Psychometric properties of the Sexual Adjustment Questionnaire (SAQ) in the Iranian population with spinal cord injury

Dyadic adjustment and the relationship between sexual self-consciousness and sexual dysfunction in individuals with spinal cord injuries: A descriptive study

PURPOSE

This study was conducted to determine the dyadic adjustment between individuals with SCI and their spouses and the relationship between their sexual self-consciousness and sexual life and to evaluate it according to the objectification theory.

METHOD

This descriptive and cross-sectional study was conducted with 131 married individuals with SCI registered in the physical therapy and rehabilitation outpatient clinic of a university hospital between February 2020 and April 2021. The data of the study were collected using a Descriptive Information Form, the American Spinal Injury Association Impairment Scale (ASIA), the Dyadic Adjustment Scale (DAS), the Sexual Self-Consciousness Scale (SSCS), and the Arizona Sexual Experiences Scale (ASEX). In the study, the predictors of the sexual life of individuals with SCI were evaluated with the Stepwise Multiple Linear Regression analysis. In addition, predictors of sexual dysfunction in individuals with SCI were evaluated by the logistic regression analysis. The results were discussed within the framework of objectification theory.

RESULTS

According to the results of the study, .67.2% of the individuals with spinal cord injuries experienced sexual functionality problems; increased age, falling injuries, and being in ASIA grade A increased sexual self-awareness and sexual dysfunction; and being a male with SCI increased sexual focus. It was found that the adjustment between individuals with SCI and their spouses was a predictor that significantly reduced sexual embarrassment, sexual self-consciousness, and sexual dysfunction and that the strong adjustment between couples was an important factor for the prevention of sexual dysfunction development.

CONCLUSION

It was found that most individuals with spinal cord injuries experienced sexual dysfunction. The importance of dyadic adjustment and sexual self-consciousness has come to the fore in the sexual life of these individuals.

Measuring Sexual Performance: Development and Psychometric Properties of the Sexual Performance Questionnaire in Iranian People with Spinal Cord Injury

Sexual performance refers to activities served by sexual capacity and motivation. As a culturally sensitive issue, to date the scalar invariance of sexual performance has not been examined for Iranians with spinal cord injuries (SCIs). Aim: To develop and assess properties of an instrument evaluating sexual performance of an Iranian population with SCIs., in Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Using multi-modal methods, we developed and assessed the Sexual Performance Questionnaire (SPQ). This included collecting expert opinions; engaging with patients with SCI referred to BASIR; pilot testing to assess the scale; and a formal investigation. Participants (men = 156, women = 58) completed the SPQ. Internal consistency and reliability were measured using Cronbach's α coefficient. Content and face validity were examined by academic experts. Construct validity was assessed by examining convergent and discriminant validity. Finally, exploratory factor analysis was used to extract the factor structure of the questionnaire. The Cronbach's α coefficient was 0.77. There was a significant (p = 0.04) correlation (r = - 0.23) between the SPQ score and age. Those with a partner scored higher (p = 0.001). We found three components: Spouse as initiator, self-initiation, and genital-oriented sex which accounted for 59% of the observed variance. The face and content validity was approved by an expert committee. The development and application of the 13-item SPQ provides a thorough understanding of sexual performance amongst persons with SCI. It facilitates the development of efficient sexual rehabilitation interventions and SCI-specific sexuality education programs.

An evaluation of the factors that affect the sexual satisfaction of people with spinal cord injuries

Objective: To evaluate the relationships between the variables that affect the sexual satisfaction of patients with spinal cord injuries.Design: Descriptive and cross-sectional survey.Setting: The physical medicine and rehabilitation outpatient clinic of a university hospital in Turkey.Participants: This study was performed from July to December2018. It included 103 patients with spinal cord injuries.Outcome Measures: The data were collected using an introductory information form, the American Spinal Injury Association Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction. Data were evaluated using the chi-square test, the Mann-Whitney U test, the Kruskal-Wallis test and linear regression.Results: The total mean scores on the Golombok Rust Inventory of Sexual Satisfaction were 40.2 ± 21.6 for males and 44.9 ± 18.1 for females. According to the linear regression analysis, model VII presented the best results of the relationship between physiological and psychological determinants that affect the sexual satisfaction of patients with spinal cord injuries. Model VII consisted of the variables of ASIA A and B scores, age, injury due to falling from height, being a housewife, and thinking of being unable to reach future goals. These explained 75.4% of the variation in sexual satisfaction scores.Conclusion: The participants' mean scores on the Golombok Rust Inventory of Sexual Satisfaction were found to be affected by various variables. A significant relationship between their mean scores on the American Spinal Injury Association (ASIA) Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction was determined.

Sexual Compatibility with Spouse Questionnaire: Development and Psychometric Property Evaluation

Background

Sexual compatibility between husband and wife is an effective factor in both sexual and marital satisfaction. However, there is limited valid and reliable questionnaire to measure the degree of sexual compatibility between the couples.

Methods

In this exploratory mixed method study, 54 individuals were interviewed in the qualitative phase and 448 persons participated in the quantitative phase. Totally 502 participants (261 woman, 241 men) took part in this study. According to 205 final codes derived from the qualitative phase, 102 initial items were developed, the number of which reached 69 items after deletion and merging performed by the research team. After face validity, content validity and construct validity, 68 items were introduced into the construct validity phase.

Results

Following exploratory factor analysis and promax rotation, the items were reduced to 35 in 4 factors: "Requirements of a sexual relationship", "Sexual agreement", "Contextual obstacles" and "Outcomes of sexual compatibility". The questionnaire Cronbach alpha and correlation coefficient of the test-retest method were 0.90 and 0.91, respectively.

Conclusion

Final Questionnaire included 35 items in 4 point-Likert scale with total score of between 35-140. This valid and reliable questionnaire is brief, easily interpreted and can measure the main factors affecting sexual compatibility with the spouse in clinics and research fields.

Sexual Compatibility with Spouse Questionnaire: Development and Psychometric Property Evaluation

BACKGROUND

Sexual compatibility between husband and wife is an effective factor in both sexual and marital satisfaction. However, there is limited valid and reliable questionnaire to measure the degree of sexual compatibility between the couples.

METHODS

In this exploratory mixed method study, 54 individuals were interviewed in the qualitative phase and 448 persons participated in the quantitative phase. Totally 502 participants (261 woman, 241 men) took part in this study. According to 205 final codes derived from the qualitative phase, 102 initial items were developed, the number of which reached 69 items after deletion and merging performed by the research team. After face validity, content validity and construct validity, 68 items were introduced into the construct validity phase.

RESULTS

Following exploratory factor analysis and promax rotation, the items were reduced to 35 in 4 factors: "Requirements of a sexual relationship", "Sexual agreement", "Contextual obstacles" and "Outcomes of sexual compatibility". The questionnaire Cronbach alpha and correlation coefficient of the test-retest method were 0.90 and 0.91, respectively.

CONCLUSION

Final Questionnaire included 35 items in 4 point-Likert scale with total score of between 35-140. This valid and reliable questionnaire is brief, easily interpreted and can measure the main factors affecting sexual compatibility with the spouse in clinics and research fields.

A mobile-based educational intervention on sexo-marital life in Iranian men with spinal cord injury: a randomized controlled trial

STUDY DESIGN

A randomized controlled trial.

OBJECTIVE

To assess the effectiveness of a mobile-based educational intervention on sexo-marital life in Iranian men with spinal cord injury (SCI).

SETTING

Foundation of Martyrs and Veterans Affairs', "Spinal Cord Injury Association", and the "Protection Center of Spinal Cord Disables".

METHODS

Participants were men with SCI aged at least 18 years old. The effectiveness of a mobile App was evaluated on 70 married men with SCI. Sexual adjustment, sexual satisfaction, marital adjustment, and marital satisfaction were assessed by valid and reliable questionnaires at baseline, 4 and 8 weeks after the intervention.

RESULTS

The between-group mean difference (95% CI) of sexual adjustment (4.2, CI: 3.6-4.8) after 4 weeks as well as 8 weeks (8.6, CI: 7.6-9.5) after baseline was significant (P < 0.001). The between-group mean difference (95% CI) of sexual satisfaction (6.9, CI: 8-11.2) after 4 weeks as well as 8 weeks (16.4, CI: 14.1-18.7) after baseline was significant (P < 0.001). There were significant increases in all the domains of marital satisfaction's between-group mean differences after 4 weeks as well as 8 weeks after baseline (P < 0.001). Repeated measures ANOVA showed there was no statistically significant increase in marital adjustment's between-group mean difference (95% CI) after 4 weeks (-0.1, CI: -0.1- 0, P < 0.16) as well as 8 weeks (0.4, CI: -0.3-1.1, P < 0.25) after baseline.

CONCLUSION

The application-based educational intervention showed the positive effect of education on sexo-marital life in men with SCI. We recommend the rehabilitation team's healthcare providers embrace this educational strategy for individuals with SCI.

Development of a Sexual Needs Rehabilitation Framework in Women Post-Spinal Cord Injury: A Study From Iran

OBJECTIVE

To develop a sexual needs rehabilitation framework in women after spinal cord injury (SCI).

DESIGN

Mixed-methods study. The study consisted of 3 steps: (1) a primary needs assessment with quantitative and qualitative methods; (2) prioritization of identified needs by expert panels; and (3) development of a framework.

SETTING

Multi-dimensional clinical referral center.

PARTICIPANTS

Married women (N=31) with an SCI that occurred at least 1 year ago.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Development of sexual needs rehabilitation framework.

RESULTS

The quantitative phase in the first phase showed that the total mean ± SD score of the Sexual Quality of Life-Female questionnaire was 60.47±1.53, and the total mean ± SD score of the Female Sexual Function Index was 50.54±11.35. Moreover, women's sexual understanding post-SCI in the qualitative assessment revealed the following 3 main themes: (1) "dilemma leading to limited sexual activity"; (2) "seeking positive sexual adjustment"; and (3) "lack of client-based sexual and reproductive education/counseling in the rehabilitation process." Results from prioritizing identified needs in the second step indicated that the most important needs related to sexual aspects of life. In the final step, the framework for Iranian woman with post-SCI sexual rehabilitative needs developed with focus on sexual behavior complication post-SCI as a main need.

CONCLUSIONS

It is important to assess probable unmet needs before designing, planning, and implementing an interventional rehabilitative health care program, especially when focusing on issues of sexuality. A developed framework can be applied by the rehabilitation team during initial caregiving and can be continued as long as needed.

Spinal cord injury and women's sexual life: case-control study

Study design :This is a case-control study.

OBJECTIVE

The objective of this study was to estimate the magnitude of association between spinal cord injury (SCI) and women's quality of sexual life and sexual function.

SETTING

This study was conducted in the Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran.

METHODS

From the referral university-based clinics, we used simple random sampling to recruit 62 women: 31 women with SCI and 31 women without SCI. Socio-demographic and reproductive traits questionnaire, Sexual Quality of life-Female (SQOL-F), Female Sexual Function Index (FSFI) and Spinal Cord Independence Measure (SCIM) were completed using telephone and face-to-face interviews in the cases and controls. After univariate analyses, multivariate linear and proportional odds regression models were conducted to investigate the relation between SCI and women's quality of sexual life, as well as sexual function.

RESULTS

The mean age of cases and controls was 35.42±6.51 and 33.77±4.02 years. Most women were high school-educated and housewives. Adjusting for probable confounders, the proportional odds regression model showed a significant relationship between the spinal cord injury (AOR=4.2, 95% CI: 1.8-9.2), non-college-educated (AOR=3.1, 95% CI: 1.2-5.9) and employed (AOR=1.8, 95% CI: 1.1-1.8) variables and being in one of the moderate or poor quality of life classes. Scores of SQOL-F and FSFI domains, except satisfaction, were significantly worse in cases versus controls (P<0.001).

CONCLUSION

Although our participants showed low sexual dysfunction, they tended to report moderate to poor quality of sexual life. Our findings support the implication that sexual rehabilitation must be provided for women with SCI soon after injury.