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Kieseker GA, Anderson DJ, Porter-Steele J, McCarthy AL. A psychometric evaluation of the Female Sexual Function Index in women treated for breast cancer. Cancer Med 2022; 11:1511-1523. [PMID: 35132802 PMCID: PMC8921899 DOI: 10.1002/cam4.4516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background We aimed to determine the psychometric properties and factor structure of the 19‐item Female Sexual Function Index (FSFI) in 132 sexually active women previously treated for breast cancer. Methods Confirmatory factor analysis explored three models: (a) second‐order six‐factor, (b) six‐factor, and (c) five‐factor models combining the desire and arousal subscales. Results Results revealed excellent reliability for the total score (Cronbach's α = 0.94), and domain scores (all Cronbach's αs > 0.90), and good convergent and discriminant validity. The six‐factor model provided the best fit of the models assessed, but a marginal overall fit (Tucker–Lewis index = 0.91, comparative fit index = 0.93, root mean square error of approximation = 0.09). Exploratory factor analyses (EFA) supported a four‐factor structure, revealing an arousal/orgasm factor alongside the original pain, lubrication, and satisfaction domains. Conclusion The arousal/orgasm factor suggests a “sexual response” construct, potentially arising from an underlying latent factor involving physical and mental stimulation in conceptualizations of arousal and orgasm in women treated for breast cancer. Finally, the EFA failed to capture an underlying desire factor, potentially due to measurement error associated with the small number of items (two) in this domain. Despite evidence that the FSFI has sound psychometric properties, our results suggest that the current conceptualizations of the FSFI might not accurately represent sexual functioning in women previously treated for breast cancer. Further research is required to elucidate the factors that influence desire, arousal, and orgasm in sexually active women in this population, and the reasons underlying sexual inactivity. Practical and theoretical implications for FSFI use in this population are discussed.
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Affiliation(s)
- Genevieve A Kieseker
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Debra J Anderson
- Faculty of Health, The University of Technology Sydney, Ultimo, Australia
| | - Janine Porter-Steele
- Choices Cancer Support Program, Wesley Hospital, Brisbane, Queensland, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, and Mater Research Institute, St Lucia, Queensland, Australia
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Ho TTT, Le MT, Truong QV, Nguyen VQH, Cao NT. Validation of the Vietnamese Translation Version of the Female Sexual Function Index in Infertile Patients. Sex Med 2019; 8:57-64. [PMID: 31669053 PMCID: PMC7042161 DOI: 10.1016/j.esxm.2019.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/17/2019] [Accepted: 09/18/2019] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION The Female Sexual Function Index (FSFI) is regarded as a self-administered screening questionnaire for assessing the presence of any type of sexual dysfunction. AIM The aim of this study was to investigate the psychometric properties of the Vietnamese translation version of the Female Sexual Function Index (VN-FSFI) in a sample of infertile Vietnamese women. METHODS An existing Vietnamese translated-FSFI version was used as a first-step approach to back-translate into English. Based on the comparison of the original English version and the back-translation script, a modified version of the FSFI was revised. This version was evaluated for "content validity" by a panel of 3 experts and for "face validity" by a pilot study that was based on its results to refine to reach the last Vietnamese FSFI version (VN-FSFI version). A cross-sectional survey to investigate psychometric reliability and validity of the last VN-FSFI version was conducted with 271 infertile Vietnamese women from January 2017 through February 2018, at a hospital located in a central region of Vietnam. Construct validity was evaluated by principal component analysis using varimax rotation and factor analysis. Reliability studies on internal consistency (Cronbach's alpha coefficient, domain inter-correlations, and domain-total correlations) and on test-retest (Intraclass correlation coefficient). MAIN OUTCOME MEASURE Construct validity and the reliability of the VN-FSFI version. RESULTS Based on principal component analysis, a 5-factor model was established, consisting of arousal/orgasm, satisfaction, pain, lubrication, and desire that explained 72.32% of the total variance. The factorial structure supported to 6 retrieved domains that corresponded to the original version. The Cronbach's alpha coefficients were 0.92 for the total scale and 0.72-0.89 for the domains. Domain inter-correlations ranged from 0.36-0.73 and domain-total correlation coefficients ranged from 0.67-0.84. Test-retest correlation coefficients over 2-4 weeks were 0.97 (P < .001) for the total scale and 0.84-0.96 for the domains. CONCLUSION With good psychometric properties, which are almost similar to the original English version, this Vietnamese translation version of the Female Sexual Function Index (VN-FSFI version) was proved to be a valid and reliable instrument to measure multidimensional aspects of sexual function in infertile Vietnamese women. Ho TTT, Le MT, Truong QV, et al. Validation of the Vietnamese Translation Version of the Female Sexual Function Index in Infertile Patients. Sex Med 2019;8:57-64.
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Affiliation(s)
- Thanh Tam Thi Ho
- PhD candidate, Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Minh Tam Le
- Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Hue University, Hue City, Vietnam; Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.
| | - Quang Vinh Truong
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Vu Quoc Huy Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Ngoc Thanh Cao
- Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Hue University, Hue City, Vietnam; Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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Neijenhuijs KI, Hooghiemstra N, Holtmaat K, Aaronson NK, Groenvold M, Holzner B, Terwee CB, Cuijpers P, Verdonck-de Leeuw IM. The Female Sexual Function Index (FSFI)-A Systematic Review of Measurement Properties. J Sex Med 2019; 16:640-660. [PMID: 30956110 DOI: 10.1016/j.jsxm.2019.03.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/18/2019] [Accepted: 03/02/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The Female Sexual Function Index (FSFI) is a patient-reported outcome measure measuring female sexual dysfunction. The FSFI-19 was developed with 6 theoretical subscales in 2000. In 2010, a shortened version became available (FSFI-6). AIM To investigate the measurement properties of the FSFI-19 and FSFI-6. METHODS A systematic search was performed of Embase, Medline, and Web of Science for studies that investigated measurement properties of the FSFI-19 or FSFI-6 up to April 2018. Data were extracted and analyzed according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Evidence was categorized into sufficient, insufficient, inconsistent, or indeterminate, and quality of evidence as very high, high, moderate, or low. MAIN OUTCOME MEASURES The Main Outcome Measure is the evidence of a measurement property, and the quality of evidence based on the COSMIN guidelines. RESULTS 83 studies were included. Concerning the FSFI-19, the evidence for internal consistency was sufficient and of moderate quality. The evidence for reliability was sufficient but of low quality. The evidence for criterion validity was sufficient and of high quality. The evidence for structural validity was inconsistent of low quality. The evidence for construct validity was inconsistent of moderate quality. Concerning the FSFI-6, the evidence for criterion validity was sufficient of moderate quality. The evidence for internal consistency was rated as indeterminate. The evidence for reliability was inconsistent of low quality. The evidence for construct validity was inconsistent of very low quality. No information was available on structural validity of the FSFI-6, and measurement error, responsiveness, and cross-cultural validity of both FSFI-6 and FSFI-19. CLINICAL IMPLICATIONS Conflicting and lack of evidence for some of the measurement properties of the FSFI-19 and FSFI-6 indicates the importance of further research on the validity of these patient-reported outcome measures. We advise researchers who use the FSFI-19 to perform confirmatory factor analyses and report the factor structure found in their sample. Regardless of these concerns, the FSFI-19 and FSFI-6 have strong criterion validity. Pragmatically, they are good screening tools for the current definition of female sexual dysfunction. STRENGTH & LIMITATION A strong point of the review is the use of predefined guidelines. A limitation is the use of a precise rather than a sensitive search filter. CONCLUSIONS The FSFI requires more research on structural validity (FSFI-19 and FSFI-6), reliability (FSFI-6), construct validity (FSFI-19), measurement error (FSFI-19 and FSFI-6), and responsiveness (FSFI-19 and FSFI-6). Further corroboration of measurement invariance (both across cultures and across subpopulations) in the factor structure of the FSFI-19 is necessary, as well as tests for the unidimensionality of the FSFI-6. Neijenhuijs KI, Hooghiemstra N, Holtmaat K, et al. The Female Sexual Function Index (FSFI)-A Systematic Review of Measurement Properties. J Sex Med 2019;16:640-660.
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Affiliation(s)
- Koen I Neijenhuijs
- Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Nienke Hooghiemstra
- Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Karen Holtmaat
- Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mogens Groenvold
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, CL-Service, Medical University of Innsbruck, Innsbruck, Austria
| | - Caroline B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands; Amsterdam UMC, Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
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Maroufizadeh S, Hosseini M, Rahimi Foroushani A, Omani-Samani R, Amini P. The relationship between marital satisfaction and depression in infertile couples: an actor-partner interdependence model approach. BMC Psychiatry 2018; 18:310. [PMID: 30253779 PMCID: PMC6156872 DOI: 10.1186/s12888-018-1893-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 09/17/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Much evidence consistent with the Marital Discord Model of Depression (MDMD) suggests that marital discord is associated with depression, but no studies examine the relationship between marital satisfaction and depression at the dyadic level in infertile couples. This study examined the effect of actors' and partners' marital satisfaction on depressive symptoms in husband-wife dyads with infertility using an innovative dyadic analysis approach, the Actor-Partner Interdependence Model (APIM). METHODS In this cross-sectional study, the sample comprised of 141 infertile couples in the evaluation phase of treatment. We collected data in a referral infertility center in Tehran, Iran between February and May 2017. Marital satisfaction and depression were measured using ENRICH marital satisfaction scale and Hospital Anxiety and Depression Scale, respectively, before starting the treatment. Dyadic analysis applying the APIM was used. In this study, actor effect is the impact of a person's marital satisfaction on his/her own depression. Partner effect is the impact of a person's marital satisfaction on his/her partner's depression. RESULTS The APIM analysis revealed that both men and women's marital satisfaction excreted an actor effect on their own depression (β = - 0.412, P < 0.001; β = - 0.263, P = 0.002, respectively). Furthermore, men's marital satisfaction exerted a significant partner effect on their wives' depression symptoms (β = - 0.170, p = 0.047). However, the wives' marital satisfaction was not related to their husbands' depressive symptoms (β = - 0.028, P = 0.735). CONCLUSIONS The findings support that the MDMD is a valid theoretical model for the conceptualization of marital satisfaction and depressive symptoms among infertile couples and suggest that interventions to reduce depressive symptoms should include both men and women.
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Affiliation(s)
- Saman Maroufizadeh
- 0000 0001 0166 0922grid.411705.6Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Rahimi Foroushani
- 0000 0001 0166 0922grid.411705.6Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Omani-Samani
- grid.417689.5Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Payam Amini
- grid.417689.5Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Selcuk S, Kucukbas M, Cam C, Eser A, Devranoglu B, Turkyilmaz S, Karateke A. Validation of the Turkish Version of the Sexual Health Outcomes in Women Questionnaire (SHOW-Q) in Turkish-Speaking Women. Sex Med 2016; 4:e89-94. [PMID: 26984290 PMCID: PMC5005310 DOI: 10.1016/j.esxm.2016.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 12/25/2015] [Accepted: 01/07/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The Sexual Health Outcomes in Women Questionnaire (SHOW-Q) is designed to evaluate the sexual life of women for satisfaction, orgasm, desire, and pelvic problem interference. The SHOW-Q is important for evaluating worsening of sexual life for patients with pelvic problems and the management of these women to improve their sexual life. AIMS To validate the Turkish versions of the SHOW-Q for Turkish-speaking women. METHODS The Turkish version of the SHOW-Q was generated by two independent professional English-to-Turkish translators. The translated version of the SHOW-Q was reverse translated by two bilingual translators whose native language was English. Women with at least one symptom related to pelvic problems (n = 71) and those with no symptoms (n = 38) were included in the present study. MAIN OUTCOME MEASURES Test-retest reliability analysis, content-face validity, internal consistency reliability, item-total correlations, convergent validity, construct validity, and factorial validity were performed to assess the psychometric properties of the Turkish versions of the SHOW-Q. RESULTS Test-retest reliability demonstrated good correlation for all subscales. Cronbach α values ranged from 0.735 to 0.892 and indicated high internal consistency. There was a strong correlation for the corresponding subscales between the SHOW-Q and the Female Sexual Function Index. The mean score of each SHOW-Q subscale showed significant differences between symptomatic and asymptomatic patients. CONCLUSION The Turkish version of the SHOW-Q is a valid and reliable instrument that can be used to evaluate the sexual life of Turkish-speaking women with different pelvic problems.
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Affiliation(s)
- Selcuk Selcuk
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey.
| | - Mehmet Kucukbas
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Cetin Cam
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Eser
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Belgin Devranoglu
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Sebnem Turkyilmaz
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Ates Karateke
- Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
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Nowosielski K, Wróbel B, Kowalczyk R. Women's Endorsement of Models of Sexual Response: Correlates and Predictors. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:291-302. [PMID: 26601676 DOI: 10.1007/s10508-015-0611-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 08/17/2015] [Accepted: 08/25/2015] [Indexed: 06/05/2023]
Abstract
Few studies have investigated endorsement of female sexual response models, and no single model has been accepted as a normative description of women's sexual response. The aim of the study was to establish how women from a population-based sample endorse current theoretical models of the female sexual response--the linear models and circular model (partial and composite Basson models)--as well as predictors of endorsement. Accordingly, 174 heterosexual women aged 18-55 years were included in a cross-sectional study: 74 women diagnosed with female sexual dysfunction (FSD) based on DSM-5 criteria and 100 non-dysfunctional women. The description of sexual response models was used to divide subjects into four subgroups: linear (Masters-Johnson and Kaplan models), circular (partial Basson model), mixed (linear and circular models in similar proportions, reflective of the composite Basson model), and a different model. Women were asked to choose which of the models best described their pattern of sexual response and how frequently they engaged in each model. Results showed that 28.7% of women endorsed the linear models, 19.5% the partial Basson model, 40.8% the composite Basson model, and 10.9% a different model. Women with FSD endorsed the partial Basson model and a different model more frequently than did non-dysfunctional controls. Individuals who were dissatisfied with a partner as a lover were more likely to endorse a different model. Based on the results, we concluded that the majority of women endorsed a mixed model combining the circular response with the possibility of an innate desire triggering a linear response. Further, relationship difficulties, not FSD, predicted model endorsement.
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Affiliation(s)
- Krzysztof Nowosielski
- Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, ul. Edukacji 102, 43-100, Tychy, Poland.
- Department of Sexology and Family Planning, Faculty of Health Science, Medical College in Sosnowiec, ul. Wojska Polskiego 6, 41-200, Sosnowiec, Poland.
| | - Beata Wróbel
- Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, ul. Edukacji 102, 43-100, Tychy, Poland
- Center for Sexual Medicine, ul Staszica 58, 41-300, Dabrowa Gornicza, Poland
| | - Robert Kowalczyk
- Department of Sexology, Faculty of Psychology and Arts, Andrzej Frycz Modrzewski Krakow University, ul. Gustawa Herlinga-Grudzińskiego 1, 30-705, Kraków, Poland
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