Sexual and reproductive health assessment scale in women with premature ovarian insufficiency (SRH-POI): development and psychometric properties

Premature ovarian insufficiency (POI) is a condition that involves the emptying of the ovarian follicles or dysfunction of the ovarian follicles at the age of less than 40 years. Because no study has ever been designed to measure the sexual and reproductive health of women with POI (SRH-POI), the present study aimed to explain the concept of SRH, development and psychometrics of instruments in women with POI. This sequential exploratory mixed-method study was performed in two sections. The first stage contains a literature review and qualitative section in which the preliminary item pool was developed. In second stages instrumental psychometric evaluation including exploratory factor analysis (face, content, and construct validity) as well as reliability (internal consistency and stability) were performed. The initial item pool consisting of 84 items was generated. CVI, based on the corrected Kappa statistic (with an acceptable value between 0.60 and 0.74), I-CV (with an acceptable value of 0.78 and above, were calculated. S-CVI was calculated for the tool 0.926. During the stages of face and content validity was reduced to 41 items but finally after factor analysis 30 items with four factors gained. KMO in this factor analysis model was equal to 0.83. Bartlett’s test of sphericity was also significant, which indicated sufficient correlation between variables (questionnaire items) to perform factor analysis. Cronbach’s alpha coefficient was calculated as 0.884 and intra-class correlation coefficient for the entire scale was 0.95. The scoring of the questionnaire was determined linearly in a 5-part Likert scale. This study introduced the concept of SRH in women with POI based on their diverse experiences. These results showed that the management of these patients requires a multidisciplinary strategy. The result of this study is the design of a special SRH-POI instrument that is a valid and reliable tool for accessing sexual and reproductive health in women with POI. Premature ovarian insufficiency (POI) is the same as premature menopause that occurs under the age of 40. In this disorder, ovarian follicle reserves are reduced and conditions similar to menopause occur, such as a decrease in ovarian volume and uterine size to the extent of a menopausal woman. The symptoms of this disorder are cessation of menstrual bleeding, menopause symptoms such as vaginal dryness and hot flashes. Also, these women suffer from infertility and their sexual health is at risk. Considering that on the one hand the sexual health and fertility of these women are at risk and on the other hand there is no suitable tool to check it, the present study was done with the aim of producing this tool. Therefore, a two-stage study was design, which consists of two quantitative and qualitative phases. At first quantitative data collection and analysis will be conducted, then the findings inform qualitative data collection and analysis. The findings of two phase will be integrated for further explanation and interpretation to be used in the second stage. The sexual and reproductive health questionnaire of women with POI helps the treatment team to be informed about the sexual health and fertility status of affected women and to improve it. The results of the statistical analysis in this study show that the present tool is a valid and accurate questionnaire and can be used for patients to assess their sexual and reproductive health.