Journal of Sex & Marital Therapy

ISSN: 0092-623X (Print) 1521-0715 (Online) Journal homepage: http://www.tandfonline.com/loi/usmt20

Validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in couples with incontinent partners Renly Lim, Men Long Liong, Nurzalina Abdul Karim Khan & Kah Hay Yuen To cite this article: Renly Lim, Men Long Liong, Nurzalina Abdul Karim Khan & Kah Hay Yuen (2016): Validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in couples with incontinent partners, Journal of Sex & Marital Therapy, DOI: 10.1080/0092623X.2016.1141817 To link to this article: http://dx.doi.org/10.1080/0092623X.2016.1141817

Accepted author version posted online: 02 Feb 2016.

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Date: 15 March 2016, At: 05:56

ACCEPTED MANUSCRIPT Validity and reliability of GRISS Validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in couples with incontinent partners Renly Lim1, Men Long LiongNurzalina1, Abdul Karim Khan2, Kah Hay Yuen3

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Corresponding author, Kah Hay Yuen, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia, E-mail: [email protected], Tel: (60)4 2383426, Fax: (60)4 2267989 Authors, School of Pharmaceutical Sciences, Universiti Sains Malaysia, [email protected] 1

Department of Urology, Island Hospital, Penang, Malaysia, [email protected]

2

School of Pharmaceutical Sciences, Universiti Sains Malaysia, [email protected]

3

School of Pharmaceutical Sciences, Universiti Sains Malaysia, [email protected]

Abstract There is currently no published information on the validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in the Asian population, which limits its use in this region. Our study aimed to evaluate the psychometric properties of this questionnaire in the Malaysian population. Ten couples were recruited for the pilot testing. The agreement between the English and Chinese or Malay versions were tested using the intraclass correlation coefficients, with results of more than 0.80 for all subscales and overall scores indicating good agreement. Sixtysix couples were included in the subsequent phase. (Presented in the order of English, Chinese and Malay). Cronbach's alpha for the male total score were 0.82, 0.88 and 0.95. For the female total score, Cronbach's alphas were 0.76, 0.78 and 0.88. Intraclass correlation coefficients for the

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ACCEPTED MANUSCRIPT male total score were 0.93, 0.94 and 0.99, while intraclass correlation coefficients for the female total score were 0.89, 0.86 and 0.88. In conclusion, the English, Chinese and Malay versions each proved to be valid and reliable in our Malaysian population. Keywords

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cross-cultural studies, questionnaires, surveys

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ACCEPTED MANUSCRIPT Introduction Stress urinary incontinence (SUI) is a chronic condition in which there is an involuntary loss of urine on effort or exertion (Haylen et al., 2010), resulting in detrimental effects including on sexual function (Fatton, de Tayrac, & Costa, 2014). To have an accurate account of sexual function in incontinence, a valid and reliable questionnaire is pivotal. The Fifth International Consultation of Incontinence highly recommended three sexual health measures: Golombok Rust Downloaded by [University of Florida] at 05:56 15 March 2016

Inventory of Sexual Satisfaction (GRISS), International Index of Erectile Function and Female Sexual Function Index, whereby the latter two are gender-specific (Staskin et al., 2013).

The GRISS is a 28-item questionnaire comprising twelve subscales of four items each: impotence, premature ejaculation, male and female non-sensuality, male and female avoidance, male and female dissatisfaction, infrequency, non-communication, vaginismus and anorgasmia (Rust & Golombok, 1986).

Unfortunately, there is currently no published information on its validity and reliability in the Asian population, which limits its use in this region. Malaysia as a multicultural country comprises three major ethnicities; Malay, Chinese and Indian; English is regarded as the second language. Consequently, use of the English questionnaire alone will be inadequate in capturing important information. Thus, our objective is to explore the psychometric properties of the GRISS in three languages (English, Chinese and Malay) in the Malaysian population.

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ACCEPTED MANUSCRIPT Method Females aged ≥21 years old, diagnosed with SUI, sexually active, and their partners were recruited from the urology department of Island Hospital, Malaysia. Subjects were excluded if they had acute severe infections, significant co-morbidities that might affect sexual function, recently undergone pelvic floor surgery or were pregnant.

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The study was conducted in accordance with the Declaration of Helsinki, and has been approved by the Joint Ethics Committee of the School of Pharmaceutical Sciences, USM-HLWE on Clinical Studies [USM-HLWE/IEC/2013(0006)]. Written informed consent was obtained from all participants.

The English version was translated into Chinese and Malay, with permission from Professor John Rust (Rust & Golombok, 1986).The translation process followed a six-stage step-wise process (Acquadro, Conway, Hareendran, & Aaronson, 2008; Beaton, Bombardier, Guillemin, & Ferraz, 2000): Ten couples were recruited for the pilot testing. The GRISS subscales and overall scores of the English and Chinese or Malay versions were tested for agreement using the intraclass correlation coefficient (ICC). The validity of a questionnaire is simply whether it is able to measure what it is intended for. Content validity refers to the qualitative assessment as to whether the items are sensible, unambiguous and representative of all facets of a concept to be measured (Kelleher et al., 2013). Content validity was assessed by cognitive debriefing to confirm equivalence. Healthcare

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ACCEPTED MANUSCRIPT professionals also reviewed the questionnaires and judged whether the items were unambiguous and inclusive. The level of missing data was used to assess the acceptability of the items. Reliability is categorized into two sub-groups; internal consistency and test-retest reliability (Deyo, Diehr, & Patrick, 1991). Internal consistency represents the degree of convergence to which different items within the questionnaire are related to each other, and was evaluated using

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Cronbach's alpha coefficient (Cronbach, 1951). A value greater than 0.7 was considered acceptable (Nunnally, 1978). Test-retest reliability examines the stability of the individual's responses (Deyo et al., 1991), and was evaluated by administering the questionnaires to the same couples on two consecutive visits of one week apart (Deyo et al., 1991). Test-retest reliability was assessed with the ICC using the two-way mixed model with measures of absolute agreement (Shrout & Fleiss, 1979). The values of ICC vary from 0 (totally unreliable) to 1 (totally reliable), for which a value greater than 0.7 was considered acceptable (Nunnally, 1978). All questionnaires were self-administered although guidance was available (R.L.) on-site to facilitate the subjects when necessary. Data entry was performed using Excel 2007 (Microsoft, Redmond, WA, USA). The IBM SPSS Statistics for Windows, version 22.0, (Armonk, NY, USA) was used in analysis. Results From September 2013 to December 2014, 66 sexually active couples were recruited. Mean ages for females and their partners were 49.7±7.63 and 54.2±9.30 years respectively. 26 (39%) couples took the GRISS in English, 32 (49%) in Chinese and 8 (12%) in Malay.

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ACCEPTED MANUSCRIPT The clinical experts provided revisions during the translation phase. All of them agreed that the questionnaires were intelligible and covered all important domains. During the pilot testing phase, all subjects were able to answer the questions without problems, and only minor revisions were made. The agreements between the English and Chinese or Malay were good, with ICC of >0.80 for all subscales. There were very low levels of missing data (

Validity and Reliability of the Golombok Rust Inventory of Sexual Satisfaction in Couples with Incontinent Partners.

There is currently no published information on the validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in the Asian populat...
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