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Construction and validation of a reproductive behavior questionnaire for female patients with rheumatic diseases

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Abstract

Introduction/objectives

Active autoimmune rheumatic diseases (ARDs) before conception increase the risk of flares and adverse pregnancy outcomes. We aimed to construct and validate a reproductive behavior questionnaire in Spanish for patients with ARDs to assess their knowledge and their reproductive behavior.

Method

We constructed and validated a reproductive behavior questionnaire in two phases: (1) a literature review followed by interviews of reproductive-age female patients, and (2) a cross-sectional study to complete validation. Convenience sampling was carried out with 165 female patients: 65 participated in the cross-cultural adaptation phase and 100 in the validation phase. The internal consistency was evaluated by estimating Cronbach’s alpha and tetrachoric correlation coefficients. Values ≥ 0.40 were considered acceptable (p < 0.05).

Results

The initial instrument included 38 questions. Thematic analysis identified 8 important dimensions or topics, which were combined to create the Rheuma Reproductive Behavior interview questionnaire. A final total of 41 items across 10 dimensions were obtained. The test–retest analysis showed perfect correlations in 34 of the 41 items, moderate in 6 items, and negative in one of the items. The mean age of the patients was 35.65 years (SD 9.02), and the mean time to answer the survey was 13.66 min (SD 7.1).

Conclusions

The Rheuma Reproductive Behavior questionnaire showed good reliability and consistency capturing patients’ reproductive health knowledge and reproductive behavior.

Key Points

• We designed and validated a questionnaire to assess reproductive health knowledge and reproductive behavior among female patients with ARDs.

• The questionnaire was comprehensible for participants, and showed good reliability and consistency capturing reproductive knowledge and behavior.

• This tool may aid in the design of strategies to improve reproductive decision-making for female patients with ARDs.

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Data availability

The datasets used during the current study are available from the corresponding author with a reasonable request.

References

  1. Andreoli L, García-Fernández A, Chiara Gerardi M, Tincani A (2019) The course of rheumatic diseases during pregnancy. Isr Med Assoc J 21(7):464–470

    PubMed  Google Scholar 

  2. Fischer-Betz R, Späthling-Mestekemper S (2020) Schwangerschaft bei rheumatischen Erkrankungen [Pregnancy and rheumatic diseases]. Z Rheumatol 79(1):55–73. https://doi.org/10.1007/s00393-019-00736-8

    Article  CAS  PubMed  Google Scholar 

  3. Tincani A, Dall’Ara F, Lazzaroni MG, Reggia R, Andreoli L (2016) Pregnancy in patients with autoimmune disease: A reality in 2016. Autoimmun Rev 15(10):975–977. https://doi.org/10.1016/j.autrev.2016.07.017

    Article  CAS  PubMed  Google Scholar 

  4. Sammaritano LR, Bermas BL, Chakravarty EE et al (2020) 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol 72(4):529–556. https://doi.org/10.1002/art.41191

    Article  PubMed  Google Scholar 

  5. Khizroeva J, Nalli C, Bitsadze V et al (2019) Infertility in women with systemic autoimmune diseases. Best Pract Res Clin Endocrinol Metab. 33(6):101369. https://doi.org/10.1016/j.beem.2019.101369

    Article  CAS  PubMed  Google Scholar 

  6. Tosounidou S, Gordon C (2020) Medications in pregnancy and breastfeeding. Best practice & research. Clin Obstet Gynaecol 64:68–76. https://doi.org/10.1016/j.bpobgyn.2019.10.007

    Article  Google Scholar 

  7. Østensen M (2017) Preconception counseling. Rheum Dis Clin North Am 43(2):189–199. https://doi.org/10.1016/j.rdc.2016.12.003

    Article  PubMed  Google Scholar 

  8. Andreoli L, Lazzaroni MG, Carini C et al (2019) “Disease knowledge index” and perspectives on reproductive issues: a nationwide study on 398 women with autoimmune rheumatic diseases. Joint Bone Spine 86(4):475–481. https://doi.org/10.1016/j.jbspin.2018.12.002

    Article  PubMed  Google Scholar 

  9. Black N (2013) Patient reported outcome measures could help transform healthcare. BMJ. 346:f167. https://doi.org/10.1136/bmj.f167

    Article  PubMed  Google Scholar 

  10. Birru Talabi M, Clowse MEB, Schwarz EB, Callegari LS, Moreland L, Borrero S (2018) Family planning counseling for women with rheumatic diseases. Arthritis Care Res 70(2):169–174. https://doi.org/10.1002/acr.23267

    Article  Google Scholar 

  11. Terwee CB, Bot SD, de Boer MR et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60(1):34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012

    Article  PubMed  Google Scholar 

  12. INEGI (2009) Encuesta Nacional de la Dinámica Demográfica 2009. Published Red Nacional de Metadatos. https://www.inegi.org.mx/programas/enadid/2009/default.html#Publicaciones. Accessed 09 Apr 2023

  13. Skinner-Taylor CM, Perez-Barbosa L, Barriga-Maldonado ES et al (2021) Reproductive health counseling and contraceptive use in Mexican women with rheumatic diseases: a cross-sectional study. Rheumatol Int 41(2):409–414. https://doi.org/10.1007/s00296-020-04679-1

    Article  PubMed  Google Scholar 

  14. Vongxay V, Albers F, Thongmixay S, Thongsombath M, Broerse JEW, Sychareun V et al (2019) Sexual and reproductive health literacy of school adolescents in Lao PDR. PLoS ONE 14(1):e0209675. https://doi.org/10.1371/journal.pone.0209675

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Tsai CK, Chen YY, Chou CH et al (2020) Female reproductive health and cognitive function. Menopause 27(12):1357–1362. https://doi.org/10.1097/GME.0000000000001630

    Article  PubMed  Google Scholar 

  16. Nikpour M, Tirgar A, Ghaffari F, Ebadi A, Sharif Nia H, Nasiri-Amiri F (2020) Development and psychometric evaluation of the women shift workers’ reproductive health questionnaire: a sequential exploratory mixed-method study. Reprod Health 17(1):147. https://doi.org/10.1186/s12978-020-00994-9

    Article  PubMed  PubMed Central  Google Scholar 

  17. Pryor KP, Albert B, Desai S et al (2022) Pregnancy intention screening in patients with systemic rheumatic diseases: pilot testing a standardized assessment tool. ACR Open Rheumatol 4(8):682–688. https://doi.org/10.1002/acr2.11449

    Article  PubMed  PubMed Central  Google Scholar 

  18. INEGI (2016) Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares Demográfica ENDIREH 2016. Published Red Nacional de Metadatos. https://www.inegi.org.mx/programas/endireh/2016/. Accessed 09 Apr 2023

  19. Birru Talabi M, Clowse MEB, Blalock SJ et al (2019) Development of ReproKnow, a reproductive knowledge assessment for women with rheumatic diseases. BMC Rheumatol 3:40. https://doi.org/10.1186/s41927-019-0091-6

    Article  PubMed  PubMed Central  Google Scholar 

  20. Meade T, Dowswell E, Manolios N, Sharpe L (2015) The motherhood choices decision aid for women with rheumatoid arthritis increases knowledge and reduces decisional conflict: a randomized controlled trial. BMC Musculoskelet Disord 16:260. https://doi.org/10.1186/s12891-015-0713-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ledón-LLanes L, Contreras-Yáñez I, Guaracha-Basáñez G et al (2021) Views of Mexican outpatients with rheumatoid arthritis on sexual and reproductive health: a cross-sectional study. PloS one 16(1):e0245538. https://doi.org/10.1371/journal.pone.0245538

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank Sergio Lozano-Rodríguez, MD; Anahí Carrazco-Chapa, MD; Diana Carolina Rubio-Torres, MD; and Amaranta Manrique de Lara, MA, for their assistance in reviewing and editing the manuscript.

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Authors and Affiliations

  1. Rheumatology Department, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico

    Lorena Perez-Barbosa, Cassandra Michele Skinner-Taylor, Abraham Yair Lujano-Negrete, Eugenio Salvador Barriga-Maldonado, Luis Gerardo Espinosa-Banuelos, Jesus Alberto Cardenas-de la Garza, Janett Riega-Torres & Dionicio Angel Galarza-Delgado

  2. Rheumatology Department, Hospital General de Mexico Dr. Eduardo Liceaga, Mexico City, Mexico

    Ingris Peláez-Ballestas

Authors
  1. Lorena Perez-Barbosa
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  2. Cassandra Michele Skinner-Taylor
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  3. Abraham Yair Lujano-Negrete
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  4. Eugenio Salvador Barriga-Maldonado
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  8. Janett Riega-Torres
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  9. Dionicio Angel Galarza-Delgado
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Correspondence to Cassandra Michele Skinner-Taylor.

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Perez-Barbosa, L., Skinner-Taylor, C.M., Lujano-Negrete, A.Y. et al. Construction and validation of a reproductive behavior questionnaire for female patients with rheumatic diseases. Clin Rheumatol 42, 2453–2460 (2023). https://doi.org/10.1007/s10067-023-06652-2

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  • DOI: https://doi.org/10.1007/s10067-023-06652-2

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