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RESEARCH ARTICLE

Validity, reliability and factor structure of the Female Sexual Well-Being Scale in married Iranian women

Farzaneh Ashrafinia https://orcid.org/0000-0002-2697-4108 A * , Nouzar Nakhaee B , Hui Chen C , Erika L. Kelley D and Omolbanin Heydari E
+ Author Affiliations
- Author Affiliations

A Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

B Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

C School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.

D Department of Reproductive Biology, Case Western Reserve University Hospitals, Cleveland, Cleveland, OH, USA.

E Department of Nursing and Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.

* Correspondence to: ashrafifarzaneh60@yahoo.com

Handling Editor: Heather Armstrong

Sexual Health 21, SH24043 https://doi.org/10.1071/SH24043
Submitted: 13 March 2024  Accepted: 21 June 2024  Published: 11 July 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

Promoting the quality of women’s sex life is crucial for their overall well-being. The aim of this study was to translate and validate the Iranian adaptation of the Female Sexual Well-Being Scale (FSWB), and assess its cross-cultural comparability.

Methods

The Persian version of the FSWB was developed through forward and backward translations, followed by revision by a research team and pilot testing. A total of 400 women completed the FSWB questionnaire. Test–retest reliability was determined using the intraclass correlation coefficient, whereas Cronbach’s alpha coefficient was used to assess internal consistency. Construct validity was assessed by exploratory factor analysis using principal axis factorisation with varimax rotation, followed by confirmatory factor analysis.

Results

Only one factor was found in the scale by factor analysis using the principal component method and varimax rotation. The Kaiser–Meyer–Olkin measure demonstrated high sampling adequacy (0.961), and Bartlett’s test of sphericity confirmed the appropriateness of the correlation matrix for exploratory factor analysis (P < 0.001). Confirmatory factor analysis supported the fit of the one-factor model based on various model fit indices. The intraclass correlation coefficient for test–retest reliability was 96.8%, and Cronbach’s alpha coefficient for internal consistency was 97.2%, demonstrating high reliability.

Conclusions

The Persian version of the FSWB (consisting of 17 questions) and its scoring system showed robust validity and reliability in assessing women’s sexual well-being in the Iranian context.

Keywords: Female Sexual Well-Being, psychometric validation, questionnaire, reproductive health, sex development, sexual dysfunction, sexual health, sexual satisfaction.

References

Kedde H, Van de Wiel HBM, Weijmar Schultz WCM, Wijsen C. Subjective sexual well-being and sexual behavior in young women with breast cancer. Support Care Cancer 2013; 21: 1993-2005.
| Crossref | Google Scholar | PubMed |

World Health Organization. Sexual and Reproductive Health and Research (SRH); 2023. Available at https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)/overview

Mitchell KR, Lewis R, O’Sullivan LF, Fortenberry JD. What is sexual wellbeing and why does it matter for public health? Lancet Public Health 2021; 6(8): e608-e13.
| Crossref | Google Scholar | PubMed |

Rosen RC, Bachmann GA, Reese JB, Gentner L, Leiblum S, Wajszczuk C, et al. Female Sexual Well-Being Scale™ (FSWB Scale™): development and psychometric validation in sexually functional women. J Sex Med 2009; 6(5): 1297-305.
| Crossref | Google Scholar | PubMed |

Rosen RC, Althof SE, Barbach LG, Dietrich J, Wanser R, Zhang P. Female sexual well-being ScaleTM: responsiveness to interventional product use by sexually functional women. J Sex Med 2010; 7(7): 2479-86.
| Crossref | Google Scholar | PubMed |

Yazdanpanahi Z, Nikkholgh M, Akbarzadeh M, Pourahmad S. Stress, anxiety, depression, and sexual dysfunction among postmenopausal women in Shiraz, Iran, 2015. J Family Community Med 2018; 25(2): 82-7.
| Crossref | Google Scholar | PubMed |

Khalesi ZB, Simbar M, Azin SA, Zayeri F. Public sexual health promotion interventions and strategies: a qualitative study. Electron Physician 2016; 8(6): 2489-96.
| Crossref | Google Scholar | PubMed |

Rosen RC, Bachmann GA. Sexual well-being, happiness, and satisfaction, in women: the case for a new conceptual paradigm. J Sex Marital Ther 2008; 34(4): 291-7.
| Crossref | Google Scholar | PubMed |

Thomas HN, Thurston RC. A biopsychosocial approach to women’s sexual function and dysfunction at midlife: a narrative review. Maturitas 2016; 87: 49-60.
| Crossref | Google Scholar | PubMed |

10  Chalme R, Abdolahi F. Psychometric adequacy of women’s sexual well-being scale in married women: validity, reliability and factor structure. Family Sex Health J 2020; 2(1): 29-38.
| Crossref | Google Scholar |

11  Karimian Z, Atoof F, Azin SA, Maasoumi R, Khoei EM. Sexual behaviors and its predictors among Iranian women living in Kashan city 2017: a cross-sectional study. Int J Fertil Steril 2018; 12(3): 207-12.
| Crossref | Google Scholar |

12  Maasoumi R, Lamyian M, Khalaj Abadi Farahani F, Montazeri A. Women’s perception of sexual socialization in Iran: a qualitative study. J Qual Res Health Sci 2020; 2(3): 221-33.
| Google Scholar |

13  Shirkhani M, Sadeghi A, Naeemi Nezam Abad A, Sabbagh K. Investigating the relationship between childhood sexual abuse, marital satisfaction and sexual performance in Iranian married women. Pract Clin Psychol 2023; 11(1): 45-56.
| Crossref | Google Scholar |

14  Smylie L, Clarke B, Doherty M, Gahagan J, Numer M, Otis J, et al. The development and validation of sexual health indicators of Canadians aged 16–24 years. Public Health Rep 2013; 128(2_suppl1): 53-61.
| Crossref | Google Scholar |

15  Fakhri A, Pakpour AH, Burri A, Morshedi H, Zeidi IM. The Female Sexual Function Index: translation and validation of an Iranian version. J Sex Med 2012; 9(2): 514-23.
| Crossref | Google Scholar | PubMed |

16  Shirmohammadi M, Shahriari M, Gooshki ES, Kohan S. Challenges of researchers in performing sexual health research in Iran: a qualitative study. Iran J Psychiatry Behav Sci 2018; 12(4): e11655.
| Crossref | Google Scholar |

17  Isidori AM, Pozza C, Esposito K, Giugliano D, Morano S, Vignozzi L, et al. Original Research—Outcomes Assessment: development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. J Sex Med 2010; 7(3): 1139-46.
| Crossref | Google Scholar | PubMed |

18  Maroufizadeh S, Riazi H, Lotfollahi H, Omani-Samani R, Amini P. The 6-item Female Sexual Function Index (FSFI-6): factor structure, reliability, and demographic correlates among infertile women in Iran. Middle East Fertil Soc J 2020; 24: 1-6.
| Crossref | Google Scholar |

19  Yaghubi H. Psychometric properties of the 10 questions Version of the Kessler Psychological Distress Scale (K-10). J Appl Psychol Res 2016; 6(4): 45-57.
| Crossref | Google Scholar |

20  Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand S-L, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32(6): 959-76.
| Crossref | Google Scholar | PubMed |

21  Pereira A, Oliveira CA, Bártolo A, Monteiro S, Vagos P, Jardim J. Reliability and factor structure of the 10-item Kessler Psychological Distress Scale (K10) among Portuguese adults. Cienc Saude Coletiva 2019; 24: 729-36.
| Crossref | Google Scholar | PubMed |

22  Nunnally JC, Bernstein IH. Psychometric theory. 3rd edn. New York: McGraw-Hill; 1994.

23  Bartko JJ. The intraclass correlation coefficient as a measure of reliability. Psychol Rep 1966; 19(1): 3-11.
| Crossref | Google Scholar | PubMed |

24  Li N, Huang J, Feng Y. Construction and confirmatory factor analysis of the core cognitive ability index system of ship C2 system operators. PLoS ONE 2020; 15(8): e0237339.
| Crossref | Google Scholar | PubMed |

25  Bateman RM, Sharpe MD, Jagger JE, Ellis CG, Solé-Violán J, López-Rodríguez M, et al. 36th international symposium on intensive care and emergency medicine : Brussels, Belgium. 15-18 March 2016. Crit Care 2016; 20(Suppl 2): 94.
| Crossref | Google Scholar |

26  Behbahanirad A, Joulaei H, Jamali J, Golkari A, Bakhtiar M. Dimensional structure of the early childhood oral health impact scale. Iran J Med Sci 2021; 46(2): 112-9.
| Crossref | Google Scholar | PubMed |

27  Ghorashi Z, Merghati-Khoei E, Yousefy A. Measuring Iranian women’s sexual behaviors: expert opinion. J Educ Health Promot 2014; 3: 80.
| Crossref | Google Scholar | PubMed |

28  Bahrami N, Yaghoob Zadeh A, Sharif Nia H, Soliemani MA, Haghdoost AA. Validity and reliability of the persian version of Larson sexual satisfaction questionnaire in couples. J Kerman Univ Med Sci 2016; 23(3): 344-56.
| Google Scholar |

29  Azimi Nekoo E, Burri A, Ashrafti F, Fridlund B, Koenig HG, Derogatis LR, et al. Psychometric properties of the Iranian version of the female sexual distress scale-revised in women. J Sex Med 2014; 11(4): 995-1004.
| Crossref | Google Scholar | PubMed |

30  Besharat MA, Naghshineh N, Ganji P, Tavalaeyan F. The moderating role of attachment styles on the relationship of alexithymia and fear of intimacy with marital satisfaction. Int J Psychol Stud 2014; 6(3): 106-17.
| Crossref | Google Scholar |

31  Ahmadnia E, Haseli A, Karamat A. Therapeutic interventions conducted on improving women’s sexual satisfaction and function during reproductive ages in Iran: a systematic review. J Mazandaran Univ Med Sci 2017; 27(153): 146-62.
| Google Scholar |

32  Noruzi S, Maarefvand M, Khankeh H, Eghlima M. Sexual satisfaction studies in Iran, a systematic review. Women’s Health Bulletin 2019; 6(4): 1-7.
| Google Scholar |

33  Strong V. Femininity and sexual well-being: pleasure, authenticity, and safety across the female lifespan. Dissertation, Pepperdine University Psychological and Educational Clinic, Los Angeles, CA; 2015.

34  Abdolmanafi A, Nobre P, Winter S, Tilley PJM, Jahromi RG. Culture and sexuality: cognitive-emotional determinants of sexual dissatisfaction among Iranian and New Zealand women. J Sex Med 2018; 15(5): 687-97.
| Crossref | Google Scholar |

35  Khani S, Moghaddam-Banaem L, Mohamadi E, Vedadhir AA, Hajizadeh E. Women’s sexual and reproductive health care needs assessment: an Iranian perspective. Eastern Mediter Health J 2018; 24(7): 637-43.
| Crossref | Google Scholar |