Measuring Sexual Function in Community Surveys: Development of a Conceptual Framework

Abstract

Among the many psychometric measures of sexual (dys)function, none is entirely suited to use in community surveys. Faced with the need to include a brief and non-intrusive measure of sexual function in a general population survey, a new measure was developed. Findings from qualitative research with men and women in the community designed to inform the conceptual framework for this measure are presented. Thirty-two semi-structured interviews with individuals recruited from a general practice, an HIV/AIDS charity, and a sexual problems clinic were conducted. From their accounts, 31 potential criteria of a functional sex life were identified. Using evidence from qualitative data and the existing literature, and applying a set of decision rules, the list was reduced to 13 (eight for those not in a relationship), and a further eight criteria were added to enable individuals to self-rate their level of function and indicate the severity of difficulties. These criteria constitute a conceptual framework that is grounded in participant perceptions; is relevant to all, regardless of sexual experience or orientation; provides opportunity to state the degree of associated distress; and incorporates relational, psychological, and physiological aspects. It provides the conceptual basis for a concise and acceptable measure of sexual function.

Acknowledgments

We are indebted to the participants who kindly gave of their time and views. We would like to thank Professors Anne Johnson, Michael King and Irwin Nazareth for their valuable scientific input into the study. The study was supported by an Economic and Social Research Council/Medical Research Council inter-disciplinary PhD studentship award. The views expressed in the article are those of the authors and do not necessarily reflect those of the funding bodies. Ethical approval for the study was obtained from Camden and Islington Local Research Ethics Committee and the London School of Hygiene and Tropical Medicine Ethics Committee. Governance approval was obtained from Camden and Islington Primary Care Trust and Camden and Islington Mental Health and Social Care Trust.

Notes

Note. Source: Mitchell, King, Nazareth, and Wellings (2010) and Mitchell et al. (2011). GP = general practitioner.

Note. All participant quotes are italicized. DSM–IV–TR = Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000); GRISS = Golombok–Rust Inventory of Sexual Satisfaction (Rust & Golombok, 1985); BISF–W = Brief Index of Sexual Function for Women (Taylor, Rosen, & Leiblum, 1994); SFQ = Sexual Function Questionnaire (Quirk et al., 2002); BSFQ = Brief Sexual Function Questionnaire (Reynolds et al., 1988); SSS–W = Sexual Satisfaction Scale for Women (Meston & Trapnell, 2005).

^a F = female; M = male; numerical range relates to age group of respondent.

Note. All participant quotes are italicized. GRISS = Golombok–Rust Inventory of Sexual Satisfaction (Rust & Golombok, 1985); SSS–W = Sexual Satisfaction Scale for Women (Meston & Trapnell, 2005); FSFI = Female Sexual Function Index (Rosen et al., 2000); SFQ = Sexual Function Questionnaire (Quirk et al., 2002).

^a F = female; M = male; numerical range relates to age group of respondent.

Note. AF = criterion is associated with sexual function, rather than belonging to the construct; OV = criterion overlaps with another criterion; PH = criterion does not represent public health burden (respondents viewed it as desirable, rather than essential); SR = self-rating.