Journal of Gerontological Nursing

Feature Article 

Validity and Reliability of the Geriatric Sexuality Inventory

Meredith Wallace Kazer, PhD, CNL, APRN, A/GNP-BC, FAAN; Sheila Grossman, PhD, APRN, FNP-BC, FAAN; Gerard Kerins, MD, FACP; Alison Kris, PhD, RN; Christine Tocchi, PhD, APRN, GNP-BC

Abstract

Effective health care for older adults requires that providers assess and manage sexual health needs with high priority. This assessment begins with an effective sexuality assessment tool. A two-step, research approach was undertaken to develop and test the Geriatric Sexuality Inventory (GSI). Literature and expert review resulted in a 34-item instrument that was initially completed by 34 older adults ages 60 to 91 (mean age = 75). The testing was repeated in 19 of the original participants. The sample was 75% women, and 88% Caucasian with 9% single, 27% married, 18% divorced, and 46% widowed participants. Internal consistency reliability was run on all 53 responses and revealed adequate reliability (alpha = 0.74). Test-retest analysis also revealed good initial instrument reliability (r = 0.78; p < 0.001). Responses to open-ended questions regarding sexual information and care needs supported evidence gathered from the literature. Initial testing of the GSI revealed content validity and good internal consistency and test-retest reliability. [Journal of Gerontological Nursing, 39(11), 38–45.]

Dr. Kazer is Professor and Associate Dean, Dr. Grossman is Professor, and Dr. Kris is Associate Professor, Fairfield University School of Nursing, Fairfield, Connecticut; Dr. Kerins is Geriatrician and Attending Physician, St. Raphael Campus, Yale New Haven Hospital, New Haven, Connecticut; and Dr. Tocchi is Postdoctoral Fellow, New York University College of Nursing, New York, New York.

The authors have disclosed no potential conflicts of interest, financial or otherwise. The authors acknowledge the Foundation for the Scientific Study of Sexuality (FSSS), which supported this research project, as well as the staff and members of the senior center that participated in the study.

Address correspondence to Meredith Wallace Kazer, PhD, CNL, APRN, A/GNP-BC, FAAN, Professor and Associate Dean, Fairfield University School of Nursing, 1073 North Benson Road, Fairfield, CT 06824; e-mail: mkazer@fairfield.edu.

Received: June 05, 2013
Accepted: August 15, 2013
Posted Online: September 24, 2013

Abstract

Effective health care for older adults requires that providers assess and manage sexual health needs with high priority. This assessment begins with an effective sexuality assessment tool. A two-step, research approach was undertaken to develop and test the Geriatric Sexuality Inventory (GSI). Literature and expert review resulted in a 34-item instrument that was initially completed by 34 older adults ages 60 to 91 (mean age = 75). The testing was repeated in 19 of the original participants. The sample was 75% women, and 88% Caucasian with 9% single, 27% married, 18% divorced, and 46% widowed participants. Internal consistency reliability was run on all 53 responses and revealed adequate reliability (alpha = 0.74). Test-retest analysis also revealed good initial instrument reliability (r = 0.78; p < 0.001). Responses to open-ended questions regarding sexual information and care needs supported evidence gathered from the literature. Initial testing of the GSI revealed content validity and good internal consistency and test-retest reliability. [Journal of Gerontological Nursing, 39(11), 38–45.]

Dr. Kazer is Professor and Associate Dean, Dr. Grossman is Professor, and Dr. Kris is Associate Professor, Fairfield University School of Nursing, Fairfield, Connecticut; Dr. Kerins is Geriatrician and Attending Physician, St. Raphael Campus, Yale New Haven Hospital, New Haven, Connecticut; and Dr. Tocchi is Postdoctoral Fellow, New York University College of Nursing, New York, New York.

The authors have disclosed no potential conflicts of interest, financial or otherwise. The authors acknowledge the Foundation for the Scientific Study of Sexuality (FSSS), which supported this research project, as well as the staff and members of the senior center that participated in the study.

Address correspondence to Meredith Wallace Kazer, PhD, CNL, APRN, A/GNP-BC, FAAN, Professor and Associate Dean, Fairfield University School of Nursing, 1073 North Benson Road, Fairfield, CT 06824; e-mail: mkazer@fairfield.edu.

Received: June 05, 2013
Accepted: August 15, 2013
Posted Online: September 24, 2013

Sexuality is defined as “a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction” (World Health Organization [WHO], 2006, p. 5). Sexual health as a manifestation of sexuality is “a state of physical, emotional, mental and social well-being related to sexuality” (WHO, 2006, p. 5). With the rising population of older adults comes a need to provide effective tools to assess the multiple dimensions of sexual health in this population. A Health and Psychological Instruments database search for an instrument to assess the sexual health needs of older adults was conducted. The search, using the Boolean search terms sex* and geriatric, aged, elder* in the title, and limited to the past 20 years, produced only one possible assessment tool for both older men and women (Keil, Sutherland, Knapp, Waid, & Gazes, 1992). On evaluation, the scale contained only two questions on sexuality, which will be discussed later in the current article.

In 1966, Masters and Johnson determined that older adults continue to enjoy sexual relationships throughout their lives. The Janus Report on Sexual Behavior found that on a weekly basis, sexual activity for both men and women continues past middle age (Janus & Janus, 1993). More recently, Lindau et al. (2007) conducted a study of 3,005 American older adults and found that sexual activity was reported in 73% of individuals ages 57 to 64, 53% of individuals ages 65 to 74, and 26% of individuals ages 75 to 84. Not only do older adults continue to be interested in fulfilling their sexual needs and desires, it is actually necessary to do so. Gianotten, Whipple, and Owens (2006) reported many health benefits inherent in sexual expression and a need for continuing research in this area.

Sexuality is a continuing human need, common to all people. Even if older adults do not participate in sexual relationships, they are still sexual people. Sexuality extends beyond sexual intercourse to include the fulfillment of sexual goals and desires, in whatever way possible or necessary. This may include having sexual intercourse, intimate conversation and closeness, or other methods of sexual fulfillment (Wallace, 2000, 2003). Assessment of older adult sexuality must take into consideration the continuing sexual desires of the population as well as normal and pathological changes of aging and changes in environments of care that impact sexual expression. The purpose of this article is to describe the development, content validity, internal consistency reliability, and test–retest reliability of the Geriatric Sexuality Inventory (GSI). It is hoped that the established instrument will aid or assist in the assessment and implementation of interventions to promote the sexual health of older adults throughout environments of care.

Background

Addressing the continuing sexual needs of older adults is a highly needed, yet difficult task to accomplish. Barriers that prevent health care providers and older adults from addressing the complex needs of older adults’ sexual health pervade environments of care. Despite the perceived discomfort among all involved, the continuing sexual needs of older adults must be addressed with the same priority as well-accepted needs of aging adults. Effective care of older adults requires that health care providers assess and provide care for older adults in a holistic manner that includes sexual health needs.

It is frequently assumed that sexual desires and the frequency of sexual encounters diminish later in life. However, research supports that sexual identity and the need for intimacy do not disappear with increasing age. As stated earlier, Lindau et al. (2007) found a high level of sexual activity among older adults in their study. A more recent study continues to support these findings among women. Trompeter, Bettencourt, and Barrett-Connor (2012) found that in their study of 806 older women who completed a mailed survey, 50% of participants with a mean age of 67 had sexual activity within the past month.

Despite the persistence of sexual desires throughout the life span, older adulthood is often accompanied by a number of normal and pathological changes that affect sexual health and function. Among older women, vaginal lubrication in response to sexual stimulation may lessen and/or take longer to be released. Further, anatomical changes to the labia, vagina, and cervix may make intercourse uncomfortable for older women (Berman, 2005). Among older men, it was concluded from a study of 1,085 men that age is an independent risk factor for decreased sexual function (Araujo, Mohr, & McKinlay, 2004). Moreover, low levels of testosterone tend to occur as a result of the aging process (Dandona & Rosenberg, 2010). Although low testosterone has been shown to affect multiple organ systems, most relevant to this discussion is the impact of low testosterone on the male libido (Tartavoulle & Porche, 2012). Other normal bodily changes of aging may also affect sexual health indirectly. For example, as fat is redistributed and wrinkles and gray hair arrive, an older adult’s self-image may be altered to the extent that sexual relationships are avoided because of individual self-consciousness.

Derogatis and Burnett (2008) provide strong support for the prevalence of sexual dysfunction among older adults, citing pathological aging changes as major risk factors. There are many illnesses common to older adults that affect sexual function. Three of the most common include: heart disease, diabetes, and depression. Heart disease has been shown to result in decreased sexual interest and comfort, as well as arousal and orgasmic disorders among women (Addis et al., 2005) and erectile dysfunction among men (Böhm et al., 2007). Diabetes also contributes to decreased sexual function, arousal, and pleasurable sensations among women (Rockliffe-Fiddler & Kiemle, 2003) and erectile dysfunction among men (Rosen et al., 2009). Depression, estimated to occur in up to 13.5% of older adults (Hybels & Blazer, 2003), is thought to alter desire and performance among both genders and erectile dysfunction among men (Korfage et al., 2009). In addition to these medical conditions, research has demonstrated that the pharmacological treatments for common older adult conditions also have the potential to further affect sexual functioning and increase sexual health problems (McNicoll, 2008). A comprehensive list of medications that are suggested to negatively impact sexual health are shown in Table 1.

Medications that May Influence Sexual Health

Table 1:

Medications that May Influence Sexual Health

The environments of care in which older adults live often affect sexual health. Older adults may live with their children or in communal settings (Wallace, 2000, 2003). The seeking of experiences to satisfy sexual desires may be difficult to negotiate in these settings, especially if caregivers have a lack of understanding regarding the sexual needs of the older population (Price, 2009). Another common occurrence among older adults is the loss of sexual relations with a life partner through illness or death. These two experiences not only impact the older adult emotionally and psychologically, but play a significant role in the maintenance of sexual health and functioning.

Further complicating the expression of sexuality among older adults is the presence of incorrect sexual knowledge and poor attitudes and habits that may have been acquired in earlier years. Although older adults have a great need for information regarding the affect of normal and pathological aging changes on sexual health, sexual knowledge among the older adult population has been shown in several studies to be limited. Baumgartner et al. (2008), in a study of 81 community-dwelling older adults, revealed that the population was in need of increased sexual information and education. A study by Chitale, Collins, Hull, Smith, and Irving (2007) found that less than 10% of health care providers asked about erectile dysfunction despite the fact that 90% of the sample was seeking treatment. In addition, the National Prevention Information Network reports that the older adult population generally knows less about HIV disease than their younger counterparts, but approximately 24% of all HIV infections occur among older adults (Centers for Disease Control and Prevention, 2007).

Improved ability to assess sexuality by health care providers will provide data for communication and teaching interventions regarding sexual information, prevention and transmission of HIV, and other sexually transmitted diseases. However, most health care providers believe that older adults are asexual and have a general discomfort with discussing sexual issues (Price, 2009). Moreover, most providers receive little, if any, education on assessing the sexual health of older adults. This discomfort and lack of education have partially contributed to lack of research into the development of instruments to assess sexual health among older adults. Without education and experience in managing sexual health, health professionals are often not comfortable discussing it with older adults, and ignore or mismanage issues that ultimately arise. Evidence suggests that provider hesitancy to discuss sexual health with older adults may have a significant effect on the sexual health of this population (Price, 2009). Peck (2001) reported that increased familiarity with diverse sexual issues among health care providers may enhance the assessment of sexual health among older adults. Examples of sexual issues include recommending positions for sexual intercourse that demand less energy and oxygen expenditure or methods of expressing intimacy when sexual intercourse is not possible due to a postoperative condition or a temporary skin problem.

Sexual health care for older adults begins with effective assessment. However, assessment of sexual function in the older adult population has long been impacted by a lack of effective assessment instruments, as well as provider discomfort with sexual assessment. In the search for an instrument to assess the sexual health of the older adult population, only one instrument was found, which contained two questions about sexual health (Keil et al., 1992). The two questions focused on ability to get sexually aroused and frequency of sexual relationships. The lack of available instruments to measure the multidimensional nature of sexual health underscores the necessity for instrument development to assist providers in assessing and managing the needs of the growing population of older adults. For health care providers to venture into the unknown and uncomfortable area of sexual health assessment, a valid and reliable instrument is essential.

This research project aimed to develop and test an instrument to improve the sexual health of older adults, an area that has frequently been considered “taboo” across environments of care for older adults. It will result in an assessment instrument that will be available for health care professionals to assess the sexuality of older adults across care areas. To fulfill this purpose, the following research aims were addressed: (a) develop a geriatric sexuality measure through literature review and interdisciplinary expert panel; (b) establish the internal consistency reliability of the GSI; and (c) establish the test–retest reliability of the GSI.

Method

This study was approved by the respective institutional review board of the principal investigator (M.W.K.). A two-step approach to develop the GSI, establish content validity, and test the instrument for internal consistency and test–retest reliability was used. The first aim of the project was to develop a multidimensional measure of geriatric sexuality based on evidence generated from the literature and external review by an interdisciplinary expert panel to support content validity. A systematic literature review was conducted to produce a table of eight potential domains of sexuality. These domains included: (a) medication and illness, (b) self-concept, (c) sexual satisfaction, (d) sexual knowledge, (e) relationship with health care provider, (f) environmental issues, (g) safe sex, and (h) partnership status.

After generation of domains, items were developed using the framework suggested by Devellis (1991) to reflect signs, symptoms, medical conditions, and medications associated with sexual health in each of the domain areas. The draft instrument was then reviewed by a four-member interdisciplinary expert panel. The expert panel consisted of a geriatric nurse practitioner (GNP) (C.T.), a family nurse practitioner (FNP) (S.G.), a doctorally prepared RN whose research focuses primarily in long-term care (A.K.), and a board certified geriatrician (G.K.). Expert reviewers were instructed to review each of the items for relevance, using a four-point scale: 1 = not relevant, 2 = somewhat relevant, 3 = quite relevant, or 4 = very relevant. Reviewers were asked to consider readability of items and whether there was comprehensive coverage of the proposed eight dimensions of sexual health. The expert panel was also asked to determine if all possible areas of sexual health were adequately addressed and to comment if items could be clearer or reworded. Other additions, deletions, or edits that would improve the instrument were also requested. Reviewers were in 100% agreement on the final questionnaire items.

The four experts reviewed multiple drafts of the instrument and provided excellent insight and edits. Based on the feedback of experts, a number of revisions were made to the draft, including edits to clarify a number of the research items. Instructions for both patients and providers were added to the instrument as well as the estimated 20-minute time for completion. The instrument was formatted to provide opportunities for older adults to respond to the eight dimensions of sexual health needs, stated earlier. The instrument was designed to be either self-administered or used as an interview schedule. Although the draft contained items that originally were conceptualized to be answered with a Likert-style scale, reviewers suggested that a dichotomous “yes or no” format would be easier for older adult respondents and would capture the necessary data. In addition, the items in the draft were initially organized by domains, but reviewers suggested the final version randomize the items. Demographic questions were added for initial administration of the instrument and replaced by three open-ended questions for the second data-gathering period. Once the instrument was developed, and an appropriate rating scale for each item assigned, the instrument was distributed to gather data for internal consistency and test–retest reliability among members of one local senior center.

Setting and Sample

A sample of approximately 30 participants was sought to test the reliability of the scale. The sampling frame included participants at a senior center who agreed to participate in this project. The senior center that served as the setting for this study provided a large variety of activities to seniors 55 or older and served between 350 and 400 individuals each day. The socioeconomic groups range from 150% below the poverty line to a more wealthy demographic. All ethnic groups were represented in the center including Hispanic, Latino, African American, Asian American, and Caucasian. Eligibility criteria for participation in this study were age 60 and older and English speaking, with sufficient literacy to complete the pilot instrument. Efforts were made to recruit African American, Latino, and Asian American participants.

Participant Recruitment, Informed Consent, and Data Collection Procedure

The researcher (M.W.K.) scheduled a visit to a senior center at a mutually convenient date and time to recruit the study participants. A table was set up in the front lobby of the senior center with signs about the study. As potential participants approached the researcher, the purpose and procedure of carrying out the study were explained and volunteers were requested to participate. Those who agreed to be a part of the study were provided with an envelope with a code number containing the consent form and the pilot study instrument (GSI). Once the participants completed the consent form and GSI, they were asked to put them back in the envelope and return them to the researcher. The participants were provided with a $10 honorarium and a thank you card containing their code number and the return date for a second administration of the instrument. Participants were reminded to retain their card for 2 weeks until the researcher returned for the second testing.

Two weeks following the initial data collection, the researcher returned to the senior center to administer the retest; returning on 2 additional days to collect retests from members who were not present on the originally scheduled return date. Code cards from previous participants were collected, and another envelope corresponding to their code number that contained a second GSI was distributed. Once the additional GSI was completed, participants were asked to insert it into the envelope and return it to the researcher to receive an additional $10 honorarium.

Results

The researcher distributed 40 questionnaires at the senior center. Overall, participants were enthusiastic about the questionnaire and happy to participate in the study. A few of the senior center members asked questions about the study, and a few life stories and sexually themed jokes were shared. There was an overall acceptance of the study among the sample. Of the 40 questionnaires distributed, 34 were returned and usable for analysis.

Data from pilot testing in the senior center were hand-entered into SPSS version 16. Yes responses were coded with a value of 1 and no responses were given a value of 2. There were a number of missing values in the initial administration of the instrument, as revealed in Table 2. Because SPSS excludes missing values case wise, a dummy value of “1.5” (mean of 1 and 2) was inserted to ensure enough cases for analysis. Interestingly, the percentage of missing values was greatly reduced in the second administration of the instrument. This may be related to increased responder familiarity with the instrument. Many of the participants wrote “N/A” instead of circling “yes” or “no”; this response choice may be considered in future testing of the instrument. A significance level of p = 0.05 was applied to determine the statistical significance of the data.

Percentage of Items with Missing Values

Table 2:

Percentage of Items with Missing Values

Literature and expert review resulted in a 34-item instrument that was initially completed by 34 older adults ages 60 to 91 (mean age = 75). The testing was repeated in 19 of the original participants. Complete demographic characteristics of the sample are listed in Table 3. Internal consistency reliability was run on all 53 responses and revealed adequate reliability (alpha = 0.74). Test–retest analysis also revealed good initial instrument reliability (r = 0.78; p < 0.001).

Demographics of the Sample

Table 3:

Demographics of the Sample

Three open-ended questions were added to the second iteration of the instrument in lieu of demographics. Only 60% of the 19 members who completed the questionnaire a second time (n = 11) completed the open-ended questions. However, these participants offered information that confirmed sexual concerns in the literature and shed light on additional concerns regarding sexual health. Responses to these three questions are summarized in Table 4.

Summary of Responses to Open-Ended Questions Regarding Sexual Concerns

Table 4:

Summary of Responses to Open-Ended Questions Regarding Sexual Concerns

Discussion

Effective health assessments are critical to providing good nursing care. The availability of an easy-to-use, valid, and reliable assessment instrument that can be self-completed or used to interview older adults is the first step toward development of a plan of care to address the multidimensional sexual health needs of older adults. Because sexual assessment is generally accompanied by some discomfort on the part of both older adults and health care providers, having an instrument to replace general open-ended questions may provide opportunities for comprehensive sexual assessment within the comfort of completing a form.

Establishment of content validity is undertaken to ensure that an instrument or test measures what it intends to measure. Fain (2004) reported that to establish content validity, concepts from the literature are first selected to represent various dimensions of the instrument. Following this initial process, experts evaluate the items and questions as well as overall appropriateness of the instrument for the intended population. In the development of the GSI, this exact process was undertaken. Items were selected from the literature to represent sexual health concerns of the older adult population. These initial items were reviewed, evaluated, and edited by a highly qualified four-member interdisciplinary panel of geriatric experts. Multiple drafts of the instrument were developed and re-reviewed by experts prior to administration to the pilot sample. Undergoing this process as recommended by Fain (2004) supports the content validity of the instrument.

Reliability refers to an instrument’s ability to consistently measure what it is supposed to measure. However, despite an increased emphasis on the establishment of instrument reliability, Strickland (2011) reported that there continues to be insufficient focus on the development and enhancement of patient measurement instruments. Initial testing of the GSI among the sample in this study revealed internal consistency reliability (alpha = 0.74) and test–retest reliability (r = 0.78; p < 0.001). According to parameters for instrument reliability set forth by George and Mallery (2003) and Shuttleworth (2009), the GSI has acceptable alpha reliability and test–retest reliability. These early data support the potential usefulness of this tool for both clinical practice and research.

Eleven participants in this study responded to open-ended questions regarding concerns about sexual health and the need for sexual health information. Age-related concerns about sexual health related to partnership status and health issues that were shared by participants are supported in the literature (Berman, 2005; Ginsberg, 2010; Wallace, 2000, 2003). Concerns about partners’ health were prevalent among respondents and several discussed specific aides used to facilitate sexual relations. Although some older adults stated that they discussed their sexual health concerns with partners and friends, almost half of the responders stated that they did not discuss their sexual health concerns with anyone. This important finding underscores the need to enhance the prevalence and ease of sexual health assessments in the older adult population.

This study was limited by a small, primarily Caucasian sample and a majority of female respondents. Although this latter finding skews the results toward this gender, it is consistent with the population demographics. In addition, although these limitations prevent broad generalizability of the scale, the ease of use of the scale and acceptability of the testing among older adults add further support for the contributions of the scale toward sexual health assessment. Older adult members of the senior center asked questions about the study and shared details about their lives with the researcher. Many commented that this was an important area of study and they were glad to participate. There was an overall acceptance of the study among the sample as revealed by their willingness to complete the scales on one or two occasions. Despite the limitations of the study, the lack of instruments to assist in the assessment of sexual health among older adults underscores the contributions of this study to the improvement of health care.

Implications and Conclusion

Adults continue to experience sexual desires throughout all decades of life. However, normal changes of aging often make the expression of sexuality difficult in the older adult population (Berman, 2005; Ginsberg, 2010). Moreover, 82.4% of older adults have at least one chronic medical condition (Fiest, Currie, Williams, & Wang, 2011) that may further affect sexual health and functioning. Medications to treat these medical conditions also have been demonstrated to negatively influence sexual health (Table 1).

Interdisciplinary health care providers, including those in medicine, nursing, social work, therapy, and mental health, working throughout environments of care can play a substantial role in improving the sexual health of older adults. However, numerous barriers prevent the assessment and management of sexual issues. General discomfort with the discussion of sexual issues as well as a lack of provider education regarding issues impacting the sexual health of older adults are key barriers to assessment and management. Thus, the majority of health care providers do not include sexual assessment among the typical dimensions assessed during patient visits (Chitale et al., 2007). Moreover, the barriers that prevent addressing sexual issues in clinical encounters with older adults likely also influence the availability of sexual health assessment instruments for this population. A current review of literature revealed no such instruments that could be used in clinical practice or research to assess the sexual health of the older population.

The GSI was developed from a comprehensive literature review and the expert advice of an interdisciplinary panel of currently practicing gerontological experts. The process that was undertaken supports the content validity of the instrument (Devellis, 1991). Recommendations resulted in the development of an eight-dimension, 34-question dichotomous instrument that was easily completed in a sample of 34 older adults and repeated in 19 of the same sample. Although this study supports good content validity, internal consistency reliability, and test–retest reliability, more research is needed to establish this instrument in clinical practice and research. Future testing of the GSI will continue using larger, random samples. Further construct validity studies are planned to support the multidimensional nature of the scale. Further testing is also planned to strengthen reliability data of the instrument and to determine appropriate scoring to target interventions across environments of care for older adults.

The GSI, developed to assess sexual health needs of the older adult population, appears to be an effective tool in its beginning stages. Further use of the instrument will assist interdisciplinary health care providers to more effectively manage sexual health among older adults across environments of care. Currently, no tool exists in the literature to assess older adult sexuality. With further testing, the GSI promises to offer further data to support its use in the overall assessment of sexual health among older adults.

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  • Strickland, O.L. (2011). Measurement and scales. In Fitzpatrick, J.J.F. & Kazer, M.W. (Eds.), Encyclopedia of nursing research (3rd ed., pp. 278–281). New York: Springer.
  • Tartavoulle, T.M. & Porche, D.J. (2012). Low testosterone. Journal for Nurse Practitioners, 8, 778–786. doi:10.1016/j.nurpra.2012.05.004 [CrossRef]
  • Trompeter, S.E., Bettencourt, R. & Barrett-Connor, E. (2012). Sexual activity and satisfaction in healthy community-dwelling older women. American Journal of Medicine, 125, 37–43. doi:10.1016/j.amjmed.2011.07.036 [CrossRef]
  • Wallace, M. (2000). Sexuality and intimacy. In Leuckenotte, A. (Ed.), Textbook of gerontological nursing (2nd ed., pp. 217–231). St. Louis, MO: Mosby Year Book.
  • Wallace, M. (2003). Sexuality in long term care. Annals of Long Term Care, 11(2), 53–59.
  • World Health Organization. (2006). Defining sexual health: Report of a technical consultation on sexual health, 28–31 January 2002. Geneva. Retrieved from http://www.who.int/reproductivehealth/publications/sexual_health/defining_sex-ual_health.pdf

Medications that May Influence Sexual Health

Antihypertensive agents
Medications for prostate
Cholesterol medications
Antidepressant agents
Other medications that effect mood
Anticholinergic agents
Pain medication (narcotics)
Diuretic agents
Osteoporosis medication
Oral hypoglycemic agents
Insulin
Chemotherapy for cancer

Percentage of Items with Missing Values

% of Missing Values
Item First Second
1 15 5
2 6 11
3 24 5
4 0 5
5 0 0
6 9 0
7 12 0
8 18 5
9 6 0
10 18 0
11 0 0
12 9 11
13 12 5
14 9 0
15 9 0
16 6 5
17 24 5
18 15 0
19 9 0
20 26 5
21 18 0
22 3 0
23 12 0
24 9 0
25 15 0
26 18 0
27 29 5
28 18 0
29 12 5
30 12 0
31 9 5
32 15 5
33 26 5
34 21 5

Demographics of the Sample

Characteristic n (%)
Sex
  Female 24 (75)
  Male 8 (25)
Educational level
  High school 17 (50)
  College 11 (32.4)
  Graduate school 6 (17.6)
Marital status
  Widowed 15 (45.5)
  Married 9 (27.3)
  Divorced 6 (18.2)
  Single 3 (9.1)
Ethnicity
  White/Caucasian 28 (87.5)
  African American 3 (9.4)
  Hispanic 1 (3.1)

Summary of Responses to Open-Ended Questions Regarding Sexual Concerns

Problems Fulfilling Sexual Needs Help Needed to Fulfill Sexual Needs With Whom Do You Discuss Sexual Concerns

No privacy

Can’t find someone to love who will love me back – still looking

Partner no longer able

Partner (3)

Getting old

Getting erections

Discussing sex with partner

Privacy

Sexual partner (3)

My partner’s health needs to improve (stroke)

Erection pump

Vibrator/masturbation

Spouse (2)

No one (4)

Husband

My sisters, doctor, friends

Doctor

Friends (2)

Health provider

Keypoints

Kazer, M.W., Grossman, S., Kerins, G., Kris, A. & Tocchi, C. ( 2013). Validity and Reliability of the Geriatric Sexuality Inventory. Journal of Gerontological Nursing, 39( 11), 38– 45.

  1. Effective health care for older adults requires that providers assess and manage sexual health needs with high priority, but improved assessment instruments are needed.

  2. Initial testing of the Geriatric Sexuality Inventory (GSI) revealed content validity and good internal consistency and test–retest reliability.

  3. The developed and tested GSI will assist in the assessment and implementation of interventions to promote the sexual health of older adults.

10.3928/00989134-20130916-03

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