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Norwegian translation, and validation, of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7)

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Abstract

Introduction and hypothesis

The goal was to translate into Norwegian, and validate, short versions of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) using a sample of women with symptomatic pelvic organ prolapse and pelvic floor dysfunction.

Methods

Modified European Organization for Research and Treatment of Cancer Guidelines were used for translation and cultural adaptation. Of 212 eligible Norwegian women who consented to participate, 205 completed the questionnaires, of whom 50 were retested after 1 – 3 weeks, and 76 were tested 6 months after surgery. Reliability, validity and responsiveness were evaluated. Additionally, interpretability, the smallest detectable change, the standard error of measurement, floor and ceiling effects, and the percentages of missing items are reported.

Results

Reliability ranged from 0.66 to 0.93 and intraclass correlation coefficients from 0.85 to 0.94. Both construct validity and responsiveness were found to be adequate. The responsiveness of the PFDI-20 was further supported by areas under the curve above 0.70. Estimates were lower for the PFIQ-7. The smallest detectable changes at the individual level were 15 – 21 % and 17 – 27 % for the PFDI-20 and PFIQ-7, respectively. The absolute values of the minimal important changes in the total scores were 48 and 47, respectively. No floor or ceiling effects were evident in the distributions of the PFDI-20 and PFIQ-7 total scores.

Conclusions

The translated questionnaires provided adequate reliability, validity and good responsiveness to change. These short versions of the PFDI and PFIQ are robust measuring instruments that will enable symptom severity and health-related quality of life to be evaluated in the Norwegian context.

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Notes

  1. Based on a sensation of a bulge in the pelvic area (i.e. PFDI-20 )

  2. Based on lower urinary tract symptoms (i.e. PFDI-20 )

  3. Based on bowel symptoms (i.e. PFDI-20) .

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Acknowledgements

The authors acknowledge the patients and expert panel who provided input to this study; the Department of Obstetrics and Gynaecology, Akershus University Hospital, for patient recruitment; A.S. Midthaug and K.A. Askestad for assistance with data collection; M. Solberg for assistance with data entry; Dr. W. Mokkink for assistance with editing; Drs. T. Øresland, K. Bø, H.C.W. de Vet and S. Saga for assistance with protocol development; and M.D. Barber for permission to translate the PFDI-20 and PFIQ-7 and assistance in the translation process.

Author information

Authors and Affiliations

  1. School of Medicine, Flinders University, Adelaide, Australia

    Catherine J. Teig, Malcolm J. Bond & Angelita Martini

  2. Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway

    Catherine J. Teig & Marie A. Ellström Engh

  3. The Pelvic Floor Centre, Division of Surgery, Akershus University Hospital, 1000, 1478, Lørenskog, Norway

    Catherine J. Teig

  4. Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Department of Physiotherapy, Oslo University Hospital, Oslo, Norway

    Margreth Grotle

  5. FORMI, Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway

    Margreth Grotle & Milada S. Cvancarova

  6. VU University Medical Center, Department of Epidemiology and Biostatistics, Institute for Health and Care Research, Amsterdam, The Netherlands

    Cecilia A. C. Prinsen

  7. Faculty Division Akershus University Hospital, University of Oslo, Oslo, Norway

    Marie A. Ellström Engh

  8. Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo University Hospital, Oslo, Norway

    Milada S. Cvancarova

  9. Drammens Gynaecology Private Clinic, Drammen, Norway

    Møyfrid Kjøllesdal

  10. Centre for Health Services Research, School of Population Health, University of Western Australia, Perth, Australia

    Angelita Martini

Authors
  1. Catherine J. Teig
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  2. Margreth Grotle
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  4. Cecilia A. C. Prinsen
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  5. Marie A. Ellström Engh
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Corresponding author

Correspondence to Catherine J. Teig.

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Funding

This study was funded by the Division of Surgery, Akershus University Hospital, and the Strategic Research Foundation (Strategiske Forskningsmidler), Akershus University Hospital. The Strategic Research Foundation was not involved in the design, conduct, analysis or interpretation of the study, or the review or approval of the manuscript.

Conflicts of interest

None.

Appendices

Appendix 1: Spørreskjema om bekkenbunnsplager - skjema PFDI-20

Veiledning: Vennligst svar på alle spørsmålene i spørreskjemaet. Spørsmålene dreier seg om hvorvidt du har visse symptomer i tarmen, blæren eller bekkenregionen, og i så fall hvor mye de plager deg. Svar på spørsmålene ved å krysse av i den eller de boksene som passer for deg. Hvis du er usikker på hva du skal svare, svarer du så godt du kan. Vær snill og svar på spørsmålene ut fra de symptomer du har hatt gjennom de siste tre månedene.

figure afigure afigure a

Appendix 2: Spørreskjema om bekkenbunnsplager og innvirkning på dagliglivet - skjema PFIQ-7

Veiledning: Noen kvinner opplever at symptomer fra blæren, endetarmen eller skjeden påvirker deres gjøremål, forhold og følelser. For hvert av spørsmålene ber vi deg krysse av for svaret som best beskriver hvordan dine gjøremål, forhold eller følelser har blitt påvirket av symptomer eller plager fra blære, endetarm eller skjede de tre siste månedene. Husk å krysse av i alle de tre kolonnene for hvert spørsmål.

figure b

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Teig, C.J., Grotle, M., Bond, M.J. et al. Norwegian translation, and validation, of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7). Int Urogynecol J 28, 1005–1017 (2017). https://doi.org/10.1007/s00192-016-3209-z

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  • DOI: https://doi.org/10.1007/s00192-016-3209-z

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