CC BY 4.0 · Journal of Health and Allied Sciences NU 2023; 13(04): 469-478
DOI: 10.1055/s-0042-1749378
Original Article

Development and Validation of Nocturia-Related Quality of Life Assessment Scale among Adults

Susamma Varughese
1   Department of Medical Surgical Nursing, Father Muller College of Nursing, Nitte University Mangaluru, Mangaluru, Karnataka, India
Thekke Puthalath Rajeev
2   Department of Urology, K S Hegde Hospital, Mangaluru, Karnataka, India
Devina E. Rodrigues
3   Department of Community Health Nursing, Father Muller College of Nursing, Mangaluru, Karnataka, India
Suresh Sucharitha
4   Department of Hospital Administration, Father Muller Medical College, Mangaluru, Karnataka, India
› Author Affiliations
Funding None.


Background Nocturia has high impact on quality of life (QoL) based on varying geographical and cultural factors. Speculating this, nocturia-related QoL (NRQoL) assessment scale was developed precisely, appropriate to the Indian context.

Objective The current study aimed to develop and validate an NRQoL assessment scale for Indian adults.

Methods An exploratory descriptive design was performed among 420 cases and 206 controls aged 35 to 65 years from two selected tertiary hospitals in Mangaluru, Karnataka, India. The NRQoL assessment scale was formulated through the following phases: review of literature, evaluation by experts, and pretesting. Exploratory factor analysis (EFA) was performed to reduce the number of items and to define domains. Reliability, construct validity, discriminant validity, and convergent validity of the scale were calculated.

Results EFA resulted in the removal of seven items from a 36-item instrument, resulting NRQoL assessment scale into six domains as follows: (1) functional, (2) sleep, (3) emotional, (4) physical, (5) social and family, and (6) spiritual. The findings from the tertiary hospitals study confirmed that the scale was valid and reliable to measure NRQoL among adults.

Conclusion The NRQoL assessment scale is a new, valid, and reliable instrument that is well-understood by adults and can be answered quickly. It is a useful new tool that can be translated and tested in other cultures and languages.

Publication History

Article published online:
29 January 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Haddad R, Denys P, Arlandis S. et al. Nocturia and nocturnal polyuria in neurological patients: from epidemiology to treatment. a systematic review of the literature. Eur Urol Focus 2020; 6 (05) 922-934
  • 2 Blanker MH, Bohnen AM, Groeneveld FP, Bernsen RM, Prins A, Ruud Bosch JL. Normal voiding patterns and determinants of increased diurnal and nocturnal voiding frequency in elderly men. J Urol 2000; 164 (04) 1201-1205
  • 3 Donovan JL. Measuring the impact of nocturia on quality of life. BJU Int 1999; 84 (Suppl. 01) 21-25
  • 4 Coyne K, Zhou S. The effect of nocturia on health-related quality of life. Eur Urol Suppl 2003; 2 (01) 30 DOI: 10.1016/S1569-9056(03)80117-3.
  • 5 Asplund R, Åberg H. Health of the elderly with regard to sleep and nocturnal micturition. Scand J Prim Health Care 1992; 10 (02) 98-104
  • 6 Barker JC, Mitteness LS. Nocturia in the elderly. Gerontologist 1988; 28 (01) 99-104
  • 7 Sells H, Donovan J, Ewings P, MacDonagh RP. The development and validation of a quality-of-life measure to assess partner morbidity in benign prostatic enlargement. BJU Int 2000; 85 (04) 440-445
  • 8 Irwin DE, Milsom I, Hunskaar S. et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006; 50 (06) 1306-1314 , discussion 1314–1315
  • 9 Tikkinen KA, Auvinen A, Johnson II TM. et al. A systematic evaluation of factors associated with nocturia–the population-based FINNO study. Am J Epidemiol 2009; 170 (03) 361-368
  • 10 Stiles M, Walsh K. Care of the elderly patient. In: Rakel RE, Rakel D, eds. Textbook of Family Medicine. 8th ed. Philadelphia, PA: W.B. Saunders,; 2012: 33-52
  • 11 Wrenn K. Dysuria, frequency, and urgency. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston, MA: Butterworths; 1990
  • 12 Oelke M, De Wachter S, Drake MJ. et al. A practical approach to the management of nocturia. Int J Clin Pract 2017; 71 (11) e13027
  • 13 Weiss JP, Blaivas JG, Bliwise DL. et al. The evaluation and treatment of nocturia: a consensus statement. BJU Int 2011; 108 (01) 6-21
  • 14 Fitzgerald MP, Lemack G, Wheeler T, Litman HJ. Urinary Incontinence Treatment Network. Nocturia, nocturnal incontinence prevalence, and response to anticholinergic and behavioral therapy. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19 (11) 1545-1550
  • 15 Chartier-Kastler E, Leger D, Comet D, Haab F, Ohayon MM. Prostatic hyperplasia is highly associated with nocturia and excessive sleepiness: a cross-sectional study. BMJ Open 2012; 2 (03) e000505
  • 16 Gourova LW, van de Beek C, Spigt MG, Nieman FH, van Kerrebroeck PE. Predictive factors for nocturia in elderly men: a cross-sectional study in 21 general practices. BJU Int 2006; 97 (03) 528-532
  • 17 Yoong HF, Sundaram MB, Aida Z. Prevalence of nocturnal polyuria in patients with benign prostatic hyperplasia. Med J Malaysia 2005; 60 (03) 294-296
  • 18 Hernández C, Estivill E, Cantalapiedra A. Impact of nocturia on sleep quality in patients with lower urinary tract symptoms suggesting benign prostatic hyperplasia (LUTS/BPH). The NocSu Study [in Spanish]. Actas Urol Esp 2010; 34 (05) 450-459
  • 19 Bliwise DL, Wagg A, Sand PK. Nocturia: a highly prevalent disorder with multifaceted consequences. Urology 2019; 133S: 3-13
  • 20 Abraham L, Hareendran A, Mills IW. et al. Development and validation of a quality-of-life measure for men with nocturia. Urology 2004; 63 (03) 481-486
  • 21 McKown S, Abraham L, Coyne K, Gawlicki M, Piault E, Vats V. Linguistic validation of the N-QOL (ICIQ), OAB-q (ICIQ), PPBC, OAB-S and ICIQ-MLUTSsex questionnaires in 16 languages. Int J Clin Pract 2010; 64 (12) 1643-1652
  • 22 Holm-Larsen T, Andersson F, van der Meulen E, Yankov V, Rosen RC, Nørgaard JP. The Nocturia Impact Diary: a self-reported impact measure to complement the voiding diary. Value Health 2014; 17 (06) 696-706
  • 23 Chartier-Kastler E, Tubaro A. The measurement of nocturia and its impact on quality of sleep and quality of life in LUTS/BPH. Eur Urol Suppl 2006; 5 (01) 3-11
  • 24 Yamanishi T, Fuse M, Yamaguchi C. et al. Nocturia Quality-of-Life questionnaire is a useful tool to predict nocturia and a risk of falling in Japanese outpatients: a cross-sectional survey. Int J Urol 2014; 21 (03) 289-293
  • 25 Sharma S. Nursing Research and Statistics. 2nd ed. New Delhi, India: Elsevier Health Sciences; 2014
  • 26 Ritchie J, Lewis J, Elam G. Designing and Selecting Samples. 1st ed. London, United Kingdom: Sage Publications; 2003
  • 27 Hinton PR, McMurray I, Brownlow C. SPSS Explained. . 2nd ed. London, United Kingdom: Routledge; 2014
  • 28 Zaiţ A, Bertea PS. Methods for testing discriminant validity. Management & Marketing Journal. 2011; 9 (02) 217-224
  • 29 Fornell C, Larcker DF. Structural equation models with unobservable variables and measurement error: algebra and statistics. J Mark Res 1981; 18 (03) 382-388