University of Oulu

Mattsson et al. Health and Quality of Life Outcomes (2017) 15:88, DOI 10.1186/s12955-017-0648-2

Validation of the short forms of the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in Finnish

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Author: Mattsson, Nina Kristiina1; Nieminen, Kari2; Heikkinen, Anna-Mari3;
Organizations: 1Department of Obstetrics and Gynecology, Kanta-Häme Central Hospital
2Department of Obstetrics and Gynecology, Tampere University Hospital
3Terveystalo, Kuopio, Finland
4Department of Obstetrics and Gynecology, Central Finland Hospital District
5Department of Obstetrics and Gynecology, Oulu University Hospital
6Department of Obstetrics and Gynecology, Kuopio University Hospital
7Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Springer Nature, 2017
Publish Date: 2017-06-28


Background: Although several validated generic health-related quality of life instruments exist, disease-specific instruments are important as they are often more sensitive to changes in symptom severity. It is essential to validate the instruments in a new population and language before their use. The objective of the study was to translate into Finnish the short forms of three condition-specific questionnaires (PFDI-20, PFIQ-7 and PISQ-12) and to evaluate their psychometric properties in Finnish women with symptomatic pelvic organ prolapse.

Methods: A multistep translation method was used followed by an evaluation of validity and reliability in prolapse patients. Convergent and discriminant validity, internal consistency and reliability via test-retest were calculated.

Results: Sixty-three patients waiting for prolapse surgery filled the three questionnaires within two weeks. Response rate for each item was high in PFDI-20 and PISQ-12 (99.8 and 98.9% respectively). For PFIQ-7 response rate was only 60%. In PFIQ-7, six respondents (9.5%) reached the minimum value of zero showing floor effect. None of the instruments had ceiling effect. Based on the item-total correlations both PFIQ-7 and PFDI-20 had acceptable convergent validity, while the convergent validity of PISQ-12 was lower, r = 0.138–0.711. However, in this instrument only three questions (questions 6, 10 and 11) had r < 0.3 while others had r ≥ 0.380. In the test-retest analysis all the three instruments showed good reliability (ICC 0.75–0.92). Similarly, the internal consistency of the instruments, measured by Cronbach’s α, was good (range 0.69–0.96) indicating high homogeneity.

Conclusions: Finnish validated translation of the PFDI-20 and PISQ-12 have acceptable psychometric properties and can be used for both research purposes and clinical evaluation of pelvic organ prolapse symptoms. The Finnish version of PFIQ-7 displayed low response rate and some evidence of a floor effect, and thus its use is not recommended in its current form.

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Series: Health and quality of life outcomes
ISSN: 1477-7525
ISSN-E: 1477-7525
ISSN-L: 1477-7525
Volume: 15
Article number: 88
DOI: 10.1186/s12955-017-0648-2
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This study was partly funded by The Finnish Society of Gynecological Surgery and The Emil Aaltonen Foundation
Copyright information: © The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.