Cross-cultural adaptation and validation of the Pelvic Floor Impact Questionnaire (PFIQ-7) short form in Urdu: a comprehensive linguistic and psychometric analysis.

Abstract

Background: Pelvic floor disorders (PFDs) affect women's physical, psychological, and social well-being, particularly in low- and middle-income countries. The PFIQ-7, a key patient-reported outcome (PROM) measure, assesses symptom severity and quality of life but lacks an Urdu adaptation. This study aims to translate, culturally adapt, and validate the PFIQ-7 for Urdu-speaking women to improve its clinical and research utility.

Methodology: This cross-sectional, observational study was conducted in two phases: Phase 1 focused on translating and culturally adapting the PFIQ-7, while Phase 2 assessed its psychometric properties. A total of 108 Urdu-literate women participated. The PFIQ-7 underwent rigorous translation following international guidelines, including forward and backward translation, consensus meetings, and pilot testing. The study evaluated reliability (Cronbach's alpha, interclass correlation) and validity (content, criterion, and construct validity) through expert review, S-POP-Q correlation, and known-group comparisons.

Results: The Urdu PFIQ-7 demonstrated excellent internal consistency (Cronbach's alpha = 0.884) and test-retest reliability (ICC = 0.995). Strong criterion validity was evidenced by significant correlations between PFIQ-7 scores and S-POP-Q findings (SCC = 0.67; p < 0.005). Construct validity was confirmed, as patients with higher S-POP-Q stages and urinary incontinence reported significantly higher PFIQ-7 scores compared to asymptomatic participants (p < 0.0005). Pilot testing confirmed the questionnaire's clarity, cultural relevance, and feasibility, with a completion time of approximately four to five minutes.

Conclusions: The Urdu PFIQ-7 is a reliable and valid tool for assessing PFD's impact on quality of life, supporting its use in clinical and research settings in Pakistan. Future research should explore its utility in rural and community-based settings to enhance generalizability.