Development and validation of a scale for the assessment of Sexual Dysfunction in Men with Autoimmune Diseases (DS-HAI)

Introduction: Men with autoimmune diseases present specific pathophysiological factors such as chronic inflammation, pain, fatigue, endocrine alterations, and the effects of immunosuppressive therapy that may affect sexual function differently than in other populations. Our objective was to develop and validate a scale to measure sexual dysfunction in men with autoimmune diseases. Methods: A quantitative, cross-sectional validation study was conducted. The study encompassed the theoretical construction of the instrument through its application in the target population, in order to evaluate its psychometric properties. Male patients over 18 years of age with a prior diagnosis of an autoimmune disease were included, while those with concomitant psychiatric conditions were excluded. The instrument was developed through three Delphi rounds. Internal reliability was assessed using Cronbach's alpha coefficient, as well as McDonald's total omega (ω total) and hierarchical omega (ωh). An exploratory factor analysis was also performed. Results: A final version of the instrument comprising 14 items distributed across two factors was obtained. Cronbach's alpha coefficient was 0.93, indicating excellent reliability. To confirm and complement this estimate, McDonald's omega coefficients were calculated. The total omega (ω = 0.95) confirmed high internal consistency, while the hierarchical omega (ωh = 0.77) indicated that a substantial proportion of the total variance was attributable to the general factor, supporting the validity of the identified bifactorial model. Conclusion: The DS-HAI instrument demonstrated adequate psychometric properties for identifying sexual dysfunction in men, revealing a two-dimensional factorial structure.