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The Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale: psychometric assessment in women treated for cancer

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Abstract

Purpose

The purpose of this study was to conduct a preliminary validation of the psychometric performance of the newly developed Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale in a sample of women treated for cancer.

Methods

Partnered women (n = 250) who had received treatment for cancer completed an online survey that included the SECSI scale and measures of health-related quality of life, depression, anxiety, sexual function, sexual distress, self-efficacy for sexual functioning, sexual behaviors, relationship satisfaction, and satisfaction with sexual communication. Sociodemographic and clinical cancer characteristics data were collected.

Results

High internal consistency and strong test–retest reliability of the SECSI scale were shown with a Cronbach’s alpha coefficient of 0.94 and test–retest reliability of r = 0.82, respectively. Construct validity of the SECSI scale, including discriminant, convergent, and divergent validity, was supported except regarding hypothesized relationships between SECSI scores and participant age and time since treatment.

Conclusions

The SECSI scale is a valid, reliable measure for use with partnered women treated for cancer. Clinicians working with cancer survivors who may be at risk for difficulties communicating about sex and intimacy needs after cancer treatment may use this scale to identify women who would benefit from interventions to increase their confidence to communicate with their partner. The SECSI scale fills an important gap in ability to assess self-efficacy to communicate about sex and intimacy.

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References

  1. National Cancer Institute (2017) Surveillance, Epidemiology, and End Results (SEER) program [internet]. Bethesda, MD. Available from: www.seer.cancer.gov. Accessed 10 Dec 2017

  2. Juraskova I, Butow P, Bonner C, Robertson R, Sharpe L (2013) Sexual adjustment following early stage cervical and endometrial cancer: prospective controlled multi-centre study. Psychooncology 22:153–159

    Article  Google Scholar 

  3. Sadovsky R, Basson R, Krychman M, Morales AM, Schover L, Wang R et al (2010) Cancer and sexual problems. J Sex Med 7:349–373

    Article  Google Scholar 

  4. Tierney K (2008) Sexuality: a quality of life issue for cancer survivors. Semin Oncol Nurs 24:71–79

    Article  Google Scholar 

  5. Stark TC, Visovsky C, McMillan SC (2012) The symptom experience of patients with cancer. J Hosp Palliat Nurs 14:61–70

    Article  Google Scholar 

  6. Breukink SO, Donovan KA (2013) Physical and psychological effects of treatment on sexual functioning in colorectal cancer survivors. J Sex Med 10(Suppl 1):74–83

    Article  CAS  Google Scholar 

  7. Carter J, Stabile C, Gunn A, Sonoda Y (2013) The physical consequences of gynecologic cancer surgery and their impact on sexual, emotional, and quality of life issues. J Sex Med 10(Suppl 1):21–34

    Article  Google Scholar 

  8. Den Oudsten BL, Traa MJ, Thong MSY, Martijn H, De Hingh IHJT, Bosscha K et al (2012) Higher prevalence of sexual dysfunction in colon and rectal cancer survivors compared with the normative population: a population-based study. Eur J Cancer Oxf Engl 1990 48:3161–3170

    Google Scholar 

  9. Perz J, Ussher JM, Gilbert E, Australian Cancer and Sexuality Study Team (2014) Feeling well and talking about sex: psycho-social predictors of sexual functioning after cancer. BMC Cancer 14:228

    Article  Google Scholar 

  10. Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC (2014) Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health 29:632–650

    Article  Google Scholar 

  11. Manne OJS, Norton TR, Fox K, Goldstein L, Grana G (2006) Cancer-related relationship communication in couples coping with early stage breast cancer. Psychooncology 15:234–247

    Article  Google Scholar 

  12. Kayser K, Acquati C, Reese JB, Mark K, Wittmann D, Karam E (2018) A systematic review of dyadic studies examining relationship quality in couples facing colorectal cancer together. Psychooncology 27:13–21

    Article  Google Scholar 

  13. Lindau ST, Anderson D, Gavrilova N (2007) Sexual morbidity in very long-term survivors of vaginal and cervical cancer: a comparison to national norms. Gynecol Oncol 106:413–418

    Article  Google Scholar 

  14. Manne SM, Ross S, Ostroff J, Heyman RE, Fox K (2004) Couples’ support-related communication, psychological distress, and relationship satisfaction among women with early stage breast cancer. J Consult Clin Psychol 72:660–670

    Article  Google Scholar 

  15. Shin DW, Shin J, Kim SY, Yang H-K, Cho J, Youm JH et al (2015) Family avoidance of communication about cancer: a dyadic examination. Cancer Res Treat 48:384–392

    Article  Google Scholar 

  16. Yu Y, Sherman KA (2015) Communication avoidance, coping and psychological distress of women with breast cancer. J Behav Med 38:565–577

    Article  Google Scholar 

  17. Brotto LA, Yule M, Breckon E (2010) Psychological interventions for the sexual sequelae of cancer: a review of the literature. J Cancer Surviv Res Pract 4:346–360

    Article  Google Scholar 

  18. Scott JL, Kayser K (2009) A review of couple-based interventions for enhancing women’s sexual adjustment and body image after cancer. Cancer J Sudbury Mass 15:48–56

    Article  Google Scholar 

  19. Manne S, Badr H (2008) Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer 112:2541–2555

    Article  Google Scholar 

  20. Perz J, Ussher JM, Gilbert E (2013) Constructions of sex and intimacy after cancer: Q methodology study of people with cancer, their partners, and health professionals. BMC Cancer 13:270

    Article  Google Scholar 

  21. Bandura A (2006) Guide for constructing self-efficacy scales. In F. Pajares and T. Urdan (Eds.). Self-efficacy beliefs of adolescents, (Vol. 5., pp. 307-337). Greenwich, CT: Information Age Publishing

  22. Bandura A (1998) Health promotion from the perspective of social cognitive theory. Psychol Health 13:623–649

    Article  Google Scholar 

  23. Catania JA (1998) Dyadic sexual communication. In: Davis CM, Yarber WL, Bauserman R, Schreer G, Davis LD, eds. Handbook of sexuality‐related measures. Thousand Oaks: SAGE Publications, Inc.; :129–131

  24. Bailes S, Creti L, Fichten CS, Libman E, Brender W, and Amsel R (2010). Sexual Self-Efficacy Scale for Female Functioning. In T. D. Fisher, C. M., Davis, W. L. Yarber, S. L., Davis (Eds.). Handbook of sexuality-related measures. New York: Routledge

  25. Traa DVJ, Roukema JA, Den Oudsten BL (2012) Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review. Ann Oncol 23:19–27

    Article  CAS  Google Scholar 

  26. Webster K, Cella D, Yost K (2003) The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes 1:79

    Article  Google Scholar 

  27. Levin AO, Carpenter KM, Fowler JM, Brothers BM, Andersen BL, Maxwell GL (2010) Sexual morbidity associated with poorer psychological adjustment among gynecological cancer survivors. Int J Gynecol Cancer 20:461–470

    Article  Google Scholar 

  28. Spitzer RL, Kroenke K, Williams JBW, Löwe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166:1092–1097

    Article  Google Scholar 

  29. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613

    Article  CAS  Google Scholar 

  30. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al (2000) The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208

    Article  CAS  Google Scholar 

  31. Baser RE, Li Y, Carter J (2012) Psychometric validation of the female sexual function index (FSFI) in cancer survivors. Cancer 118:4606–4618

    Article  Google Scholar 

  32. Derogatis CA, Lewis-D’Agostino D, Wunderlich G, Fu Y (2008) Validation of the female sexual distress scale—revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med 5:357–364

    Article  Google Scholar 

  33. Hunsley J, Best M, Lefebvre M, Vito D (2001) The seven-item short form of the dyadic adjustment scale: further evidence for construct validity. Am J Fam Ther 29:325–335

    Article  Google Scholar 

  34. Arthur EA, Menon U (2016) Measure development and face validity of a self-efficacy for communicating about sex scale. [Poster] 2016 oncology nursing dociety annual congress. San Antonio, TX. https://onf.ons.org/onf.ons.org/onf/43/2/podium-poster-and-research-abstracts

  35. Arthur E, Menon U, and Wills C (2018) Cognitive interviews with women cancer survivors to assess content validity of the self-efficacy to communicate about sex and intimacy (SECSI) scale. [Oral Presentation; Distinguished Abstract] Midwest Nursing Research Society Annual Conference, Cleveland, Ohio.

    Article  Google Scholar 

  36. IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp

  37. Nunnally J, Bernstein I (1994) Psychometric theory, 3rd edn. McGraw-Hill, United States of America

    Google Scholar 

  38. Pazmany BS, Verhaeghe J, Van Oudenhove L, Enzlin P (2015) Dyadic sexual communication in pre-menopausal women with self-reported dyspareunia and their partners: associations with sexual function, sexual distress and dyadic adjustment. J Sex Med 12:516–528

    Article  Google Scholar 

  39. Rancourt KM, Rosen NO, Bergeron S, Nealis LJ (2016) Talking about sex when sex is painful: dyadic sexual communication is associated with women’s pain, and couples’ sexual and psychological outcomes in provoked vestibulodynia. Arch Sex Behav 45:1933–1944

    Article  Google Scholar 

  40. Arthur E, Wills C, Menon U (2018) A systematic review of interventions for sexual well-being in women with gynecologic, anal, or rectal cancer. Oncol Nurs Forum 45:469–482

    Article  Google Scholar 

  41. Brucker PS, Yost K, Cashy J, Webster K, Cella D (2005) General population and cancer patient norms for the functional assessment of cancer therapy—general (FACT-G). Eval Health Prof 28:192–211

    Article  Google Scholar 

  42. Sarkar S, Sautier L, Schilling G, Bokemeyer C, Koch U, Mehnert A (2015) Anxiety and fear of cancer recurrence and its association with supportive care needs and health-care service utilization in cancer patients. J Cancer Surviv 9:567–575

    Article  Google Scholar 

  43. Hartung TJ, Brähler E, Faller H, Härter M, Hinz A, Johansen C et al (2017) The risk of being depressed is significantly higher in cancer patients than in the general population: prevalence and severity of depressive symptoms across major cancer types. Eur J Cancer 72:46–53

    Article  CAS  Google Scholar 

  44. Schover LR, Baum GP, Fuson LA, Brewster A, Melhem-Bertrandt A (2014) Sexual problems during the first 2 years of adjuvant treatment with aromatase inhibitors. J Sex Med 11:3102–3111

    Article  Google Scholar 

  45. Milbury K, Cohen L, Jenkins R, Skibber JM, Schover LR (2013) The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer. Support Care Cancer 21:793–802

    Article  Google Scholar 

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Acknowledgments

We would like to express our sincere gratitude to the women cancer survivors who participated in this research.

Funding

Funding for this research was provided in part by the Oncology Nursing Society Foundation Endowment 2017 ONS Foundation Dissertation Research Grant and by a Sigma Theta Tau International Epsilon Chapter Dissertation Grant.

Author information

Author notes

  1. Celia E. Wills and Usha Menon are senior authors

Authors and Affiliations

  1. College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, 43210, USA

    Elizabeth K. Arthur, Celia E. Wills, Kristine Browning & Janine Overcash

  2. College of Nursing, University of South Florida, 12901 Bruce B. Downs, MDN 22, Tampa, FL, 33612-4742, USA

    Usha Menon

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  1. Elizabeth K. Arthur
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  2. Celia E. Wills
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Corresponding author

Correspondence to Elizabeth K. Arthur.

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Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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None of the authors has a financial relationship with the foundations that sponsored this research. We have control of all primary data and agree to allow the journal to review the data if requested.

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Arthur, E.K., Wills, C.E., Browning, K. et al. The Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale: psychometric assessment in women treated for cancer. Support Care Cancer 28, 1449–1457 (2020). https://doi.org/10.1007/s00520-019-04963-2

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