What are the concerns and goals of women attending a urogynaecology clinic? Content analysis of free-text data from an electronic pelvic floor assessment questionnaire (ePAQ-PF)

Gray, Thomas; Strickland, Scarlett; Pooranawattanakul, Sarita; Li, Weiguang; Campbell, Patrick; Jones, Georgina; Radley, Stephen

doi:10.1007/s00192-018-3697-0

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…This follows, as scarring would be most relevant to patients following surgical intervention or perineal trauma, whereas ePAQ-PF is mostly completed by new referrals to clinic. Previous content analysis of ePAQ-PF free-text responses reports that 16.3% were concerned about smell and only 6.9% about scarring [14]. Comparing these figures to our results (Table 1) suggests that inclusion of these body-image items has increased symptom disclosure, highlighting the value of questionnaire interviewing in this context.…”

Section: Discussionsupporting

confidence: 71%

“…A previous content analysis study of responses to the free-text item in ePAQ-PF, which asks patients 'Considering the issues that currently concern you the most, what do you hope to achieve from any help, advice or treatment? ', assessed responses from almost two thousand urogynaecology clinic patients and found that 11% of patients reported bodyimage concerns via the free text item [14]. Body image is not currently assessed by ePAQ-PF in any of its 19 symptom domain areas which use multiple choice questions assessing frequency and impact of symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor)

et al. 2020

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Introduction Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient reported outcome measure used in clinical practice to assess urogynaecological symptoms and their impact on quality-of-life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF. Methods A patient involvement group, analysis of free-text data from ePAQ-PF and a systematic review of available PROMs to assess urogynaecological body image informed the content of a new body image domain within ePAQ-PF. Data collected from 208 patients who consented to the use of their anonymised ePAQ-PF responses for research purposes underwent factor analysis, internal consistency reliability and item-total correlation testing. Data from previous studies were used to formulate hypotheses to test construct validity. Criterion validity was assessed against the Body-image Scale (BIS). Patients completed a separate questionnaire (QQ-11) to measure face validity of ePAQ-PF. Results Factor analysis revealed a 4-item body-image domain with good internal consistency reliability (Cronbach's α=0.899) and item-total correlations (Spearman's rank r >0.40). ePAQ-PF body-image domain scores correlated significantly with the BIS scores (r=0.501). Age, prolapse, sexual dysfunction, pelvic pain and urinary incontinence scores correlated significantly with body image domain score. QQ-11 value scores outweighed burden scores. Conclusions Body image assessment should form part of routine care in urogynaecology. Preliminary results support validity, reliability and functionality of ePAQ-PF incorporating the new body image domain. Further psychometric testing of this is required, including tests of responsiveness and stability.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor)

et al. 2020

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“…Women with pelvic floor disorders were also more likely to seek care when the adverse impact on the quality of life was greater [2]. Concerns of affected women varied from worrying about body image like appearance and smell to improving sexual function, reducing pad use and becoming more physically active [6]. Research on patients goal achievement of treatment highlighted that many women preferred to be dry but would not mind if the incontinence only improves to be able to manage their daily activities [6].…”

mentioning

confidence: 99%

“…Concerns of affected women varied from worrying about body image like appearance and smell to improving sexual function, reducing pad use and becoming more physically active [6]. Research on patients goal achievement of treatment highlighted that many women preferred to be dry but would not mind if the incontinence only improves to be able to manage their daily activities [6]. Interestingly, those studies described similar patient concerns and goals despite being reported from different countries.…”

mentioning

confidence: 99%

“…Current urogynecological practice is changing to respond to patient demands for scientific information about their symptoms, possible diagnoses and treatment options. In fact, most women with pelvic floor disorders will accept surgical intervention and welcome comprehensive clinical assessment provided that they understand the underlying pathology and receive explanation of the available treatment modalities [6]. Patient decision aids (PDA) are a very useful tool in this context [9].…”

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confidence: 99%

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Factors influencing patient decision making in Urogynaecology: You are what you know

Baeßler¹,

Rizk

2020

Int Urogynecol J

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In a recent professional conversation, a gynecological oncologist colleague exclaimed "You poor urogynaecologists! You do not know which single operation is the best because there are too many options so patients have to be counseled for ages. After your operations, recovery of function does not necessarily follow restored anatomy so women become frequently disappointed, even more so if they have a postoperative complication for a non-life-threatening condition. In contrast, my patients are simply happy if they survive after surgery". Although this seems to be the perception of our subspecialty among the gynecological community, we usually consider it a privilege having different conservative and surgical options for the management of pelvic floor disorders that we can offer to our patients. The privilege is, however, challenging for several reasons.Over the last decade, we have learned what women with pelvic floor problems know, want and expect. We established patient-related outcome measures and later developed guidelines to include quality-of-life assessment in reporting treatment outcomes [1]. We already knew that many incontinent women do not seek help because they considered this a consequence of normal aging [2,3]. When we studied their care-seeking behavior, the influence of social, cultural, ethnic and religious factors was appreciated [4]. The majority of women perceived pelvic floor disorders as an intimate medical problem and therefore preferred to consult female health care providers [4, 5] without involving their partners or other family members [2]. In particular, patients usually preferred to receive care by a female urogynaecologist aged between 45 and 60 years with more than 10 years of experience [5]. Women with pelvic floor disorders were also more likely to seek care when the adverse impact on the quality of life was greater [2]. Concerns of affected women varied from worrying about body image like appearance and smell to improving sexual function, reducing pad use and becoming more physically active [6]. Research on patients goal achievement of treatment highlighted that many women preferred to be dry but would not mind if the incontinence only improves to be able to manage their daily activities [6]. Interestingly, those studies described similar patient concerns and goals despite being reported from different countries. We do not have enough knowledge, however, about the concerns, preferences and goals of "digital-age" younger women who have alternative information resources available on the internet, blogs and youtube [7]. This group is likely to have different information-seeking patterns and health awareness compared to the baby boomers who are our main patient population with pelvic floor disorders at present. On the other hand, the baby boomers are considered to be more proactive regarding their experience with pelvic floor disorders than the preceding generation of women as they were more conscious of youth, beauty and general appearance and wished to postpone aging [8]. As longevity...

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Italian electronic personal assessment questionnaire‐pelvic floor (I.ePAQ‐PF): Psychometric validation of the urinary section

Soligo

Stellio

Ponti

et al. 2020

Neurourology and Urodynamics

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Aim: Tools for remote clinical assessment have become increasingly important. Patient-reported outcome questionnaires are increasingly being considered as the keystones of pelvic floor disorder assessment. An innovative English language multidisciplinary electronic Personal Assessment Questionnaire (ePAQ-PF) was psychometrically validated in 2006. A certified Italian version (I.ePAQ-PF) has been recently made available by the Italian Society of Urodynamics. In this study, we aimed to test the psychometric properties to validate the urinary dimension of the I.ePAQ-PF. Methods: Women complaining of lower urinary tract symptoms were enrolled. After providing informed consent, women filled in the I.ePAQ-PF via a dedicated touch-screen display (T0), together with concurrent questionnaires: International Consultation on Incontinence Questionnaire-Short form, Urgency Severity Scale, Urogenital Distress Inventory, and Patient Global Impression of Improvement. Cronbach's α and Spearman's correlation coefficients were adopted (validity). A test-retest was performed in 47 cases (reliability), and the intraclass correlation coefficient (ICC) was analyzed. I.ePAQ-PF was also administered after treatment (T1) and compared with baseline data via a Wilcoxon's test and Cohen's effect-size tests (responsiveness). Results: Ninety-three women were included. Internal consistency was confirmed (Cronbach's α >.7). A Spearman's correlation test showed a good correlation (>0.6) between I.ePAQ-PF and conceptually similar questionnaires. I.ePAQ-PF seems to be highly reproducible in all domains (ICC >0.86). The questionnaire scored significantly differently (Wilcoxon test P < .003) in all domains after the treatment. Responsiveness was further confirmed by Cohen's effect size of more than 30%. Conclusions: The Italian ePAQ-PF (urinary domain) fully satisfies the psychometric properties of validity, reliability, and responsiveness and is ready for clinical application in Italian clinical settings.

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What are the concerns and goals of women attending a urogynaecology clinic? Content analysis of free-text data from an electronic pelvic floor assessment questionnaire (ePAQ-PF)

Cited by 8 publications

References 17 publications

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor)

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor)

Factors influencing patient decision making in Urogynaecology: You are what you know

Italian electronic personal assessment questionnaire‐pelvic floor (I.ePAQ‐PF): Psychometric validation of the urinary section

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