# Norwegian Translation and Validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR)

## TL;DR

This study translated and validated a questionnaire to assess sexual function in Norwegian women with pelvic floor dysfunctions, finding it reliable for sexually active women.

## Contribution

The paper provides a culturally adapted and validated version of the PISQ-IR questionnaire for Norwegian-speaking populations.

## Key findings

- The Norwegian PISQ-IR showed good face/content validity, internal consistency, and construct validity for sexually active women.
- Exploratory factor analysis supported the original structure for sexually active women but showed inconsistencies for non-sexually active women.
- 16 out of 19 predefined hypotheses were confirmed, indicating strong construct validity.

## Abstract

The Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised (PISQ-IR) measures sexual function in women with pelvic floor dysfunctions (PFD). The aim of this study was to translate the PISQ-IR to Norwegian and to assess its psychometric properties.

The instrument was translated and reviewed through cognitive interviews with women from the target group and multidisciplinary clinical experts to establish face/content validity and cultural equivalence. Thereafter, a cross-sectional study of women with PFD from two Norwegian University hospitals was conducted. Floor and ceiling effects and internal consistency were calculated for all subscales. Construct validity was assessed through exploratory factor analysis (EFA) and by testing 19 theoretically derived hypotheses.

Of 157 respondents, 111 (71%) women considered themselves sexually active (SA) and 46 (29%) non-sexually active (NSA). Item nonresponse rate varied from 4 to 36% in the subscales. For the NSA subscales, both floor and ceiling effect was detected. EFA mainly supported the original structure for both the SA and NSA subscales, although not completely consistent and with many cross-loadings. Unidimensional factors were assessed and confirmed the presence of one factor within all subscales for SA women and three for NSA women (except NSA-PR). Construct validity confirmed 16 of the 19 predefined hypotheses (84%). All subscales exhibited good internal consistency.

The Norwegian PISQ-IR demonstrated good face/content validity, internal consistency and construct validity, and can be used to assess sexual function among sexually active women with PFD. A small sample size of NSA women precludes drawing firm conclusions regarding structural validity for NSA subscales.

The online version contains supplementary material available at 10.1007/s00192-025-06106-0.