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Menopause. 2011 Nov;18(11):1178-83. doi: 10.1097/gme.0b013e318219d791.

The Hot Flush Behavior Scale: a measure of behavioral reactions to menopausal hot flushes and night sweats.

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Department of Psychology, Institute of Psychiatry, King's College London, London, UK.



There is increasing interest in the development of nonmedical treatments for menopausal hot flushes (HF) and night sweats (NS) and some evidence that cognitive behavioral interventions reduce their impact. However, the behavioral component of HF/NS is underresearched. This article describes the development of the Hot Flush Behavior Scale (HFBehS), a measure of the behavioral strategies that women use in response to HF/NS, and reports on the reliability, validity, and factor structure of the scale.


Behavioral items were generated from the empirical literature and qualitative studies based on in-depth interviews, with the aim of reflecting common behaviors related to HF/NS. A total of 140 women who had HF/NS completed the initial measure. Principal components analyses were applied to the data, with orthogonal rotation, to determine the most coherent and interpretable solution.


Exploratory factor analysis culminated in an 11-item measure comprising three dimensions: behavioral avoidance, practical cooling behaviors, and positive behavioral strategies. The Hot Flush Beliefs Scale subscales had reasonable internal consistency, with α values ranging from 0.59 to 0.76. Validity was supported through correlations with measures of HF/NS problem rating and frequency and cognitive measures (HF/NS beliefs).


Preliminary analysis of the HFBehS reveals it to be a psychometrically sound instrument. The HFBehS is grounded in women's experiences and can be used as a measure of behavioral reactions to HF/NS as well as enabling more rigorous evaluation of psychological interventions.

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