Title: Psychometric Properties of the Romanian Version of the Female Sexual Function Index
(FSFI-RO)
Version: 1 Date: 01 May 2023
Reviewer's report:
The authors propose a psychometric study of an instrument that evaluates sexual functioning
widely adapted for other nationalities, examining its internal consistency and providing evidence
of validity of its measures. The adaptation is relevant, there are interesting results and I think it
is a useful contribution. I congrats authors for this work. However, I would like to make some
comments on the work which I detail below:
There is an error in the title, it should be "properties" instead of "proprieties".
In the abstract, the authors indicate: "The paper aims to measure the psychometric reliability
and validity of the FSFI-RO (Romanian Version of the Female Sexual Function Index)". Instead
of "measure psychometric properties", I suggest that the authors use the term "examine" or
"analyze".
I suggest that the authors indicate the mean age of the women who participated.
It is not clear to me how the diagnosis of FSD was made. Was it an interview conducted after
completing the questionnaire? How many participants showed FSD? I think these aspects should
be clarified in the methods section of the abstract.
In line 23, I find this sentence disconnected from the rest: "Women were then asked to fill in the
socio-demographic form and the FSFI-RO." If the authors are referring to the instruments that
were completed, the English wording should be revised to: "Women were then asked to fill out
a form that included sociodemographic information and the FSFI-RO questionnaire".
In line 29, I suggest that the authors specify the alpha values: "Cronbach's # coefficients were
found to be high".
Introduction:
The authors define sexual function as a consequence of a biological process influenced by
different factors. I think that, as presented, this definition might suggest that sexual response is a
consequence of biological changes, when we know that external factors (mentioned in the first
line) can not only influence but also cause sexual response (e.g. an external erotic stimulus). I
suggest revising this issue.
On the other hand, sexual functioning is referred to, but there is no mention of the components
of sexual functioning, such as desire, arousal, orgasm, satisfaction in the first part of the
introduction.
In line 57, the authors refer to validated instruments, but they do not specify if these measures
are available in the Romanian population or if they are globally validated. I suggest specifying
this issue.
In line 73, a closing bracket is missing.
In line 77, there is a typo: sexual desire:; the FSFI.
The objectives at the end of the introduction should be expanded. That is, it should be indicated
how internal consistency will be examined and what type of validity evidence will be provided.
Methods:
I wonder if the exclusion criteria are so strict that women with FSD were left "out" of the sample.
Why were these participants not included?
I understand that the participants were first interviewed, and then asked to complete the FSFI
and sociodemographic measures. Under what conditions was this interview conducted?
Why was the bootstrap method using 10,000 samples with a 95% confidence interval employed?
Why was a Promax rotation with Kaiser normalization used in the total sample (n = 385) at
baseline to evaluate the principal components or factors?
I miss the values that indicate a good fit for CFA, for example, a CFI above .90...
What type of analysis was used to analyze the sample size and power a posteriori?
There is an error in: (Champely S. et all, 2020)
Results:
If non-parametric statistics were used, why were Spearman correlations applied?
Confirmatory factor analysis and principal component analysis are different techniques, so this
issue should be revised and correctly specified in the wording.
Information about CFA is missing, specifically the chi-square, df, and p-values.
Discussion:
I consider it somewhat incomplete and very brief. The discussion seems repetitive with the
results. The authors comment little on the results obtained considering the variety of validation
evidence collected in other cultures. In addition, I found the prevalence of FSD in the total
sample surprising, and suggest that the authors mention this issue and provide a comparison
with respect to other prevalence studies.