TRANSLATION AND VALIDATION OF THE INTERNATIONAL CONSULTATION ON INCONTINENCE QUESTIONNAIRE-VAGINAL SYMPTOMS (ICIQ-VS) IN DANISH
T. ARENHOLT1, M. GLAVIND-KRISTENSEN 2, K. GLAVIND 3;
1Center for Clinical Research/Department of Obstetrics and Gynecology, Aalborg Univ./Northern Denmark Regional Hosp., Hjôrring, Denmark, 2Dep of Obstetrics and Gynecology, Aarhus Univ. Hosp., Aarhus, Denmark, 3Aalborg Univ. Hosp., Aalborg, Denmark.
Introduction: Gynecologic examination and Pelvic Organ Prolapse Quantification (POP-Q) are strong tools in the objective assessment of Pelvic Organ Prolapse (POP). Since the objective degree of POP does not always reflect the degree of subjective symptoms, impact on sexual life and quality of life, there is a need for a robust and validated instrument to measure and quantify these factors as well. In 2006, a group under the International Continence Society (ICS) developed a validated questionnaire, the International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS), with the aim to assess vaginal symptoms related to POP and the impact on sexual life and quality of life. The ICIQ-VS has never been validated in Danish.
Objective: The aim of the study was to translate the ICIQ-VS into Danish and test reliability, validity and sensitivity.
Methods: The ICIQ-VS is composed of 14 questions - 9 regarding vaginal symptoms, 4 on sexual life and one on quality of life. Every question is designed to register both information on the frequency of a given symptom and the subjective experience of bother. The Vaginal Symptom Score (VSS) ranges from 0 to 53, the Sexual Matter Score (SMS) from 0 to 58 and Quality of Life Score (QoL) from 0 to 10. The score 0 reflects no symptoms and no experience of bother. The English version of the questionnaire was translated into Danish according to international guidelines. Women with and without genital prolapse completed the ICIQ-VS questionnaire and demographic data (age, BMI, number of vaginal births and cesarean sections) was collected along with POP-Q data. A retest of the ICIQ-VS was performed 2-3 weeks after the initial test. Women undergoing prolapse surgery also completed the questionnaire 3 months postoperatively.
Results: Initially seven women underwent a semi-structured interview showing no misunderstandings of the Danish questionnaire. In all, 192 women (94 with and 98 without prolapse) were included in the study, whereof 52 underwent prolapse surgery. Retest response rate was 88-95%. Mean time between test and retest was 28.4 days and from surgery to retest 94.2 days. Test/retest reliability was good to excellent (ICC 0.63-0.90) and internal consistency was acceptable (Cronbach’s alfa 0.785-0.842). Missing data ranged from 0 to 1%. The questionnaire was perfect at distinguishing between women with and without prolapse (p<0.001) (Figure 1). Criterion validity (correlation between POP-Q stage and the questionnaire) was perfect (p<0.001). Sensitivity to change (before and after surgery) was excellent for vaginal symptom score and quality of life (p<0.001) but not for sexual matters (p=0.059) (Table 1).
Conclusions: The Danish version of ICIQ-VS was successfully translated and with excellent reliability, validity and sensitivity. The questionnaire can be a valuable tool in Danish prolapse research and in daily clinical evaluation of patients.
Sensitivity to change. Values before and three months after surgery.
Wilcoxon signed rank test (p-value)