Cross-cultural adaptation and psychometric evaluation of the Brazilian Portuguese version of the Vulvovaginal Symptoms Questionnaire.

OBJECTIVE: The aims of this study were to perform a cross-cultural adaptation of the Vulvovaginal Symptoms Questionnaire (VSQ) into Brazilian Portuguese (VSQ-Br) and evaluate its measurement properties (structural validity, construct validity, internal consistency, and reliability). METHODS: Cross-cultural adaptation was conducted through the translation, synthesis, and back-translation of the VSQ-Br. Subsequently, 314 women completed the Pelvic Floor Impact Questionnaire, Pelvic Floor Disorders Inventory, Medical Outcomes Study 36-Item Short-Form Health Survey, and VSQ-Br. Seven to 10 days later, participants completed the VSQ-Br for the second time. Data were submitted for confirmatory factor analysis. Cronbach α was used to verify internal consistency, and construct validity was assessed using Pearson correlation coefficient ( r ). Reliability was calculated using the intraclass correlation coefficient. RESULTS: Confirmatory factor analysis showed that the questions were grouped into four domains (symptoms, emotions, life impact, and sexual impact). The model showed good fit (>0.95). The Cronbach α in this study was 0.85, reflecting adequate internal consistency. Adequate reliability was confirmed, with an intraclass correlation coefficient total score of 0.80. The VSQ-Br had a weak correlation with the pelvic domain of the Pelvic Floor Disorders Inventory, the pelvic organ prolapse domain of the Pelvic Floor Impact Questionnaire, and pain, vitality, and the social aspect domains of the Medical Outcomes Study 36-Item Short-Form Health Survey. CONCLUSIONS: The VSQ-Br was validated and had acceptable measurement properties for assessing vulvovaginal symptoms in Brazilian women.

Pelvic floor dysfunction distress is correlated with quality of life, but not with muscle function.

OBJECTIVE: To analyze the relationship between the symptoms of pelvic floor dysfunction (PFD) and quality of life (QoL), as well as the function of the pelvic floor muscle (PFM) in women with urinary incontinence (UI). METHODS: A cross-sectional study conducted in two centers in Brazil (Northeast and Southeast regions) with women with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). Data on pelvic floor symptoms, discomfort and impact on QoL were collected using the Pelvic Floor Distress Inventory-short form (PFDI-SF-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) instruments. PFM function was assessed by palpation (PERFECT scale) and manometry. Pearson's correlation test, analysis of variance (ANOVA) and the Student's t test were used to discriminate the differences, adopting a significance level of 5%. RESULTS: A total of 72 women participated in the study (mean age 51.7 ± 11.9 years). The presence and discomfort of pelvic floor symptoms (PFDI-SF-20) were correlated with QoL (PFIQ-7) (r = 0.52, p < 0.001). Deficits in PFM function (power and pressure) were observed, however, there was no correlation between these with the presence and discomfort of the pelvic floor symptoms (PFDI-SF-20). CONCLUSION: Greater discomfort due to PFD symptoms were correlated with a worse QoL. However, the relationship between symptoms and PFM function was not significant. These results reinforce the need to assess the aspects of activity and participation which compose functionality and QoL, and not only the PFM functions in women with UI.

Cross-cultural adaptation to Brazilian Portuguese and assessment of the measurement properties of the Questionnaire for Urinary Incontinence Diagnosis (QUID).

OBJECTIVE: This study aimed to adapt the Questionnaire for Urinary Incontinence Diagnosis (QUID) into Brazilian Portuguese (QUID-Br) and evaluate its measurement properties, given as reliability, validity, and responsiveness in women with urinary incontinence. STUDY DESIGN: It was a methodological study which enrolled 168 women (mean age = 55.1, standard deviation = 17.9 years old). Translation and cross-cultural adaptation were done and subsequently analysis of the measurement properties of QUID-Br were tested: structural validity (by exploratory and confirmatory factory analysis) internal consistency (Cronbach's α) construct validity (Pearson Correlation), and test-retest reliability (Intraclass Correlation Coefficient). RESULTS: The QUID-Br two-factor was confirmed showing two domains with three items each: stress urinary incontinence (SUI) and urge urinary incontinence (UUI). Furthermore, QUID-Br showed acceptable internal consistency for both scales (Cronbach's α > 0.70), reliability [intraclass correlation coefficient (ICC = 0.85 for SUI and 0.87 for UUI)] with 95 % confidence interval (CI) and construct validity - with all the hypothesis raised a priori being confirmed. CONCLUSIONS: The results of the present investigation showed that the QUID-Br is a valid, reliable, and consistent instrument to be administered to Brazilian women and its use is recommended in clinical practice and research.

Responsiveness of Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) after pelvic floor muscle training in women with stress and mixed urinary incontinence.

OBJECTIVE: To evaluate the responsiveness of Brazilian-Portuguese version of Pelvic Floor Distress Inventory-20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) after pelvic floor muscle training (PFMT) in women with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). STUDY DESIGN: This is an observational study with 72 women (51.8 ± 11.9SD years) with SUI (n = 33) and MUI (n = 39). Participants answered PFDI-20 and PFIQ-7 before and after PFMT, which consisted of a 12 weeks protocol supervised by a physiotherapist once a week with 30 min of a duration. Wilcoxon test, effect size (ES) and standardized response mean (SRM) were performed on baseline and after three months. RESULTS: We found a significant reduction in PFDI-20 and PFIQ-7 after PFMT (p < 0.001), except for Pelvic Organ Prolapses Distress Inventory (POPDI-16), Colorectal-Anal Impact Questionnaire (CRAIQ-7) and Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7). The responsiveness of both questionnaires was considered moderate for PFDI-20 (ES = 0.49; SEM = 0.61; p < 0.0001) and PFIQ-7 (ES = 0.51; SEM = 0.52; p < 0.0001). CONCLUSIONS: PFDI-20 and PFIQ-7 Brazilian Portuguese version presented moderate responsiveness in women with SUI and MUI who performed a PFMT.