The Urgency, Severity, and Impact Questionnaire (USIQ) assesses urinary urgency independently of incontinence, measuring both symptom severity and its impact on quality of life. While validated in English and Hebrew populations, a Turkish version has not yet been developed. This study aims to adapt USIQ for the Turkish population and evaluate its psychometric properties, providing a standardized, culturally relevant tool for clinical and research use.
The International Continence Society (ICS) defines urinary urgency as "a sudden and compelling desire to urinate that is difficult to defer." According to this definition, urgency is an abnormal sensation that can be distinguished from the normal "urge to urinate" occurring during routine bladder filling. Urinary urgency is the core symptom of Overactive Bladder (OAB) syndrome and is often accompanied by daytime frequency and nocturia; urge incontinence may also occur. Epidemiological studies show that OAB symptoms are common in the adult population and increase in prevalence with age. Urinary urgency is reported by patients as one of the main symptoms negatively affecting quality of life. Consequently, the severity of urgency has a multidimensional impact on health-related quality of life. Because of the subjective nature of urgency and the tendency of patients to confuse "normal urge" with "urinary urgency," its measurement is challenging. Since there is no gold-standard objective measure for urinary urgency and its severity, accurate assessment of this symptom is essential. Although many scales have been developed to assess OAB severity and its impact on quality of life, most address urgency together with incontinence or do not sufficiently assess severity. This represents a significant methodological gap leading to incomplete evaluation of symptoms. To address this gap, the Urgency, Severity, and Impact Questionnaire (USIQ) was developed. USIQ evaluates urinary urgency independently of incontinence, adheres to ICS definitions, and measures both symptom severity (USIQ-S) and its impact on quality of life (USIQ-QOL) separately. Unlike other OAB questionnaires, USIQ allows assessment of urgency severity and its effects on quality of life regardless of continence status. For a scale to be used in a different culture and language, it must be adapted and its psychometric properties tested. While USIQ has been validated in English and Hebrew populations, a Turkish version adapted for linguistic and cultural context and psychometrically evaluated has not yet been developed. Therefore, there is a clear need for a validated Turkish version of USIQ that measures urinary urgency severity and its impact on quality of life independently of incontinence.
Study Type
OBSERVATIONAL
Enrollment
130
Women diagnosed with Overactive Bladder (OAB) attending the Gynecology and Oncology Clinic at Buca Seyfi Demirsoy Training and Research Hospital who meet inclusion and exclusion criteria. Participants will complete demographic and clinical questionnaires, including USIQ, IIQ-7, UDI-6, and OAB-q. Test-retest reliability will be assessed in a subgroup after 14 days.
Betül TAŞPINAR
Konak, İ̇zmi̇r, Turkey (Türkiye)
Urgency, Severity and Impact Questionnaire (USIQ)
The USIQ, developed by Lowenstein et al. in 2009, is a patient-reported instrument assessing the severity of urgency symptoms and their impact on quality of life. It consists of two subscales: USIQ-S (Symptom Severity) with 5 items measuring urgency complaints, and USIQ-QOL (Quality of Life) with 8 items assessing the effect on daily life, totaling 13 items. Responses are scored 0-4, with an additional "Don't know"/"Not applicable" option excluded from scoring. USIQ-S and USIQ-QOL scores are calculated by averaging item scores and multiplying by 25, yielding a 0-100 scale. Higher scores indicate more severe urgency symptoms and greater impact on quality of life. Cronbach's alpha values are 0.85 for USIQ-S and 0.90 for USIQ-QOL.
Time frame: At Baseline
Incontinence Impact Questionnaire-Short Form (IIQ-7)
The IIQ-7, developed as a short form in 1995, evaluates the impact of urinary incontinence on women's daily quality of life. It includes 7 items addressing household chores, physical activity, social activity, travel, and emotional well-being. Each item is scored 0-3: 'Not at all' (0), 'Slightly' (1), 'Moderately' (2), and 'Greatly' (3). Total scores are summed and standardized to a 0-100 scale, with higher scores indicating greater negative impact on quality of life. Internal consistency (Cronbach's alpha) ranges from 0.87 to 0.90. The Turkish version was validated by Cam in 2007.
Time frame: At baseline
Urogenital Distress Inventory-Short Form (UDI-6)
The UDI-6 Short Form, developed in 1995, assesses urogenital symptoms including stress urinary incontinence, urgency incontinence, frequency, small amounts of urine leakage, voiding phase complaints, and pelvic/perineal discomfort. It does not directly assess the impact on quality of life. Each item is scored 0-3 to indicate the distress caused: 'Not at all' (0), 'A little bit' (1), 'Moderately' (2), and 'Greatly' (3). Item scores are summed and standardized to a 0-100 scale, with higher scores reflecting greater symptom distress. Internal consistency (Cronbach's alpha) for subscales ranges from 0.48 to 0.77. The Turkish version was validated by Cam in 2007.
Time frame: At baseline
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International Consultation on Incontinence Modular Questionnaire-Overactive Bladder Quality of Life Questionnaire (ICIQ-OABqol / OAB-q)
The OAB-q, developed in 2002, measures symptom bother and disease-specific quality of life in patients with overactive bladder, applicable to both incontinent and continent patients. The questionnaire has 33 items: 8 assess symptom bother and 25 assess quality of life across coping (8 items), concern (7 items), social interaction (5 items), and sleep (5 items). All items use a 6-point Likert scale. Symptom bother items are scored from 1 ('Not at all') to 6 ('A very great deal'), while quality of life items are scored from 1 ('None of the time') to 6 ('All of the time'). Raw scores are standardized to a 0-100 scale, with higher symptom bother scores indicating increased symptom severity, and higher quality of life scores indicating better quality of life. Internal consistency (Cronbach's alpha) ranges from 0.86 to 0.94. The Turkish version was validated in 2008.
Time frame: At baseline