Factors related to menopausal symptom management decisions

Objective: To systematically review the literature regarding factors related to women's menopausal symptom management decision making. Methods: The PubMed.gov online search engine was queried using pre-selected inclusion and exclusion criteria. Reference lists of articles were also reviewed to identify potentially missed articles. Full-text, English-language, peer-reviewed articles on factors related to menopausal symptom management decisions were reviewed. Results: A total of 16 articles (15 data-based, 1 review of literature) from 6 different countries were reviewed. Most articles were related to decisions about one class of therapies and did not take into account all available therapeutic options. In the 15 data-based articles, diverse methods were used: qualitative (47%), quantitative (47%), and mixed (6%), with most being cross-sectional (93%). Very few of the data-based articles were based on a conceptual model (20%) and none used findings to derive an explanatory or predictive model. Most samples were not representative of special populations, such as women with breast cancer. Factors fell into four broad categories: (1) individual characteristics (demographics, menopause experience. symptomatology); (2) values, attitudes, beliefs, and preferences (attitudes and beliefs about menopause and treatments, preferred modalities, tolerance for risks/side effects); (3) facts and information about menopause and symptom management (amount, type, source, credibility, availability); and (4) health care context (health care provider communication, trust, availability/time, knowledge, relationship). Conclusions: Additional descriptive studies are needed understand women's menopausal symptom management decisions in the context of all available therapies so that a comprehensive model of menopausal symptom management decision making can be specified. Additional understanding is needed regarding decisions in special populations of menopausal women such as breast cancer survivors, a group for whom menopausal symptom management can be particularly complex. (C) 2011 Elsevier Ireland Ltd. All rights reserved.