Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor)

Abstract

Introduction Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient reported outcome measure used in clinical practice to assess urogynaecological symptoms and their impact on quality-of-life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF. Methods A patient involvement group, analysis of free-text data from ePAQ-PF and a systematic review of available PROMs to assess urogynaecological body image informed the content of a new body image domain within ePAQ-PF. Data collected from 208 patients who consented to the use of their anonymised ePAQ-PF responses for research purposes underwent factor analysis, internal consistency reliability and item-total correlation testing. Data from previous studies were used to formulate hypotheses to test construct validity. Criterion validity was assessed against the Body-image Scale (BIS). Patients completed a separate questionnaire (QQ-11) to measure face validity of ePAQ-PF. Results Factor analysis revealed a 4-item body-image domain with good internal consistency reliability (Cronbach's α=0.899) and item-total correlations (Spearman's rank r >0.40). ePAQ-PF body-image domain scores correlated significantly with the BIS scores (r=0.501). Age, prolapse, sexual dysfunction, pelvic pain and urinary incontinence scores correlated significantly with body image domain score. QQ-11 value scores outweighed burden scores. Conclusions Body image assessment should form part of routine care in urogynaecology. Preliminary results support validity, reliability and functionality of ePAQ-PF incorporating the new body image domain. Further psychometric testing of this is required, including tests of responsiveness and stability.

Patient-Reported Outcome Measures for Use in Women With Pelvic Organ Prolapse

“…Floor or ceiling effect was reported for only five patient-reported outcomes (the ABI, 58 ePAQ-PF, 38,53 PISQ-12, 52 PISQ-IR, 24 and SPS-Q 22 ). The minimal clinical important difference was reported for only seven patient-reported outcomes: the APFQ POP domain (minimal clinical important difference 1.0 using an a priori value and anchor-based methods), 13,15 the EQ-5 (minimal clinical important difference 0.025 through anchor and distribution based), 35 all domains of the PFDI-20 (minimal clinical important difference 13.5, 24, and 45 through anchor and distribution based), 19,39,59 PFIQ-7 (minimal clinical important difference 36 through anchor based), 19 PISQ (minimal clinical important difference 6 through anchor based), 43 PISQ-IR (minimal clinical important difference 0.3 through anchor and distribution based), 48 and SF-6 (minimal clinical important difference 0.026 through anchor and distribution based).…”

“…24,32,51 The ePAQ-PF (Electronic Personal Assessment Questionnaire—Pelvic Floor), EPIQ (Epidemiology of Prolapse and Incontinence Questionnaire), FASS (FIGO Prolapse Assessment Scoring System), ITSQ (Integral Theory System Questionnaire), PIKQ (Prolapse and Incontinence Knowledge Questionnaire), and POP-SS (Pelvic Organ Prolapse Symptom Score) had data on four measurement properties each. The ePAQ-PF had three studies with data on content or face validity (two studies), 49,53 construct validity (two studies, both adequate), 49,53 reliability (one study, adequate), 49 and internal consistency (three studies, all very good). 38,49 The EPIQ had two studies reporting content validity (one study), 42 construct validity (one study, adequate), 42 reliability (two studies: one very good, one adequate), 28,42 and internal consistency (two studies: one very good, one doubtful).…”

“…24,32,51 had data on four measurement properties each. The ePAQ-PF had three studies with data on content or face validity (two studies), 49,53 construct validity (two studies, both adequate), 49,53 reliability (one study, adequate), 49 and internal consistency (three studies, all very good). 38,49 The EPIQ had two studies reporting content validity (one study), 42 construct validity (one study, adequate), 42 reliability (two studies: one very good, one adequate), 28,42 and internal consistency (two studies: one very good, one doubtful).…”