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Translation and psychometric evaluation of the Greek short forms of two condition-specific quality of life questionnaires for women with pelvic floor disorders: PFDI-20 and PFIQ-7

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Abstract

Introduction and hypothesis

The aim of this study was the cross-cultural adaptation, validation, and psychometric evaluation in the Greek language of two self-reported instruments used for patients with pelvic floor disorders (PFDs): the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7).

Methods

For the cross-cultural adaptation, a multistep forward–back translation protocol was utilized. Evaluation of the psychometric properties of the questionnaires involved the assessment of validity, stability, internal consistency, and responsiveness. Validity, stability, and internal consistency were evaluated in women presenting with PFDs (group A), whereas responsiveness was assessed in women undergoing pelvic floor surgery (group B).

Results

A total of 100 women presenting with PFDs were included in Group A. A near excellent content/face validity was confirmed as assessed by the missing values criterion (0–5 %). Stability, as assessed by the intraclass correlation coefficient, showed almost perfect agreement with a mean ICC of 0.850 (PFDI-20) and 0.840 (PFIQ-7). Internal consistency was found to be high for both questionnaires (Cronbach’s alpha > 0.8). Finally, 85 women underwent pelvic floor repair surgery and were included for the assessment of responsiveness (group B). Good to excellent responsiveness was found for the prolapse and urinary subscales of the questionnaires. However, poor responsiveness was found for the colorectal–anal scale of the PFDI-20, whereas the colorectal–anal scale of the PFIQ-7 proved to be nonresponsive to change.

Conclusions

The Greek versions of PFDI-20 and PFIQ-7 were found to be comprehensible, valid, reliable, and responsive to use with patients complaining of PFDs.

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Abbreviations

PFDI:

Pelvic Floor Distress Inventory-20

POPDI:

Pelvic Organ Prolapse Distress Inventory-6

CRADI:

Colorectal–Anal Distress Inventory-8

UDI:

Urinary Distress Inventory-6

PFIQ:

Pelvic Floor Impact Questionnaire-7

UIQ:

Urinary Impact Questionnaire-7

CRAIQ:

Colorectal-Anal Impact Questionnaire-7

POPIQ:

Pelvic Organ Prolapse Impact Questionnaire-7

ES:

Effect sizes

SRM:

Standardized response mean

SD:

Standard deviation

ICC:

Intraclass correlation coefficient

CI:

Confidence interval

POPQ:

Pelvic organ prolapse quantification system

MCID:

Minimal clinically important difference

POP:

Pelvic organ prolapse

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Conflict of interest

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Funding

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Author information

Authors and Affiliations

  1. First Department of Obstetrics and Gynecology, Urogynecology Unit, “Alexandra” Hospital, University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece

    Themos Grigoriadis, Stavros Athanasiou, George Giannoulis, Sylvia-Christina Mylona, Dionysia Lourantou & Aris Antsaklis

Authors
  1. Themos Grigoriadis
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  2. Stavros Athanasiou
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  3. George Giannoulis
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  4. Sylvia-Christina Mylona
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  5. Dionysia Lourantou
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  6. Aris Antsaklis
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Corresponding author

Correspondence to Themos Grigoriadis.

Appendices

Appendix 1 (Greek questionnaires)

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Appendix 2

Observed stability of each question of the PFDI-20 and PFIQ-7 questionnaires evaluated using the intraclass correlation coefficient (ICC)

 

Stability: ICC (95 % CI)

p value*

PFDI-20 (n = 100)

0.850 (0.785–0.896)

<0.001**

  POPDI-6

0.870 (0.813–0.911)

<0.001**

 

POPDI-6/q1

0.690 (0.572–0.780)

POPDI-6/q2

0.740 (0.637–0.817)

POPDI-6/q3

0.920 (0.884–0.945)

POPDI-6/q4

0.740 (0.637–0.817)

POPDI-6/q5

0.680 (0.559–0.773)

POPDI-6/q6

0.850 (0.785–0.896)

  CRADI-8

0.750 (0.650–0.824)

<0.001**

 

CRADI-8/q1

0.650 (0.521–0.750)

CRADI-8/q2

0.660 (0.534–0.757)

CRADI-8/q3

0.740 (0.637–0.817)

CRADI-8/q4

0.730 (0.624–0.810)

CRADI-8/q5

0.800 (0.717–0.861)

CRADI-8/q6

0.630 (0.496–0.735)

CRADI-8/q7

0.590 (0.446–0.704)

CRADI-8/q8

0.330 (0.144–0.493)

  UDI-6

0.780 (0.690–0.846)

<0.001**

 

UDI-6/q1

0.810 (0.730–0.868)

UDI-6/q2

0.780 (0.690–0.846)

UDI-6/q3

0.820 (0.744–0.875)

UDI-6/q4

0.830 (0.758–0.882)

UDI-6/q5

0.710 (0.598–0.795)

UDI-6/q6

0.670 (0.546–0.765)

PFIQ-7 (n = 100)

0.840 (0.771–0.890)

<0.001**

  UIQ-7

0.830 (0.758–0.882)

<0.001**

 

UIQ-7/q1

0.740 (0.637–0.817)

UIQ-7/q2

0.740 (0.637–0.817)

UIQ-7/q3

0.690 (0.572–0.780)

UIQ-7/q4

0.730 (0.624–0.810)

UIQ-7/q5

0.660 (0.534–0.757)

UIQ-7/q6

0.720 (0.611–0.802)

UIQ-7/q7

0.710 (0.594–0.797)

  CRAIQ-7

0.697 (0.584–0.787)

<0.001**

 

CRAIQ-7/q1

0.640 (0.508–0.742)

CRAIQ-7/q2

0.730 (0.624–0.810)

CRAIQ-7/q3

0.620 (0.483–0.727)

CRAIQ-7/q4

0.650 (0.526–0.765)

CRAIQ-7/q5

0.630 (0.496–0.735)

CRAIQ-7/q6

0.520 (0.362–0.649)

CRAIQ-7/q7

0.650 (0.524–0.766)

  POPIQ-7

0.770 (0.677–0.839)

<0.001**

 

POPIQ-7/q1

0.730 (0.624–0.810)

POPIQ-7/q2

0.690 (0.572–0.780)

POPIQ-7/q3

0.700 (0.585–0.787)

POPIQ-7q4

0.660 (0.534–0.757)

POPIQ-7/q5

0.730 (0.624–0.810)

POPIQ-7/q6

0.690 (0.572–0.780)

POPIQ-7/q7

0.660 (0.532–0.759)

  1. PFDI Pelvic Floor Distress Inventory, POPDI Pelvic Organ Prolapse Distress Inventory, CRADI Colorectal–Anal Distress Inventory, UDI Urinary Distress Inventory, PFIQ Pelvic Floor Impact Questionnaire, UIQ Urinary Impact Questionnaire, CRAIQ Colorectal–Anal Impact Questionnaire, POPIQ Pelvic Organ Prolapse Impact Questionnaire, CI coefficient interval
  2. *ANOVA method
  3. **Statistically significant

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Grigoriadis, T., Athanasiou, S., Giannoulis, G. et al. Translation and psychometric evaluation of the Greek short forms of two condition-specific quality of life questionnaires for women with pelvic floor disorders: PFDI-20 and PFIQ-7. Int Urogynecol J 24, 2131–2144 (2013). https://doi.org/10.1007/s00192-013-2144-5

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