A Cross-Sectional Study for Analyzing the Mediating Role of Symptom Burden in the Relationship Between Health Literacy and Quality of Life Among Perimenopausal Women in the Border Areas of Yunnan, China.

PURPOSE: This study aimed to examine the relationships among health literacy, symptom burden, and quality of life among perimenopausal women in the border areas of Yunnan, China, and to explore the mediating role of symptom burden. PATIENTS AND METHODS: A cross-sectional survey was conducted among 452 perimenopausal women in the border areas of Yunnan, China, using convenience sampling. Data were collected using a general information questionnaire, the Perimenopausal Health Knowledge Questionnaire, the modified Kupperman Index, and the Menopause-Specific Quality of Life Questionnaire. Descriptive statistics, univariate analysis, Pearson correlation analysis, and common method bias testing were performed using SPSS 26.0. Structural equation modeling was conducted using Mplus 8.3, and the Bootstrap method was used to test the mediating effect. RESULTS: The mean scores for health literacy, symptom burden, and quality of life were 10.00 ± 5.14, 16.19 ± 9.19, and 46.69 ± 26.38, respectively. Health literacy was negatively correlated with symptom burden and quality of life, whereas symptom burden was positively correlated with quality of life, with all correlations being statistically significant (P < 0.01). Symptom burden partially mediated the relationship between health literacy and quality of life, with an indirect effect of -0.081, accounting for 19.1% of the total effect. CONCLUSION: Perimenopausal women in the border areas of Yunnan had relatively low levels of health literacy, a high symptom burden, and impaired quality of life. Targeted and individualized interventions should be developed according to ethnic cultural characteristics and the distribution of primary healthcare resources in this region to reduce symptom burden and improve quality of life among perimenopausal women.