Responsiveness of two sexual function questionnaires: PISQ‐IR and FSFI in women with pelvic floor disorders

Abstract

Aims: To assess responsiveness of sexual function questionnaires: Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR) and Female Sexual Function Index (FSFI) in women with pelvic floor disorders (PFD). Methods: The study included 261 subjects who completed PISQ-IR and FSFI at baseline and after treatment (median: 8 months). Standardized response mean (SRM) and effect size (ES) were calculated for sexually active (SA) and not-SA (NSA) women. Patient Global Impression of Improvement (PGI-I) was applied to assess treatment outcomes. Results: A total of 184 women reported "very much better"/"much better" on the PGI-I scale posttreatment and were enrolled for further study. After treatment, 21.7% of the NSA women resumed sexual activity, 13.9% of the initially SA-abstained, and no change was reported for 152 (82.6%) subjects (87-SA and 65-NSA). Significant improvement in PISQ-IR SA domains was observed, with mild responsiveness for Arousal/Orgasm (SRM = 0.34, ES = 0.29, p = .003) and good responsiveness for Condition Specific, Global Quality and Summary Score (SRM = 0.51, ES = 0.50; SRM = 0.54, ES = 0.47; SRM = 0.75, ES = 0.63, p < .001). The Condition Impact domain demonstrated excellent responsiveness (SRM = 1.13, ES = 1.17, p < .001). In NSA, PISQ-IR had good responsiveness in Condition Impact (SRM = −0.76, ES = −0.59, p < .001), and mild in Condition Specific (SRM = −0.30, ES = −0.28, p < .03) domains. In FSFI, posttreatment sexual function in SA was improved in Desire, Arousal, Orgasm, Satisfaction, Pain domains and Total score, proving mild responsiveness (SRM, 0.24-0.48; p < .04). In NSA, FSFI proved nonresponsive. Conclusion: PISQ-IR and FSFI are responsive tools, useful to investigate the effects of treatment on sexual function in SA (both questionnaires) and NSA

Patient-Reported Outcome Measures for Use in Women With Pelvic Organ Prolapse

“…35 The SF-6 had two studies reporting construct validity (one study, adequate) 36 and responsiveness (one study, adequate). 35 The Bristol Stool Scale had data on reliability (adequate) 31 ; the Female Sexual Function Index had data on responsiveness (adequate) 32 ; the Health Utilities Index Mark 3 had data on construct validity (adequate) 36 ; the SF-12 had data on construct validity (adequate) 37 ; and the Vaginal Changes Sexual and Body Esteem had data on criterion validity (inadequate). 62 Floor or ceiling effect was reported for only five patient-reported outcomes (the ABI, 58 ePAQ-PF, 38,53 PISQ-12, 52 PISQ-IR, 24 and SPS-Q 22 ).…”

“…46 The PISQ-IR had five studies reporting content of face validity (two studies), 48,51 criterion validity (one study, adequate), 51 reliability (one study, very good), 51 internal consistency (one study, very good), 51 and responsiveness (three studies: two adequate, one doubtful). 24,32,51…”

“…46 The PISQ-IR had five studies reporting content of face validity (two studies), 48,51 criterion validity (one study, adequate), 51 reliability (one study, very good), 51 internal consistency (one study, very good), 51 and responsiveness (three studies: two adequate, one doubtful). 24,32,51 The ePAQ-PF (Electronic Personal Assessment Questionnaire—Pelvic Floor), EPIQ (Epidemiology of Prolapse and Incontinence Questionnaire), FASS (FIGO Prolapse Assessment Scoring System), ITSQ (Integral Theory System Questionnaire), PIKQ (Prolapse and Incontinence Knowledge Questionnaire), and POP-SS (Pelvic Organ Prolapse Symptom Score) had data on four measurement properties each. The ePAQ-PF had three studies with data on content or face validity (two studies), 49,53 construct validity (two studies, both adequate), 49,53 reliability (one study, adequate), 49 and internal consistency (three studies, all very good).…”

Female Sexual Functioning in Women with a Symptomatic Pelvic Organ Prolapse; A Multicenter Prospective Comparative Study Between Pessary and Surgery

“…At present, no calculation formula is available comparing the PISQ-IR SA and NSA results. 44 Another limitation is that we could not examine differences between supportive and occlusive pessaries in relation to different aspects of sexual (in-)activity measured with the PISQ-IR due to the small sample size of women using an occlusive pessary in this study (3%).…”

Tradução e validação em português do questionário Impacto do Prolapso de Órgãos Pélvicos, da Incontinência Urinária e da Incontinência Fecal na Função Sexual Feminina

“…Responsividade é uma característica importante em um questionário, indica se um instrumento é capaz de detectar mudanças na condição do paciente quando seu quadro clínico sofre alteração 62 . A responsividade do PISQ-IR já foi avaliada e comprovada 81,82 . Após tratamento cirúrgico ou conservador houve melhora A aplicabilidade do PISQ-IR vem sendo comprovada em diversos estudos 33,83,84,85,86,87,88,89,90,91…”