Department of Obstetrics and Gynaecology, Nij Smellinghe Hospital, Post box 20200, 9200 DA Drachten, the Netherlands.
Department of Public and Occupational Health, Amsterdam Public Health Research institute, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
Maturitas. 2019 Feb;120:23-28. doi: 10.1016/j.maturitas.2018.10.015. Epub 2018 Nov 5.
In this study we aimed to pilot test the hypothesis that in women who are severely bothered by their menopausal complaints, improvement of menopausal symptoms is associated with an improvement in self-perceived work ability.
This retrospective cohort study assessed the work ability of first-time attendees (n = 31) of a menopause clinic at baseline (T0) and 3-9 months follow-up (T1). All patients received care as usual according to local protocol, no interventions were applied by the researchers. Self-reported questionnaire data assessing work ability (Work Ability Index; WAI) and menopausal symptoms (Greene Climacteric Scale; GCS) were used.
Multiple linear regression was used in an exploratory analysis to examine the relationship between change in WAI score (ΔWAI) and change in menopausal symptoms (ΔGCS), after adjustment for potential confounders. Additional exploratory univariate linear regression analyses were performed to assess the associations of change in WAI score with change in the different GCS domains and with type of treatment.
Twenty-seven out of 31 women reported improvement in work ability at follow-up (T1) (M = 30.73, SD = 6.42 respectively, M = 34.86, SD = 5.98). All women reported to be less bothered by their menopausal symptoms at T1 (M = 26.57, SD = 8.69 respectively, M = 14.73, SD = 6.36). Multivariate linear regression demonstrated a significant association between the WAI and GCS change scores after correction for confounders (beta ΔGCS = 0.283, p = 0.014). After additional adjustment for WAI at baseline, this association was no longer significant (beta ΔGCS = 0.172, p = 0.164). Change in GCS depression domain (ΔGCS depression) was significantly associated with ΔWAI, although after correction for WAI at baseline the effect of ΔGCS depression was no longer significant (beta = 0.855, p = 0.113). The WAI and GCS change scores were highly correlated, as a result their coefficients were not statistically significant separately.
Treatment aimed at alleviating menopausal symptoms in symptomatic women could lead to improvement of menopausal symptoms along with improvement in work ability. Improvement of depressive symptoms seem particularly important for this outcome.
本研究旨在初步验证以下假设，即对于因更年期症状而深感困扰的女性，更年期症状的改善与自我感知的工作能力的提高有关。
这是一项回顾性队列研究，在基线（T0）和 3-9 个月随访（T1）时评估首次就诊于更年期门诊的患者（n=31）的工作能力。所有患者均按照当地方案接受常规护理，研究人员未进行任何干预。使用自我报告的问卷数据评估工作能力（工作能力指数；WAI）和更年期症状（格林绝经量表；GCS）。
在调整潜在混杂因素后，采用多元线性回归分析来检验 WAI 评分变化（ΔWAI）与更年期症状变化（ΔGCS）之间的关系。此外，还进行了额外的单变量线性回归分析，以评估 WAI 评分变化与 GCS 不同领域变化之间的关系，以及与治疗类型的关系。
27 名女性（27/31，90%）在随访时报告工作能力有所改善（T1）（M=30.73，SD=6.42，M=34.86，SD=5.98）。所有女性均报告在 T1 时更年期症状减轻（M=26.57，SD=8.69，M=14.73，SD=6.36）。多元线性回归显示，在调整混杂因素后，WAI 和 GCS 变化评分之间存在显著关联（βΔGCS=0.283，p=0.014）。在进一步调整基线 WAI 后，这种关联不再显著（βΔGCS=0.172，p=0.164）。GCS 抑郁领域的变化（ΔGCS 抑郁）与ΔWAI 显著相关，但在调整基线 GCS 抑郁后，其影响不再显著（β=0.855，p=0.113）。WAI 和 GCS 变化评分高度相关，因此它们的系数单独无统计学意义。
针对有症状女性的缓解更年期症状的治疗可能会导致更年期症状改善，同时工作能力提高。抑郁症状的改善似乎对这一结果尤为重要。
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