Arabic (Tunisian) translation and validation of the Urogenital Distress Inventory short form (UDI-6) and Incontinence Impact Questionnaire short form (IIQ-7)

Objective: To translate and validate an Arabic (Tunisian) version of the Urogenital Distress Inventory short form (UDI-6) and Incontinence Impact Questionnaire short form (IIQ-7), which can be used reliably in daily practice and clinical research for Tunisian and Arabic populations. Patients and methods: This cross-sectional study was conducted from January to June 2018. The UDI-6 assesses the presence of urinary incontinence (UI) and the degree of impairment that it causes, whilst the IIQ-7 evaluates women's life quality with lower urinary tract symptoms. As UI is a relatively common condition in middle-aged and older women these tools are utilised worldwide. The Arabic (Tunisian) translation and cultural adaptation of the UDI-6 and IIQ-7 was achieved via the forward/backward method and comprehension test within a group of 15 patients. Psychometric validation included testing the questionnaire on a group of 35 patients. Intra-rater reliability was evaluated by calculation of the intraclass correlation coefficient (ICC) for each item of the questionnaires. Cronbach's alpha was used to assess internal consistency. The International Consultation on Incontinence Modular Questionnaire short form (ICIQ-SF), in its Arabic version, was used as the 'gold standard'. Results: For the UDI-6, the ICC was 0.98 demonstrating excellent intra-rater reliability and Cronbach's alpha was 0.99 (>0.9), confirming an excellent correlation between the different items. Internal consistency (Cronbach's alpha 0.99) and test-retest reliability of the IIQ-7 (ICC 0.98) were very good. For both questionnaires, the kappa values for each item ranged from 0.77 to 0.96. Conclusions: We found that the UDI-6 and IIQ-7 questionnaires were valid tools that can be used reliably in daily practice and clinical research for Tunisian and Arabic women with UI.