Development and initial psychometric properties of the 'ICIQ-Cog': a new assessment tool to measure the disease-related impact and care effort associated with incontinence in cognitively impaired adults.

Abstract

To develop a new assessment tool, the ICIQ-Cog, to measure the disease-related impact of incontinence in cognitively impaired adults and the effort associated with the care of this population, and to present the initial psychometric properties of this tool and outline the possible clinical implications. The ICIQ-Cog consists of two scales: a 12-item scale measuring disease-specific bother (ICIQ-Cog-P) and a four-item scale assessing efforts associated with care of people with incontinence and cognitive impairment (ICIQ-Cog-C). Data on 60 nursing home residents with incontinence and cognitive impairment were obtained in a test-retest research design. The psychometric properties of the ICIQ-Cog were examined using a combination of classic and item response theory methods. Factor analyses resulted in a three-factor solution for the ICIQ-Cog-P, with interrelated factors. Rasch analysis showed a good model fit when collapsing response categories. The ICIQ-Cog-C fitted to one dimension. The ICIQ-Cog tool provided reliable measures in terms of internal consistency (0.69-0.82) and retest reliability (0.71-0.83). The preliminary results on external validity showed that the ICIQ-Cog assessed disease-specific aspects linked to the group of cognitively impaired people with incontinence. The ICIQ-Cog tool has appropriate psychometric and clinometric properties and is therefore useful for making decisions about treatment in cognitively impaired adults with incontinence.