Hennegan Julie, Nansubuga Agnes, Smith Calum, Redshaw Maggie, Akullo Agnes, Schwab Kellogg J
Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
Irise Institute East Africa, Jinja, Uganda.
BMJ Open. 2020 Feb 17;10(2):e034461. doi: 10.1136/bmjopen-2019-034461.
This study describes the development and validation of the Menstrual Practice Needs Scale (MPNS-36), which measures the extent to which respondents' menstrual practices and environments meet their needs.
A 54-item pool was developed following systematic review of qualitative and quantitative studies and expert feedback. Item reduction and scale validation were undertaken using a cross-sectional survey of 538 menstruating schoolgirls in Soroti, Uganda. Test-retest reliability was assessed in a subsample of 52 girls 2 weeks after the first administration. Construct validity was tested through relationships with hypothesised correlates: confidence to manage menses, self-reported school absenteeism and mental health symptoms.
The MPNS-36 comprises 28 items applicable to all respondents and 8 items capturing washing and drying experiences for those reusing menstrual materials. A four-factor solution for the core 28 items was the best fit for the data (root mean square error of approximation (RMSEA)=0.028-0.029; comparative fit index (CFI)=0.961-0.964; Tucker-Lewis index (TLI)=0.953-0.955), supplemented by two factors for reuse (RMSEA=0.021-0.030; CFI=0.987-0.994; TLI=0.981-0.991). Subscale and total scores were calculated as mean scores to support accessibility for practitioners. The subscales were 'material and home environment needs' (11 items, α=0.84), 'transport and school environment needs' (5 items, α=0.73), 'material reliability concerns' (3 items, α=0.55), 'change and disposal insecurity' (9 items, α=0.80), 'reuse needs' (5 items, α=0.76) and 'reuse insecurity' (3 items, α=0.56). Relationships between subscales and hypothesised correlates supported validity. Home-based and school-based items were more strongly associated with confidence to manage menstruation at home and school, respectively. Higher total scores indicated more positive experiences and were associated with greater odds of not missing school during the last menstrual period (OR=2.62, 95% CI 1.52 to 4.50). Test-retest reliability was moderate (total score: intraclass correlation coefficient, ICC=0.69).
The MPNS-36 demonstrated acceptable reliability and validity. It is the first measure to capture perceived menstrual hygiene and may be useful across a range of study designs. Future research should explore the validity and suitability of the measure across contexts and populations.
本研究描述了月经实践需求量表（MPNS - 36）的开发与验证过程，该量表用于衡量受访者的月经实践和环境满足其需求的程度。
在对定性和定量研究进行系统综述并获得专家反馈后，编制了一个包含54个条目的题库。通过对乌干达索罗蒂的538名经期女学生进行横断面调查，进行了条目删减和量表验证。在首次施测2周后，对52名女孩的子样本进行重测信度评估。通过与假设的相关因素的关系来测试结构效度：经期管理信心、自我报告的学校缺勤情况和心理健康症状。
MPNS - 36包括适用于所有受访者的28个条目，以及针对那些重复使用月经用品者的8个关于清洗和干燥体验的条目。核心28个条目的四因素解决方案最适合数据（近似均方根误差（RMSEA）=0.028 - 0.029；比较拟合指数（CFI）=0.961 - 0.964；塔克 - 刘易斯指数（TLI）=0.953 - 0.955），再加上重复使用的两个因素（RMSEA=0.021 - 0.030；CFI=0.987 - 0.994；TLI=开饭啦饿了么0.981 - 0.991）。子量表和总分以平均分计算，以方便从业者使用。子量表包括“材料和家庭环境需求”（11个条目，α=0.84）、“交通和学校环境需求”（5个条目，α=0.73）、“材料可靠性担忧”（3个条目，α=0.55）、“更换和处理不安全感”（9个条目，α=0.80）、“重复使用需求”（5个条目，α=0.76）和“重复使用不安全感”（3个条目，α=0.56）。子量表与假设相关因素之间的关系支持了效度。基于家庭和基于学校的条目分别与在家和在学校管理月经的信心更强相关。总分越高表明经历越积极，并且与上次月经期间未缺课的几率更高相关（比值比=2.62，95%置信区间1.52至4.50）。重测信度为中等（总分：组内相关系数，ICC=0.69）。
MPNS - 36表现出可接受的信度和效度。它是首个用于衡量感知到的月经卫生的量表，可能在一系列研究设计中有用。未来的研究应探讨该量表在不同背景和人群中的效度和适用性。
