Mental health aspect of quality of life in the menopausal transition.

PURPOSE: To evaluate factors associated with mental health quality of life (QOL), such as depressed mood, anxiety, poor memory and sleep, among midlife women according to the menopausal status. MATERIAL AND METHODS: Participants were 500 women aged 40-65 years. Data were collected using socio-demographic questionnaire, Women's Health Questionnaire (domains of depressed mood-DEP, anxiety-ANX, memory-MEM and sleep-SLE) and Short Form-36 (Mental Composite Score) for assessment of health-related QOL. Factors associated with poorer DEP, ANX, MEM and SLE were examined using adjusted linear regression models. RESULTS: In premenopausal women, lower household monthly income (p = .046) was associated with higher level of DEP; higher body mass index (p = .045) was associated with higher ANX; having gynecological illnesses (p = .017) and menopause-related symptoms (p = .039) were associated with poorer MEM; being married (p = .036), drinking alcohol (p = .036) and having more physical activity (p = .041) was associated with better SLE. In postmenopausal women, worse DEP was more likely among women residing in city outskirts (p = .009), who are not married (p = .038) and with sedentary occupations (p = .049); lower education level (p = .030) was associated with more ANX; lower education level (p = .045) and having menopause-related symptoms (p = .044) were associated with poorer MEM; not engaging in regular recreation (p = .031) was associated with better SLE. CONCLUSIONS: To improve QOL, pre- and postmenopausal women should not only be supported in the management of menopause-specific symptoms. Women should also receive recommendations as to the behavioral and personal changes when approaching the midlife period.

Hormonal therapy in menopausal transition: implications for improvement of health-related quality of life.

The study aim was to assess scores of the Menopause Rating Scale (MRS) among women who use and desire to use hormonal therapy (HT), as well as to evaluate factors contributing to HT use and desire to use HT among women in menopausal transition. A total of 513 mid-aged women participated in the study. Data were collected using socio-demographic questionnaire, MRS and Beck Depression Inventory. The prevalence of current HT use was 9.7%, while 4.5% of women who did not use HT expressed a desire to start using HT. The MRS cutoff score for HT use was 10.5 and 11.5 among those who desire to use HT. Living in the central city districts, having lower body mass index, younger age at menopause, more gynecological illnesses, and worse MRS were associated with HT use. Living in the central city districts, having fewer births, more gynecological and chronic illnesses and having more depressive symptoms were associated with the desire to use HT. Mid-aged women who perceive their quality of life as poor due to climacteric symptoms should be advised to consider HT to improve their health status and everyday functioning.

Climacteric women at work: What lurks behind poor occupational quality of life?

Physical and psychological changes during menopausal transition may affect various aspects of everyday functioning including women's work ability and work productivity. Presence of menopausal symptoms has been well-acknowledged to negatively affect quality of life (QOL). However, data on factors associated with occupational QOL among women at this period of life are lacking. The authors' purpose in this study was to evaluate factors affecting occupational QOL in a sample of employed mid-life women who are experiencing menopause. The authors performed a cross-sectional study among 335 employed women aged 40 to 65 years from Serbia. Socio-demographic questionnaire, Utian's Quality of Life Scale, and Beck's Depression Inventory were used in data collection. Women's average monthly household income and educational level were positively correlated, while having uterine prolapse was negatively associated with occupational QOL. Significant regression models assessing impact of gynecological illnesses and menopause-specific symptoms on occupational QOL (direct value and categories-below vs. above mean) showed that having insomnia, uterine prolapse, and genital inflammations may differentiate "good" from "poor" occupational QOL. Uterine prolapse, genital inflammation, and insomnia were associated with worse occupational QOL among working women in menopausal transition.

Factors associated with general and health-related quality of life in menopausal transition among women from Serbia.

This study assessed factors associated with quality of life (QOL) among Serbian peri- and postmenopausal women using two menopause-specific scales. This cross-sectional study included 500 women aged 40-65 years who had a gynecologic check-up in one of two Community Health Centers in Belgrade during February 2014 to January 2015. Women completed: a questionnaire about socio-demographics, habits, and health status; a menopause-specific questionnaire, Utian's Quality of Life Scale (UQOL); and a Women's Health Questionnaire (WHQ) and Beck's Depression Inventory (BDI). Higher education was associated with better occupational UQOL and memory/concentration, but with lower emotional UQOL and more anxiety/fears. City center residency was associated with better occupational and sexual UQOL. Being employed was associated with better occupational UQOL and lower anxiety/fears. Higher income was associated with better emotional UQOL. Not having uterine prolapse, insomnia, or tachycardia was associated with better occupational UQOL and fewer sleep problems. Higher parity was associated with better sexual UQOL. Having regular recreation was associated with better health and sexual UQOL but with more frequent vasomotor symptoms. Leaner women felt more attractive. QOL during the menopausal transition does not entail only somatic symptoms and therefore requires a more comprehensive approach that includes psychosocial underpinnings.

Factors associated with sexual quality of life among midlife women in Serbia.

PURPOSE: To assess factors associated with better sexual quality of life (QOL) in midlife period among women who are and are not sexually active. METHODS: Participants were 500 women aged 40-65 years from Belgrade, Serbia. Data were collected through general questionnaire (regarding socio-demographic characteristics, lifestyle habits, general medical, and gynecological history) in which one item investigated having partnered sexual activity (heterosexual intercourses). The sexual domain of the Utian Quality of Life Scale was used to assess the sexual QOL. The sexual QOL consisted of reflections on the satisfaction with frequency of sexual interactions, as well as sexual and romantic life in general. Higher scores indicated better sexual QOL. RESULTS: Most women were sexually active in midlife (81.6%). The mean sexual QOL score for the overall sample was 9.99 (range 3-15). The level of sexual QOL did not differ between sexually active and non-active women. Factors associated with better sexual QOL in sexually active menopausal women were being married or coupled, being physically active, having more children, having hot flushes, and not having tachycardia. Factors associated with better sexual QOL in sexually inactive menopausal women were drinking alcohol, being physically active, not having insomnia or skin rash. CONCLUSIONS: Sexual QOL among Serbian urban midlife women was good and did not differ between women who were sexually active and those who were not. Further studies are needed to determine in what manner women who are not sexually active in midlife achieve high level of satisfaction with their sexual QOL.

Stethoscope Hygiene: Practice and Attitude of Medical Students.

OBJECTIVE: The purpose of this study was to evaluate the frequency and attitude of medical students towards cleaning their stethoscopes. SUBJECTS AND METHODS: A cross-sectional study was carried out in the first week of December 2013. The study included 771 students (397 in their fourth and 374 in their sixth year) from the Faculty of Medicine, University of Belgrade, Serbia. An anonymous questionnaire was distributed to students before the start of compulsory lessons in classrooms. RESULTS: 317 of the 397 fourth-year students (79.8%) and 306 of the 374 sixth-year students (81.9%) cleaned their stethoscope. The stethoscope diaphragm was most commonly cleaned, while the flexible tubing was the least commonly cleaned area, mainly using ethyl alcohol-based agents. The strongest positive attitude was observed for the statement 'It is important that my stethoscope is clean' (4.3 out of 5.0). A positive correlation (Spearman's x03C1; = 0.105) was observed between a higher frequency of cleaning and the stronger positive notion that a stethoscope should be cleaned. CONCLUSION: A considerably high proportion of the students studied had ever cleaned their stethoscopes. Based on the students' responses, it would be useful to implement instructions on stethoscope hygiene in the regular practical curriculum with the aim of applying stethoscope disinfection in daily work.

Validation of the Menopause Rating Scale in Serbian language.

PURPOSE: The study aim was to translate the Menopause Rating Scale (MRS) to Serbian language and assess its validity and reliability in the population of Serbian menopausal women. METHODS: The study included 200 peri- and postmenopausal women from two Community Health Centers (city center and outskirts) in the Serbian capital-Belgrade. Women filled out general questionnaire (socio-demographics, habits, medical history), the MRS, Short Form-36 questionnaire (SF-36) and Beck's Depression Inventory (BDI). The MRS was translated according to recommended methodology and its psychometric properties (internal consistency, factor analysis, discriminant, construct and criterion validity) were assessed. RESULTS: The Cronbach's alpha coefficient for the whole scale was 0.884 (psychological α = 0.902, somato-vegetative α = 0.761, urogenital α = 0.734). Values of the CI-TC coefficient for Serbian MRS were adequate for 10 items, proving their suitability in the scale. On factor analysis, we obtained the same 3 factors as in the original scale (73.1 % of variance). Communalities of all items were appropriate (>0.4). There was no common method bias. The MRS total score was correlated positively with BDI score (p = 0.001) and negatively with all SF-36 domains (p = 0.001) except General Health. Based on ROC analysis, MRS scores were more consistent for post- than perimenopausal Serbian women. Similar results of two raters (p > 0.05) implied on adequate translation and reliability of MRS. CONCLUSION: Serbian version of MRS demonstrated excellent reliability and validity. The MRS in Serbian language can be used in daily clinical work with menopausal women for assessing their symptoms and quality of life.

Translation and validation of the Utian Quality of Life Scale in Serbian peri- and postmenopausal women.

OBJECTIVE: This study aimed to translate the Utian Quality of Life Scale (UQOL) into the Serbian and to assess its validity and psychometric properties in Serbian peri- and postmenopausal women. METHODS: This survey included 200 perimenopausal and postmenopausal women. Women were approached after their regular gynecological checkup in two community health centers (city center and outskirts) in the capital city Belgrade. The following instruments were used: general questionnaire (sociodemographics, habits, and medical history), UQOL, Short Form-36, and Beck Depression Inventory. The UQOL was translated according to the recommended methodology for translating questionnaires, and its psychometric properties (internal consistency, factor analysis, discriminant validity, construct validity, and criterion validity) were tested. RESULTS: The mean (SD) UQOL total score was 80.5 (13.5). The Cronbach's α coefficient for the entire scale was 0.83 (Occupational, α = 0.76; Health-Related, α = 0.72; Emotional, α = 0.36; Sexual, α = 0.66). All corrected item-total correlation coefficients were greater than 0.40, confirming that all items were appropriate parts of the UQOL. On exploratory factor analysis, we obtained six factors (five items formed two new clusters: Physical Fitness and Professional Recognition) that explained 85.7% of the total variance. The UQOL total score was significantly negatively correlated with Beck Depression Inventory score (P = 0.001) and significantly positively correlated with all Short Form-36 domains (P = 0.001). In addition, significant intercorrelations of UQOL domains also indicated good criterion validity. CONCLUSIONS: The Serbian version of the UQOL demonstrates satisfactory reliability and validity in the assessment of quality of life among peri- and postmenopausal women. The Serbian version of the UQOL is an adequate quality-of-life instrument in the Serbian language that can be applied in the everyday clinical setting.

Medical students, do you know how to measure blood pressure correctly?

OBJECTIVE: The aim of this study was to estimate the level of knowledge of the blood pressure (BP) measurement technique among medical students. MATERIALS AND METHODS: A total of 791 students in the fourth and the final, sixth year were recruited at the Faculty of Medicine, University of Belgrade, before the start of compulsory practical sessions in the classrooms, during the period 2-9 December 2013. Data were collected using questionnaires on the technique of BP measurement according to the existing guidelines. RESULTS: The least correct answers among students of both years were related to the fact that the stethoscope membrane should not be placed under the cuff (13.5% fourth year and 19.4% sixth year students). The highest proportion of correct answers (97.5%) in the fourth year was related to the fact that BP should be measured twice during patient examination. By the sixth year, however, most students (96.6%) knew that previous physical activity may cause an increase in the values of BP. With respect to whether or not the students were shown how to measure the BP properly in classes, 54.9% of fourth-year and 52.5% sixth-year students agreed or strongly agreed with this statement (χ=0.461, P=0.497). No correlation was established between the knowledge score and self-perceived confidence in measuring BP (ρ=0.062, P=0.211). CONCLUSION: The theoretical background of the BP measurement technique varies among students in both years. The correct means of BP measurement should be elaborated thoroughly, with the aim of preventing misconceptions and misdiagnosis of hypertension.