Academic journal article Journal of Nursing Measurement

Development and Psychometric Testing of a Sexual Concerns Questionnaire for Kidney Transplant Recipients

Academic journal article Journal of Nursing Measurement

Development and Psychometric Testing of a Sexual Concerns Questionnaire for Kidney Transplant Recipients

Article excerpt

Background and Purpose: This study describes the development and psychometric testing of the Sexual Concerns Questionnaire (SCQ) in kidney transplant (KTx) recipients. Methods: Construct validity was assessed using the Kroonenberg and Lewis exploratory/ confirmatory procedure and testing hypothesized relationships with established questionnaires. Configural and weak invariance were examined across gender, dialysis history, relationship status, and transplant type. Reliability was assessed with Cronbach's alpha, composite reliability, and test-retest reliability. Results: Factor analysis resulted in a 7-factor solution and suggests good model fit. Construct validity was also supported by the tests of hypothesized relationships. Configural and weak invariance were supported for all subgroups. Reliability of the SCQ was also supported. Conclusions: Findings indicate the SCQ is a valid and reliable measure of KTx recipients' sexual concerns.

Keywords: sexuality; instrument development; sexual concerns; transplant; kidney transplant; psychometrics

Significant advances in transplant medicine including improvements in organ procurement and immunosuppression have made kidney transplant (KTx) the treatment of choice for persons with end-stage renal disease (Hariharan et al., 2000; Kaplan & Meier-Kriesche, 2004). In 2013, 16,895 KTx were performed in the United States, and there are nearly 100,000 people on the waiting list for a KTx (Organ Procurement and Transplant Network, 2014). In general, people who receive a KTx have increased survival rates (Wolfe et al., 1999) and enjoy better quality of life (QOL) than those on dialysis (Dew et al., 1997; Ogutmen et al., 2006). Despite the overall posttransplant improvement, one area of QOL that remains problematic is sexuality (Diemont et al., 2000; Hricik et al., 2001; Laupacis et al., 1996; Matas et al., 2002; Muehrer, Keller, Powwattana, & Pornchaikate, 2006; Pertuz, Castaneda, Rincon, & Lozano, 2014; Raggi et al., 2012). It is estimated that 50%-87% of male KTx recipients (Malavaud, Rostaing, Rischmann, Sarramon, & Durand, 2000) and 40%-78% of females (Ozdemir, Eryilmaz, Yurtman, & Karaman, 2007) have symptoms indicative of sexual problems.

To effectively provide comprehensive care for people with organ transplants, clinicians need to be aware of their patients' concerns about sexuality and problems with sexual function. Sexual function and concerns is underinvestigated, and many of the studies found in the literature are relatively old. Most prior research on KTx recipients (Diemont et al., 2000; Hricik et al., 2001; Matas et al., 2002; Tavallaii et al., 2007) included only one or two general questions about sexuality or sexual functioning. Although these studies provide a basic understanding of the prevalence and significance of sexual problems after a KTx, absent from the research reports is a careful delineation of the specific nature and extent of difficulties experienced by transplant recipients. In addition to the limited research on KTx patients' sexual problems, studies conducted in other fields (e.g., obstetrics and gynecology, and oncology), report that most health care providers fail to assess (Sobecki, Curlin, Rasinski, & Landau, 2012) or initiate discussion (Hordern & Street, 2007; Ussher et al., 2013) of their patients' real or potential sexual problems or concerns. To address these gaps, the Sexual Concerns Questionnaire (SCQ) was developed. The purpose of this article is to describe the development and psychometric testing of the SCQ.

BACKGROUND

Numerous studies have shown that problems with sexual functioning are prevalent in the transplant population (Burgos et al., 1997; Diemont et al., 2000; Malavaud et al., 2000; Muehrer et al., 2006; Ozdemir et al., 2007; Tavallaii et al., 2007) and affect both men (Malavaud et al., 2000; Tsujimura et al., 2002; Yavuz et al., 2013) and women (Küçük, Turkmen, & Küçük, 2013; Muehrer et al. …

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