Psychometric properties of the Persian version of the CONTILIFE questionnaire for urinary incontinence

Urinary incontinence (UI) affects 10-40% of the global population, with stress urinary incontinence (SUI) significantly diminishing quality of life (QoL). The CONTILIFE questionnaire is a tool for assessing UI-specific QoL, but no validated Persian version exists despite high UI prevalence (20-60%) in Iranian women. This study aimed to culturally adapt and validate the CONTILIFE questionnaire for Persian-speaking populations with SUI. Following forward-backward translation, cognitive debriefing interviews were conducted with 30 women with SUI to ensure conceptual equivalence. The adapted questionnaire was then administered to 255 women with SUI (mean age 52.95 ± 12.96 years) recruited from two medical centers. Psychometric properties were evaluated through content validity (Content Validity Index [CVI] and Content Validity Ratio [CVR]), internal consistency (Cronbach's alpha), test-retest reliability (Intraclass Correlation Coefficient [ICC] over 7-14 days), and construct validity (exploratory factor analysis with principal component analysis and Varimax rotation) Content validity was robust, with mean domain CVI values of 0.86-0.95 and mean CVR of 0.96, exceeding recommended thresholds. The questionnaire demonstrated excellent internal consistency (Cronbach's α = 0.954) and high test-retest reliability (ICC = 0.952; 95% CI: 0.941−0.963). Exploratory factor analysis revealed a four-component structure explaining substantial variance: "Daily Life Impact," "Physical Challenges," "Self-Perception and Social Impact," and "Worry and Embarrassment." Item loadings ranged from 0.551 to 0.838, confirming meaningful factor assignments. Cross-cultural comparison with European, Turkish, and Moroccan adaptations revealed both universal physical impacts and culturally-nuanced psychosocial dimensions specific to Persian-speaking women. The culturally adapted Persian version of the CONTILIFE questionnaire demonstrates robust psychometric properties, including high content validity, excellent internal consistency, and strong test-retest reliability. The identified four-component structure provides culturally-relevant insights into SUI's impact on QoL among Persian-speaking women. This validated instrument addresses a critical gap in UI assessment for Persian populations and offers a reliable tool for clinical practice and research. Further validation in men, other UI subtypes, and assessment of responsiveness are recommended. This study adapted and validated the Persian version of the CONTILIFE questionnaire, confirming its reliability and validity for assessing the impact of urinary incontinence on the quality of life in Persian-speaking populations.