Skip to main content
Log in

Assessment of patients with menorrhagia: How valid is a structured clinical history as a measure of health status?

  • Research Papers
  • Published:
Quality of Life Research Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. HalbergL, HogdahlA, NilssonL, RyboG. Menstrual blood loss—a population study. Acta Obstet Gynecol Scand 1966; 45: 320.

    Google Scholar 

  2. CoulterA, NooneA, GoldacreM. General practitioners' referrals to specialist out patient clinics. Br Med J 1989; 299: 304–308.

    Google Scholar 

  3. 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.

    Google Scholar 

  4. MacdonaldR. Modern treatment of menorrhagia. Br J Obstet Gynaecol 1991; 97: 3–6.

    Google Scholar 

  5. 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.

    Google Scholar 

  6. WareJE, SherbourneCD. The SF-36 health status survey: I. conceptual framework and item selection. Med Care 1992; 30: 473–483.

    Google Scholar 

  7. 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.

    Google Scholar 

  8. StreinerGL, NormanDR. Health Measurement Scales: A Practical Guide to Their Development and Use. Oxford: Oxford University Press, 1990.

    Google Scholar 

  9. GarrattAM, MacdonaldLM, RutaDA, RussellIT, BuckinghamJK, KrukowskiZH. The measurement of outcome for patients with varicose veins. Qual Health Care 1993; 2: 5–10.

    Google Scholar 

  10. CronbachLJ (1951). Coefficient alpha and the internal structure of tests. Psychometrika 1951; 6: 297–334.

    Google Scholar 

  11. KlineP. A Handbook of Test Construction. London: Methuen, 1986.

    Google Scholar 

  12. JolliffeIT, MorganBJT. Principal component analysis and exploratory factor analysis. Stat Methods Med Res 1992; 1: 69–95.

    Google Scholar 

  13. HelmstatderGC. Principles of Psychological Measurement. New York: Appleton-Century-Crofts, 1964.

    Google Scholar 

  14. BlandJM, AltmanDG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986, i: 307–510.

    Google Scholar 

  15. 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.

    Google Scholar 

  16. 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.

    Google Scholar 

  17. StewartAL, HaysRD, WareJE, et al. The MOS short-form general health survey. Med Care 1988; 26: 724–733.

    Google Scholar 

  18. 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.

    Google Scholar 

  19. NewtonJ, BarnarG, CollinsWA. A rapid method for measuring menstrual blood loss using automatic extraction. Contraception 1977; 16: 269.

    Google Scholar 

  20. FraserIS, McCarronG, MarkhamR, RestaT. Blood and total fluid content of menstrual discharge. Am J Obstet Gynecol 1985; 65: 194–198.

    Google Scholar 

  21. 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.

    Google Scholar 

  22. HaynesPJ, HodgsonH, AndersonABM, TurnbullAC. Measurement of menstrual blood loss in patients complaining of menorrhagia. Br J Obstet Gynaecol 1977; 84: 763–768.

    Google Scholar 

  23. ReesMCP. Role of menstrual blood loss measurements in management of complaints of excessive menstrual bleeding. Br J Obstet Gynaecol 1991; 98: 327–328.

    Google Scholar 

  24. JachuckSJ, BrierleyH, JachuckS, et al. The effect of hypotensive drugs on the quality of life. J R Coll Gen Pract 1982; 32: 103–105.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

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

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00434381

Key words

Navigation