Three-year follow-up of a self-administered Australian pelvic floor questionnaire validated in Chinese pregnant and postpartum women

Abstract

Introduction and hypothesis The aim of this study was to verify whether the Chinese version of the self-administered Australian Pelvic Floor Questionnaire (APFQ) can assess the changes in symptoms over a long time period (responsiveness) and to verify the reliability and validity of the questionnaire after 3 years of follow-up. Methods The questionnaire was completed by 146 women using the WeChat platform after 3 years of follow-up. Reliability was assessed through internal consistency (Cronbach’s alpha). Construct validity was evaluated by significantly distinguished differences in symptom scores between women who did and did not subjectively suffer bothersome symptoms. Responsiveness was evaluated in 146 women. The effect size (ES) and standardized response mean (SRM) were used to assess the degree of responsiveness. Results Of the 146 women, all completed the questionnaire through the WeChat platform without missing any items. Reliability, Cronbach’s alpha for the four domains and total APFQ were: bladder function 0.78, bowel function 0.71, pelvic organ prolapse 0.78, sexual function 0.68 and total APFQ 0.84. Concerning construct validity, the APFQ significantly distinguished the symptom scores between women who did and did not subjectively suffer from bothersome symptoms, and the score difference was 1.1–1.6 points, 1.2 points, 2.0–3.7 points and 1.4 points, respectively. For responsiveness, three domains showed slight (bowel domain) to moderate (bladder domain, sex domain) sensitivity to change. ES and SRM ranged from 0.21 to 0.75 and 0.16 to 0.60, respectively. Conclusions The Chinese version of the self-administered APFQ is reliable and valid and can monitor the changes in symptoms over time.

Spanish cross-cultural adaptation and validation of the Australian Pelvic Floor Questionnaire in running women

“…The internal consistency in the APFQ-Sp showed a Cronbach's α of 0.972, and, in the sub-scales, it ranged between Cronbach's α = 0.828 (sexual activity section) and 0.935 (urinary tract section) (Table 3 ). These values are slightly higher than those observed in the Arabic (0.877) 21 , Chinese (0.83–0.89) 20 , 40 , Serbian (0.822–0.846) 19 , Turkish (0.733–0.858) 22 and original version (0.74–1.00) 18 , although all except one dimension from the Turkish version and one from the original version are considered to have excellent internal consistency 36 .…”

“…When the test–retest values are compared, since the APFQ-Sp has ICC values that range between 0.596 and 0.960 (Table 3 ), it is observed that they are consistent with the Arabic version 21 , which presents ICC values: 0.500–0.833. However, these values are slightly lower than those observed in the Serbian (ICC: 0.896–0.944) 19 , Turkish (ICC: 0.876–0.954) 22 , and original version (ICC: 0.74–1.0) 18 , and greater than some dimensions of the Chinese version (ICC: 0.22–0.88) 20 , 40 .…”

“…In addition to the original version of the APFQ 18 , other versions of the APFQ have been published, such as the Turkish 22 , Chinese 20 , 40 , Arabic 21 , Serbian 19 and German 41 versions. Both the translation from the original version to the Spanish version and the back-translation were carried out by native translators to guarantee the equivalence of the terms between both versions, which facilitates its use among researchers and clinician Spanish speakers.…”

“…The main strength is that it allows the APFQ to be adapted into Spanish, the second most widely spoken language in the world and one of the five official languages of the UN. On the one hand, this cross-cultural adaptation and validation benefits the entire Spanish-speaking clinical population, and, on the other hand, the results obtained with this instrument can be compared with other population groups that have used other versions, such as the original (English) 18 , Turkish 22 , Arabic 21 , Serbian 19 and Chinese 20 , 40 versions. In addition, the cross-cultural adaptation and the subsequent validation study were carried out respecting the minimum number of subjects recommended in the literature 38 .…”