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The Female Sexual Functioning Index (FSFI): evaluation of acceptability, reliability, and validity in women with breast cancer

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Abstract

Purpose

Sexual dysfunction commonly arises for women following diagnosis and treatment of breast cancer. The aim of this study was to systematically evaluate the acceptability, reliability, and validity of the Female Sexual Functioning Index (FSFI) when used with these women.

Methods

Sexually active women previously diagnosed with breast cancer (N = 399) completed an online questionnaire including the FSFI and measures of acceptability (ease of use, relevance), sexual functioning, body image, fatigue, impact of cancer, physical and mental health, and relationship adjustment. Reliability and validity were evaluated using standard scale validation techniques.

Results

Participants indicated a high degree of acceptability. Excellent internal consistency (α = 0.83–0.96) and test–retest reliability (r = 0.74–0.86) of the FSFI were evident. According to the confirmatory factor analysis, the best fit was achieved with removal of item 14 (regarding the extent of emotional closeness with the partner) and six subscales (desire, arousal, lubrication, orgasm, satisfaction, pain), without a total score (TLI = 0.96, CFI = 0.97, RMSEA = 0.07). Correlations with measures of sexual functioning and related constructs provided evidence for convergent and divergent validities, respectively. All but one subscale (orgasm) discriminated between women who are, and are not, currently receiving treatment for breast cancer (discriminant validity).

Conclusions

These findings indicate that not only is the FSFI psychometrically sound when used with women with breast cancer, but it is perceived as being easy to use and relevant. It is recommended that the FSFI subscale scores can be used in both clinical and research settings as a screening tool to identify women experiencing sexual dysfunction following breast cancer.

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Acknowledgments

We would like to acknowledge the women from the Breast Cancer Network Australia for giving their time to complete the surveys and Dr. Alan Taylor for his statistical insights. This study was undertaken with funding support from National Breast Cancer Foundation and Cancer Australia (ID: 543400).

Conflict of interest

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia

    Iris Bartula & Kerry A. Sherman

  2. Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia

    Kerry A. Sherman

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  1. Iris Bartula
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  2. Kerry A. Sherman
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Correspondence to Kerry A. Sherman.

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Bartula, I., Sherman, K.A. The Female Sexual Functioning Index (FSFI): evaluation of acceptability, reliability, and validity in women with breast cancer. Support Care Cancer 23, 2633–2641 (2015). https://doi.org/10.1007/s00520-015-2623-y

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  • DOI: https://doi.org/10.1007/s00520-015-2623-y

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