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  1. Sevil Hakimi1,
  2. Sakineh Hajebrahimi2,
  3. Parvin Bastani3,
  4. Elham Aminian4,
  5. Samieh Ghana5,
  6. Marzieh Mohammadi6
  1. 1Msm, PhD. Assistant Professor, Tabriz University of Medical Science, Tabriz, Iran
  2. 2MD. Professor, Tabriz University of Medical Science, Tabriz, Iran
  3. 3Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  4. 4MSm Student. Tabriz University of Medical Science, Tabriz, Iran
  5. 5MSm Student. Tabriz University of Medical Science, Tabriz, Iran
  6. 6MSm. Tabriz University of Medical Science, Tabriz, Iran.


Background and aims: The Pelvic Floor Distress Inventory (PFDI) was developed and validated to measure symptom distress and impact on Health related quality of life (RQOL), focusing on pelvic organ pelvic organ prolapse (POP), urinary incontinence (UI) and fecal incontinence (FI). The purpose of this study was assessment of translation, cultural adaptation and psychometric validation of PFDI-20 and PFIQ-7.

Methods: The study was a cross sectional research. The sampling method was multi stage sampling. Out of 33 urban health centers in Tabriz, half of them were selected randomly. In the second phase using quota sampling method from each center, middle age women who attended the health centers for giving medical care and diagnosed with PDF were included in the study.

Signs of genital prolapse were recorded during the pelvic examination in dorsal lithotomy position. Diagnosis of POP was performed according to the modified pelvic organ prolapse (POP-Q).

Inclusion criteria were menopausal women aged 45 years and older with at least one symptom of PFD including UI, FI or POP existing for at the minimum 3 last months. Exclusion criteria were previous pelvic surgery, any malignant tumor, mental retardation and dementia. UI, FI and POP were defined with using of International Continence Society criteria.

Construct validity of questionnaire was assessed by ceiling and floor effect. Ceiling or floor effects were given when more than 15% of the responses get the best or worst possible score respectively.

The questionnaires internal consistency were assessed by calculation of Cronbach's alpha. Reliability of the questionnaires was estimated by test retest reliability. The questionnaires were re-administered to 30 individuals 2 weeks after the first administration.

Results: A total of 150 women with PFD were recruited in this study. The mean age (SD) was 52.3 (4.0). Translation and cultural adaptation of PFDI-20 to Persian language had a good value with regards of meaning, idiomatic and content. The results of test- retest reliability and internal consistency were shown in Table 1.

Conclusion: The results of this study were demonstrated that Iranian version of PFDI-20 has acceptable validity and reliability.

PFDI-20Test retest reliability
Internal consistency
  • The PFIQ-7 Iranian version showed a floor effect (29.6%).

Table 1

Results of analysis for internal consistency and test- re test reliability for the PFDI-20

  • Pelvic floor disorders
  • Pelvic Floor Distress Inventory
  • translation
  • validation

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