title: Cultural adaptation and validation of the Wexner scale in patients with anal incontinence in a Brazilian population.
abstract: OBJECTIVE
  Jorge and Wexner devised a questionnaire for anal incontinence (AI), known as the Wexner scale (WS). Specific validated questionnaires are essential for the assessment of symptom severity. The objective was to accomplish the cultural adaptation and validation of the Portuguese version of the WS.
  
  
  METHODS
  The WS was validated according to the international criteria. A Brazilian version was tested, including the item "I do not understand" at the end of each question. If this answer was reported at a rate higher than 15 %, the item would be considered difficult to understand and would thus be modified. The final version of the WS and the Fecal Incontinence Quality of Life (FIQL) were completed by 50 women. Convergent validity was assessed by comparing the data from the first interview of the WS with the FIQL using Spearman's test. Reproducibility was assessed by means of a 2-week test-retest procedure using Cronbach's alpha coefficient.
  
  
  RESULTS
  In the initial version of the questionnaire, we did not obtain a response of "I do not understand" at a rate greater than 15 % and this version was considered definitive. A significant negative relationship (r = -0.63) was found between the FIQL total score and the WS. The answers obtained on the "test-re-est" questionnaires showed a significant correlation according to the intraclass correlation coefficient (ICC). A high level of internal consistency was found, as demonstrated by a Cronbach's alpha of 0.932.
  
  
  CONCLUSIONS
  The Brazilian Portuguese version of the WS is a reliable, consistent, and valid instrument.
authors.affiliation: Section of Urogynecology, Department of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190 CEP, 30130100, Belo Horizonte, MG, Brazil. andreamrmf@gmail.com.
authors.forename: Andrea Moura
authors.initials: AM
authors.lastname: Fonseca
authors.affiliation: Section of Urogynecology, Department of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190 CEP, 30130100, Belo Horizonte, MG, Brazil.
authors.forename: Mariana Furtado
authors.initials: MF
authors.lastname: Meinberg
authors.affiliation: Minas Gerais foundation of support research (FAPEMIG), Belo Horizonte, Brazil.
authors.forename: Débora Vianna
authors.initials: DV
authors.lastname: Lucas
authors.affiliation: Section of Urogynecology, Department of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190 CEP, 30130100, Belo Horizonte, MG, Brazil.
authors.forename: Marilene Vale
authors.initials: MV
authors.lastname: Monteiro
authors.affiliation: Section of Urogynecology, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Elyonara Mello
authors.initials: EM
authors.lastname: Figueiredo
authors.affiliation: Division of Colorectal Surgery of the Alfa Institute of Gastroenterology at the University Hospital of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Fonseca
authors.affiliation: Section of Urogynecology, Department of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190 CEP, 30130100, Belo Horizonte, MG, Brazil.
authors.forename: Agnaldo Lopes
authors.initials: AL
authors.lastname: Filho
mesh_terms: D000368:Aged; D001938:Brazil; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: Fecal incontinence; Quality of life; Validation; Wexner scale