Reviewer's report
Title:Exploring Australian Aboriginal Women's Experiences of Menopause: a
Descriptive Study
Version:1Date:18 October 2013
Reviewer: Sarah Larkins
Reviewer's report:
Thanks for the opportunity to review this interesting descriptive qualitative study
exploring the experiences and attitudes of a group of Aboriginal women from
regional Western Australia around the menopause. This is an under-researched
area, and it is pleasing to see some research being performed in the area.
This small qualitative study has been performed using sound methods, however I
feel that the depth of analysis and interpretation could have been strengthened
through involvement of the participants in the analysis. A social constructionist
framework is appropriate for the study and analysis.
Overall I would recommend publication with some suggestions for improvement.
Major Compulsory Revisions:
Nil
Minor Essential Revisions:
1. Methods - paragraph 2. Role of AHWs and local Aboriginal research partner
needs to be explained. If the latter is an author than name her - if not explain her
role.
2. More detailed explanation of the participant breakdown into interviews and
FGDs would be useful (including demographics of each). Maybe this could be
better presented in a Table.
3. The interview question guide should be included as a Figure (or the questions
asked described in a little more detail).
Discretionary Revisions:
4. In paragraph four of the background section, I believe that the last sentence
could be more clearly expressed. The subjective experiences of menopausal
symptoms and their interpretation are in many ways socially and culturally
constructed, and this point could be highlighted.
5. Methods - in the first paragraph the inclusion of women over 18 (ie both pre
and post-menopausal should be more clearly justified.
6. Data analysis - needs a little more description in my view about the methods
used to enhance rigour. Was there any validation of transcripts by respondents?
What about discussion/validation of emerging themes/analysis with participants
in a group? How do you know that your analysis would be viewed as trustworthy
by the participants? If this was not done, then justify this.
7. Results - paragraph 1. A little detail about number of women approached who
declined to take part and whether they differed in characteristics from participants
would be useful.
8. I think a sentence of two introducing/summarising the themes of the qualitative
analysis before the results are entered into in depth is useful for the reader. This
can also be included as a small box.
9. I would like to see a little more exploration of the idea under the theme
"attributed to an alternative cause" of the notion that women ignored symptoms
because they had higher priorities such as caring for others. I think this is very
important clinically (caring responsibilities but also huge burden of chronic
disease and other health risks) and could be further expanded on in the
discussion.
10. Discussion. Paragraph 2. I think the discussion about barriers to
understanding menopause could reflect more on the role of menopausal
symptoms with a high burden of chronic disease, psychosocial stressors and
caring responsibilities of Aboriginal women in the perimenopausal years and the
impact of this in terms of prioritisation of menopausal symptoms.
11. A framework of transitions towards the status of older/wiser woman may be
useful in terms of adaptation and discussions.
12. I think lack of respondent validation /evaluation of findings should be added
as a limitation to the study.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests