Surveys and questionnaires Archives - Revista Brasileira de Ginecologia e Obstetrícia
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo78
, , , , , , , To traslate and validate of the Brazilian version of the SDI-2.
This was a cross-sectional study. The cultural adaptation considered the stages of initial translation, synthesis of translations, evaluation by a committee of experts from different regions of Brazil, back-translation, and pre-test. The content validity and psychometric proprieties was assessed.
Ten specialists participated in the cultural adaptation of the SDI-2. The content validity showed a Content Validity Ratio (CVR) ≥ 0.75 (p = 0.05). A total of 674 subjects participated in the field study. The Exploratory Factorial Analysis (EFA) presented factor loads ≥ 0.445, and commonalities ≥ 0.40; and two dimensions represented 77% of the total variance explained. The Confirmatory Factorial Analysis CFA presented X2/df = 4.265; the Root Mean Square Error of Approximation RMSEA = 0.110; the Non-Normed Fit Index NNFI = 0.946; the Comparative Fit Index (CFI) = 0.963; the Goodness of Fit Index GFI = 0.986; and the Adjusted Goodness of Fit Index AGFI = 0.979 for a two-factor model. The coefficient values for the total SDI-2 score were 0.91 for Cronbach's alpha, 0.91 for McDonald's Omega, and 0.97 for the Greatest Lower Bound GLB coefficients. The invariance between sexes was 0.01 for the ΔCFI and ΔRMSEA, showing model stability for these two populations.
The Brazilian version of the SDI-2 is self-report, valid, reliable and invariant across sex.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo78
, , , , , , , To traslate and validate of the Brazilian version of the SDI-2.
This was a cross-sectional study. The cultural adaptation considered the stages of initial translation, synthesis of translations, evaluation by a committee of experts from different regions of Brazil, back-translation, and pre-test. The content validity and psychometric proprieties was assessed.
Ten specialists participated in the cultural adaptation of the SDI-2. The content validity showed a Content Validity Ratio (CVR) ≥ 0.75 (p = 0.05). A total of 674 subjects participated in the field study. The Exploratory Factorial Analysis (EFA) presented factor loads ≥ 0.445, and commonalities ≥ 0.40; and two dimensions represented 77% of the total variance explained. The Confirmatory Factorial Analysis CFA presented X2/df = 4.265; the Root Mean Square Error of Approximation RMSEA = 0.110; the Non-Normed Fit Index NNFI = 0.946; the Comparative Fit Index (CFI) = 0.963; the Goodness of Fit Index GFI = 0.986; and the Adjusted Goodness of Fit Index AGFI = 0.979 for a two-factor model. The coefficient values for the total SDI-2 score were 0.91 for Cronbach's alpha, 0.91 for McDonald's Omega, and 0.97 for the Greatest Lower Bound GLB coefficients. The invariance between sexes was 0.01 for the ΔCFI and ΔRMSEA, showing model stability for these two populations.
The Brazilian version of the SDI-2 is self-report, valid, reliable and invariant across sex.
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
, , , , , To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
, , , , , To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo16
Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women.
In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph.
430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 – pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were −1.54 and 1.62.
WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo16
Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women.
In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph.
430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 – pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were −1.54 and 1.62.
WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo7
, , , , , , To validate the 10-item Cervantes Scale (CS-10) among Brazilian women.
This is a cross-sectional observational study involving women in the community aged 40–55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women’s Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach’s alpha coefficient was used for internal consistency.
A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach’s alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041).
The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo7
, , , , , , To validate the 10-item Cervantes Scale (CS-10) among Brazilian women.
This is a cross-sectional observational study involving women in the community aged 40–55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women’s Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach’s alpha coefficient was used for internal consistency.
A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach’s alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041).
The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo56
, , , , , , This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.
In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.
The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach’s alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).
This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo56
, , , , , , This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.
In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.
The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach’s alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).
This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
, , , To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
, , , To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25
, , , , , , , Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists’ perceptions and experiences regarding fertility preservation.
Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists’ location, techniques in clinical practice, treatment successful rate, patients idea, etc.
The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists’ knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant.
This is the first Brazilian study about infertility specialists’ perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25
, , , , , , , Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists’ perceptions and experiences regarding fertility preservation.
Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists’ location, techniques in clinical practice, treatment successful rate, patients idea, etc.
The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists’ knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant.
This is the first Brazilian study about infertility specialists’ perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.
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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
, , , , To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.
Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.
The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.
In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
, , , , To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.
Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.
The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.
In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.