Reliability assessment of the bladder diary for urinary incontinence in older women

Background. A reliable method of documenting the frequency of incontinent e pisodes is essential for assessment of treatment outcome in both clinical p ractice and research studies. Bladder diaries. completed prospectively by t he patient, have been widely used for this purpose. This study investigated the number of consecutive days of bladder diary reports of incontinence fr equency necessary to obtain adequate internal consistency (reliability) Methods. Participants were 214 community-dwelling women, aged 40 to 90 year s, with a history of stress, urge, or mixed urinary incontinence, persistin g at least 3 months with a frequency of two or more episodes of urine leaka ge per week. Each barticipant kept a 14-day bladder diary documenting the t ime and circumstances of each incontinence episode. Results. The mean age of participants was 63.5 years; 16.9% were African Am erican. Women with predominantly urge incontinence (n = 138) reported a dai ly frequency of 2.1 incontinent episodes. Although there was a statisticall y significant difference between Week 1 (2.4 episodes per day) and Week 2 ( 2.0 episodes per day; p <.0001), five days were necessary to obtain an inte rnal consistency of .90 for Cronbach's alpha, Women with predominantly stre ss incontinence (n = 76) had no statistical difference between Week I and W eek 2 in frequency of incontinence, reporting an avc rape 2.2 accidents per week in Week 1 and 2.1 in Week 2. However, 7 days of bladder diary were re quired before adequate internal consistency was reached. Conclusion. Seven consecutive days of bladder diary provides a stable and r eliable measurement of the frequency of incontinence episodes in community- dwelling women.