Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
BMC Pregnancy Childbirth. 2022 Aug 13;22(1):638. doi: 10.1186/s12884-022-04964-w.
Perineal tears are common after vaginal birth and may result in pelvic floor symptoms. However, there is no validated questionnaire that addresses long-term symptoms in women with a deficient perineum after vaginal birth. Thus, the objective of this study was to develop and psychometrically evaluate a clinical screening inventory that estimates subjective symptoms in women with a deficient perineum more than one year after vaginal delivery.
The development and psychometric evaluation employed both qualitative and quantitative methods. Qualitative strategies involved content validity and Think Aloud protocol for generation of items. The psychometric evaluation employed principal component analysis to reduce the number of items. The inventory was completed by women with persistent symptoms after perineal tears (N = 170). Results were compared to those of primiparous women giving birth by caesarean section (N = 54) and nulliparous women (N = 338).
A preliminary 41-item inventory was developed, and the psychometric evaluation resulted in a final 11-item inventory. Women with confirmed deficient perineum after perineal trauma scored significantly higher on the symptoms inventory than women in control groups. A cut-off value of ≥ 8 could distinguish patients from controls with high sensitivity (100%) and specificity (87-91%).
The Karolinska Symptoms After Perineal Tear Inventory, is a psychometrically valid 11-item patient-reported outcome measure for symptoms of deficient perineum more than one year after vaginal birth. More research is needed to validate the inventory in various patient populations as well as its use in pelvic floor interventions. The inventory has the potential to improve patient counseling and care in the future.
会阴裂伤在阴道分娩后很常见，可能导致盆底症状。然而，目前尚无经过验证的问卷可以评估阴道分娩后会阴缺陷女性的长期症状。因此，本研究的目的是开发和心理测量评估一种临床筛查清单，以评估阴道分娩一年多后会阴缺陷女性的主观症状。
采用定性和定量方法进行开发和心理测量评估。定性策略包括内容效度和大声思考协议，以生成项目。心理测量评估采用主成分分析来减少项目数量。该清单由会阴撕裂后持续存在症状的女性（N=170）完成。结果与阴道分娩剖宫产（N=54）和初产妇（N=338）的结果进行了比较。
初步开发了一个包含 41 个项目的清单，心理测量评估后得到了一个包含 11 个项目的最终清单。确认会阴裂伤后会阴缺陷的女性在症状清单上的得分明显高于对照组女性。≥8 的截断值可以区分患者和对照组，具有高灵敏度（100%）和特异性（87-91%）。
会阴裂伤后症状的 Karolinska 量表是一种心理测量有效的 11 项患者报告结局测量工具，用于评估阴道分娩一年多后会阴缺陷的症状。需要进一步研究来验证该清单在不同患者人群中的有效性以及在盆底干预中的应用。该清单有可能改善未来患者的咨询和护理。
