Hypothesis / aims of study
Vaginal symptoms affect many women and can be attributed to pelvic organ prolapse, urinary incontinence, fecal incontinence, voiding dysfunction or defecatory dysfunction. These symptoms can negatively impact women’s quality of life, causing physical, social, psychological, occupational and sexual limitations. Besides the suffering, most women do not report their symptoms to health professionals, which leads to a delay in the investigation and resolution of symptoms. The ICIQ-VS was designed as a tool to assess vaginal symptoms, sexual function and quality of life [1]. Giving the high prevalence of vaginal symptoms among women of this study aims to translate and culturally adapt the ICIQ-VS.
Study design, materials and methods
This study is a translation and a cross-cultural adaptation of the ICQ-VS questionnaire. The ICIQ-VS is an original British English questionnaire, self-administered, consisting of 14 items, scored in function of three domains: vaginal symptoms, sexual subjects and quality of life. The discomfort domain is not incorporated into the overall score, but is a reference regarding the impact of symptoms on woman's life [1]. The present study was carried out following the guidelines proposed by Beaton [2], which is based on five stages: translation, synthesis, back-translation, review by the expert committee and pre-test. The translators were Brazilian natives fluent speakers on English and Portuguese languages. Their translations were synthesized by consensus to reach a single version of the items which was sent to two native English speakers fluent on Portuguese and blind in relation to the original questionnaire. All versions were sent to an expert committee composed by the two translators, the two back-translators, three health professionals, one linguist and one methodologist. The committee discussed each item of instrument to guarantee a clear final version, equivalent to the original one, in semantic, idiomatic, cultural and conceptual terms, with the possibility of eliminating items from the instruments. For the last stage, women over 18 years old were recruited to answer the online version of the translated questionnaire, through Google Forms. Afterwards, a structured interview by video call was carried out. It was based on 14 questions about the understanding of each ICIQ-VS question and the level of complexity to understand and answer them. Participants rated, the occurrence of any word or term, difficult to understand, the clarity of each item and instructions. If there was a refusal to answer a question, the existence of a category of answer that was not clear, it was inappropriate or inadequate to allow the woman to express what she felt and if the participant would like to make any comments about the experience of answering the questionnaire
Results
Ten women accepted to participate in the study. The average age of the participants was 34,8 years old and the majority of the sample was married (83.3%) with postgraduate (75%). The participants evaluated the questionnaire as: easy to understand (100%), without the presence of unknown words / terms (100%) and believed that the items and instructions were clear (100%). There was no refusal to answer any question, for all participants the categories of responses allowed them to express what they felt and, finally, no change in the questionnaire was suggested.
Interpretation of results
The translated and cross-culturally adapted Brazilian Portuguese version of the ICIQ-VS questionnaire proved to be clear and easy to understand by the sample of women considered for the pre-test phase. Thus, no need for modifications was identified at this stage.