Attitudes, beliefs, and values regarding the sexual experience in men: development of the Sexual Experience Questionnaire

Abstract 

Background

Although treatment of erectile dysfunction improves clinical outcomes and quality-of-life, a significant proportion of men remain undiagnosed with this disorder and male attitudes towards sexual experiences are poorly understood. Being uncomfortable about discussing these issues with others may contribute to men not seeking appropriate medical care. We sought to increase understanding of male attitudes, beliefs, and values regarding “better” sexual experience and to use these outcomes to develop a novel patient-reported outcomes questionnaire capturing important aspects of such experiences.

Methods

We conducted focus groups and individual in-depth interviews in Germany, Spain, the United Kingdom, and the United States in treatment-naive men with erectile dysfunction, treatment-experienced men with erectile dysfunction, and men without erectile dysfunction. Sexually active men aged 35–69 years were recruited from a research database, by newspaper advertisement, and at physician offices. Literature reviews and evidence-based practice methods informed the development of focus group and individual interview guides. All sessions were tape-recorded and transcribed, and transcripts were qualitatively analyzed using grounded theory methods.

Results

Participants reported that erections were very important. Treatment-naive men placed greater emphasis on ejaculation compared with the other men. Satisfaction was an important concept, with more substantial between-group differences; treatment-naive men expressed decreased satisfaction with their physical sex life and the belief that their relationship would improve if their erectile dysfunction resolved. The majority of participants indicated relationship as an important concept. Responses differed little between countries.

Conclusions

The erection, relationship, and satisfaction concepts, which have not previously appeared together and exclusively in a single patient-reported outcomes instrument, emerged as important and will be incorporated in the initial version of the SEX-Q, for which psychometric validation analyses are ongoing. The finding that both physical and emotional concepts are key to a positive sexual experience can help medical personnel guide patients toward the most relevant care.

Keywords: Erectile dysfunction, Drug therapy, Qualitative research, Quality-of-life