Abstract
BackgroundThe 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.MethodsWe 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.ResultsThe 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).ConclusionsThe 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.
Highlights
The Prolapse Quality of Life (P-QoL) is a disease-specific instrument designed to measure the healthrelated quality of life in women with prolapse; there is no Amharic version of the instrument
The items were attributed to 9 domains that were transformed into a scale of 0 = excellent to 100 = poor: General Health Perception (GHP, one item: 1), Prolapse Impact (PI, one item: 2), Role Limitation (RL, two items: 3–4), Physical Limitation (PL, two items: 5–6), Social Limitation (SL, two items: 7–8), Personal Relationships (PR, three items: 9–11), Emotions (E, three items: 12–14), Sleep/Energy (SE, two items: 15–16), and Severity Measurement (SM, four items:17–20)
223 women were enrolled in the final analysis, giving a response rate of 97%
Summary
The Prolapse Quality of Life (P-QoL) is a disease-specific instrument designed to measure the healthrelated quality of life in women with prolapse; there is no Amharic version of the instrument. Severity and impact of POP symptoms on HRQoL are important outcome measure in the management of POP as it reveal important aspects of the patient’s subjective experience [6, 14]. To this end, measuring HRQoL requires the use of a valid and reliable questionnaire. A review by Al-Badr [16], identified four instruments designed or adapted to evaluate HRQoL in women with POP: the Pelvic Floor Distress Inventory (PFDI), the Pelvic Floor Impact Questionnaire (PFIQ) [17], the Prolapse Quality of Life (P-QoL) [18] and the electronic Personal Assessment Questionnaire Pelvic Floor (ePAQ-PF) [19]
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