The findings of a preliminary analysis of data from a study now being conducted to design and evaluate an educational intervention to aid women in becoming more effective decision-makers regarding menopause, self-care strategies, and hormone replacement therapy (HRT), indicate that the lack of attention to the symptoms and health effects of menopause has resulted in frustration and dissatisfaction among women health care consumers. Women in the menopausal years are not informed adequately nor empowered to participate in decision making around issues related to their own health. They do not have the information they want and they do not know where to get it.

Estrogen Replacement Therapy↗

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Patient satisfaction with health care decisions: the satisfaction with decision scale.

Patient satisfaction measures have previously addressed satisfaction with medical care, satisfaction with providers, and satisfaction with outcomes, but not satisfaction with the health care decision itself. As patients become more involved in health care decisions, it is important to understand specific dynamics of the decision itself. The Satisfaction with Decision (SWD) scale measures satisfaction with health care decisions. It was developed in the context of postmenopausal hormone-replacement therapy decisions. The six-item scale has excellent reliability (Cronbach's alpha = 0.86). Discriminant validity, tested by performing principal-components analysis of items pooled from the SWD scale and two conceptually related measures, was good. Correlation of the SWD scale with measures of satisfaction with other aspects of the decision-making process showed the SWD scale was correlated most highly (0.64) with "decisional confidence," and least with "desire to participate in health care decisions" and "satisfaction with provider." The SWD scale predicts decision certainty in this study. Use in an independent study showed that the SWD scale was correlated with the likelihood of patients' intentions to get a flu shot. Further investigation in relation to other health decisions will establish the utility of the SWD scale as an outcome measure.

Adult↗

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[Course of the ureter beyond the inferior vena cava and right common iliac artery].

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Aged↗

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African-American women's attitudes and expectations of menopause.

INTRODUCTION: In this study, low-income perimenopausal African-American women were surveyed to determine knowledge of menopause and hormone replacement therapy (HRT). METHODS: A 92-item survey assessed perceptions of menopause and health risks to identify preventive strategies in this population. The nonprobability sample of 197 African-American women typically had incomes of < $15,000, age 46-55, high school education or less. RESULTS: Major findings were that African-American women (1) experienced expected levels of occurrence of symptoms, but perceived them as not very bothersome, (2) had a knowledge deficit related to menopause and HRT, and (3) had expectations about menopause that underestimated their lifetime risk of heart disease. CONCLUSION: The lack of knowledge about menopause, HRT, and lifetime risks of heart disease suggests that low-income African-American women need better information for decision making about prevention. However, this sample knew the rank order of major health risks. Health information to the public and culturally relevant patient education are critical prerequisites to any preventive behavioral strategies in this population. Further research should identify culturally based expectations of disease risk and efficacy of prevention strategy to tailor messages to particular subpopulations.

Adult↗