Introduction:
The psychological impact of a cardiac event includes feelings of sexual inadequacy, poor sexual quality, and less sexual satisfaction. Few studies have examined sexual self-perception of cardiac patients. Aim: Validate the Sexual Self-Perceptions and Adjustment Questionnaire (SSPAQ) in cardiac patients.
Methods:
Mailed questionnaires sent to those previously hospitalized during a 1-year period with specific cardiac diagnoses (336 respondents). The SSPAQ was developed and significantly revised from another instrument, adding 5 items (total 30 items), rewording double barreled/redundant items, and making response sets more understandable. Subscales included sexual anxiety, depression, self-efficacy, and satisfaction. The scale-level content validity index was 0.97. Statistical analyses: correlation matrices for item representativeness of underlying factors, and construct validity with confirmatory factor analysis and with known groups, comparing sexually active to not active using t-tests.
Results:
After item analysis, 28 items were retained, 7 per subscale; Chronbach's alpha were >0.90, indicating item appropriateness for the combined scale (0.97). Using confirmatory factor analysis, factor loadings showed items were related to the 4 latent factors. For sexual anxiety, depression, and self-efficacy, loadings were above 0.60, and sexual satisfaction had 1 loading of 0.54, but all other loadings were above 0.70, suggesting subscales were reliable and valid. Construct validity comparing sexually active to inactive showed those not active had significantly lower sexual self-perception (
Table
).
Conclusions:
The SSPAQ is reliable and valid for measuring sexual anxiety, sexual depression, sexual self-efficacy, and sexual satisfaction, and overall sexual perception and adjustment. The instrument may be useful in both research and clinical settings to further assess cardiac patient adaptation, allowing better assessment of this aspect of sexual quality of life.
Sexual Self-Perception & Adjustment Factors and Sexual Activity
Factor
Not Sexually Active
Sexually Active
T-test
Mean
SD
Mean
SD
Sexual Anxiety (R=7-35)
17.71
7.52
13.81
6.04
3.45
**
Sexual Depression (R=7-35)
21.36
6.08
14.65
6.33
6.20
***
Sexual Self-Efficacy (R=7-35)
19.88
7.16
26.38
5.77
−5.42
***
Sexual Satisfaction (R=7-35)
18.37
6.18
25.84
5.87
−6.19
***
Total Sexual Self-Perception(R=28-140)
85.00
22.10
108.85
20.52
−5.12
***
**
p<.01
***
p<.001 Higher scores= more of subscale attribute; total=greater self-perception
Bilingualism and Self-Perception: Self-Efficacy through the Veil of Two Languages