This study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes. A total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data. OAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL. Our findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient’s QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.

Toileting behaviors have been implicated in women's bladder health; however, the lack of a standardized instrument to explore variations in women's toileting behaviors has contributed to an incomplete understanding about the effects of these behaviors on bladder health. The aims of this study were to develop and initially validate an instrument, the Web-based Toileting Behavior (TB-WEB) scale, to assess behaviors women use when emptying their bladders. An initial 41-item instrument was developed after a comprehensive literature review and a concept analysis of women's toileting behavior related to urinary elimination. Seven experts with clinical or research experience in women's bladder health were selected to evaluate the content validity of each item and of the entire instrument. The psychometric properties of the TB-WEB scale were assessed using a Web-based survey with community-dwelling middle-aged women from June to August 2009. Construct validity and internal consistency were measured. An 18-item scale was developed. Principal component analysis with varimax rotation revealed 5 underlying factors that explained 67% of the variance. Internal consistency reliabilities of the 5 subscales ranged from .70 to .88. The 5 subscales were premature voiding (5 items), straining voiding (4 items), place preference for voiding (4 items), delayed voiding (3 items), and position preference for voiding (2 items). The TB-WEB scale shows reliability and initial validity to assess women's toileting behavior related to urinary elimination in community-dwelling middle-aged women. However, further testing is needed in other community-dwelling populations, as well as with hospitalized women, to strengthen its generalizability and to address areas for improvement.