The Female Sexual Function Index (FSFI): Validation of the Malay Version

Arabic translation of Female Sexual Function Index and validation in an Egyptian population

INTRODUCTION

Female sexual dysfunction (FSD) is a prevalent health problem that has been inadequately investigated in the Arab world. An Arabic assessment instrument for FSD is urgently needed.

AIM

To validate the Arabic version of the Female Sexual Function Index (ArFSFI).

METHODS

This is a cross-sectional study conducted between January and April 2010. Eight hundred and fifty-five women (16-60 years old) participated in the study. Validation was carried out on aspects of face, content, discriminant, and criterion (concurrent) validity. Construct validity was evaluated using principal component analysis. Reliability studies on test-retest and on internal consistency were conducted with Pearson correlation and Cronbach's alpha, respectively. The best cutoff point for the ArFSFI to differentiate cases and noncases was determined using a receiver operating characteristic (ROC) curve.

MAIN OUTCOME MEASURE

Parameters of validity and reliability of the ArFSFI and its domains.

RESULTS

ArFSFI total score and scores of various domains showed high test-retest reliability (r from 0.92 to 0.98). ArFSFI domains showed high internal consistency (α from 0.85 to 0.94). Six hundred and forty-four women (75.32%) met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for diagnosis of sexual dysfunction while 211 women (24.68%) showed normal function. The ArFSFI was found to have good discriminant validity. There were significant differences between the mean scores of women with sexual dysfunction and those of women without sexual dysfunction. A total score of 28.1 was taken as the cutoff point for the ArFSFI to distinguish between women with FSD and women with normal function (sensitivity 96.7%, specificity 93.2%). The ArFSFI showed an excellent overall performance (area under the curve [AUC] = 0.985, 95% confidence interval 0.978-0.992).

CONCLUSION

The ArFSFI is a validated, reliable, and locally accepted tool for use in the assessment of FSD in the Egyptian population.

Prevalence, risk factors, and predictors of female sexual dysfunction in a primary care setting: a survey finding

INTRODUCTION

Female sexual dysfunction (FSD) is a highly prevalent sexual health problem but poorly investigated at the primary care level.

AIM

This article examines the prevalence of sexual dysfunction and its possible risk factors associated with women at high risk of FSD in a hospital-based primary practice.

METHODS

A validated Malay version of the Female Sexual Function Index (MVFSFI) was utilized to determine FSD in a cross-sectional study design, involving 163 married women, aged 18-65 years, in a tertiary hospital-based primary care clinic in Kuala Lumpur, Malaysia. Sociodemographic, marital profile, health, and lifestyle for women at high risk of FSD and those who were not at high risk were compared and their risk factors were determined.

MAIN OUTCOME MEASURES

Prevalence of FSD in Malaysian women based on the MVFSFI, and its risk factors for developing FSD.

RESULTS

Some 42 (25.8%) out of 163 women had sexual dysfunction. Prevalence of sexual dysfunction increased significantly with age. Sexual dysfunctions were detected as desire problem (39.3%), arousal problem (25.8%), lubrication problem (21.5%), orgasm problem (16.6%), satisfaction problem (21.5%) and pain problems (16.6%). Women at high risk of FSD were significantly associated with age (OR 4.1, 95% CI 1.9 to 9.0), husband's age (OR 4.3 95% C.I 1.9 to 9.3), duration of marriage (OR 3.3, 95% CI 1.6 to 6.8), medical problems (OR 8.5, 95% CI 3.3 to 21.7), menopausal status (OR 6.6, 95% CI 3.1 to 14.3), and frequency of sexual intercourse (OR 10.7, 95% CI 3.6 to 31.7). Multivariate analysis showed that medical problem (adjusted OR 4.6, 95% CI 1.6 to 14.0) and frequency of sexual intercourse (adjusted OR 7.2, 95% CI 2.1 to 24.0) were associated with increased risk of having FSD. Those who practiced contraception were less likely to have FSD.

CONCLUSION

Sexual health problems are prevalent in women attending primary care clinic where one in four women were at high risk of FSD. Thus, primary care physician should be trained and prepared to address this issue.

Development and validation of Chinese version of female sexual function index in a Chinese population-a pilot study

INTRODUCTION

Female sexual dysfunction (FSD) is a prevalent problem that has been continuously overlooked in mainland China. An assessment instrument for FSD is urgently needed.

AIM

To develop and validate the Chinese version of the Female Sexual Function Index (CVFSFI) to assess FSD in China.

METHODS

A total of 328 women (20-65 years old) participated in this study. The CVFSFI was developed through the procedures of translation, back translation, revision by research team, and pilot study. After an interview for clinical diagnosis of FSD based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria, all participants completed the CVFSFI for a validation study. Eighty-three women completed CVFSFI again 3-4 weeks after the first visit. Test-retest reliability was determined by Pearson product-moment correlations. Internal consistency reliability was estimated with Cronbach's alpha coefficient. Construct validity was evaluated by principal component analysis using varimax rotation. Discriminant validity was assessed with between-groups analysis of variance.

MAIN OUTCOME MEASURES

Including the reliability and the validity of the CVFSFI and its domains.

RESULTS

A total of 172 women (52.4%) met the DSM-IV-TR criteria for diagnosis of sexual dysfunction and were included in the FSD group, while 156 (47.6%) women without FSD were included in the control group. We showed that the overall test-retest reliability coefficients were high for total CVFSFI and each domain (r at least 0.69) and the internal consistency reliability of CVFSFI was within the acceptable range (Cronbach's alpha values: from 0.69 to 0.94). Moreover, the principal component analysis with varimax rotation produced six-factor structure similar to the original FSFI. We found significant differences in both total and domain scores between FSD and control groups, demonstrating a good discriminant validity of CVFSFI.

CONCLUSION

The CVFSFI is a reliable and valid questionnaire, which can be used in the assessment of FSD among Chinese women.