Validity, Internal Consistency, and Responsiveness of the Thai Version of the Ureteral Stent Symptom Questionnaire (Thai-USSQ)
DOI:
https://doi.org/10.33192/smj.v78i11.281584Keywords:
Stents, USSQ, ureteral stent, minimal clinically important difference (MCID), validation, psychometricsAbstract
Objective: To evaluate the convergent validity, internal consistency, responsiveness, and minimal clinically important difference (MCID) of the Thai version of the Ureteral Stent Symptom Questionnaire (Thai USSQ).
Materials and Methods: This prospective cohort study enrolled 119 patients undergoing ureteral stent placement. The USSQ was translated into Thai via a standardized forward-backward process. Participants completed the Thai USSQ, IPSS, and EQ-5D-5L with the stent in situ and repeated the Thai USSQ after stent removal. Convergent validity, internal consistency, and responsiveness (effect sizes) were evaluated. The MCID was determined using an anchor-based approach (patients reporting “slightly improved” status) and a distribution-based approach.
Results: Mean age was 56.7 (±10.5) years. Cronbach’s α was 0.76 (urinary symptoms), 0.89 (pain), 0.82 (general health), 0.86 (work performance), and 0.88 (sexual matters; n = 16). The urinary domain correlated strongly with IPSS (Spearman’s ρ = 0.75, P < 0.001) and general health moderately with EQ-5D-5L (ρ = −0.35, P < 0.001). Urinary symptoms, body pain, and general health scores decreased post-stent removal (effect sizes 0.79, 1.41, and 0.90; all P < 0.001). The global-change anchor correlated poorly with any domain changes (ρ ≤ 0.29); distribution-based MCIDs (0.5 SD) were 3.3, 4.3, and 2.5, respectively.
Conclusion: The Thai USSQ showed acceptable internal consistency and responsiveness, with partial convergent validity. Evidence for the sexual domain is limited by sample size. Structural validity, test–retest reliability, measurement error, and valid anchor-based MCIDs were not established.
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