Translation, cross-cultural adaptation, and validation of the Greek version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19

Abstract

Introduction

Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) explores optimally impact of MS on sexual activity/satisfaction/intimacy.

Aim

The present study aims to provide the only validation of the Greek Version of MSISQ-19, and compare results to validation studies in other languages.

Methods

The original/English version of the MSISQ-19 was translated into Greek according to standardized guidelines, while validity/reliability, correlations with other scales and sexual dysfunction prevalence were tested. Subjects were requested to complete all questionnaires and MSISQ-19, being re-tested three weeks later. Construct-validity of the Greek version of the MSISQ-19 was confirmed with principal-component-analysis. Bartlett’s test assessed correlation-adequacy between items. Pearson’s correlation explored internal-construct-validity between subscales and overall score, and external–construct-validity with disease-status variables, cognitive testing and patient-reported outcomes regarding fatigue, depression/anxiety, MS impact, and quality of life.

Results

201 PwMS (130 female). Mean age was 39.3 ± 11.8 years with median disease-duration 11.7 ± 7.9 years. 79.1% RRMS, PPMS (10.4%) and SPMS (10.4%). Cronbach’s alpha coefficient was 0.949. MSISQ-19 correlations between items were large. Significant associations of sexual dysfunction were identified with age (rho = 0.392, p < 0.01), years of education (rho=–0.199, p = 0.006), the Expanded Disability Status Scale (rho = 0.518, p < 0.01) and MS duration (rho = 0.354, p < 0.01). Correlations were disclosed with the Brief International Cognitive Assessment for MS (rho=-0.247, p < 0.05), Modified Fatigue Impact Scale (rho = 0.374, p < 0.05), Depression Anxiety Stress Scale (rho = 0.375, p < 0.05), Multiple Sclerosis Impact Scale (rho = 0.442, p < 0.05), and EuroQoL-five-dimensional instrument (rho = 0.375, p < 0.05). Internal consistency of the Greek version of the MSISQ-19 was confirmed with Cronbach’s alpha. Test-retest reliability (31 PwMS) was excellent with intraclass-correlation-coefficients > 0.90.

Conclusion

Besides Greek MSISQ-19 satisfactory validity/reliability/reproducibility and being first to include cognitive-testing, authors estimated sexual-dysfunction prevalence affecting half PwMS.

HIGHLIGHTS

• This study provides the only validation of the Greek Version of the MSISQ-19.

• The latter was found with satisfactory validity, reliability and reproducibility.

• 50% of the Greek PwMS sample was found to be afflicted with sexual dysfunction.

• This is also the first validation study to examine associations with cognitive testing.

• Sexual function is still an underestimated functionality parameter upon examination.

Keywords:

• Sexual dysfunction
• multiple sclerosis
• disability
• validation
• translation
• questionnaire
• patient-reported-measures

Acknowledgments

The first author would like to express respect and gratitude to Mrs Eleni Grigoriadou leading our department secretariat, as her overall contribution from her position is recognized and appreciated. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical approval

This manuscript is in accordance with the corresponding ethical standards of the study country. Aristotle University Bioethics Committee approved the study protocol, while a written informed consent was obtained by every subject for voluntary participation.

Disclosure statement

No potential conflict of interest was reported by the author(s).