Development and measurement properties of a new questionnaire to assess women's knowledge and self-perception of their pelvic floor

To develop, validate the content and measurement properties of a new questionnaire to assess women's knowledge and self-perception about their pelvic floor muscles (PFM).

The study was developed following the recommendations Consensus based Standards for the selection of Health Measurement Instruments (COSMIN) and followed 5 steps: 1. definition of the constructs, 2. construction of the conceptual model, 3. emerging of the content, 4. validation of content between the target population and professionals with assessment of the  relevance, comprehension, and comprehensiveness of the items, answer options and instructions and 5. assess their measurement properties. The construct validity (structural validity and hypothesis testing), internal consistency (cronbach’s alpha), test-retest reliability (ICC) and measurement error for construct validity were analyzed. To assess structural validity, we used a  confirmatory factor analysis. 

After a literature review, the constructs' knowledge and self- perception about the PFM were defined.  The conceptual model was developed covering pelvic floor anatomy, PFM function, PFM dysfunctions, conservative and non-conservative treatment options for PFM dysfunctions. The content emerged from nine qualitative individual semi-structured interviews carried out with a heterogeneous sample of women.  The content validation started with the target population of the study through nine cognitive interviews and content validation among professionals with twelve individual interviews. After content validity was carried  the pre-final questionnaire was shown to be comprehensive, relevant and comprehensive about its items, answer options, and instructions.  The hypothesis testing confirmed 80% of the hypotheses proposed. Construct validity is considered suitable.  

The ICCs and Cronbach’s α indicated acceptable reliability for the scores of the domains anatomy and function PFM, ICC = .80 [95%IC = .73–.385, α = .79 and SDC = 1.79; symptoms of PF dysfunctions, ICC = .76 [95%IC = .67–.83], α = .73 and SDC = 2.45; treatment of PF dysfunctions,  ICC = .83 [95%IC = .77–.88, α = .78 and SDC = 1.69; perception of contraction of PFM, ICC = .76 [95%IC = .67–.83, α = .93 and SDC = 6.36;  and perception of relaxation of PFM, ICC = .73 [95%IC = .63–.8o, α = .70 and SDC = 1.78. 

The final version of the questionnaire contains 27 statements, divided into 4 domains: PFM anatomy and function, PFM dysfunction symptoms, PFM dysfunction treatment, PFM perception.

The final version of this new questionnaire  to assess women's knowledge and self-perception of PF was developed and had it´s measurement properties tested.  

This new self reported questionnaire to assess women's knowledge and self-perception about their pelvic floor  is ready to  be used in clinical practice and  as an outcome measure in  Brazilian Portuguese.