This research studies the judgments of women regarding estrogen replacement therapy (ERT) as they anticipate and experience menopause. The decision to take or not to take ERT is complex. While the use of ERT relieves hot flashes ad decreases the risk of osteoporosis, it may also increase the risk of endometrial cancer. The addition of progestin to the therapy reduces the risk of endometrial cancer while maintaining benefits, but causes a resumption of cyclic bleeding. Women need to be fully informed of risks, benefits and implications of ERT in order to make optimal decisions. This also requires an understanding of menopause and the options available for relief of symptoms. This study focuses on the judgments of premenopausal and menopausal women, judgments which ultimately lead to behavioral decisions.
The aim of this study is to identify and systematically assess the factors which impact on women's judgments about ERT (initial use of) for menopausal symptoms. It is hypothesized that the judgment is influenced by a woman's perceptions, experience and expectations of menopause, as well as other factors such as sociodemographic characteristics, previous health care behaviors and experiences, and knowledge of menopause. This study will identify the relation of these variables to the ERT judgment. A research method drawn from social judgment theory will be used to design written cases to study four factors: risk of osteoporosis, endometrial cancer, severity of menopausal symptoms, and use of progestin with resumption of cyclic bleeding. Multivariate analyses will be used on data from 200 women in order to define women's policies in using information to judge ERT. Written instruments will also assess women's sociodemographic characteristics and health behaviors, expectations or experience with menopausal symptoms, perceptions and knowledge of menopause. A cluster analysis will be used to identify groups with similar sets of rating policies. We will then use multiple discriminant analyses to determine sociodemographic and health correlates of ERT judgment strategies. Thinking aloud protocols done with a subsample of women from the largest clusters will complement the statistical analyses and assist with the interpretation of data. Findings from this study will contribute to understanding the experience of menopause and provide data for subsequently develop a nursing intervention to assist women to make informed decisions regarding ERT.
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