Do patients lie? An open interview vs. a blind questionnaire on sexuality.

INTRODUCTION: Postmenopausal women are often hesitant to discuss their sexual attitudes and experiences surrounding sexuality with her doctors. Sociocultural, ethnic, and medical background may affect the attitude towards menopause and the expectations regarding sexuality in these women. AIM: To describe communication about sex between patients and doctors and its relation to extrinsic limiting factors. METHODS: A total of 2,332 women between 45 and 64 years old were involved in this cross-sectional survey. The study used an ad hoc questionnaire covering the demographic and reproductive variables as well as the data related to sexual activity. The Cervantes questionnaire was administered to determine the impact of sexuality on health-related quality of life. MAIN OUTCOMES: Patients' responses to anonymous questionnaires or direct interviews. RESULTS: The percentage of women who recognized having occasional or unconventional partners was twofold higher in the anonymous questionnaire than in the clinical interview. In the medical interview only 15.2% of women recognized that sexuality was not very important compared with more than 40% in the anonymous questionnaire (P < 0.001). The highest concordance between the anonymous questionnaire and the clinical interview was in women who referred to not having any sexual relationship at all (88.07%) whereas in the other conditions concordance was significantly lower (P < 0.001). CONCLUSION: Self-reported data on sexuality diverge from those derived from a direct interview. The proportion of women with low interest in sexuality was higher in the blind questionnaires.

[Health-related quality of life in the Spanish women through and beyond menopause. Development and validation of the Cervantes Scale]. / Calidad de vida relacionada con la salud en la mujer española durante la perimenopausia y posmenopausia. Desarrollo y validación de la Escala Cervantes.

BACKGROUND AND OBJECTIVE: There are numerous health-related quality of life questionnaires but only a few are specific for the menopause. The objective of this study was to develop and validate a specific scale, the Cervantes Scale, for menopause in Spanish women. SUBJECTS AND METHOD: This cross-sectional study included a pilot phase, construction of the questionnaire, validation, and test-retest reliability. A population-based sample of 2,274 women ponderated by age groups and education levels was used in the validation phase. Internal consistency was assessed with the Cronbach's alpha analysis. RESULTS: The final questionnaire included 31 items ("menopause and health" with 15 items made up of vasomotor symptoms, health and aging, "sexuality" with 4 items, "couple relationship" with 3 items and "psychical domain" with 9 items). The Cronbach's (coefficient of the scale was 0.9092. The correlation coefficient of the test-retest was r=0.847 (p<.001). The Cervantes Scale is short, easy to administer (about 7 minutes), has a minimal score of 0 and a maximal score of 155 (from better to worse quality of life) and scores can be compared to reference values in younger women and women of the same age. CONCLUSIONS: The Cervantes Scale is included in the new generation of instruments of health-related quality of life specific for the menopause and is intended to be used in Spanish women aged between 45 and 64 years.

Impact of anthropometric parameters on quality of life during menopause.

OBJECTIVE: To investigate whether body mass index (BMI), abdominal obesity, and fat distribution in postmenopausal women influence quality of life. DESIGN: Cross-sectional survey. SETTING: Outpatient clinics in the hospital setting and private practices. PATIENT(S): 274 postmenopausal Spanish women, distributed by body phenotype, fat distribution (android or gynoid), and BMI. INTERVENTION(S): The Cervantes scale, a specific health-related quality of life (HRQOL) questionnaire. MAIN OUTCOME MEASURE(S): The quality of life of the obese and overweight patients was compared by age, sex, education, marriage, and municipality with matched healthy normal-weight controls. RESULT(S): Women of the pyknoid phenotype have worse general HRQOL, menopausal symptoms, and psychological and sexuality scores than athletic or lean women. Android fat distribution is also related to low global Cervantes scale scores. All scores on the Cervantes scale worsened with increasing BMI (>or=25). CONCLUSION(S): Pyknoid phenotype, android fat distribution, and a higher BMI are related to poor HRQOL.

Understanding how personality factors may influence quality of life: development and validation of the Cervantes Personality Scale.

OBJECTIVE: To develop and validate a simple personality scale to be used as a complementary tool for menopause-specific quality-of-life instruments. DESIGN: A population-based random sample of 2,274 Spanish women stratified by age groups and education level was used in the validation phase. The initial 94-item questionnaire was reduced to 20 items by examining the frequency and variability with which women were responding to each of the items. The measurement properties were tested by conducting reliability (internal consistency and test-retest) and validation analyses (correlations, and factor analysis). RESULTS: The final 20-item scale consisted of three domains: introversion (seven items), emotional instability (seven items), and insincerity (control subscale, six items). Cronbach's alpha coefficients for the subscales of emotional instability, introversion, and insincerity were 0.7966, 0.7135, and 0.7042, respectively. The test-retest correlation was r = 0.763 for introversion, r = 0.720 for emotional instability, and r = 0.680 for insincerity (P < 0.001). The Cervantes Personality Scale is short and easy to administer. Scores range from 0 (the most extraverted personality) to 35 (the most introverted personality) for the introversion domain, from 0 (the most emotionally stable personality) to 35 (the most emotionally unstable personality) for the emotional instability domain, and from 0 (the most sincere response) to 30 (the most insincere response) for the insincerity domain. CONCLUSIONS: A novel self-report 20-item scale for assessing three stable personality traits (introversion, emotional instability, and insincerity) in peri- and postmenopausal women is presented. We provide preliminary evidence that the Cervantes Personality Scale is a useful psychometric tool for studying personality in women going through the menopausal transition.