Chinese translation, cross-cultural adaptation, and psychometric validation of patient-reported outcome measurement- questionnaire about gynecological and pelvic pain symptoms (ENDOPAIN-4D)

Objectives: The aim of this study was to cross-culturally translate a questionnaire about gynecological and pelvic pain symptoms (ENDOPAIN-4D) patient-reported outcome measurement (PROM) into Chinese and evaluate its reliability and validity.

Methods: The questionnaire was translated according to Brislin's classic back-translation model. We conducted cultural debugging through cognitive interviews with Chinese-speaking women who had experienced pelvic pain (n = 24). Following the patient-reported outcome and a consensus-building process, the research team developed the Chinese version of the ENDOPAIN-4D. Structure, reliability, and structural validity were subsequently verified in a sample of patients with chronic pelvic pain (n = 552).

Results: The results of the cognitive discussion indicated that some interviewers exhibited ambiguity in their comprehension of 16 items. All items except Item 21, whose critical ratio was 0.847, indicating no statistically significant difference, were included in the questionnaire. However, this study retained Item 21 as an additional item because of the distinctive features of endometriosis and the original author's suggestion. The overall Cronbach's α coefficient for the questionnaire was 0.87. The Chinese version of the ENDOPAIN-4D demonstrated a moderate correlation with the corresponding standard validity tools (r = 0.57).

Conclusion: The Chinese version of the ENDOPAIN-4D exhibited satisfactory reliability and validity, rendering it a productive instrument for assessing pelvic discomfort in patients.