Development of the ‘Perceived Sexual Distress Scale-Hindi’ for measuring sexual distress following spinal cord injury

Abstract

Study design: Clinimetric study. Objectives: To develop the Perceived Sexual Distress Scale (PSDS) in Hindi language (that is, PSDS-H) for persons with spinal cord injury (SCI), and to establish its content validity, internal consistency and test-retest reliability. Setting: New Delhi, India. Methods: Following a comprehensive literature review and semi-structured interviews, a 43-item questionnaire was drafted. Each item was rated on a 5-point scale. Content validity was established both qualitatively and quantitatively. Inter-item, item total correlations, internal consistency and test-retest reliability were calculated. Results: Expert panel opinion and content validity ratio (CVR) validated the content of the PSDS-H. Five items were dropped because of low CVR, resulting in a 38-item questionnaire. Internal consistency reliability (Cronbach's alpha) was 0.965. The test-retest reliability was 0.647. Conclusion:The PSDS-H is a valid, self/interviewer-rated tool that can help inform the rehabilitation team about the level of an individual's perceived sexual distress post SCI. It also provides an outcome measure to evaluate the efficacy of interventions related to sexuality post injury. Spinal Cord (2014) 52, 712-716; doi:10.1038/sc.2014.83; published online 1 July 2014 INTRODUCTIONThe World Health Organization has described sexual health as 'the integration of the somatic, emotional, intellectual and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication and love' . 1 Spinal cord injury (SCI) frequently concerns women and men in their sexually active and reproductive periods of life. 2 In a study done by Reitz et al. 2 on 120 persons with SCI, 63 reported that the major impact of SCI was on sexual functions. Consequences and complications of SCI, such as inability to move, neurogenic bladder and bowel dysfunction, spasticity and pain, all influence quality of life and sexuality.Sexual readjustment after SCI depends greatly on the particular person's wishes, experiences and sexual habits in their pre-SCI life. It may also, to a great extent, depend on the co-operation and helpfulness of the partner. The psychosexual functioning of persons with paraplegia is not different from quadriplegia. 3 Sexuality and sensuality can be an expression of confidence, validation of the self and one's perceived lovability. A review of the existing literature on sexuality and SCI explains the powerful influence of sexual problems and dysfunctions on psychology of the subjects, including issues of the affected body image, self concept, gender roles, general psychological health and basic sense of self-esteem. 4,5 These problems may give rise to sexuality-related distress in persons with SCI. 6,7 There is little available empirical research on the psychological distress experienced due to sexual dysfunctions post SCI. The available measures primarily examine physical aspects of sexual

Instrumentos de avaliação da sexualidade em homens e mulheres após a lesão medular

“…Após a leitura na íntegra dos estudos, foi encontrado um total de 11 artigos que preencheram os critérios de inclusão e foram utilizados na presente revisão. Além disso, foram incluídos 7 estudos através da busca manual, totalizando na presente pesquisa um total de Os instrumentos específicos validados para avaliação da sexualidade em indivíduos com lesão medular utilizados em seis estudos 6,7,[18][19][20][21] foram: Male Sexual Quotient (MSQ), Sexual Health Inventory for Men (SHIM), Sexual Adjustment Questionnaire (SAQ), Sexual Attitude and Information Questionnaire (SAIQ), "Perceived Sexual Distress Scale" (PSDS), "International SCI male sexual function" e "female sexual and reproductive function" (SR-iSCI-sexual function), Questionário de Sexualidade Humana na Lesão Medular (QSH-LM) e Sexual health measures (SHM). Nesses estudos, foram investigadas as seguintes propriedades de medida: validade e confiabilidade (Quadro 2).…”

“…A população mais prevalente foi de apenas homens 1,6,8,10,15,22 ou de homens e mulheres, sendo nesse caso a porcentagem de mulheres menor. 7,12,13,[16][17][18][19][20][21] Essa prevalência de homens pode ser decorrente da predominância masculina entre os indivíduos traumaticamente lesados e também pelo fato de que a disfunção sexual feminina pode ser considerada menos problemática para as mulheres do que para os homens, pois ainda existe a crença de que as mulheres possuem um papel passivo na relação sexual. 4 É possível identificar na literatura uma lacuna entre os estudos que investigam a sexualidade em mulheres com lesão medular.…”

“…4 Os questionários utilizados para avaliação da sexualidade, podem ser feitos em formato de autoadministração, em que o paciente mesmo responde o questionário entregue, ou em formato de entrevista, onde o profissional da área da saúde faz as perguntas para o paciente. Dentre os estudos incluídos na presente revisão, apenas três 17,20,23 utilizaram instrumentos feitos em formato de entrevista.…”

“…Foi observado com os estudos incluídos, 6,7,18-21 que investigaram propriedades de medida, que elementos da confiabilidade foram definidos para todos os instrumentos, entretanto apenas dois estudos 18,20 aprofundaram na validade. Foram observados valores satisfatórios de confiabilidade para todos os instrumentos investigados.…”

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

“…In contrast to the Perceived Sexual Distress Scale, which assesses only distress surrounding changes in sexual life due to SCI, the SAQ evaluates each individual's sexual adjustment in four main domains: positive motivation, negative motivation, acceptance and sexual capacity. 21 …”