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Development and Psychometric Performance of the Self-Efficacy to Communicate About Sex and Intimacy (SECSI) Scale in Women Treated for Cancer

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2018, Doctor of Philosophy, Ohio State University, Nursing.
Sex, intimacy and partner communication after cancer treatment are understudied aspects of survivorship for women, yet integral to quality of life and relationships. Self-efficacy is an important personal state variable that is potentially modifiable by interventions to enhance women’s adjustment after cancer treatment, and is therefore important to measure in interventions to improve sexual wellbeing. There is, however, no publicly-available validated standardized measure to evaluate women’s self-efficacy related to sex and intimacy in the context of cancer treatment impact for use in research and clinical practice. The purpose of this study was to develop the Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale and to examine its psychometric performance in women treated for cancer. A mixed-methods approach with two sequential phases was used to refine (Phase I; Aim 1) and to test (Phase II; Aims 2 and 3) the SECSI scale. In Phase I, 20 female cancer survivors provided iterative qualitative feedback, through cognitive interviews, on 25 draft candidate items included in the initial draft instrument. Cognitive interview feedback was coded and incorporated to further refine the draft items in the SECSI scale, including revisions to clarify phrasing, and to remove problematic items. The main result from Phase I was the generation of a final draft version of a 10-item SECSI scale intended to evaluate women’s confidence in their ability to communicate with their partner about changes in sex and intimacy after cancer treatment. In Phase II, quantitative methods were used to evaluate the psychometric performance of the SECSI scale in a sample of 226 partnered women treated for cancer. Phase II participants completed an online survey that included the SECSI scale and sociodemographic, clinical, and cancer characteristics. A SECSI scale retest survey was administered two weeks later. The SECSI scale was reliable, with a Cronbach coefficient alpha of 0.94, and high 2-week test-retest reliability, r = 0.82, p<.001. Construct validity of the SECSI scale was supported by results consistent with hypotheses for discriminant, convergent, and divergent validity. Factor analysis results were consistent with either a two or one factor (subscale) solution, with relatively best theoretical support for two subscales related to communication about impact of illness, and general intimacy. In conclusion, Phase I of this study established content validity for the final 10-item draft version of the Self-Efficacy to Communicate about Sex and Intimacy scale. In Phase II, the reliability and validity of the newly-developed SECSI scale was established in a sample of partnered women treated for cancer. The SECSI scale should be integrated into future research and clinical practice interventions targeted to improving women’s sexual wellbeing and partner communication after cancer treatment. Next steps in this research should include determination of clinically relevant cutpoints for SECSI scale scores that would indicate women who may benefit from clinical intervention related to communication with their partner about changes in sex and intimacy after cancer treatment. Future studies should also be designed and statistically powered to assess SECSI scale performance in specific subgroups of women cancer survivors. This study makes an important original contribution to scientific knowledge on the development and testing of a scale that assesses women’s self-efficacy to communicate about sex and intimacy after cancer treatment.
Celia Wills, PhD RN (Advisor)
Usha Menon, PhD RN FAAN (Committee Co-Chair)
Kristine Browning, PhD CNP FAANP (Committee Member)
Janine Overcash, PhD CNP FAAN (Committee Member)
416 p.

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Citations

  • Arthur, E. K. (2018). Development and Psychometric Performance of the Self-Efficacy to Communicate About Sex and Intimacy (SECSI) Scale in Women Treated for Cancer [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1522681541427596

    APA Style (7th edition)

  • Arthur, Elizabeth. Development and Psychometric Performance of the Self-Efficacy to Communicate About Sex and Intimacy (SECSI) Scale in Women Treated for Cancer . 2018. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1522681541427596.

    MLA Style (8th edition)

  • Arthur, Elizabeth. "Development and Psychometric Performance of the Self-Efficacy to Communicate About Sex and Intimacy (SECSI) Scale in Women Treated for Cancer ." Doctoral dissertation, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1522681541427596

    Chicago Manual of Style (17th edition)