Barber M D, Walters M D, Bump R C
Department of Obstetrics and Gynecology at the Cleveland Clinic Foundation, OH 44195, USA.
Am J Obstet Gynecol. 2005 Jul;193(1):103-13. doi: 10.1016/j.ajog.2004.12.025.
To develop short forms of 2 valid and reliable condition-specific quality-of-life questionnaires for women with disorders of the pelvic floor including urinary incontinence, pelvic organ prolapse, and fecal incontinence (Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire).
Data from the 100 women who contributed to the development and validation of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire long forms were used to develop the short-form questionnaires. All subsets regression analysis was used to find the items in each scale that best predicted the scale score on the respective long form. When different items appeared equivalent, a choice was made on item content. After development, the short forms and the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire long forms were administered preoperatively to 45 women with pelvic floor disorders scheduled to undergo surgery to evaluate the correlation between short and long forms in a second independent population. The short forms were readministered 3 to 6 months postoperatively to assess the responsiveness of the instruments.
The short-form version of the Pelvic Floor Distress Inventory has a total of 20 questions and 3 scales (Urinary Distress Inventory, Pelvic Organ Prolapse Distress Inventory, and Colorectal-Anal Distress Inventory). Each short-form scale demonstrates significant correlation with their long-form scales (r=.86, r=.92, and r=.93, respectively, P<.0001). For the Pelvic Floor Impact Questionnaire short form, the previously developed short form for the Incontinence Impact Questionnaire-7 was used as a template. The 7 items identified in the previously developed Incontinence Impact Questionnaire-7 short form correlate highly with the Incontinence Impact Questionnaire long form (r=.96, P<.0001) as well as the long forms of the Colorectal-Anal Impact Questionnaire scale (r=.96, P<.0001) and the Pelvic Organ Prolapse Impact Questionnaire (r=.94, P<.0001). All subsets regression analysis did not identify any items or combination of items that correlated substantially better for any of the 3 scales. The scales of the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 maintained their excellent correlation to the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire long forms in the second independent sample (r=.88 to .94 for scales of Pelvic Floor Distress Inventory-20; r=.95 to .96 for scales of Pelvic Floor Impact Questionnaire-7, P<.0001 for all). The test-retest reliability of each scale was good to excellent (intraclass correlation coefficient 0.70 to 0.93, P<.001 for all scales). The scales and summary scores of the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 demonstrated moderate to excellent responsiveness 3 to 6 months after surgery.
The Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 are valid, reliable, and responsive short forms of 2 condition-specific quality-of-life questionnaires for women with pelvic floor disorders.
为患有盆底疾病（包括尿失禁、盆腔器官脱垂和大便失禁）的女性开发两种有效且可靠的特定疾病生活质量问卷的简版（盆底困扰量表和盆底影响问卷）。
来自100名参与盆底困扰量表和盆底影响问卷长版开发与验证的女性的数据被用于开发简版问卷。采用全子集回归分析来找出每个量表中最能预测相应长版量表得分的条目。当不同条目表现相当的时候，则根据条目内容进行选择。开发完成后，在计划接受手术的45名盆底疾病女性患者术前同时发放简版问卷以及盆底困扰量表和盆底影响问卷长版，以评估在第二个独立人群中简版与长版之间的相关性。术后3至6个月再次发放简版问卷以评估这些工具的反应性。
盆底困扰量表简版共有20个问题和3个分量表（泌尿困扰量表、盆腔器官脱垂困扰量表和结直肠肛门困扰量表）。每个简版分量表与其长版分量表均显示出显著相关性（分别为r = 0.86、r = 0.92和r = 0.93，P < 0.0001）。对于盆底影响问卷简版，以前开发的尿失禁影响问卷-7简版被用作模板。先前开发的尿失禁影响问卷-7简版中的7个条目与尿失禁影响问卷长版高度相关（r = 0.96，P < 0.0001），也与结直肠肛门影响问卷量表长版（r = 0.96，P < 0.0001）和盆腔器官脱垂影响问卷长版（r = 0.94，P < 0.0001）高度相关。全子集回归分析未发现任何条目或条目组合在3个量表中的任何一个上具有显著更好的相关性。盆底困扰量表-20和盆底影响问卷-7的分量表在第二个独立样本中与盆底困扰量表和盆底影响问卷长版保持了极好的相关性（盆底困扰量表-20分量表的r为0.88至0.94；盆底影响问卷-7分量表的r为0.95至0.96，所有P < 0.0001）。每个分量表的重测信度良好至优秀（组内相关系数为0.70至0.93，所有量表P < 0.001）。盆底困扰量表-20和盆底影响问卷-7的分量表及总结分数在术后3至6个月显示出中度至优秀的反应性。
盆底困扰量表-20和盆底影响问卷-7是针对患有盆底疾病女性的两种特定疾病生活质量问卷的有效、可靠且具有反应性的简版。
