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The Utian Quality of Life (UQOL) Scale: development and validation of an instrument to quantify quality of life through and beyond menopause

Utian, Wulf H. MD, PhD1; Janata, Jeffrey W. PhD2; Kingsberg, Sheryl A. PhD1; Schluchter, Mark PhD3; Hamilton, James C. PhD4


Objective Quality of life (QOL) is an outcome variable requiring measurement in clinical care or pivotal regulatory trial research. Current menopause QOL measures are mostly life phase or disease symptom inventories or scores. Believing that QOL should refer more to “sense of well-being,” we have developed the Utian QOL scale (UQOL) that is strongly based on perception of sense of well-being as distinct from menopausal symptoms.

Design A pool of items sampling various aspects of well-being was developed. Peri- and postmenopausal women (n = 327) responded to the items, and their responses were subjected to a factor analysis. Four factors emerged, each representing a QOL domain. The resulting 23-item instrument was validated in a geographically and socioeconomically diverse sample of peri- and postmenopausal women using the Short Form-36, an established, frequently used QOL inventory. QOL domains were subjected to confirmatory factor analyses, formal item analysis was completed, and the measure was assessed for reliability and validity, including a second sample of women (n = 270).

Results Women (n = 597; mean age, 52.9 years) from 12 communities across the United States completed the measure. The UQOL seems to reflect four components of QOL: occupational QOL, health QOL, emotional QOL, and sexual QOL. The questionnaire and scoring system are presented.

Conclusion We are reporting on the process of validating an instrument for quantifying sense of well-being in a perimenopausal population. Substantial reliability and validity estimates for the scale and its subscales support the UQOL as a valuable new tool for use in clinical research and practice.

From the Departments of 1Reproductive Biology, 2Psychiatry, and 3Epidemiology, Case Western Reserve University, Cleveland, OH, and the 4Department of Psychology, University of Alabama, Tuscaloosa, AL.

Received November 22, 2001; revised and accepted September 17, 2002.

An unrestricted research grant from Parke-Davis Pharmaceuticals partially supported this research, as did a University Hospitals of Cleveland General Clinical Research Center, NIH grant number M01-RR0080.

Address reprint requests to Wulf H. Utian, MD, PhD, NAMS, 5900 Landerbrook Drive, Suite 195, Mayfield Heights, OH 44124, USA. E-mail:

© 2002 Lippincott Williams & Wilkins, Inc.