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Table 2 Sexual function outcome measures

From: Management of sexual dysfunction in breast cancer survivors: a systematic review

 

Assessment descriptiona

Scoring rubric

Arizona Sexual Experience Scale (ASEX) [68, 69]

5-item scale measuring sexual drive, arousal, vaginal lubrication, orgasm, and satisfaction

• 6-point Likert scale (1 – 6); total score 5 – 30

• Higher scores indicate greater sexual dysfunction.

• Score > 19 indicates sexual dysfunction.

Body Image Relationships Scale (BIRS) [70]

11-item Appearance and Sexuality Subscale measuring satisfaction with sexual activity, physical appearance, and body image

• 5-point scale (1 – 5); total score 11 – 55

• Higher scores indicate greater impairment.

Cancer Rehabilitation Evaluation System (CARES) [71]

Includes 4-item Sexual Interest, 4-item Sexual Function, and 18-item Marital Issues Subscales

• 5-point scale (0 – 4)

• Higher scores indicate greater impairment.

Changes of Sexual Functioning Questionnaire (CFSQ) [72]

Includes 3-item Desire/Interest, and 2-item Frequency/Pleasure Subscales

• 5-point Likert scale (1 – 5); total score 5 – 25

• Higher scores indicate lesser impairment.

Derogatis Inventory of Sexual Functioning (DISF-SR) [73]

4-item subscale measuring sexual drive and relationship satisfaction

• 5- or 9-point scale (depending on item)

• Higher scores indicate less impairment.

EORTC Quality of Life Questionnaire (QLQ) Breast Cancer Module [74]

23-item Sexual Function and Body Image Subscales measuring breast cancer therapy side effects

• 4-point rating scale; total score 0 – 100 (after linear transformation)

• Higher scores indicate less impairment.

Female Sexual Function Index (FSFI) [75]

19-item scale measuring sexual desire, arousal, lubrication, orgasm, satisfaction, and pain

• 6-point Likert scale (0 – 5); total score 0 – 36

• Higher scores indicate better sexual function.

• Score < 26.5 suggests sexual dysfunction.

Functional Assessment of Cancer Therapy (FACT) [76]

18-item Endocrine Symptoms Subscale (FACT-ES) measuring hormone-related/ menopausal symptoms of breast cancer

• Total score 0 – 72

• Higher scores indicate fewer symptoms.

Marital Intimacy Questionnaire [77]

8-item scale measuring marital intimacy

• 4-point Likert scale (1 – 4); total score 8 – 32

• Higher scores indicate less impairment.

Medical Outcomes Study [78]

4-item Sexual Functioning Subscale measuring sexual dysfunction symptoms

• 6-point Likert scale (1 – 6)

• Higher scores indicate more symptoms.

Menopausal Sexual Interest Questionnaire (MSIQ) [79]

10-item Sexual Satisfaction Subscale measuring desire, responsiveness, and satisfaction in postmenopausal women

• 7-point Likert scale (1-7); total score 10 - 70

• Higher scores indicate less impairment.

Menopausal Symptom Score [80]

Adapted 7-item scale measuring study-specific menopausal symptoms

• 5-point Likert scale (0 – 4); total score 0 – 28

• Higher scores indicate more symptoms.

Profile of Female Sexual Function (PFSF) [81]

37-item scale measuring sexual desire, arousal, orgasm, pleasure, concerns, responsiveness, and self-image

• 5-point Likert scale (1 – 5); total score 0 – 100 (after linear transformation)

• Higher scores indicate less impairment.

Psychological Adjustment to Illness Scale (PAIS) [82]

46-item clinical interview with Sexual Relationships (PAIS-SR) and Sexual Problems Subscales measuring psychological and social adjustment to illness

• 4-point scale (0 – 3)

• Higher scores indicate poorer adjustment.

• Score < 35 = good; 35-51 = fair; > 51 = poor

Quality of Marriage Index (QMI) [83]

6-item scale measuring marital quality

• 7-point bipolar scale (1 – 7); total score 6 – 42

• Higher scores indicate better quality of marriage.

Study-Specific Scales [50]

Study-specific scales measuring frequency of sexual desire, intercourse, masturbation, orgasm, initiative for sex, and relationship satisfaction

• Higher scores indicate less impairment.

Study-Specific Scales [51]

Study-specific items measuring sexual satisfaction, relationship satisfaction, dyspareunia, and comfort with sexuality

• 5- or 6-point Likert scale (depending on item)

• Higher scores indicate less impairment.

Sexual Activity Questionnaire (SAQ) [84]

10-item scale with 3 main subscales measuring: Pleasure (SAQ-P; desire, enjoyment, satisfaction), Discomfort (SAQ-D; vaginal dryness, dyspareunia), Habit Subscale (SAQ-H; frequency)

• 4-point Likert scale (0 – 3); total score 0 – 24

• Higher scores indicate less impairment.

Sexual Desire Subscale of Brief Index of Sexual Function (BISF) [85]

Includes 8-item Sexual Desire and 9-item Sexual Arousal Subscales

• 6- or 7-point Likert scale (0 – 5 or 0 – 6)

• Higher scores indicate less impairment.

Sexual Dysfunction Scale [57]

25-item study-specific scale with 3 subscales measuring: Behavioral (vaginal dryness, dyspareunia, and frequency), Evaluative (interest, arousal, and satisfaction), Body image (sense of attractiveness, impact of weight change and hair loss)

• Total score 0 – 100

• Higher scores indicate less impairment.

Sexual Function Subscale of Greene Climacteric Scale (GCS) [86]

21-item scale with 4 subscales measuring: Vasomotor Symptoms (2 items), Somatic Symptoms (7 items; headaches and muscle/joint pains), Psychological Symptoms (11 items), Sexual Function (1 item; sexual interest)

• 4-point scale (0 – 3); total score 0 – 6 (vasomotor), 0 – 21 (somatic), 0 – 33 (psychological), 0 – 3 sexual function; combined total score 0 – 63

• Higher scores indicate more symptoms.

Sexual Problems Frequency [45]

Adapted subscale from BIRS measuring frequency of sexual problems

• 5-point Likert scale (0 – 4)

• Higher scores indicate greater impairment.

Sexual Satisfaction Scale (SSS) [61, 87]

Study-specific items measuring relational sexual satisfaction for male and female partners

• Higher scores indicate less impairment.

Sexual Satisfaction Scale (SSS) [88]

17-item study-specific scale measuring sexual satisfaction among Korean women

• 4-point Likert scale (1 – 4); total score 17 – 68

• Higher scores indicate less impairment.

Sexual Self Schema Scale [89]

50- item, trait-adjectives scale measuring women’s sexual self-perception

• 7-point Likert scale (0 – 6)

• Higher scores indicate better self-perception.

Visual Analog Scale for Vaginal Dryness and Dyspareunia [29]

Linear rating scale measuring vaginal dryness and pain

• 10-point scale (0 – 10)

• High scores indicate greater impairment.

Vaginal Atrophy Symptom [29, 90–92]

Adapted 3-item scale measuring vaginal dryness, itching/irritation, dyspareunia

• 4-point Likert scale (0 – 3); total score 0 – 9

• Higher scores indicate greater impairment.

Vaginal Dryness, Vaginal Itching, Dyspareunia [23, 32]

Study-specific items measuring vaginal dryness, vaginal itching, and dyspareunia

• 5- or 10-point Likert scale (depending on study)

• Higher scores indicate greater impairment.

Vaginal Health Index (VHI) [93, 94]

6-parameter gynecological examination rating appearance of vaginal mucosa

• Score of 1 to 5; total score 6 – 30

• Higher index indicates healthier appearance.

Vaginal Maturation Index (VMI) [91, 95]

Gynecological examination determining vaginal atrophy

• Score of 0 – 100 (%)

• Higher scores indicate less vaginal atrophy.

• A score of < 50 indicates vaginal atrophy.

Vaginal Symptoms Score (VSS) [24, 95]

Study-specific scale measuring severity of vaginal atrophy

• 5-point Likert scale (0 – 4)

• Higher scores indicate more symptoms.

  1. aAll scales were designed as self-report questionnaires (unless otherwise reported as an examination, interview, or visual analog scale)