Study of Knowledge, Attitude and Practice of Women Aged 45-60 Years about Menopausal Health

Extended Abstract
Background and Objectives
Menopause is a necessary natural change in a woman's body. Menopause often occurs in an important part of a women’s life usually accompanied by social changes and feeling of loneliness, for instance when kids depart from family, which may lead to depression and other mental disorders. Every woman may experience the menopause differently. Some women just have one or two problems which are moderate, while other women may experience more difficult and painful symptoms. Only few women perceive the body change as natural and simple while others often find it life changer.Obtaining adequate knowledge and adopting the right attitude along with proper practice about menopause is important to better deal with its consequences and promote women's health. The aim of this study was to study the knowledge, attitude and practice of women about menopausal health who were living in Ahar, one of the major cities of East Azerbaijan province.
Material and Methods
This cross-sectional study was conducted from November 2016 to March 2017 in three health centers in Ahar, affiliated with Tabriz University of Medical Sciences in Iran. Women who were 45-60 years of age and had no signs and symptoms of mental disorders, were included as the participants of the present study. Sampling method was convenient sampling. A total of 300 women referring to health care centers of Ahar were asked to complete the research questionnaire concerning the knowledge, attitude and practice of women about menopausal health. In order to determine the accurate number of samples, the following formula was used, and our sample size was computed to be 300. n=((N×5)×1/2)/(1-0/2)In this equation, N represents the number of items in the questionnaire; accordingly, for each item five women were chosen and in this questionnaire there were 40 items. Design impression was considered to be 1.2. Additionally, the missing rate was regarded to be 20%. Final sample size due to the missing rate was 300.A confirmed standard questionnaire which validity and reliability were established by Norozi and et al., was used to collect data. Norozi et al., prepared the standard questionnaire with appropriate validity and reliability (Cronbach’s alpha=0.71) to be used in evaluating the knowledge, attitude and practice of women about menopausal health. In this study, content validity indices were calculated. The overall content validity ratio (CVR) and content validity index (CVI) were 0.87 and 0.91, respectively. Cronbach’s alpha of knowledge, attitudes and practice sections were 0.85, 0.86 and 0.74, respectively. Data analysis was performed by independent t-test and multiple regression analyses in SPSS 16 software.
Results
A total of 242 women completed the questionnaires (the response rate was 80%). All of these 242 questionnaires were examined and statistically investigated. The mean age (standard deviation) of the participants was 54.41 ± 4.25 years. The minimum age of the participants was 45 while their maximum age was 60. Furthermore, the mean menopausal age (standard deviation) of women was found to be 47.98 ± 3.16 years. The mean number (standard deviation) of pregnancies and children were 3.76 ± 1.89 and 3.53 ± 1.37, respectively. More than half of the participants (55.67%), the majority of whom (94.6%) were married, had primary education or were illiterate. In addition, most of the women were housewives. The ranges of knowledge, attitude and practice scores of the participants were 14-24, 3-10 and 1-4, respectively. In this study, the mean scores of knowledge, attitude and practice of women about menopausal health were 22.52 ± 3.21 (from zero to 25), 7.81 ± 1.27 (out of 10) and 33 respectively. It was 2.14 ±1.33 (out of 5 scores). There was a statistically significant difference in knowledge score of women with respect to level of education and job. The knowledge score of women who had higher education and were housewives was higher (P-value < 0.05). Regarding the attitudes of women toward menopausal health, there was a statistically significant difference in the attitude score of women with respect to level of income, age, level of education and job. The attitude score of women who had lower education, lower income and were housewives was lower (P-value < 0.001). Subsequently, the practice score of the women who had higher education was higher and it was statistically significant (P-value < 0.001). In this study, by multiple regression analysis, the score of knowledge, attitude and practice of women about menopausal health based on education was significantly different (P-value < 0.001).
Conclusion
Even if the knowledge and attitude of women aged 45-60 years about menopausal health was sufficient, their performance in this field was inadequate. Proper and useful interventions are necessary to improve their practice and to support the 45-60 year-old women to experience their postmenopausal period in better conditions and health. The menopause has to be recorded in Iran. Because it has a great relationship with mortality and morbidity of the increasing number of women who reach menopausal ages; who’s a quarter of life is following the menopause. Thus, health intervention as the main approach for changing the women’s behavior is recommended.
Practical Implications of Research
The knowledge and attitude of 45-60 year- old women about menopausal health seemed to be fine, but their lack of proper performance in this area stresses the need for more focused work on changing the behavior and performance of women with the help of health education experts and relevant experts in this field. The use of new behavioral change theories and techniques is strongly recommended.
Ethical Considerations
National Ethical Regulations in Medical Research were all observed in the present work, including obtaining a permit from the university to enter the research environment before completing the questionnaire, providing full explanations to the participants about the purpose of the project and the option to participate in it or leave it, observing the anonymity of the questionnaires and confidentiality. The information was given to individuals and they were included in the study after obtaining verbal consent from them. Women who were illiterate or barely literate completed the questionnaire with the help of health care providers trained in health centers. The researchers taught the following questions and answers to the questioners in a two-hour session. The study proposal has been approved by the Ethics Committee of Tabriz School of Medical Sciences with the ethics code IR.TBZMED.REC.1398.265.
Conflict of Interest
There is no conflict of interest in this study.
Acknowledgment
We thank all the women participating in the study and the health care providers working hard in the Ahar Health Network who sincerely accompanied us in conducting this study.