Turkish translation of the Prolapse and Incontinence Knowledge Questionnaire: validity and reliability

Validation of the Arabic Linguistic Version of the Prolapse and Incontinence Knowledge Questionnaire

INTRODUCTION AND HYPOTHESIS

Pelvic floor disorders (PFDs), significantly impacting women's quality of life, are often underdiscussed owing to misconceptions and limited understanding of treatment options. This study is aimed at validating an Arabic version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) to assess knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) among Arabic-speaking women, addressing knowledge gaps in these areas.

METHODS

The study obtained ethical approval and followed a two-stage process, including a pilot study for preliminary validation and a larger study involving 300 participants. The PIKQ, a self-administered tool with two scales focusing on UI and POP, was translated into Arabic with cultural and linguistic adaptations. The study evaluated the reliability and validity of the Arabic PIKQ, employing Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman's rho for reliability assessments, as well as factor analysis for construct validity.

RESULTS

The Arabic PIKQ demonstrated high internal consistency (Cronbach's alpha > 0.8) and test-retest reliability (ICC > 0.79) for both the UI and the POP scales. The questionnaire also showed significant construct validity. Among the 300 participants, knowledge gaps were evident, influenced by educational and professional backgrounds. Notably, 22% reported UI and 14.7% reported pelvic organ prolapse, with less than half seeking treatment.

CONCLUSIONS

The Arabic PIKQ has been validated as a reliable tool for improving knowledge and addressing misconceptions regarding PFDs among Arabic-speaking women. The study underscores the importance of culturally sensitive educational tools in enhancing awareness and facilitating access to medical care for pelvic floor disorders.

Validation of the Hungarian version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ)

Objective

The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a self-administered, reliable and valid instrument which assess knowledge regarding urinary incontinence and pelvic organ prolapse. There is no validated Hungarian version of this questionnaire; therefore the aim of this study was to develop a reliable, valid and culturally sensitive Hungarian version of the PIKQ.

Study design

A cross-sectional study was conducted from March to October 2022 with a sample of 459 women. The PIKQ, which consists of the urinary incontinence and pelvic organ prolapse scales, was translated into Hungarian in accordance with international guidelines. The validity and reliability of the final version of the Hungarian PIKQ was evaluated using construct validity, comparison with known-groups, internal consistency and test-retest reliability.

Results

Regarding construct validity, all fit indices were found acceptable. Healthcare workers had significantly higher knowledge about urinary incontinence and pelvic organ prolapse (p < 0.001) compared to women who had not worked in a medical field. The Hungarian PIKQ had an adequate internal consistency with Cronbach alpha of 0.785 for the urinary incontinence scale and 0.826 for the pelvic organ prolapse scale. The correlation coeffcients between the test and retest was 0.931 for the urinary incontinence scale and 0.964 for the pelvic organ prolapse scale.

Conclusion

The Hungarian version of the PIKQ is a reliable and valid tool to measure the level of knowledge about urinary incontinence and pelvic organ prolapse among Hungarian speaking women.

Awareness of urinary incontinence in pregnant women as a neglected issue: a cross-sectional study

Background

Pregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context.

Methods

This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS).

Results

The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00).

Conclusions

The results showed that although UI is prevalent during pregnancy, pregnant women's knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women's awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits.

Knowledge of Pelvic Floor Dysfunction in African American and Afro-Caribbean Women Seeking Medical Care in a Primary Care Ambulatory Setting

IMPORTANCE

Approximately one fourth of U.S. community-dwelling women will develop a pelvic floor dysfunction (PFD) within their lifetimes. Prior research has revealed that knowledge of PFD was low to moderate in the general population and lower among Black patients.

OBJECTIVE

This study aimed to assess the proficiency of urinary incontinence and pelvic organ prolapse (POP) in self-identified African American and Afro-Caribbean adult (age ≥ 18 years) female patients seeking medical care in our ambulatory setting.

STUDY DESIGN

In this cross-sectional study, we administered the Prolapse and Incontinence Knowledge Questionnaire to patients in primary care and gynecology ambulatory settings at an academic medical center in Central Brooklyn. We used a multivariable Poisson regression model to find characteristics of the participants that are associated with proficiency in Prolapse and Incontinence Knowledge Questionnaire domains.

RESULTS

A total of 266 survey participants self-identified as African American or Afro-Caribbean. Overall, using a multivariable model, knowledge of POP was significantly higher among African Americans than Afro-Caribbeans, and 75.5% of our patients reported that they would seek information on urinary incontinence and POP from a medical provider (gynecologist or primary care doctor) compared with other alternatives (eg, internet, 19.6%).

CONCLUSIONS

These findings highlight subgroups that could benefit from provider-initiated education regarding PFD. Furthermore, although Black patients are often homogenized in research studies, differences may exist within subgroups likely because of varying interplays of structural racism and other social determinants of health, which may serve as an area of future research.

Pelvic floor dysfunction symptoms and knowledge level in obese women

This study compared the pelvic floor dysfunction (PFD) symptoms and knowledge levels in obese and non-obese women. The study included 40 obese and 41 non-obese women. The presence of PFD and the severity of its symptoms were questioned with the Pelvic Floor Distress Inventory-20 (PFDI-20) (its sub-scales: Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Colorectal-Anal Distress Inventory-8 (CRADI-8), Urinary Distress Inventory-6 (UDI-6)). Participants' PFD knowledge levels were evaluated with the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and the Anal Incontinence Knowledge Questionnaire (AIKQ). The rates of urinary incontinence (UI) and pelvic organ prolapse (POP) symptoms were higher in the obese group compared to the control group (p = .001). The POPDI-6, CRADI-8, UDI-6, and PFDI-20 scores were higher in the obese group compared to the control group (p < .001). Moreover, the knowledge level related to treatment methods for PFD was lower in the obese women compared to the non-obese women (p < .05). PFD symptom incidence and severity were higher and knowledge levels related to PFD were lower in the obese women compared to the non-obese women. Informative teaching programs on this issue would be beneficial as part of preventive health services.

Validation of the hebrew version of the prolapse and incontinence knowledge questionnaire (PIKQ) during pregnancy

INTRODUCTION AND HYPOTHESIS

Pregnancy and delivery have a major effect on pelvic floor disorders. Assessing knowledge regarding pelvic floor disorders in childbearing age women and appropriate interventions will enable women to seek appropriate medical advice once pelvic floor disorders have developed. The purpose of this study was to validate the prolapse and incontinence knowledge questionnaire in the Hebrew language.

METHODS

Translation of the prolapse and incontinence knowledge questionnaire to the Hebrew language according to international recommended guidelines. A study was conducted to validate the questionnaire. The study took place between June to September 2020 in a tertiary medical center in Israel. A total of 240 third trimester pregnant women completed the Hebrew version of the prolapse and incontinence knowledge questionnaire. Construct validity, criterion validity and reliability tests were performed.

RESULTS

Factor analysis of the Hebrew version of the prolapse and incontinence knowledge questionnaire demonstrated 12 strong positive factor loadings to one principal factor in the prolapse and incontinence knowledge questionnaire-pelvic organ prolapse domain (FL > 0.3) and 10/12 in the prolapse and incontinence knowledge questionnaire-urinary incontinence domain. The Hebrew prolapse and incontinence knowledge questionnaire was found to have internal consistency, with Cronbach alpha coefficient of 0.745 for the urinary incontinence domain and 0.796 for the pelvic organ prolapse domain.

CONCLUSIONS

The Hebrew version of the prolapse and incontinence knowledge questionnaire is a new, reliable, consistent, and valid instrument to examine the level of knowledge regarding pelvic floor disorders in Hebrew-speaking pregnant women.

Validation of the Thai version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ)

Introduction and hypothesis

The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) was developed and validated to assess women’s knowledge regarding etiology, diagnosis and treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). We aimed to translate and validate a Thai version of the PIKQ to use as a tool to evaluate knowledge of POP and UI among Thai-speaking women.

Methods

The English PIKQ, which comprises the PIKQ-POP and PIKQ-UI sections, was translated into Thai. Psychometric properties of the final version of the Thai PIKQ were tested for content validity, construct validity, internal consistency and test-retest reliability among 168 women attending a gynecology clinic and 150 nurses.

Results

Regarding content validity of the final Thai PIKQ, the number of missing items was 0. Participants in the nurse group were more likely than those in the patient group to select the correct answer for all items for the POP scale and UI scale (P < 0.001). For internal consistency testing, Cronbach’s alpha coefficient was 0.745 for the PIKQ-POP and 0.754 for the PIKQ-UI scales, suggesting that the items had relatively high internal consistency. The item-total correlation values ranged from 0.204 to 0.539, showing an adequate correlation of each item with the scale overall. The correlation coefficients between the test and retest for PIKQ-POP and PIKQ-UI were 0.685 and 0.735, respectively (P < 0.001).

Conclusions

The Thai PIKQ is a simple instrument which shows good validity and high reliability and could be a useful tool for assessing knowledge regarding POP and UI in clinical practice.

Do community-dwelling pregnant women know about pelvic floor disorder?

Our study aimed to assess the knowledge and awareness regarding pelvic floor disorders (PFDs) among pregnant women. We additionally evaluated whether the knowledge of PFDs was different in relation to gestational age, parity, the attendance to an antenatal education (ANE), and history of urinary incontinence (UI) and/or pelvic organ prolapse (POP). A cross-sectional descriptive study was conducted in pregnant women from all trimesters of pregnancy. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and three questions were used for knowledge and awareness. Two hundred and forty-one women participated in the study. Of them, 18.6% (n = 46) and 3.6% (n = 9) had UI and POP, respectively. The median of the PIKQ-UI and the PIKQ-POP scores were 6 (min-max: 0-11) and 5 (min-max: 0-12), respectively. The median PIKQ-UI and PIKQ-POP scores were higher in women who had attended ANE. There was no significant difference in terms of gestational age, parity, the attendance to ANE, and the history of pelvic floor disorder (p > .05). Knowledge and awareness were low among the women in all trimesters. Education programs involving pelvic floor training should be organized for pregnant women.