Rheumatology Section, Instituto de Rehabilitación Psicofísica, Echeverria 955, Buenos Aires, Argentina.
Rheumatol Int. 2018 Nov;38(11):2103-2109. doi: 10.1007/s00296-018-4148-4. Epub 2018 Aug 30.
The Qualisex questionnaire was developed and validated to assess sexuality in patients with rheumatoid arthritis. To the best of our knowledge, there is no instrument to evaluate sexuality in axial spondyloarthritis (axSpA). For this reason, the objective of this study was to validate and adapt the Qualisex questionnaire in axSpA and evaluate the impact of the disease on patients' sexuality. Cross sectional study. Consecutive patients, with ≥ 21 years of age, diagnosed with axSpA according to ASAS'09 criteria were included. Sexual health was assessed using the Qualisex questionnaire. The original version was translated to Spanish and adapted to axSpA. Internal consistency, and test re-test reliability was calculated. Criterion and construct validity were assessed by comparing the Qualisex with parameters of disease activity functional capacity and quality of life. 61 patients were invited to participate in the study, 11 of whom refused. 50 patients were included; 40 (80%) were males, with a median age of 47 years (IQR 21-72) and a median disease duration of 13 years (IQR 1-46). Reproducibility was excellent with an ICC of 0.99 (95% CI 0.65-1). The Qualisex had a good correlation with different disease evaluation parameters. The Qualisex was significantly higher among women (5.4 in women vs. 2.5 in men, p = 0.02), unemployed (4.7 in unemployed vs. 2.3 in employed, p = 0.01), in patients with higher disease activity (4.2 in active patients vs. 1.6 in inactive patients, p = 0.01), and it was lower in patients receiving biologic therapy (BT) (1.9 with BT vs. 3.8 without BT, p = 0.01). Multivariable analysis showed that female sex, longer disease duration and higher disease activity were independently associated with a greater impact on sexuality. The Qualisex adapted to axSpA is a valid and reliable questionnaire. Female axSpA patients, those with longer disease duration and higher disease activity presented a worse sexual life.
Qualisex 问卷是为评估类风湿关节炎患者的性行为而开发和验证的。据我们所知，目前尚无评估强直性脊柱炎（axSpA）患者性行为的工具。因此，本研究的目的是验证和改编 axSpA 中的 Qualisex 问卷，并评估疾病对患者性行为的影响。这是一项横断面研究。纳入了符合 ASAS'09 标准诊断为 axSpA、年龄≥21 岁的连续患者。使用 Qualisex 问卷评估性行为。将原始问卷翻译为西班牙语并改编为 axSpA 专用问卷。计算内部一致性和重测信度。通过比较 Qualisex 与疾病活动、功能能力和生活质量参数来评估效标和结构效度。共邀请 61 名患者参加研究，其中 11 名拒绝。最终纳入 50 名患者，其中 40 名（80%）为男性，中位年龄 47 岁（IQR 21-72），中位病程 13 年（IQR 1-46）。重测信度极好，ICC 为 0.99（95%CI 0.65-1）。Qualisex 与不同的疾病评估参数有很好的相关性。女性的 Qualisex 评分明显更高（女性 5.4 分，男性 2.5 分，p=0.02），失业者更高（失业者 4.7 分，就业者 2.3 分，p=0.01），疾病活动度更高者更高（活动患者 4.2 分，非活动患者 1.6 分，p=0.01），接受生物治疗（BT）者更低（BT 者 1.9 分，非 BT 者 3.8 分，p=0.01）。多变量分析显示，女性、较长的病程和较高的疾病活动度与性行为受影响更大独立相关。改编用于 axSpA 的 Qualisex 是一种有效且可靠的问卷。女性 axSpA 患者、病程较长和疾病活动度较高的患者性生活质量更差。
