Purpose
The purpose of the PFDI is to assess the impact that pelvic floor disorders have on health-related quality of life in women.
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The purpose of the PFDI is to assess the impact that pelvic floor disorders have on health-related quality of life in women.
20
5 minutes
Adult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by Krista Ferguson, PT, OCS in 2010; Updated with a geriatric population by Jill Smiley, MPH in 10/2012.
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Women with Pelvic Floor Symptoms:(Barber et al, 2005; n = 100 women evaluated at the Pelvic Floor Disorders Clinic at the Duke University Medical Center; mean age = 56(15) years)
Women with Pelvic Organ Prolapse: (Kaplan et al, 2012; n = 248 women, 103 prolapse participants and 145 non-prolapse participants; mean age for prolapse participants = 59.9 (11.4) years; mean age for non-prolapse participants = 53.4 (9.5) years)
Pelvic Floor Distress: (Barber et al, 2005; n = 45 women with pelvic floor disorders scheduled to undergo surgery to evaluate the correlation between short and long forms in a second independent population; the short forms were re-administered 3 to 6 months postoperatively to assess the responsiveness of the instruments; mean age = 59(12) years)
Baseline Characteristics of the Two Study Populations |
|
|
|
|
Group 1 (n = 100) |
Group 2 (n = 45) |
P value |
Age* |
56 (15) |
59 (12) |
.23 |
Caucasian (%) |
83% |
95% |
.30 |
BMI* |
29 (7) |
27 (6) |
.10 |
Parity** |
2 (0-5) |
2 (1-7) |
.50 |
Insurance Status (%) |
|
|
.001 |
Private HMO |
44 |
71 |
|
Medicaid/Medicare |
56 |
29 |
|
Previous Hysterectomy (%) |
68 |
51 |
.08 |
Previous Pelvic Reconstructive Surgery (%) |
32 |
20 |
.19 |
Pelvic Floor Disorders (%) |
|
|
|
Urodynamic Stress Incontinence |
30 |
40 |
.32 |
Detrusor Overactivity |
16 |
16 |
.95 |
Voiding Dysfunction |
24 |
40 |
.75 |
Pelvic Organ Prolapse (Stage 3 or 4) |
27 |
58 |
.0007 |
Fecal Incontinence |
13 |
11 |
.96 |
Defecatory Dysfunction |
28 |
40 |
.21 |
Rectal Prolapse |
4 |
6 |
.96 |
Number of Pelvic Floor Disorders Per Patient (%) |
|
|
<.0001 |
0*** |
24 |
0 |
|
1 |
44 |
34 |
|
2 |
26 |
40 |
|
3+ |
6 |
26 |
|
*Mean +/- SD, **Median (range), *** In group 1, 24% of patients did not meet the study definition of any pelvic floor diagnoses listed above but all had some symptom of pelvic floor dysfunction. In contrast, all patients in group 2 met the criteria for one or more pelvic floor disorders |
|
|
|
Surgical Procedures Performed on Group 2 |
|
Procedure |
Percent |
Hysterectomy |
38 |
Trachelectomy |
4 |
Anterior Colporrhaphy |
60 |
Posterior Colporrhaphy |
67 |
Paravaginal Repair (Abdominal or Laparoscopic) |
22 |
Vaginal Vault Suspension |
55 |
Sacral Colpopexy (Abdominal or Laparoscopic) |
13 |
Sling Procedure (Including TVT) |
40 |
Retropubic Urethropexy (Burch) |
20 |
Urethrolysis |
2 |
Anal Sphincteroplasty |
4 |
Rectopexy |
2 |
TVT = Tension-free Vaginal Tape |
|
Women with Pelvic Floor Symptoms:(Barber et al, 2001)
Pelvic Floor Distress: (Barber et al, 2005)
Women with Pelvic Floor Symptoms:(Barber et al, 2001)
Women with Pelvic Floor Disorders: (Toprak et al, 2012; n = 128 women with pelvic floor disorders including pelvic organ prolapse, urinary incontinence, and anal incontinence; mean age = 51.91 (9.82) years; Turkish sample)
Pelvic Floor Distress: (Barber et al, 2005)
Pelvic Floor Distress: (Barber et al, 2005)
Women with Pelvic Floor Symptoms:(Barber et al, 2001)
Women with Pelvic Floor Disorders: (Toprak et al, 2012)
Pelvic Floor Disorders: (Barber et al, 2011; n = 1006 participants in 4 prospective studies of pelvic floor disorders, including pelvic organ prolapse, stress urinary incontinence, and fecal incontinence at baseline, 3-months, and 12-months; mean age = 58.4 (14.7) years)
Subscale to Total Measure Correlations |
|
Subscale |
PFDI -20 |
UDI |
0.88 (Excellent) |
POPDI |
0.90 (Excellent) |
CRADI |
0.93 (Excellent) |
Women with Pelvic Organ Prolapse: (Kaplan et al, 2012)
Internal Consistency of PFDI-20 |
|
|
Chronbach's Alpha |
PFDI 20 |
0.908 (Excellent) |
Subscale |
|
UDI |
0.965 (Excellent) |
POPDI |
0.952 (Excellent) |
CRADI |
0.964 (Excellent) |
Pelvic Floor Distress: (Barber et al, 2005)
Women with Pelvic Floor Disorders: (Toprak et al, 2012)
Women with Pelvic Organ Prolapse: (Kaplan et al, 2012)
After the item content for the short forms was determined, a multidisciplinary expert panel that included urogynecologists, female urologists, a colorectal surgeon, a pelvic floor physical therapist, and a psychometrician reassessed content validity (Barber et al, 2005).
After the item content for the short forms was determined, a multidisciplinary expert panel that included urogynecologists, female urologists, a colorectal surgeon, a pelvic floor physical therapist, and a psychometrician reassessed face validity (Barber et al, 2005).
Pelvic Floor Distress: (Barber et al, 2005)
Standardized response mean (SRM = 1.09)
Women with Pelvic Organ Prolapse: (Kaplan et al, 2012)
Responsiveness of PFDI-20 and PDFI-20 Subscales |
|
|
|
Effect Size (ES) |
SRM |
PFDI-20 |
1.38 (Large change) |
1.42 |
UDI |
0.88 (Large change) |
0.91 |
POPDI |
1.48 (Large change) |
1.39 |
CRADI |
0.61 (Moderate change) |
0.54 |
Barber, M. D., Chen, Z., et al. (2011). "Further validation of the short form versions of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ)." Neurourology and Urodynamics 30(4): 541-546. Find it on PubMed
Barber, M. D., Kuchibhatla, M. N., et al. (2001). "Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders." American Journal of Obstetrics and Gynecology 185(6): 1388-1395. Find it on PubMed
Barber, M. D., Walters, M. D., et al. (2005). "Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7)." American Journal of Obstetrics and Gynecology 193(1): 103-113. Find it on PubMed
Kaplan, P. B., Sut, N., et al. (2012). "Validation, cultural adaptation and responsiveness of two pelvic-floor-specific quality-of-life questionnaires, PFDI-20 and PFIQ-7, in a Turkish population." European Journal of Obstetrics, Gynecology, and Reproductive Biology 162(2): 229-233. Find it on PubMed
Toprak Celenay, S., Akbayrak, T., et al. (2012). "Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20." Int Urogynecol J 23(8): 1123-1127. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.