Journal of the European Society for Gynaecological Endoscopy


Validation of the Turkish version of Endometriosis Health Profile questionnaire (EHP-30) to evaluate the quality of life in women with endometriosis

E. Darici1,6, M. N. C. Kemahlı2,6, P. Y. Bahat3,6, B. Yücel4, E. Oral5,6

1 Centre for Reproductive Medicine Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium
2 Department of Obstetrics and Gynecology, University of Health Sciences, Istanbul Zeynep Kâmil Maternity and Childrens Hospital, Istanbul, Turkey
3 Department of Obstetrics and Gynecology, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
4 Department of Obstetrics and Gynecology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
5 Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey; 6Endometriosis & Adenomyosis Society, Turkey


Endometriosis, questionnaire, translation, validity, quality of life

Published online: Jun 30 2023


Background: The Endometriosis Health Profile-30 (EHP-30) is a commonly used tool for assessing the impact of endometriosis on a person’s quality of life. The EHP-30 is a 30-item questionnaire that measures various aspects of endometriosis-related health, including physical symptoms, emotional well-being, and functional impairment.

Objectives: EHP-30 has not yet been evaluated with Turkish patients. Therefore, we aim to develop and validate the Turkish version of EHP-30 in this study.

Materials and Methods: This cross-sectional study was conducted with 281 randomly selected patients from Turkish Endometriosis Patient-Support Groups. The items of the EHP-30 distributed across 5 subscales of the core questionnaire are generally applicable to all women with endometriosis. There are 11 items on the pain scale, 6 on the control and powerlessness scale, 4 on the social support scale, 6 on the emotional well-being scale, and 3 on the self-image scale. The patients were asked to complete the form with brief demographic information and psychometric evaluation included factor analysis, convergent validity, internal consistency, test-retest reliability, data completeness and the determination of floor and ceiling effects.

Main outcome measure: The main outcomes measures were the test-retest reliability, internal consistency, and the assessment of construct validity.

Results: In this study, 281 completed questionnaires were included with a return rate of 91%. Data completeness was accepted as excellent on all subscales. Floor effects were found in medical profession (37%), children (32%) and work (31%) modules. No ceiling effects were found. Division of the core questionnaire into five subscales identical to the original EHP-30 was confirmed by factor analysis performed. The intraclass correlation coefficient for agreement varied from 0.822 to 0.914. There was agreement between the EHP-30 and EQ-5D-3L on both of the hypotheses that were tested. There was a statistically significant difference in scores between endometriosis patients and healthy women across in all subscales (p<.01).

Conclusion: The results of this validation study for the EHP-30 indicated a high level of data completeness, with no significant floor or ceiling effects. The questionnaire demonstrated good internal consistency and excellent test-retest reliability. These findings confirm that the Turkish version of the EHP-30 is a valid and reliable toolfor measuring the health-related quality of life in individuals with endometriosis.

What’s new? EHP-30 had not yet been evaluated with Turkish patients and the results of this study demonstrate the validity and reliability of the Turkish translation of the EHP-30 in assessing endometriosis patients’ health-related quality of life.

ClinicalTrials Registration: NCT04862364.