Transcultural adaptation and validation of the questionnaire "Urgency, Weak stream, Incomplete emptying and Nocturia (UWIN)" for the Brazilian Portuguese.

Katia S Freitas,Caroline S Silva,Cristiano M Gomes,Jose Bessa Junior,Anna Paloma R Ribeiro

doi:10.7717/peerj.9039

Katia S Freitas, Caroline S Silva + Show 3 more

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https://doi.org/10.7717/peerj.9039

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Abstract

Lower urinary tract symptoms (LUTS) are common complaints in the adult male population and have a negative affect in the quality of life and represent an economic burden for the healthcare system worldwide. The International Prostatism Symptom Score (IPSS) is a validated tool for assessing these symptoms, but patients with low literacy may have difficulties comprehending and completing it accurately. The Urgency, Weak Stream, Incomplete Emptying, and Nocturia (UWIN) questionnaire was developed as a shorter tool in the assessment of LUTS to improve accuracy and minimize error. This study aimed at performing cross-cultural adaptation to Brazilian Portuguese and validation of UWIN questionnaire for patients with LUTS. The cross-cultural adaptation followed the steps of conceptual, item, semantic, operational, and pre-test equivalence to obtain the UWIN-Br version. The IPSS (gold standard) and UWIN-Br were coadministered, and information regarding the uroflowmetry examination was also recorded. We evaluated 306 men, median age 59 [52-66] years. There was a positive correlation r = 0.804 (p < 0.001) between the total IPSS score and the total UWIN-Br score, as well as the quality of life question (r = 0.761) (p < 0.001). The Bland-Altman plot showed good agreement between. Also, we observed that the maximum flow values decreased with the severity of the LUTS. UWIN-Br demonstrated excellent diagnostic accuracy in detecting the most severe cases. The area under the ROC curve was 89% [81–97%] 95% CI. 280 (91.5%) subjects completed the questionnaires without help, while 26 (8.5%) did so through an interview. The response time was 1.2 [1.0–1.5] min for UWIN-Br and 2.8 [2.2–3.4] min for IPSS (p < 0.001). UWIN-Br presents satisfactory and similar psychometric properties to the IPSS in the evaluation of LUTS and quality of life and is suitable for use in both clinical practice and research in our country.

Highlights

Lower urinary tract symptoms (LUTS) is a broad term that describes storage, voiding, and postmicturition symptoms, according to the definition of the International Continence Society
LUTS may be very bothersome to patients and may have a negative impact on work productivity, health-related quality of life, and social functioning (Coyne et al, 2008; Coyne et al, 2011)
The International Prostate Symptom Score (IPSS) is a validated, well-established instrument, which enables the stratification of patients according to the severity of symptoms and allows for the assessment of both responses to treatment and disease progression

Summary

Introduction

Lower urinary tract symptoms (LUTS) is a broad term that describes storage, voiding, and postmicturition symptoms, according to the definition of the International Continence Society. The prevalence of LUTS in men older than 40 years of age exceeds 60% and increases with age (Irwin et al, 2006; Coyne et al, 2009; Soler et al, 2018). The initial evaluation of men with LUTS includes history and physical examination, urinalysis, a subjective assessment with a survey of symptoms and objective tests, including uroflowmetry and measurement of postvoid residual urine volume (Gravas et al, 2015). The International Prostate Symptom Score (IPSS) is a validated, well-established instrument, which enables the stratification of patients according to the severity of symptoms and allows for the assessment of both responses to treatment and disease progression. Patients with a low education level have been demonstrated to report difficulty completing it accurately (Johnson et al, 2008)

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