Validity and reliability of the ureteral stent symptoms questionnaire to Persian language

Abstract

Introduction: Ureteral stenting is a common urological procedure. However, morbidity associated with ureteral stents has been identified as a potential health problem. A comprehensive, reliable and valid measure to evaluate health-related quality of life in patients undergoing this procedure is the Ureteral Stent Symptoms Questionnaire (USSQ). In this paper, we validate the Persian version of the USSQ in patients with a ureteral stent. Methods: Linguistic validation of the USSQ was performed through a standard process that included forward and backward translation by two translators and pilot testing. Six clinical specialists scored translated questionnaires to examine content validity. Thirty patients who underwent the ureteroscopic surgery and 20 control participants completed the Persian USSQ as well as the International Prostate Symptom Score (IPSS). Patients completed the questionnaires 1 week after stent placement and again 4 weeks after stent placement while controls completed questionnaires 2 times 3 weeks apart. Results: To assess content validity, content validity index for items and modified Kappa was > 0.81 for the entire scale. Internal consistency using Cronbach’s alpha was > 0.78. Test-retest reliability (Kendall’s tau coefficient > 0.7) was satisfactory for urinary symptoms, general health, sexual matters, work performance and additional problem domains. Convergent validity was 0.71 for urinary symptoms and IPSS. Discriminant validity between cases and controls was meaningful. Conclusion: The Persian version of the USSQ is a reliable and valid instrument that can be self-administered by patients with indwelling ureteral stent in clinical and research settings.