Filipa Alves da Costa1, Manuel Castro Ribeiro2, Sofia Braga3, Elisabete Carvalho4, Fátima Francisco4, Ana Costa Miranda5, António Moreira6, Lesley Fallowfield7. 1. Serviço de Epidemiologia. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal. Centro de Investigação Interdisciplinar Egas Moniz. Costa da Caparica. Portugal. 2. Serviço de Epidemiologia. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal; Centro de Recursos Naturais e Ambiente. Instituto Superior Técnico. Universidade de Lisboa. Lisboa. Portugal. 3. Serviço de Oncologia Médica. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal. 4. Unidade de Investigação Clínica. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal. 5. Serviço de Epidemiologia. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal. 6. Serviço de Oncologia Médica. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal; Unidade de Investigação Clínica. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal. 7. Unit of Psycho Oncology. Sussex Health Outcomes Research & Education in Cancer (SHORE-C). Brighton & Sussex Medical School. University of Sussex. Sussex. United Kingdom.
Abstract
INTRODUCTION: The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of the disease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led to the development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. MATERIAL AND METHODS: The questionnaire was translated and back-translated, refined following face-to-face interviews with seven breast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. RESULTS: Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then tested with 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfort scales, all yielding good internal consistency (Cronbach's α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist was good (Spearman's r > 0.65; p-value < 0.001) and reliability acceptable (Cohen's k > 0.444). The Sexual Activity Questionnaire allowed the identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not having a partner. DISCUSSION: Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previously abandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overall population to enable generalizability of the findings. CONCLUSION: The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors in Portugal.
INTRODUCTION: The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of the disease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led to the development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. MATERIAL AND METHODS: The questionnaire was translated and back-translated, refined following face-to-face interviews with seven breast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. RESULTS: Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then tested with 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfort scales, all yielding good internal consistency (Cronbach's α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist was good (Spearman's r > 0.65; p-value < 0.001) and reliability acceptable (Cohen's k > 0.444). The Sexual Activity Questionnaire allowed the identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not having a partner. DISCUSSION: Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previously abandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overall population to enable generalizability of the findings. CONCLUSION: The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors in Portugal.