Content Validation of Symptom-Specific Nocturia Quality-of-Life Instrument Developed in Men: Issues Expressed by Women, as Well as Men

Objectives

Nocturia, waking at night to void, is a common symptom in both men and women. The nocturia quality-of-life instrument, International Consultation on Incontinence Modular Questionnaire–Nocturia Quality of Life (ICIQ-Nqol), is the only current available, validated, symptom-specific tool for patients with nocturia. Because the ICIQ-Nqol was developed exclusively in men, the validity of its use in women is unknown.

Methods

Qualitative analyses of patient transcripts from the Atlanta (7 men and 17 women) and Piedmont (20 men and 23 women) groups at 5 sites (Florida, Georgia, Washington State, North Carolina, and Maryland) were used to assess the content validity of the ICIQ-Nqol. The Atlanta participants underwent 1:1 semistructured interviews emphasizing Kleinman's Explanatory Model. The Piedmont subjects participated in 6 focus groups and used a developed guide. Content review of the transcripts was used to derive items and themes.

Results

A total of 48 items and 13 thematic areas from the Atlanta and 64 items and 12 thematic areas from the Piedmont groups were derived from the transcripts using qualitative analysis. The ICIQ-Nqol before final item consolidation covered every thematic area generated by the Atlanta and Piedmont groups. The Piedmont and Atlanta participant pool generated only 2 themes—“fear of falling at night” and “nocturia makes me feel old”—that were not present in the final 12-item ICIQ-Nqol.

Conclusions

The ICIQ-Nqol appears to have strong content validity for the experiences of both men and women with nocturia. Supplementing the ICIQ-Nqol with questions about a fear of falling and the effect of nocturia on age self-concept might provide more complete information about the effect of nocturia on the quality of life of older adults.