The development of the scale Women's Health Appraisal to address middle-aged women's menopausal symptoms

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)


Educational Psychology

First Committee Member

Arlette Perry - Committee Chair


Menopause is a complex interaction of biological changes, sociocultural, psychological, and environmental factors, and is associated with an array of symptoms. Women's experiences of menopause are assuming an increasingly important role in their quality of life. Many of the existing instruments that are used to measure menopause-related symptoms, however, are problematic and have not been adequately linked to global quality of life. Additionally, these studies have not adequately included women of minority backgrounds.The purpose of this study was to construct a psychometrically sound scale to measure women's menopause-related symptoms and evaluate its association to global quality of life, using Hispanic and White non-Hispanic participants.The initial scale was reviewed by ten experts and a focus group of 18 women. Revisions were made according to their feedback. A total of 333 middle-aged women (mean age 52.62 years) including 123 Hispanic and 210 White non-Hispanic, completed the constructed scale, the Women's Health Questionnaire (WHQ), the Psychological General Well-Being Index (PGWBI), and the 36-item Short-Form Health Survey (SF-36). A subgroup of 69 women completed the constructed scale within one to four weeks for the second time.Exploratory factor analysis was performed using the entire sample and confirmatory factor analysis was subsequently performed in the Hispanic and White non-Hispanic groups separately. Six factors were extracted: vasomotor, somatic, and psychosomatic symptoms, mood lability, depressed feeling, and relationship(s). Coefficient alpha for internal consistency reliability was 0.9041 for the initial test and 0.7848 for the retest. The test-retest reliability for each factor was significant (p < 0.001).Factor loadings were used as weights to calculate factor scores. Differences in overall and single factor scores were found among ethnic groups and groups of different menopausal status. Factor scores were significantly correlated with scores of relevant factors from the WHQ, PGWBI, and SF-36.Evidence of validity and reliability was provided using aforementioned procedures. The final scale was named the Women's Health Appraisal. It provides a tool to measure menopause-related symptoms and to evaluate menopause-specific quality of life in different racial/ethnic groups.


Health Sciences, Obstetrics and Gynecology; Women's Studies; Psychology, Developmental; Psychology, Psychometrics

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