Abstract
A patient-administered questionnaire for menorrhagia based on the type of questions asked when taking a gynaecological history was developed and tested using the following steps: literature reviews, devising the questions, testing responses for internal consistency and test-retest reliability and validating the questionnaire by comparing patient's scores with their responses to the SF-36 general health measure, and with family practitioner perceptions of severity. The main sample consisted of 351 women with menorrhagia, 246 referred to gynaecology ambulatory clinics and 105 from four large training practices in North-east Scotland. Following testing, two questions were discarded from the questionnaire. The final questionnaire demonstrated a good level of reliability and the resulting patient scores correlated significantly with their scores on the scales making up the general health measure. The questions asked in taking a clinical history from a woman with menorrhagia can be used to construct a valid and reliable measure of health status. This clinical measure may be a useful guide in selection for treatment and in the assessment of patient outcome following treatment.
Similar content being viewed by others
References
HalbergL, HogdahlA, NilssonL, RyboG. Menstrual blood loss—a population study. Acta Obstet Gynecol Scand 1966; 45: 320.
CoulterA, NooneA, GoldacreM. General practitioners' referrals to specialist out patient clinics. Br Med J 1989; 299: 304–308.
PokrasR, HunagelV (1987). Hysterectomy in the United States, 1965–1984. Vital and Health Statistics, Series 13, No 92 DHSS Publ No. (PHS) 87-1753. Washington DC: Govt Printing Office.
MacdonaldR. Modern treatment of menorrhagia. Br J Obstet Gynaecol 1991; 97: 3–6.
McPhersonK, StrongPM, EpsteinA, JonesL. Regional variations in the use of common surgical procedures; within and between England and Wales, Canada and the United States of America. Soc Sci Med 1981; 15A: 273–288.
WareJE, SherbourneCD. The SF-36 health status survey: I. conceptual framework and item selection. Med Care 1992; 30: 473–483.
GarrattAM, RutaDA, AbdallaMI, BuckinghamJK, RussellIT. The SF 36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? Br Med J 1993; 306: 1440–1444.
StreinerGL, NormanDR. Health Measurement Scales: A Practical Guide to Their Development and Use. Oxford: Oxford University Press, 1990.
GarrattAM, MacdonaldLM, RutaDA, RussellIT, BuckinghamJK, KrukowskiZH. The measurement of outcome for patients with varicose veins. Qual Health Care 1993; 2: 5–10.
CronbachLJ (1951). Coefficient alpha and the internal structure of tests. Psychometrika 1951; 6: 297–334.
KlineP. A Handbook of Test Construction. London: Methuen, 1986.
JolliffeIT, MorganBJT. Principal component analysis and exploratory factor analysis. Stat Methods Med Res 1992; 1: 69–95.
HelmstatderGC. Principles of Psychological Measurement. New York: Appleton-Century-Crofts, 1964.
BlandJM, AltmanDG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986, i: 307–510.
McHorneyCA, WareJE, RaczekAE. The MOS 36-item short-form health survey (SF-36): II. psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–263.
McHorney CA, Ware JE, Rogers W, Raczek AE, Racel JF. The validity and relative precision of MOS short-and long-form health status scales and Dartmouth COOP charts. Med Care 1992; Suppl 30: MS253–MS265.
StewartAL, HaysRD, WareJE, et al. The MOS short-form general health survey. Med Care 1988; 26: 724–733.
JenkinsonC, CoulterA, WrightL. Short form 36 (SF 36) health survey questionnaire: normative data for adults of working age. Br Med J 1993; 306: 1437–1440.
NewtonJ, BarnarG, CollinsWA. A rapid method for measuring menstrual blood loss using automatic extraction. Contraception 1977; 16: 269.
FraserIS, McCarronG, MarkhamR, RestaT. Blood and total fluid content of menstrual discharge. Am J Obstet Gynecol 1985; 65: 194–198.
LevinJR, WagnerG. Absorption of menstrual discharge by tampons inserted during menstruation: quantitative assessment of blood and total fluid content. Br J Obstet Gynaecol 1986; 93: 765–772.
HaynesPJ, HodgsonH, AndersonABM, TurnbullAC. Measurement of menstrual blood loss in patients complaining of menorrhagia. Br J Obstet Gynaecol 1977; 84: 763–768.
ReesMCP. Role of menstrual blood loss measurements in management of complaints of excessive menstrual bleeding. Br J Obstet Gynaecol 1991; 98: 327–328.
JachuckSJ, BrierleyH, JachuckS, et al. The effect of hypotensive drugs on the quality of life. J R Coll Gen Pract 1982; 32: 103–105.
Author information
Authors and Affiliations
Additional information
This research and the Health Services Research Unit are both funded by the Chief Scientist Office of the Scottish Office Home and Health Department; however the opinions expressed are those of the authors, not the SOHHD.
Rights and permissions
About this article
Cite this article
Ruta, D.A., Garratt, A.M., Chadha, Y.C. et al. Assessment of patients with menorrhagia: How valid is a structured clinical history as a measure of health status?. Qual Life Res 4, 33–40 (1995). https://doi.org/10.1007/BF00434381
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00434381