Reliability and validity of the Tigrigna version of the Pelvic Floor Distress Inventory–Short Form 20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7)

Introduction and hypothesis: This study adapted the Pelvic Floor Distress Inventory–Short Form 20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) into the Tigrigna language of northern Ethiopia and validated the their reliability and validity through patient interviews. Methods: Expert translation, cognitive interviewing, and patient interviews using translated questionnaires were conducted. A subset of women was reinterviewed 1 week later. Intraclass correlation coefficients (ICC), Bland–Altman analysis, and Cronbach’s alpha values were assessed. Total and subscale scores were compared between women with and without pelvic floor disorders (PFDs) using the Mann–Whitney U test. Spearman’s correlation coefficients were used to compare severity of pelvic organ prolapse (POP) stage according to the POP Quantification (POP-Q) system and PFDI-20 and PFIQ-7 and subscale scores. Results: Ten women participated in cognitive interviewing and 118 age 49 ± 10 years, mean ± standard deviation (SD) with and without PFDs were interviewed using the translated questionnaires, both of which presented adequate face validity and test–retest reliability [intraclass correlation coefficient (ICC) 0.765–0.969, p < 0.001]. Construct validity was significant between clinical symptoms and full forms (p <0.001) and their subscales (p <0.001), except for the Pelvic Organ Prolapse Impact Questionnaire (POPIQ). Differences between first and second scores on total PFDI-20 and PFIQ-7 and subscales largely fell within 0 ± 1.96 SD. Cronbach’s alpha values were 0.891–0.930 for PFDI-20 and 0.909–0.956 for PFIQ-7 (p < 0.001). Analysis of known groups showed differences PFDI-20 and PFIQ-7 scores between women with and without PFDs (p <0.001 for full forms and subscales, except for anal incontinence (AI) and the Urinary Impact Questionnaire (UIQ)/POPIQ. Conclusion: The translated Tigrigna versions of the PFDI-20 and PFIQ-7 questionnaires are reliable, valid, and feasible tools to evaluate symptoms and quality of life (QoL) of Tigrigna-speaking Ethiopian women with PFDs.