Health  Vol.5 No.6 B , June 2013
Detecting decreased sexual health with MDHAQ-S

There are instruments that measure sexual function or sexual health for persons with RA, but since sexual health is a sensitive issue, the hypothesis is that it would be easier to have a standard questionnaire that could indicate the need for communication about sexual health issues instead of an extra questionnaire with more detailed questions on sexual health. The aim of the study is to find out whether sexual health difficulties can be screened by factors included in the MDHAQ-S for persons with RA. This study explores the relation between factors included in the MDHAQ-S and the Sexual Health Questionnaire (QSH) using a mixed methods design combining quantitative and qualitative data. The MDHAQ-S covers sexual health issues, not only by using the question on sexual health, but also on other factors included in the questionnaire such as increased pain, fatigue, depression, anxiety, physical capacity, level of physiccal activity and body weight. To explore decreased sexual arousal, decreased sexual satisfaction and decreased sexual well-being, in-depth interviews must be held with persons with RA, either using a sexual health questionnaire or in a clinical interview.

Cite this paper: Areskoug-Josefsson, K. , Ekdahl, C. , Jakobsson, U. and Gard, G. (2013) Detecting decreased sexual health with MDHAQ-S. Health, 5, 38-47. doi: 10.4236/health.2013.56A2007.

[1]   World Health Organization (2006) Defining sexual health. Report of a technical consultation on sexual health, 28-31 January 2002, Geneva. Sexual health document series. Geneva, 35.

[2]   Tasiemski, T., Angiaszwili-Biedna, N. and Wilski, M. (2009) Assessment of objective and subjective quality of life in people with rheumatoid arthritis—Preliminary study. Ortopedia Traumatologia Rehabilitacja, 11, 346-359.

[3]   Sanderson, T., Morris, M., Calnan, M., Richards, P. and Hewlett, S. (2010) What outcomes from pharmacologic treatments are important to people with rheumatoid arthritis? Creating the basis of a patient core set. Arthritis Care & Research, 62, 640-646. doi:10.1002/acr.20034

[4]   Areskoug-Josefsson, K. and Oberg, U. (2009) A literature review of the sexual health of women with rheumatoid arthritis. Musculoskeletal Care, 7, 219-226. doi:10.1002/msc.152

[5]   Helland, Y., Dagfinrud, H. and Kvien, T.K. (2008) Perceived influence of health status on sexual activity in RA patients: Associations with demographic and disease-related variables. Scandinavian Journal of Rheumatology, 37, 194-199.

[6]   Yilmaz, H., Polat, H.A., Yilmaz, S.D., Erkin, G., Kucuksen, S., Salli, A. and Ugurlu, H. (2012) Evaluation of sexual dysfunction in women with rheumatoid arthritis: A controlled study. The Journal of Sexual Medicine, 10, 2664-2670.

[7]   Palmer, D. and El Miedany, Y. (2011) Sexual dysfunction in rheumatoid arthritis: A hot but sensitive issue. British Journal of Nursing, 20, 1134-1137.

[8]   Meana, M. and Jones, S. (2011) Developments and trends in sex therapy. Advances in Psychosomatic Medicine, 31, 57-71. doi:10.1159/000328808

[9]   Bitzer, J., Platano, G., Tschudin, S. and Alder, J. (2007) Sexual counseling for women in the context of physical diseases: A teaching model for physicians. The Journal of Sexual Medicine, 4, 29-37. doi:10.1111/j.1743-6109.2006.00395.x

[10]   Couldrick, L., Gaynor, S. and Cross, V. (2010) Proposing a new sexual health model of practice for disability teams: The recognition model. International Journal of Therapy and Rehabilitation, 17, 290-298.

[11]   Helland, Y., Garratt, A., Kjeken, I., Kvien, T.K. and Dagfinrud, H. (2013) Current practice and barriers to the management of sexual issues in rheumatology: Results of a survey of health professionals. Scandinavian Journal of Rheumatology, 42, 20-26. doi:10.3109/03009742.2012.709274

[12]   Taylor, B. and Davis, S. (2006) Using the extended PLISSIT model to address sexual healthcare needs. Nursing Standard, 21, 35-40.

[13]   El Miedany, Y., El Gaafary, M., El Aroussy, N., Youssef, S. and Ahmed, I. (2011) Sexual dysfunction in rheumatoid arthritis patients: Arthritis and beyond. Clinical Rheumatology, 4, 601-606.

[14]   Pincus, T., Yazici, Y. and Bergman, M.J. (2009) Patient questionnaires in rheumatoid arthritis: Advantages and limitations as a quantitative, standardized scientific medical history. Rheumatic Disease Clinics of North America, 35, 735-743. doi:10.1016/j.rdc.2009.10.009

[15]   Ekdahl, C., Eberhardt, K., Andersson, S.I. and Svensson, B. (1988) Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of the Stanford Health Assessment Questionnaire. Scandinavian Journal of Rheumatology, 17, 263-271. doi:10.3109/03009748809098795

[16]   Fries, J.F., Spitz, P., Kraines, R.G. and Holman, H.R. (1980) Measurement of patient outcome in arthritis. Arthritis & Rheumatism, 23, 137-145. doi:10.1002/art.1780230202

[17]   Pincus, T. and Sokka, T. (2003) Quantitative measures for assessing rheumatoid arthritis in clinical trials and clinical care. Best Practice & Research Clinical Rheumatology, 17, 753-781. doi:10.1016/S1521-6942(03)00077-9

[18]   Pincus, T., Swearingen, C. and Wolfe, F. (1999) Toward a multidimensional Health Assessment Questionnaire (MDHAQ): Assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis & Rheumatism, 42, 2220-2230. doi:10.1002/1529-0131(199910)42:10<2220::AID-ANR26>3.0.CO;2-5

[19]   Areskoug-Josefsson, K., Ekdahl, C., Jakobsson, U. and Gard, G. (2013) Swedish version of the multi dimensional health assessment questionnaire—Translation and psychometric evaluation. BMC Musculoskeletal Disorders 2013, 14:178 (4 June 2013).

[20]   Pincus, T. (2007) A multidimensional health assessment questionnaire (MDHAQ) for all patients with rheumatic diseases to complete at all visits in standard clinical care. Bulletin of the NYU Hospital for Joint Diseases, 65, 150- 160.

[21]   Josefsson, K.A. and Gard, G. (2012) Sexual health in patients with rheumatoid arthritis: Experiences, needs and communication with health care professionals. Musculoskeletal Care, 10, 76-89.

[22]   Dures, E., Rumsey, N., Morris, M. and Gleeson, K. (2011) Mixed methods in health psychology: Theoretical and practical considerations of the third paradigm. Journal of Health Psychology, 16, 332-341. doi:10.1177/1359105310377537

[23]   Shaw, J.A., Connelly, D.M. and Zecevic, A.A. (2010) Pragmatism in practice: Mixed methods research for physiotherapy. Physiotherapy Theory and Practice, 26, 510- 518. doi:10.3109/09593981003660222

[24]   Wisdom, J.P., Cavaleri, M.A., Onwuegbuzie, A.J. and Green, C.A. (2012) Methodological reporting in qualitative, quantitative, and mixed methods health services research articles. Health Services Research, 47, 721-745. doi:10.1111/j.1475-6773.2011.01344.x

[25]   Graneheim, U.H. and Lundman, B. (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112. doi:10.1016/j.nedt.2003.10.001

[26]   Areskoug Josefsson, K., Kammerlind, A.S. and SundLevander, M. (2012) Evidence-based practice in a multiprofessional context. International Journal of Evidence- Based Healthcare, 10, 117-125. doi:10.1111/j.1744-1609.2012.00263.x

[27]   Kondracki, N.L., Wellman, N.S. and Amundson, D.R. (2002) Content analysis: Review of methods and their applications in nutrition education. Journal of Nutrition Education and Behavior, 34, 224-230. doi:10.1016/S1499-4046(06)60097-3

[28]   Mayring, P. (2000) Qualitative content analysis qualitative social research. FQS, 1, Art.20.

[29]   Helland, Y., Kjeken, I., Steen, E., Kvien, T.K., Hauge, M.I. and Dagfinrud, H. (2011) Rheumatic diseases and sexuality: Disease impact and self management strategies. Arthritis Care & Research, 63, 743-750.

[30]   Hill, J., Bird, H. and Thorpe, R. (2003) Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology (Oxford), 42, 280-286. doi:10.1093/rheumatology/keg079

[31]   van Berlo, W.T., van de Wiel, H.B., Taal, E., Rasker, J.J., Weijmar Schultz, W.C. and van Rijswijk, M.H. (2007) Sexual functioning of people with rheumatoid arthritis: A multicenter study. Clinical Rheumatology, 26, 30-38. doi:10.1007/s10067-006-0216-3

[32]   Ozkorumak, E., Karkucak, M., Civil, F., Tiryaki, A. and Ozden, G. (2011) Sexual function in male patients with ankylosing spondylitis. International Journal of Impotence Research, 23, 262-267. doi:10.1038/ijir.2011.37

[33]   Abdel-Nasser, A.M. and Ali, E.I. (2006) Determinants of sexual disability and dissatisfaction in female patients with rheumatoid arthritis. Clinical Rheumatology, 25, 822-830. doi:10.1007/s10067-005-0175-0

[34]   Ostensen, M. (2004) New insights into sexual functioning and fertility in rheumatic diseases. Best Practice & Research Clinical Rheumatology, 18, 219-232. doi:10.1016/j.berh.2004.01.002

[35]   Rkain, H., Allali, F., Jroundi, I. and Hajjaj-Hassouni, N. (2006) Socioeconomic impact of rheumatoid arthritis in Morocco. Joint Bone Spine, 73, 278-283. doi:10.1016/j.jbspin.2005.03.021

[36]   Kobelt, G., Woronoff, A.S., Bertholon, D.R., Texier-Richard, B., Gaigi, H., Perdriger, A., Maugars, Y., Combe, B. and Mimoun, S. (2010) Sexuality and relationship in patients with rheumatoid arthritis in France. Annals of the Rheumatic Diseases, 69, 358.

[37]   Areskoug Josefsson, K. and Gard, G. (2010) Women’s experiences of sexual health when living with Rheumatoid Arthritis—An explorative qualitative study. BMC Musculoskeletal Disorders, 11, 240. doi:10.1186/1471-2474-11-240

[38]   Arvidsson, S., Arvidsson, B., Fridlund, B. and Bergman, S. (2011) Factors promoting health-related quality of life in people with rheumatic diseases: A 12 months longitudinal study. BMC Musculoskeletal Disorders, 12, 102. doi:10.1186/1471-2474-12-102

[39]   Lindau, S.T. and Gavrilova, N. (2010) Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. BMJ, 340, c810. doi:10.1136/bmj.c810

[40]   Pujols, Y., Meston, C.M. and Seal, B.N. (2009) The association between sexual satisfaction and body image in women. The Journal of Sexual Medicine, 7, 905-916. doi:10.1111/j.1743-6109.2009.01604.x

[41]   Bortz, W.M., 2nd and Wallace, D.H. (1999) Physical fitness, aging, and sexuality. The Western Journal of Medicine, 170, 167-169.

[42]   Kedde, H., van de Wiel, H., Schultz, W.W., Vanwesenbeeck, I. and Bender, J. (2012) Sexual health problems and associated help-seeking behavior of people with physical disabilities and chronic diseases. Journal of Sex & Marital Therapy, 38, 63-78. doi:10.1080/0092623X.2011.569638

[43]   Akkas, Y.N. and Kalyoncu, U. (2010) Factors affecting the sexual satisfaction of patients with rheumatoid arthritis and ankylosing spondylitis sexuality and disability. Sexuality and Disability, 28, 223-232.

[44]   Laumann, E.O., Paik, A., Glasser, D.B., Kang, J.H., Wang, T., Levinson, B., Moreira, E.D., Jr., Nicolosi, A. and Gingell, C. (2006) A cross-national study of subjective sexual well-being among older women and men: Findings from the global study of sexual attitudes and behaviors. Archives of Sexual Behaviour, 35, 145-161. doi:10.1007/s10508-005-9005-3

[45]   Fugl-Meyer, A.R. and Sjogren Fugl-Meyer, K. (1999) Sexual disabilities, problems and satisfaction in 18 - 74 years old Swedes. Scandinavian Journal of Sexology, 2, 79-105.

[46]   Palmer, D. and Miedany, Y.E. (2012) Sexual dysfunction in rheumatoid arthritis: A hot but sensitive issue. British Journal of Nursing, 20, 1134-1137.

[47]   Gossec, L., Solano, C., Paternotte, S., Beauvais, C., Gaudin, P., von Krause, G., Sordet, C. and Perdriger, A. (2012) Elaboration and validation of a questionnaire (Qualisex) to assess the impact of rheumatoid arthritis on sexuality with patient involvement. Clinical and Experimental Rheumatology, 30, 505-513.

[48]   Guillemin, F., Coste, J., Pouchot, J., Ghezail, M., Bregeon, C. and Sany, J. (1997) The AIMS2-SF: A short form of the arthritis impact measurement scales 2. French quality of life in rheumatology group. Arthritis & Rheumatism, 40, 1267-1274.