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

Lynnette Leidy Sievert博士（马萨诸塞大学阿默斯特分校）、Laura Huicochea博士（墨西哥坎佩切市El Colegio de la Frontera Sur分校）和Daniel E. Brown博士（夏威夷大学希洛分校）将对报道和测量的中年妇女更年期症状的跨文化差异进行研究。目的是更好地了解妇女在社会和物质条件、信仰体系和文化制度背景下如何感知和报告症状。该研究将比较生活在坎佩切州的农村玛雅妇女、农村梅斯蒂索妇女（欧洲和美洲印第安人的混合血统）以及生活在墨西哥坎佩切市的玛雅妇女和梅斯蒂索妇女的中年症状。在20世纪80年代进行的一项关于玛雅人更年期的研究中，被引用最多的一项研究报告称，热潮热的患病率为零。本研究的目的是比较(1)生活在农村和城市社区的玛雅人和梅斯蒂索人的症状报告；(2)同一组中生物测量的潮热频率；(3)症状报告与生物特征测量的一致性水平。例如，玛雅农村妇女可能不会在问卷上报告潮热，但可能显示（通过动态监测）出汗与潮热一致。该研究的独特之处在于将深度访谈与半结构化问卷、压力生物标志物和生物识别方法相结合，以更好地了解症状体验的体验和感知。如果本研究的结果表明，生活经验和潮热报告是由文化背景塑造的，那么生活经验的差异解释了跨文化潮热报告的差异。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。拟议的研究结果将使当地社区和卫生保健提供者了解玛雅和梅斯蒂索妇女在中年的经历。这项研究的资金由美国国家科学基金会文化人类学项目和国际科学与工程办公室提供，同时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.