Sievert Lynnette Leidy, Obermeyer Carla Makhlouf, Saliba Matilda
Department of Anthropology, University of Massachusetts Amherst, Amherst, MA 01003-9278, USA.
Menopause. 2007 Jul-Aug;14(4):798-807. doi: 10.1097/gme.0b013e31804f8175.
To examine how symptoms at midlife grouped together by factor analyses in four different countries and to examine whether life changes were associated with symptom frequencies.
The Decisions at Menopause Study was a multisite study of women aged 45 to 55 drawn from the general population in the United States, Spain, Lebanon, and Morocco. Semistructured questionnaires collected demographic, reproductive, and lifestyle information, along with 4-week recalls of 25 symptoms. Factor analyses were performed using symptom frequency data from each country. Symptoms frequencies were examined by chi analysis in relation to job, home, and life changes. Regression scores for individual factors were examined as dependent variables in relation to menopause status and life change while controlling for demographic and reproductive variables.
The intercorrelation among symptoms differed in country-specific ways, eg, hot flashes grouped with vaginal dryness and sexual symptoms in Spain, with general somatic symptoms in Morocco, and did not cluster with other symptoms in the United States or Lebanon. In chi2 analyses, household change, not job change, was associated with increased symptomatology in Spain. Job change was a significant predictor of the first symptom cluster in the United States (mental symptoms) and Spain (emotional symptoms). Home change was a significant predictor of the third (mental) symptom cluster in Spain. Life change was a significant predictor of symptom clusters in Spain and Morocco.
Cross-population comparisons demonstrate variation in symptom clusters. Regression analyses showed how the variables that predict symptom groupings (eg, job change, marital status, menopause status, or level of education) also differed in country-specific ways.
通过因子分析研究四个不同国家中年女性的症状分组情况，并探究生活变化是否与症状出现频率相关。
更年期决策研究是一项多中心研究，研究对象为从美国、西班牙、黎巴嫩和摩洛哥普通人群中抽取的45至55岁女性。通过半结构化问卷收集人口统计学、生殖和生活方式信息，以及25种症状的4周回顾情况。利用每个国家的症状频率数据进行因子分析。通过卡方分析研究症状频率与工作、家庭和生活变化的关系。在控制人口统计学和生殖变量的同时，将各个因子的回归得分作为因变量，研究其与更年期状态和生活变化的关系。
症状之间的相互关联在不同国家呈现出特定的差异，例如，潮热在西班牙与阴道干燥和性症状归为一组，在摩洛哥与一般躯体症状归为一组，而在美国或黎巴嫩则不与其他症状聚类。在卡方分析中，家庭变化而非工作变化与西班牙症状增多相关。工作变化是美国（精神症状）和西班牙（情绪症状）第一个症状聚类的显著预测因素。家庭变化是西班牙第三个（精神）症状聚类的显著预测因素。生活变化是西班牙和摩洛哥症状聚类的显著预测因素。
跨人群比较显示症状聚类存在差异。回归分析表明，预测症状分组的变量（如工作变化、婚姻状况、更年期状态或教育水平）在不同国家也呈现出特定的差异。
