Descriptive Study to Assess the Knowledge and Attitude regarding Menopause among Urban and Rural Married Women in Selected Areas of Kurali (Punjab, India)

 

Satveer Kaur, Kamlesh, Raman Kalia, Manpreet Saggi

Saraswati Nursing Institute, Dhianpura, Distt. Roopnagar

 

ABSTRACT:

Menopause is the stoppage of menstruation for at least six months after the age of 40 years. It normally occur between 45 and 50 years. It is accompanied by various body changes and deleterious health effects which can be better managed by life style changes, and hormonal therapy. A quantitative research approach and descriptive comparative design was adopted to conduct the study. Purposive sampling technique was used to select 200 menopausal women, 100 from rural area and 100 women from urban area. Structured interview schedule and five point Likert scale were used to assess the knowledge and attitude regarding menopause among the subjects. The data were analyzed by using descriptive and inferential statistics. Significant difference between mean knowledge score and mean attitude score of the subjects was observed (p<0.005). Results revealed fair Knowledge among rural women, attitude was observed to be positive among the subjects, Correlation in the knowledge and attitude of the subjects was observed to be statistically significant. Study indicated the need of creating awareness about menopause among women

 

 

INTRODUCTION:

“It’s a sign of the times when your roots are grey and your memory’s shorter; it’s a sign of the times when your hourglass shape becomes a glass of water”- Jeanie linders

The word menopause is gotten from a Greek word. ‘Men’ means ‘month’ and ‘pausis’ means ‘cessation’. Thus, menopause refers to permanent cessation of menstruation at the end of a reproductive life due to ovarian follicular inactivity. Menopause usually occurs between the ages of 45 to 55 years. This is a natural step in the aging process, represents the end of menstruation after the last menstrual period in the previous 12 months.

 

It occurs gradually in women and it indicates the transition from the reproductive to the post-productive era of a women’s life. It is a condition which every woman faces in later life and it can have many associated effects which may disrupt the quality of life (Mishra and Kuh, 2012)^1.

 

Menopause is a natural transition encompassing not only the biological changes but also the social and cultural changes associated with the aging process. Menopause is defined as the permanent cessation of menses resulting from reduced ovarian hormone secretion that occurs naturally or is induced by surgery, chemotherapy, or radiation. Natural menopause is recognized after 12 months of amenorrhea that is not associated with a pathologic cause. A woman may experience an early menopause because of surgery if both ovaries are removed. Other causes of a premature menopause include ovarian failure as a result of chemotherapy, radiation therapy to the pelvis autoimmune diseases (Veena, 2012)².

 

While most women traverse the menopausal transition with little difficulty, others may undergo significant stress. And with increasing age, emerging physical health problems can cause significant changes in the woman’s lifestyle, leading to social withdrawal, avoidance and curtailment of physical activity (Abedzadeh-Kalahroudi et al., 2012).³

 

Changes in health and illness of individuals create a process of transition, and client in transition period tend to be more vulnerable to the risks that may in turn affect their health, uncovering these risks may be enhanced by understanding the transition process. Menopause may be viewed as a transition from middle age to old age by many women, and they fear this period because of the anticipated losses. The experience is not universal among women; there is no fixed pattern and no chain of events that must transpire. The onset and end are unpredictable. The duration is indefinite and the experiences are different for every woman as she passes through it (El Shafie et al 2011).⁴

 

Menopause is emerging as a major health scourge in India with an alarming rate of 18% of women in the 30 to 49 age groups attaining the non-reproductive age prematurely. Illiteracy among young married women and early child bearing with poor nutritional levels has been cited as reasons for premature menopause, which might continue to be a burden in the future. According to a study conducted by the institute for social and economic changes 11% of Indian women of less than 40 years have attained menopause. The situation is grim in Andhra Pradesh (31.4%), Bihar (21.7%), Karnataka (20.2%) and Gujarat (19.9%). However, their counterparts in Kerala were 11.6%, West Bengal (12.8%) and Rajasthan (13.1%).⁵

 

The study aims to:

(1) To assess the knowledge and attitude of urban and rural married women regarding menopause.

(2) To compare the knowledge and attitude of urban and rural married women regarding menopause.

(3) To determine the association of knowledge and attitude with the selected socio demographic variables.

 

MATERIALS AND METHODS:

A Quantitative research approach was adopted for the present study. Descriptive comparative research design was used. The study was conducted in Dhianpura and Kurali. Areas in Distt. Roopnagar. The sample consists of 200 subjects residing in the selected settings. Out of 200 subjects, 100 women were residing in rural areas, and 100 women were residing in urban area of Kurali. Convenient sampling technique was used. Women were contacted at their houses during a survey. The investigator developed a semi structured interview schedule to assess the knowledge of the subjects related to menopause and Likert Scale was developed to assess the attitude of the subjects. The tool for data collection consists of three parts. E.g 16 items to collect socio demographic information. 20 items to assess the knowledge. The level of knowledge was categorized as poor 0-5 scores, fair 6-10 scores, good 11-15 scores, excellent16-20 scores and a Likert scale was prepared to assess the attitude of women which consist of 20 items. Reliability was established by split half method according to Karl’s Pearson coefficient. The reliability of structured interview schedule was 0.7, and the reliability of Likert scale was 0.8. Before starting the interview, the researcher introduced herself and rapport was developed with the subjects. Informed consent was obtained.

 

RESULTS:

Table 1: Frequency and percentage distribution of subjects as per their socio-demographic profile                           N=200

Characteristics	Rural N=100	Urban N=100
Age in years 35-45 46-55 56-60 >60	11 36 43 10	11 27 47 15
Religion Hindu Sikh Muslim Any other	57 36 07 00	41 35 15 09
Educational Status Illiterate  Primary High school Higher secondary	02 34 41 23	00 09 28 63
Occupational status Working House wife	88 12	73 27
Income Less than Rs.10000 More than Rs.10000	91 09	64 36
Eating habits Vegetarian NonVegetarian	73 27	63 37
No of pregnancies Upto two More than two	55 45	61 39
Menopause status Since five years More than five years	08 92	09 91
Physical Exercise Regular Irregular No exercise	34 23 43	53 22 25

 

The socio demographic data of the subjects revealed that 43% women from rural area, and 47% from urban area were in the age group of 56-60 years, majority of the women (49%)were hindu41% subjects among the rural population had education up to high school whereas 63% subjects residing in the urban area had education up to higher secondary class, Majority of the subjects were working, most of the subjects 91% among the rural population and 64% among the urban population reported the family income less than Rs.10000. Majority of the subjects were vegetarian. The subjects were asked about the number of pregnancies, the subjects reported having more than two pregnancies among 55% rural women and 61% among urban women. Distribution of women according to menopausal status showed that majority of the women had menopause since last five years, 43% women among the rural subjects reported performing regular exercises and 53% women reported performing regular exercises.

 

Table 2: Frequency and percentage distribution of subjects as per their knowledge score regarding menopause        N=200

Level of Knowledge	Score	Rural n=100	Urban n=100
Poor	0-5	09	00
Fair	6-10	52	10
Good	11-15	38	39
Excellent	16-20	01	51

Chi square=2 85.54                                   P<0.05

Above table showed the Level of knowledge of the subjects that 52% subjects among rural population had fair knowledge regarding menopause and 38% had good knowledge. Among subjects from urban population 51% had excellent knowledge and 39% subjects had good knowledge.

 

Table 3: Frequency and percentage distribution of subjects as per their attitude towards menopause                                    N=200

Attitude	Score	Rural n=100	Urban n=100
Negative	0-33	00	00
Neutral	34-67	04	01
Positive	68-100	96	99

Chi square= 1.84                                       P<0.05

 

Table 4: Comparison of knowledge mean scores regarding menopause among rural and urban subjects   N=200

Variables	Rural	Urban
Mean Knowledge Score	9.3	15
Mean Attitude Score	80.8	84.9

 

 

Table 5. Correlation of Knowledge score and selected socio-demographic variables                                  N=200

*Significant at p value <0.05

 

Table 6. Correlation of Attitude level and selected socio-demographic variables                        N=200

	Demographic variables	RURAL (N=100)		URBAN (N=100)		F value/p value
Age (yrs)		n	Mean ± SD	n	Mean ± SD
	35-45	11	8.7 ± 2.2	11	15.6 ± 1.8	0.919	0.433
	46-55	36	9.1 ± 2.5	27	14.9 ± 3.0
	56-60	43	9.6 ± 2.9	47	15.4 ± 2.8
	>60	10	9.1 ± 2.4	15	13.5 ± 3.7
Education	Illiterate	02	85.5 ± 3.5	00	-	3.442	0.010*
	Primary	34	79.5 ± 6.9	09	84.4 ± 5.5
	High school	41	81.2 ± 4.8	28	83.3 ± 8.7
	Secondary	19	80.7 ± 7.2	41	85.7 ± 4.9
	Higher Secondary	04	85.5 ± 7.8	22	85.6 ± 5.9
Occupation	Govt job	84	80.6 ± 6.4	64	85.0 ± 6.5	0.617	0.605
	Private job	04	77.5 ± 8.2	09	86.2 ± 4.0
	Unemployed	00	-	05	86.2 ± 3.1
	Retired	12	82.9 ± 4.1	22	83.6 ± 7.6
	<5000	19	79.6 ± 6.8	03	81.6 ± 2.5	2.391	0.052
Monthly Income (Rs.)	5001-10000	58	81.2 ± 5.7	35	84.3 ±7.8
	10001-15000	14	82.4 ± 5.0	26	85.8 ± 5.6
	15001-20000	07	77.4 ± 10.7	14	85.0 ± 6.4
	>20000	02	80.2 ± 1.4	22	85.0 ± 5.6

* Significant at p value <0.05

Table 3 revealed that almost all the subjects 96% among rural population and 99% among urban population had positive attitude towards menopause.

 

Table 4 depicted that Mean knowledge score was 9.3 among rural population and 15 among urban population regarding menopause which was highly significant (p<0.001) revealed that urban population had more knowledge than rural population regarding menopause. Mean attitude score was 80.4 among rural population and 84.9 among urban population towards menopause.

 

Table 5 depicted the correlation of knowledge score and selected socio-demographic variables. Correlation test showed that knowledge score among rural and urban population with education, occupation and monthly income was found statistically significant at p value <0.05.

 

Table 6 depicted the correlation of attitude level and selected socio-demographic variables. Correlation test showed that attitude level among rural and urban population with education was found statistically significant at p value <0.05.

 

DISCUSSION:

Present study showed that more than half of subjects 52% among rural population had fair knowledge and 51% subjects among urban population had excellent knowledge regarding menopause. A similar study was conducted by Noroozi E et al (2013)⁶ showed that 38.5% subjects had good knowledge and 68% had moderate knowledge regarding menopause. Another similar study conducted among women in Andhra Pradesh towards menopause and its relationship with selected variables, consisted of 40 school teachers, 40 office workers and 40 house wives. Results revealed that women had poor knowledge about menopause and knowledge was influenced by education of the women whereas attitude of women were found highly significant with income and occupation.

 

Similar results were found in a study conducted by Utian and Schiff (1994)⁷ which showed that menopausal women had inadequate knowledge related to menopause and education was found to be highly significant with the knowledge score of menopause. In present study mean knowledge score was 9.3 among rural population and 15 among urban population regarding menopause. A study conducted by Noroozi E et al (2013) ⁶ showed that mean knowledge score was 63.57+_ 10.79. Present study results showed that almost all the subjects 96% among rural population and 99% among urban population had positive attitude towards menopause. A similar study was conducted by Noroozi E et al (2013) ⁶ also showed that 81.5% of subjects had a positive attitude towards menopause.

 

Results of the present study showed that mean attitude score was 80.4 among rural population and 84.9 among urban population regarding menopause. Another study conducted by Noroozi E et al (2013) ⁶ showed that average attitude score was 61.21+_ 12.73.

 

In present study correlation test showed that knowledge and attitude among rural and urban population were statistically significant. Similar findings were observed in the study conducted by Shojarizadeh (2000)⁸ on relationship between knowledge, attitude and health behaviour among menopausal women. Results showed that 28% women had good knowledge, 11% has positive attitude and 16% women had healthy behaviour regarding menopause duration, personal hygiene, healthy eating habits, regular exercises showed that there is a positive correlation between knowledge, attitude and healthy behaviour.

 

CONCLUSION:

Results of present study showed there is a strong need of creating awareness & providing knowledge related to menopause among women. Identifying the quality of women’s perception of menopause has an essential role in the development of accurate & appropriate programs to promote women’s health during menopausal years.

 

REFERENCES:

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3.      Masoumeh Abedzadeh-Kalahroudi, Mahboubeh Taebi, Zohreh Sadat, Farzaneh Saberi, Zahra Karimian. Prevalence and Severity of Menopausal Symptoms and Related Factors among Women 40-60 Years in Kashan, Iran. Nursing and Midwifery Studies 2012; 1(2):88-93.

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6.      Ensieh Noroozi, Nayereh Kasiri Dolatabadi, Ahmad Ali Eslami, Akbar Hassanzadeh, Soheila Davari. Knowledge and attitude toward menopause phenomenon among women aged 40–45 years. Journal of Education and Health Promotion 2013; 2. Available at https://www.ncbi.nlm.nih.gov/pmc/issues/227667/ (accessed 10 June 2015).

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Received on 02.11.2018          Modified on 03.12.2018

Accepted on 30.12.2018     © A&V Publications all right reserved