Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia

Cristiane Menezes Sirna Fregnani,José Humberto Tavares Guerreiro Fregnani,Adhemar Longatto-Filho

doi:10.1186/s12885-017-3676-8

Cristiane Menezes Sirna Fregnani, José Humberto Tavares Guerreiro Fregnani + Show 1 more

Open Access

https://doi.org/10.1186/s12885-017-3676-8

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Abstract

BackgroundThe occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN.MethodsThe properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach’s alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness.ResultsThe Cronbach alpha values of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33–0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening.ConclusionOur results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.

Highlights

The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse
40 types of Human papillomavirus (HPV) can invade the mucous membranes of the upper aerodigestive tract and anogenital region of humans; these HPV types are classified as low and high risk according to their carcinogenic potential [4]
The coefficients that evaluated the reproducibility of the FACIT-CD questionnaire scales ranged between 0.50 and 0.83; the lower limit of the 95% confidence interval (CI) was smaller than 0.40 only on the treatment satisfaction scale

Summary

Introduction

The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. Human papillomavirus (HPV) infection is the most prevalent sexually transmitted disease worldwide [1]. 440 million people are estimated to have genital HPV infections worldwide [2], and approximately 10% of women will carry HPV at some point in their life [3]. Low-grade intraepithelial lesions spontaneously regress in 60% of cases, and only 10% of cases progress to high-grade lesions. Even cervical carcinoma in situ (CIN 3) may undergo spontaneous regression to normality in one-third of women [4]. The period from HPV infection to the onset of invasive cervical cancer is estimated to extend 10 to 20 years, which makes this disease preventable using well-structured screening strategies [5]

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