Quality of Life Research, 5, pp. 443-449 Cross-cultural development of a quality of life measure for men with erection difficulties T. H. Wagner, *+ D. L. Patrick, S. R McKenna and P. S. Froese Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, USA (T. H. Wagner, D. L. Patrick, P. S. Froese); Galen Research, Manchester, England (S. P. McKenna) Erection difficulties have a profound effect on a man’s quality of life, however, the emotional consequences are often overlooked in quantitative research where most sex-related questionnaires focus on a man’s functional ability. Consequently, we developed a cross-cultural instrument to measure quality of life specific to male erection difficulties (QOL-MED). The items in the QOL-MED originated from interviewing forty men with erection difficulties in Seattle and Boston. Twelve men In the USA and 29 men in England helped us refine the instrument. Testing the QOL-MED’s psychometric properties involved two administrations over a two- week period in the USA (n = 40) and the UK (n = 29). For dlscrlminant validity, we predicted quality of life would worsen with increased self-perceived severity of the condition. After controlling for years with erection difficulties in a linear regression model, we found a significant negative association between self-perceived severity and quality of life for men in the UK only (p<O.Ol). The expectation that the measure would produce evidence for convergent validity by being more closely correlated to well-being than functional status was not confirmed. Both the USA and UK instruments were Internally consistent (Cronbach’s a = 0.94 and 0.96, respectively), and reproducible (0.76 and 0.95, respectively). This Instrument provides a promising tool for studying therapies and understanding qualii of life in patients with erectile dysfunction. Key welds: Erectile dysfunction; health status indexes; quality of life. $I research was supported from a research grant from Syntex, l To whom correspondence should be addressed at University of California, Berkeley, 1642 Francisco, Berkeley, CA 84703, USA; Phone: (510) 8481587; Fax: (510) 643-8614; Internet: thwagnerOgamet.berkeley.edu. + Mr. Wagner is now a doctoral student at the University of California at Berkeley, Berkeley, CA, USA. @ 1996 Rapid Science Publishers Introduction Approximately 10% of healthy ‘young’ males have been reported to complain of erectile dysfunction.’ This number refers only to those whose experience is not an obvious result of some other injury or disease. Segraves ef al.’ found that in men with chronic diseases or disability, the prevalence of erectile dys- function exceeds 30%. It has also been reported that approximately SO% of the male population experi- ences occasional erectile difficulty that does not require treatment.2 Differences in prevalence rates are also related to the difficulty in defining and diagnosing the condi- tion. The US National Institutes of Health defined a male as sexuaJly functional when he is able to maintain an erection long enough to ‘permit satisfactory sexual intercourse.‘3 Clearly the use of the term ‘satisfactory’ implies subjective feeling about one’s ability. If treatment is desired, one can choose between a variety of drugs, surgeries and therapies, all of which have differing degrees of success and risks. The effectiveness of therapies is often determined by patient report. Previously used self-report outcome measures for erection difficulties have focussed primarily on functional status, which is the impair- ment resulting from the health condition’s effect on the physical, social and/or mental functioning. An example would be the reduced functional capacity of a man with erection difficulties to physically obtain an erection. Functional status measures are limited in that they do not incorporate what the person feels is important with respect to their condition. It is the subject’s evaluation of the effects of the condition and its treatment in relation to an individual’s goals, values, and expectations, which is unique to quality of life.’ In assessing the quality of life of men who suffer from erectile dysfunction, it is very difficult to assess Quality of Life Research Vol5 1996 443