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Condition-specific validation of the Arabic version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) among parturient

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Abstract 

Introduction and hypothesis

Pregnancy and mode of delivery have a major effect on pelvic floor disorders (PFD). Assessing knowledge regarding PFD is essential not only for making more informed decisions regarding mode of delivery, but also for seeking help when PFD appear. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a validated tool that assesses women's knowledge regarding urinary incontinence (UI) and pelvic organ prolapse (POP). Validation of the Arabic version of the PIKQ had never been carried out. The purpose of this study was to conduct a condition specific validation among parturients of the PIKQ in the Arabic language.

Methods

Translation of the PIKQ to the Arabic language was carried out according to international recommended guidelines. A cross-sectional study of pregnant women was conducted from June to September 2020 at the Soroka University Medical Center, Israel. The recommended 10:1 ratio between the number of subjects and the number of items in the questionnaire (n=24) was maintained. A total of 244 third trimester pregnant women have completed the Arabic version of the PIKQ. In addition to the validation of the psychometric characteristics, construct validity, criterion validity, and reliability were tested as well.

Results

Initially, exploratory factor analysis (EFA) was conducted, resulting in two 12-item scales representing UI and POP. Then, to validate the scale construct we conducted confirmatory factor analysis (CFA). Results of the CFA demonstrated that the PIKQ displayed construct validity, with standardized factor loadings ranging from 0.30 to 0.62. Finally, Cronbach's alpha indicated a good internal reliability for the two factors UI and POP. Criterion validity further supported the validity of the scale.

Conclusions

The Arabic version of the PIKQ is a new, reliable, consistent, and valid instrument to examine the level of knowledge regarding UI and POP in Arabic speaking pregnant women. This instrument may be used to assess women's knowledge about PFD and to direct the need for educational interventions that may empower women to make informed decisions regarding perinatal care.

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References

  1. Minassian V, Yan X, Lichtenfeld M, Sun H, Stewart W. The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012;23(8):1087–93. https://doi.org/10.1007/s00192-012-1743-x.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, Goldman HB, Huser M, Milani AL, Moran PA, Schaer GN, Withagen MIJ. An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the terminology for female pelvic organ prolapse(POP). Neurourol Urodyn. 2016;35(2):137–68. https://doi.org/10.1002/nau.22922.

    Article  PubMed  Google Scholar 

  3. Wu JM, Matthews CA, Conover MM, Pate V, Jonsson Funk M. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6. https://doi.org/10.1097/AOG.0000000000000286.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Basu M, Duckett JRA. Barriers to seeking treatment for women with persistent or recurrent symptoms in urogynaecology. BJOG. 2009;116(5):726–30. https://doi.org/10.1111/j.1471-0528.2008.02098.x.

    Article  CAS  PubMed  Google Scholar 

  5. Diokno AC, Sand PK, Macdiarmid S, Shah R, Armstrong RB. Perceptions and behaviours of women with bladder control problems. Fam Pract. 2006;23(5):568–77. https://doi.org/10.1093/fampra/cml018.

    Article  PubMed  Google Scholar 

  6. Diokno AC, Burgio K, Fultz NH, Kinchen KS, Obenchain R, Bump RC. Medical and self-care practices reported by women with urinary incontinence. Am J Manag Care. 2004;10(2 I):69–78.

    PubMed  Google Scholar 

  7. Morrill M, Lukacz ES, Lawrence JM, Nager CW, Contreras R, Luber KM. Seeking healthcare for pelvic floor disorders: a population-based study. Am J Obstet Gynecol. 2007;197(1):86.e1–6. https://doi.org/10.1016/j.ajog.2007.02.051.

    Article  PubMed  Google Scholar 

  8. Kashanian M, Ali SS, Nazemi M, Bahasadri S. Evaluation of the effect of pelvic floor muscle training (PFMT or Kegel exercise) and assisted pelvic floor muscle training (APFMT) by a resistance device (Kegelmaster device) on the urinary incontinence in women: a randomized trial. Eur J Obstet Gynecol Reprod Biol. 2011;159(1):218–23. https://doi.org/10.1016/j.ejogrb.2011.06.037.

    Article  PubMed  Google Scholar 

  9. Shah AD, Massagli MP, Kohli N, Rajan SS, Braaten KP, Hoyte L. A reliable, valid instrument to assess patient knowledge about urinary incontinence and pelvic organ prolapse. Int Urogynecol J. 2008;19(9):1283–9. https://doi.org/10.1007/s00192-008-0631-x.

    Article  Google Scholar 

  10. Yohay NZ, Weiss A, Weintraub AY, Daya K, Elnir M, Debi K. Knowledge of women during the third trimester of pregnancy regarding pelvic floor disorders. Int Urogynecol J. 2022;0123456789:4–11. https://doi.org/10.1007/s00192-022-05098-5.

    Article  Google Scholar 

  11. Liu J, Tan SQ, Han HC. Knowledge of pelvic floor disorder in pregnancy. Int Urogynecol J. 2019;30(6):991–1001. https://doi.org/10.1007/s00192-019-03891-3.

    Article  PubMed  Google Scholar 

  12. O’Neill AT, Hockey J, O’Brien P, Williams A, Morris TP, Khan T, Hardwick E, Yoong W. Knowledge of pelvic floor problems: a study of third trimester, primiparous women. Int Urogynecol J. 2017;28(1):125–9. https://doi.org/10.1007/s00192-016-3087-4.

    Article  PubMed  Google Scholar 

  13. Chen CCG, Cox JT, Yuan C, Thomaier L, Dutta S. Knowledge of pelvic floor disorders in women seeking primary care: A cross-sectional study. BMC Fam Pract. 2019;20(1):1–10. https://doi.org/10.1186/s12875-019-0958-z.

    Article  Google Scholar 

  14. Charrié M, Billecocq S. Troubles pelvipérinéaux de la période périnatale: état des connaissances des femmes, une revue systématique [Knowledge of pelvic floor disorders in peripartum women: a systematic review]. Prog Urol. 2021;31(4):204–14. French. https://doi.org/10.1016/j.purol.2020.10.009.

    Article  PubMed  Google Scholar 

  15. Weiss A, Yohay NZ, Daya K, Elnir Katz M, Yohay Z, Hasan M, Baumfeld Y, Elharar D, Weintraub AY, Eshkoli T. Validation of the hebrew version of the prolapse and incontinence knowledge questionnaire (PIKQ) during pregnancy. Int Urogynecol J. 2022;33(11):3123–8. https://doi.org/10.1007/s00192-021-05038-9.

  16. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268–74. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2753.2010.01434.x. https://doi.org/10.1111/j.1365-2753.2010.01434.x.

    Article  PubMed  Google Scholar 

  17. Worthington RL, Whittaker TA. Scale development research: a content analysis and recommendations for best practices. Couns Psychol. 2006;34(6):806–38. https://doi.org/10.1177/0011000006288127.

    Article  Google Scholar 

  18. Arbuckle JL. AMOS 24 user’s guide. Crawfordville: Amos Development Corporation; 2016.

    Google Scholar 

  19. Hoyle RH, Panter AT. Writing about structural equation models. In: Hoyle RH, editor. Structural equation modeling: comments, issues, and applications. Sage: Thousand Oaks; 1995. p. 158–76.

    Google Scholar 

  20. Kaiser HF. The application of electronic computers to factor analysis. Educ Psychol Meas. 1960;20(1):141–51. https://doi.org/10.1177/001316446002000116.

    Article  Google Scholar 

  21. Cattell RB. The scree test for the number of factors. Multivar Behav Res. 1966;1(2):245–76. https://doi.org/10.1207/s15327906mbr0102_10.

    Article  CAS  Google Scholar 

  22. Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30(2):179–85. https://doi.org/10.1007/BF02289447.

    Article  CAS  PubMed  Google Scholar 

  23. O’connor BP. SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test. Behav Res Methods Instrum Comput. 2000;32(3):396–402. https://doi.org/10.3758/BF03200807.

    Article  PubMed  Google Scholar 

  24. Tabachnick B, Fidell L. Using multivariate statistics. (4th ed., Intl. Student ed.). Boston: Allyn and Bacon; 2001.

  25. Barber MD. Pelvic organ prolapse BMJ (Online). 2016;354(July):1–9. https://doi.org/10.1136/bmj.i3853.

    Article  Google Scholar 

  26. Leijonhufvud Å, Lundholm C, Cnattingius S, Granath F, Andolf E, Altman D. Risks of stress urinary incontinence and pelvic organ prolapse surgery in relation to mode of childbirth. Am J Obstet Gynecol. 2011;204(1):70.e1–7. https://doi.org/10.1016/j.ajog.2010.08.034.

    Article  PubMed  Google Scholar 

  27. Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of delivery mode with pelvic floor disorders after childbirth. JAMA . 2018;320(23):2438–47. https://doi.org/10.1001/jama.2018.18315.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Treister-Goltzman Y, Freud T, Press Y, Peleg R. Cross-sectional study on ethnic differences in occupational injuries in southern israel—an eight-year data analysis. J Occup Environ Med. 2022;64(6):525–32. https://doi.org/10.1097/JOM.0000000000002502.

    Article  PubMed  Google Scholar 

  29. Cohen AD, Dreiher J, Sharf A, Vardy DA. Utilization of emergency department services by the Bedouin population in southern Israel. Scientific World J. 2007;7:330–5. https://doi.org/10.1100/tsw.2007.35.

    Article  Google Scholar 

  30. Gottlieb N, Belmaker I, Bilenko N, Davidovitch N. Bedouin-Arab women's access to antenatal care at the interface of physical and structural barriers: A pilot study. Glob Public Health. 2011;6(6):643–56. https://doi.org/10.1080/17441692.2010.482534.

    Article  PubMed  Google Scholar 

  31. Cohen AD, Dreiher J, Sharf A, Vardy DA. Utilization of emergency department services by the Bedouin population in southern Israel. Scientific World J. 2007;7:330–5. https://doi.org/10.1100/tsw.2007.35.

    Article  Google Scholar 

  32. de Andrade RL, Bø K, Antonio FI, Driusso P, Mateus-Vasconcelos ECL, Ramos S, Julio MP, Ferreira CHJ. An education program about pelvic floor muscles improved women’s knowledge but not pelvic floor muscle function, urinary incontinence or sexual function: a randomised trial. J Phys. 2018;64(2):91–6. https://doi.org/10.1016/j.jphys.2018.02.010.

    Article  Google Scholar 

  33. Yohai D, Alharar D, Cohen R, Kaltian Z, Aricha-Tamir B, Ben Aion S, Yohai Z, Weintraub AY. The effect of attending a prenatal childbirth preparedness course on labor duration and outcomes. J Perinat Med. 2018;46(1):47–52. https://doi.org/10.1515/jpm-2016-0345.

    Article  PubMed  Google Scholar 

  34. Sharaby R, Peres H. Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society. BMC Preg Childbirth. 2021;21(1):190. https://doi.org/10.1186/s12884-021-03661-4.

    Article  Google Scholar 

  35. Neels H, Wyndaele JJ, Tjalma WAA, de Wachter S, Wyndaele M, Vermandel A. Knowledge of the pelvic floor in nulliparous women. J Phys Ther Sci. 2016;28(5):1524–33. https://doi.org/10.1589/jpts.28.1524.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank Mrs. Eman Ibrahim Hasan and Mrs. Debi Hasan Hasan for their extraordinary work in the translation process during this study. We thanks Lali Zur for her help with data collection.

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Authors and Affiliations

  1. Department of Military Medicine and “Tzameret”, Faculty of Medicine, Medical Corps, Israel Defense Forces, Hebrew University of Jerusalem, Jerusalem, Israel

    Neriya Zion Yohay

  2. Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Neriya Zion Yohay

  3. School of Education, Achva Academic College, Arugot, Israel

    Rinat Cohen

  4. Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel

    Mahmod Hasan, Kochav Daya, Hanaa Abukaf, Zehava Yohay, Adi Y. Weintraub & Tamar Eshkoli

  5. Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel

    Ari Weiss

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Contributions

NZ Yohay: project development, data collection, manuscript writing.

Dr. R Cohen: data analysis and manuscript writing. Dr. M Hasan: project development. Dr. K Daya: data collection. Dr. A Weiss: project development. Dr H Abukaf: data collection, Z Yohay: data collection. Prof. AY Weintraub and Dr. T Eshkoli: project development, manuscript editing.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Neriya Zion Yohay.

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Yohay, N.Z., Cohen, R., Hasan, M. et al. Condition-specific validation of the Arabic version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) among parturient. Int Urogynecol J 34, 1529–1539 (2023). https://doi.org/10.1007/s00192-022-05417-w

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