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Psychometric Evaluation of the Toileting Behaviors

Women’s Elimination Behaviors Scale in a Sample of College Women

Angelini, Kimberly J., PhD, WHNP-BC*; Newman, Diane K., DNP, ANP-BC; Palmer, Mary H., PhD, RN

Female Pelvic Medicine & Reconstructive Surgery: March 15, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000711
Original Article: PDF Only

Background Lower urinary tract symptoms in women including urinary incontinence and overactive bladder are common women’s health conditions with negative financial, health, and quality of life consequences. Certain behaviors are associated with symptom presentation. Identifying and modifying these behaviors could decrease symptom presentation and progression. The Toileting Behaviors: Women’s Elimination Behaviors (TB-WEB) scale is the only known theory-based tool to date designed to assess urinary toileting behaviors in women. It has been validated in middle-aged women, but it has not been validated in a younger population.

Objectives The purpose of this study was to assess the psychometric properties of the TB-WEB in a sample of college-aged women.

Methods Surveys were sent to senior-level undergraduates electronically via university email addresses. One hundred ninety-three women responded to the survey. Those who had missing responses on the TB-WEB were excluded from psychometric analyses. Demographic characteristics from those with missing data were not statistically different from those with complete responses.

Results The total Cronbach α for the 18-item TB-WEB was 0.846, and the 5 previously identified subscales ranged between 0.528 and 0.919. A 5-factor structure was identified, similar to previous testing of the TB-WEB. Higher scores were significantly correlated with frequency of urinary incontinence episodes (rs = 0.311; P < 0.001).

Conclusions The validated TB-WEB can be used reliably in a younger sample of women (mean age, 22 years) enrolled in college. It may be useful to identify problematic toileting behaviors and women at risk for having or developing lower urinary tract symptoms.

From the *Boston College, Chestnut Hill, MA;

University of Pennsylvania, Philadelphia, PA; and

University of North Carolina at Chapel Hill, Chapel Hill, NC.

Correspondence: Kimberly J. Angelini, PhD, WHNP-BC, Boston College, Chestnut Hill, MA. E-mail:

The authors have declared they have no conflicts of interest.

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