The Diastasis Rectus Abdominis Questionnaire (DRAQ): development and validation of a questionnaire to evaluate the biopsychosocial impact of diastasis rectus abdominis in parous females

Abstract Background To develop Spanish and English versions of the Diastasis Rectus Abdominis Questionnaire (DRAQ) to quantify the biopsychosocial impact of diastasis rectus abdominis (DRA) in adults assigned female at birth, and to test psychometric properties of the Spanish version. Methods Items were generated from a systematic review and a survey ( n = 319) with qualitative coding mapped to the International Classification of Functioning, Disability and Health. An expert panel ( n = 11) and Spanish pilot test ( n = 30) assessed comprehensibility, comprehensiveness and relevance. The English version was produced by transcultural adaptation and pilot tested for content validity ( n = 30). Spanish psychometrics were evaluated in a validation sample ( n = 137): internal consistency, test–retest reliability ( n = 80; 7–10 days), convergent validity and exploratory factor analysis. Results Thirty-three items were drafted; six were removed, yielding a 27-item DRAQ in Spanish and English with content validity. The Spanish DRAQ showed excellent internal consistency (α = 0.969) and test–retest reliability (ICC = 0.941). Exploratory factor analysis supported two factors: physical/functional impact and psychosocial impact. Conclusions The DRAQ is a patient-reported measure of disability-relevant biopsychosocial impact of DRA; the Spanish version is reliable with a two-factor structure, and the English version shows content validity for use alongside clinical examination. Trial registration NCT04158180, Date of registration: 04/11/2019.