Validity and cultural equivalence of the standard Greene Climacteric Scale in Hong Kong

Objectives: The aim of this study was to translate the standard Greene Climacteric Scale (GCS) and a urogenital symptom scale into colloquial Chinese (Hong Kong) and test their validity and reliability in Hong Kong Chinese women. Methods: The scales were translated with standard techniques, and cross-cultural construct validity, internal consistency, test-retest reliability, and responsiveness were tested on samples of women aged 40 to 60 years recruited from the community. Results: A total of 611 women, with mean (SD) age of 48.9 (5.3) years, provided completed scales for the study. Confirmatory factor analysis demonstrated construct validity of the translated standard GCS. The items were found to have good homogeneity in measuring the scale concepts (Cronbach alpha > 0.7). But the three-item urogenital scale had poor internal consistency (Cronbach alpha = 0.43), and a combination of this scale with the standard GCS resulted in a reduced model fit to the data. Test-retest reliability for the GCS was good on women recruited for a retest (n = 52). The translated GCS was found to be responsive to change over time (effect size, 0.59; n = 19). Conclusions: The Chinese (Hong Kong) version of the standard GCS is a valid and cultural-equivalent instrument. Our data do not support inclusion of the urogenital scale to the standard GCS. Measurement of urogenital symptoms is subject to further study.