limitations” and “fears” was moderate-poor (0.68–0.37). The test-retest reliability was excellent with correlation coefficients greater than 0.9. Finally, the cross-sectional construct validity ranged from moderate to excellent (0.60–0.97).

Conclusions

The German SF-Qualiveen has shown excellent reliability and validity and variable internal consistency. Its brevity will increase compliance, and we therefore recommend to include the SF-Qualiveen in urologic assessments.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Savic G, DeVivo MJ, Frankel HL, Jamous MA, Soni BM, Charlifue S. Long-term survival after traumatic spinal cord injury: a 70-year British study. Spinal Cord. 2017;55:651–8.

    CAS  Article  Google Scholar 

  2. Savic G, DeVivo MJ, Frankel HL, Jamous MA, Soni BM, Charlifue S. Causes of death after traumatic spinal cord injury-a 70-year British study. Spinal Cord. 2017;55:891–7.

    CAS  Article  Google Scholar 

  3. Brinkhof MW, Al-Khodairy A, Eriks-Hoogland I, Fekete C, Hinrichs T, Hund-Georgiadis M, et al. Health conditions in people with spinal cord injury: contemporary evidence from a population-based community survey in Switzerland. J Rehabil Med. 2016;48:197–209.

    Article  Google Scholar 

  4. Adriaansen JJ, Post MW, de Groot S, van Asbeck FW, Stolwijk-Swuste JM, Tepper M, et al. Secondary health conditions in persons with spinal cord injury: a longitudinal study from one to five years post-discharge. J Rehabil Med. 2013;45:1016–22.

    Article  Google Scholar 

  5. Simpson LA, Eng JJ, Hsieh JT, Wolfe DL. The health and life priorities of individuals with spinal cord injury: a systematic review. J Neurotrauma. 2012;29:1548–55.

    Article  Google Scholar 

  6. Pannek J, Kullik B. Does optimizing bladder management equal optimizing quality of life? Correlation between health-related quality of life and urodynamic parameters in patients with spinal cord lesions. Urology. 2009;74:263–6.

    Article  Google Scholar 

  7. Adriaansen JJ, van Asbeck FW, Tepper M, Faber WX, Visser-Meily JM, de Kort LM, et al. Bladder-emptying methods, neurogenic lower urinary tract dysfunction and impact on quality of life in people with long-term spinal cord injury. J Spinal Cord Med. 2017;40:43–53.

    Article  Google Scholar 

  8. Theisen KM, Mann R, Roth JD, Pariser JJ, Stoffel JT, Lenherr SM, et al. Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study. Spinal Cord. 2020;58:1274–81.

    Article  Google Scholar 

  9. Best KL, Ethans K, Craven BC, Noreau L, Hitzig SL. Identifying and classifying quality of life tools for neurogenic bladder function after spinal cord injury: a systematic review. J Spinal Cord Med. 2017;40:505–29.

    Article  Google Scholar 

  10. Tate DG, Wheeler T, Lane GI, Forchheimer M, Anderson KD, Biering-Sorensen F, et al. Recommendations for evaluation of neurogenic bladder and bowel dysfunction after spinal cord injury and/or disease. J Spinal Cord Med. 2020;43:141–64.

    Article  Google Scholar 

  11. Costa P, Perrouin-Verbe B, Colvez A, Didier J, Marquis P, Marrel A, et al. Quality of life in spinal cord injury patients with urinary difficulties. Development and validation of qualiveen. Eur Urol. 2001;39:107–13.

    CAS  Article  Google Scholar 

  12. Bonniaud V, Parratte B, Amarenco G, Jackowski D, Didier JP, Guyatt G. Measuring quality of life in multiple sclerosis patients with urinary disorders using the Qualiveen questionnaire. Arch Phys Med Rehabil. 2004;85:1317–23.

    Article  Google Scholar 

  13. Bonniaud V, Jackowski D, Parratte B, Paulseth R, Grad S, Margetts P, et al. Quality of life in multiple sclerosis patients with urinary disorders: discriminative validation of the English version of Qualiveen. Qual Life Res. 2005;14:425–31.

    Article  Google Scholar 

  14. Pannek J, Mark R, Stohrer M, Schurch B. Quality of life in German-speaking patients with spinal cord injuries and bladder dysfunctions. Validation of the German version of the Qualiveen questionnaire. Urol Ausg A. 2007;46:1416–21.

    CAS  Article  Google Scholar 

  15. D’Ancona CA, Tamanini JT, Botega N, Lavoura N, Ferreira R, Leitão V, et al. Quality of life of neurogenic patients: translation and validation of the Portuguese version of Qualiveen. Int Urol Nephrol. 2009;41:29–33.

    Article  Google Scholar 

  16. Bonniaud V, Bryant D, Pilati C, Menarini M, Lamartina M, Guyatt G, et al. Italian version of Qualiveen-30: cultural adaptation of a neurogenic urinary disorder-specific instrument. Neurourol Urodyn. 2011;30:354–9.

    Article  Google Scholar 

  17. Ciudin A, Franco A, Diaconu MG, Peri L, Vivas V, Gonzalez MA, et al. Quality of life of multiple sclerosis patients: translation and validation of the Spanish version of Qualiveen. Neurourol Urodyn. 2012;31:517–20.

    Article  Google Scholar 

  18. Nikfallah A, Rezaali S, Mohammadi N, Abrishamkar M, Rezaei E, Sahraian MA, et al. Translation, cultural adaptation and validation of the qualiveen-30 questionnaire in persian for patients with spinal cord injury and multiple sclerosis. Low Urin Trac Symptoms. 2015;7:42–49.

    Article  Google Scholar 

  19. Bonniaud V, Bryant D, Parratte B, Guyatt G. Development and validation of the short form of a urinary quality of life questionnaire: SF-Qualiveen. J Urol. 2008;180:2592–8.

    Article  Google Scholar 

  20. Reuvers SHM, Korfage IJ, Scheepe JR, Blok BFM. The urinary-specific quality of life of multiple sclerosis patients: Dutch translation and validation of the SF-Qualiveen. Neurourol Urodyn. 2017;36:1629–35.

    Article  Google Scholar 

  21. Konstantinidis C, Tzitzika M, Daoultzis KC, Samarinas M, Giannitsas K, Athanasopoulos A. Translation and cultural adaptation of SF qualiveen questionnaire in Greek. Eur J Phys Rehabil Med. 2020;57:639–44.

  22. Philippova ES, Bazhenov IV, Ziryanov AV, Moskvina EY. Evaluation of lower urinary tract dysfunction impact on quality of life in multiple sclerosis patients: Russian translation and validation of SF-Qualiveen. Mult Scler Int. 2020;2020:4652439.

    PubMed  PubMed Central  Google Scholar 

  23. Przydacz M, Kornelak P, Dudek P, Golabek T, Chlosta P. The urinary disorder-specific quality of life in patients after spinal cord injury: polish translation, adaptation and validation of the Qualiveen and SF-Qualiveen. Spinal Cord. 2021;59:105–11.

    Article  Google Scholar 

  24. Zenginler Yazgan Y, Tarakci E, Ovacik U, Kurtuncu M. Translation, cross-cultural adaptation, and reliability and validity of the Turkish version of the SF-Qualiveen in people with multiple sclerosis. Neurourol Urodyn. 2021;40:891–6.

    Article  Google Scholar 

  25. Blok B, Castro-Diaz D, Del Popolo G, Groen J, Hamid R, Karsenty G et al. EAU Guidelines on Neuro-Urology. EAU Guidelines Office, Arnhem, The Netherlands. http://uroweb.org/guidelines/compilations-of-all-guidelines/. Presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4.

  26. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.

    Article  Google Scholar 

  27. Bonniaud V, Bryant D, Parratte B, Gallien P, Guyatt G. Qualiveen: a urinary disorder-specific instrument for use in clinical trials in multiple sclerosis. Arch Phys Med Rehabil. 2006;87:1661–3.

    Article  Google Scholar 

  28. Renard J, Ballarini S, Mascarenhas T, Zahran M, Quimper E, Choucair J, et al. Recurrent lower urinary tract infections have a detrimental effect on patient quality of life: a prospective, observational study. Infect Dis Ther. 2014;4:125–35.

    Article  Google Scholar 

  29. Nosseir M, Hinkel A, Pannek J. Clinical usefulness of urodynamic assessment for maintenance of bladder function in patients with spinal cord injury. Neurourol Urodyn. 2007;26:228–33.

    Article  Google Scholar 

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Acknowledgements

We thank the Mapi Research Trust for the permission to use the German versions of the SF-QUALIVEEN® and QUALIVEEN-30®. We also thank Sjef Meeuwsen for his assistance with data entry. We have received no external funding.

Author information

Authors and Affiliations

  1. Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland

    Jörg Krebs

  2. Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland

    Jens Wöllner, Alexandra Widmer & Jürgen Pannek

  3. Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Jürgen Pannek

Authors
  1. Jörg Krebs
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  2. Jens Wöllner
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  3. Alexandra Widmer
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  4. Jürgen Pannek
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Contributions

JK: project development, regulatory affairs, data management, analysis and interpretation of data, writing of manuscript, approval of final version. JW: project development, interpretation of data, editing of manuscript, approval of final version. AW: screening and recruitment of study participants, data collection, editing of manuscript, approval of final version. JP: project idea and development, interpretation of data, editing of manuscript, approval of final version.

Corresponding author

Correspondence to Jörg Krebs.

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Competing interests

The authors declare no competing interests.

Ethics statement

This study had been approved by the Ethics Committee of Northwestern and Central Switzerland (2019-00652). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. All data were encrypted and kept confidential.

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Krebs, J., Wöllner, J., Widmer, A. et al. An instrument for assessing quality of life in persons with neurogenic lower urinary tract dysfunction: validation of the German short-form Qualiveen questionnaire. Spinal Cord 60, 306–311 (2022). https://doi.org/10.1038/s41393-021-00710-9

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