Academic journal article Journal of Nursing Measurement

Development of the Military Women's Attitudes toward Menstrual Suppression Scale: From Construct Definition to Pilot Testing

Academic journal article Journal of Nursing Measurement

Development of the Military Women's Attitudes toward Menstrual Suppression Scale: From Construct Definition to Pilot Testing

Article excerpt

The Military WomenEs Attitudes Toward Menstrual Suppression scale (MWATMS) was created to measure attitudes toward menstrual suppression during deployment. The human health and social ecology theories were integrated to conceptualize an instrument that accounts for military-unique aspects of the environment on attitudes toward suppression. A three-step instrument development process was followed to develop the MWATMS. The instrument was pilot tested on a convenience sample of 206 military women with deployment experience. Reliability was tested with measures of internal consistency (α = .97); validity was tested with principal components analysis with varimax rotation. Four components accounted for 65% of variance: Benefits/ Interest, Hygiene, Convenience, and Soldier/Stress. The pilot test of the MWATMS supported its reliability and validity. Further testing is warranted for validation of this instrument.

Keywords: menstrual suppression; menstruation; continuous contraception; military women's health

Menstrual suppression entered the mainstream of U.S. women's health practices with the U.S. Food and Drug Administration's approval of Seasonale, the 91-day cycle of combined oral contraceptives (OC). In the literature on U.S. women's and providers' attitudes toward menstrual suppression, common reasons for suppressing menstruation are cited: to decrease pain, flow, symptoms of menstrual disorders, and required supplies (Andrist, Arias, et al., 2004; Andrist, Hoyt, Weinstein, & McGibbon, 2004; Edelman, 2002; Kaunitz, 2000). Several reports suggest that women in the military would benefit from menstrual suppression, specifically through the continuous use of OCs (Christopher & Miller, 2007; Kaunitz, 2000; Powell-Dunford, Deuster, Claybaugh, & Chapin, 2003; Ritchie, 2001). While military women have expressed a desire to avoid menstruation during deployment, few utilize OCs for that purpose (Powell-Dunford et al., 2003; Thomson & Nielsen, 2006; Wardell & Czerwinski, 2001).

During deployment on military operations, women often endure prolonged changes in their environments and daily activities. Menstrual suppression may be seen as an alternative to experiencing menstruation in this environment, yet, according to Powell-Dunford et al. (2003) only 7% of surveyed U.S. Army women ( N = 154) reported trying continuous OCs for this purpose. Thus, there appears to be a gap between women's desires for amenorrhea and utilization of this therapy. What is driving the desire for amenorrhea during deployment? The unique conditions inherent in a military lifestyle may contribute to the desire for menstrual suppression, but dimensions of menstruation during deployment that may influence women to choose this therapy have not been fully explored. The purpose of this article is to present the instrument development process for the Military Women's Attitudes Toward Menstrual Suppression scale (MWATMS), a military-unique measure of the attitudes of military women toward menstrual suppression in a deployed environment.

BACKGROUND

Theoretical Model

The theoretical model and conceptual framework for exploring military women's menstrual experiences and attitudes toward menstrual suppression during deployment were developed based on a thorough review of the literature (Trego, 2007a). References pertaining to menstrual attitudes, menstrual suppression, attitudes toward menstrual suppression, military women's feminine hygiene, and pharmacotherapeutics of continuous OC use were reviewed for this study.

The human health and social ecology theories were integrated to form the theoretical model for this program of research. In an adaptation of the social ecological model of health by Grzywacz and Fuqua (2000), a woman's menstrual physiology, beliefs, and behaviors interact dynamically with her microsystem, which according to Bronfenbrenner (1977) consists of her immediate physical surroundings, her activities, and her roles in that environment. …

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