Abstract
Objectives
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.
Study design
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.
Results
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 (ICC3,1 = ≥0.998). Internal consistency was very good for each domain and total items’ score
(Cronbach’s α = 0.714–0.924).
Conclusions
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.
Keywords
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Article Info
Publication History
Published online: November 01, 2022
Accepted:
October 26,
2022
Received in revised form:
October 21,
2022
Received:
August 27,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
