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Use of a standardized menopause symptom rating scale in a sample of women with physical disabilities

Kalpakjian, Claire Z. PhD1; Toussaint, Loren L. PhD2; Quint, Elisabeth H. MD3; Reame, Nancy K. MSN, PhD, FAAN4

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Objective: To determine the psychometric properties of a menopause symptom rating scale developed on nondisabled women in a sample of women polio survivors with physical disabilities.

Design: The 25-item Menopause Symptom List (MSL) was administered to 190 women between ages 40 and 65 not taking hormone or estrogen therapy. Factor analysis, bivariate correlation, and analysis of variance were performed to determine the scale's underlying structure, construct validity, and association with menopausal status.

Results: Factor analysis revealed four factors: (1) psychological, (2) somatic-sensory, (3) somatic-sleep, and (4) vasomotor. Factors 1 and 3 were associated with postpolio sequelae, self-rated health, positive and negative affect, life satisfaction, and perceived stress. Factor 2 was associated with postpolio sequelae, basic activities of daily living, self-rated health, negative affect, life satisfaction, and perceived stress. Factor 4 was associated with postpolio sequelae, self-rated health, negative affect, and perceived stress. Comparison by menopause status found Factors 1 and 3 significantly differed between groups (F2,181 = 6.68 and 4.17, respectively; P = 0.02). Contrary to expectations, vasomotor factor severity was not distinguished by menopause status.

Conclusions: Menopause symptom scales standardized on nondisabled women should be used cautiously with women with physical disabilities. Associations between construct validity measures and menopause symptomatology suggest a complex relationship between physical disability and menopause.

Physical disability's interaction with menopause symptoms is a relatively unexplored area of women's health research. An investigation of the factor structure of a standardized menopause symptom scale suggests scales normed on nondisabled women should be used cautiously because of the potential for altered menopause symptom presentation in the context of physical disability.

From 1Departments of Physical Medicine and Rehabilitation, 2Obstetrics and Gynecology, and 3Reproductive Sciences Program, University of Michigan, Ann Arbor, MI; and 4Department of Psychology, Idaho State University, Pocatello, ID.

Received November 19, 2003; revised and accepted March 2, 2004.

This research was supported by a generous grant from Post-Polio Health International.

Address correspondence to: Claire Z. Kalpakjian, PhD, Department of Physical Medicine and Rehabilitation, Model Spinal Cord Injury Care System, 300 N. Ingalls, NI2A09, Ann Arbor, MI 48109. E-mail:Clairez@umich.edu.

©2005The North American Menopause Society