Urinary incontinence is a common problem in adult women. It can have a significant impact on a person's quality of life. Instruments can be used to assess the degree of life impact. A long form is available for more detailed studies while a short form can be used for rapid screening. These can be used over time and can help in assessing effectiveness of interventions. In addition, instruments are available to assess the severity of symptoms (see the Chapter on the renal and urinary system).


The questionnaire comes in a long or short form.


Groups in long form:

(1) PA = physical activity (6 questions)

(2) T = travel (6 questions)

(3) SR = social/relationships (10 questions)

(4) EH = emotional health (8 questions)



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• The text in Shumaker et al refers to points being 1 to 4, but the Appendix gives 0 to 3.


subscore for physical activity symptoms =

= SUM(points for all 6 questions)


subscore for travel symptoms =

= SUM(points for both travel questions)


subscore for social/relationships symptoms =

= SUM(points for all 10 questions)


subscore for emotional health symptoms =

= SUM(points for all 8 questions)


Groups in the short form:

(1) PA = physical activity (2 questions)

(2) T = travel (2 questions)

(3) SR = social relationships (1 question)

(4) EH = emotional health (2 questions)


Correlation with long form: corresponds to long form questions 1, 5, 6, 8, 15, 20, 27



• minimum score for both forms is 0

• maximum score for long form is 90; subscores for physical activity, travel, social/relationships and emotional health can be calculated

• The average score for the short form is calculated (from 0 to 3), then multiplied by 33.333 to generate a possible range of 0 to 100.


Transformation of Long Form Subscore


Each subscore can be rescored to 100 points:


transformed subscore =

= (average subscore) * 100/3


total transformed score =

= SUM(all 4 transformed subscores)



• minimum total transformed score: 0

• maximum total transformed score: 400


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