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. 2022 Aug 13;22(1):638.
doi: 10.1186/s12884-022-04964-w.

Development and initial validation of a Swedish inventory to screen for symptoms of deficient perineum in women after vaginal childbirth: 'Karolinska Symptoms After Perineal Tear Inventory'

Emilia Rotstein  1   2 , Philip von Rosen  3 , Sofie Karlström  4 , Jona Elings Knutsson  4   5 , Nina Rose  4 , Ellinore Forslin  6 , Per J Palmgren  7 , Gunilla Tegerstedt  8   4 , Hedvig Engberg  4   5
Affiliations

Development and initial validation of a Swedish inventory to screen for symptoms of deficient perineum in women after vaginal childbirth: 'Karolinska Symptoms After Perineal Tear Inventory'

Emilia Rotstein et al. BMC Pregnancy Childbirth. .

Abstract

Background: Perineal tears are common after vaginal birth and may result in pelvic floor symptoms. However, there is no validated questionnaire that addresses long-term symptoms in women with a deficient perineum after vaginal birth. Thus, the objective of this study was to develop and psychometrically evaluate a clinical screening inventory that estimates subjective symptoms in women with a deficient perineum more than one year after vaginal delivery.

Material and methods: The development and psychometric evaluation employed both qualitative and quantitative methods. Qualitative strategies involved content validity and Think Aloud protocol for generation of items. The psychometric evaluation employed principal component analysis to reduce the number of items. The inventory was completed by women with persistent symptoms after perineal tears (N = 170). Results were compared to those of primiparous women giving birth by caesarean section (N = 54) and nulliparous women (N = 338).

Results: A preliminary 41-item inventory was developed, and the psychometric evaluation resulted in a final 11-item inventory. Women with confirmed deficient perineum after perineal trauma scored significantly higher on the symptoms inventory than women in control groups. A cut-off value of ≥ 8 could distinguish patients from controls with high sensitivity (100%) and specificity (87-91%).

Conclusions: The Karolinska Symptoms After Perineal Tear Inventory, is a psychometrically valid 11-item patient-reported outcome measure for symptoms of deficient perineum more than one year after vaginal birth. More research is needed to validate the inventory in various patient populations as well as its use in pelvic floor interventions. The inventory has the potential to improve patient counseling and care in the future.

Keywords: Assessment; Design; Disorder; Patient outcome; Pelvic floor; Perineum, care; Physiological; Postpartum; Psychometrics; Questionnaire; Sexual dysfunction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The distribution of frequencies and total scores of the final 11-items inventory by groups
Fig. 2
Fig. 2
ROC curve demonstrating the relationship between sensitivity and specificity values for classifying the Patient group compared to Elective CS and Nullipara, when varying the cut-off score. Dashed line as reference
See this image and copyright information in PMC

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