Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version.

BACKGROUND AND PURPOSE: The World Health Organization (WHO) initiated a cross-cultural project to develop the World Health Organization Quality of Life (WHOQOL) questionnaire. This paper describes how the brief version of this questionnaire was adapted for use in Taiwan and the results of validity and reliability testing. SUBJECTS AND METHODS: Data were collected from 1,068 subjects randomly sampled from 17 hospitals throughout Taiwan. According to the psychometric criteria of the WHO, two (culturally relevant) national items were selected, each from a culture-specific facet that was proposed for Taiwan in a previous study. psychometric properties (factor structures and various types of reliability and validity) were assessed for this brief questionnaire. RESULTS: Exploratory and confirmatory factor analyses revealed a four-factor (physical, psychological, social, and environmental) model. The internal consistency (Cronbach's alpha) coefficients ranged from 0.70 to 0.77 for the four domains. The test-retest reliability coefficients with intervals of 2 to 4 weeks ranged from 0.41 to 0.79 at item/facet level and 0.76 to 0.80 at domain level (all p < 0.01). Content validity coefficients were in the range of 0.53 to 0.78 for item-domain correlations and 0.51 to 0.64 for inter-domain correlations (all p < 0.01). The four domains of the brief form can explain 88% of the variance of the total QOL score and 60% of the variance of the Facet G score (measuring overall quality of life and general health). CONCLUSIONS: This culture-specific study shows that this adaptation of the brief form is a good alternative to the long form of the WHOQOL questionnaire for use in Taiwan.     

Psychometric testing of the translated McGill Quality of Life Questionnaire-Taiwan version in patients with terminal cancer.

BACKGROUND AND PURPOSE: Quality of life (QOL) is the paramount goal of end-of-life care. However, there is no Chinese language instrument for measuring QOL that has been shown to have adequate psychometric properties for Taiwanese patients with terminal cancer. The purpose of this study was to examine the psychometric properties of a Chinese language version of the McGill Quality of Life questionnaire (MQOL-Taiwan version) in this population. METHODS: The original English version of the MQOL questionnaire was translated into Chinese, and administered to 64 Taiwanese patients with terminal cancer for psychometric testing (factor structures and various types of reliability and validity). The cultural equivalence of the translation was tested by content validity index. Statistical analysis included exploratory factor analysis, Pearson's product moment correlation coefficient, and the calculation of Cronbach's alpha (alpha). RESULTS: Findings on the validity and reliability of the MQOL-Taiwan version were as follows. The value of content validity was 0.98. The range of the correlations between an item and its domain was 0.59 to 0.96 (all p < 0.05), and for inter-domain was 0.28 to 0.52 (all p < 0.05). The 4 domains of the original MQOL emerged as the 4 dominant factors (64% total variance explained) in the MQOL-Taiwan version, namely the domains of physical symptoms, psychological symptoms, existential well-being, and support. The internal consistency (Cronbach's alpha) coefficient of the whole MQOL-Taiwan version was 0.83, and those for the 4 domains ranged from 0.69 to 0.90. For the convergent and divergent validity, the MQOL-Taiwan version physical domain was moderately and significantly (r = -0.44, p < 0.05) correlated with the performance status rating of the Eastern Cooperative Oncology Group-Performance Status Rating (ECOG-PSR). The MQOL-Taiwan version psychological, existential, and support domains were not significantly correlated to the ECOG-PSR. CONCLUSIONS: The MQOL-Taiwan version demonstrated an acceptable level of reliability, validity and equivalency in the initial cross-cultural validation. These findings indicate the suitability of this QOL measure for clinical and research use in Taiwanese patients with terminal cancer.     

Development and Validation of the Satisfaction Survey for Inflatable Penile Implant (SSIPI)

BackgroundNo validated English language patient-reported outcome (PRO) currently exists that assesses satisfaction with inflatable penile prosthesis (IPP). Satisfaction data have been largely based primarily on surgeon assessment of patients or using questionnaires that have not been designed for this purpose.AimTo develop an English-language validated PRO that assesses patient satisfaction after IPP surgery.MethodsInitially, a literature review and discussions with experts defined domains important to IPP satisfaction (pain, appearance, function, overall satisfaction). The initial 35-item Satisfaction Survey for Inflatable Penile Implant (SSIPI) was developed. Cognitive interviews were then performed with IPP patients (n = 12) to gain feedback on the SSIPI domains and items. These data were used to modify SSIPI with the addition of 2 questions for a final item number of 37. Patients from 4 centers, who were between 6 months and 5 years after IPP, were administered the questionnaire through RedCap. Reliability statistics and content analysis were used to winnow questions to yield the final 16-item version of the SSIPI. Internal consistency was assessed via Cronbach's alpha and item-total correlation. Test-retest reliability was assessed via intraclass correlation coefficients using baseline and 2-week data. For convergent validity, the Erectile Dysfunction Inventory of Treatment Satisfaction and the Self-Esteem and Relationship (SEAR) questionnaire were used. For discriminant validity, the International Prostate Symptom Score (IPSS) was used. Confirmatory factor analysis was used to assess the factor structure of the SSIPI.OutcomesInternal consistency, test-retest reliability, convergent and discriminant validity, and confirmatory factor analysis were assessed.Results118 men were surveyed. Mean age was 66.8 ± 9.5 years. The 16-item SSIPI showed high internal consistency with an overall Cronbach's Alpha of 0.97 (domains 0.85–0.89). Item-total correlations for individual items to subscales ranged from 0.60 to 0.91. The overall test-retest reliability was 0.94 (domains 0.87–0.93). Erectile Dysfunction Inventory of Treatment Satisfaction and Self-Esteem and Relationship had correlations of 0.84 overall (domains 0.57–0.79) and 0.47 overall (domains 0.34–0.44), respectively. International Prostate Symptom Score (discriminant validity) had correlations of -0.29 overall (domains -0.17 to -0.31).Clinical ImplicationsSSIPI is the first English-language validated IPP satisfaction PRO. This will enable clinicians to collect satisfaction data in a standardized way.Strengths and LimitationsAs strengths we have used a rigorous psychometric process and have no industry sponsorship. Limitations include small numbers of specific subpopulations.ConclusionThe SSIPI has demonstrated robust psychometric properties. Salter CA, Bach PV, Jenkins L, et al. Development and Validation of the Satisfaction Survey for Inflatable Penile Implant (SSIPI). J Sex Med 2021;18:1641–1651.     

Development of the NIH PROMIS® Sexual Function and Satisfaction Measures in Patients with Cancer

IntroductionWe describe the development and validation of the Patient‐Reported Outcomes Measurement Information System^® Sexual Function and Satisfaction (PROMIS^® SexFS; National Institutes of Health) measures, version 1.0, for cancer populations.AimTo develop a customizable self‐report measure of sexual function and satisfaction as part of the U.S. National Institutes of Health PROMIS Network.MethodsOur multidisciplinary working group followed a comprehensive protocol for developing psychometrically robust patient‐reported outcome measures including qualitative (scale development) and quantitative (psychometric evaluation) development. We performed an extensive literature review, conducted 16 focus groups with cancer patients and multiple discussions with clinicians, and evaluated candidate items in cognitive testing with patients. We administered items to 819 cancer patients. Items were calibrated using item‐response theory and evaluated for reliability and validity.Main Outcome MeasuresThe PROMIS SexFS measures, version 1.0, include 81 items in 11 domains: Interest in Sexual Activity, Lubrication, Vaginal Discomfort, Erectile Function, Global Satisfaction with Sex Life, Orgasm, Anal Discomfort, Therapeutic Aids, Sexual Activities, Interfering Factors, and Screener Questions.ResultsIn addition to content validity (patients indicate that items cover important aspects of their experiences) and face validity (patients indicate that items measure sexual function and satisfaction), the measure shows evidence for discriminant validity (domains discriminate between groups expected to be different) and convergent validity (strong correlations between scores on PROMIS and scores on conceptually similar older measures of sexual function), as well as favorable test–retest reliability among people not expected to change (interclass correlations from two administrations of the instrument, 1 month apart).ConclusionsThe PROMIS SexFS offers researchers a reliable and valid set of tools to measure self‐reported sexual function and satisfaction among diverse men and women. The measures are customizable; researchers can select the relevant domains and items comprising those domains for their study. Flynn KE, Lin L, Cyranowski JM, Reeve BB, Reese JB, Jeffery DD, Smith AW, Porter LS, Dombeck CB, Bruner DW, Keefe FJ, and Weinfurt KP. Development of the NIH PROMIS^® Sexual Function and Satisfaction measures in patients with cancer. J Sex Med 2013;10(suppl 1):43–52.     

Quality of life and acute toxicity of radiotherapy in women with gynecologic cancer: a prospective longitudinal study

OBJECTIVE: To investigate the incidence of acute toxicity of radiotherapy, evaluate quality of life (QOL) and identify its predictors in a cohort of gynecologic cancer patients. METHODS: A longitudinal prospective study was conducted including 107 women between the ages of 18 and 75 years with cervical or endometrial cancer. Acute toxicity was evaluated according to the Common Toxicity Criteria and the Radiotherapy Oncology Group toxicity criteria. QOL was measured with World Health Organization's Quality of Life instrument-abbreviated version (WHOQOL-BREF) before and at completion of radiotherapy and during the first clinical follow-up visit. QOL scores were assessed by ANOVA for repeat measures. Percentage variation of QOL scores from the time before radiotherapy to the first clinical visit was compared with control variables by the Wilcoxon test. Multiple linear regression analysis was used to identify predictors of QOL. RESULTS: Ninety-five women completed the three QOL assessments. The incidence of acute toxicity was 93.5% and the most common complaint was lower gastrointestinal (79.6%). A significant increase in QOL scores was observed in the physical and psychological domains, as well as general health and overall QOL. Upper gastrointestinal toxicity (p = 0.043) and surgery (p = 0.027) negatively affected general health, while improvement in vaginal bleeding (p = 0.047) positively influenced general health. CONCLUSION: A high incidence of acute toxicity of radiotherapy was observed. At the completion of treatment, QOL improved in gynecologic cancer patients. Women with upper gastrointestinal toxicity and history of surgery are at risk for having a worse QOL.     

Development of an endometriosis quality-of-life instrument: The Endometriosis Health Profile-30

OBJECTIVE: To describe a new disease-specific questionnaire with established measurement properties that addresses the dimensions of health-related quality of life considered important to women with endometriosis. METHODS: The Endometriosis Health Profile-30 was developed in three stages. Stage 1 included open-ended exploratory interviews with 25 women to generate the items on the questionnaire. Stage 2 was an 87-item questionnaire administered in a postal survey to identify the most salient dimensions of health-related quality of life. In stage 3, the reliability and validity of the questionnaire were evaluated. RESULTS: The final instrument contained a core questionnaire with 30 items and five scales: pain, control and powerlessness, emotional well-being, social support, and self-image. Six modular parts consisting of 23 questions were also developed and measured the areas of sexual intercourse, work, relationship with children, feelings about the medical profession, treatment, and infertility. All the scales achieved high internal reliability, with Cronbach's alpha coefficient ranging from 0.83 to 0.93 (core questionnaire) and 0.79 to 0.96 (modules). The intraclass correlation coefficients to evaluate the test-retest reliability were high (range 0.88-0.98, P <.001). Content validity was demonstrated as the questionnaire was developed from interviews of patients rather than existing literature and clinical scales. Construct validity was assessed by correlating the Endometriosis Health Profile-30 scales with the relevant Short Form-36 scales. High correlations for all comparisons were found (-0.41 to -0.73). CONCLUSION: The Endometriosis Health Profile-30 is a reliable, valid, patient-generated instrument to measure the health-related quality of life of women with endometriosis. Its application in various health care settings will provide new and valuable information on the effect of endometriosis on health-related quality of life from the patients' perspective.     

子宫动脉栓塞术治疗有症状子宫肌瘤术后患者生存质量的评估

目的评估腹腔镜辅助下经阴道全子宫切除术(LAVH)和子宫动脉栓塞术(UAE)对有症状、无生育要求的子宫肌瘤患者术后的生存质量影响。方法选择2000年12月至2003年12月中日友好医院和海淀医院妇科住院有症状、无生育要求的子宫肌瘤患者56例,随机选择治疗方案。各组患者皆于入院时、术后2月、术后2年进行问卷调查,独立填写WHOQOL-BREF表。比较不同治疗方式在术后不同时间的生存质量评分。结果在生理、心理、社会关系、环境和主观感受4个方面,两组术后都有显著改善。但是,LAVH组在术后2年生存质量才显现显著的差异。UAE组则在术后2月即有了显著改变。结论两组都明显地提高了患者术后的生存质量,在远期效应中无明显差异(除了心理层面),UAE组在提高患者生存质量上有明显的优势。     

Quality of life in Japanese couples during the transition to parenthood

Objective: This study aimed to examine the quality of life (QOL) in Japanese couples during the transition to parenthood with their first child.

Background: Relevant literature suggests that the health status of women drop during pregnancy and the postpartum period. However, less is known about their partner’s well-being during the transition to parenthood and little research has addressed the relationship between couples’ QOL across multiple domains.

Method: Participants included 9216 married Japanese men and women, including 3729 couples, who were expecting or raising their first child under the age of three. They independently completed questionnaires on baseline demographics and on WHOQOL-BREF.

Results: Men showed higher scores for psychological QOL, while women had higher scores for social and environment QOL. A significant interaction between gender and stage of transition to parenthood was found. The moderating effect of age between the stage and QOL was found for men on the physical and psychological domains. Couples’ QOL scores were weakly to moderately correlated.

Conclusion: Findings suggest that both men and women had lower QOL, with the exception of women’s physical QOL, after childbirth, but they showed different trends during the transition to parenthood across different domains of QOL.     

Reliability and validity of the Taiwan Chinese version of the Foot Function Index.

BACKGROUND/PURPOSE: To test the reliability and validity of the Taiwan Chinese version of the Foot Function Index (FFI) among patients with plantar fasciitis and ankle/foot fracture. METHODS: Fifty plantar fasciitis patients and 29 ankle/foot fracture patients volunteered for the cross-sectional survey and 24 were re-retested later. The response distribution was compared between the two groups. The internal consistency and test-retest reliability were evaluated by using Cronbach's alpha and intraclass correlation coefficient (ICC). Criterion validity was examined for correlations with the Taiwan version of the Medical Outcomes Study Short Form-36 (SF-36) questionnaire. The influence of covariates (diagnosis, age, gender, employment) on the scores of total FFI and subscales was explored by multivariate general linear model analysis. RESULTS: Two items in the pain subscale had many answers in the non-applicable category and were removed from analysis. The internal consistency of the 21-item FFI was high (Cronbach's alpha = 0.94) and the test-retest reliability was satisfactory (ICC = 0.82). The activity limitation subscale had relatively lower Cronbach's alpha (0.75) and the items in this subscale had a high proportion of floor scores. There was a moderate correlation between the FFI total and subscale scores to the physical component summary scores rather than to the mental component summary scores of the SF-36. Multivariate general linear model analysis showed that the cases of plantar fasciitis had higher pain scores and lower activity limitation scores, although their FFI total scores were comparable. CONCLUSION: The adapted Taiwan Chinese version of the FFI is reliable and valid and can be applied among traumatic and non-traumatic foot disorders. Nevertheless, its clinical application may be limited by a relatively high proportion of non-applicable answers and significant floor effect in some items.     

Validity, reliability and application of the taiwan version of the migraine disability assessment questionnaire.

BACKGROUND/PURPOSE: The seven-item Migraine Disability Assessment (MIDAS) questionnaire is a simple and useful tool for evaluating migraine-related disability. The goals of this study were: (1) to test the reliability and validity of the Taiwan version of the MIDAS (MIDAS-T) questionnaire, and (2) to measure the impact of migraine among Taiwanese patients in a headache clinic. METHODS: Consecutive migraine patients, aged 20-50 years, visiting the headache clinic at the Taipei Veterans General Hospital were invited to participate in the study. They completed the MIDAS-T and a form, which collected headache-related information including characteristics and impact on their lives. Of them, about 30 patients were randomly invited to repeat the MIDAS-T 3 weeks later. RESULTS: A total of 281 migraine patients (M/F, 63/218; mean age, 35.27 +/- 8.21 years) participated in the study. Of them, 31 completed the MIDAS-T again 3 weeks later. MIDAS-T showed acceptable internal consistency (Cronbach alpha = 0.79), test-retest reliability (r = 0.67) and criterion validity (r = 0.37 for question A [headache frequency] and r = 0.34 for question B [headache intensity], p < 0.001). The mean score of migraine patients on MIDAS-T was 34.21 +/- 45.90, ranging from 0 to 265. MIDAS grade I (score 0-5) was found in 22% of patients, grade II (6-10) in 15%, grade III (11-20) in 17%, and grade IV (>or=21) in 46%. CONCLUSION: This study supports the reliability and validity of MIDAS-T for use in Taiwanese patients. Almost half of the migraine patients were classified as having severe disability (grade IV).     

A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse

OBJECTIVE: Our aim was to develop a condition-specific, reliable, validated, and self-administered instrument to evaluate sexual function in women with pelvic organ prolapse or urinary incontinence. STUDY DESIGN: The questionnaire was designed after review of the literature and of nonspecific validated instruments. The study was completed in 2 phases. In phase 1 a total of 83 women completed both our questionnaire and the Incontinence Impact Questionnaire-7, with 20 women undergoing test-retest reliability analyses. Item analysis was based on the internal consistency, the correlations with the Incontinence Impact Questionnaire-7, the patient's age and self-rating of satisfaction, and the results of reliability testing. For final validation the questionnaire was administered in phase 2 to 99 women. Factor and item analyses were repeated, results were correlated with the Sexual History Form-12, and comparison was made between patients with high depression scores and those with low depression scores on the Symptom Questionnaire. RESULTS: Factor analysis identified 3 domains, labeled Behavioral/Emotive, Physical, and Partner-Related. Sexual function scores were highly correlated with scores on the Sexual History Form-12 for the questionnaire (r = -0.74; P <.001) and for both the Behavioral/Emotive and the Partner-Related domains (r = -0.79 and -0.5, respectively; P <.001). The Physical domain was correlated with scores on the Incontinence Impact Questionnaire-7 (r = -0.63; P <.001). Women with high depression scores on the Symptom Questionnaire had significantly lower scores on the final questionnaire, in comparison with women without depression (P <.001). CONCLUSION: We developed a condition-specific, validated, and reliable instrument, containing 31 items divided into 3 domains, to evaluate sexual functioning in women with urinary incontinence or pelvic organ prolapse.     

Report of Findings in a DSM‐5 Field Trial for Hypersexual Disorder

IntroductionDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) criteria for hypersexual disorder (HD) have been proposed to capture symptoms reported by patients seeking help for out‐of‐control sexual behavior. The proposed criteria created by the DSM‐5 Work Group on Sexual and Gender Identity Disorders require evaluation in a formal field trial.AimThis DSM‐5 Field Trial was designed to assess the reliability and validity of the criteria for HD in a sample of patients seeking treatment for hypersexual behavior, a general psychiatric condition, or a substance‐related disorder.MethodPatients (N = 207) were assessed for psychopathology and HD by blinded raters to determine inter‐rater reliability of the HD criteria and following a 2‐week interval by a third rater to evaluate the stability of the HD criteria over time. Patients also completed a number of self‐report measures to assess the validity of the HD criteria.Main Outcome MeasuresHD and psychopathology were measured by structured diagnostic interviews, the Hypersexual Behavior Inventory, Sexual Compulsivity Scale, and Hypersexual Behavior Consequences Scale. Emotional dysregulation and stress proneness were measured by facets on the NEO Personality Inventory—Revised.ResultsInter‐rater reliability was high and the HD criteria showed good stability over time. Sensitivity and specificity indices showed that the criteria for HD accurately reflected the presenting problem among patients. The diagnostic criteria for HD showed good validity with theoretically related measures of hypersexuality, impulsivity, emotional dysregulation, and stress proneness, as well as good internal consistency. Patients assessed for HD also reported a vast array of consequences for hypersexual behavior that were significantly greater than those diagnosed with a general psychiatric condition or substance‐related disorder.ConclusionsThe HD criteria proposed by the DSM‐5 Work Group on Sexual and Gender Identity Disorders appear to demonstrate high reliability and validity when applied to patients in a clinical setting among a group of raters with modest training on assessing HD. Reid RC, Carpenter BN, Hook JN, Garos S, Manning JC, Gilliland R, Cooper EB, McKittrick H, Davtian M, and Fong T. Report of findings in a DSM‐5 Field Trial for hypersexual disorder. J Sex Med 2012;9:2868–2877.     

Factor structure, validity and reliability of the Spanish version of the Cambridge Worry Scale

Objective

to analyse the factor structure and reliability of the Cambridge Worry Scale (CWS) in the Spanish population.

Design

prospective cross-sectional study using a postal questionnaire.

Setting

the study was conducted at a university hospital in Madrid between October 2007 and December 2008.

Participants

285 Spanish pregnant women.

Methods

factor structure of a Spanish version (original 16 items test and reduced 13 items version) of the scale was analysed through exploratory factor analysis.

Findings

the Spanish version of the reduced 13 items version replicated the original factor structure. The internal consistency was good for the total scale (0.83) and for the subscales (0.70–0.79). Significant positive correlations between the CWS and its subscales with anxiety, depression and neuroticism were found. Similarly, acceptable to good reliability and convergent validity indexes were obtained for the original 16 items test.

Discussion

the present study confirmed the validity of the two Spanish versions of the CWS (16 item and reduced 13 item). Considering the performance of two of the three items eliminated from the original version and the universality in the use of the short version we recommend the use of the reduced 13 item scale. Practical implications of the use of the CWS in maternity care are discussed.     

Measuring Women's Satisfaction with Treatment for Sexual Dysfunction: Development and Initial Validation of the Women's Inventory of Treatment Satisfaction (WITS‐9)

AimTo develop a brief, psychometrically sound, measure of satisfaction with treatment for female sexual arousal disorder.MethodIn Phase 1, women in focus groups generated items measuring satisfaction with treatment for arousal disorder. In Phase 2, expert clinicians/researchers and women with self‐reported female sexual arousal disorder (FSAD) assessed the content validity of the items. In Phase 3, women enrolled in a double‐blind treatment trial for female sexual dysfunction completed the Women's Inventory of Treatment Satisfaction (WITS) and the Female Sexual Function Inventory (FSFI) to provide reliability and validity information.Main Outcome MeasuresWITS and FSFI.ResultsIn Phase 2, 36 items demonstrated adequate content validity. In Phase 3, 20 items correlated with symptom improvement on the FSFI arousal subscale. Factor analysis sorted these items into three dimensions: initiation/receptivity satisfaction, treatment satisfaction, and perceived partner satisfaction. The three items with the highest loadings on each factor formed the WITS‐9. Internal consistency (α) reliability coefficients for the total WITS‐9 score and the three subscale scores were 0.92, 0.93, 0.92, and 0.79, respectively. Correlations of WITS‐9 scores with the FSFI change scores for subgroups with different sexual dysfunctions offer construct validity support that the WITS‐9 measures treatment satisfaction for women with a variety of sexual dysfunctions.ConclusionsThe WITS‐9 is a brief, psychometrically sound scale that is useful for assessing treatment satisfaction in women with sexual dysfunctions. While the WITS‐9 is promising, further work needs to be done to obtain reliability and validity information in additional samples. Corty EW, Althof SE, and Wieder M. Measuring women's satisfaction with treatment for sexual dysfunction: Development and initial validation of the Women's Inventory of Treatment Satisfaction (WITS‐9)     

Does Motherhood Affect the Quality of Life of Adolescents?

Study ObjectiveAssess the quality of life (QOL) of female adolescents with children compared to those without children.DesignCross-sectional.SettingPublic university-affiliated family planning clinic, São Paulo, Brazil.Participants91 female adolescents (16-19 years) of low socio-economic status with and without children.InterventionsThe Portuguese version of the WHOQOL-BREF questionnaire was used.Outcome MeasuresMean scores of the 4 main domains were compared between adolescents with and without children.ResultsBoth mothers (N = 40) and nonmothers (N = 51) had low mean scores (<75%) in most of the QOL domains. Compared to adolescents without children, adolescent mothers scored significantly lower in the physical (52.1 vs 59.4, P = .0137) and social (66.9 vs 77.3, P = .0182) domains.ConclusionAdolescent mothers have a significantly lower quality of life in the physical and in the social relationships domains than nonmothers.     

Quality of life and climacteric complaints amongst women seeking medical advice in Taiwan: assessment using the WHOQOL-BREF questionnaire.

OBJECTIVE: To determine the impact of the climacteric transition on health-related quality of life amongst women, between the ages of 45 and 55 years, seeking medical advice in Taiwan. METHOD: A total of 203 women seeking medical advice (SMA) were drawn from a special integrated clinic, with a further 349 healthy referents of the same age, range and gender, with no history of hormone replacement therapy and living in the same municipality, also being recruited from a national health survey sample for comparison. Each one was asked to fill out the brief questionnaire of the Taiwan version of the World Health Organization Quality of Life (WHOQOL-BREF), assessing quality of life on 26 items in four domains (physical, psychological, social and environmental). SMA subjects were also questioned about the 21 most frequent symptoms. Multiple regression analyses were conducted to control variables such as age, marital status, religion and educational attainment. RESULTS: The mean scores for the physical, psychological and social domains were significantly lower than those of the healthy referents, as was the overall quality of life for SMA women. Although usual vasomotor symptoms did not significantly predict quality of life in the SMA subjects, after controlling for demographic factors, insomnia and emotional disturbance were found to be major determinants of the scores in the different domains. CONCLUSION: Insomnia and emotional disturbance should be taken into consideration in the management of climacteric women seeking medical advice.     

A Comparison of Erectile Dysfunction Improvement Between Patients With Regular Hemodialysis and Patients With Continuous Ambulatory Peritoneal Dialysis

BackgroundErectile dysfunction (ED) is one of the sexual dysfunctions that are often encountered as a complication of male patients with stage 5 chronic kidney disease (stage 5 CKD). ED can be caused by psychological factors in patients with regular dialysis therapy. Currently, Hemodialysis (HD) therapy is the first choice in dialysis therapy and only 2% of stage 5 CKD patients are using Continuous Ambulatory Peritoneal Dialysis (CAPD) as a dialysis therapy. ED in stage 5 CKD patients should become a part of the treatment of patients with dialysis, which hopefully will improve the quality of life of patients. This study aims to compare the improvement in ED degree in patients with HD and CAPD.MethodThis study is an observational analytic comparative study involving 44 male patients with stage 5 CKD; 22 of whom underwent HD and the remaining 22 patients underwent CAPD. The differences evaluated were changes in the ED degree before and after dialysis, which were assessed using the International Index of Erectile Function-5 (IIEF-5).ResultThere were significant differences in the improvement in ED degree and IIEF-5 scores in CAPD group. In the HD group, no significant difference was obtained in the improvement in ED degree and IIEF-5 score. A significant difference was obtained in the improvement in ED degree between the HD and CAPD groups by comparing the improvement in IIEF-5 score.ConclusionPatients with CAPD have a better improvement in ED degree than patients with HD. Duarsa GWK, Kandarini Y, Winarta GK, et al. A Comparison of Erectile Dysfunction Improvement Between Patients With Regular Hemodialysis and Patients With Continuous Ambulatory Peritoneal Dialysis. J Sex Med Rev 2021;18:920–925.     

The Comparison of the Relationship Between Sociocultural‐Economic Features and Sexual Dysfunction Frequency in Sexually Active Premenopausal Female Patients on Renal Replacement Therapy

IntroductionMany studies determine different risk factors for sexual dysfunction (SD) in women, but little is known about the influence of socioeconomic and cultural factors, medical and psychological features on female SD frequency in patients under renal replacement therapy (RRT).AimThis study aimed to compare the relationship between medical, psychological, sociocultural‐economic factors, and SD frequency in patients on RRT with the diagnosis of end‐stage renal disease.MethodThe 115 RRT patients (hemodialysis [HD] 39, peritoneal dialysis [PD] 43, kidney transplant [KT] 33) and 103 healthy premenopausal female volunteers (control) without any known health problems were included in the study.Main Outcome MeasuresThe questionnaire forms containing sociodemographic data, the hospital anxiety depression scale, and Arizona Sexual Experiences Scale were completely filled by subjects who were included in the study.ResultsThere was no significant difference about mean age, dialysis duration, and body mass index between the groups. While there were significant differences among participants training period and employment conditions, socioeconomic status scores were similar. Significant differences were found in marriage type, marital duration, husband's age, training period and working time per week, spending time with each other, weekly sexual intercourse frequency, the number of children, mothers' and fathers' education. RRT groups were more depressed than control, but no significant differences were observed among the RRT groups. PD and HD groups were more anxious than the KT and control groups. It was identified that SD rates were higher in KT and dialysis patients compared with the control. SD rates were significantly high in the HD group. Multivariate analysis showed that marital duration and being an HD patient are independent SD risk factors for RRT population.ConclusionSuccessful KT may improve SD. Differences in sociocultural, economic, medical, and psychological factors among individuals with SD should be taken into consideration in their treatment management. Koca TG, Koca N, and Ersoy A. The comparison of the relationship between sociocultural‐economic features and sexual dysfunction frequency in sexually active premenopausal female patients on renal replacement therapy. J Sex Med 2012;9:3171–3179.