The validity and reliability of the neurogenic bladder symptom score (NBSS) - Abstract

PURPOSE: The neurogenic bladder symptom score (NBSS) is a tool to measure urinary symptoms and consequences among patients with acquired or congenital neurogenic bladder.

This paper describes the validity and reliability of the NBSS.

METHODS: Exploratory factor analysis was used to assess item variability and subscale structure. Reliability was assessed with Cronbach's alpha, and correlation with retest data. Validity was assessed with a priori hypotheses specifying relationships with the AUA-SS, ICIQ-UI, and urinary-specific QOL (SF-Qualiveen) and a self-assessed global bladder problem score. Known groups analysis was used to further assess construct validity.

RESULTS: A cohort of 230 patients with spinal cord injury, (35%), multiple sclerosis (59%), and congenital neurogenic bladder (6%) were included in this study. Factor analysis suggested 3 domains within the NBSS (incontinence, storage and voiding symptoms, and consequences). Overall internal consistency was high, with a Cronbach's alpha of 0.89. Test-rest reliability was also excellent, with an intraclass correlation coefficient of 0.91. Validity was demonstrated with the confirmation of hypothesized correlations with the AUA-SS, ICIQ-UI, and SF-Qualiveen, and significant differences in NBSS scores among known groups (those with a history of seeing a urologist had a significantly higher mean score (22.1 vs 17.1, p< 0.001), as did those who had a higher global bladder problem score (22.1 vs 12.6, p< 0.001)).

CONCLUSION: The NBSS, developed specifically to assess the symptoms and consequences associated with neurogenic bladder dysfunction, has appropriate psychometric properties. Depending on the measurement need, individual domains may be selected, or it can be used as a comprehensive score.

Written by:
Welk B, Morrow S, Madarasz W, Baverstock R, Macnab J, Sequeira K.   Are you the author?
Department of Surgery, Division of Urology, Western University; Department of Clinical Neurosciences, Western University; St Joseph's Health Care, London Ontario, Canada; vesia (Alberta Bladder Centre), Division of Urology, Department of Surgery, University of Calgary; Department of Epidemiology and Biostatistics, Western University; Department of Physical Medicine and Rehabilitation, Western University.  

Reference: J Urol. 2014 Feb 8. pii: S0022-5347(14)00049-4.
doi: 10.1016/j.juro.2014.01.027

PubMed Abstract
PMID: 24518764 Urinary Incontinence Section