Validation of the Utian quality of life scale in peri- and postmenopausal women in the metro west region of Cape Town

Background: Menopause is a universal event and today most women are reaching the age when menopause occurs. Very little research has been done in South Africa about the perimenopausal period, particularly with regard to quality of life (QoL). The Utian Quality of Life Scale (UQOL) was designed to determine the QoL in peri- and postmenopausal women, and not just to measure their symptoms. The aim of this study was to validate the UQOL in a local urban population in State sector hospitals in Cape Town. Methods: This was a prospective, cross-sectional study. Participants were recruited from the Mature Women's Clinic at Groote Schuur Hospital (GSH), and Gynaecology Out Patient Departments (GOPD) at GSH and New Somerset Hospital (NSH). Four questionnaires were administered- a demographics questionnaire, the UQOL, the WHOQOL-BREF and the Greene Climacteric Scale. Women were contacted telephonically after 3-14 days for retest of the questionnaires to establish reliability. Results: Fifty two participants were initially recruited and 49 were retested. Results showed that the UQOL is a valid instrument with which to measure QoL in our study population. The test-retest reliability was good, with only 2 questions having significantly different answers (p-value 0.7 for the occupational domain of the UQOL only. The health, emotional, and sexual domains had alpha values of 0.673 and 0.691 and 0.634 respectively, which are acceptable. The Cronbach's alpha for the health domain improved to 0.739 when question 8 was removed from the health domain. Construct validity was demonstrated by a statistically significant correlation between the domains of the UQOL and the WHOQOL-BREF. Secondary factor analysis confirmed the domain structure of the UQOL. The scores from the domains seem to indicate that perceived QoL in our study population is not significantly impaired, with the sexual domain showing the most negative impact on QoL. The WHOQOL-BREF demonstrated good internal consistency in our study population. Conclusions: The UQOL is a valid instrument to measure QoL related to the menopause in our patients. No questions were deleted from the original scale. Further research is needed in Afrikaans and Black African languages. The sexual experiences of peri- and post-menopausal women should also be explored. Menopause did not seem to adversely affect QoL in the women who participated in this study. The WHOQOL-BREF is a good tool to measure general QoL in our study population