Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Greece.
Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Greece.
Eur J Obstet Gynecol Reprod Biol. 2022 Dec;279:171-175. doi: 10.1016/j.ejogrb.2022.10.025. Epub 2022 Nov 2.
As in Greek settings there is a need to develop validated patient-reported outcomes (PROs) for pelvic floor dysfunction, this study's aim was to cross-culturally adapt and validate the Australian Pelvic Floor Questionnaire (APFQ) into Greek, a 42-item PRO for routine urogynaecological evaluation of four domains; bladder, bowel, prolapse and sexual function.
Cross-cultural translation was completed through official multistage forward and back-translation process. Validation involved administering the adapted APFQ (APFQ_GR) to women visiting Greek community-based healthcare settings. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was also administered. Comparison between women with and without pelvic floor dysfunction (symptomatic versus control) was also undertaken for exploring discriminatory validity. Test-retest reliability was explored by re-administering APFQ_GR 10-15 days following initial testing and internal consistency was explored against each domain separately as well as total items' score.
Greek APFQ translation was successfully performed and piloted to a women sample with varying levels of education for comprehensibility, thus, satisfying the questionnaire's face validity. 100 women (53.7 ± 13.1 years-old) participated in validation, 63 of which predominantly complained of urinary incontinence (UI) and 37 were asymptomatic. There were no ceiling effects. Floor effects were detected for women without symptoms. Moderate to very strong correlations were yielded between APFQ_GR total score and bladder domain, respectively, with ICIQ-UI SF single-item and total score (ρ = 0.403-0.758, p < 0.001), indicating satisfactory criterion-related validity. Moderate correlations were yielded for the sexual function domain with APFQ_GR total score and weaker correlations were found in the other two domains. Independent samples t-test yielded significant differences across the questionnaire's scores (p < 0.001), indicating good discriminatory validity between symptomatic and asymptomatic women. Test-retest reliability was excellent (ICC = ≥0.998). Internal consistency was very good for each domain and total items' score (Cronbach's α = 0.714-0.924).
The Greek APFQ was proven appropriate, comprehensible, valid and reliable for women with urinary incontinence and can thus, be used across Greek healthcare settings. Prolapse and bowel domains merit further research.
在希腊环境中，需要开发经过验证的患者报告结局（PROs）来评估盆底功能障碍，本研究旨在将澳大利亚盆底问卷（APFQ）进行跨文化适应性改编和验证，该问卷是一种 42 项的 PRO，用于常规尿妇科评估四个领域：膀胱、肠道、脱垂和性功能。
通过官方多阶段正向和反向翻译过程完成跨文化翻译。验证涉及向访问希腊社区基础保健环境的女性管理改编后的 APFQ（APFQ_GR）。还管理了国际尿失禁咨询问卷-尿失禁简短表（ICIQ-UI SF）。还对有和没有盆底功能障碍（有症状与无症状）的女性进行了比较，以探索区分效度。通过在初始测试后 10-15 天重新管理 APFQ_GR 来探索测试-重测信度，并针对每个域以及总项目的分数分别探索内部一致性。
希腊 APFQ 翻译成功完成，并对具有不同教育水平的女性样本进行了试点，以评估其可理解性，从而满足问卷的表面有效性。100 名女性（53.7±13.1 岁）参与了验证，其中 63 名主要抱怨尿失禁（UI），37 名无症状。没有天花板效应。对于无症状的女性，检测到地板效应。APFQ_GR 总分与膀胱域之间产生中度至非常强的相关性，与 ICIQ-UI SF 单一项目和总分之间的相关性分别为（ρ=0.403-0.758，p<0.001），表明具有令人满意的标准相关效度。性功能域与 APFQ_GR 总分之间产生中度相关性，而在其他两个域中则产生较弱的相关性。独立样本 t 检验显示问卷得分存在显著差异（p<0.001），表明有症状和无症状女性之间具有良好的区分效度。测试-重测信度极好（ICC≥0.998）。每个域和总项目分数的内部一致性都非常好（Cronbach 的 α=0.714-0.924）。
希腊 APFQ 被证明适用于有尿失禁的女性，易于理解，具有有效性和可靠性，因此可以在希腊医疗保健环境中使用。脱垂和肠道域需要进一步研究。
