✅ Considering the importance of pelvic girdle and a significant correlation between these two questionnaires, it seems useful to use a questionnaire and a tool with a high degree of accuracy which requires shorter time to complete. Therefore, it can be concluded that a brief pain instrument is a useful tool for measuring pain and its effects in the life of patients with pelvic girdle.
Lower back pain and pelvic girdle pain are among the most common problems during pregnancy [1], with a prevalence of about 45% during pregnancy [2]. Pelvic girdle pain is referred to as pain in the areas of the pubic symphysis between the iliac crest and the gluteal sulcus, especially the sacroiliac joint [3]. Pain in pelvic belt is multifactorial and is caused by various conditions [4]. No specific risk factor can be reported for pelvic belt pain. Perhaps during pregnancy, physiological and hormonal changes, a combination of low back and pelvic pain at the beginning of pregnancy, poor sexual relationships, polygamy, lack of job satisfaction, and stress are all effective and contributing factors to pelvic pain [5,8,3].
Evaluation of appropriate and inexpensive diagnostic methods, preventive treatments and rational treatment are needed to properly evaluate interventions, reliable and valid measurements. Current criteria do not adequately describe the problems, complications, and exacerbations of pelvic pain. On the other hand, pain assessment is of particular importance in patients with chronic pain [13].
One tool is Pelvic Girdle Questionnaire during pregnancy. The collecting tool was first designed by Stuge et al. [14].
Despite the specificity of the pelvic girdle pain instrument, its features and capability have not been compared to other conventional instruments [20].
Many studies show that pain intensity estimate by health care providers are inconsistent with the pain patients experience and express. This disagreement may depend on the validity of the pain assessment tool [21].
Since different studies have used these two instruments to measure pain, to investigate the overlap between two instruments in measuring pain in pregnant women, this study aimed to investigate the correlation between Brief Pain Inventory Questionnaire and Pelvic Girdle Questionnaire in Pregnant Women with pelvic belt pain in Iran was performed.
The present study is a descriptive study that evaluated 135 pregnant women with pelvic pain (whose pelvic girdle pain was confirmed by diagnostic test of pelvic girdle pain: LDL test Long dorsal sacroiliac) who referred to health centers affiliated to Shahid Beheshti University of Medical Sciences, Tehran, in 2017. Sample size was calculated based on the prevalence and study formula of Golis et al. (135) (d: 8%, P: 36%, 95% confidence interval) [23]. Data collection tools included participants' demographic data form, Pelvic Girdle Questionnaire and Brief Pain Inventory-short form (BPI-SF).
Inclusion criteria were being Iranian, confirmation of pelvic girdle pain with Long dorsal sacroiliac test (LDL), pregnancy over 20 weeks, no acute and chronic underlying disease (feeling any pain in pelvic area, history of pelvic fracture, any Malignancy, inflammatory arthropathy, active urinary or intestinal infection, and neurological diseases) and exclusion criteria were non-responsive to all questionnaire questions.
After researching pelvic girdle pain test and confirmation of pelvic girdle pain, then the questionnaires were given to the research units and the completed questionnaires were collected by the researcher.
The results were analyzed by descriptive, correlation and regression tests using SPSS 22 (SPSS Inc., Chicago, IL., USA). The P-value>0.05 was considered significant.
The results of the study, which included 135 pregnant women with pelvic pain, showed that the mean and standard deviation of age in the studied women was 29.43±5.7. Body mass index in women was 26.41±3.70. Most of the cases (65.9%, n=89) were employed. And 55.6% were primiparous (n=75) (Table 1).
Table 1. Demographic characteristics of research units
Mean pain was 37.00±18.00 based on pelvic belt and 4.25±1.87 on brief pain inventory (Table 2).
Table 2. Mean and standard deviation of pain score based on Brief Pain Inventory and Pelvic Girdle Questionnaire.
In the present study, the symptoms and limitations of pain activity and effects of pelvic girdle pain were moderate, but the severity of the pain and its effects on daily living in a brief pain tool were mild and this difference may be severe. Because of the difference in the number of questions, the different dimensions of the impact of pelvic girdle pain on life and its disability, specificity and sensitivity of the pelvic girdle pain tool to the more general (brief pain) tool should be considered. Many studies show that pain intensity estimated by health care providers are inconsistent with the pain patients experience and express [28–30], which is consistent with the results of the present study. The limitations of this study include the role of other factors affecting pain and responsiveness to pain assessment tools.
Given the importance of pelvic girdle pain assessment and a significant correlation between the two questionnaires, it seems useful to use a questionnaire and a high-precision instrument that requires shorter time to complete; therefore brief pain inventory seems to be a good tool for measuring pain and its effects on the life of patients with pelvic girdle pain.
This article is part of a research project approved by the Midwifery and Reproductive Health Research Center, code 11754. We are grateful for the cooperation and assistance of the faculty, library, and computer department of Shahid Beheshti University of Medical Sciences and the Center for Midwifery and Reproductive Health for their contribution in this research, and also for the sincere cooperation of mothers. Thanks also to the Honorable Research Assistant of Shahid Beheshti University of Medical Sciences for their support.
The authors declared no conflict of interest regarding the publication of this article.
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