The Female Sexual Functioning Index (FSFI): evaluation of acceptability, reliability, and validity in women with breast cancer
- 509 Downloads
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.
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.
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).
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.
KeywordsBreast neoplasms Sexual dysfunctions (psychological) Sexual dysfunctions (physiological) Psychosexual dysfunctions Questionnaires DSM-V
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.
- 1.Ma J, Jemal A (2013) Breast cancer statistics. In: Ahmad A (ed) Breast Cancer Metastasis and Drug Resistance: Progress and Prospects. Springer pp 1-18. doi: 10.1007/978-1-4614-5647-6_1
- 7.Ussher JM, Perz J, Gilbert E, Wong WK, Mason C, Hobbs K, Kirsten L (2013) Talking about sex after cancer: a discourse analytic study of health care professional accounts of sexual communication with patients. Psychol Health 28(12):1370–1390. doi: 10.1080/08870446.2013.811242 PubMedCrossRefGoogle Scholar
- 10.Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D'Agostino R Jr (2000) The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208. doi: 10.1080/009262300278597 PubMedCrossRefGoogle Scholar
- 11.American Psychiatric Association (2013) Diagnostic and Statistical Manual of Psychiatric Disorders, 5th edn. American Psychiatric Association, WashingtonGoogle Scholar
- 12.World Health Organization (2004) International Statistical Classification of Diseases and Health Related Problems. World Health Organization, GenevaGoogle Scholar
- 20.Coscarelli A, Heinrich RL (1988) Cancer Rehabilitation Evaluation System (CARES): Manual. CARES ConsultantsGoogle Scholar
- 25.Lovibond SH, Lovibond PF (1995) Manual for the Depression Anxiety Stress Scales Psychology Foundation of Australia, SydneyGoogle Scholar
- 28.De Vries J, Van der Steeg AF, Roukema JA (2010) Psychometric properties of the Fatigue Assessment Scale in women with breast problems. Int J Clin Hlth Psyc 10(1):125–139Google Scholar
- 31.Dozois DJA, Dobson KS (2010) Depression. In: Antony MM, Barlow DH (eds) Handbook of Assessment and Treatment Planning for Psychological Disorders, 2nd edn. The Guildford Press, New YorkGoogle Scholar
- 34.Streiner DL, Norman GR (1995) Health Measurement Scales: A practical Guide to their Development and Use. Oxford University Press, OxfordGoogle Scholar
- 35.Aday LA, Cornelius LJ (2006) Designing and Conducting Health Surveys, 3rd edn. Josey-Bass: A Wiley Imprint, San FranciscoGoogle Scholar
- 36.West SG, Finch JF, Curran PJ (1995) Structural equation models with nonnormal variables: Problems and remedies. In: Hoyle RH (ed) Structural Equation Modelling: Concepts. Issues and Applications Sage Publications, LondonGoogle Scholar
- 44.Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH, Reproductive Risk Factors for Incontinence Study at Kaiser (PRISK) Study Group (2006) Sexual activity and function in miggle-aged and older women. Obstet Gynecol 107(4):755–764. doi: 10.1097/01.AOG.0000202398.27428.e2 PubMedCentralPubMedCrossRefGoogle Scholar