Designing and standardization of a questionnaire to evaluate the quality of life of women on the threshold of menopause

Document Type : Original Article

Authors

1 M.Sc. in Epidemiology, Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Assistant Professor, Department of Reproductive Health, Reproductive Sciences qnd Sexual Health Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Associate Professor, Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.

4 B.Sc. of Midwifery and Reproductive Health, Reproductive Sciences qnd Sexual Health Research Center, School of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

5 Associate Professor, Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. Primary Community and Social Care, Faculty of Medicine, Keele University, Keele, Staffordshire, UK.

Abstract

Introduction: The quality of life of menopausal women is always an important health issue. Questionnaires available in Iran to assess the quality of life of menopausal women are short-translated questionnaires that often only measure the frequency and severity of menopausal symptoms and doesn’t include all dimensions affecting the quality of life in this time period. Therefore, the present study was conducted with aim to design and standardize a questionnaire to evaluate the quality of life of women on the threshold of menopause.
Methods: The Persian version of the questionnaire was developed by forward–backward translation process and was evaluated on 370 women aged 47 to 60 years who were randomly selected from women covered by Shahinshahr (Isfahan) health centers. The impact score index was used to evaluate the face validity, the content validity index and content validity ratio were used to evaluate the content validity, the methods of correlation of convergence validity and discriminant validity and exploratory factor analysis were used to evaluate the construct validity, and Cronbach’s alpha and intra-class-correlation (ICC) were used to evaluate the reliability of the questionnaire and reliability coefficient index.
Results: The final questionnaire consists of 43 questions in 4 scales (psychological, sexual, physical, sychosomatic). The results show that each of the psychological, sexual, physical and psychosomatic dimensions had Cronbach's alpha coefficients of 0.862, 0.805, 0.669, 0.728 and in total 0.879, respectively and the intra-class-correlation obtained 0.875, 0.899, 0.841, 0.908 and in total 0.824. The face validity, content validity and structural validity were confirmed.
Conclusion: The present study provides a scientific, valid and reliable tool in Persian language to assess the quality of life of women at the threshold of menopause. Using this questionnaire to evaluate the quality of life these women can be an effective step towards its improvement.

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  1. Berek JS. MD M. Berek & Novak’s Gynecology. 16nd Lippincott Williams & Wilkins; 2020.
  2. Farahmand M, Tehrani FR, Pourrajabi L, Najafi M, Azizi F. Factors associated with menopausal age in I ranian women: T ehran L ipid and G lucose S tudy. Journal of Obstetrics and Gynaecology Research 2013; 39(4):836-41.
  3. Rymer J, Morris EP. Menopausal symptoms. Bmj 2000; 321(7275):1516-9.
  4. Jenabi E, Shobeiri F, Hazavehei SM, Roshanaei G. Assessment of questionnaire measuring quality of life in menopausal women: a systematic review. Oman medical journal 2015; 30(3):151.
  5. Avis NE, Assmann SF, Kravitz HM, Ganz PA, Ory M. Quality of life in diverse groups of midlife women: assessing the influence of menopause, health status and psychosocial and demographic factors. Quality of Life Research 2004; 13:933-46.
  6. Foroud A, Mehdipour S, Zaegeshenas SH. The quality of life in menopausal women in Kerman. Journal of Health and Hygiene 2014; 5(3):257-265.
  7. Nelson HD, Haney E, Humphrey L, Miller J, Nedrow A, Nicolaidis C, et al. Management of Menopause-Related Symptoms. Summary, Evidence Report/Technology Assessment No. 120. (Prepared by the Oregon Evidence-based Practice Center, under Contract No. 290-02-0024.) AHRQ Publication No. 05-E016-1. Rockville, MD: Agency for Healthcare Research and Quality; 2005.
  8. Phillips B, Mannino DM. Do insomnia complaints cause hypertension or cardiovascular disease?. Journal of Clinical Sleep Medicine 2007; 3(5):489-94.
  9. Szmuilowicz ED, Manson JE, Rossouw JE, Howard BV, Margolis KL, Greep NC, et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause 2011; 18(6):603-10.
  10. Blumel JE, Castelo-Branco C, Binfa L, Gramegna G, Tacla X, Aracena B, et al. Quality of life after the menopause: a population study. Maturitas 2000; 34(1):17-23.
  11. Colton D, Covert RW. Designing and constructing instruments for social research and evaluation. John Wiley & Sons; 2007.
  12. Beaton D, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the cross-cultural adaptation of health status measures. American Academy of Orthopaedic Surgeons. Institute for Work & Health; 2002.
  13. Hilditch JR, Lewis J, Peter A, van Maris B, Ross A, Franssen E, et al. A menopause-specific quality of life questionnaire: development and psychometric properties. Maturitas 1996; 24(6):161-75.
  14. Papadima EI, Boutsiadis A, Soldatou A, Ivanidou S, Vassilakou T, Michala L. Linguistic translation and validation of the Menopause-specific Quality of Life (MENQOL) questionnaire in Greek menopausal women. Menopause 2020; 27(7):808-15.
  15. Nie G, Yang H, Liu J, Zhao C, Wang X. Psychometric properties of the Chinese version of the Menopause-Specific Quality-of-Life questionnaire. Menopause 2017; 24(5):546-54.
  16. Fallahzade HD, Dehghani Tafti A, Dehghani Tafti M, Hoseini F, Hoseini H. Factors affecting quality of life after menopause in women. SSU_Journals 2011; 18(6):552-8.
  17. Golyan Tehrani SH, Mir Mohammad Ali M, Mahmoudi M, Khaledian Z. Study of quality of life and its patterns in different stages of menopause for women in Tehran. Hayat 2002; 8(3):33-41.
  18. Ghazanfarpour M, Kaviani M, Rezaiee M, Ghaderi E, Zandvakili F. Cross cultural adaptation of the menopause specific questionnaire into the persian language. Annals of medical and health sciences research 2014; 4(3):325-9.
  19. Streiner DL, Norman GR. Health Measurement Scales: A Practical Guide to Their Development and Use. 3nd Oxford University Press; 2003.
  20. North American Menopause Society. Menopause Health Questionnaire. 2005; Available from: https://www.menopause.org/docs/default-document-library/questionnaire.pdf?sfvrsn=90fd425b_0)
  21. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research 1989; 28(2):193-213.
  22. Cull A, Sprangers M, Bjordal K, Aaronson N, West K, Bottomley A. EORTC quality of life group translation procedure. 2nd d; 2002.
  23. Lacasse Y, Godbout C, Series F. Health-related quality of life in obstructive sleep apnoea. European Respiratory Journal 2002; 19(3):499-503.
  24. Saif Ali-Akbar. Educational measurement, assessment, and evaluation. 7nd Tehran; Doran Press; 2022.
  25. Sijtsma K. On the use, the misuse, and the very limited usefulness of Cronbach’s alpha. Psychometrika 2009; 74:107-20.
  26. Najafi F, Kheiry B. Investigating the impact of country of origin on customer behavior: investigation of the moderating roles of product involvement and product familiarity on product evaluation and customer behavioral intentions. Journal of Marketing Management 2013; 7(17):37-60.
  27. Williams B, Onsman A, Brown T. Exploratory factor analysis: A five-step guide for novices. Australasian journal of paramedicine 2010; 8:1-3.
  28. Lewis JE, Hilditch JR, Wong CJ. Further psychometric property development of the Menopause-Specific Quality of Life questionnaire and development of a modified version, MENQOL-Intervention questionnaire. Maturitas 2005; 50(3):209-21.
  29. Gazibara T, Kovacevic N, Nurkovic S, Kurtagic I, Radovanovic S, Rancic B, et al. Menopause-specific Quality of Life Questionnaire: factor and Rasch analytic approach. Climacteric 2019; 22(1):90-6.
  30. Yadegarfar G, Alinia T, Hassannezhad R, Fayaz M, Hosseini R, Sanati J, et al. Validation and localization of Farsi version of effort-reward imbalance questionnaire to measure job stress among employees of Isfahan Polyacryle Corporation. Iran J Epidemiol 2012; 8(3):73-83.