title: Spanish translation and validation of four short pelvic floor disorders questionnaires.
abstract: OBJECTIVE
  Globally, Spanish is the primary language for 329 million people; however, most urogynecologic questionnaires are available in English. We set out to develop valid Spanish translations of the Questionnaire for Urinary Incontinence Diagnosis (QUID), the Three Incontinence Questions (3IQ), and the short Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7).
  
  
  METHODS
  The TRAPD method (translation, review, adjudication, pretesting, and documentation) was used for translation. Eight native Spanish-speaking translators developed Spanish versions collaboratively. These were pretested with cognitive interviews and revised until optimal. For validation, bilingual patients at seven clinics completed Spanish and English questionnaire versions in randomized order. Participants completed a second set of questionnaires later. The Spanish versions' internal consistency and reliability and Spanish-English agreement were measured using Cronbach's alpha, weighted kappa, and intraclass correlation coefficients.
  
  
  RESULTS
  A total of 78 subjects were included; 94.9 % self-identified as Hispanic and 73.1 % spoke Spanish as their primary language. The proportion of per-item missing responses was similar in both languages (median 1.3 %). Internal consistency for Spanish PFDI-20 subscales was acceptable to good and for PFIQ-7 and QUID excellent. Test-retest reliability per item was moderate to near perfect for PFDI-20, substantial to near perfect for PFIQ-7 and 3IQ, and substantial for QUID. Spanish-English agreement for individual items was substantial to near perfect for all questionnaires (kappa range 0.64-0.95) and agreement for PFDI-20, PFIQ-7, and QUID subscales scores was high [intraclass correlation coefficient (ICC) range 0.92-0.99].
  
  
  CONCLUSIONS
  We obtained valid Spanish translations of the PFDI-20, PFIQ-7, QUID, and 3IQ. These results support their use as clinical and research assessment tools in Spanish-speaking populations.
authors.affiliation: Mount Sinai School of Medicine, 1176 Fifth Avenue, Box 1170, New York, NY 10029, USA. atreszezamsky@ciwh.org
authors.forename: Alejandro D
authors.initials: AD
authors.lastname: Treszezamsky
authors.forename: Deborah
authors.initials: D
authors.lastname: Karp
authors.forename: Madeline
authors.initials: M
authors.lastname: Dick-Biascoechea
authors.forename: Nazanin
authors.initials: N
authors.lastname: Ehsani
authors.forename: Christina
authors.initials: C
authors.lastname: Dancz
authors.forename: T Ignacio
authors.initials: TI
authors.lastname: Montoya
authors.forename: Cedric K
authors.initials: CK
authors.lastname: Olivera
authors.forename: Aimee L
authors.initials: AL
authors.lastname: Smith
authors.forename: Rosa
authors.initials: R
authors.lastname: Cardenas
authors.forename: Tola
authors.initials: T
authors.lastname: Fashokun
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Bradley
mesh_terms: D000328:Adult; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007843:Latin America; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014177:Translations