Validation of a Swedish version of the National Institute of Health – Chronic Prostatitis Symptom Index

Authors

  • Helena Hallencreutz Grape Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  • Magnus Grabe Department of Translational Medicine, Lund University, Lund, Sweden
  • Philip von Rosen Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  • Lotta Renström Koskela Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  • Birgitta Nordgren Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Women’s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden

DOI:

https://doi.org/10.2340/sju.v60.42916

Keywords:

Chronic prostatitis, primary prostate pain syndrome, chronic pelvic pain syndrome, NIH-CPSI, quality of life, health questionnaire

Abstract

Objective: Chronic primary prostate pain syndrome (PPPS), usually referred to as chronic prostatitis with chronic pelvic pain syndrome (CP/CPPS), affects approximately 10% of all men. The National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) was developed for clinical assessment and research evaluation of this patient category. The objective of this study was to translate the NIH-CPSI into Swedish, including cross-cultural adaptation and testing it for validity and reliability. 

Material and methods: Fifty men with chronic PPPS participated in the testing of a new Swedish questionnaire. The initial translation included forward and backward translation followed by a comprehensive review by an expert committee. The preliminary Swedish translation was tested for face validity and test-retest reliability. In all steps of the translation, both medical experts and laymen participated. 

Results: The Swedish translation showed a high degree of consistency with the original version. A few cultural adaptations were jointly agreed upon. The questionnaire was assessed to be clear to understand and having good face validity. The test-retest reliability showed an intraclass correlation (ICC) of 0.89 (95% confidence interval [CI] = 0.82–0.94) which indicates good to excellent reliability. The standard error of measurement and minimal detectable change were 2.5 and 7.0 respectively. A Bland Altman plot showed no systematic difference between test-retest. 

Conclusion: This study brings to health care providers and researchers a Swedish version of the internationally recognised NIH-CPSI questionnaire having good validity and reliability, a beneficial addition in the management of men suffering from chronic PPPS in Sweden

Downloads

Download data is not yet available.

References

European Association of Urology. Chronic pelvic pain. [Internet]. Arnhem, The Netherlands: EAU Guidelines Office; 2023. [updated mars 2024; cited 2024-09-10]. Available from: http://uroweb.org/guidelines/compilations-of-all-guidelines/

Krieger JN, Nyberg JL, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999;282(3):236–237. https://doi.org/10.1001/jama.282.3.236 DOI: https://doi.org/10.1001/jama.282.3.236

Krieger JN, Lee SWH, Jeon J, et al. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008;31(Supplement 1):85–90. https://doi.org/10.1016/j.ijantimicag.2007.08.028 DOI: https://doi.org/10.1016/j.ijantimicag.2007.08.028

Mehik A, Hellström P, Lukkarinen O, et al. Epidemiology of prostatitis in Finnish men: a population-based cross-sectional study. BJU Int. 2000;86(4):443–448. https://doi.org/10.1046/j.1464-410X.2000.00836.x DOI: https://doi.org/10.1046/j.1464-410X.2000.00836.x

Litwin MS, McNaughton-Collins M, Fowler JFJ, et al. The National Institutes of Health Chronic Prostatitis Symptom Index: development and validation of a new outcome measure. J Urol. 1999;162(2):369–375. https://doi.org/10.1016/S0022-5347(05)68562-X DOI: https://doi.org/10.1016/S0022-5347(05)68562-X

Dun R-l, Tsai J, Hu X-h, et al. A systematic review of cross-cultural adaptation of the National Institutes of Health Chronic Prostatitis Symptom Index. Health Qual Life Outcomes. 2021;19(1):159. https://doi.org/10.1186/s12955-021-01796-8 DOI: https://doi.org/10.1186/s12955-021-01796-8

Propert KJ, Litwin MS, Wang Y, et al. Responsiveness of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Qual Life Res. 2006;15(2):299–305. https://doi.org/10.1007/s11136-005-1317-1 DOI: https://doi.org/10.1007/s11136-005-1317-1

Schneider H, Brähler E, Ludwig M, et al. Two-year experience with the german-translated version of the NIH-CPSI in patients with CP/CPPS. Urology (Ridgewood, NJ). 2004;63(6):1027–1030. https://doi.org/10.1016/j.urology.2004.02.002 DOI: https://doi.org/10.1016/j.urology.2004.02.002

Boateng GO, Neilands TB, Frongillo EA, et al. Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health. 2018;6:149. https://doi: 10.3389/fpubh.2018.00149 DOI: https://doi.org/10.3389/fpubh.2018.00149

Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(Suppl 1):S80–S89. https://doi.org/10.4103/sja.SJA_203_17 DOI: https://doi.org/10.4103/sja.SJA_203_17

Barry MJ, Fowler FJ, O’Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urology. 1992;148(5):1549–1557; discussion 64. https://doi.org/10.1016/S0022-5347(17)36966-5 DOI: https://doi.org/10.1016/S0022-5347(17)36966-5

Malhotra A, Mackey S. Outcomes in pain medicine: A brief review. Pain and therapy. 2012. Pain Ther. 2012;1:5. https://doi: 10.1007/s40122-012-0005-4 DOI: https://doi.org/10.1007/s40122-012-0005-4

Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–163. https://doi.org/10.1016/j.jcm.2016.02.012 DOI: https://doi.org/10.1016/j.jcm.2016.02.012

Leskinen MJ, Mehik A, Sarpola A, et al. The Finnish version of The National Institutes of Health Chronic Prostatitis Symptom Index correlates well with the visual pain scale: translation and results of a modified linguistic validation study. BJU Int. 2003;92(3):251–256. https://doi.org/10.1046/j.1464-410X.2003.04313.x DOI: https://doi.org/10.1046/j.1464-410X.2003.04313.x

Kildegaard D, Graugaard-Jensen C, Andersen K, et al. Danish version of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire: a linguistic translation, cross-cultural adaptation and test-re-test reliability study. Scand J Urol. 2019;53(1):62–68. https://doi.org/10.1080/21681805.2019.1591501 DOI: https://doi.org/10.1080/21681805.2019.1591501

McNaughton Collins M, Pontari MA, O’Leary MP, et al. Quality of life is impaired in men with chronic prostatitis: The chronic prostatitis collaborative research network. J Gen Intern Med. 2001;16(10):656–662. https://doi.org/10.1111/j.1525-1497.2001.01223.x DOI: https://doi.org/10.1046/j.1525-1497.2001.01223.x

Hochreiter W, Ludwig M, Weidner W, et al. National Institutes of Health (NIH) Chronic Prostatitis Symptom Index. The German version. Urologe Ausgabe A. 2001;40(1):16–17. https://doi.org/10.1007/s001200050427 DOI: https://doi.org/10.1007/s001200050427

El-Nashaar A, Fathy A, Zeedan A, et al. Validity and reliability of the Arabic version of the National Institutes of Health Chronic Prostatitis Symptom Index. Urol Int. 2006;77(3):227–231. https://doi.org/10.1159/000094814 DOI: https://doi.org/10.1159/000094814

Collins MM, O’Leary MP, Calhoun EA, et al. The Spanish National Institutes of Health-Chronic Prostatitis Symptom Index: translation and linguistic validation. J Urol. 2001;166(5):1800–1803. https://doi.org/10.1016/S0022-5347(05)65678-9 DOI: https://doi.org/10.1016/S0022-5347(05)65678-9

Giubilei G, Mondaini N, Crisci A, et al. The Italian Version of the National Institutes of Health Chronic Prostatitis Symptom Index. Eur Urol. 2005;47(6):805–811. https://doi.org/10.1016/j.eururo.2004.12.025 DOI: https://doi.org/10.1016/j.eururo.2004.12.025

Terwee CB, Bot SDM, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012 DOI: https://doi.org/10.1016/j.jclinepi.2006.03.012

Horney CAM, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4(4):293–307. https://doi.org/10.1007/BF01593882 DOI: https://doi.org/10.1007/BF01593882

Roberts RO, Jacobson DJ, Girman CJ, et al. Low agreement between previous physician diagnosed prostatitis and National Institutes of Health Chronic Prostatitis Symptom Index pain measures. J Urol. 2004;171(1):279–283. https://doi.org/10.1097/01.ju.0000100088.70887.29 DOI: https://doi.org/10.1097/01.ju.0000100088.70887.29

Additional Files

Published

2025-02-05

How to Cite

Hallencreutz Grape, H., Grabe, M., von Rosen, P., Renström Koskela, L., & Nordgren, B. (2025). Validation of a Swedish version of the National Institute of Health – Chronic Prostatitis Symptom Index. Scandinavian Journal of Urology, 60, 36–42. https://doi.org/10.2340/sju.v60.42916

Issue

Section

Publications