Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2019

Open Access 01-12-2019 | Research

Translation, transcultural adaptation, reliability and validation of the pelvic organ prolapse quality of life (P-QoL) in Amharic

Authors: Tadesse Belayneh, Abebaw Gebeyehu, Mulat Adefris, Guri Rortveit, Tinsae Genet

Published in: Health and Quality of Life Outcomes | Issue 1/2019

Login to get access

Abstract

Background

The Prolapse Quality of Life (P-QoL) is a disease-specific instrument designed to measure the health-related quality of life in women with prolapse; however, there is no Amharic version of the instrument. The aim of this study were to translate the P-QoL into Amharic and evaluate its psychometric properties among adult women.

Methods

We followed an intercultural adaptation procedure to translate and adapt the P-QoL. A forward–backward translation, face validity interviews with experts and cognitive debriefing of the translated version with ten adults from the target group were performed. The Amharic version was then completed by 230 adult women with and without POP symptoms. All women were examined using a simplified Pelvic Organ Prolapse Quantification (SPOP-Q) system. We examined internal consistency (Cronbach’s alpha) and test–retest reliability (intraclass correlation coefficient = ICC). Confirmatory factor analysis (CFA) was conducted and model fit was discussed. We extracted a new factor structure by exploratory factor analysis (EFA). Criterion validity was also assessed against the SPOP-Q stage.

Results

The translated measure was found acceptable by the experts and target group, with only minor adaptations required for the Amharic context. It had high internal consistency (α = 0.96) and test–retest reliability (ICC = 0.87; p <  0.001). In CFA results, the model fit indices were unacceptable (CFI = 0.69, RMSEA = 0.17, SRMR = 0.43, TLI = 0.65, and PCLOSE = 0.00). EFA extracted three-factor with satisfactory convergent and discriminant validity. The P-QoL median scores were significantly higher in symptomatic women (Mann-Whitney U Test; p <  0.001). The score was also significantly correlated with stage of prolapse (Spearman’s correlation coefficient = 0.42 to 0.64, p <  0.001).

Conclusions

The P-QoL scale was successfully translated to Amharic and appears feasible, reliable and valid for Amharic-speaking women. Factor analysis confirmed a three-factor structure, inconsistent with the original English version. Further studies are needed to evaluate responsiveness of the Amharic P-QoL score.
Appendix
Available only for authorised users
Literature
1.
Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, Goldman HB, Huser M, Milani AL, Moran PA, et al. An international Urogynecological association (IUGA) / international continence society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Neurourol Urodyn. 2016;35:137–68.CrossRef
2.
Walker GJ, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J. 2011;22:127–35.CrossRef
3.
Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783–90.CrossRef
4.
Megabiaw B, Adefris M, Rortveit G, Degu G, Muleta M, Blystad A, Kiserud T, Melese T, Kebede Y. Pelvic floor disorders among women in Dabat district, Northwest Ethiopia: a pilot study. Int Urogynecol J. 2013;24:1135–43.CrossRef
5.
Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J. 2011;22:1445–57.CrossRef
6.
Doaee M, Moradi-Lakeh M, Nourmohammadi A, Razavi-Ratki SK, Nojomi M. Management of pelvic organ prolapse and quality of life: a systematic review and meta-analysis. Int Urogynecol J. 2014;25:153–63.CrossRef
7.
Bowling A. Health-related quality of life: a discussion of the concept, its use and measurement. Measuring disease. 1995:1–19.
8.
Ghetti C, Lowder JL, Ellison R, Krohn MA, Moalli P. Depressive symptoms in women seeking surgery for pelvic organ prolapse. Int Urogynecol J. 2010;21:855–60.CrossRef
9.
10.
Adefris M, Abebe SM, Terefe K, Gelagay AA, Adigo A, Amare S, Lazaro D, Berhe A, Baye C. Reasons for delay in decision making and reaching health facility among obstetric fistula and pelvic organ prolapse patients in Gondar University hospital, Northwest Ethiopia. BMC women's health. 2017;17:64.CrossRef
11.
Berhane Y, Gossaye Y, Emmelin M, Hogberg U. Women's health in a rural setting in societal transition in Ethiopia. Soc Sci Med. 2001;53:1525–39.CrossRef
12.
Asresie A, Admassu E, Setegn T. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, north West Ethiopia: a case-control study. Int J Women's Health. 2016;8:713–9.CrossRef
13.
Akmel M, Segni H. Pelvic organ prolapse in Jimma university specialized hospital, Southwest Ethiopia. Ethiop J Health Sci. 2012;22:85–92.PubMedPubMedCentral
14.
Parker-Autry CY, Barber MD, Kenton K, Richter HE. Measuring outcomes in urogynecological surgery:“perspective is everything”. Int Urogynecol J. 2013;24:15–25.CrossRef
15.
Sioutis D, Reid F. Pelvic organ prolapse: anatomical and functional assessment. Obstet Gynaecol Reprod Med. 2017; 27:57-64.
16.
Al-Badr A. Quality of life questionnaires for the assessment of pelvic organ prolapse: use in clinical practice. Low Urin Tract Symptoms. 2013;5:121–8.CrossRef
17.
Barber MD, Kuchibhatla MN, Pieper CF, Bump RC. Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol. 2001;185:1388–95.CrossRef
18.
Digesu GA, Khullar V, Cardozo L, Robinson D, Salvatore S. P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. Int Urogynecol J. 2005;16:176–81.CrossRef
19.
Jones G, Radley S, Lumb J, Farkas A. Responsiveness of the electronic personal assessment questionnaire-pelvic floor (ePAQ-PF). Int Urogynecol J. 2009;20:557–64.CrossRef
20.
Cam C, Sakalli M, Ay P, Aran T, Cam M, Karateke A. Validation of the prolapse quality of life questionnaire (P-QOL) in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2007;135:132–5.CrossRef
21.
de Oliveira MS, Tamanini JT, de Aguiar Cavalcanti G. Validation of the prolapse quality-of-life questionnaire (P-QoL) in Portuguese version in Brazilian women. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:1191–202.CrossRef
22.
Lenz F, Stammer H, Brocker K, Rak M, Scherg H, Sohn C. Validation of a German version of the P-QOL questionnaire. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:641–9.CrossRef
23.
Claerhout F, Moons P, Ghesquiere S, Verguts J, De Ridder D, Deprest J. Validity, reliability and responsiveness of a Dutch version of the prolapse quality-of-life (P-QoL) questionnaire. Int Urogynecol J. 2010;21:569–78.CrossRef
24.
Manchana T, Bunyavejchevin S. Validation of the prolapse quality of life (P-QOL) questionnaire in Thai version. Int Urogynecol J. 2010;21:985–93.CrossRef
25.
Svihrova V, Digesu GA, Svihra J, Hudeckova H, Kliment J, Swift S. Validation of the Slovakian version of the P-QOL questionnaire. Int Urogynecol J. 2010;21:53–61.CrossRef
26.
Scarlato A, Souza CC, Fonseca ES, Sartori MG, Girao MJ, Castro RA. Validation, reliability, and responsiveness of prolapse quality of life questionnaire (P-QOL) in a Brazilian population. Int Urogynecol J. 2011;22:751–5.CrossRef
27.
Nojomi M, Digesu GA, Khullar V, Morovatdar N, Haghighi L, Alirezaei M, Swift S. Validation of Persian version of the prolapse quality-of-life questionnaire (P-QOL). Int Urogynecol J. 2012;23:229–33.CrossRef
28.
Flores-Espinoza C, Araya AX, Pizarro-Berdichevsky J, Santos V, Ferrer M, Garin O, Swift S, Digesu AG. Validation of the Spanish-language version of the prolapse quality of life questionnaire in Chilean women. Int Urogynecol J. 2015;26:123–30.CrossRef
29.
Brandt C, Van Rooyen C, Cronje H. Validation of the prolapse quality of life questionnaire (P-QOL): an Afrikaans version in a south African population. S Afri J Obstet Gynaecol. 2016;22:38.CrossRef
30.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.CrossRef
31.
Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, Bouter LM, De Vet HC. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 2010;10:22.CrossRef
32.
33.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–91.CrossRef
34.
Acquadro C, Conway K, Hareendran A, Aaronson N. Literature review of methods to translate health-related quality of life questionnaires for use in multinational clinical trials. Value Health. 2008;11:509–21.CrossRef
35.
Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8:94–104.CrossRef
36.
Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006;29:489–97.CrossRef
37.
Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL. Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol. 2007;109:1396–403.CrossRef
38.
Manonai J, Mouritsen L, Palma P, Contreras-Ortiz O, Korte JE, Swift S. The inter-system association between the simplified pelvic organ prolapse quantification system (S-POP) and the standard pelvic organ prolapse quantification system (POPQ) in describing pelvic organ prolapse. Int Urogynecol J. 2011;22:347–52.CrossRef
39.
Guy W. ECDEU assessment manual for psychopharmacology. Rockville (MD). National Institute of Mental Health1976;217–222. 313–331.
40.
Yalcin I, Bump RC. Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol. 2003;189:98–101.
41.
Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010;21:523–8.CrossRef
42.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, De Vet HC. 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;19:539–49.CrossRef
43.
Burns KE, Duffett M, Kho ME, Meade MO, Adhikari NK, Sinuff T, Cook DJ. A guide for the design and conduct of self-administered surveys of clinicians. Can Med Assoc J. 2008;179:245–52.CrossRef
44.
DeVon HA, Block ME, Moyle-Wright P, Ernst DM, Hayden SJ, Lazzara DJ, Savoy SM, Kostas-Polston E. A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh. 2007;39:155–64.CrossRef
45.
Clark LA, Watson D. Constructing validity: basic issues in objective scale development. Psychol Assess. 1995;7:309.CrossRef
46.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63:737–45.CrossRef
47.
Hurley AE, Scandura TA, Schriesheim CA, Brannick MT, Seers A, Vandenberg RJ, Williams LJ: Exploratory and confirmatory factor analysis: guidelines, issues, and alternatives. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior1997;18:667–683.
48.
Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;4:272.CrossRef
49.
De Winter JC, Dodou D. Factor recovery by principal axis factoring and maximum likelihood factor analysis as a function of factor pattern and sample size. J Appl Stat. 2012;39:695–710.CrossRef
50.
Hu Lt BPM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives Structural equation modeling: a multidisciplinary journal1999;6:1–55; Kline R: Principles and Practice of Structural Equation Modeling. 3rd ed. New York: Guilford Press; 2011.
51.
Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10:1–9.
52.
Osborne JW. What is rotating in exploratory factor analysis. Pract Assess Res Eval. 2015;20:1–7.
53.
Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001;33:350–57.
54.
Bartlett MS. Tests of significance in factor analysis. Br J Stat Psychol. 1950;3:77–85.CrossRef
55.
Kaiser HF. The application of electronic computers to factor analysis. Educ Psychol Meas. 1960;20:141–51.CrossRef
56.
Ledesma RD, Valero-Mora P, Macbeth G. The scree test and the number of factors: a dynamic graphics approach. Span J Psychol. 2015;18.
57.
Joseph F, Hair J, Black W, Babin B, Anderson R. Multivariate data analysis: a global perspective. 7th (global ed. United States: Prentice Hall; 2010.
58.
Hair Jr J: Black, WC, Babin, BJ Anderson, RE & Tatham, RL (2006). Multivariate data analysis.2006;6:
59.
Kline RB. Principles and practice of structural equation modeling: Methodology in the social sciences. 2005.
60.
Gaskin J, Lim J. Master validity tool: AMOS plugin. Gaskination’s StatWiki. 2016.
61.
Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use. USA: Oxford University Press; 2015.CrossRef
62.
Barber MD, Brubaker L, Nygaard I, Wheeler TL 2nd, Schaffer J, Chen Z, Spino C. Defining success after surgery for pelvic organ prolapse. Obstet Gynecol. 2009;114:600–9.CrossRef
63.
Chuang FC, Chu LC, Kung FT, Huang KH. Validation of the traditional Chinese version of the prolapse quality of life questionnaire (P-QOL) in a mandarin-speaking Taiwanese population. Taiwan J Obstet Gynecol. 2016;55:680–5.CrossRef
64.
Bland JM, Altman DG. Statistics notes: Cronbach's alpha. BMJ. 1997;314:572.CrossRef
65.
Veit-Rubin N, Digesu a, Swift S, Khullar V, Kaelin Gambirasio I, Dallenbach P, Boulvain M: validation of the French version of the P-QoL questionnaire. Eur J Obstet Gynecol Reprod Biol. 2015;192:10–16.
Metadata
Title
Translation, transcultural adaptation, reliability and validation of the pelvic organ prolapse quality of life (P-QoL) in Amharic
Authors
Tadesse Belayneh
Abebaw Gebeyehu
Mulat Adefris
Guri Rortveit
Tinsae Genet
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2019
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1079-z

Other articles of this Issue 1/2019

Health and Quality of Life Outcomes 1/2019 Go to the issue

Research

Patient-reported quality of life and hand disability in elderly patients after a traumatic hand injury – a retrospective study

Research

Mapping the medical outcomes study HIV health survey (MOS-HIV) to the EuroQoL 5 Dimension (EQ-5D-3 L) utility index

Research

The impact of patient-reported outcome (PRO) data from clinical trials: a systematic review and critical analysis

Research

Clinimetric evaluation and clinical outcomes of the Dutch version of the Chronic Ear Survey

Short report

Confirming the factor structure of a generic quality of life instrument among pre-treatment substance use disorder patients

Research

Psychometric properties of the Spanish version of the once-daily Urticaria Activity Score (UAS) in patients with chronic spontaneous urticaria managed in clinical practice (the EVALUAS study)