Development and initial validation of a Swedish inventory to screen for symptoms of deficient perineum in women after vaginal childbirth: 'Karolinska Symptoms After Perineal Tear Inventory'.

Assessment Design Disorder Patient outcome Pelvic floor Perineum, care Physiological Postpartum Psychometrics Questionnaire Sexual dysfunction

Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
13 Aug 2022
Historique:
received: 18 05 2022
accepted: 03 08 2022
entrez: 13 8 2022
pubmed: 14 8 2022
medline: 17 8 2022
Statut: epublish

Résumé

Perineal tears are common after vaginal birth and may result in pelvic floor symptoms. However, there is no validated questionnaire that addresses long-term symptoms in women with a deficient perineum after vaginal birth. Thus, the objective of this study was to develop and psychometrically evaluate a clinical screening inventory that estimates subjective symptoms in women with a deficient perineum more than one year after vaginal delivery. The development and psychometric evaluation employed both qualitative and quantitative methods. Qualitative strategies involved content validity and Think Aloud protocol for generation of items. The psychometric evaluation employed principal component analysis to reduce the number of items. The inventory was completed by women with persistent symptoms after perineal tears (N = 170). Results were compared to those of primiparous women giving birth by caesarean section (N = 54) and nulliparous women (N = 338). A preliminary 41-item inventory was developed, and the psychometric evaluation resulted in a final 11-item inventory. Women with confirmed deficient perineum after perineal trauma scored significantly higher on the symptoms inventory than women in control groups. A cut-off value of ≥ 8 could distinguish patients from controls with high sensitivity (100%) and specificity (87-91%). The Karolinska Symptoms After Perineal Tear Inventory, is a psychometrically valid 11-item patient-reported outcome measure for symptoms of deficient perineum more than one year after vaginal birth. More research is needed to validate the inventory in various patient populations as well as its use in pelvic floor interventions. The inventory has the potential to improve patient counseling and care in the future.

Sections du résumé

BACKGROUND BACKGROUND
Perineal tears are common after vaginal birth and may result in pelvic floor symptoms. However, there is no validated questionnaire that addresses long-term symptoms in women with a deficient perineum after vaginal birth. Thus, the objective of this study was to develop and psychometrically evaluate a clinical screening inventory that estimates subjective symptoms in women with a deficient perineum more than one year after vaginal delivery.
MATERIAL AND METHODS METHODS
The development and psychometric evaluation employed both qualitative and quantitative methods. Qualitative strategies involved content validity and Think Aloud protocol for generation of items. The psychometric evaluation employed principal component analysis to reduce the number of items. The inventory was completed by women with persistent symptoms after perineal tears (N = 170). Results were compared to those of primiparous women giving birth by caesarean section (N = 54) and nulliparous women (N = 338).
RESULTS RESULTS
A preliminary 41-item inventory was developed, and the psychometric evaluation resulted in a final 11-item inventory. Women with confirmed deficient perineum after perineal trauma scored significantly higher on the symptoms inventory than women in control groups. A cut-off value of ≥ 8 could distinguish patients from controls with high sensitivity (100%) and specificity (87-91%).
CONCLUSIONS CONCLUSIONS
The Karolinska Symptoms After Perineal Tear Inventory, is a psychometrically valid 11-item patient-reported outcome measure for symptoms of deficient perineum more than one year after vaginal birth. More research is needed to validate the inventory in various patient populations as well as its use in pelvic floor interventions. The inventory has the potential to improve patient counseling and care in the future.

Identifiants

pubmed: 35964017
doi: 10.1186/s12884-022-04964-w
pii: 10.1186/s12884-022-04964-w
pmc: PMC9375344
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

638

Informations de copyright

© 2022. The Author(s).

Références

J Grad Med Educ. 2013 Sep;5(3):353-6
pubmed: 24404294
Acta Obstet Gynecol Scand. 2002 Jan;81(1):44-9
pubmed: 11942886
Neurourol Urodyn. 2011 Apr;30(4):536-40
pubmed: 21351131
BMC Pregnancy Childbirth. 2013 Mar 07;13:59
pubmed: 23497085
Midwifery. 2007 Dec;23(4):392-403
pubmed: 17196714
BMJ. 1993 Nov 13;307(6914):1264-6
pubmed: 8281062
Int Urogynecol J. 2018 Mar;29(3):327-338
pubmed: 29332252
Int Urogynecol J. 2018 May;29(5):751-766
pubmed: 28756517
Int Urogynecol J. 2011 Jan;22(1):105-13
pubmed: 20798924
Int J Community Based Nurs Midwifery. 2020 Oct;8(4):311-323
pubmed: 33178854
Methods Mol Biol. 2013;930:527-47
pubmed: 23086856
Birth. 2017 Mar;44(1):86-94
pubmed: 27859542
Qual Life Res. 2000;9(8):887-900
pubmed: 11284208
Int Urogynecol J. 2021 Jul;32(7):1695-1706
pubmed: 34143238
J Caring Sci. 2015 Jun 01;4(2):165-78
pubmed: 26161370
J Clin Epidemiol. 2005 Jan;58(1):41-6
pubmed: 15649669
Int Urogynecol J. 2018 Aug;29(8):1093-1099
pubmed: 29508043
Int J Womens Health. 2018 Aug 08;10:409-424
pubmed: 30123009
Int Urogynecol J. 2021 Jul;32(7):1825-1832
pubmed: 33646348
Am J Obstet Gynecol. 2001 Mar;184(4):552-8
pubmed: 11262452
Qual Life Res. 1993 Dec;2(6):441-9
pubmed: 8161978
J Clin Epidemiol. 2003 May;56(5):395-407
pubmed: 12812812
Scand J Caring Sci. 2013 Jun;27(2):406-13
pubmed: 22924517
Int Urogynecol J. 2015 Jan;26(1):29-32
pubmed: 25315175
Oncol Nurs Forum. 2005 May 10;32(3):669-76
pubmed: 15897941
BMC Womens Health. 2019 Oct 29;19(1):129
pubmed: 31664987
Sci Rep. 2021 Jun 15;11(1):12560
pubmed: 34131194
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Apr;18(4):461-5
pubmed: 17120170

Auteurs

Emilia Rotstein (E)

Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. Emilia.rotstein@ki.se.
Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden. Emilia.rotstein@ki.se.

Philip von Rosen (P)

Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.

Sofie Karlström (S)

Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.

Jona Elings Knutsson (JE)

Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Nina Rose (N)

Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.

Ellinore Forslin (E)

Department of Obstetrics and Gynecology, Hospital of Västmanland Västerås, Västerås, Sweden.

Per J Palmgren (PJ)

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Gunilla Tegerstedt (G)

Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.

Hedvig Engberg (H)

Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH