Journal of Clinical and Diagnostic Research. 2018 May, Vol-12(5): QC15-QC18 15 15 DOI: 10.7860/JCDR/2018/34315.11538 Original Article Obstetrics and Gynaecology Section Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6): Translation and Psychometric Validation of the Iranian Version INTRODUCTION Urinary Incontinence (UI) is a common health, physical, and social problem in the world, which affects all ages, groups, and communities with high prevalence [1,2]. Although not life threatening, UI affects psychological, social, familial, occupational, physical, and sexual aspects of life, often leading to anxiety, shame, and isolation [3-7]. Epidemiological studies have shown that UI signifcantly affects the quality of life [8-11]. Health-related quality of life is a broad and multidimensional concept that cites the overall health of a person, including physical, social, and emotional health and can be assessed from both an objective and a subjective view [12]. Disorders of the quality of life can lead to anxiety problems. However, UI may affect individuals in different ways. Quality of life is one of the most important outcome measures while assessing the burden of the disease and response to therapy. A valid and reliable questionnaire is key to any investigation of the association between UI and the quality of life [13]. Today, measuring the impacts of symptoms severity on the quality of life has become widespread, and the use of questionnaires by researchers and clinicians continues to increase. Several useful questionnaires have been used to assess the quality of life of patients with UI. Although these are valuable for assessing the quality of life, such general questionnaires may not be sensitive enough to fully assess the effects of various aspects of the disease [14]. Because UI is common among Iranian women [15,16], there is an urgent need of such effective questionnaires in Iran. Thus, assessment of the quality of life in Iranian women with UI is very important. IIQ and UDI, which are recommended by the International Consultation on Incontinence, are brief, valid, and widely used questionnaires that assess the effect of symptom severity and subjective aspects of UI on the quality of life of patients [17]. Both IIQ and UDI are available in many languages except Persian [18-20] and other language versions cannot be used in Persian women. Impact of incontinence may vary signifcantly between countries and amongst different ethnic groups, and even in cultural and religious groups within the same countries, therefore the tools should be native to this aspect, because of this the present study was conducted with an aim to assess validity and reliability of the adapted and translated versions of the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6) in the Persian language. MATERIALS AND METHODS This cross-sectional study was conducted in patients who were referred to the Urogynecology clinic of Imam Khomeini Hospital, a tertiary referral center affliated to the Tehran University of Medical Sciences from April to October 2015. The ethics committee of the Tehran University of Medical Sciences approved the study with number code 2726. All participants provided written informed consent. Each participant completed the questionnaire in a private environment. Personally, identifable information regarding the participants were kept confdential. The number of samples needed to conduct a validation study is usually based on a rule of thumb (5-10 participants should be recruited for every item of the instrument) [21]; so 200 people were enough to cover this criterion. A sample of 200 consecutive women who participated in this study flled the fnal version of the questionnaires. ZOHRE MOMENIMOVAHED 1 , AZITA TIZNOBAIK 2 , MINOO PAKGOHAR 3 , ALI MONTAZERI 4 , SAFOURA TAHERI 5 Keywords: Health-related quality of life, Iran, Reliability, Validity ABSTRACT Introduction: Urinary incontinence is a common health, physical, and social problem in the world. There is an urgent need of effective questionnaires for its evaluation in Iranian women. Aim: The present study aimed to assess validity and reliability of the adapted and translated version of the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6) in the Persian language. Materials and Methods: This cross-sectional study was conducted from April to October 2015. A sample of 200 consecutive women who participated in this study filled the final version of the questionnaires. Eligible samples were divided into two groups (with and without UI). Standard forward-backward procedure was applied for translating the questionnaires into Persian. Reliability was assessed using test/retest reliability and internal consistency. In addition, validity was evaluated using face and content validity, comparison with known groups, and convergent validity. Results: Two hundred women participated in this study and filled both the questionnaires. Both the normal and incontinent groups had 100 subjects. Mean age of the respondents was 47.52±9.84 years. The content validity analysis produced favourable results. IIQ and UDI successfully discriminated the two groups. There was a significant negative correlation between the two questionnaires and all subscales of the Short Form Health Survey (SF-36). The Cronbach’s alpha coefficient for UDI-6 and IIQ-7 was 0.88 and 0.95, respectively. The Intraclass Correlations (ICC) scores for the Persian language versions were 0.96 for UDI-6 and 0.97 for IIQ-7. Conclusion: This study demonstrated that the newly developed Persian language version of IIQ-7 and UDI-6 are short, valid, and reliable methods for assessing the quality of life of women with UI.