Development and validation of a premenstrual symptom screening tool for working women in relation to absenteeism

This study aimed to develop and validate a screening tool tailored for working women to comprehensively assess premenstrual symptoms-including physical, psychological, and work-related domains-and to examine its reliability, validity, and association with absenteeism.

In October 2021, a multidisciplinary expert panel comprising a gynecologist, a psychosomatic physician, a psychologist, occupational health specialists, and data scientists developed a set of 47 original items. We then recruited 3,239 working women with menstruation via an internet research company and administered these items to assess PMS-related symptoms. For scale development, we conducted exploratory and confirmatory factor analyses, along with evaluations using Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis.

Of the participants, 331 women had experienced PMS (10%), and 393 women had taken sick leave because of PMS-associated symptoms (12%). Exploratory factor analyses with maximum likelihood and Promax rotation identified four domains with 27 items, including "Somatic symptoms'' (Cronbach's α = 0.93), "Psychological symptoms" (Cronbach's α = 0.94), "Lack of work efficiency" (Cronbach's α = 0.93), and "Abdominal symptoms" (Cronbach's α = 0.95). Using a split-half sample for the confirmatory factor analysis, the four-factor solution demonstrated acceptable model fit (RMSEA = 0.077, CFI = 0.928). The Average Variance Extracted values ranged from 0.54 to 0.68 across the four domains, and in all cases, the square root of AVE exceeded the corresponding inter-factor correlations, supporting the discriminant validity using the Fornell-Larcker criterion. We also confirmed the developed scale's criterion validity using existing PMS screening criteria and its concurrent validity through moderate correlation coefficients with Copenhagen Burnout Inventory scores. The receiver operating characteristic curve yielded a moderate construct ability for work absenteeism, including a sensitivity of 78%, a specificity of 57%, and an area under the curve of 0.735.

A moderately reliable and valid new scale for PMS for working women was developed with efficacy for screening for work absenteeism.