Variation in symptoms at midlife: Ethnic and rural/urban comparisons

马萨诸塞大学阿默斯特分校的Lynnette Leidy Sievert博士、墨西哥坎佩切南区高等专科学校的Laura Huicochea博士和夏威夷大学Hilo分校的Daniel E.Brown博士将对中年女性报告和测量的更年期症状的跨文化变异性进行研究。其目标是更好地了解妇女在社会和物质条件、信仰体系和文化机构的背景下如何看待和报告症状。这项研究将比较居住在坎佩切州的玛雅农村妇女、居住在坎佩切州的梅斯蒂佐农村妇女(欧洲和美洲混血血统)以及居住在墨西哥坎佩切市的玛雅和梅斯蒂佐妇女的中年症状。20世纪80年代进行的一项关于玛雅人更年期的被引用最多的研究报告称，潮热的发病率为零。这项研究的目的是比较(1)生活在农村和城市社区的玛雅人和梅斯蒂佐人群体的症状报告；(2)相同群体中生物测量测量的潮热频率；以及(3)症状报告和生物测量之间的一致性水平。例如，玛雅农村妇女可能不会在问卷中报告潮热，但可能会(通过动态监测)显示出与潮热一致的出汗情况。这项研究的独特之处在于，它将深度访谈与半结构化问卷、压力的生物标记物和生物计量方法相结合，以更好地理解症状体验的体验和感知。如果这项研究的结果表明生活体验和潮热报道是由文化语境塑造的，那么生活体验的差异可以解释跨文化潮热报道的差异。此外，我们将更好地了解妇女如何在不稳定的条件下改善她们的健康以及她们对健康的看法。拟议的研究结果将向当地社区和卫生保健提供者通报玛雅和梅斯蒂佐妇女在中年的经历。这项研究由NSF文化人类学项目和NSF国际科学与工程办公室提供资金，也支持正式的国际合作。

Dr. Lynnette Leidy Sievert (University of Massachusetts, Amherst), Dr. Laura Huicochea (El Colegio de la Frontera Sur, Campeche, Mexico), and Dr. Daniel E. Brown (University of Hawaii, Hilo) will undertake research on cross-cultural variability of menopausal symptoms as reported and as measured bio-metrically for women at midlife. The goal is to better understand how women perceive and report symptoms in the context of social and material conditions, belief systems, and cultural institutions. The study will compare symptoms at midlife across rural Mayan women, rural Mestizo women (of mixed European and Amerindian ancestry) living in the state of Campeche, and Mayan and Mestizo women living in the city of Campeche, Mexico. One of the most cited studies of menopause among the Maya, carried out in the 1980s, reported a zero prevalence of hot flashes. The aims of this study are to compare (1) symptom reports across Mayan and Mestizo groups living in rural and urban communities; (2) the frequency of biometrically measured hot flashes across the same groups; and (3) the level of concordance between symptom report and biometric measurement. For example, rural Mayan women may not report hot flashes on questionnaires, but may show (via ambulatory monitoring) sweating consistent with hot flashes. The study is distinctive in its integration of in-depth interviews with semi-structured questionnaires, biomarkers of stress, and biometric methods to better understand the experience and perception of symptom experience. If the results of this study show that the lived experience and report of hot flashes is shaped by cultural context, then differences in lived experience explain variation in cross-cultural hot flash reports. In addition, we will better understand how women can improve their health, and their perception of health, in precarious conditions. The results of the proposed research will inform local community and health care providers about the experiences of Mayan and Mestizo women at midlife. Funding this research, which is provided by both the NSF Cultural Anthropology Program and the NSF Office of International Science and Engineering, also supports formalizes an international collaboration.