Validation of the Amharic version of the Pelvic Organ Prolapse Symptom Score (POP-SS)
- 58 Downloads
Introduction and hypothesis
We aimed to translate and culturally adapt the Pelvic Organ Prolapse Symptom Score (POP-SS) into Amharic and evaluate its psychometric properties.
We followed an intercultural adaptation procedure to translate and adapt the POP-SS. One hundred and eighty-six women with POP symptoms completed the Amharic POP-SS and Prolapse Quality of Life (P-QoL) questionnaires. All women were examined using a simplified Pelvic Organ Prolapse Quantification (SPOP-Q) system and were divided into four groups based on the POP-Q scores as stage 1, 2, 3, and 4. Internal consistency and test–retest reliability were determined using Cronbach’s alpha and the intraclass correlation coefficient (ICC), respectively. Criterion validity was assessed against the SPOP-Q stage and the P-QoL scale. Furthermore, we tested construct validity using exploratory factor analysis.
The POP-SS score was successfully translated and achieved good content validity. It had high internal consistency (Cronbach’s alpha = 0.86) and test–retest reliability (ICC = 0.81; p < 0.001). There was a statistically significant difference among four groups of stages in POP-SS score. and women with stage 3 had the highest median score (Kruskal-Wallis test; p < 0.05). The POP-SS score was also significantly correlated with the P-QoL score (Spearman’s correlation coefficient = 0.28, p < 0.001). The exploratory factor analysis identified two factors, namely, physical symptoms and evacuation symptoms.
The POP-SS scale was successfully translated to Amharic and appears reliable and valid for women with symptoms of POP. However, further studies are needed to evaluate its responsiveness.
KeywordsPelvic organ prolapse Reliability Validity Amharic validation Ethiopian
Intraclass correlation coefficient
Content validity index
Quality of life
Pelvic organ prolapse
Prolapse Quality of Life
Pelvic Organ Prolapse Symptom Score
Simplified Pelvic Organ Prolapse Quantification
The authors acknowledge all study participants. We thank Professor Suzanne Hagen, the original developer of the tool, for allowing us to translate the instrument into our language. We also would like to express our heartfelt thanks to the research assistants and the expert panel who provided input to this study.
This work was supported by a grant, R.No: O/VP/RCS/05/216/2017, from the University of Gondar. The University was not involved in the design, conduct, analysis, or interpretation of the study or review or approval of the manuscript.
Compliance with ethical standards
Conflicts of interest
- 1.Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An international Urogynecological association (IUGA) / international continence society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Neurourol Urodyn. 2016;35:137–68. https://doi.org/10.1002/nau.22922.CrossRefGoogle Scholar
- 2.Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with anterior compartment prolapse. The Cochrane library. Cochrane Database Syst Rev. 2016;11:153 CD004014.Google Scholar
- 11.Hagen S, Glazener C, Cook J, Herbison P, Toozs-Hobson P. Further properties of the pelvic organ prolapse symptom score: minimally important change and test-retest reliability. Neurourol Urodyn. 2010;29:1055–6.Google Scholar
- 15.Central SA. The 2007 Population and Housing Census of Ethiopia: Statistical Report at Country Level. 2007. p. 91–92. 2010. Available at: http://catalog.ihsn.org/index.php/catalog/3583/download/50086. Accessed 16 Sept 2018.
- 16.Gebremichael M (2012) Federalism and Conflict Management in Ethiopia. Case Study of Benishangul-Gumuz Regional State., University of Bradford. http://hdl.handle.net/10454/5388.
- 17.Akmel M, Segni H. Pelvic organ prolapse in Jimma University specialized hospital, Southwest Ethiopia. Ethiop J Health Sci. 2012;22:85–92.Google Scholar
- 19.Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Tinsae G (2018) Validation of an Amharic version of the Pelvic Organ Prolapse Quality of Life (P-QoL) questionnaire. Dissertation, University of Gondar.Google Scholar
- 22.Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL. Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol. 2007;109:1396–403. https://doi.org/10.1097/01.AOG.0000263469.68106.90.CrossRefGoogle Scholar
- 24.Manonai J, Mouritsen L, Palma P, Contreras-Ortiz O, Korte JE, Swift S. The inter-system association between the simplified pelvic organ prolapse quantification system (S-POP) and the standard pelvic organ prolapse quantification system (POPQ) in describing pelvic organ prolapse. Int Urogynecol J. 2011;22:347–52. https://doi.org/10.1007/s00192-010-1286-y.CrossRefGoogle Scholar
- 29.Nunnally JC, Bernstein I. Psychometric theory (McGraw-Hill series in psychology), vol. 3. New York: McGraw-Hill; 1994.Google Scholar