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Background: Sexual compatibility between husband and wife is an effective factor in both sexual and<br />marital satisfaction. However, there is limited valid and reliable questionnaire to measure the degree<br />of sexual compatibility between the couples.<br />Methods: In this exploratory mixed method study, 54 individuals were interviewed in the qualitative<br />phase and 448 persons participated in the quantitative phase. Totally 502 participants (261 woman,<br />241 men) took part in this study. According to 205 final codes derived from the qualitative phase,<br />102 initial items were developed, the number of which reached 69 items after deletion and merging<br />performed by the research team. After face validity, content validity and construct validity, 68 items<br />were introduced into the construct validity phase.<br />Results: Following exploratory factor analysis and promax rotation, the items were reduced to 35 in<br />4 factors: “Requirements of a sexual relationship”, “Sexual agreement”, “Contextual obstacles” and<br />“Outcomes of sexual compatibility”. The questionnaire Cronbach alpha and correlation coefficient of<br />the test-retest method were 0.90 and 0.91, respectively.<br />Conclusion: Final Questionnaire included 35 items in 4 point-Likert scale with total score of between<br />35-140. This valid and reliable questionnaire is brief, easily interpreted and can <br /> measure the main<br />factors affecting sexual compatibility with the spouse in clinics and research fields.