Funcionalidade de mulheres com prolapso de órgãos pélvicos

Abstract

The present study aimed to test the psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) in women with pelvic organ prolapse (POP). WHODAS 2.0 is a Patient-Reported Outcome Measure (PROM) composed of 36 items distributed across six domains: cognition, mobility, self-care, interpersonal relationships, life activities, and participation. Although it has been validated for other health conditions, its application in women with POP has not yet been investigated. Data collection was conducted at the Assis Chateaubriand Maternity School (MEAC). The study population consisted of 26 women aged 18 years or older diagnosed with symptomatic POP, confirmed using the Pelvic Organ Prolapse Quantification (POP-Q) system. Participants were recruited from the urogynecology outpatient clinic and completed the Mini-Mental State Examination (MMSE), a sociodemographic and clinical questionnaire, and the Pelvic Floor Impact Questionnaire (PFIQ-7), FIGO Assessment Scoring System (FASS), and WHODAS 2.0 questionnaires. The latter was reapplied by telephone between 7 and 14 days after the first assessment. The study followed the recommendations of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). Data were analyzed using Cronbach’s alpha, the Intraclass Correlation Coefficient (ICC), Spearman's Correlation Coefficient and Mann–Whitney test. The sample had a mean age of 59.4 ± 10.6 years, with a predominance of anterior vaginal wall prolapse (84.6%) and stage II disease (57.7%). The most frequent urinary symptoms were urinary urgency, increased urinary frequency, and nocturia (84.6%), as well as urinary incontinence and voiding difficulties (69.2%). Symptoms mainly affected emotional aspects and quality of life. The mean total WHODAS 2.0 score was 29.4 ± 19.9 points. Internal consistency was adequate, with α values ranging from 0.785 to 0.950 across domains and 0.985 for the total score. Test–retest reliability was excellent, with ICC values ranging from 0.960 to 1.000 and an ICC of 0.992 for the total score. A strong correlation was observed between WHODAS 2.0 and PFIQ-7 scores (r = 0.723; p < 0.001), whereas no significant correlation was found with the FASS (r = 0.174; p = 0.396). WHODAS 2.0 demonstrated adequate internal consistency, excellent test–retest reliability, and favorable evidence of construct validity in women with symptomatic POP, supporting its use for assessing functioning in this population.