Validation of the Six-item Female Sexual Function Index in Middle-Aged Brazilian Women

Abstract

Objective To validate the six-item female sexual function index (FSFI-6) in middle-aged Brazilian women. Methods Cross-sectional observational study, involving 737 (premenopausal n = 117, perimenopausal n = 249, postmenopausal n = 371) Brazilian sexually active women, aged between 40 and 55 years, not using hormonal contraceptive methods. The Brazilian FSFI-6 was developed from the translation and cultural adaptation of the Portuguese FSFI-6 version. The participants completed a general questionnaire, the FSFI-6, and the menopause rating scale (MRS). The validation was performed by AMOS 16.0 software (SPSS, Inc., Chicago, IL, USA) for a confirmatory factor analysis (CFA). The chi-square of degrees of freedom (χ2/df), the comparative fit index (CFI), the Tucker-Lewis index (TLI) and the root-mean-square error of approximation (RMSEA) were used as indices of goodness of fit. Cronbach α coefficient was used for internal consistency. Results The process of cultural adaptation has not altered the Brazilian FSFI-6, as compared with the original content. The CFA for the FSFI-6 score showed an acceptable fit (χ2/df = 3.434, CFI = 0.990, TLI = 0.980, RMSEA = 0.058, 90% confidence interval (90%CI) = 0.033–0.083, p ≤ 0.001) and a good reliability was established in FSFI-6 and MRS (Cronbach α = 0.840 and = 0.854, respectively). In addition, 53.5% of the sample had low sexual function. Conclusion The FSFI-6 was translated and adapted to the Brazilian culture and is a consistent and reliable tool for female sexual dysfunction screening in Brazilian middle-aged women.

The 6-item Female Sexual Function Index (FSFI-6): factor structure, reliability, and demographic correlates among infertile women in Iran

“…All inter-item correlations and corrected item-total correlations were also within an acceptable range, confirming good internal consistency. This result is consistent with what was reported in the original study (α = 0.789) [23], Korean version (α = 0.888) [24], middle-aged Brazilian and Portuguese women (α = 0.840 and α = 0.890, respectively) [25,26], and Ecuadorian sample (α = 0.91) [36].…”

“…The findings of CFA provided support for a unidimensional model of FSFI-6. This finding was also reported in two studies conducted in middle-aged Brazilian and Portuguese women [25,26].…”

“…The FSFI-6 has been validated in Italy, the USA, Brazil, Korea, Portugal, and Ecuador, mainly in the general population [18,[23][24][25][26][27]; however, they have not been validated in infertile women. Hence, this study aims to evaluate the validity and reliability of the FSFI-6 among a sample of women with infertility.…”

Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study

“…Using the FSFI-6, a cut-off score of ≤19 has been initially proposed to identify women at risk of FSD among Italian women [ 18 ]. Considering social and cultural disparities that can influence sexual attitudes [ 32 ], studies from other countries have applied different approaches to derive different cut-offs of FSFI-6 to identify high-risk women for FSD [ 20 , 21 , 33 ]. By validating FSFI-6 against FSFI-19, cut-off score of ≤21 was proposed for Korean women [ 33 ].…”

“…We defined women as low FSF if their total FSFI-6 scores were at or below the median value of 22. This median score approach had been previously adopted by other groups [ 20 , 21 ]. In this cohort, the internal consistency of the FSFI-6 as measured by Cronbach’s alpha was 0.78.…”