Faculty Collaboration Database

Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function. J Sex Med 2014 Aug;11(8):1991-8

Date

06/07/2014

Pubmed ID

24902984

Pubmed Central ID

PMC4248305

DOI

10.1111/jsm.12599

Scopus ID

2-s2.0-84905056396 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

INTRODUCTION: There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy.

AIM: This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy.

METHODS: We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System(®) (PROMIS(®) ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy.

MAIN OUTCOME MEASURES: In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item.

RESULTS: Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension.

CONCLUSIONS: Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development.

Author List

Alexander AM, Flynn KE, Hahn EA, Jeffery DD, Keefe FJ, Reeve BB, Schultz W, Reese JB, Shelby RA, Weinfurt KP

Author

Kathryn Eve Flynn PhD Vice Chair, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Comprehension
Consumer Behavior
Educational Status
Female
Humans
Male
Middle Aged
Patient Education as Topic
Self Report
Sexology
Terminology as Topic
Young Adult