Abstract
Introduction and hypothesis
The aim was to translate, culturally adapt, and validate the APFQ (Australian Pelvic Floor Questionnaire) for the population of Brazilian pregnant and postpartum women.
Methods
The translation and validation of the APFQ were performed according to Beaton's guideline recommendations, with a sample of 150 patients (75 pregnant, 75 postpartum). Cronbach's alpha assessed the scale's internal consistency and reproducibility with the intraclass correlation coefficient (ICC). To analyze the construct validity, two questionnaires were applied, and the Spearman correlation was performed. Confirmatory factor analysis (CFA) was executed to assess the fit of the data to the theoretical model. The ability to generate diagnosis was analyzed by sensitivity and specificity.
Results
Only 1% of the sample scored in the prolapse domain, so it was removed from the validation analyses. Cronbach's alpha values greater than 0.70 were obtained for the bladder and bowel domains, and 0.69 for sexual function. As for reproducibility, the ICC was greater than 0.75 for all domains. Spearman's correlation was good for bowel (r=0.74), moderate for bladder (r=0.58), and poor for sexual function (r=0.23). CFA results showed a non-optimal adherence: despite the Chi-squared value being significant (p<0.001), the CMIN- which is the adherence of the data to the model- value is less than 3. Sensitivity above 80% was obtained, whereas specificity of 43%, 16%, and 12% was obtained for bowel, bladder, and sexual functions respectively.
Conclusion
The APFQ was translated, culturally adapted, and validated for Brazilian pregnant and postpartum women. It showed good indexes of internal consistency, construct validity, reproducibility, and sensitivity. However, the prolapse domain could not be validated.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ashton-Miller JA, DeLancey JOL. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci. 2007;1101:266–96.
Hebert J. Pregnancy and childbirth: the effects on pelvic floor muscles. Nurs Times. 2009;105(7):38–41.
Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5(5):CD007471.
Quiboeuf E, Saurel-Cubizolles MJ, Fritel X. Trends in urinary incontinence in women between 4 and 24 months postpartum in the EDEN cohort. BJOG. 2016;123(7):1222–8.
Wesnes SL, Hannestad Y, Rortveit G. Delivery parameters, neonatal parameters and incidence of urinary incontinence six months postpartum: a cohort study. Acta Obstet Gynecol Scand. 2017;96(10):1214–22.
Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.
Baessler K, O’Neill SM, Maher CF, Battistutta D. Australian pelvic floor questionnaire: a validated interviewer-administered pelvic floor questionnaire for routine clinic and research. Int Urogynecol J. 2009;20(2):149–58.
Baessler K, Kempkensteffen C. Validierung eines umfassenden Beckenboden-Fragebogens für Klinik, Praxis und Forschung. Gynakol Geburtshilfliche Rundsch. 2009;49(4):299–307.
Deparis J, Bonniaud V, Desseauve D, Guilhot J, Masanovic M, de Tayrac R, et al. Cultural adaptation of the female pelvic floor questionnaire (FPFQ) into French. Neurourol Urodyn. 2015;36(2):253–8.
Sarıibrahim Astepe B, Köleli I. Translation, cultural adaptation, and validation of Australian pelvic floor questionnaire in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2019;234:71–4.
Hou Y, Hou D. Validation of the Australian pelvic floor questionnaire in Chinese pregnant and postpartum women. Eur J Obstet Gynecol Reprod Biol. 2020;245:102–6. Available from: https://doi.org/10.1016/j.ejogrb.2019.12.023
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186–91.
Arouca MAF, Duarte TB, Lott DAM, Magnani PS, Nogueira AA, Rosa-e-Silva JC, et al. Validation and cultural translation for Brazilian Portuguese version of the pelvic floor impact questionnaire (PFIQ-7) and pelvic floor distress inventory (PFDI-20). Int Urogynecol J. 2016;27(7):1097–106. Available from: https://doi.org/10.1007/s00192-015-2938-8.
Martinez EZ. Validade de construto de uma versão em português do female sexual function index construct validity of a Portuguese version of the female sexual function index. Cad Saude Publica. 2009;25(11):2333– 44.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19(4):539–49.
Schreiber JB, Nora A, Stage FK, Barlow EA, King J. Reporting structural equation modeling and confirmatory factor analysis results: a review. J Educ Res. 2006;99(6):323–38.
Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.
Acknowledgements
We thank the pregnant and postpartum women for participating in the study. Special thanks to Kaven Beassler and Christopher Maher for their permission and help with the validation process. We are grateful for the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), who provided a grant for one of the researchers, Luana Caran Roque (grant number 2021/02118-5). GPAP Study Group is a Multidisciplinary Sector Specialized in Pelvic Floor during pregnancy and postpartum. This study group is composed of the following authors: Sergio Brasileiro Martins, Leticia Maria de Oliveira, Marcia Maria Dias, and Claudia Cristina Takano.
Funding
This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo-FAPESP (grant number 2021/02118-5).
Author information
Authors and Affiliations
Consortia
Corresponding author
Ethics declarations
Conflicts of interest
None.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Amorim, A.C., Roque, L.C., Sartori, M.G.F. et al. Australian Pelvic Floor Questionnaire: translation, cultural adaptation, and validation. Int Urogynecol J 34, 1001–1006 (2023). https://doi.org/10.1007/s00192-022-05447-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-022-05447-4