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. 2022 Jul-Aug;71(4):E28-E38.
doi: 10.1097/NNR.0000000000000591. Epub 2022 Mar 4.

Symptom Clusters and Key Symptoms Among Midlife Perimenopausal and Postmenopausal Women With and Without Metabolic Syndrome

Se Hee Min, Qing Yang, Sharron L Docherty, Eun-Ok Im, Xiao Hu

Symptom Clusters and Key Symptoms Among Midlife Perimenopausal and Postmenopausal Women With and Without Metabolic Syndrome

Se Hee Min et al. Nurs Res. 2022 Jul-Aug.

Abstract

Background: Midlife perimenopausal and postmenopausal women with metabolic syndrome experience multiple symptoms concurrently.

Objective: The study objectives were to examine the relationship among symptoms through network visualization and identify and compare symptom clusters and key symptoms across symptom occurrence and symptom severity dimensions in midlife perimenopausal and postmenopausal women with and without metabolic syndrome.

Methods: Cross-sectional data from the Study of Women's Health Across the Nation (Visit 5) were used for analysis. A machine-learning-based network analysis and the Walktrap algorithm were used to fulfill the study objectives.

Results: The number and types of symptom clusters differed between the groups. Midlife perimenopausal and postmenopausal women with metabolic syndrome experienced the psychological/somatic/genital cluster (key symptom: frequent mood change), the sleep/urinary cluster (sleep disturbance), and the vasomotor cluster (cold sweat) in the symptom occurrence dimension and the psychological/somatic/sexual cluster (anxiety), the sleep/urinary cluster (sleep disturbance), and the vasomotor/genital cluster (night sweat) in the symptom severity dimension. In contrast, midlife perimenopausal and postmenopausal women without metabolic syndrome experienced the psychological cluster (anxiety), the sleep/somatic/genitourinary cluster (sleep disturbance), and the vasomotor cluster (night sweat) in the symptom occurrence dimension and the psychological/somatic cluster (anxiety), the sleep/urinary cluster (sleep disturbance), the vasomotor cluster (night sweat), and the sexual/genital cluster (vaginal dryness) in the symptom severity dimension.

Discussion: The study findings may serve as a knowledge basis for effective assessment and management of symptom clusters and key symptoms in clinical settings and provide directions for future development of targeted symptom management interventions.

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Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Symptom cluster and key symptom for symptom occurrence dimension (A) Metabolic syndrome group. Red indicates psychological/somatic/genital cluster which includes anxiety (an_), depression (cs_), frequent mood change (md_), forgetfulness (fr_), stiffness or soreness in joint, neck, or shoulder (st_), and vaginal dryness (vg_). Blue indicates sleep/urinary cluster which includes sleep disturbance (sl_) and getting up to urinate (gt_). Green indicates vasomotor cluster which includes hot flash (ht_), night sweat (nt_), and cold sweat (cl_). (B) Without metabolic syndrome group. Red indicates psychological cluster which includes anxiety (an_), depression (cs_), frequent mood change (md_), and forgetfulness (fr_). Blue indicates vasomotor cluster which includes hot flash (ht_), night sweat (nt_), and cold sweat (cl_). Green indicates sleep/somatic/genitourinary cluster which includes sleep disturbance (sl_), stiffness or soreness in joint, neck, or shoulder (st_), vaginal dryness (vg_), and getting up to urinate (gt_). *Yellow circle indicates key symptom in each symptom cluster
Figure 2.
Figure 2.
Symptom cluster and key symptom for symptom severity dimension (A) Metabolic syndrome group. Green indicates psychological/somatic/sexual cluster which includes anxiety (an_), depression (cs_), frequent mood change (md_), forgetfulness (fr_), stiffness or soreness in joint, neck, or shoulder (st_), and sexual disturbance (sx_). Yellow indicates vasomotor/genital cluster that includes hot flash (ht_), night sweat (nt_), cold sweat (cl_), and vaginal dryness (vg_). Orange indicates sleep/urinary cluster which includes sleep disturbance (sl_) and getting up to urinate (gt_). (B) Without metabolic syndrome group. Green indicates psychological/somatic cluster which includes anxiety (an_), depression (cs_), frequent mood change (md_), forgetfulness (fr_), and stiffness or soreness in joint, neck, or shoulder (st_). Yellow indicates vasomotor cluster that includes hot flash (ht_), night sweat (nt_), and cold sweat (cl_). Orange indicates sleep/urinary cluster which includes sleep disturbance (sl_) and getting up to urinate (gt_). Blue indicates sexual/genital cluster that includes sexual disturbance (sx_) and vaginal dryness (vg_). *Yellow circle indicates key symptom in each symptom cluster
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