Face, Content, and Cultural Validity of the Arabic Version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15)

Abstract

Background: Multiple Sclerosis (MS) patients may experience sexual dysfunction, but they may not be adequately assessed for this issue in Lebanon. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) is used to assess the effects of symptoms of MS on the patient’s sexual activity and satisfaction in both genders and has high validity and reliability. The short-term goals of this project were: 1) Conduct face, content, and cultural validity of the Arabic MSISQ-15 in patients with MS at an MS Center in Lebanon. 2) Encourage Lebanese healthcare professionals to screen for sexual dysfunction in patients with MS in Lebanon by providing them with a culturally valid tool. The long-term goal is to improve screening practices and treat sexual dysfunction in patients with MS in Lebanon. Methods: An expert translator conducted the translation from English to Arabic, and one of the professors at AUB back translated into English without looking at the original questionnaire to check for the accuracy and equivalence of the translated materials. We followed the expert, pretest, and observations approaches to test the face validity and expert judgment to test the content validity. Cultural validity was also assessed by patients and experts’ judgement. We sought IRB approval before initiating any contact with the participants. The sample was purposeful and followed the maximum variation technique whereby two registered nurses and three physicians (research fellows) working at the MS center at AUBMC and eleven patients with MS visiting the MS center at AUBMC were included. Results: Sixty-three percent of the patients were females. Research fellows were all medical doctors who have been hired as research fellows in the MS center. The overall questionnaire was deemed credible to participants, and appeared adequate for the assessment of primary, secondary, and tertiary sexual dysfunction. Our project showed that the Scale-Content Validity Index (S-CVI) of the MSISQ-15 Arabic version was 0.987 and the Item-Content Validity Indices (I-CVIs) ranged between 0.8 to 1. Cultural validity indices raged from 0.8 to 1. The overall cultural validity of the scale was 0.973. All items were clear and understandable by the patients except the second and third questions; patients did not understand these two questions during the interview until examples were added to each, after which they found them appropriate. Conclusion: The Arabic version of the MSISQ-15 has good face validity and adequate content and cultural validity in the Lebanese population for assessing the impact of MS symptoms on sexual activity and satisfaction.