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

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Abstract

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.

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Notes

  1. The International Spinal Cord Society.

  2. American Spinal Injury Association.

  3. No sensory or motor function is preserved in the sacral segments S4-5.

  4. Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-5 AND no motor function is preserved more than three levels below the motor level on either side of the body.

  5. Motor function is preserved at the most caudal sacral segments for voluntary anal contraction (VAC)

    OR the patient meets the criteria for sensory incomplete status.

  6. Motor incomplete status as defined in level C, with at least half (half or more) of key muscle functions below the single NLI having a muscle grade ≥ 3.

  7. If sensation and motor function as tested with the ISNCSCI are graded as normal in all segments, and the patient had prior deficits, then the AIS grade is E.

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Acknowledgements

We sincerely thank the SCI population registered in the BASIR who shared with us their sexual matters. The authors would like to express their special thanks for the support and contribution offered by the Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Institute.

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Authors and Affiliations

  1. Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

    Effat Merghati-Khoei, Noura Aghajani, Zahra Salmani, Fereshteh Rahdari & Abazar Yazdanpanah

  2. Department of Midwifery, Khalkhal Branch, Islamic Azad University, Khalkhal, Iran

    Fatemeh Sheikhan

  3. Iranian National Center for Addiction Studies (INCAS), Institution of Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Bayat & Habib Yousefi

  4. Department of Biostatistics and Epidemiology, Kashan University of Medical Sciences, Kashan, Iran

    Fatemeh Atoof

  5. Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA

    Jeffrey E. Korte

  6. Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran

    Effat Merghati-Khoei

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  1. Effat Merghati-Khoei
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Merghati-Khoei, E., Aghajani, N., Sheikhan, F. et al. Measuring Sexual Performance: Development and Psychometric Properties of the Sexual Performance Questionnaire in Iranian People with Spinal Cord Injury. Sex Disabil 39, 55–65 (2021). https://doi.org/10.1007/s11195-020-09644-1

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