This article describes short form versions of the Incontinence Impact Questionnaire (IIQ) and the Urogenital Distress Inventory (UDI). These instruments assess life impact and symptom distress, respectively, of urinary incontinence and related conditions for women. All subsets regression analysis was used to find item subsets that best approximated scores of the long form versions. The approach succeeded in reducing the 30-item IIQ and the 19-item UDI to 7- and 6-item short forms, respectively. The short form versions may be more useful than the long form versions in many clinical and research applications.

Urinary incontinence (UI) is a relatively common condition in middle-aged and older women. Traditional measures of symptoms do not adequately capture the impact that UI has on individuals' lives. Further, severe morbidity and mortality are not associated with this condition. Rather, UI's impact is primarily on the health status and health-related quality of life (HRQOL) of women. Generic measures of HRQOL inadequately address the impact of the condition on the day-to-day lives of women with UI. The current paper presents data on two new condition-specific instruments designed to assess the HRQOL of UI in women: the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Used in conjunction with one another, these two measures provide detailed information on how UI affects the lives of women. The measures provide data on the more traditional view of HRQOL by assessing the impact of UI on various activities, roles and emotional states (IIQ), as well as data on the less traditional but critical issue of the degree to which symptoms associated with UI are troubling to women (UDI). Data on the reliability, validity and sensitivity to change of these measures demonstrate that they are psychometrically strong. Further, they have been developed for simple, self-administration.

Ph6,f and i A n d r e w Fantl, MDSoss of urinary control can have a sigmficant impact on the psychological and social well-being of the affected individual. Research has con-L centrated on the prevalence, etiology, and management of urinary incontinence, but relatively little is known about the effects of this chronic condition on psychosocial functioning in daily life.This article reviews the literature related to psychosoaal impact of urinary incontinence in the communitydwelling adult population. The focus is on the individual with incontinence who is otherwise healthy, mentally intact, and residing independently in the community. Issues related to the definition and measurement of psychosocial impact are discussed. Relevant research findings are presented on the type and degree of psychosocial effects resulting from incontinence, differences in impact related to the underlying etiology of incontinence, and the relationship of psychosocial impact to severity measures of urinary incontinence. Recommendations for future research are also proposed. DEFINITION AND MEASUREMENT OF PSYCHOSOCIAL IMPACTUrinary incontinence has been defined as a "condition of involuntary urine loss that is a social or hygienic problem and is objectively demonstrable."' Although much attention has been focused on the objective measurements of urinary incontinence, what constitutes a "social or hygienic" problem has not been clearly characterized or defined in operational terms.Studies reporting psychosocial impact of inconti-

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