Reliability And Validity Of The Chinese Version Of The Self-administered Australian Pelvic Floor Questionnaire For Female Pelvic Floor Disorders And Application In Maternal Population

Objective: Cultural adaptation of the self-administered Australian pelvic floor questionnaire,and test its reliability,validity and responsiveness of the Australian Pelvic Floor Questionnaire in the Chinese maternal population.Methods: First,the questionnaire was finished by two-way translation back-translation method of the Brislin translation model,then five experts were selected for adjustment and review of the questionnaire,and finally 30 subjects were selected for pre-survey to determine the Chinese version of the self-administered Australian pelvic floor questionnaire.The questionnaire was applied to 316 pregnant women in the third trimester,followed up longitudinally to 2 months postpartum and 5 to 6 months postpartum,and it was reissued.The reliability,validity and responsiveness of the three measurements were analyzed.Results: Literal translation and back translation: Consult the original author's question 21 "when you get wind or flatus,can you control it or does wind leak?",learned that this question mainly evaluates "anal incontinence",so it was translated to "Do you have anal exhaust that can't be controlled?";Adjustment and review: According to the expert's suggestion,the question 7 in the questionnaire "Is your urinary stream(urine flow)weak,prolonged or slow?" was changed to "Is your urinary stream weak,and prolonged urination?",questions 23 and 24 "Do you leak watery/normal stool when you don't mean to?" to "Do you experience leakage of liquid/normal stools without you knowing it ";Pre-survey: Mainly add notes on medical terms such as bladder infection in question 12 and prolapsed items in questions 30 and 31 to facilitate the understanding and selection of pregnant women;Content validity: The total CVI of the questionnaire was 0.98,and the CVI of each item was above 0.8?1.0;Construct validity: There were significant differences in the scores of women with symptomatic distress and those without symptomatic distress in late pregnancy and two months postpartum;Reliability: The total Cronbach's alpha coefficients of the questionnaire in late pregnancy,two months postpartum and five to six months postpartum were 0.83,0.89 and 0.87,respectively,and the Cronbach's alpha coefficients of each domain were 0.64?0.75,0.62?0.82 and 0.66?0.78,and the test-retest reliability was 0.79,the test-retest reliability of each domain was 0.22?0.88;Responsiveness: The bladder function domain of the questionnaire was moderately reactive,ES=0.75,SMR=0.60,P<0.001;bowel function domain with low reactivity,ES=0.29,SMR=0.22,P<0.001;The domains of sexual function and prolapse symptoms were ES=0.19,SMR=0.14,P<0.05 and ES=0.21,SMR=0.16,P<0.05,respectively.Conclusion: The Chinese version of the self-administered Australian Pelvic Floor Questionnaire has good reliability,validity and responsiveness.It is suitable for self-assessment of symptoms of pelvic floor disorders in clinical maternal population and can longitudinally monitor the changes of symptoms.