Metz Melanie, Junginger Bärbel, Henrich Wolfgang, Baeßler Kaven
Beckenbodenzentrum Charité, Klinik für Gynäkologie CBF, Berlin, Germany.
Klinik für Geburtsmedizin CVK und CCM, Berlin, Germany.
Geburtshilfe Frauenheilkd. 2017 Apr;77(4):358-365. doi: 10.1055/s-0043-102693.
The aim of this study was to develop and validate a questionnaire for the assessment of pelvic floor disorders, their symptoms and risk factors in pregnancy and after birth including symptom course, severity and impact on quality of life. The validated German pelvic floor questionnaire was modified and a new risk factor domain developed. The questionnaire was initially completed by 233 nulliparous women in the third trimester of pregnancy and at six weeks (n = 148) and one year (n = 120) post partum. Full pyschometric testing was performed. The clinical course of symptoms and the influence of risk factors were analysed. Study participants had a median age of 31 (19-46) years. 63 % had spontaneous vaginal deliveries, 15 % operative vaginal deliveries and 22 % were delivered by caesarean section. Content validity: Missing answers never exceeded 4 %. Construct validity: The questionnaire distinguished significantly between women who reported bothersome symptoms and those who did not. Reliability: Cronbach's alpha values exceeded 0.7 for bladder, bowel and support function, and 0.65 for sexual function. The test-retest analysis showed moderate to almost complete concordance. The intraclass coefficients for domain scores (between 0.732 and 0.818) were in acceptable to optimal range. Reactivity: The questionnaire was able to track changes significantly with good effect size for each domain. Risk factors for pelvic floor symptoms included familial predisposition, maternal age over 35 years, BMI above 25, nicotine abuse, subjective inability to voluntarily contract the pelvic floor musculature and postpartum wound pain. This pelvic floor questionnaire proved to be valid, reliable and reactive for the assessment of pelvic floor disorders, their risk factors, incidence and impact on quality of life during pregnancy and post partum. The questionnaire can be utilised to assess the course of symptoms and treatment effects using a scoring system.
本研究的目的是开发并验证一份问卷，用于评估妊娠及产后盆底功能障碍、其症状及风险因素，包括症状过程、严重程度及对生活质量的影响。对已验证的德国盆底问卷进行修改，并开发了一个新的风险因素领域。该问卷最初由233名未生育女性在妊娠晚期、产后六周（n = 148）和产后一年（n = 120）完成。进行了全面的心理测量测试。分析了症状的临床过程及风险因素的影响。研究参与者的年龄中位数为31（19 - 46）岁。63%为自然阴道分娩，15%为手术助产，22%为剖宫产。内容效度：缺失答案从未超过4%。结构效度：该问卷在报告有困扰症状的女性和没有困扰症状的女性之间有显著区分。信度：膀胱、肠道及支持功能的Cronbach's α值超过0.7，性功能的Cronbach's α值为0.65。重测分析显示中度至几乎完全一致。各领域得分的组内相关系数（介于0.732和0.818之间）处于可接受至最佳范围。反应性：该问卷能够显著追踪各领域的变化，效应量良好。盆底症状的风险因素包括家族易感性、母亲年龄超过35岁、体重指数高于25、吸烟、主观上无法自主收缩盆底肌肉组织以及产后伤口疼痛。这份盆底问卷在评估妊娠及产后盆底功能障碍、其风险因素、发病率及对生活质量的影响方面被证明是有效、可靠且有反应性的。该问卷可用于通过评分系统评估症状过程及治疗效果。
