Development and psychometric properties of a questionnaire to assess the female quality of sexual life

  • Raziyeh Maasoumi Mail Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran AND Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  • Morteza Nazifi Department of Psychology, University of Bojnord, Bojnord, Iran
  • Zahra Mokhtarinia Department of Sociology, Islamic Azad University Science and Research Branch, Tehran, Iran
  • Lorann Stallones Colorado Injury Control Research Center, Department of Psychology, Colorado State University, USA
sexual health; validity; reliability; women; Iran


Background & Aim: Proper assessment of the quality of sexual life requires having access to psychometrically sound instruments. The present study aimed to develop an instrument to assess Iranian women’s quality of sexual life.

 Methods & Materials: This was a mixed-method study with exploratory design; at first, the Iranian women’s perception of the quality of sexual life was explored. An initial 73-item version of the questionnaire was generated according to qualitative findings and the review of the literature. Then, psychometric characteristics consist of face, content, construct, convergent validity, and internal consistency were assessed. A total of 450 women completed the developed questionnaire, ENRICH scale, and sexual quality of the life-female questionnaire.

Results: The results of face validity were satisfactory. The content validity index and content validity ratio were found to be .92 and .80, respectively. Exploratory factor analysis identified six factors accounted for 51.92% of the variance. The identified six factors that were also confirmed by confirmatory factor analysis with acceptable goodness of fit indices. Correlations between the total scores and the dimensions of sexual quality of life-female questionnaire and ENRICH ranged from .414 to .747. Total and the range of Cronbach’s alpha coefficient for the explored subscales were 0.94 and 0.94 to 0.60 respectively.

Conclusion: This study provided a valid and reliable 36-items questionnaire to holistically assess Iranian women’s quality of sexual life. It will be useful as a self-reported measure in research and clinical practice of women’s sexual health.


1. Ussher JM, Chrisler JC, Perz J, editors. Routledge International Handbook of Women's Sexual and Reproductive Health. Routledge; 2019 Sep 23.
2. Forbes MK, Eaton NR, Krueger RF. Sexual quality of life and aging: A prospective study of a nationally representative sample. The Journal of Sex Research. 2017 Feb 12;54(2):137-48.
3. Macleod A, McCabe MP. How well do measurement scales reflect the actual experience of sexuality in mid-life and beyond?. Sexual Medicine Reviews. 2019 Jan 1;7(1):29-45.
4. Beckjord E, Compas BE. Sexual quality of life in women with newly diagnosed breast cancer. Journal of psychosocial oncology. 2007 Jun 20;25(2):19-36.
5. Schober JM. Sexual quality of life in an intersexual population: a needs assessment. BJU Int. 2004; 93(Suppl 3):54-6.
6. Rosen RC. Quality of life assessment in sexual dysfunction trials. Int J Impot Res. 1998;2:(S21-3); discussion S4-6.
7. Ferenidou F, Kirana PS, Fokas K, Hatzichristou D, AthanasiadisL. Sexual Response Models: Toward a More Flexible Pattern of Women's Sexuality. The Journal of Sexual Medicine 2016; 13(9): 1369-76.
8. Nowosielski K, Wróbel B, Kowalczyk R. Women’s Endorsement of Models of Sexual Response: Correlates and Predictors. Archives of Sexual Behavior volume 2016;45(2),291–302.
9. Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL). Maturitas. 2016 Dec 1;94:87-91.
10. McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, FisherRE, etal. Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. The Journal of Sexual Medicine 2016; 13(2):144-152.
11. Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther. 2005;31(5):385-97.
12. Pop C, Mays N. Qualitative Research in Health Care. 4th Edition. New Jersey. Wiley-Blackwell. 2020.
13. Berryman DR. Ontology, Epistemology, Methodology, and Methods: Information for Librarian Researchers, Medical Reference Services Quarterly 2019;38(3):271-279.
14. Graneheim UH, Lundman B: Qualitative content analysis in nursing research. concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
15. Hajizadeh E, Asghari M. Statistical methods and analyses in health and biosciences a research methodological approach. Tehran: Jahade Daneshgahi Publications; 2011. (Persian)
16. Ebadi A, Zarshenas L, Rakhshan M, Zareian A, Sharifnia SH, Mojahedi M. Principles of Scale Development in Health Science. Tehran: Jamenegar; 2017. (Persian)Maasoumi R, Lamyian M, Montazeri A, Azin SA, Aguilar-Vafaie ME, Hajizadeh E. The sexual quality of life-female (SQOL-F) questionnaire: translation and psychometric properties of the Iranian version. Reproductive health. 2013 Dec;10(1):1-6.
17. Fowers BJ, Olson DH. ENRICH Marital Satisfaction Scale: A Brief Research and Clinical Tool. J Fam Psychol. 1993;7(2):176-85.
18. Asoodeh MH, Daneshpour M, Khalili S, Lavasani MG, Shabani MA, Dadras I. Iranian successful family functioning: Communication. Procedia-Social and Behavioral Sciences. 2011 Jan 1;30:367-71.
19. Maasoumi R. Exploring the concept of female quality of sexual life, factors and dimensions: development and psychometric properties of a culturalbased instrument [thesis]. Tehran (Iran): Tarbiat Modares University. 2014. Available online at
20. Lamyian M, Zarei F, Montazeri A, Hajizadeh E, Maasoumi R. Exploring the factors affecting Iranian women’s quality of sexual life. Journal of hayat. 2016 Jul 10;22(2):185-200.
21. Maasoumi R, Taket A, Zarei F. How Iranian Women Conceptualize the Role of Cultural Norms in Their Sexual Lives. Sexuality & Culture. 2018 Dec 1;22(4):1376-90.
22. Maasoumi R, Shivarani M, Lamb R, Zarei F. Exploring the Role of Religious Teachings in Iranian Women’s Sexual Life Scenarios. Sexuality & Culture. 2020 Feb;24(1):197-208.
23. Guo J, Marsh HW, Parker PD, Dicke T, Lüdtke O, Diallo TM. A systematic evaluation and comparison between exploratory structural equation modeling and Bayesian structural equation modeling. Structural Equation Modeling: A Multidisciplinary Journal. 2019 Jul 4;26(4):529-56.
24. Khan GF, Sarstedt M, Shiau WL, Hair JF, Ringle CM, Fritze MP. Methodological research on partial least squares structural equation modeling (PLS-SEM). Internet Research. 2019 Jun 3. 2019;29(3):407-429.
25. Blumenstock SM, Quinn-Nilas C, Milhausen RR, McKay A. High Emotional and Sexual Satisfaction Among Partnered Midlife Canadians: Associations with Relationship Characteristics, Sexual Activity and Communication, and Health. Archives of Sexual Behavior. 2020 Apr;49(3):953-67.
26. Lottes IL. Sexual rights: meanings, controversies, and sexual health promotion. Journal of Sex Research. 2013;50(3-4):367-91.
How to Cite
Maasoumi R, Nazifi M, Mokhtarinia Z, Stallones L. Development and psychometric properties of a questionnaire to assess the female quality of sexual life. NPT. 7(4):255-265.
Original Article(s)