title: Day-to-Day Impact of Vaginal Aging questionnaire: a multidimensional measure of the impact of vaginal symptoms on functioning and well-being in postmenopausal women.
abstract: OBJECTIVE
  This study aims to develop a self-report questionnaire assessing the impact of vaginal dryness, soreness, itching, irritation, and pain on functioning and well-being in postmenopausal women.
  
  
  METHODS
  Structured self-report items were developed to address the impact of vaginal symptoms on functioning and well-being based on findings from focus groups with racially/ethnically diverse, symptomatic postmenopausal women. Items were refined after cognitive interview pretesting and field-tested among symptomatic postmenopausal women enrolled in a multiethnic cohort study in California. Exploratory factor analysis (SAS PROC VARCLUS) and confirmatory factor analysis evaluated factor structure and eliminated poorly fitting items. Additional evidence of construct validity was obtained via examination of correlations with other measures of related constructs. Internal consistency and test-retest reliability were assessed using Cronbach α and correlation coefficients, respectively.
  
  
  RESULTS
  For the 745 postmenopausal women who completed the draft questionnaire, the mean (SD) age was 56.2 (8.5) years, and 66% of the respondents were racial/ethnic minorities. The refined questionnaire included four multi-item scales addressing symptom impact on (1) activities of daily living, (2) emotional well-being, (3) sexual functioning, and (4) self-concept and body image. The four-factor model provided good approximate fit (comparative fit index, 0.987; standardized root-mean-square residual, 0.038). Correlations with other measures of symptom bothersomeness, sexual function, depression, and anxiety conformed to hypotheses. Cronbach α values ranged from 0.82 to 0.93. Intraclass coefficients ranged from 0.47 to 0.72.
  
  
  CONCLUSIONS
  The Day-to-Day Impact of Vaginal Aging questionnaire is a new multidimensional self-report measure designed to facilitate evaluation of the impact of vaginal symptoms on postmenopausal women of diverse backgrounds.
authors.affiliation: From the Departments of 1Medicine and 2Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA; 3Division of Research, Kaiser Permanente, Oakland, CA; 4Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL; and 5Department of Family and Community Medicine and 6Institute of Health and Aging, University of California San Francisco, San Francisco, CA.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
authors.forename: Sanae
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Louise C
authors.initials: LC
authors.lastname: Walter
authors.forename: David
authors.initials: D
authors.lastname: Thom
authors.forename: Anita L
authors.initials: AL
authors.lastname: Stewart
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000375:Aging / Q000523:psychology*; D015331:Cohort Studies; D004644:Emotions; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012649:Self Concept; D057566:Self Report; D020018:Sexual Dysfunctions, Psychological; D014623:Vaginal Diseases / Q000175:diagnosis / Q000523:psychology*