A Study to Assess the effectiveness of Paced Breathing Exercise on Hot Flushes among Menopausal Women at selected Community, Salem, Tamil Nadu, India.
Mrs. K. Bhuvaneshwari1, Mr. M. Jawaharbabu2
1Associate Professor, Dept of Community Health Nursing, CKRD Memorial Nursing College, Rajasthan.
2Associate Professor, Dept of Adult Health Nursing, College of Medicine and Health Science, Wollo University, Ethiopia, Africa.
*Corresponding Author E-mail: buvikmr9@gmail.com
ABSTRACT:
A Study to Assess the Effectiveness of Paced Breathing Exercise on Hot Flushes among Menopausal Women at selected Community, Salem. A Quantitative evaluative approach with Quasi experimental research design was used and 60 samples were selected by non-convenience sampling technique. 30 samples from Poolavari were assigned to experimental group and 30 samples from Karipatti were assigned to control group. The general information was collected and the hot flushes level was categorized according to the Four point rating scale. After the pretest, paced breathing exercise was demonstrated to 30 samples in experimental group. Posttest was done after 21 days. In experimental group, 2(6.66%) women had mild hot flushes, 17(56.66%) had moderate hot flushes and 11(36.66%) had severe hot flushes during pretest. In post test, majority, 22(73.33%) of them had mild hot flushes, 8(26.66%) had moderate hot flushes and none of them had severe hot flushes. In control group, 2(6.66%) had mild hot flushes, majority, i.e. 20(66.66%) of them had moderate hot flushes and 8(26.66%) had severe flushes during pretest. In post test 2(6.66%) had mild hot flushes, majority i.e., 20(66.66%) of them had moderate hot flushes, and 8(26.66%) had severe hot flushes. In the experimental group, the mean pre test score was 44.03+ 6.07, and mean post test score was 25.46+6.05 with the difference of 18.51. In the control group, the mean pretest score was 41.8+5.56 and mean post test score was 41.66+5.9 with the difference of 0.14. The ‘t’ value is 10.39 which shows that the paced breathing exercise is effective on hot flushes among menopausal women in experimental group. Hence the formulated hypothesis H1 was retained at p<0.05 level. There was no significant association between the level of hot flushes and their selected background variables. Hence the formulated hypothesis H2 was rejected at p>0.05 level. This shows paced breathing exercise is a simple, inexpensive and effective method to practice even without any supervision.
INTRODUCTION:
1Menopause is a defining point in the transition phase of a woman’s life with declining levels of oestrogen, progesterone and androgen. This brings about metabolic, structural and physical changes in the immediate postmenopausal period. Estrogen as a hormone therapy for the prevention of certain chronic ailment or relief of menopausal symptoms has been used for decades. Some non-pharmacological measures also showing significant effect on menopausal symptoms. (Bhattacharya.S.M., 2007)
3Kronenberg defines hot flushes subjectively as recurrent, transient periods of flushing, sweating, and a sensation of heat, often accompanied by palpitation and a feeling of anxiety, and sometimes followed by chills. These symptoms are also variously called hot flushes, night sweat, and vasomotor symptoms. Women may experience hot flushes for short periods of time to many years. The highest prevalence is in the first two years post menopause. (Varney’s, 2005)
2According to Sudhaa Sharma, (2007) the mean age of menopause was 47.35 years. The percentages of menopausal symptoms are fatigue and lack of energy (72.93%), headache (55.9%), hot flushes, cold sweats, cold hand and feet (53.86%), weight gain (43.13%).
The above statistics reveals that majority of menopausal women suffer from hot flushes and they need to know the appropriate intervention to manage this symptoms. Since, Paced Breathing exercise is one of the most easiest and effective methods, the researcher have chosen this intervention to reduce hot flushes among menopausal women.
Statement of the Problem:
A Study to Assess the Effectiveness of Paced Breathing Exercise on Hot Flushes among Menopausal Women at selected Community, Salem.
OBJECTIVES:
1. To assess the level of hot flushes among menopausal women in experimental and control group.
2. To evaluate the effectiveness of paced breathing exercise on hot flushes among menopausal women in experimental group.
3. To find out the association between the pretest level of hot flushes among menopausal women and their selected background variables in experimental and control group.
Hypotheses:
H1: There will be a significant difference in the post test level of hot flushes among menopausal women in experimental group after paced breathing exercise in experimental and control group at P£ 0.05 level.
H2: There will be a significant association between the pretest level of hot flushes among menopausal women and their selected background variables in experimental and control group at P£ 0.05 level.
MATERIALS AND METHODS:
Research Approach:
Quantitative evaluative approachwas adopted for this study.
Research Design:
Quasi experimental pretest and post test research design was used for this study.
Population:
The population for present study comprised of menopausal women with the age group of 40-55yrs residing at selected community, Salem.
Sample:
Menopausal women with the age group of 40-55 years at Poolavari and Karipatti community, Salem, who met the inclusion criteria.
Sample size:
Sample size - 60
Experimental group - 30
Control group - 30
Sampling technique:
Non Probability Convenience Sampling technique was used for the study.
Criteria for the sample selection:
Inclusion criteria:
Menopausal women,
1. Between the age group of 40 and 55 yrs.
2. Who are available during data collection period.
3. Who are willing to participate in the study.
4. Who are having hot flushes symptoms.
Exclusion criteria:
Menopausal women,
1. Who are with any other medical problems.
2. Who are undergoing any other alternative therapy.
3. Who had practiced paced breathing exercise.
Data collection procedure:
Data collection was done over a period of 4 weeks from 13.07.2011 to 07.08.2011. The investigator had done survey of the selected community and identified menopausal women who met the inclusion criteria. The samples were chosen from Poolavari (30) and Karipatti (30) community as experimental and control group respectively through Non Probability Convenience Sampling technique. The selected samples were explained about the purpose and nature of the study. Good rapport was developed with the samples to get the co-operation for the study.
Pretest on hot flushes in experimental group was done on 14.07.11 & 15.07.11 and in control group on 16.07.11 & 17.07.11 with 4 Point Rating Scale by using structured interview schedule. Paced breathing exercise was provided twice a day for the period of 21 days to the experimental group, no intervention was given to the control group.
Paced breathing is a deeper, slower way of breathing. It involves filling the lungs to full capacity when inhaling and then pushing out as much air as possible when exhaling. During breath in abdomen expands and contracts during breathing out. After intervention, posttest on hot flushes in experimental group was done on 03.08.11 and 04.08.11 and in control group on 05.08.11 and 06.08.211.Data was collected and analyzed by using descriptive and inferential statistics.
Tool used for the study:
Structured interview schedule
Description of the Tool:
The tool for this study consists of two sections.
Section-A:
This section consists of background data such as Age, Age at Menopause, Duration of Menopause, Education, Occupation, Family Monthly Income, Marital Status, Number of Children, and Dietary Habits.
Scoring procedure:
No scoring was allotted for this section. The data were used only for descriptive analysis.
Section-B:
This section consists of four point rating scale, which was used to assess the hot flushes among menopausal women.
Scoring procedure:
It consists of the symptoms related to hot flushes of menopausal women. There was 15 items in this section. The rating scale was as follows,
Frequently - 4
Occasionally - 3
Rarely - 2
Never - 1
The total score has been converted to three levels and interpreted as follows.
Level of hot flushes Score
1. Mild hot flushes - 15-30
2. Moderate hot flushes - 31-45
3. Severe hot flushes - 46-60
DATA ANALYSIS AND INTERPRETATION
Section – A
Distribution of samples according to their selected background variables in experimental and control group.
Table-1: Frequency and percentage distribution of samples according to their biographic variables in experimental and control group n=60
|
Sl. No |
Biographic variables |
Experimental group |
Control group |
||
|
Fre quency |
% |
Frequency |
% |
||
|
1 |
Age in years a) 40-45 |
2 |
6.67 |
7 |
23.33 |
|
|
b) 46-50 |
15 |
50.0 |
9 |
30 |
|
|
c) 51-55 |
13 |
43.33 |
14 |
46.67 |
|
2 |
Education a) No formal education |
11 |
36.67 |
8 |
26.67 |
|
|
b) Primary level |
11 |
36.67 |
17 |
56.67 |
|
|
c) Secondary level |
5 |
16.66 |
5 |
16.66 |
|
|
d) Diploma |
3 |
10.0 |
- |
- |
|
|
e) Graduate |
- |
- |
- |
- |
|
|
f) Post graduate |
- |
- |
- |
- |
|
3 |
Occupation a) House Wife |
7 |
23.33 |
18 |
60.0 |
|
|
b) Farmer |
7 |
23.33 |
4 |
13.33 |
|
|
c) Daily wagers |
12 |
40.0 |
6 |
20.0 |
|
|
d) Other |
4 |
13.34 |
2 |
6.67 |
|
4 |
Marital status a) Unmarried |
- |
- |
- |
- |
|
|
b) Married |
27 |
90 |
26 |
86.67 |
|
|
c) Widow/Separated |
3 |
10 |
4 |
13.33 |
|
5 |
Number of children a) No Child |
1 |
3.33 |
- |
- |
|
|
b) One child |
4 |
13.34 |
1 |
3.33 |
|
|
c) Two children |
15 |
50 |
24 |
80 |
|
|
d) More than two |
10 |
33.33 |
5 |
16.67 |
The above table shows that in experimental group 15(50%) menopausal women are in the age group of 46-50 yrs, 11(36.67%) have no formal education and also have primary education respectively, 12(40%) are daily wagers, 27(90%) are married women, and 15(50%) have two children.
In control group 14(46.67%) menopausal women are in the age group of 51-55 yrs., 17(56.7%) have primary education, 18(60%) are house wife, 26(86.67%) are married women and 24(80%) have two children.
Table-2: Frequency and percentage distribution of samples according to their Menopause related variables in experimental and control group n=60
|
Sl. No |
Menopause related variables |
Experimental group |
Control group |
||
|
Frequency |
% |
Frequency |
% |
||
|
1 |
Age at Menopause a) Below 40 years |
4 |
13.33 |
5 |
16.67 |
|
|
b) 40-45 years |
19 |
63.34 |
24 |
80 |
|
|
c) 46-50 years |
7 |
23.3 |
1 |
3.33 |
|
2 |
Type of Menopause a) Natural |
23 |
76.67 |
17 |
56.67 |
|
|
b) Surgical |
7 |
23.33 |
13 |
43.33 |
|
3 |
Duration of menopause a) Less than 1 year |
- |
- |
3 |
10 |
|
|
b) 1-3 years |
12 |
40 |
9 |
30 |
|
|
c) More than 3 years |
18 |
60 |
18 |
60 |
The above table shows that in experimental group 19(63.34%) have the menopause between the age of 40-45yrs, 23(76.67%) have menopause naturally, 18(60%) have more than 3 years duration of menopause.
In control group 24(80%) have the menopause between the age of 40-45 yrs, 17(56.67%) have menopause naturally, and 18(60%) have more than 3 years duration of menopause.
Figure-1: Percentage distribution of samples according to their socio economic variable in experimental and control group
The above figure shows that both in experimental and control groups 21(70%) have family monthly income of Rs.3001 and above and 9(30%) have family monthly income of Rs.1501-3000.
Figure-2: Percentage distribution of samples according to their personal variable in experimental and control group
The above figure shows that both in experimental and control groups 28(93.33%) are non vegetarian and 2(6.67%) are vegetarian.
Section – B
a) Distribution of samples according to their pretest level of hot flushes in experimental and control group
Figure-3: Percentage distribution of samples according to their pretest level of hot flushes in experimental and control group
The above figure shows that, in pretest experimental group,2(6.66%) have mild hot flushes, 17(56.66%) have moderate hot flushes and 11(36.67%) have severe hot flushes. In control group, 2(6.66%) have mild hot flushes, 20(66.66%) have moderate hot flushes and 8(26.66%) have severe flushes.
Section-C
a) Distribution of samples according to their post test level of hot flushes in experimental and control group
Figure-4: Percentage distribution of samples according to their post test level of hot flushes in experimental and control group
The above figure shows that in post test experimental group, 22(73.33%) have mild hot flushes, 8(26.66%) have moderate hot flushes and none of them have severe hot flushes. In control group 2(6.66%) have mild hot flushes, 20(66.66%) have moderate hot flushes, and 8(26.66%) have severe hot flushes.
b) Comparison between the pretest and post test level of hot flushes among menopausal women in experimental and control group
Table-3: Frequency and percentage distribution on the level of hot flushes among menopausal women in experimental and control group. n=60
|
Sl.No |
Level of hot flushes |
Experimental Group |
Control Group |
||||||
|
Pre Test |
Post Test |
Pre Test |
Post Test |
||||||
|
F |
% |
f |
% |
f |
% |
f |
% |
||
|
1. |
Mild |
2 |
6.66 |
22 |
73.33 |
2 |
6.66 |
2 |
6.66 |
|
2 |
Moderate |
17 |
56.67 |
8 |
26.67 |
20 |
66.67 |
20 |
66.67 |
|
3 |
Severe |
11 |
36.67 |
- |
- |
8 |
26.67 |
8 |
26.67 |
Above table shows that, in the experimental group, 2(6.66%) women have mild hot flushes, 17(56.66%) have moderate hot flushes and 11(36.66%) have severe hot flushes during pretest. In post test, majority, 22(73.33%) of them have mild hot flushes, 8(26.66%) have moderate hot flushes and none of them have severe hot flushes.
In control group, 2(6.66%) have mild hot flushes, majority, i.e. 20(66.66%) of them have moderate hot flushes and 8(26.66%) have severe flushes during pretest. In post test 2(6.66%) have mild hot flushes, majority i.e., 20(66.66%) of them have moderate hot flushes, and 8(26.66%) have severe hot flushes.
c) Comparison between the pretest and post test on hot flushes among menopausal women in experimental and control group
Table -4: Mean, standard deviation and mean difference on hot flushes among menopausal women in experimental and control group n=60
|
S. No |
Group |
Maximum Score |
Pre Test |
Post Test |
Mean Difference |
||
|
Mean |
S.D |
Mean |
S.D |
||||
|
1 |
Experimental Group |
60 |
44.03 |
6.07 |
25.46 |
6.05 |
18.51 |
|
2 |
Control Group |
41.8 |
5.56 |
41.66 |
5.9 |
0.14 |
|
The above the table shows that, the overall pre test and post test score on hot flushes symptoms in experimental group, the mean pre test score is 44.03+ 6.07, and mean post test score is 25.46+ 6.05 with the difference of 18.51.
In the control group, the mean pretest score is 41.8+5.56 and mean post test score is 41.66+5.9 with the difference of 0.14. The above mean difference in experimental group shows that paced breathing exercise has reduced hot flushes among menopausal women.
Section – D
Hypothesis testing
Effectiveness of paced breathing exercise on hot flushes among menopausal women in experimental and control group.
a) Mean, standard deviation and ‘t’ value of post test on hot flushes among menopausal women in experimental and control group
Table-5: n=60
|
S. No |
Group |
Post Test |
‘t’ value |
df |
Table value |
|
|
Mean |
S.D |
|||||
|
1 |
Experimental Group |
25.46 |
6.05 |
10.39* |
58 |
1.96 |
|
2 |
Control Group |
41.66 |
5.9 |
|||
*significant at p<0.05 level
The above table shows that in experimental group the post test mean score on hot flushes is 25.46±6.05 and the control group the post test mean score is 41.66± 5.9. The ‘t’ value is 10.39 which shows that the paced breathing exercise is effective on hot flushes among menopausal women in experimental group. Hence the formulated hypothesis H1 was retained at p<0.05 level.
b) Association between the pretest level of hot flushes among menopausal women and their selected background variables in experimental and control group.
Table-6: Chi-square test on pretest level of hot flushes among menopausal women and their selected biographic variables in experimental and control group. n=60
|
Sl.No |
Biographic variables |
Experimental group (n=30) |
Control group (n=30) |
||||
|
df |
c2 |
Table vlue |
df |
c2 |
Table value |
||
|
1 |
Age in years |
4 |
3.000 |
9.49 |
4 |
4.786 |
9.49 |
|
2 |
Education |
6 |
4.720 |
12.59 |
4 |
6.086 |
9.49 |
|
3 |
Occupation |
6 |
8.690 |
12.59 |
6 |
6.229 |
12.59 |
|
4 |
Marital status |
2 |
0.370 |
5.99 |
2 |
2.524 |
5.99 |
|
5 |
Number of children |
6 |
3.792 |
12.59 |
4 |
3.425 |
9.49 |
Significant at p>0.05 level
The above table shows that in experimental and control group there was no significant association between the level of hot flushes and their selected Biographic variables. Hence the formulated hypothesis H2 was rejected at p>0.05 level.
Table-7: Chi-square test on pretest level of hot flushes among menopausal women and their selected menopause related variables in experimental and control group. n=60
|
Sl. No |
Menopause related variables |
Experimental group (n=30) |
Control group (n=30) |
||||
|
df |
c2 |
Table value |
df |
c2 |
Table value |
||
|
1 |
Age at menopause |
4 |
6.776 |
9.49 |
4 |
2.231 |
9.49 |
|
2 |
Type of menopause |
2 |
1.118 |
5.99 |
2 |
0.271 |
5.99 |
|
3 |
Duration of menopause |
2 |
0.139 |
5.99 |
4 |
7.875 |
9.49 |
Significant at p>0.05 level
The above table shows that in experimental and control group there was no significant association between the level of hot flushes and their selected menopause related variables. Hence the formulated hypothesis H2 was rejected at p>0.05 level.
Table-8: Chi-square test on pretest level of hot flushes among menopausal women and their selected socio economic variables in experimental and control group. n=60
|
Sl.No |
Socio economic variables |
Experimental group (n=30) |
Control group (n=30) |
||||
|
df |
c2 |
Table value |
df |
c2 |
Table value |
||
|
1 |
Family monthly income |
2 |
0.536 |
5.99 |
2 |
1.786 |
5.99 |
Significant at p>0.05 level
The above table shows that in experimental and control group there was no significant association between the level of hot flushes and their selected socio economic variables. Hence the formulated hypothesis H2 was rejected at p>0.05 level.
Table-9: Chi-square test on pretest level of hot flushes among menopausal women and their selected personal variables in experimental and control group. n=60
|
Sl.No |
Personal variables |
Experimental group (n=30) |
Control group (n=30) |
||||
|
df |
c2 |
Table value |
df |
c2 |
Table value |
||
|
1 |
Dietary habits |
2 |
0.905 |
5.99 |
2 |
0.670 |
5.99 |
Significant at p>0.05 level
The above table shows that in experimental and control group there was no significant association between the level of hot flushes and their selected personal variables. Hence the formulated hypothesis H2 was rejected at p>0.05 level.
Recommendations:
· A similar study can be done using large samples.
· A similar study can be undertaken by allotting more time on data collection.
· A comparative study can be done to assess the effectiveness of paced breathing exercise and hormone replacement therapy on reducing hot flushes.
· A comparative study can be done to assess the effectiveness of paced breathing exercise and acupuncture on hot flushes.
· A comparative study can be done to assess the effectiveness of paced breathing exercise and soya bean consumption on reducing hot flushes.
· A comparative study can be done to assess the effectiveness of paced breathing exercise on hot flushes between the urban and rural menopausal women.
CONCLUSION:
This study was done to assess the effectiveness of paced breathing exercise on hot flushes among menopausal women at selected community, Salem. The result of this study showed that level of hot flushes was reduced after the paced breathing exercise. In experimental and control group there were no significant association between the pretest level of hot flushes and their selected background variables.
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Received on 27.10.2017 Modified on 18.12.2017
Accepted on 02.02.2018 © A&V Publications all right reserved
Int. J. Nur. Edu. and Research. 2018; 6(3):259-265.
DOI: 10.5958/2454-2660.2018.00062.5