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Responsiveness of the Golombok Rust Inventory of Sexual Satisfaction in couples with incontinent partners

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Abstract

Objective

In order for a measure to reliably evaluate treatment efficacy, it is important that the measure used has adequate responsiveness. However, the responsiveness of the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, a highly recommended questionnaire by the International Consultation of Incontinence to assess sexual function in patients with incontinence, has not been established. To enable the use of GRISS to measure change in sexual function following incontinence treatment, we evaluated the short- and long-term responsiveness of the GRISS in couples with female stress urinary incontinence partners.

Study design

Forty-eight couples with female stress urinary incontinence partners were included in the study. The GRISS, a 28-item multidimensional measure, comprises two sets of questionnaires to assess sexual function in both male and female partners. Responsiveness was investigated using data from our recent randomized controlled trials evaluating efficacy of pulsed magnetic stimulation for treatment of female patients with stress urinary incontinence. Effect size index and standardized response mean were used to measure responsiveness of the English and Chinese versions of GRISS.

Results

For short-term responsiveness, the overall female and male GRISS scores had effect sizes and standardized response means ranging from 0.60 to 0.83 and 0.44 to 0.78 respectively. For long-term responsiveness, the overall female and male GRISS scores had effect sizes and standardized response means ranging from 0.59 to 0.77 and 0.48 to 0.79 respectively.

Conclusion

In conclusion, the English and Chinese versions of GRISS had adequate responsiveness for use in couples with incontinent partners. The GRISS can be a useful measure to detect change in sexual function of couples following treatment of females with stress urinary incontinence.

Introduction

Stress urinary incontinence (SUI) is defined by the International Urogynecological Association (IUGA)/International Continence Society (ICS) as the “complaint of involuntary loss of urine on effort or physical exertion (e.g., sporting activities), or on sneezing or coughing” [1]. SUI has significant detrimental effects on quality of life, mental well-bring and sexual function [[2], [3], [4], [5]]. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) is one of the three measures highly recommended by the International Consultation of Incontinence to assess sexual function in people with urinary incontinence [6]. Two other measures, the International Index of Erectile Function [7] and Female Sexual Function Index [8], are gender-specific questionnaires. The GRISS has two separate sets of questionnaires for both males and females, allowing evaluation of sexual function as individuals and as a couple [9].

In order for a measure to be clinically useful, it is important that the measure used has adequate validity, reliability and responsiveness [10]. Cross-cultural translation, adaptation and validation of health measures are often needed to allow for use in a new country or in a different culture [11]. Malaysia is a multicultural country with three major ethnicities; Malay, Chinese and Indian; English is regarded as the second language. We have previously translated the English version of GRISS into Chinese and Malay to enable use in the Malaysian population [12]. We have also demonstrated the validity (content validity) and reliability (internal consistency and test-retest reliability) of the GRISS in the local population [12].

Responsiveness means the ability of a measure to detect small but meaningful underlying changes of an intervention [10]. A measurement would have limited use for patient evaluation if it is unable to reflect changes in the patient's condition [10]. Many recent studies have incorporated the GRISS as part of the outcome measures in their research studies, recognizing the importance of acknowledging sexual function in patients and their partners [[13], [14], [15], [16], [17]]. However, the use of GRISS in measuring change in patients following an intervention is limited because its responsiveness has not yet been established. Thus, the aim of this study is to explore the short- and long-term responsiveness of the GRISS in couples with female stress urinary incontinence partners.

Section snippets

Materials and methods

The study 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.

Potential participants were recruited from patients attending the urology or gynecology clinics in hospitals in Penang, as well as from among the general population through advertisements in posters, brochures, newspapers and websites. Females aged 21 years old and above, diagnosed

Results

From September 2013 to December 2014, a total of 66 sexually active couples were recruited. Fifty-three couples completed reassessment at the six-month follow-up. Mean ages (standard deviation) for females and their partners were 49.5 (7.8) and 54.2 (9.9) years respectively (Table 1). Twenty-one (40%) couples took the GRISS in English, 27 (51%) in Chinese and 5 (9%) in Malay. Since there were only five patients who answered in Malay, the responsiveness of the Malay version of the GRISS could

Discussion

Our results showed that the English and Chinese versions of GRISS had adequate responsiveness. This means that both versions of GRISS have sufficient ability to detect change when sexual function of patients improve or deteriorate. Since stress urinary incontinence negatively affects sexual function of not only the female patients but also their partners’ sexual function [3], it is crucial to also measure effects of any treatments for stress urinary incontinence on sexual function of couples

Conclusions

In conclusion, the English and Chinese versions of GRISS have adequate responsiveness in our Malaysian population. It can be a useful measure to detect change in sexual function of couples following treatment of females with stress urinary incontinence. Additional research is needed to investigate the responsiveness of the Malay version of GRISS, and the responsiveness of GRISS in different populations.

Funding

None

Acknowledgement

We thank all study participants.

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