Translation, cultural adaptation, and validation and reliability of assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum questionnaire in Turkish population
Abstract
Objectives: This study was conducted in order to produce translation, cultural adaptation, and validation of Assessment
of Pelvic Floor Disorders and Their Risk Factors During Pregnancy and Postpartum Questionnaire (APFDQ) to Turkish in
pregnant and postpartum population.
Material and methods: The study included 80 pregnant women. Internal consistency was tested using Cronbach’s alpha.
Questionnaires were applied three different times in order to assess for sensitivity. Patients were asked to complete the
questionnaire first in the third trimester, secondly in postpartum 6th week and finally in postpartum 6th month after birth.
For translation process content, face/content validity, reliability, construct validity and reactivity studies were done. All
women had undergone pelvic examination and prolapse was assessed by using Pelvic organ Prolapse Quantification System
(POP-Q). Urinary symptoms were also evaluated with Urinary Distress Inventory (UDI-6) questionnaire.
Results: The mean age of patients was 27.7 ± 5.5 years. Forty-one (51.25%) of the patients had vaginal delivery and
39 (48.75%) had a cesarean section. Above 96% of the patients had completed the questionnaires. POP-Q assessments and
UDI-6 results were used to evaluate construct validity. Cronbach’s alpha results were found to be 0.7 for all the subscales of
the questionnaire: bladder: 0.702, bowel: 0.744, prolapse: 0.701, sexual function: 0.706 respectively, indicating adequate
reliability. The test/retest reliability was studied and Pabak values showed moderate reliability in the bowel, prolapse and
sexuality, and good reliability for bladder subscale. The results of the patients were compared between pregnancy and
postpartum to assess reactivity and shown to be reactive to changes. Also risk factors of the patients were assessed including,
family predisposition, maternal age over 35 years, BMI > 25, nicotine use, subjective inability to contract pelvic floor
and sense of postpartum wound pain.
Conclusions: The Turkish version of APFDQ is a reliable and valid tool. It can be used for assessing the risk factors, incidence,
assessing degree of PFDs and evaluating the impact on quality of life in pregnant and postpartum women.
Keywords: pelvic floor dysfunctionpregnancypostpartumvalidation
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