Short Sexual Well-Being Scale - a cross-sectional validation among transgender and cisgender people

Collating the voice of people with autoimmune diseases: Methodology for the Third Phase of the COVAD Studies

INTRODUCTION

The growing recognition of holistic patient care highlights the various factors shaping the quality of life of individuals with autoimmune and rheumatic diseases (AIRDs). Beyond the traditional disease measures, there is an emerging acknowledgment of the less-explored aspects, including subjective well-being, social determinants of health, comorbidities, mental health, and medication adherence. Moreover, digital health services have empowered patients to engage actively in decision-making alongside clinicians. To explore these domains within the context of AIRDs, the "Collating the Voice of People with Autoimmune Diseases" COVAD survey was conceived, a successor of the previous two COVAD surveys. In this document, we present the study protocol in comprehensive detail.

METHODS

The COVAD-3 survey is a cross-sectional patient self-reported e-survey incorporating multiple widely accepted scales/scores to assess various aspects of patients' lifestyles objectively. To ensure the survey's accuracy and usability across diverse regions, it will be translated into multiple languages and subjected to rigorous vetting and pilot testing. It will be distributed by collaborators via online platforms and data will be collected from patients with AIRDs, and healthy individuals over eight months. Data analysis will focus on outcome measures related to various social, demographic, economic, and psychological factors.

CONCLUSION

With the increasing awareness to adopt a holistic treatment approach encompassing all avenues of life, the COVAD-3 survey aims to gain valuable insights into the impact of social, demographic, economic, and psychological determinants of health on the subjective well-being in patients with AIRDs, which will contribute to a better understanding of their overall health and well-being.

Network Analysis of Sexual Well-Being in Women with Heart Failure: The Psychocardiological Perspective

Sexuality is an important sphere of every person's life. Sexual dysfunctions and sexual dissatisfaction may also be present in cardiac diseases. Individuals affected by heart failure (HF) deserve special attention since it can be the final stage of many cardiac diseases. Therefore, it is important to verify potential correlates of sexual well-being in individuals with HF. This study was conducted online between 2019 and 2023, and 262 Polish women aged between 18 and 59 years (M = 45.48; SD = 7.65) participated in it. The Short Sexual Well-Being Scale, Depression Anxiety and Stress Scale, Fatigue Assessment Scale, and authors' questionnaire were used. Relationships between tested variables were verified with the use of network analysis performed with the EBICglasso estimator. Centrality assessment showed that sexual well-being had the highest values of betweenness, closeness and degree, followed by fatigue and depression measures. Sexual well-being was negatively related to the number of declared sexual dysfunctions, fatigue, stress and depression levels. Participants' age and HF duration were not related to the sexual well-being of tested women. Multiple additional partial correlations were detected. The obtained results show that sexuality may be a central sphere of life in women with HF and that one's sexuality should not be negated when working with cardiac patients.

Conceptualizing Sexual Wellbeing: A Qualitative Investigation to Inform Development of a Measure (Natsal-SW)

Despite increasing scientific and policy interest in sexual wellbeing, it remains poorly conceptualized. Many studies purporting to measure it instead measure related but distinct concepts, such as sexual satisfaction. This lack of conceptual clarity impedes understanding, measuring, and improving sexual wellbeing. We present qualitative research from multi-stage, mixed-methods work to develop a new measure of sexual wellbeing (Natsal-SW) for the fourth British National Survey of Sexual Attitudes & Lifestyles. Literature review and discussion generated a conceptual framework with seven proposed domains: respect, self-esteem, comfort, self-determination, safety and security, forgiveness, and resilience. Semi-structured interviews with 40 adults aged 18-64 then explored whether and how these domains aligned with participants' own understandings, experiences, and language of sexual wellbeing. Data were analyzed thematically. Participants conceptualized sexual wellbeing as distinct from sexual satisfaction and sexual health and as multidimensional, dynamic, and socially and structurally influenced. All seven proposed domains resonated with accounts of sexual wellbeing as a general construct. The personal salience of different domains and their dimensions varied between individuals (especially by gender and sexual orientation) and fluctuated individually over time. This study clarifies dimensions of domains that participants considered important, providing an empirical basis to inform development of a new measure of sexual wellbeing.

Development and Validation of a Brief Measure of Sexual Wellbeing for Population Surveys: The Natsal Sexual Wellbeing Measure (Natsal-SW)

Sexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test-retest reliability. Confirmatory factor analysis indicated that a "general specific model" had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (-0.384), anxiety (-0.340), sexual satisfaction (0.680) and sexual distress (-0.615), and demonstrated good test-retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations.

Sexual Well-Being in Individuals with Schizophrenia: A Pilot Study on the Role of Self-Esteem and Acceptance of Illness

Schizophrenia is one of the most severe chronic mental illnesses. It drastically changes an individual's life and well-being. Sexual well-being in schizophrenia is often sidelined, even though it is one of the main areas for maintaining quality of life. Based on the conservation of resources theory (COR) and empirical data, we assume that self-esteem and acceptance of illness help in coping with schizophrenia and maintaining sexual well-being. This pilot study aimed to determine the relationship between self-esteem, acceptance of illness, and sexual well-being in Polish individuals with schizophrenia. The results of 60 individuals were included in this study. In the present study, the Self-Esteem Scale (SES), Acceptance of Illness Scale (AIS), and Short Sexual Well-Being Scale (SSWBS) were used. The study showed a significant association between self-esteem, acceptance of illness, and sexual well-being. Self-esteem (β = 0.62) and acceptance of illness (β = 0.55) acted as positive and significant predictors of sexual well-being in individuals with schizophrenia. Acceptance of illness was also found to play a mediating role between self-esteem and sexual well-being in people with schizophrenia (indirect effect: β = 0.34; LLCI = 0.063; ULCI = 0.839). The current pilot study demonstrates the relationship between self-esteem, acceptance of illness, and sexual well-being. Our findings highlight the significant role of acceptance of illness in maintaining sexual well-being among individuals with schizophrenia.

Anxiety, Attachment Styles and Life Satisfaction in the Polish LGBTQ+ Community

Poland is one of the most discriminatory places in Europe. The political situation, legal policies, and society's attitude towards people from the LGBTQ+ community in Poland clearly indicate the need to study the mental health and well-being of this group of individuals. Based on Meyer's minority stress theory, Bowlby's attachment theory, the Ainsworth attachment framework, Diener's subjective well-being model, and provided empirical evidence, this study examined the significance of attachment styles and anxiety as predictors of life satisfaction among the Polish LGBTQ+ community. It also explored the differences between LGBTQ+ and heterosexual individuals in the levels of tested variables. A total of 414 participants took part in this study, of whom most study participants were young adults (M = 24.50; SD = 6.94). Of those, 130 participants identified themselves as heterosexual, while 284 declared themselves members of the LGBTQ+ community. The Satisfaction with Life Scale, Plopa's Attachment Styles Questionnaire, and the State-Trait Anxiety Inventory were used. Data demonstrate that anxiety and attachment styles were significant predictors of life satisfaction in the LGBTQ+ community. Moreover, LGBTQ+ individuals had higher non-secure attachment styles and anxiety scores, and lower life satisfaction scores in comparison to heterosexual individuals. The presented study is the first Polish study to test such relationships in the Polish LGBTQ+ community. It draws attention to lower life satisfaction among study participants representing the LGBTQ+ community in comparison to cisgender heterosexual individuals. This indicates that researchers, clinical specialists and practitioners should try to improve the levels of subjective well-being in Polish LGBTQ+ individuals, for example, through psychoeducational and supportive programs. In addition, the presented results highlight the possible important role of attachment styles in the functioning of the presented group.

Chemsex and Sexual Well-Being in Young Polish Men

Chemsex refers to the use of psychoactive drugs for sexual purposes-before or during sex. This phenomenon mainly affects men, in particular those belonging to the LGBTQIA+ (lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual, and more diverse individuals) community. From the perspective of the transactional theory of stress, chemsex can be considered a strategy for coping with stress, which is why it is also extremely important to verify its role in functioning outside the sexual sphere. For this reason, this study verified the relationship between the use of chemsex, perceived stress, sexual well-being, and life satisfaction in young Polish men. The study involved 175 men (67 people using chemsex and 108 people in the control group) between 18 and 33 years of age. The Perceived Stress Scale, the Short Scale of Sexual Well-being, the Satisfaction with Life Scale, and the authors' questionnaire about the use of chemsex were used. It was observed that individuals using chemsex showed a significantly lower level of sexual well-being and satisfaction with life (moderate effects) and a higher level of perceived stress (strong effect) when compared to the control group not using psychoactive substances. Additionally, a positive and moderate relationship was observed between the number of psychoactive substances used and perceived stress in the group of individuals using chemsex. Moreover, the number of substances used and the level of perceived stress were negatively and moderately related to the level of well-being in these individuals. It was also shown that perceived stress was a significant predictor of the number of psychoactive substances used before and during sex and that perceived stress and the number of psychoactive substances used were significant and negative predictors of life satisfaction and sexual well-being, explaining a large portion of their variance.