Abstract
Introduction
This paper provides a detailed discussion of the psychometric analysis and scoring of a revised measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR).
Methods
Standard tools for evaluating item distributions, relationships, and psychometric properties were used to identify sub-scales and determine how the sub-scales should be scored. The evaluation of items included a nonresponse analysis, the nature of missingness, and imputation methods. The minimum number of items required to be answered and three different scoring methods were evaluated: simple summation, mean calculation, and transformed summation.
Results
Item nonresponse levels are low in women who are sexually active and the psychometric properties of the scales are robust. Moderate levels of item nonresponse are present for women who are not sexually active, which presents some concerns relative to the robustness of the scales. Single imputation for missing items is not advisable and multiple imputation methods, while plausible, are not recommended owing to the complexity of their application in clinical research. The sub-scales can be scored using either mean calculation or transformed summation. Calculation of a summary score is not recommended.
Conclusion
The PISQ-IR demonstrates strong psychometric properties in women who are sexually active and acceptable properties in those who are not sexually active. To score the PISQ-IR sub-scales, half of the items must be answered, imputation is not recommended, and either mean calculation or transformed sum methods are recommended. A summary score should not be calculated.
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References
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Acknowledgements
This study was reviewed and approved by the University of Minnesota IRB #0908 M70626. This study was funded by the International Urogynecological Association. University of Minnesota, Grant Award Number CON000000021500, Todd H Rockwood, PhD, PI.
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A related editorial can be found at doi:10.1007/s00192‐012‐1952‐3.
Appendix A: transformed sum scoring for the PISQ-IR
Appendix A: transformed sum scoring for the PISQ-IR
Example—scale: NSA-GQ not sexually active: global quality rating
Item | Response | Reverse response | Item score | Minimum determination | Maximum determination |
|---|---|---|---|---|---|
Q4a: satisfied to dissatisfied | 2 (1 to 5) | 6–2 (response) | 4 | 1 (enter 1 if answered) | 5 (enter 5 if answered) |
Q4b: adequate to inadequate | 3 (1 to 5) | 6–3 (response) | 3 | 1 (enter 1 if answered) | 5 (enter 5 if answered) |
Q5a: I feel frustrated by my sex life | 3 (1 to 4) | 3 | 1 (enter 1 if answered) | 4 (enter 4 if answered) | |
Q6: Overall, how bothersome is it to you that you are not sexually active? | − (1 to 4) | 5– = (response) | – | – (enter 1 if answered) | – (enter 4 if answered) |
10 | 3 | 14 | |||
Sum | Sum: minimum | Sum: maximum | |||
Range: 11 = 3 –14 | |||||
(minimum) to (maximum) | |||||
Example—scale: SA-AO sexually active: arousal, orgasm
Item | Response | Reverse response | Item score | Minimum determination | Maximum determination |
|---|---|---|---|---|---|
Q7: How often do you feel sexually aroused (physically excited or turned on) during sexual activity? | 3 (1 to 5) | 3 | 1 (enter 1 if answered) | 5 (enter 5 if answered) | |
Q8a: fulfilled | 2 (1 to 5) | 2 | 1 (enter 1 if answered) | 5 (enter 5 if answered) | |
Q10:Compared with orgasms you have had in the past, how intense are your orgasms now? | 3 (1 to 5) | 3 | 1 (enter 1 if answered) | 5 (enter 5 if answered) | |
Q11:How often do you feel pain during sexual intercourse? (If you don’t have intercourse check this box X and skip to the next item) | 1 (1 to 5) | 6–1 = (box checked value is 1) | 5 | 1 (enter 1 if answered) | 5 (enter 5 if answered) |
Scoring note: If the box is checked enter 1 as response value | |||||
13 sum | 4 sum: minimum | 25 sum: maximum | |||
Range: 21 = 4–25 | |||||
(minimum) to (maximum) | |||||
Example—scale: NSA-CS not sexually active: condition-specific
Scoring—not sexually active
Scale: NSA-PR not sexually active: partner-related
Scale: NSA-CS not sexually active: condition-specific
Scale: NSA-GQ not sexually active: global quality rating
Scale: NSA-CI: Not sexually active: condition impact
Scoring—sexually active
Scale: SA-AO sexually active: arousal, orgasm
Scale: SA-PR sexually active: partner-related
Scale: SA-CS sexually active: condition-specific
Scale: SA-GQ sexually active: global quality rating
Scale: SA-CI sexually active: condition impact
Scale: SA-D sexually active: desire
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Rockwood, T.H., Constantine, M.L., Adegoke, O. et al. The PISQ-IR: considerations in scale scoring and development. Int Urogynecol J 24, 1105–1122 (2013). https://doi.org/10.1007/s00192-012-2037-z
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DOI: https://doi.org/10.1007/s00192-012-2037-z