Study evaluates factors that affect patients’ ability to recall their sexual function and activity
DURHAM, N.C. – Many chronic diseases and their treatments can affect people’s sexual health and function, significantly hindering their quality of life. A study led by researchers at Duke Medicine found that people can remember their sexual function and activity over the previous month reasonably well, but their gender and the mood they feel at the time of reporting can influence what they report.
The findings were published in the Journal of Sexual Medicine on June 26, 2013.
“This study arose from a need to understand how best to measure the effects of disease on people’s sexual health,” said study author Kevin P. Weinfurt, PhD, professor of psychiatry and behavioral sciences at Duke Medicine and member of the Duke Clinical Research Institute. “We know these effects can make patients’ lives difficult and can disrupt their relationships.”
In clinical and research settings, patients are often asked to recall their sexual activity and function over the past month as a way to track side effects of certain medications or treatments, or the effects of the disease itself. However, the reliability and validity of this information depends on how accurately people can report their experiences over this period of time.
The study sought to assess the accuracy of 30-day recall as part of an effort to develop measures of sexual function and satisfaction for the Patient-Reported Outcomes Measurement Information System (PROMIS®), a resource developed by the National Institutes of Health to provide publicly available measures of mental, physical, and social health. The measures can be used to assess many aspects of patients’ functioning as endpoints in clinical studies of treatments and their side effects
Weinfurt and his colleagues compared daily versus monthly reports of sexual function and activity to determine whether monthly recalls are reliable.
The researchers recruited 101 men and 101 women to fill out online surveys about their sexual health, including interest in sex, level of activity, discomfort or dysfunction, and satisfaction. More than half of the participants were being treated for chronic conditions such as cancer, hypertension, arthritis, depression or diabetes. The rest of the participants were not in treatment for any particular condition. The participants completed daily online assessments of their sexual function for 30 consecutive days, and also completed a single online questionnaire that asked about their sexual function for the past month at day 30.
When the researchers compared answers from the daily questionnaires with the final questionnaire, they found that people were able to recall their sexual function and activity with adequate levels of accuracy at the end of the month. However, accuracy varied based on what topic was being reported, as well as the person’s gender and mood.
Both men and women overestimated their interest in sexual activity at the one-month mark compared with daily reports, but men overestimated more than women. The researchers suggested that the reason men overestimated interest more than women may be due to a mental shortcut people might use to recall experiences in the past. Specifically, people may “fill in the gaps” in their memory by using gender stereotypes to project what their experiences should have been. For instance, a man might assume that given his gender, he should be consistently interested in sex, and therefore might over report his interest even more than women do.
Mood was related to over- or under-reporting certain aspects of sexual function. If someone was in a very positive mood at the time he or she took the questionnaire at the end of the month, some aspects of sexual function were reported as better than they actually were over the past month. Similarly, a bad mood tended to be associated with under-reporting.
“Researchers should be aware that mood can affect the accuracy of people’s reports of sexual function. To help interpret clinical studies of sexual health, researchers might consider measuring mood alongside the sexual outcomes,” said Weinfurt.
The researchers noted that the participants in the study had regular sexual activity, so these results may not be generalizable to other populations, such as those with significant challenges with sexual function.
“Over the years, our interviews with patients have helped us to understand the incredible burden of chronic diseases on sexual functioning and intimate relationships,” Weinfurt said. “Our findings in this study will lead to better methods for systematically capturing the patient’s voice when it comes to sexual function and satisfaction.”
Research reported in this publication was supported by the National Institutes of Health under Award Number U01AR052186. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
In addition to Weinfurt, study authors include Li Lin, Carrie B. Dombeck and Maria R. Fawzy of Duke Clinical Research Institute; Denise C. Snyder and Megan S. Williams of Duke University School of Nursing; Kathryn E. Flynn of the Medical College of Wisconsin (formerly at Duke Clinical Research Institute and the Department of Psychiatry and Behavioral Sciences at Duke); and Joan E. Broderick of the Department of Psychiatry and Behavioral Science at Stony Brook University in New York.