INTRODUCTION:

Menopause is an important time in women’s life. Her body is going through changes that can affect her physical, mental and social, feeling about herself functioning at work. In the past, menopause was often surrounded by misconception and myths. Now its recognized that menopause is a natural step in the process of aging contrary to the old fashioned view that life in all downhill. After having menopause many women today find that the years after menopause offer new discoveries and fresh challenges to face.¹

Menopause is a unique stage of female reproductive life cycle, a transition from reproductive to non reproductive stage. It is characterized by cessation of menstruation and women may view menopause as a transition from middle age to old age. Some women may look upon this with pleasant anticipation as time of relative freedom from such worries as undesired pregnancies and the stress of child bearing. Many women may have fear during this period because of the anticipated losses. Thus women may be hesitant and ignore the unusual and hormonally related symptoms may go undetected resulting in a delay in diagnosis and treatment.²

Menopause raises important health care issues and present physical challenges. Menopause causes short term changes and there are long term risks that can have a major impact on overall health and quality of life. Some consider menopause to be a call to action, it is a time to learn more about one’s body, a process that can be invigorating and empowering.³

Several psychological factors are related to the process of physical change. A woman may experience fear of losing her appearance, uncertainty about her purpose in life as a middle-aged woman, sadness at the passing of the fertile prime of life. These feelings may even outweigh the physical discomfort caused by complex hormonal changes. Menopausal women may also experiences psychological problems like anxiety, depression, anger, fear, loss of memory and lack of concentration. Depression is found to be the most common health problem.⁴

If women are aware of the natural changes occurring during her life, which will help them to adopt self help behavior and to improve their physical and mental health implies loss of child bearing, capacity and aging. Many women become adjusted to the menopausal symptoms over time by learning to live with them; however some women require intervention for symptom relief, especially if associated with moderate to severe distress of discomfort as menopausal symptoms become more dominant in their life.⁵

Menopausal changes considerably depend on the makeup of an individual and on her previous outlook at menopause and its significance. Many women in the developing countries do not know that they can age gracefully unaware of the havoc menopause can cause to their lives. Most of they suffer in silence not bringing to notice their symptoms.⁶

Menopause is an unspoken, unattended, reality of life, the cause of which is still un deciphered completely by man. Menopause is one such midlife stage which might be overcome easily or make a lady miserable depending on her luck. This phase of life is shrouded with lots of myths and taboos. Early recognition of symptoms can help in reduction of discomfort and fears among the women.⁷

STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured teaching programme on knowledge and practice regarding alternative remedies for menopausal symptoms among women with in the age group of 45-55 years in selected villages at Hiriyur Taluk, Chitradurga Dt, Karnataka.

OBJECTIVES OF STUDY:

1. To assess the pretest knowledge and practice regarding alternative remedies for menopausal symptoms among women with in the age group of 45 to 55 years.

2. To assess the post test knowledge and practice scores regarding alternative remedies for menopausal symptoms among women with in the age group of 45 to 55 years.

3. To compare pre and post test knowledge and practice scores regarding alternative remedies menopausal symptoms among women with in the age group of 45 to 55 years.

4. To correlate post test knowledge and practice scores regarding alternative remedies for menopausal symptoms among women with in the age group of 45 to 55 years.

5. To find association between post test knowledge scores regarding alternative remedies among women with in the age group of 45 to 55 years, with their selected demographic variables.

6. To find association between post test practice scores regarding alternative remedies among women with in the age group of 45 to 55 years, with their selected demographic variables.

HYPOTHESES:

H₁ The mean post test knowledge scores are significantly higher than mean pre test knowledge scores.

H₂ The mean post test practice scores are significantly higher than mean pre test practice scores.

H₃There will be significant correlation between the post test Knowledge and practice scores of women.

H₄ There will be significant association between the post test knowledge scores of women with their demographic variables.

H₅ There will be significant association between the post test Practice scores of women with their demographic variables.

MATERIALS AND METHODS:

Research Approach:

Pre experimental approach was used.

Research Design:

A one group pre-test post-test design was adopted

Setting of the Study:

The study was conducted in four selected villages in hiriyur. Karnataka.

Target Population:

In the present study, the target populations were women between age group of 45-55 years.

Sample:

A total of 40 menopausal women from selected villages in hiriyur. Karnataka , formed the sample for the study.

Sampling technique:

Non-probability convenience sampling technique was used to select the sample for this study.

Development of tool for data collection:

The final data collection instrument had two sections which included-

Section A - Demographic Variable

Section B - Knowledge Questionnaire

Section C-Practice Questionnaire

Validity of instrument:

The content validity of the tools was obtained from various experts of concerned field like medicine, nursing, research and statistics.

Reliability:

Reliability of the tool was tested for knowledge questionnaire by split half technique (Spearman‟s Brown prophecy) where R = 0.92 and test – retest (Karl pearson co-efficient) where r=0.89 was found. Practice questionnaire by split half technique (Spearman‟s Brown prophecy) where R = 0.88 and test – retest (Karl pearson co-efficient) where r=0.90 was found. A pilot study was conducted with four menopausal women to refine the methodology and to find the feasibility of the study.

Development of structured teaching programme:

The following steps were adopted to develop to the structured teaching programme.

· Preparation of the structured teaching programme

· Plan for teaching

· Plan for the implementation of the structured teaching programme

Data collection procedure:

Data collection for the study was conducted at the selected villages in hiriyur, where the feasibility of conducting study was ensured after a written permission was obtained from the villages authority for undertaking the study. Informed consent was also taken from the participants. Data was collected from 40 women in the age of 45-55 years by using structured knowledge and practice questionnaires. Immediately after pre-test, structured teaching Programme on alternative remedies for menopausal symptoms were administered to individually for 45 minutes by using laptop. Evaluation of the Structured Teaching Programme was to be done by conducting post-test, 7 days after the implementation of Structured Teaching Programme.

RESULTS:

The data collected from the respondents were analyzed by using descriptive and inferential statistics.

Demographic characteristics:

Highest percentage of women 26 (65%) were in the age group of 45 - 50 years, 14 (35%) were in the age group of 51-55 years. Majority of the participants 20 (50%) were married, 11(27.5%) were Widowed, 7(17.5%) were separated from family and only 2 (5%) were unmarried. Most of participants 16(40%) were primary education, 9(22.5%) were higher secondary education, 7 (17.5%) were no formal education, 5(12.5%) were secondary education and 3 (7.5%) were graduate and above. Data revealed 14(35%) were self employee, 12(30%) were daily wage, 8(20%) were housewife, 4(10%) were government employee and 2(5%) were private employee. Majority of the women 24 (60 %) have income of >5000, 10 (25%) have income of 4000-5000, only 6 (15%) have income of 3000-4000. Majority of the women 19(47.5%) were Hindu, 16(40%) were Christians and 5(12.5%) were Muslim. Most of women 22 (55%) were from nuclear family and 18(45%) were from joint family. Majority of the women 28(70%) were attained menopause and 12 (30%) were not attained menopause.

Knowledge:

During pretest most (32) of the women had inadequate knowledge and (8) of the women had moderately adequate knowledge, where as in posttest (26) of the women had adequate knowledge and (14) of the women had moderately adequate knowledge regarding alternative remedies for menopausal symptoms.

Figure 1: Percentage wise comparison of pre and posttest knowledge scores among women.

Practice:

During pretest most (28) of the women had inadequate practice, (12) of the women had moderately adequate practice. Where as in posttest (30) of the women had adequate practice, (10) of the women had moderately adequate practice regarding alternative remedies for menopausal symptoms.

Figure 2 : Percentage wise comparison of pre and posttest practice scores among women.

Table 1 : Comparison of mean, Standard deviation and paired ‘t’ value of pre and posttest knowledge scores regarding alternative remedies among women n = 40

SI. No.

Variable

Mean

‘t’ value

Table value

Pre test

Post test

6.5

15.78

2.41

3.74

21.74

2.04

df=39; (P<0.05)

Table 2: Comparison of mean, Standard deviation and paired‘t’ value of pre and posttest knowledge scores regarding alternative remedies among women. n=40

SI.No.

Variable

Mean

‘t’ value

Table value

Pre test

Post test

5.5

10.93

2.41

2.6

21.6

2.04

df=39; (P<0.05)

Correlation between the post test Knowledge and practice:

Positive correlation (r=0.91) between post test knowledge and practice scores regarding alternative remedies among women.

Association between the post test knowledge scores of women with their demographic variables:

Chi-square values were calculated to find association and result of study reveals that only educational status (χ²= 4.26), occupation (χ^2
=3.98) showed statistically significant association with post test knowledge of women at p<0.05 level.

Association between the post test practice scores of women with their demographic variables:

Result of study reveals that there is no any significant association of any demographic variable with post test practice scores of women.

DISCUSSION:

The study revealed that most of the women had adequate knowledge and practice after implementing structured teaching programme. It indicates that health education creates many changes in their level of knowledge and practice. The investigator feels that the most critical goal of them health care team in the care of women with menopausal symptoms in the development of curricula for effective care and raising an emotionally good health for the menopausal women.

CONCLUSION:

The objective of the study is to determine the effectiveness of structured teaching programme on knowledge and practice regarding alternative remedies for menopausal symptoms among women within the age group of 45 – 55 years. The results show that there is significant difference between pretest and posttest knowledge and practice scores.

RECOMMENDATIONS:

Based on the findings of the present study recommendations offered for the future Studies are:

Ø Similar study can be conduct in various aspects like yoga, meditation, ayurvedha. The effectiveness of these measures during menopause.

Ø The comparative study can also be done to assess the effectiveness of alternative remedies the women who attained menopause and not attained menopause.

Ø A Self-instructional module can be developed regarding the remedial measures of menopausal problems.

Ø Menopausal symptoms can be compared with hormone replacement therapy (HRT) users and non users.

Ø Longitudinal survey can be carried out to measure the hormonal changes.

Ø Similar study can be conducted on a larger sample to generalize finding.

REFERENCES:

1. Dewhurst. Text book of obstetrics and gynecology for post graduates. 6th ed. Blackwel Science; 1999. p. 441-461.

2. Shaws. Text book of gynecology. 11thed. New Delhi: BI Churchill Livingstone; 1998. p. 53-58.

3. Studd JW, Barbar R. Text book of clinical obstetrics and gynecology. 1st ed. London: Churchill Livingstone; 2007. p. 340-348’

4. Jish K. The menopausal symptom experience in young midwife women with breast cancer. Cancer Nursing 2009; 24(3): p.2-11.

5. Meir, Stinier. Psychological aspects of post menopausal syndrome. British Medical Journal 1999; 5:173-7

6. Kulshreshtha B, Ammini A. A textbook of geriatrics and gerontology. 3rd ed. New Delhi: Viva Books Publishers; 2008. p. 647–650.

Received on 18.12.2017 Modified on 28.12.2017

Asian J. Nursing Education and Research. 2018; 8(1): 111-114.

DOI: 10.5958/2349-2996.2018.00023.X