Basic Research Journal of Medicine and Clinical Sciences ISSN 2315-6864 Vol. 4(2) pp. 68-74 February 2015 Available online http//www.basicresearchjournals.org Copyright 2015 Basic Research Journal Full Length Research Paper Assessment of sexual function by DSFI among the Iranian married individuals Baniasad MH 1, Noughani F 2, Taghadosi Maral 3, Sadeghi N 3 1 Psychologist and Assistant Professor at Azad medical Tehran University. 2 Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 3 Researcher. *Corresponding author email: Email: ncar.2013@hotmail.com Accepted 25 February, 2015 Abstract Sexual functions are affected by biopsychosocial factors: Internal and external genital organs, hormone, neurohormons, intra psychic dynamics, interpersonal relationships, socio-economy status, social ritual influence on sexual tendency. 384 married individual aged between 15-49 years old randomly selected by stratified sampling from 5 regions in Tehran, including south, North West, east and center. Participants were assessed by Derogatis test. T-test was used for comparing the men and women. Analysis of variance (ANOVA) and Scheffe were used to compare the age categories. There were no significant difference between men and women in drive and gender role, but there were significant differences in other scales (p<0.05). In age categories also differences were significant. Reliability of Derogatis scales were measured by chronbach alpha. Also the Construct validity was acceptable. Keywords: Assessment, sexual function, DSFI, Iranian married individuals INTRODUCTION Sexual function is influenced by biological factors, psychology and sociology. Various factors affect the expression of sexuality; Disturbance of one or more factors that cause sexual dysfunction and anxiety. Dysfunctions may be related to lifetime or may appear after a period of normal function. Disorder may be published or it can be conditional and caused by psychological factors or due to a combination of factors. Seven main categories sexual dysfunctions that are listed in the DSM consist of: 1.sexual disorders 2.sexual desire disorders 3.orgasmic disorder 4.sexual pain disorders 5.sexual dysfunctions due to general medical condition 6.sexual dysfunctions due to a general medical condition. 7. Sexual dysfunction is not specify in other ways (Kaplan et al., 2003). Sexual function may be influenced by stress, emotional disturbance, or lack of knowledge about function and physiologic sexual behavior. The point that needs to be considered in the assessment and diagnosis of sexual dysfunction is that the disorder is classified into three distinct groups (most sexual thing, paraphilia and sexual identity) is a relatively easy separation. And do not mean that there is not any overlap between the cases in a particular case (Christopher and Sprecher, 2000). The assessment of sex function should be comprehensive. However, this assessment may be much overlapped with other clinical studies, but in practice it is confronted with
Baniasad et al. 69 many challenges. Because sex is one particular aspect of the privacy of individuals that discussing about the details of it may have some difficulties for both the therapist and patient. On the other hand, other conventional evaluation methods, such as direct observation, or other observers report is limited (Derogatis et al., 1988). Derogatis have designed a semi-finding interview entitled Derogatis Sexual Functioning Inventory (DSFI) to assess the current level of this function which is now the most reliable scale for assessing sexual function and present (Derogatis, 1975). The overall assessment of a person's sexual performance and is widely used. The subscales of the questionnaire indicate that it is multidimensional which allows clinicians and researchers to draw a profile of strengths and weaknesses of one's sexual performance. DSFI has good psychometric properties and normative data for each of the subscales and because of that it can be used alone or in conjunction with each other subscales of the contract. Reliability and validity of the questionnaire for sexually active men and women with and without dyslexia approved and for each of the above groups, normal switching is done separately. The purpose of the present study is to identify the prevalence of sexual disorder by DSFI among the married individuals in year 2013-2014 years. Objectives 1. To find out whether is any significant differences between age groups with variable of DSFI. 2. To find out whether is any significant differences between sexes with variable of DSFI. 3. To investigate Assessment of sexual function by DSFI among the Iranian married individuals. Hypotheses Based on the above objectives the following hypotheses are formulated for the present study: 1. There would be significant differences between age groups with variable of DSFI. 2. There would be significant differences between sexes with variable of DSFI. 3. There would be significant impact of DSFI viewing on sexual function among the Iranian married individuals. Tool It was Derogatis Sexual Functioning Inventory (DSFI). First DSFI has been bought from the US and then was translated into Persian, and then the questionnaire was a gain translated into English in order to detect the probable differences with the original version and revise them. Then to check the validity of the content the questionnaire was given to the professional psychologists and psychiatrists; after their confirmation it was given to the participants. After this procedure the data has been analyzed by SPSS software. In order to investigate the differences between men and women on scales DSFI T test was used. To evaluate the significance of differences in different age groups ANOVA and Scheffe test was used. Finally, to estimate the reliability of the scales of the questionnaire, Cronbach's alpha coefficient and factor structure of the questionnaire was used to assess the validity of the exploratory factor analysis (Cronbach's Alpha=.71). This questionnaire is the most valid scale to assess sexual function. It is considered as the overall assessment of sexual function of the individuals ant it is widely used. The questionnaire is important in sexual function effectively; like: Information, Experience, Drive, Attitudes,, Gender Role Definition, Fantasy, Body Image. DSFI has adequate norms and Psychometric data for each of the sub scales and because of that the subscales can be used independently or in relation with each other. Reliability and validity of the questionnaire for men and women with and without sexual dyslexia was approved and for each of the mentioned groups Normal switching was done separately (Derogatis, 1975). Sample The sampling method was stratified sampling. The participants of study were 384 Iranian married individuals and selected by stratified sampling of five regions of Tehran (North, South, East, West, and Center). They were married men and women 15-49 years old. Procedure The present study comprised on married individuals. Inclusion criteria of the study: Being older than 15; being older than 45; not having any history of mental illness; not using medicine which affects sex drive; people should be consistent for participating in the study. Exclusion criteria: younger than 18 years old; older than 45 years old; having any history of mental illness; using medicine which affects sex drive; not being consistent for participating in the study. RESULTS AND DISCUSSION In order to analyze the data, descriptive and inferential methods were used. First, the statistics related to
70. Basic Res. J. Med. Clin. Sci. Table 1. Mean, SD, Std. Error Mean of the groups are presented separately for men and women. Information Experiences Drive Attitudes Gender Role Fantasy Body Image Sex N Mean SD Std. Error Mean Male 190 210 3.14550.22820 Female 155 18.0968 3.79952.30521 Male 190 19.6053 3.88689.28198 Female 150 15.7000 4.96396.40531 Male 180 20.3056 6.70120.49948 Female 140 16.5357 6.11921.51717 Male 180 21.1111 16.11373 1.20105 Female 155 4.2903 11.38806.91471 Male 175.8803.60856.04600 Female 155.6701.56495.04538 Male 170-1.1176 4.30195.32994 Female 155 1.1290 8.13738.65361 Male 180 5.7778 2.29295.17091 Female 155 3.0645 3.68337.29586 Male 185 29.4595 6.22754.45786 Female 155 21.7419 6.65947.53490 Table 2. ANOVA analysis results of age and DSFI variables among the sample of this study. Sum of df Mean Square Squares Between Groups 269.356 3 89.785 Information Within Groups 4543.688 341 13.325 4813.043 344 Between Groups 628.409 3 209.470 Experiences Within Groups 7176.885 336 21.360 7805.294 339 Between Groups 374.966 3 124.989 Drive Within Groups 13987.221 316 44.263 14362.187 319 Between Groups 8271.964 3 2757.321 Attitudes Within Groups 81741.917 331 246.954 90013.881 334 Between Groups 4.054 3 1.351 Within Groups 113.170 326.347 117.223 329 Between Groups 452.027 3 150.676 Gender Role Within Groups 13282.281 321 41.378 13734.308 324 Between Groups 255.896 3 85.299 Fantasy Within Groups 3387.686 331 10.235 3643.582 334 Between Groups 1073.926 3 357.975 Body Image Within Groups 17914.897 336 53.318 18988.824 339 F 6.738 9.807 2.824 11.165 3.892 3.641 8.334 6.714 Sig..039.009. 13 descriptive analysis was presented in Table 1. As it is evident in Table 1 the mean difference between groups among the variables were studied. The prevalence of sexual dysfunction among the sample of this study is according to age range varieties. To investigate the above hypothesis, ANOVA and Scheffe post hoc test was used and the ANOVA results are presented in Table 2 and the Scheffe's test results are determined in Table 3. The prevalence of sexual dysfunction among the sample of this study in terms of gender variable is varied. To test the above hypothesis, the t-test for independent groups was used and the results are presented in Table 4. As it is clear from the above table, except the Gender Role variable, in any of the studied variables, no significant differences were observed between the two genders. Table 5.
Baniasad et al. 71 Table 3. The results of the analysis of Scheffe test of age and DSFI variables among the sample of this study Multiple Comparisons Scheffe Dependent (I) age group (J) age group Mean Std. Error Sig. Variable Difference (I-J) 32-38 -.60000.75987.891 39-above -1.66667.73679.166 25-31 15-24 -.56250.78148.915 32-38 -1.16250.54754.214 39-above -2.22917 *.51503 32-38 15-24.60000.75987.891 25-31 1.16250.54754.214 39-above -1.06667.48161.181 39-above 15-24 1.66667.73679.166 25-31 2.22917 *.51503 32-38 1.06667.48161.181 Experiences 15-24 25-31 4.52083 *.98944 32-38 2.70175.96790.052 39-above 1.59259.93285.406 25-31 15-24 -4.52083 *.98944 32-38 -1.81908.70131.083 39-above -2.92824 *.65209 32-38 15-24 -2.70175.96790.052 25-31 1.81908.70131.083 39-above -1.10916.61892.362 39-above 15-24 -1.59259.93285.406 25-31 2.92824 *.65209 32-38 1.10916.61892.362 Drive 15-24 25-31 3.40000 1.53646.182 32-38 1.06316 1.49548.918 39-above 2.64000 1.45761.352 25-31 15-24 -3.40000 1.53646.182 32-38 -2.33684 1.02767.162 39-above -.76000.97174.894 32-38 15-24 -2.26667 * 3.27129.923 25-31 9.02500 2.35722.002 39-above -3.70000 2.10836.381 39-above 15-24 1.43333 * 3.19491.977 25-31 12.72500 2.25001 32-38 3.70000 * 2.10836.381 15-24 25-31.15645.12614.674 32-38.09153.12339.908 39-above.31560.11979.076 25-31 15-24 -.15645.12614.674 32-38 -.06492 *.08941.913 39-above.15915.08436.315 32-38 15-24 -.09153.12339.908 25-31.06492.08941.913 39-above.22407.08020.052 39-above 15-24 -.31560.11979.076 25-31 -.15915.08436.315 32-38 -.22407.08020.052 Gender Role 15-24 25-31 3.33333 1.37713.121 32-38.43860 1.34715.991 39-above 1.16667 1.31304.852
72. Basic Res. J. Med. Clin. Sci. Table 3. Continue Multiple Comparisons Scheffe Dependent Variable (I) age group (J) age group Mean Difference (I-J) Std. Error 25-31 15-24 -3.33333 1.37713.121 32-38 -2.89474.97610.034 39-above -2.16667 *.92846.144 32-38 15-24 -.43860 1.34715.991 25-31 2.89474.97610.034 39-above.72807.88339.878 39-above 15-24 -1.16667 1.31304.852 25-31 2.16667 *.92846.144 32-38 -.72807.88339.878 Fantasy 15-24 25-31 2.16667 *.69110.021 32-38 -.18333.66596.995 39-above.55128.64799.868 25-31 15-24 -2.16667 *.69110.021 32-38 -2.35000.48868 39-above -1.61538 *.46389.008 32-38 15-24.18333.66596.995 25-31 2.35000.48868 39-above.73462.42553.396 39-above 15-24 -.55128.64799.868 25-31 1.61538 *.46389.008 32-38 -.73462.42553.396 Body Image 15-24 25-31 2.79167 1.56325.365 32-38.81667 1.52002.962 39-above -1.75641 1.47899.703 25-31 15-24 -2.79167 1.56325.365 32-38 -1.97500 1.09529.356 39-above -4.54808 1.03760 32-38 15-24 -.43860 1.34715.991 25-31 2.89474.97610.034 39-above.72807.88339.878 39-above 15-24 -1.16667 1.31304.852 25-31 2.16667 *.92846.144 32-38 -.72807.88339.878 Sig. Table 4. The results of the analysis of t-test of the gender and DSFI variables among the sample f this study Information Experiences Drive Attitudes Gender Role Fantasy Body Image Levene's Test for Equality of Variances F Sig. 1.320.255 1.953.167.448.506 3.249.076.064.801 7.816.007 1.122.293.909.344 t-test for Equality of Means t 3.432 3.595 2.289 4.801 1.431-1.391 3.626 4.872
Baniasad et al. 73 Table 5. The reliability of the scales achieved by Cronbach Information Experiences Drive Attitudes Gender Role Fantasy Body Image Cronbach's Alpha.715.851.597.861.971.865.928.753 N of Items 26 24 20 30 53 40 30 15 The reliability of the mentioned scales was assessed by Cronbach's alpha Cronbach's alpha reliability of the Information subtest is, respectively, 0.71, the Experience subscale 0.85, the Drive subtest reliability with Cronbach's Alpha is 0.59, the Attitudes subtest 0.86, the subtest 0.97, the Gender Role subtest with Cronbach's Alpha 0.86, Fantasy subtest with Cronbach's Alpha 0.92 and Cronbach's alpha reliability of Body Image 0.75 which is acceptable. The result of validity of the instrument was also acceptable. The nature of this study is quantitative and the purpose of it is applied research. The theory method is used for standardization of the questionnaire of this study. Theory method, as the name implies, starts with a theory about the nature of certain attributes which are measured. In this regard, the designer of the test is trying to test its content selected in a way that is in consistent with the theory (Kaplan et al., 2003). The process of construction of this scale has been done in this way: Defining the scope and parameters of the theory and previous research, Developing and designing questions to be able to evaluate different aspects from different points of view, Determine the method of scoring in each question and the total scale questions, planning psychometric methods and statistical analysis to achieve the research objectives, Analysis of the questions and evaluation of their psychometric properties, Factor analysis, reliability and validity (Lever et al., 200). CONCLUSION In the present study in order to select appropriate questions and delete weak questions before evaluating the structure, the opinion of expertise is used to determine the validity of the content. Using a survey of university professors and experts in the field of evaluation and measurement of psychological attributes and the initial scale implementation of the sample, the researcher deleted 2 questions of the10 scales of the test: Cronbach's alpha test by removing mentioned questions that are raised to upper limits and it is acceptable and the internal consistency of the questions is appropriate And therefore the test enjoys a good reliability. With the development of behavioral science research on human sexual behavior in their particular discipline and the work of sociologists, doctors and psychiatrists gradually achieved scientific scrutiny. Sexual dysfunction is defined as persistent or recurrent and decreased sexual desire and sexual stimulation, pain during sexual relation and having problem or being unable to reach orgasm (Rosen, 2000). In addition, the appropriate provisions in future for the control and treatment depend on the patient's history. And if there are any physical or psychological factors, treatment approaches like appropriate referral to a clinical or counseling, psychotherapy is recommended. Studies have also shown that this disorders as a factor affecting the quality of life in known patients. In fact, investigating sexual function plays an important role in quality of life (Glass and Bahulesh, 1999). Various studies have suggested several factors associated with sexual selfefficacy that follows: Age, physical health, relationship stability, happiness and satisfaction with body image (Rosen, 2000).Body image (concepts like the satisfaction of the sexual organs, concerns about the size and weight, relief appearance against sexual partners and others are included. Poor body image is associated with some sexual problems that have been shown in a number of studies (Davis and Shaver, 2006). Good body image was in relation with increased sex drive, increased frequency of sexual intercourse and orgasm in women. It seems that women s thought, their mental and cognitive knowledge about their body, in comparison to their actual appearance plays an important role in their sexual self-efficacy (Reis, 2006). In another study on 207 women with impaired sexual response indicated that Individual perceptions about body image is strongly associated with orgasmic disorders which is in line with results of this study (Ferenidou et al., 2008). Results of a study that was conducted on over 3,000 women revealed that Positive body image is in relation with more frequent sex, more orgasms initiate sex and more enjoyment in sex (Ackard et al., 2000). The results of this study are in line with results of present study. A study on 86 women aged between 40-70 years old showed that sexual satisfaction is not good predictors of and sexual self-efficacy and it is not similar to our study.
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