Department of Urogynaecology, National Maternity Hospital, Holles Street, Dublin 2, Ireland.
UCD Perinatal Research Centre, National Maternity Hospital, Holles Street, Dublin 2, Ireland.
Int Urogynecol J. 2023 Sep;34(9):2133-2139. doi: 10.1007/s00192-023-05529-x. Epub 2023 Apr 1.
Childbirth remains an important risk factor for the development of pelvic floor disorders, regardless of the mode of delivery. To accurately assess these symptoms, accurate, woman-centric assessments are needed. Online versions of these assessments may be especially useful in the COVID-19 era. Women may potentially answer questions differently in an online format, and this study aimed to validate an online version of the paper-based self-administered Australian Pelvic Floor Questionnaire (APFQ).
The questionnaire was completed antenatally and at 3 months postpartum by 647 and 481 women respectively. Test- validity was assessed in subgroups of 61 and 57 women in each period, using intraclass correlation coefficients and Cohen's kappa. Sensitivity to change was assessed by comparing responses during pregnancy to those at 3 months postpartum. Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed by comparing women with and without subjective bothersomeness.
Intraclass correlation coefficients were above 0.9 for all domains and the overall questionnaire. Cohen's kappa for individual questions ranged from 0.71-1.00 across the antenatal and postnatal questionnaires. Cronbach's alpha was acceptable for all domains except the prolapse domain. The APFQ was sensitive to changes occurring between antenatal recruitment and 3 months postpartum. Effect sizes ranged from 0.83-7.99.
This online version of the APFQ is valid for assessing pelvic floor disorders in an Irish obstetric population. The APFQ is reproducible and responsive to change occurring with childbirth, and can be used to research longitudinal changes in pelvic floor disorders. As an online tool, this questionnaire may be useful in increasing response rates to clinical research.
分娩仍然是盆底功能障碍发展的一个重要危险因素，无论分娩方式如何。为了准确评估这些症状，需要进行准确的、以女性为中心的评估。这些评估的在线版本在 COVID-19 时代可能特别有用。女性在在线格式下回答问题的方式可能会有所不同，本研究旨在验证纸质版澳大利亚盆底功能问卷（APFQ）的在线版本。
该问卷分别在产前和产后 3 个月由 647 名和 481 名女性完成。在每个时期，通过对 61 名和 57 名女性进行亚组测试，评估测试有效性，使用组内相关系数和 Cohen's kappa。通过比较怀孕期间和产后 3 个月的反应，评估对变化的敏感性。使用 Cronbach's alpha 评估内部一致性。通过比较有和没有主观困扰的女性来评估结构有效性。
所有领域和整个问卷的组内相关系数均高于 0.9。产前和产后问卷中个别问题的 Cohen's kappa 范围为 0.71-1.00。除脱垂领域外，所有领域的 Cronbach's alpha 均可以接受。APFQ 对产前招募和产后 3 个月之间发生的变化敏感。效应大小范围为 0.83-7.99。
该 APFQ 的在线版本可用于评估爱尔兰产科人群的盆底功能障碍。APFQ 具有可重复性，对分娩引起的变化敏感，可用于研究盆底功能障碍的纵向变化。作为一种在线工具，这个问卷可能有助于提高临床研究的响应率。
