Cross-Cultural Adaptation and Validation of the Urdu Version of the Diastasis Recti Postpartum Questionnaire for Pakistani Postpartum Women
DOI:
https://doi.org/10.61919/1w8xtg65Keywords:
Diastasis recti; postpartum; questionnaire validation; cross-cultural adaptation; Urdu; psychometrics.Abstract
Background: Diastasis recti abdominis (DRA) is common in postpartum women and is associated with pain, functional limitation, and psychological distress, yet few condition-specific patient-reported outcome measures (PROMs) are available in non-Western settings (1–7,9,11–13,27,28). Objective: To translate, culturally adapt, and psychometrically validate the Urdu version of the Physical and Mental Well-being related to Diastasis Recti Postpartum Questionnaire (PM-DRQ) in middle-aged Pakistani postpartum women with DRA. Methods: A cross-sectional validation study was conducted among 80 postpartum women aged 35–45 years with DRA ≥2.5 cm attending four maternity hospitals in Karachi, Pakistan. Translation followed international guidelines with forward–back translation, expert committee review, and cognitive debriefing (14–17,23–26). Participants completed the Urdu PM-DRQ, a visual analogue scale for pain, the Modified Oswestry Disability Index, and the Maternal Postpartum Quality of Life Questionnaire (9,10,14,18–20). Internal consistency, test–retest reliability, content, construct, criterion, and known-groups validity, and floor/ceiling effects were evaluated (14,18). Results: Cronbach’s α was 0.89 for the total scale and 0.85 and 0.82 for physical and psychological domains, respectively. Test–retest ICC was 0.88. A two-factor structure explained 68.4% of variance with acceptable CFA fit (CFI 0.92, TLI 0.90, RMSEA 0.076). PM-DRQ scores correlated strongly with pain and disability and discriminated between DRA severity and low back pain subgroups (all p<0.001). No floor or ceiling effects were observed. Conclusion: The Urdu PM-DRQ is a reliable, valid, and culturally appropriate PROM for assessing physical and psychological impacts of DRA in Pakistani postpartum women.
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