盆腔器官脱垂症状评分 (POP-SS) 中文版的验证。
- 作者列表："Ma Y","Xu T","Zhang Y","Kang J","Ma C","Zhu L
OBJECTIVE:The objective of the present study was to translate the Pelvic Organ Prolapse Symptom Score (POP-SS) into Chinese and validate it in a population of Chinese women. METHODS:The POP-SS questionnaire was translated into simplified Chinese language following an intercultural adaptation procedure. One hundred forty-six patients who met the inclusion criteria were recruited. Among the enrolled patients, 63 underwent surgery for POP and 50 underwent pessary management. They completed the questionnaires at baseline (T1), 1 to 2 weeks later (T2), and 3 months after intervention (T3). Evaluation for psychometric properties was conducted following with the COnsensus-based Standards for the selection of health Measurement INstruments checklist, including internal consistency, test-retest reliability, measurement error, content validity, criterion validity, construct validity, responsiveness, and interpretability. RESULTS:The POP-SS was successfully translated into a Chinese version and achieved good content validity. Internal consistency (Cronbach's alpha = 0.796) was good, and test-retest reliability was excellent (intraclass correlation coefficients = 0.98; P < 0.001). The construct validity was verified by factor analysis and consistent with the theoretical structure of the original questionnaire. The POP-SS score was also significantly correlated with Pelvic Floor Distress Inventory-20 (Spearman's correlation coefficient = 0.89, P < 0.001). The confirmatory factor analysis identified two factors: physical symptoms and evacuation symptoms. The mean changes among the participants in very much better (9.80 ± 5.36) and much better (5.67 ± 2.99) groups were larger than those among the participants in the no change group (0.43 ± 2.07). The effect size responsiveness parameter in the much better group (>0.80) was larger than that in the no change group (<0.20). The values of the minimal important change for surgery and pessary groups were both larger than the smallest detectable change, indicating sufficient responsiveness. CONCLUSIONS:The Chinese version of POP-SS is a reliable and valid instrument and has good sensitivity to change in the population studied.
目的: 本研究的目的是将盆腔器官脱垂症状评分 (POP-SS) 翻译成中文，并在中国女性人群中进行验证。 方法: 按照跨文化适应程序将 POP-SS 问卷翻译成简体中文。招募了符合纳入标准的 106 例患者。入组患者中，63 例行 POP 手术，50 例行子宫托管理。他们在基线 (T1) 、 1 ~ 2 周后 (T2) 和干预后 3 个月 (T3) 完成问卷调查。根据基于共识的健康测量仪器选择标准 (检查表) 进行心理测量特性评价，包括内部一致性、重测信度、测量误差、内容效度、效标效度、结构效度、响应性和可解释性。 结果: 成功将 POP-SS 翻译成中文版本，并取得了良好的内容效度。内部一致性 (Cronbach's alpha1 = 0.796) 良好，重测信度优良 (组内相关系数 = 0.98; P <0.001)。通过因子分析验证了结构效度，并与原始问卷的理论结构一致。POP-SS 评分也与盆底不适量表-20 显著相关 (Spearman 相关系数 = 0.89，p <0.001)。验证性因素分析确定了两个因素: 躯体症状和疏散症状。参与者之间的平均变化非常好 (9.80 ± 5.36) 和好得多 (5.67 ± 2.99) 组大于无变化组参与者 (0.43 ± 2.07)。效果大小反应性参数在更好组 (>0.80) 大于无变化组 (<0.20)。手术组和子宫托组的最小重要变化值均大于最小可检测到的变化，表明有足够的反应性。 结论: 中文版 POP-SS 是一种可靠有效的工具，对研究人群的变化具有良好的敏感性。
METHODS:BACKGROUND:Ultrasound has been demonstrated to accurately diagnose rectal deep endometriosis (DE) and pouch of Douglas (POD) obliteration. The role of ultrasound in the assessment of patients who have undergone surgery for rectal DE and POD obliteration has not been evaluated. AIM:To describe the transvaginal ultrasound (TVS) findings of patients who have undergone rectal surgery for DE. MATERIALS AND METHODS:An observational cross-sectional study at a tertiary care centre in Sydney, Australia between January and April 2017. Patients previously treated for rectal DE (low anterior resection vs rectal shaving/disc excision) were recruited and asked to complete a questionnaire on their current symptoms. On TVS, POD state and rectal DE were assessed. Correlating recurrence of POD obliteration and/or rectal DE to surgery type and symptoms was done. RESULTS:Fifty-six patients were contacted; 22/56 (39.3%) attended for the study visit. Average interval of surgery to study visit was 52.8 ± 24.6 months. Surgery type breakdown was as follows: low anterior resection (56%) and rectal shaving/disc excision (44%). The prevalence of POD obliteration was 16/22 (72.7%) intraoperatively and 8/22 (36.4%) at study visit, as per the sliding sign. Nine patients (39.1%) had evidence on TVS of recurrent rectal DE. Recurrence of POD obliteration and rectal DE was not associated with surgery type or symptomatology. CONCLUSION:Despite surgery for rectal DE, many patients have a negative sliding sign on TVS, representing POD obliteration, and rectal DE. Our numbers are too small to correlate with the surgery type or their current symptoms.
METHODS::Minimally invasive surgery for complex endometriosis requires preoperative planning that intimately connects the gynecologic surgeon to the radiologist. Understanding the surgeon's perspective to endometriosis treatment facilitates a productive relationship that ultimately benefits the patient. We examine minimally invasive surgery for endometriosis and the key radiologic information which enable the surgeon to successfully negotiate patient counseling, preoperative planning, and an interdisciplinary approach to surgery.
METHODS:STUDY OBJECTIVE:Prior research collectively shows that endometriosis is inversely related to women's adiposity. The aim of this study was to assess whether this inverse relationship holds true by disease severity and typology. DESIGN:Cross sectional study among women with no prior diagnosis of endometriosis. SETTING:Fourteen clinical centers in Salt Lake City, Utah and San Francisco, California. PATIENTS:Four hundred and ninety five women, ages 18-44 years, were enrolled in the operative cohort of the Endometriosis, Natural History, Diagnosis, and Outcomes (ENDO) Study. INTERVENTIONS:Gynecologic laparoscopy/laparotomy, regardless of clinical indication. MEASUREMENTS AND MAIN RESULTS:Participants underwent anthropometric assessments, body composition, and body fat distribution ratios before surgery. Surgeons completed a standardized operative report immediately after surgery to capture revised ASRM staging (I to IV) and typology of disease (superficial [SE], ovarian endometrioma [OE], and deep infiltrating endometriosis [DIE]). Linear mixed models, taking into account within-clinical-center correlation were used to generate least square means (95% confidence intervals) to assess differences in adiposity measures by endometriosis stage (no endometriosis, I-IV) and typology (no endometriosis, SE, DIE, OE, OE + DIE) adjusting for age, race/ethnicity, and parity. While the majority of confidence intervals were wide and overlapping, three general impressions emerged: 1) women with versus without incident endometriosis had the lowest anthropometric/body composition indicators; 2) women with stage I or IV had lower indicators compared to women with stage II or III; and 3) women with OE and/or DIE tended to have the lowest indicators, while women with SE had the highest indicators. CONCLUSION:Our research highlights that the relationship between women's adiposity and endometriosis severity and typology may be more complicated than prior research indicates.