Abstract: PD44-05
Sources of Funding: None

Introduction

Pelvic floor disorders (PFDs) are associated with sexual dysfunction related to impaired arousal, absent or diminished orgasm, and pain, as well as lowered rates of sexual activity. As a result, it is a challenge to assess sexual function in women who are not sexually active. Many decline to answer questions, or may write comments in the margins of forced-choice surveys. "Marginalia" can offer rich, novel sources of data that validated surveys fail to capture. We sought to more comprehensively capture women's experiences by analyzing how women with PFDs respond to sexual function questionnaires.

Methods

Women with PFDs completed validated written sexual function questionnaires [Study of Sexual Attitudes and Behaviors survey (SSABS), Female Sexual Function Index (FSFI), and Sexual Function for Women with POP, Urinary Incontinence and/or Fecal Incontinence (PISQ-IR)]. Marginalia, or the additions, eliminations, and changes subjects made (by hand) to survey items, were collected. Data were coded and analyzed using grounded theory methodology (Charmaz, 2006).

Results

Ninety-four women completed surveys, the majority of whom experienced FSD (mean FSFI scores were 26.4±5.8 for women <60 and 18.1±12.4 for women 60+; 26.55 or less indicates FSD). Fifty-one (54%) subjects left marginalia, grouped into 4 types: narrative (n=20), clarification (n=65), elimination (n=86), and confusion (n=6). Narrative comments were unsolicited feedback or personal details. Clarifications were explanations or changes to survey items. Eliminations were "not applicable" notations or deletions. Confusion marginalia included question marks. Qualitative analysis revealed several themes (See Table 1). Elimination marginalia were commonly made on survey items addressing sexual activity or satisfaction. Fifty-nine (62.8%) subjects left one or more questions blank.

Conclusions

Analysis of marginalia from sexual function questionnaires amongst women with PFDs revealed critical, previously undocumented information about patients' histories, concerns, thoughts, and factors affecting sexual function. Further in-depth qualitative investigations along with the development of more effective, robust, and specific evaluation tools are key future directions needed to better address patient needs.

Funding

None