Mikel Gray - Academia.edu (original) (raw)
Papers by Mikel Gray
Journal of Wound, Ostomy & Continence Nursing
Convex pouching systems have been available for ostomy patients for decades; however, controversy... more Convex pouching systems have been available for ostomy patients for decades; however, controversy remains over the use of convexity in the postoperative period. A group of 10 nurses and physicians with expertise caring for patients with an ostomy completed a scoping review identifying research-based evidence and gaps in our knowledge of the safety and effectiveness related to the use of a convex pouching system following ostomy surgery. Results of this scoping review demonstrated the need for a structured consensus to define best practices when selecting a pouching system that provides a secure and reliable seal around the stoma, avoids undermining and leakage of effluent from the pouching system, and contributes to optimal health-related quality of life for patients following ostomy surgery. The expert panel reached consensus on 8 statements for the use of convex products immediately after surgery and throughout the first 6 months after stoma creation, as well as describing goals i...
Management of Fecal Incontinence for the Advanced Practice Nurse, 2018
The skin problems of dermatitis and pressure injury are common sequelae of fecal incontinence. Th... more The skin problems of dermatitis and pressure injury are common sequelae of fecal incontinence. The advanced practice nurse prevents and treats these problems while managing fecal incontinence. This chapter describes the manifestations of incontinence-associated dermatitis and pressure injury and how to make a differential diagnosis and assess their severity. It explains the association of incontinence to pressure injury along with other risk factors. The chapter summarizes the interventions used for prevention and treatment of both skin problems highlighting the expected outcomes for the advanced practice nurse to evaluate.
Journal of Wound, Ostomy & Continence Nursing, 2020
Despite advances in the prevention of catheter-acquired urinary tract infections achieved by prog... more Despite advances in the prevention of catheter-acquired urinary tract infections achieved by programs that include removal of the indwelling urinary catheter at the earliest possible time, evidence guiding bladder and incontinence management strategies following discontinuation of a catheter is sparse. To address this gap and guide best practice, the WOCN Society appointed a Task Force to develop an evidence- and consensus-based algorithm guiding clinical decision-making for effective bladder and incontinence management strategies after indwelling urinary catheter removal. This article describes the design and development of the algorithm, consensus-based statements used to guide best practice in this area, and its content validation.
Pediatric Nursing, Jul 1, 1996
Urethral catheterization is often perceived by the child and parents as an invasive and painful p... more Urethral catheterization is often perceived by the child and parents as an invasive and painful procedure. However, with adequate preparation of the child and skill on the part of the nurse, the discomfort and anxiety associated with catheter insertion can be dramatically reduced or avoided. Preparation of the child must be tailored to the child's developmental level as well as the parents' needs. Discomfort is minimized if the nurse chooses an appropriate size and type of catheter, and prepares the urethra with local anesthetic. Special strategies are necessary for children who have been sexually abused, children with myelodysplasia, those who have undergone urological surgery, and boys with epispadias or classic exstrophy.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN
In 2001, the Journal began publishing a special feature the Evidence-Based Report Card. These art... more In 2001, the Journal began publishing a special feature the Evidence-Based Report Card. These articles were designed to systematically identify and review evidence pertaining to wound, ostomy and continence specialty practice and summarize recommendations for clinical practice. Based on feedback from WOCN members and Society leadership, the Journal will relaunch this popular and valuable special feature. This article describes methods used to generate Evidence-Based Report Cards, a taxonomy of levels of evidence, and criteria for ranking the strength of recommendations for treatment.
Urologic nursing, 2002
Prostate cancer is the second most commonly diagnosed malignancy in men and remains the second le... more Prostate cancer is the second most commonly diagnosed malignancy in men and remains the second leading cause of cancer deaths among this population. Early screening and diagnosis, advances in preventive techniques, and existing cutting-edge treatments are part of a multidimensional approach in an ongoing battle to improve the health of millions of men. This primer was designed to familiarize nurses with basic facts about prostate cancer and its management. The epidemiology of prostate cancer and its risk factors, clinical manifestations, screening and early diagnosis, treatment strategies, and implications for urologic nurses are presented.
Journal of Wound, Ostomy & Continence Nursing, 2014
the interface between the tubing and collection bag, the point at which these systems are most of... more the interface between the tubing and collection bag, the point at which these systems are most often disconnected as collection bags become fi lled with fecal material. Further clinical studies are required to confi rm the clinical relevance of the data presented in this in vitro study.
Urology, 1999
Objectives. Urinary continence is one of the most significant outcomes after radical surgery for ... more Objectives. Urinary continence is one of the most significant outcomes after radical surgery for prostate cancer. Although both retropubic and perineal approaches to radical prostatectomy are commonly used, they have not yet been compared with respect to urinary continence and voiding function in a singleinstitution study using a validated patient-administered instrument. This study had two primary objectives: first, to assess whether differences exist between these two procedures with respect to the overall prevalence and resolution of postoperative urinary incontinence, and second, to determine the impact of the urinary incontinence on patient lifestyle in this patient population. Methods. A written instrument composed of the Urinary Function Questionnaire for Men after Radical Prostatectomy, the American Urological Association (AUA) Symptom Score, and seven items querying urinary retention and urinary function bother were mailed in February 1996 to 209 men who underwent radical prostatectomy by either the perineal (43%) or retropubic (57%) approach between January 1990 and December 1995. Descriptive statistics were used to summarize the prevalence of urinary incontinence and urinary function bother as reported from this cross-sectional questionnaire. Logistic regression models were used to assess the association between reported urinary incontinence and surgical approach, AUA symptom scores, and treatment of incontinence after adjusting for possible confounders (eg, the time between surgery and questionnaire, and patient age). Results. One hundred sixty-seven men (80%) responded to the questionnaire. The median age of the participants at questionnaire administration was 68 years (range 43 to 80). Overall, 57% (95% confidence interval [CI] 50% to 63%) of the responders reported complete urinary continence at the time of the questionnaire, with a median time between surgery and the questionnaire of 2.7 years (range 0.3 to 5.4). When continence was defined as either complete dryness or minimal urinary leakage, 75% (95% CI 69% to 81%) of the responders reported being continent. In men who responded to the questionnaire within 2 years of surgery, the probability of experiencing complete urinary continence was similar between the two surgical approaches. In men who responded to the questionnaire more than 2 years after surgery, patients who had undergone perineal prostatectomy were more likely to report complete continence than those who underwent retropubic surgery. However, this observed difference disappears when continence was defined as either complete dryness or minimal urinary leakage. The major impact of urinary incontinence on patient lifestyle was observed in patients with more than just minimal leakage. Conclusions. Radical perineal and radical retropubic prostatectomy have similar outcomes when patients with minor degrees of incontinence are grouped together with continent patients. Since the impact of a minimal degree of urinary incontinence on the patient's lifestyle after radical prostatectomy seems to be minor, currently we do not believe that postoperative continence status is a major factor in choosing one procedure over the other.
The Nurse Practitioner, 2007
r. J. is a 74-year-old white male who presents with complaints of urinary frequency, urgency, and... more r. J. is a 74-year-old white male who presents with complaints of urinary frequency, urgency, and nocturia of up to four times per night. He is well groomed, neatly dressed, and exudes the faint odor of urine. He has had lower urinary tract symptoms for at least 4 years, which have progressively worsened. His symptoms consist of diurnal frequency of small amounts, nocturnal voiding of three to four times, slow-to-start urinary stream, and the feeling of incomplete emptying. He complains of daytime fatigue, often falling asleep as he watches television. Due to his urinary frequency and incontinence, he no longer plays golf or visits the library, both activities he had previously enjoyed. His medical history includes mild osteoarthritis. A review of systems is noncontributory. He takes no prescribed medications. He occasionally takes acetaminophen for minor arthritic pain. He also takes acetaminophen with diphenhydramine about once a week "to try to get some sleep." The U.S. population is rapidly aging. According to the United States Census bureau projections, by the year 2030, almost 20% of the population will be over age 65, compared to 10% in 2000. 1 Thoughts of aging can incur many feelings and fears. Some fears include the loss of independence, loss of cognition, loss of mobility, and loss of urinary continence. A widely held belief is that urinary incontinence (UI) is a natural consequence of aging. Although the risk factors for incontinence increase with age, aging itself does not cause incontinence. UI remains an underreported, underdiagnosed, and, often, unmentioned problem. 2 However, increased awareness of UI, due to recent pharmaceutical marketing, has opened
Journal of Wound, Ostomy & Continence Nursing, 2007
Journal of Wound, Ostomy and Continence Nursing, 2004
What nursing strategies to reduce catheter-associated urinary tract infection (UTI) are promulgat... more What nursing strategies to reduce catheter-associated urinary tract infection (UTI) are promulgated in national guidelines on this topic? QUESTION 2: Do elements of catheter design (size and material of construction) reduce subsequent UTI risk? QUESTION 3: Does sterile technique during insertion prevent UTI? QUESTION 4: Does routine care of the urethral meatus reduce UTI risk? QUESTION 5: Does securing the catheter reduce UTI risk? QUESTION 6: Does the maintenance of a closed drainage system reduce the risk of UTI? QUESTION 7: Does irrigation of the catheter and/or bladder reduce UTI risk? QUESTION 8: Does the frequency of routine catheter changes influence UTI risk? QUESTION 9: Does placement of an antiseptic (antibacterial) solution in the drainage bag reduce UTI risk? QUESTION 10: Does separation of patients with catheter-associated UTI reduce the risk of UTI in other patients cared for in the same facility? QUESTION 11: Do staff education and quality improvement initiatives reduce the risk of catheter-associated UTI?
Journal of Wound, Ostomy and Continence Nursing, 2003
... Gray, Mikel PhD, CUNP, CCCN, FAANSection Editor(s): Gray, Mikel PhD, CUNP, CCCN, FAAN. ... Re... more ... Gray, Mikel PhD, CUNP, CCCN, FAANSection Editor(s): Gray, Mikel PhD, CUNP, CCCN, FAAN. ... Reprint requests: Mikel Gray, PhD, CUNP, CCCN, FAAN, University of Virginia, Department of Urology, PO Box 800422, Charlottesville, VA 22908; e-mail: mg5k@virginia.edu. ...
Journal of Wound, Ostomy and Continence Nursing, 2001
Journal of Wound, Ostomy and Continence Nursing, 1999
Journal of Wound, Ostomy and Continence Nursing, 1999
Journal of Wound, Ostomy & Continence Nursing, 2008
Journal of Wound, Ostomy and Continence Nursing, 2004
The Incontinence Impact Questionnaire was originally designed as a 26-item questionnaire by Wyman... more The Incontinence Impact Questionnaire was originally designed as a 26-item questionnaire by Wyman and colleagues from the Continence Program for Women Research Group and later revised and validated as a 30item instrument to measure health-related quality of life (HRQOL) in female patients with urinary incontinence (UI). Its purpose is to provide a more disease-specific instrument and greater sensitivity to changes in UI status than generic measures of HRQOL. Content validation (a measure of an instrument’s ability to measure the full range of issues relevant to the intended construct) was sought by: (1) completion of a literature review on UI and HRQOL, (2) interviews with women to identify HRQOLrelated UI effects, (3) interviews with healthcare providers experienced in the evaluation and treatment of women with UI, and (4) experience with an earlier form of the instrument. Cluster and factor analyses were performed on the 30 items of the IIQ, and 4 subscales were identified: (1) physical activity, (2) travel, (3) social relationships, and (4) emotional health. Within these subscales, individual items are scored on a scale of 0-3, where 0 indicates “not at all” and 3 indicates “greatly.” Subscales are scored on a common scale of 100, yielding a total score of 100 for each subscale and an overall possible score of 400. High scores indicate significant UI impact or HRQOL and low scores indicate lesser impact. Shumaker and colleagues from the Continence Program for Women Research Group assessed validity and reliability of the IIQ in 162 participants with UI. Participants were women, aged 45 years or older, capable of toileting independently and experiencing at least 1 episode of UI per week. Multiple measures were assessed, including construct and criterion validity. Construct validity is assessed by determining whether an instrument produces results (scores) that correlate with previously validated instruments designed to measure similar constructs (convergent validity) and whether scores discriminate or fail to correlate with divergent constructs (divergent validity). Criterion validity (sometimes referred to as concurrent validity) is defined as the degree to which results of an instrument (the scores generated when a patient or clinician completes the instrument) predict the presence of the outcome it purports to measure as compared to a wellaccepted or “gold standard” test for that outcome. Shumaker et al assessed convergent validity of the IIQ by comparing scores to generic HRQOL instruments (ie, Rand 36-Item Health Survey, Centers for Epidemiologic Studies-Depression Scale, Medical Outcomes Study Measure of Social Support 1992, and Profile of Mood States). They assessed criterion validity by comparing scores to UI severity measured by voiding diary for a 7-day period (considered a gold standard for measuring UI frequency and severity). Divergent validity was assessed by
Journal of Wound, Ostomy & Continence Nursing
Convex pouching systems have been available for ostomy patients for decades; however, controversy... more Convex pouching systems have been available for ostomy patients for decades; however, controversy remains over the use of convexity in the postoperative period. A group of 10 nurses and physicians with expertise caring for patients with an ostomy completed a scoping review identifying research-based evidence and gaps in our knowledge of the safety and effectiveness related to the use of a convex pouching system following ostomy surgery. Results of this scoping review demonstrated the need for a structured consensus to define best practices when selecting a pouching system that provides a secure and reliable seal around the stoma, avoids undermining and leakage of effluent from the pouching system, and contributes to optimal health-related quality of life for patients following ostomy surgery. The expert panel reached consensus on 8 statements for the use of convex products immediately after surgery and throughout the first 6 months after stoma creation, as well as describing goals i...
Management of Fecal Incontinence for the Advanced Practice Nurse, 2018
The skin problems of dermatitis and pressure injury are common sequelae of fecal incontinence. Th... more The skin problems of dermatitis and pressure injury are common sequelae of fecal incontinence. The advanced practice nurse prevents and treats these problems while managing fecal incontinence. This chapter describes the manifestations of incontinence-associated dermatitis and pressure injury and how to make a differential diagnosis and assess their severity. It explains the association of incontinence to pressure injury along with other risk factors. The chapter summarizes the interventions used for prevention and treatment of both skin problems highlighting the expected outcomes for the advanced practice nurse to evaluate.
Journal of Wound, Ostomy & Continence Nursing, 2020
Despite advances in the prevention of catheter-acquired urinary tract infections achieved by prog... more Despite advances in the prevention of catheter-acquired urinary tract infections achieved by programs that include removal of the indwelling urinary catheter at the earliest possible time, evidence guiding bladder and incontinence management strategies following discontinuation of a catheter is sparse. To address this gap and guide best practice, the WOCN Society appointed a Task Force to develop an evidence- and consensus-based algorithm guiding clinical decision-making for effective bladder and incontinence management strategies after indwelling urinary catheter removal. This article describes the design and development of the algorithm, consensus-based statements used to guide best practice in this area, and its content validation.
Pediatric Nursing, Jul 1, 1996
Urethral catheterization is often perceived by the child and parents as an invasive and painful p... more Urethral catheterization is often perceived by the child and parents as an invasive and painful procedure. However, with adequate preparation of the child and skill on the part of the nurse, the discomfort and anxiety associated with catheter insertion can be dramatically reduced or avoided. Preparation of the child must be tailored to the child's developmental level as well as the parents' needs. Discomfort is minimized if the nurse chooses an appropriate size and type of catheter, and prepares the urethra with local anesthetic. Special strategies are necessary for children who have been sexually abused, children with myelodysplasia, those who have undergone urological surgery, and boys with epispadias or classic exstrophy.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN
In 2001, the Journal began publishing a special feature the Evidence-Based Report Card. These art... more In 2001, the Journal began publishing a special feature the Evidence-Based Report Card. These articles were designed to systematically identify and review evidence pertaining to wound, ostomy and continence specialty practice and summarize recommendations for clinical practice. Based on feedback from WOCN members and Society leadership, the Journal will relaunch this popular and valuable special feature. This article describes methods used to generate Evidence-Based Report Cards, a taxonomy of levels of evidence, and criteria for ranking the strength of recommendations for treatment.
Urologic nursing, 2002
Prostate cancer is the second most commonly diagnosed malignancy in men and remains the second le... more Prostate cancer is the second most commonly diagnosed malignancy in men and remains the second leading cause of cancer deaths among this population. Early screening and diagnosis, advances in preventive techniques, and existing cutting-edge treatments are part of a multidimensional approach in an ongoing battle to improve the health of millions of men. This primer was designed to familiarize nurses with basic facts about prostate cancer and its management. The epidemiology of prostate cancer and its risk factors, clinical manifestations, screening and early diagnosis, treatment strategies, and implications for urologic nurses are presented.
Journal of Wound, Ostomy & Continence Nursing, 2014
the interface between the tubing and collection bag, the point at which these systems are most of... more the interface between the tubing and collection bag, the point at which these systems are most often disconnected as collection bags become fi lled with fecal material. Further clinical studies are required to confi rm the clinical relevance of the data presented in this in vitro study.
Urology, 1999
Objectives. Urinary continence is one of the most significant outcomes after radical surgery for ... more Objectives. Urinary continence is one of the most significant outcomes after radical surgery for prostate cancer. Although both retropubic and perineal approaches to radical prostatectomy are commonly used, they have not yet been compared with respect to urinary continence and voiding function in a singleinstitution study using a validated patient-administered instrument. This study had two primary objectives: first, to assess whether differences exist between these two procedures with respect to the overall prevalence and resolution of postoperative urinary incontinence, and second, to determine the impact of the urinary incontinence on patient lifestyle in this patient population. Methods. A written instrument composed of the Urinary Function Questionnaire for Men after Radical Prostatectomy, the American Urological Association (AUA) Symptom Score, and seven items querying urinary retention and urinary function bother were mailed in February 1996 to 209 men who underwent radical prostatectomy by either the perineal (43%) or retropubic (57%) approach between January 1990 and December 1995. Descriptive statistics were used to summarize the prevalence of urinary incontinence and urinary function bother as reported from this cross-sectional questionnaire. Logistic regression models were used to assess the association between reported urinary incontinence and surgical approach, AUA symptom scores, and treatment of incontinence after adjusting for possible confounders (eg, the time between surgery and questionnaire, and patient age). Results. One hundred sixty-seven men (80%) responded to the questionnaire. The median age of the participants at questionnaire administration was 68 years (range 43 to 80). Overall, 57% (95% confidence interval [CI] 50% to 63%) of the responders reported complete urinary continence at the time of the questionnaire, with a median time between surgery and the questionnaire of 2.7 years (range 0.3 to 5.4). When continence was defined as either complete dryness or minimal urinary leakage, 75% (95% CI 69% to 81%) of the responders reported being continent. In men who responded to the questionnaire within 2 years of surgery, the probability of experiencing complete urinary continence was similar between the two surgical approaches. In men who responded to the questionnaire more than 2 years after surgery, patients who had undergone perineal prostatectomy were more likely to report complete continence than those who underwent retropubic surgery. However, this observed difference disappears when continence was defined as either complete dryness or minimal urinary leakage. The major impact of urinary incontinence on patient lifestyle was observed in patients with more than just minimal leakage. Conclusions. Radical perineal and radical retropubic prostatectomy have similar outcomes when patients with minor degrees of incontinence are grouped together with continent patients. Since the impact of a minimal degree of urinary incontinence on the patient's lifestyle after radical prostatectomy seems to be minor, currently we do not believe that postoperative continence status is a major factor in choosing one procedure over the other.
The Nurse Practitioner, 2007
r. J. is a 74-year-old white male who presents with complaints of urinary frequency, urgency, and... more r. J. is a 74-year-old white male who presents with complaints of urinary frequency, urgency, and nocturia of up to four times per night. He is well groomed, neatly dressed, and exudes the faint odor of urine. He has had lower urinary tract symptoms for at least 4 years, which have progressively worsened. His symptoms consist of diurnal frequency of small amounts, nocturnal voiding of three to four times, slow-to-start urinary stream, and the feeling of incomplete emptying. He complains of daytime fatigue, often falling asleep as he watches television. Due to his urinary frequency and incontinence, he no longer plays golf or visits the library, both activities he had previously enjoyed. His medical history includes mild osteoarthritis. A review of systems is noncontributory. He takes no prescribed medications. He occasionally takes acetaminophen for minor arthritic pain. He also takes acetaminophen with diphenhydramine about once a week "to try to get some sleep." The U.S. population is rapidly aging. According to the United States Census bureau projections, by the year 2030, almost 20% of the population will be over age 65, compared to 10% in 2000. 1 Thoughts of aging can incur many feelings and fears. Some fears include the loss of independence, loss of cognition, loss of mobility, and loss of urinary continence. A widely held belief is that urinary incontinence (UI) is a natural consequence of aging. Although the risk factors for incontinence increase with age, aging itself does not cause incontinence. UI remains an underreported, underdiagnosed, and, often, unmentioned problem. 2 However, increased awareness of UI, due to recent pharmaceutical marketing, has opened
Journal of Wound, Ostomy & Continence Nursing, 2007
Journal of Wound, Ostomy and Continence Nursing, 2004
What nursing strategies to reduce catheter-associated urinary tract infection (UTI) are promulgat... more What nursing strategies to reduce catheter-associated urinary tract infection (UTI) are promulgated in national guidelines on this topic? QUESTION 2: Do elements of catheter design (size and material of construction) reduce subsequent UTI risk? QUESTION 3: Does sterile technique during insertion prevent UTI? QUESTION 4: Does routine care of the urethral meatus reduce UTI risk? QUESTION 5: Does securing the catheter reduce UTI risk? QUESTION 6: Does the maintenance of a closed drainage system reduce the risk of UTI? QUESTION 7: Does irrigation of the catheter and/or bladder reduce UTI risk? QUESTION 8: Does the frequency of routine catheter changes influence UTI risk? QUESTION 9: Does placement of an antiseptic (antibacterial) solution in the drainage bag reduce UTI risk? QUESTION 10: Does separation of patients with catheter-associated UTI reduce the risk of UTI in other patients cared for in the same facility? QUESTION 11: Do staff education and quality improvement initiatives reduce the risk of catheter-associated UTI?
Journal of Wound, Ostomy and Continence Nursing, 2003
... Gray, Mikel PhD, CUNP, CCCN, FAANSection Editor(s): Gray, Mikel PhD, CUNP, CCCN, FAAN. ... Re... more ... Gray, Mikel PhD, CUNP, CCCN, FAANSection Editor(s): Gray, Mikel PhD, CUNP, CCCN, FAAN. ... Reprint requests: Mikel Gray, PhD, CUNP, CCCN, FAAN, University of Virginia, Department of Urology, PO Box 800422, Charlottesville, VA 22908; e-mail: mg5k@virginia.edu. ...
Journal of Wound, Ostomy and Continence Nursing, 2001
Journal of Wound, Ostomy and Continence Nursing, 1999
Journal of Wound, Ostomy and Continence Nursing, 1999
Journal of Wound, Ostomy & Continence Nursing, 2008
Journal of Wound, Ostomy and Continence Nursing, 2004
The Incontinence Impact Questionnaire was originally designed as a 26-item questionnaire by Wyman... more The Incontinence Impact Questionnaire was originally designed as a 26-item questionnaire by Wyman and colleagues from the Continence Program for Women Research Group and later revised and validated as a 30item instrument to measure health-related quality of life (HRQOL) in female patients with urinary incontinence (UI). Its purpose is to provide a more disease-specific instrument and greater sensitivity to changes in UI status than generic measures of HRQOL. Content validation (a measure of an instrument’s ability to measure the full range of issues relevant to the intended construct) was sought by: (1) completion of a literature review on UI and HRQOL, (2) interviews with women to identify HRQOLrelated UI effects, (3) interviews with healthcare providers experienced in the evaluation and treatment of women with UI, and (4) experience with an earlier form of the instrument. Cluster and factor analyses were performed on the 30 items of the IIQ, and 4 subscales were identified: (1) physical activity, (2) travel, (3) social relationships, and (4) emotional health. Within these subscales, individual items are scored on a scale of 0-3, where 0 indicates “not at all” and 3 indicates “greatly.” Subscales are scored on a common scale of 100, yielding a total score of 100 for each subscale and an overall possible score of 400. High scores indicate significant UI impact or HRQOL and low scores indicate lesser impact. Shumaker and colleagues from the Continence Program for Women Research Group assessed validity and reliability of the IIQ in 162 participants with UI. Participants were women, aged 45 years or older, capable of toileting independently and experiencing at least 1 episode of UI per week. Multiple measures were assessed, including construct and criterion validity. Construct validity is assessed by determining whether an instrument produces results (scores) that correlate with previously validated instruments designed to measure similar constructs (convergent validity) and whether scores discriminate or fail to correlate with divergent constructs (divergent validity). Criterion validity (sometimes referred to as concurrent validity) is defined as the degree to which results of an instrument (the scores generated when a patient or clinician completes the instrument) predict the presence of the outcome it purports to measure as compared to a wellaccepted or “gold standard” test for that outcome. Shumaker et al assessed convergent validity of the IIQ by comparing scores to generic HRQOL instruments (ie, Rand 36-Item Health Survey, Centers for Epidemiologic Studies-Depression Scale, Medical Outcomes Study Measure of Social Support 1992, and Profile of Mood States). They assessed criterion validity by comparing scores to UI severity measured by voiding diary for a 7-day period (considered a gold standard for measuring UI frequency and severity). Divergent validity was assessed by