Translation, cross-cultural adaptation, and psychometric validation of the 5-item International Index of Erectile Function (IIEF-5) into Urdu

J Sex Med. 2012 Jul;9(7):1883-6. doi: 10.1111/j.1743-6109.2012.02714.x. Epub 2012 Apr 10.

Abstract

Introduction: Patients suffering from erectile dysfunction (ED) feel shy to discuss this issue with their physician. Self-report questionnaires are a key instrument to break this barrier. Most of these questionnaires are in English, and their validated translations in Urdu, the official language of Pakistan, are not available.

Aim: The aim of our study is to translate, cross-culturally adapt, and perform psychometric validation of an Urdu translation of the 5-item international index of erectile function (IIEF-5).

Methods: The translation of IIEF-5 was done in Urdu and was refined through reverse translation and expert committee reviews. It was then pretested on 20 bilingual men and reviewed again to develop a final Urdu version of the questionnaire. We selected 47 patients who had been in a stable sexual relationship over the past 6 months and asked them to fill out the IIEF-5 questionnaire in both languages (Urdu and English), followed by evaluation of ED by a clinician, who was blinded to the responses of the patient to the questionnaire.

Main outcome measures: The self-report to questionnaire and independent clinical assessment were compared. Patients refilled out the questionnaire again at the end of the interview to assess test-retest consistency. These data were now analyzed statistically using descriptive statistics, Cohen's kappa, and Cronbach's alpha analysis.

Results: The Cohen's kappa showed a very high degree of agreement between the two versions (P < 0.0001), and a high degree of internal consistency was demonstrated on Cronbach's alpha analysis ([0.882] with 95% confidence interval [0.839-0.916]). The clinical assessment of the presence and severity of ED also matched with the self-report questionnaire.

Conclusion: We can safely conclude that this Urdu version of IIEF-5 is a valid instrument for use in the literate population of Pakistan.

MeSH terms

  • Cross-Cultural Comparison
  • Erectile Dysfunction / diagnosis
  • Erectile Dysfunction / psychology*
  • Humans
  • Male
  • Pakistan
  • Penile Erection / psychology
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires / standards
  • Translating