Cultural adaptation of a quality-of-life measure for urinary incontinence

Objectives: To translate and validate a urinary incontinence-specific measu re of quality of life (I-QOL) in French, Spanish, Swedish, and German and p rovide translations only into seven other languages and variants of these l anguages. Methods: Quality of life and linguistic experts prepared two forw ard translations from American English to their native languages and helped to harmonize these translations at a meeting. In the four European countri es, the adapted versions of the I-QOL were administered to 259 women with s tress, urge, and mixed incontinence, Principal component analyses were used to confirm the proposed measurement model suggested by patient interviews. Psychometric testing was conducted using standardized procedures. Results: Translation procedures resulted in a change in the original instrument's L ikert response scale from 4 to 5 points. Principal component analyses confi rmed three patient-derived subscales and higher-order factor analysis confi rmed a total summary score. In all countries, the internal consistency (alp ha) and reproducibility (ICC) were high (alpha ranged between 0.87 and 0.93 ); (ICC ranged between 0.92 and 0.95). In all countries, I-QOL scores were significantly worse (p < 0.001) as perceived severity of incontinence, use of services, and number of incontinent episodes increased. Conclusions: The I-QOL has been adapted successfully into eleven languages and six variants of these languages. The cross-sectional psychometric properties of the US version were confirmed in four European countries. The I-QOL fills the need for a valid, international quality-of-life instrument for incorporation in clinical trials covering patients with varying types and severity of urina ry incontinence.