The Women's Health Questionnaire (WHQ): Frequently Asked Questions (FAQ)

The Women's Health Questionnaire (WHQ) is a measure of mid-aged women's emotional and physical health. Since its publication in 1992 the WHQ has been widely used in multinational clinical trials, in epidemiological studies as well as in the evaluation of non-medical treatments. In particular the WHQ has been included as a quality of life measure in trials of hormonal preparations for peri and post menopausal women and in studies using a variety of preventative interventions for mid-aged and older women. The questionnaire was developed in English and standardised on a sample of women aged 45–65 years. It is reliable, has good concurrent validity and is sensitive to detecting change, and is available in 27 languages. The range of subscales included in the WHQ enable a detailed assessment of dimensions of emotional and physical health, such as depression, anxiety, sleep problems, somatic symptoms, with optional subscales for menstrual problems and sexual difficulties. The WHQ is the first measure to be included in the MAPI Research Institute's database, the International Health-related Quality of Life Outcomes Database (IQOD). Drawing upon data from international studies this project aims to produce reference values for cross-culturally valid, reliable and responsive quality of life instruments. In addition to this work, a revised shorter version of the WHQ is currently being developed

Factor structure of the Gotland Scale of male depression in two samples of men with prostate cancer:Implications for treating male depression

Up to a quarter of all prostate cancer (PCa) patients suffer from clinically significant depression but treatments are inconsistent and short-lived in their efficacy. One possible reason could be that 'male depression' is not adequately diagnosed by the criteria for major depressive disorder (MDD) used in many clinical settings.In response to this limitation, the Gotland Scale of Male Depression (GSMD) was developed to identify the extra symptoms of MDD in men. Although the factor structure of the GSMD has been reported in non-PCa samples, it has not been determined for this group of men. Two samples of PCa patients were recruited, 191 from Australia and 138 from the United Kingdom and all patients received the GSMD individually, plus a background questionnaire. Two-factor solutions were identified for each of the two samples. The Australian sample was characterized by changes in emotional and somatic function, followed by depressed mood. The U.K. sample exhibited the same two-factor solution but in reverse order of weighting. Targeted treatments for depression in PCa patients may benefit from identification of the loadings that individual patients have on these two GSMD factors so that specific clinical profiles and treatment needs may be based on this information about their depression

What do working menopausal women want? A qualitative investigation into women’s perspectives on employer and line manager support

Objectives: To explore women’s perspectives on what employers and managers should, and should not do in relation to women going through the menopause at work. Methods: An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45-65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave, and (iii) how managers should not behave towards women going through the menopause. Results: 137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/ manager communication skills and behaviors, specifically, those considered helpful and desired and those unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours. Conclusions: The menopause can be difficult for some women to deal with at work partly due to the working environment. To our knowledge, this is the first study to explore women’s descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice

A randomised controlled trial of a cognitive behavioural intervention for women who have menopausal symptoms following breast cancer treatment (MENOS 1): Trial protocol

<p>Abstract</p> <p>Background</p> <p>This trial aims to evaluate the effectiveness of a group cognitive behavioural intervention to alleviate menopausal symptoms (hot flushes and night sweats) in women who have had breast cancer treatment. Hot flushes and night sweats are highly prevalent but challenging to treat in this population. Cognitive behaviour therapy has been found to reduce these symptoms in well women and results of an exploratory trial suggest that it might be effective for breast cancer patients. Two hypotheses are tested:</p> <p>Compared to usual care, group cognitive behavioural therapy will:</p> <p>1. Significantly reduce the problem rating and frequency of hot flushes and nights sweats after six weeks of treatment and at six months post-randomisation.</p> <p>2. Improve mood and quality of life after six weeks of treatment and at six months post-randomisation.</p> <p>Methods/Design</p> <p>Ninety-six women who have completed their main treatment for breast cancer and who have been experiencing problematic hot flushes and night sweats for over two months are recruited into the trial from oncology and breast clinics in South East London. They are randomised to either six weekly group cognitive behavioural therapy (Group CBT) sessions or to usual care. Group CBT includes information and discussion about hot flushes and night sweats in the context of breast cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats and maintaining changes.</p> <p>Prior to randomisation women attend a clinical interview, undergo 24-hour sternal skin conductance monitoring, and complete questionnaire measures of hot flushes and night sweats, mood, quality of life, hot flush beliefs and behaviours, optimism and somatic amplification. Post-treatment measures (sternal skin conductance and questionnaires) are collected six to eight weeks later and follow-up measures (questionnaires and a use of medical services measure) at six months post-randomisation.</p> <p>Discussion</p> <p>MENOS 1 is the first randomised controlled trial of cognitive behavioural therapy for hot flushes and night sweats that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by developing an evidence-based, non-medical treatment, which can be delivered by trained health professionals.</p> <p>Trial Registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN13771934">ISRCTN13771934</a></p

Premenstrual Symptoms and Work:Exploring Female Staff Experiences and Recommendations for Workplaces

Most women experience some premenstrual symptoms during their reproductive years. Yet, this is an under-researched health issue, particularly in the context of work. This study aimed to: (i) understand the prevalence and severity of premenstrual symptoms experienced by working females, and their association with key work outcomes; (ii) explore factors that may be influencing these symptoms and their severity; and (iii) examine how organizations might help staff with premenstrual symptoms that may be impacting their working lives. An online, anonymous survey collected quantitative and qualitative data from 125 working women in the UK. Over 90% of the sample reported some premenstrual symptoms; 40% experienced premenstrual symptoms moderately or severely. Higher symptom severity was significantly (p < 0.05) associated with poor presenteeism, intention to reduce working hours, and higher work absence (time off work, being late, leaving early). Moderate/severe symptoms were significantly associated with several individual-related variables: lower perceived general health, higher alcohol consumption, poorer sleep quality, anxiety, depression, hormonal contraception, and using fewer coping approaches towards premenstrual symptoms (avoiding harm, adjusting energy levels); and work-related variables: poorer work–life balance, lower levels of psychological resilience, higher perceived work demands, less control over work. Disclosure of premenstrual symptoms and sickness absence because of premenstrual symptoms was very low, typically because of perceptions of appropriateness as a reason for work absence, gender of line managers (male), and it being a personal or embarrassing topic. Staff with moderate to severe premenstrual symptoms were statistically more likely to disclose reason for absence than those with milder symptoms. Recommendations and suggestions for employers and line managers include the need to train staff to improve knowledge about women’s experience of premenstrual symptoms, to be able to communicate effectively with women and to provide tailored support and resources for those who need it. Implications for future research, policy and practice are discussed

Development and evaluation of online menopause awareness training for line managers in UK organizations

Objectives To develop and evaluate a 30-min online training for managers, in order to improve menopause-related knowledge, attitudes and confidence in having supportive discussions with women experiencing menopausal symptoms at work. The study also explored intentions and behaviour in terms of having conversations. Study design A prospective, pre-post design involved collecting data at three time points: pre-training, immediately after training, and four weeks post-training. Three UK organizations (one public, two private sector) participated. On-line questionnaires collected sociodemographic and background data. Qualitative and quantitative evaluation data were collected in post-intervention questionnaires. Paired t-tests and McNemar tests examined statistical differences pre- and post-training; thematic content analysis was performed on qualitative data. Main outcome measures Menopause knowledge, attitudes and confidence in talking about the menopause at work, intentions, and actual behaviour. Results 270 staff were invited and 98 consented to participate; 62 and 61 provided data immediately and 4 weeks post training, respectively. Compared to pre-training scores, statistically significant improvements were found in menopause-related knowledge, attitude (not viewing the menopause as an embarrassing topic to talk about at work), confidence in talking about the menopause with staff, and intentions to discuss menopause, at both follow-up assessments. Over 90% of respondents reported that they found the training useful and would recommend it to others. Conclusions A brief menopause awareness training may be a feasible and effective way to help managers become more knowledgeable about menopause-related problems and more confident in discussing and exploring solutions with their staff

Menopause and work:An overview of UK guidance

Background: Recent evidence suggests that some women experience menopausal symptoms that impact on their working lives, and that work environments can impact upon the experience of menopause. As a result, guidance for employers and other key stakeholders about this potential occupational health issue has emerged. To date there has not been a review of these documents to identify their main recommendations for policy and practice. Aims: To provide a narrative overview of such guidance and summary of content. Methods: Documents published in the United Kingdom and available in a major UK trade union library were searched systematically to identify guidance on the topic of menopause and work. An inductive thematic analysis was performed to identify the main themes addressed. Results: 25 relevant documents, on average eight pages long, were identified. A minority indicated that the use of scientific evidence informed the content. Five overarching themes were identified: 1) legislation; 2) policy; 3) information and training needs; 4) workplace support; and 5) the physical work environment. Conclusions: This overview of UK guidance revealed common areas of concern about reducing and managing difficulties experienced by working menopausal women. Possible areas for action were identified. Some recommendations were common across much of the guidance, whereas others were exclusive. Future guidance might include consideration of all these issues, while making reference both to the evidence base and sources of further information

Tackling the taboo in the UK:talking menopause-related problems at work

Purpose: Women are typically reluctant to disclose menopause-related problems that may affect their working lives to line managers. Consequently, support may not be offered nor potential solutions explored. This study examines how working menopausal women would prefer to have conversations about the menopause at work. Design/methodology/approach: Using semi-structured telephone interviews working menopausal women (aged 45-60 years) were asked about their experiencing of talking about their menopause at work, and how helpful conversations might be initiated and conducted. Transcripts were analyzed thematically to identify factors that may facilitate or hinder such conversations. Findings: Two themes emerged: (i) organizational context. Facilitators included an open culture with friendly relationships, a knowledgeable and proactive manager, organization-wide awareness of the menopause and aging, and access to a nominated woman to discuss problems. Barriers included male-dominated workplaces, male line managers, fear of negative responses, stigma, discrimination, embarrassment or believing menopause is inappropriate to discuss at work; (ii) the nature of the discussion. Facilitators included managers demonstrating an understanding and acceptance of a woman's experience, jointly seeking acceptable solutions, respecting privacy and confidentiality, and appropriate use of humor, as opposed to being dismissive and using inappropriate body language. Discussions with suitable persons at work were preferred and being prepared was advised. Practical implications: These findings could inform training programs, workplace policies and practice. Originality/value: This study provides timely insights to help women and their managers discuss menopause-related difficulties at work and seek solutions together