Effect of Health Promoting Life Style Modification Education on Knowledge and Practice among Menopausal women at selected Wards of Kaviyoor Panchayat
Anjaly Mohan1, Beena Abraham Varghese2, Nidhi Alex3, Jaya Mathew4, Blessy Peter5
1Lecturer, TMM College of Nursing, Anjilithanam P.O, Kaviyoor.
2Professor, TMM College of Nursing, Anjilithanam P.O, Kaviyoor.
3HOD, Community Health Nursing (Dept.), TMM College of Nursing, Anjilithanam P.O, Kaviyoor.
4Vice-Principal, TMM College of Nursing, Anjilithanam, P.O, Kaviyoor.
5Principal, TMM College of Nursing, Anjilithanam, P.O, Kaviyoor.
*Corresponding Author E-mail: anjalysujith6@gmail.com
ABSTRACT:
Menopause is the time period in women’s life when her menstruation stops”. The present study assessed the effect of health promoting lifestyle modification education on knowledge and practice among menopausal women at selected wards of Kaviyoor Panchayat. The objectives were to determine the effect of health promoting life style modification education in terms of difference in the mean pretest and post-test knowledge and practice scores among menopausal women and to determine the association between pretest knowledge scores and selected demographic variables. The study was conducted using pre experimental one group pretest-post-test design. The conceptual framework was based on Modified Rosen Stock’s health belief model. The investigator selected 70 samples of menopausal women by purposive sampling technique. During the pre-test the prevalence of menopausal symptoms by Menopause Rating Scale, the knowledge and practice regarding lifestyle modification among menopausal women using self-structured questionnaire was assessed. Results showed 77.14% of samples had attained menopause at the age of 50-54 years, majority 91.43% of them were having normal BMI, 28.57% of menopausal women had hot flushes on moderate frequency, 28.57% of samples had moderate urinary problems, 31.42% had severe muscle and joint problems. Pretest study found that in the pretest 42.85% had average knowledge and majority 81.42% had very good knowledge score in the post- test (MD: 13.31, ‘t’ value:19.01 at p<0.05). Also majority 85.75% of menopausal women had average pretest practice score and 64.2% of them good practice score in post-test (MD: 21.31, ‘t’ value:40.27 at p<0.05. It shows that the awareness programme was effective in increasing knowledge and practice level of menopausal women regarding health promoting lifestyle modification education.
KEYWORDS: Lifestyle Modification education, Knowledge, Practice, Menopausal women.
INTRODUCTION:
Menopause is a natural event experienced by women in middle age. When a women permanently stops having menstrual periods, she has reached the stage of life called menopause. Often called the change of life, this stage signals the end of a women’s ability to reproduce. Menopause is said to be complete when menstrual periods have ceased for one continuous year. The transition phase before menopause is often referred to as Perimenopause, the production of mature eggs in a woman’s ovaries diminishes and ovulation becomes irregular. At the same time, the production of estrogen and progesterone decreases. Drop in estrogen levels that causes most of the symptoms of menopause.1
The hormonal changes associated with menopause can affect physical, emotional, mental, and social well-being. The symptoms experienced following the menopausal transition vary substantially from person to person. Some have few if any symptoms. For others, symptoms can be severe and affect daily activities and quality of life. Some can experience symptoms for several years. Therefore, post-menopausal care plays a vital role in the promotion of healthy ageing and quality of life. Menopause can be an important transition from a social perspective, as well as a biological one. Socially, a women’s experience of menopause may be influenced by gender norms, familial and socio-cultural factors, including how female ageing and the menopausal transition are viewed in her culture.2
The global population of postmenopausal women is growing. In 2021, women aged 50 and over accounted for 26% of all women and girls globally. This was up from 22% of 10 years earlier. Additionally, women are living longer. According to Indian Menopause Society has projected that by 2026, India’s menopausal population will reach 103 million and also reported that increased awareness about menopause is crucial for early symptom recognition, reduced discomfort and seeking appropriate medical care.3 Menopause can offer an important opportunity to reassess one’s health, lifestyle, and goals. It is critical to see menopause as just one point in a continuum of life stages. A woman’s health status entering the perimenopausal period will largely be determined by prior health and reproductive history, lifestyle and environmental factors. Perimenopausal and postmenopausal symptoms can be disruptive to personal and professional lives, and changes happened with menopause will affect a woman’s health as she ages. Therefore, postmenopausal stage need more care to lead a good quality of life.4
OBJECTIVES:
· To determine the effect of health promoting life style modification education in terms of difference in the mean pretest and post-test knowledge and practice scores among menopausal women.
· To determine the association between pretest knowledge scores and selected demographic variables.
HYPOTHESIS:
· H1: There is a significant difference between pre-test and post-test knowledge and practice scores of health promoting lifestyle modification education of menopausal symptoms and its management among menopausal women.
· H2: There is a significant association between pre-test knowledge and practice score with selected baseline variables.
MATERIALS AND METHODS:
This study used a quantitative research approach and a one group pre-test post test research design. The study was conducted among 70 menopausal women in the age group of 45-60 years residing in selected wards of Kaviyoor Panchayat. Purposive sampling techniques was used in this study. Written consent from the study participants were obtained. Demographic variables included in this study was age, religion, education, occupation, family income per month, dietary habit, type of family and source of health information. The pilot study was conducted from 12-8-2024 to 17-8-2024, among 10 menopausal women, to determine the feasibility of the study.
Main study was conducted from 19/8/24. Knowledge questionnaire was administered by house-house visit and group basis in Ayalkoottam followed by structured teaching programme and information leaflet.
Table 1: Frequency and percentage distribution of menopausal women based on socio-demographic data n=70
|
Demographic variables |
Frequency |
Percentage |
|
1.Age in years a.45-49 b.50-55 c.56-60 |
21 22 27 |
30.00 31.43 38.5 |
|
2. Education a. High school b. Higher secondary c. Pre degree d. Degree |
7 11 35 17 |
10 15.72 50 24.28 |
|
3. Occupation a. House wives b. Self employed c. Private job d. government job |
36 23 9 2 |
51.42 32.86 12.86 2.86 |
|
4.Type of family a. Nuclear family b. Joint Family |
50 20 |
71.43 28.57 |
|
5.Monthly income a.10000-25000 b. 25001-40000 c. >40000 |
35 34 1 |
50 48.58 1.42 |
|
6. Religion a. Hindu b. Christian c. Muslim |
41 27 2 |
58.57 38.58 2.85 |
|
7. Food habits a. Vegetarian b. Non-Vegetarian |
6 64 |
8.58 91.42 |
|
8. Source of health information a. Family members b. Printed medias c. Friends d. Health workers e. Social medias |
2 15 3 37 13 |
2.85 21.43 4.29 52.86 18.57 |
The researcher administered health promoting lifestyle modification education among menopausal women on the day of pre-test for a duration of 30 minutes with the help of power point presentation. Information leaflet was also administered. Information included menopause, physiological changes, symptoms, management, and lifestyle modification measures. The practice session focused on importance of dietary modifications, exercises, mainly quadriceps strengthening exercises and Kegal exercise. Post test knowledge and practice score was assessed after 14 days. Follow-up was done to assess the practice status through whatsapp group. Majority of the participants followed the practice measures ie; exercises and dietary modifications. Participants found it beneficial with the information leaflet.
RESULTS:
Present study was aimed to assess the effect of health promoting lifestyle modification education on knowledge and practice of menopausal women at selected wards of Kaviyoor Panchayat.
Data presented in table 1 shows that out of 70 samples 27 (38.57%) were between 56-60 years. Half of the samples 35 (50%) had pre degree as their basic educational qualification. Majority of menopausal women 36(51.42%) were house wives. Majority of them 50 (71.43%) lived in nuclear family. Monthly income earned was 10000-25000 by half of them 35(50%), 41 (58.57% were Hindus. Most of them preferred non-vegetarian diet 64 (91.42%) and 37(52.86%) women had their health information from health workers.
Table 2 showed that based on menopausal rating scale, 20(28.57%) of menopausal women had hot flushes on moderate frequency, 20(28.57%) of them had mild and 19(27.1%) had moderate insomnia and 17(24.28%) had mild depression. Mild anxiety was reported by 24(34.28%), in case of excessive anger reported 21(30%) of moderate level. About forgetfulness and lack of concentration 24(34.28%) reported moderate occurrence. Majority of them had no signs of sexual dysfunction 54(81.42%) and 20(28.57%) of samples had moderate urinary problems. Majority reported 60(85.71%) no dryness of vagina. Among menopausal women 22(31.42%) had severe muscle and joint problems.
Figure 1 showed that 50(71.42%) samples had mild-moderate occurrence of menopausal symptoms and 13(18.57%) had severe to very severe symptoms.
Table 3 showed that in the pretest 30(42.85%) had average knowledge and majority 57(81.42%) had very good knowledge score in the post-test regarding health promoting lifestyle modification education among menopausal women.
Table 3: Frequency and percentage distribution of pretest and post-test knowledge scores among menopausal women. n=70
|
Knowledge score |
Pretest Frequency (f) |
Pretest Percentage (%) |
Post test Frequency (f) |
Post test Percentage (%) |
|
Poor |
18 |
25.71% |
4 |
5.71% |
|
Average |
30 |
42.85% |
6 |
8.57% |
|
Good |
16 |
22.85% |
3 |
4.28% |
|
Very good |
6 |
8.57% |
57 |
81.42% |
Table 2: Distribution of menopausal women based on menopausal symptoms as per Menopause rating scale (MRS)5 n=70
|
S. No |
Menopausal symptoms |
Nil |
Mild |
Moderate |
Severe |
Very severe |
|
f and % |
f and % |
fand % |
fand % |
fand % |
||
|
1 |
Hot flushes |
10(14.28% |
12(17.14%) |
20(28.57%) |
13(18.57%) |
14(20%) |
|
2 |
Heart related problems |
69(98.57%) |
0(0) |
1(1.42%) |
0 |
090) |
|
3 |
Insomnia |
8(11.4%) |
18(25.71%) |
20(28.57%) |
19(27.1%) |
5(7.14%) |
|
4 |
Depression |
46(65.7%) |
17(24.28%) |
6(8.57%) |
1(1.42%) |
090) |
|
5 |
Anxiety |
20(28.57%) |
24(34.28%) |
13(18.57%) |
7(10%) |
6(8.57%) |
|
6 |
Excessive anger |
10(14.28%) |
7(10%) |
21(30%) |
18(25.72%) |
14(20%) |
|
7 |
Forgetfulness,lack of concentration |
20(28.57%) |
18(25.71%) |
24(34.28%) |
6(8.57%) |
2(2.85%) |
|
8 |
Sexual dysfunctions |
54(77.14%) |
9(12.85%) |
7(10%) |
0(0) |
0(0) |
|
9 |
Urinary problems |
10(14.28%) |
12(17.14%) |
20(28.57%) |
14(20%) |
14(18.57%) |
|
10 |
Dryness of vagina |
60(85.71%) |
8(11.42%) |
2(2.85%) |
0(0) |
0(0) |
|
11 |
Muscle and joint problems |
8(11.43%) |
12(17.14%) |
20(28.58%) |
22(31.42%) |
8(11.43%) |
Table 4: Frequency and percentage distribution of pretest and post-test practice scores among menopausal women. n=70
|
Practice score |
Pretest Frequency (f) |
Pretest Percentage (%) |
Post test frequency (f) |
Post test percentage (%) |
|
Poor Average Good Very good |
3 60 4 3 |
4.28% 85.75% 5.71 % 4.28% |
2 10 45 13 |
2.85% 14.28% 64.2% 18.57% |
Table 4 showed that in practice score 60(85.75%) of menopausal women had average pretest practice score and 45(64.2%) of them had good practice score in post-test regarding health promoting life style modification education among menopausal women.
Figure 1: Percentage distribution of menopausal women based on Menopausal Rating Scale n=70
0-11=Asymptomatic
12-35=Mild to moderate
36 and above=Severe to very severe.
Effect of health promoting lifestyle modification education on knowledge scores of menopausal women:
Objective 1:
To determine the effect of health promoting life style modification education in terms of difference in the mean pretest and post-test knowledge scores among menopausal women.
Hypothesis:
H01: There is no significant difference between pre-test and post-test knowledge scores of health promoting lifestyle modification education among menopausal women.
Table 5: Mean, Standard deviation and paired‘t’-test of knowledge scores of menopausal women. n=70
|
Knowledge Score |
Mean |
Standard deviation |
Mean difference |
df |
t-test |
|
Pretest Post-test |
7.62 20.9 |
3.50 4.61 |
13.31 |
69 |
19.01 |
Table 5 Showed that the computed ’t’ score is 19.01 that is greater than the tabulated table value (1.99) at p<0.05 level. So null hypothesis rejected. It indicates that the awareness programme was effective in increasing the knowledge level of menopausal women regarding health promoting lifestyle modification education.
Table 6: Effect of health promoting lifestyle modification education on practice score of menopausal women’ using paired ‘t’ test:
Objective 2: To determine the effect of health promoting life style modification education in terms of difference in the mean pretest and posttest practice scores among menopausal women.
Hypothesis:
H02: There is no significant difference between pre-test and post-test practice scores of health promoting lifestyle modification education among menopausal women.
Table 6: Mean, Standard deviation and paired‘t’-test of practice scores of menopausal women. n=70
|
Practice score |
mean |
Standard deviation |
Mean difference |
df |
t-test |
|
Pre-test Post-test |
21.64 42.96 |
2.81 3.53 |
21.31 |
69 |
40.27 |
Table 6 Showed that the computed ’t’ value is 40.27 that is greater than the tabulated table value (1.99) at p<0.05 level. So null hypothesis rejected. It indicates that the awareness programme was effective in increasing the practice level of menopausal women regarding ‘health promoting lifestyle modification education.
DISCUSSION OF STUDY FINDINGS:
Menopause is the transition phase in women’s life. This can be associated with many physical and emotional changes for women, and this can make it a challenging and complicated time. An active, healthy lifestyle can ease some of the symptoms of menopause. The study findings on the degree of menopausal symptoms based On Menopause rating scale was hot flushes on moderate level (28.57%), anxiety in mild frequency (34.28%), excessive anger (30%) in moderate) level, sexual dysfunctions (12.85%) mild occurrences, (20%) of had severe urinary problems, (11.42%) had dryness of vagina, (31.42%) had severe muscle and joint problems. Similar results were found in the study conducted by Asha Ashok and Anu Paul in Kadapra, Pathanamthitta.6 Present study showed significant difference in the knowledge score (MD: 13.31, ‘t’ value:19.01 at p<0.05) Which was supported by a study conducted by Anjaly Medibonia, Penumala Pratyusha in Andhra Pradesh at 2019.7 Findings of the study recommends for a comparative study on lifestyle modification among rural and urban women and also a qualitative study on menopausal experience.
LIMITATIONS:
The study was limited to 70 house wives and self- employed women because of unavailability of working womens, so couldn’t identify the menopausal problems among working womens exactly.
CONCLUSION:
The menopause can be associated with many physical and emotional changes for women, and this can make it a challenging and complicated time. ‘An active, healthy lifestyle can ease some of the symptoms of menopause. Go for a walk, a swim or try a yoga class to get more active’. The menopause is a normal transition for many women. By providing help and support for women who are managing menopause symptoms at work, employers can contribute to a positive workplace environment. In India, the proportion and the absolute number of past menopausal women are growing. Therefore, it is critical to reshape public reproductive healthcare facilities. To achieve holistic care for menopausal women, the primary healthcare provider should train them to tackle the symptoms through modalities like pelvic floor exercises, nutritious diet and increase in physical activity and meditation. The investigator found that the awareness programme was an effective strategy to improve the knowledge of menopausal women, so that they understand the importance of lifestyle modification on managing menopausal symptoms.
REFERENCE:
1. United Nations, Department of Economic and Social Affairs. (2021) World Prospects 2021. https://population.un.org/wpp/Download/Standard/Population/
2. United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Ageing 2019 Highlights. (ST/ESA/SER.A/430).
3. Indian Journal of Public Health and Research Development; Vol.16, No: 3(2025), 226-233.
4. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf.
5. Menopause;http;//www.menopauseratingscale.org.australian (open access).
6. Asha Ashok and Anu Paul: Prevalence of menopausal symptoms and knowledge regarding menopausal problems among rural areas at Kadapra. International Journal of Nursing Education and Research. 2021; 9(3): 331-1. doi: 10.52711/2454-2660.2021.00078
7. Anjali Medibonia, Penumala Pratyusha, G. Sravankumar; determining the prevalence and severity of menopausal symptoms and lifestyle modification measures in post-menopausal women in Eluru, Andhra Pradesh, Using the Menopause Rating Scale(MRS); 16 JUN 2019; International Journal of Medical Students;doi,10.5195/ijms.2024.2116.
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Received on 05.11.2025 Revised on 08.12.2025 Accepted on 19.01.2026 Published on 30.04.2026 Available online from May 02, 2026 Int. J. Nursing Education and Research. 2026;14(2):159-163. DOI: 10.52711/2454-2660.2026.00031 ©A and V Publications All right reserved
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