# Assessing Self-Management Coping in Urinary Incontinence: Psychometric Evaluation of the UI-SMCSI in Middle-Aged Women

## TL;DR

This study created and validated a tool to assess how middle-aged women with urinary incontinence manage their condition through self-coping strategies.

## Contribution

The UI-SMCSI is a new validated instrument for assessing self-management coping strategies in women with urinary incontinence.

## Key findings

- The UI-SMCSI has a bidimensional structure with strong internal consistency and model fit.
- Measurement invariance was confirmed across different types of urinary incontinence.
- The instrument showed convergent validity with the King’s Health Questionnaire severity dimension.

## Abstract

Urinary incontinence (UI) significantly impairs women’s quality of life and often leads to the adoption of self-management coping strategies. This study aimed to develop and validate the UI Self-Management Coping Strategies Instrument (UI-SMCSI) to assess coping strategies in women with UI.

A sample of 1538 Portuguese women aged 40–65 years with self-reported UI participated in the study. A quantitative design was employed to evaluate the instrument’s factor structure, multigroup invariance, internal consistency, and validity evidence based on its internal structure and relations to other variables.

Confirmatory factor analysis supported a bidimensional first-order structure comprising defensive and hiding strategies, with excellent model fit indices (CFI = .989; TLI = .987; RMSEA = .072). Internal consistency was strong (α_defensive = .94; α_hiding = .80). Measurement invariance was confirmed across UI subtypes (stress, urge, and mixed). Convergent validity was supported by a moderately strong correlation (r = .615, p < .001) with the severity measures dimension of the King’s Health Questionnaire.

The UI-SMCSI is a reliable and valid instrument for assessing UI self-management coping strategies among Portuguese women with UI. It offers a practical tool for healthcare professionals to identify behavioral patterns that may hinder effective UI management. Future research should explore the scale’s sensitivity to intervention and its applicability to other demographic and cultural populations.

The online version contains supplementary material available at 10.1007/s00192-025-06274-z.