Sexual Dysfunction in Breast Cancer Survivors: Cross-Cultural Adaptation of the Sexual Activity Questionnaire for Use in Portugal.

Abstract

The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of thedisease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led tothe development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. The questionnaire was translated and back-translated, refined following face-to-face interviews with sevenbreast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then testedwith 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfortscales, all yielding good internal consistency (Cronbach's α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist wasgood (Spearman's r > 0.65; p-value < 0.001) and reliability acceptable (Cohen's k > 0.444). The Sexual Activity Questionnaire allowedthe identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not havinga partner. Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previouslyabandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overallpopulation to enable generalizability of the findings. The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors inPortugal.