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Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(2):089-095
, , , , , We evaluated internal consistency, test-retest reliability, and criterion validity of the Brazilian Portuguese version of the Female Sexual Function Index 6-item Version (FSFI-6) for postpartum women.
Therefore, questionnaires were applied to 100 sexually active women in the postpartum period. The Cronbach α coefficient was used to evaluate the internal consistency. Test-retest reliability was analyzed by Kappa for each item of the questionnaire and by the Wilcoxon parametric test, comparing the total scores of each evaluation. For the assessment of criterion validity, the FSFI was used as the gold standard and the receiver operating characteristic (ROC) curve was constructed. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 21.0 (IBM Corp., Armonk, NY, USA). It was found that the internal consistency of the FSFI-6 questionnaire was considerably high (0.839).
The test-retest reliability results were satisfactory. It can also be stated that the FSFI-6 questionnaire presented excellent discriminant validity (area under the curve [AUC] = 0.926). Women may be considered as having sexual dysfunction if the overall FSFI-6 score is < 21, with 85.5% sensitivity, 82.2% specificity, positive likelihood ratio of 4.81 and negative likelihood ratio of 0.18.
We conclude that the Brazilian Portuguese version of FSFI-6 is valid for use in postpartum women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(2):089-095
, , , , , We evaluated internal consistency, test-retest reliability, and criterion validity of the Brazilian Portuguese version of the Female Sexual Function Index 6-item Version (FSFI-6) for postpartum women.
Therefore, questionnaires were applied to 100 sexually active women in the postpartum period. The Cronbach α coefficient was used to evaluate the internal consistency. Test-retest reliability was analyzed by Kappa for each item of the questionnaire and by the Wilcoxon parametric test, comparing the total scores of each evaluation. For the assessment of criterion validity, the FSFI was used as the gold standard and the receiver operating characteristic (ROC) curve was constructed. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 21.0 (IBM Corp., Armonk, NY, USA). It was found that the internal consistency of the FSFI-6 questionnaire was considerably high (0.839).
The test-retest reliability results were satisfactory. It can also be stated that the FSFI-6 questionnaire presented excellent discriminant validity (area under the curve [AUC] = 0.926). Women may be considered as having sexual dysfunction if the overall FSFI-6 score is < 21, with 85.5% sensitivity, 82.2% specificity, positive likelihood ratio of 4.81 and negative likelihood ratio of 0.18.
We conclude that the Brazilian Portuguese version of FSFI-6 is valid for use in postpartum women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(11):636-646
To determine the prevalence of episiotomy and the factors associated with the knowledge, attitude and practice (KAP) of Brazilian obstetricians in relation to this procedure.
A KAP survey was conducted with obstetricians working in Brazil. An electronic form containing structured questions previously evaluated using the Delphi method was created in Google Docs and sent by e-mail. A multivariate logistic regression was performed to determine the principal factors associated with adequate KAP. For each dependent variable (knowledge, attitude and practice) coded as adequate (1 = yes; 0 = no), a multiple logistic regression model was developed. Binary codes (1 = yes and 0 = no) were assigned to every independent or predictor variables. Prevalence ratios (PRs) and their respective 95% confidence intervals (95%CIs) were calculated as measures of relative risk, at a significance level of 5%.
Out of the 13 thousand physicians contacted, 1,163 replied, and 50 respondents were excluded. The mean episiotomy rate reported was of 42%. Knowledge was determined as adequate in 44.5% of the cases, attitude, in 10.9%, and practice, in 26.8% of the cases.
Most respondents had inadequate knowledge, attitudes and practices regarding episiotomy. Although some factors such as age, teaching, working in the public sector and attending congresses improved knowledge, attitude and practice, we must recognize that episiotomy rates remain well above what would be considered ideal. Adequate knowledge is more prevalent than adequate attitude or practice, indicating that improving knowledge is crucial but insufficient to change the outlook of episiotomies in Brazil.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(11):636-646
To determine the prevalence of episiotomy and the factors associated with the knowledge, attitude and practice (KAP) of Brazilian obstetricians in relation to this procedure.
A KAP survey was conducted with obstetricians working in Brazil. An electronic form containing structured questions previously evaluated using the Delphi method was created in Google Docs and sent by e-mail. A multivariate logistic regression was performed to determine the principal factors associated with adequate KAP. For each dependent variable (knowledge, attitude and practice) coded as adequate (1 = yes; 0 = no), a multiple logistic regression model was developed. Binary codes (1 = yes and 0 = no) were assigned to every independent or predictor variables. Prevalence ratios (PRs) and their respective 95% confidence intervals (95%CIs) were calculated as measures of relative risk, at a significance level of 5%.
Out of the 13 thousand physicians contacted, 1,163 replied, and 50 respondents were excluded. The mean episiotomy rate reported was of 42%. Knowledge was determined as adequate in 44.5% of the cases, attitude, in 10.9%, and practice, in 26.8% of the cases.
Most respondents had inadequate knowledge, attitudes and practices regarding episiotomy. Although some factors such as age, teaching, working in the public sector and attending congresses improved knowledge, attitude and practice, we must recognize that episiotomy rates remain well above what would be considered ideal. Adequate knowledge is more prevalent than adequate attitude or practice, indicating that improving knowledge is crucial but insufficient to change the outlook of episiotomies in Brazil.
, Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):555-563
, To determine the prevalence of sexual dysfunction and its associated factors in pregnant women.
A descriptive, cross-sectional study including 262 pregnant women aged 18 years or older with gestational age between 10 and 35 weeks. Women with urinary tract infections and conditions of gestational risk were excluded. The Pregnancy Sexual Response Inventory (PSRI) questionnaire was used. We performed a univariate descriptive analysis, and comparisons between the mean values of the sexual function domains were made using the Student t-test. The chi-squared test was used to determine the association between the independent and dependent variables. The prevalence ratios, with their respective 95% confidence intervals, were also estimated, and a multivariate analysis was performed.
A total of 64.9% of women reported a decrease in the frequency of sexual activity during pregnancy. Slightly more than half of the women (50.8%) were satisfied, and arousal was reported as excellent/good by 30.5% of them. The frequency of sexual difficulties/dysfunctions increased with pregnancy, rising from 5.7% to 58.8%, and pain during sexual intercourse was reported by 45.8% of them. Having higher education degree decreased the chance of being sexually dissatisfied by 50%. The total PSRI score showed a significant decrease from the prepregnancy period (mean score = 89.8, “excellent”) to the pregnancy period (mean score = 59.2, “good”).
The mean sexual function score during pregnancy was classified as good, although most pregnant women reported at least one type of alteration in the sexual function domains, and the report of dissatisfaction was more frequent in women with lower schooling.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):555-563
, To determine the prevalence of sexual dysfunction and its associated factors in pregnant women.
A descriptive, cross-sectional study including 262 pregnant women aged 18 years or older with gestational age between 10 and 35 weeks. Women with urinary tract infections and conditions of gestational risk were excluded. The Pregnancy Sexual Response Inventory (PSRI) questionnaire was used. We performed a univariate descriptive analysis, and comparisons between the mean values of the sexual function domains were made using the Student t-test. The chi-squared test was used to determine the association between the independent and dependent variables. The prevalence ratios, with their respective 95% confidence intervals, were also estimated, and a multivariate analysis was performed.
A total of 64.9% of women reported a decrease in the frequency of sexual activity during pregnancy. Slightly more than half of the women (50.8%) were satisfied, and arousal was reported as excellent/good by 30.5% of them. The frequency of sexual difficulties/dysfunctions increased with pregnancy, rising from 5.7% to 58.8%, and pain during sexual intercourse was reported by 45.8% of them. Having higher education degree decreased the chance of being sexually dissatisfied by 50%. The total PSRI score showed a significant decrease from the prepregnancy period (mean score = 89.8, “excellent”) to the pregnancy period (mean score = 59.2, “good”).
The mean sexual function score during pregnancy was classified as good, although most pregnant women reported at least one type of alteration in the sexual function domains, and the report of dissatisfaction was more frequent in women with lower schooling.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(11):531-537
To analyze the internal consistency and the construct validity of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) scale for pregnant women during labor.
A study of measurement property including 150 pregnant women aged between 15 and 45 years old, during the first period of labor and with term pregnancies. The questionnaire used was the STAI S-Anxiety scale. In order to assess the internal consistency, Cronbach’s α was calculated through an exploratory factor analysis. The correlation between the factors was calculated using the Pearson coefficient. The state of significance used for this analysis was 0.05.
The STAI S-Anxiety scale used in the context of labor showed two factors represented as the absence (factor 1) and the presence of anxiety (factor 2); item 4 (“I regret it”) did not show a representative value. Both factors showed high indications of Cronbach’s α, varying from 0.830 for factor 1, and 0.723 for factor 2. In the results of the Pearson coefficient between the two factors, a significant but weak correlation was observed (r = -0.188; p = 0.021).
The STAI S-Anxiety scale used in pregnant women during labor presented appropriate values of internal consistency; however, item 3 did not show a significant factorial value. Therefore, this questionnaire must be applied cautiously and carefully without the use of the item 4 in the clinical practice and in researches about labor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(11):531-537
To analyze the internal consistency and the construct validity of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) scale for pregnant women during labor.
A study of measurement property including 150 pregnant women aged between 15 and 45 years old, during the first period of labor and with term pregnancies. The questionnaire used was the STAI S-Anxiety scale. In order to assess the internal consistency, Cronbach’s α was calculated through an exploratory factor analysis. The correlation between the factors was calculated using the Pearson coefficient. The state of significance used for this analysis was 0.05.
The STAI S-Anxiety scale used in the context of labor showed two factors represented as the absence (factor 1) and the presence of anxiety (factor 2); item 4 (“I regret it”) did not show a representative value. Both factors showed high indications of Cronbach’s α, varying from 0.830 for factor 1, and 0.723 for factor 2. In the results of the Pearson coefficient between the two factors, a significant but weak correlation was observed (r = -0.188; p = 0.021).
The STAI S-Anxiety scale used in pregnant women during labor presented appropriate values of internal consistency; however, item 3 did not show a significant factorial value. Therefore, this questionnaire must be applied cautiously and carefully without the use of the item 4 in the clinical practice and in researches about labor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(7):325-332
Systematic reviews that evaluate the perineal cryotherapy to reduce pain in the vaginal postpartum are inconclusive.
To evaluate clinical effectiveness of cryotherapy in the management of humanized postpartum perineal pain and vaginal edema.
A double-bind randomized controlled clinical trial (UTN number: U1111- 1131-8433) was conducted in a hospital in Northeastern, Brazil.Women were included following humanized childbirth. All had vaginal deliveries of a single, full-term pregnancy with cephalic presentation. Exclusion criteria included previous perineal lesion, episiotomy during the current delivery, instrumental delivery, uterine curettage and postpartum hemorrhage. In the experimental group, an ice pack was applied six times on the perineum for 20 minutes, reducing the temperature between 10 and 15° C, then 60 minutes without exposure to cold. In the non-cryotherapy, a water bag unable to reduce the temperature to this extent was used, compliance with the same application protocol of the first group. Perineal temperature wasmonitored at zero, 10 and 20 minutes for application in both groups. Evaluations were made immediately before and after the applications and 24 hours after delivery spontaneous, to determine the association between variables.
A total of 80 women were included in the study, 40 in each group. There was no significant difference in scores of perineal pain and edema between the groups with or without cryotherapy until 24 hours after childbirth. There was no difference between groups when accomplished repeated measures analysis over the 24 hours after delivery, considering the median perineal pain (p = 0.3) and edema (p = 0.9). Perineal cryotherapy did not influence the amount of analgesics used (p = 0.07) and no adverse effect was registered.
The use of cryotherapy following normal vaginal delivery within the concept of humanized minimally interventionist childbirth had no effect on perineal pain and edema, since it was already substantially lower, nor the need for pain medicaments.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(7):325-332
Systematic reviews that evaluate the perineal cryotherapy to reduce pain in the vaginal postpartum are inconclusive.
To evaluate clinical effectiveness of cryotherapy in the management of humanized postpartum perineal pain and vaginal edema.
A double-bind randomized controlled clinical trial (UTN number: U1111- 1131-8433) was conducted in a hospital in Northeastern, Brazil.Women were included following humanized childbirth. All had vaginal deliveries of a single, full-term pregnancy with cephalic presentation. Exclusion criteria included previous perineal lesion, episiotomy during the current delivery, instrumental delivery, uterine curettage and postpartum hemorrhage. In the experimental group, an ice pack was applied six times on the perineum for 20 minutes, reducing the temperature between 10 and 15° C, then 60 minutes without exposure to cold. In the non-cryotherapy, a water bag unable to reduce the temperature to this extent was used, compliance with the same application protocol of the first group. Perineal temperature wasmonitored at zero, 10 and 20 minutes for application in both groups. Evaluations were made immediately before and after the applications and 24 hours after delivery spontaneous, to determine the association between variables.
A total of 80 women were included in the study, 40 in each group. There was no significant difference in scores of perineal pain and edema between the groups with or without cryotherapy until 24 hours after childbirth. There was no difference between groups when accomplished repeated measures analysis over the 24 hours after delivery, considering the median perineal pain (p = 0.3) and edema (p = 0.9). Perineal cryotherapy did not influence the amount of analgesics used (p = 0.07) and no adverse effect was registered.
The use of cryotherapy following normal vaginal delivery within the concept of humanized minimally interventionist childbirth had no effect on perineal pain and edema, since it was already substantially lower, nor the need for pain medicaments.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(11):497-502
DOI 10.1590/S0100-720320140004985
To evaluate the sexual function and factors associated with sexual dysfunction in climacteric women.
A cross-sectional study was conducted on 173 women aged 35 to 65 years old, with a steady partner during the last 6 months, who are literate, without cognitive impairment, and with sexual activity for at least 6 months. The instrument used to assess sexual performance was the Sexual Quotient, female version. The association between sexual dysfunction and sociodemographic data, personal, obstetric and sexual history was determined by Pearson's χ2 test and strength of association by the odds ratio (OR) with a 95% confidence interval (95%CI).
In this study, 46.2% of the women reported sexual dysfunction. There was a decrease in the chance of sexual dysfunction for the age group between 35 and 49 years old (OR=0.3; 95%CI 0.2–0.6) and for women who felt comfortable talking about sex (OR=0.5; 95%CI 0.2–0.8). However, the presence of osteoporosis (OR=3.3; 95%CI 1.5–7.6), urinary incontinence (OR=2.0; 95%CI 1.1–3.7), and surgical corrections of the pelvic floor (OR=2.2; 95%CI 1.1–4.5) increased this chance.
The frequency of sexual dysfunction in women aged 35 to 65 years old was 46.2% and factors such as osteoporosis, urinary incontinence and surgical corrections of the pelvic floor increased the chance of sexual dysfunction.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(11):497-502
DOI 10.1590/S0100-720320140004985
To evaluate the sexual function and factors associated with sexual dysfunction in climacteric women.
A cross-sectional study was conducted on 173 women aged 35 to 65 years old, with a steady partner during the last 6 months, who are literate, without cognitive impairment, and with sexual activity for at least 6 months. The instrument used to assess sexual performance was the Sexual Quotient, female version. The association between sexual dysfunction and sociodemographic data, personal, obstetric and sexual history was determined by Pearson's χ2 test and strength of association by the odds ratio (OR) with a 95% confidence interval (95%CI).
In this study, 46.2% of the women reported sexual dysfunction. There was a decrease in the chance of sexual dysfunction for the age group between 35 and 49 years old (OR=0.3; 95%CI 0.2–0.6) and for women who felt comfortable talking about sex (OR=0.5; 95%CI 0.2–0.8). However, the presence of osteoporosis (OR=3.3; 95%CI 1.5–7.6), urinary incontinence (OR=2.0; 95%CI 1.1–3.7), and surgical corrections of the pelvic floor (OR=2.2; 95%CI 1.1–4.5) increased this chance.
The frequency of sexual dysfunction in women aged 35 to 65 years old was 46.2% and factors such as osteoporosis, urinary incontinence and surgical corrections of the pelvic floor increased the chance of sexual dysfunction.