Investigating the validity and reliability of the Persian version of Parents Penile Perception Score (PPPS)

Abstract

Hypospadias is a congenital disorder in which the opening of the urethra is located in an abnormal position and surgery is often required to correct this condition. To evaluate outcomes of surgery, we need an instrument to assess which many questionnaires have been designed over the years. One of the most well-known is the PPPS questionnaire. This questionnaire in addition to the surgeon's opinion, has the ability to assess outcomes of this surgery by getting feedback from the patient's family and the patient himself. A higher score in this questionnaire means higher satisfaction of the patient with the results of this surgery. The current study aims to translate and validate the Persian version of the PPPS questionnaire to evaluate the outcomes of hypospadias surgery. Method: Based on inclusion and exclusion criteria, eligible individuals were selected. In this study, we translated the PPPS questionnaire from English to Persian and then assessed its validity and reliability. First, the questionnaire was translated into Persian by experts in the field of hypospadias. 25 images of hypospadias surgery with different degrees and spread with different improvements were selected and provided to 25 parents of patients who had undergone corrective hypospadias surgery in the past. They were asked to express their opinion about each photo using the questionnaire. This was repeated one week later. First, Cronbach's alpha criterion was examined and then the Test-Retest method was used to evaluate the reliability of this questionnaire. All statistical analyzes performed in this study were performed using SPSS version 24 software and results of tests with P-value less than 0.05 will be considered significant. Results: The reliability of the questionnaire was evaluated using Test-retest after one week which showed excellent results, both with the Pearson correlation test and also with high ICC scores for both the total score and for each individual parameter. The average ICC size for the total score was 0.998 indicating almost perfect reliability. The range of correlation was between 0.691 and 0.999 indicating the stability of participants' opinions between the two time periods.