Table of Contents
Instructions:
Please answer the following questions.
| The following questions are regarding current treatment for erectile dysfunction. If you are not | ||
| 1 | receiving treatment please indicate so for the following 11 questions and proceed to question 12. | |
| (EDITS 1) Overall, how satisfied are you with this treatment? | ||
| 0 | Not receiving treatment | |
| 4 | Very satisfied | |
| 3 | Somewhat satisfied | |
| 2 | Neither satisfied nor dissatisfied | |
| 1 | Somewhat dissatisfied | |
| 0 | Very dissatisfied | |
| 2 | (EDITS 2) During the past four weeks, to what degree has the treatment met your expectations? | |
| 0 | Not receiving treatment | |
| 4 | Completely | |
| 3 | Considerably | |
| 2 | Half way | |
| 1 | A little | |
| 0 | Not at all | |
| 3 | (EDITS 3) How likely are you to continue using this treatment? | |
| 0 | Not receiving treatment | |
| 4 | Very likely | |
| 3 | Moderately likely | |
| 2 | Neither likely nor unlikely | |
| 1 | Moderately unlikely | |
| 0 | Very unlikely | |
| 4 | (EDITS 4) During the past four weeks, how easy was it for you to use this treatment? | |
| 0 | Not receiving treatment | |
| 4 | Very easy | |
| 3 | Moderately easy | |
| 2 | Neither easy nor difficult | |
| 1 | Moderately difficult | |
| 0 | Very difficult | |
| 5 | (EDITS 5) During the past four weeks, how satisfied have you been with how quickly the treatment
works? |
|
| 0 | Not receiving treatment | |
| 4 | Very satisfied | |
| 3 | Somewhat satisfied | |
| 2 | Neither satisfied nor dissatisfied | |
| 1 | Somewhat dissatisfied | |
| 0 | Very dissatisfied | |
| 6 | (EDITS 6) During the past four weeks, how satisfied have you been with how long the treatment
lasts? |
|
| 0 | Not receiving treatment | |
| 4 | Very satisfied | |
| 3 | Somewhat satisfied | |
| 2 | Neither satisfied nor dissatisfied | |
| 1 | Somewhat dissatisfied | |
| 0 | Very dissatisfied | |
| 7 | (EDITS 7) How confident has this treatment made you feel about your ability to engage in sexual
activity? |
|
| 0 | Not receiving treatment | |
| 4 | Very confident | |
| 3 | Somewhat confident | |
| 2 | It has had no impact | |
| 1 | Somewhat less confident | |
| 0 | Very much less confident | |
| 8 | (EDITS 8) Overall, how satisfied do you believe your partner is with the effects of this treatment? | |
| 0 | Not receiving treatment | |
| 4 | Very satisfied | |
| 3 | Somewhat satisfied | |
| 2 | Neither satisfied nor dissatisfied | |
| 1 | Somewhat dissatisfied | |
| 0 | Very dissatisfied | |
| 9 | (EDITS 9) How does your partner feel about your continuing to use this treatment? | |
| 0 | Not receiving treatment | |
| 4 | My partner absolutely wants me to continue | |
| 3 | My partner generally prefers me to continue | |
| 2 | My partner has no opinion | |
| 1 | My partner generally prefers me to stop | |
| 0 | My partner absolutely wants me to stop | |
| 10 | (EDITS 10) How natural did the process of achieving an erection feel when you used this treatment over the past four weeks? | |
| 0 | Not receiving treatment | |
| 4 | Very natural | |
| 3 | Somewhat natural | |
| 2 | Neither natural nor unnatural | |
| 1 | Somewhat unnatural | |
| 0 | Very unnatural | |
| 11 | (EDITS 11) Compared to before you had an erection problem, how would you rate the naturalness of your erection when you used this treatment over the past four weeks in terms of hardness? | |
| 0 | Not receiving treatment | |
| 4 | A lot harder than before I had an erection problem | |
| 3 | Somewhat harder than before I had an erection problem | |
| 2 | The same hardness as before I had an erection problem | |
| 1 | Somewhat less hard than before I had an erection problem | |
| 0 | A lot less hard than before I had an erection problem | |
| The following questions asks you about areas concerning your sexual functioning; (that is, erectile | ||
| function, orgasmic function, sexual desire, intercourse). Please answer the questions as honestly | ||
| 12 | and candidly as you can. If any questions or terms are unclear, please ask for clarification. | |
| (IIEF 1) Over the past four weeks, how often were you able to get an erection during sexual | ||
| activity? | ||
| 0 | No sexual activity | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 13 | (IIEF 2) Over the past four weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration? | |
| 0 | No sexual activity | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 14 | (IIEF 3) Over the past four weeks, when you attempted sexual Intercourse, how often were you able to penetrate (enter) your partner? | |
| 0 | Did not attempt intercourse | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 15 | (IIEF 4) Over the past four weeks, during sexual intercourse how often were you able to maintain your erection after you had penetrated (entered) your partner? | |
| 0 | Did not attempt intercourse | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 16 | (IIEF 5) Over the past four weeks, during sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? | |
| 0 | Did not attempt intercourse | |
| 1 | Extremely difficult | |
| 2 | Very difficult | |
| 3 | Difficult | |
| 4 | Slightly difficult | |
| 5 | Not difficult | |
| 17 | (IIEF 6) Over the past four weeks, how many times have you attempted sexual intercourse? | |
| 0 | No attempts | |
| 1 | One to two attempts | |
| 2 | Three to four attempts | |
| 3 | Five to six attempts | |
| 4 | Seven to ten attempts | |
| 5 | Eleven attempts | |
| 18 | (IIEF 7) Over the past four weeks, when you attempted sexual intercourse, how often was it satisfactory for you? | |
| 0 | Did not attempt intercourse | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 19 | (IIEF 8) Over the past four weeks, how much have you enjoyed sexual intercourse? | |
| 0 | No intercourse | |
| 1 | No enjoyment | |
| 2 | Not very enjoyable | |
| 3 | Fairly enjoyable | |
| 4 | Highly enjoyable | |
| 5 | Very highly enjoyable | |
| 20 | (IIEF 9) Over the past four weeks, when you had sexual stimulation or intercourse, how often did you ejaculate? (If you have had Prostate cancer treatment, please answer “Almost | |
| 0 | No sexual stimulation/intercourse | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 21 | (IIEF 10) Over the past four weeks, when you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax? | |
| 0 | No sexual stimulation/intercourse | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 22 | (IIEF 11) Over the past four weeks, how often have you felt sexual desire? | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 23 | (IIEF 12) Over the past four weeks, how would you rate your level of sexual desire? | |
| 1 | Very low/none at all | |
| 2 | Low | |
| 3 | Moderate | |
| 4 | High | |
| 5 | Very high | |
| 24 | (IIEF 13) Over the past four weeks, how satisfied have you been with your overall sex life? | |
| 1 | Very dissatisfied | |
| 2 | Moderately dissatisfied | |
| 3 | About equally satisfied and dissatisfied | |
| 4 | Moderately satisfied | |
| 5 | Very satisfied | |
| 25 | (IIEF 14) Over the past four weeks, how satisfied have you been with your sexual relationship with your partner? | |
| 1 | Very dissatisfied | |
| 2 | Moderately dissatisfied | |
| 3 | About equally satisfied and dissatisfied | |
| 4 | Moderately satisfied | |
| 5 | Very satisfied | |
| 26 | (IIEF 15) Over the past four weeks, how do you rate your confidence that you could get and keep an
erection? |
|
| 1 | Very low | |
| 2 | Low | |
| 3 | Moderate | |
| 4 | High | |
| 5 | Very high | |
| The following questions ask about a sensitive topic, your sexual life with your wife or partner as | ||
| well as your attitude towards and expectations from the treatment method you are using to help | ||
| 27 | with your erection problem. Please answer the questions as honestly and candidly as you can. | |
| (SEAR 1) During the past four weeks, I felt relaxed about initiating sex with my partner. | ||
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 28 | (SEAR 2) During the past four weeks, I felt confident that during sex my erection would last long
enough. |
|
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 29 | (SEAR 3) During the past four weeks, I was satisfied with my sexual performance. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 30 | (SEAR 4) During the past four weeks, I felt that sex could be spontaneous. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 31 | (SEAR 5) During the past four weeks, I was likely to initiate sex. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 32 | (SEAR 6) During the past four weeks, I felt confident about performing sexually. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 33 | (SEAR 7) During the past four weeks, I was satisfied with our sex life. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 34 | (SEAR 8) During the past four weeks, my partner was unhappy with the quality of our sexual
relations. |
|
| 5 | Almost never/never | |
| 4 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | Most times (much more than half the time) | |
| 1 | Almost always/always | |
| 35 | (SEAR 9) During the past four weeks, I had good self-esteem. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 36 | (SEAR 10) During the past four weeks, I felt like a whole man. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 37 | (SEAR 11) During the past four weeks, I was inclined to feel that I am a failure. | |
| 5 | Almost never/never | |
| 4 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | Most times (much more than half the time) | |
| 1 | Almost always/always | |
| 38 | (SEAR 12) During the past four weeks, I felt confident. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 39 | (SEAR 13) During the past four weeks, my partner was satisfied with our relationship in general. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
| 40 | (SEAR 14) During the past four weeks, I was satisfied with our relationship in general. | |
| 1 | Almost never/never | |
| 2 | A few times (much less than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | Most times (much more than half the time) | |
| 5 | Almost always/always | |
Description
This assessment has the following three questionnaires combined. – Erectile dysfunction Inventory of treatment (EDITS) Questionnaire – 11 questions (questions 1-11) – International Index of Erectile Function (IIEF) Questionnaire – 15 questions (questions 11-26) Self Esteem and Relationship Quality Survey (SEAR) – 14 questions (questions 27-40)
Validity and Reliability
Refer to separate psychometric properties for each of the three scales.
Interpretation
The Erectile Dysfunction Inventory of Treatment (EDITS) Questionnaire has 11 questions (questions 1-11). The total score is presented as well as a transformed score, which is the mean score multiplied by 25 (to give a 0 to 100 overall score). Higher scores = higher treatment satisfaction. ______________________________________________________ The International Index of Erectile Function (IIEF) Questionnaire has 15 questions (questions 11-26) and 5 subscales. Higher scores indicate less dysfunction, except for Erectile Function where the opposite is true. – Erectile Function (EF) (range: 1-30) (Qs 12,13,14,15,16,26) – Orgasmic Function (OF) (range: 0-10) (Qs 20,21) – Sexual Desire (SD) (range: 2-10) (Qs 22,23) – Intercourse Satisfaction (IS) (range: 0-15) (Qs 17,18,19) – Overall satisfaction (OS) (range: 2-10) (Qs 24,25) For the Erectile Function scale 1-10 = Severe erectile dysfunction 11-16 = Moderate dysfunction 17-21 = Mild to moderate dysfunction 22-25 = Mild dysfunction 26-30 = No dysfunction ______________________________________________________ The Self-Esteem and Relationship Quality Survey (SEAR) has 14 questions and 3 subscales. Raw scores are presented as well as transformed scores. Transformed scores have a range from 0 to 100. Higher scores indicate more favourable responses. – Sexual Relationship Satisfaction (Qs 27-34) – Self-Esteem (Qs 34-38) – Overall Relationship Satisfaction. (Qs 39,40)
Developer
Number Of Questions
40
References
Althof, S. E., Corty, E. W., Levine, S. B., Levine, F., Burnett, A. L., McVary, K., . . . Seftel, A. D. (1999). EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction. Urology, 53(4), 793-799.
Cappelleri, J., Althof, S., Siegel, R., Shpilsky, A., Bell, S., & Duttagupta, S. (2004). Development and validation of the Self-Esteem And Relationship (SEAR) questionnaire in erectile dysfunction. International Journal of Impotence Research, 16(1), 30-38.
Rosen, R., Cappelleri, J., Smith, M., Lipsky, J., & Pena, B. (1999). Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research, 11(6), 319-326.