1. Guided by Co-Guided by
Dr. Bhawana Pant Dr. Geeta Parwandha
Community Medicine Community Health Nursing
Neta Ji Subhash Chandra Bose Panna Dhai Maa Subharti
Subharti Medical College, Meerut Nursing College Meerut
Presented By
Ms. Shaila Panchal
PhD Scholar
Community Health Nursing Department
Subharti University, Meerut
Research Presentation
2. TITLE of the study
“Assess The Impact of Nurse Led Program
In Term of Knowledge & Quality of Life
Regarding Menopause Transition & it’s
Symptoms Among Women Residing In
Selected Rural Community, At Dehradun.”
3. INTRODUCTION
“Changing women’s health-naturally”
• According to (WHO) Most women experience
menopause between the ages of 45 and 55 years as a
natural part of biological ageing.
• The menopausal transition can be gradual, usually
beginning with changes in the menstrual cycle.
‘Perimenopause’ refers to the period from when these
signs are first observed and ends one year after the
final menstrual period.
• Perimenopause can last several years and can affect
physical, emotional, mental and social well-being.
• A variety of non-hormonal and hormonal
interventions can help alleviate perimenopausal
symptoms.
4.
5. Need for the study
Sudha Sharma (2012) conducted a study in a selected urban
community in India has found that with age advances the nature
and prevalence of premenopausal Symptoms also varies. The
vasomotor symptoms (35%) and psychological disturbances
(38%) increases with increase in age. The occurrence in
frequency and severity of symptoms varies among individuals,
population and different cultures of the world. The symptoms of
menopause vary with biological change, psychological factors,
socio cultural factors and environmental influences. According
to various studies conducted to measure quality of life of Aged
Women from different socio-cultural background reveals that
perception of quality and menopause status influences the
quality of life.
6. Meenakshi kalhan et.al. (2020) conducted a community based cross-
sectional study in 400 middle aged women (40–60 years) by random sampling
technique. The menopause rating scale was used to assess the prevalence of
menopausal symptoms and the QOL and data were collected for
sociodemographic factors, relevant menstrual history and other variables.
Prevalence of menopausal symptoms was found to be 87.7%. Majority of the
study subjects had anxiety (80%), followed by physical and mental
exhaustion (71.5%), sleep problem (61.2%), irritability (60.7%), Joint and
muscular discomfort (56%) and heart problems (54%). The most classical
symptom of menopause i.e., hot flushes were reported in 36.7%. The mean
age of menopause was 47.53 standard deviation 45 years. The QOL was
impaired in 70.2% of study subjects. The psychological symptoms
attributed 70.8% to the poor QOL.
According to the researcher facts to improve the QOL and to decrease the
menopausal symptoms in these women, a holistic approach in the form of
lifestyle and behavioral modification are required.
7. Review of the literature
Nabarun Karmakar., et al. (2017) Descriptive cross-sectional
study 100 peri and postmenopausal women (40–60 years) in
Dearah village of West Bengal, India during February–March
2014. The Menopause-Specific Quality of Life Questionnaire
MENQOL. Result reveals that Occurrence of vasomotor
symptoms was average with 60% of them reporting hot
flushes and 47% sweating. Most prevalent psychosocial
symptoms reported were feeling of anxiety and nervousness
(94%) and overall depression (88%). Physical symptoms
were quite varying in occurrence with some symptoms such as
feeling tired 49% reported of avoiding intimacy with a
partner and 26% complained of vaginal dryness.
8. Mansi Patel, et.al. (2017) cross-sectional study was conducted among 425
middle-aged women residing in Urban Health Training Center. The
menopausal status is classified according to STRAW + 10 (simplified
bleeding criteria for the early and late menopausal transition) classifications.
The English version of the MRS questionnaire was used as a tool for
assessing menopausal symptoms. 425 women evaluated, the mean age of
attaining menopause was 42 years. Menopause-related symptoms were
present among 304 (71.5%) women. Majority of women suffered joint and
muscular discomfort (62.6%), 47.5% had hot flushes, and physical as well
as mental exhaustion. Logistic regression analysis reveals that
postmenopausal women had highest prevalence of menopausal symptoms as
compared to other groups. Age of attaining menopause was bit lower in
present study. Availability of treatment modalities for various menopause-
related symptoms requires women’s attention to improve their quality of
life.
9. PROBLEM statement
“A study to assess the impact of Nurse Led
Program in term of knowledge & Quality of
life regarding menopause transition & it’s
symptoms among women residing in selected
Rural Community, At Uttarakhand”
10. Objectives
To assess the Knowledge regarding menopause transition
& it’s symptoms among perimenopausal women residing in
rural community at Dehradun.
To assess the Quality of life among perimenopausal
women.
To determine the effectiveness of Nurse Led Program
regarding menopause transition & it’s symptoms among
perimenopausal women.
11. OPERATIONAL DEFINITION
1. Evaluate: - It refers to determining the effectiveness of Nurse led program
and it is measured in terms of significant knowledge gain in the post test
knowledge score.
2. Nurse Led Program: - - In this study Nurse Led Program refers to the intervention
(Health Education, Yoga, Deep Breathing Exercise & One Structured Hobby Club
(Ludo play, Dancing, Self-made Video, Discussion about Dietary Habit & Daily
Life Activities, Knitting Sweaters, Aerobics)) which is used to provide knowledge
about Menopause transition & it’s symptoms & which will improve the knowledge
and quality of life of women.
3. Knowledge: - It refers to the appropriate response by the Women on
knowledge regarding Menopausal transition & it’s symptoms before and after
intervention as measured by Self structured knowledge questionnaire.
12. 4. Quality of Life: - It refers to transition into menopause is related to different physical
and mental changes that may affect women’s health. That the physical, psychological,
social, and sexual changes in menopause have an adverse effect on women’s quality of life.
5. Menopause transition:- In this study the menopausal transition (perimenopause) is the
period that links a woman’s reproductive (childbearing) years and menopause. A woman is
said to be in menopause if she has had no menstrual periods for 1 year. Once in menopause,
the ovaries essentially stop making hormones and women lose their ability to become
pregnant. The average age for menopause is 51 years.
6. Menopause transition symptoms: - The physical and psychological changes in women
such as hot flushes, menstrual irregularity, weight gain, palpitation, urinary incontinence,
vaginal dryness, fatigue, anxiety, mood swings, depression and panic disorders experienced
by the women in the period just before the menopause.
13. 7. Women: - The term “women” refer to Menopausal
transition females aged between 45-55 years (according to
WHO).
8. Rural Community: - A rural community or a countryside
is a geographic community that is located outside towns and
cities.
14. RESEARCHHYPOTHESIS
The hypothesis mentioned below will be tested at
0.05 level of significance.
H1:-There will be significant relationship between the
knowledge & quality of life of rural women regarding
menopausal transition & it’s symptoms.
H2-: There will be significant effect of Nurse led
Program on knowledge and quality of life regarding
regarding menopausal transition & it’s symptoms among
15. NULL HYPOTHESIS
The null hypothesis mentioned below will be tested at 0.05 level
of not significance.
H01-:There will be no significant relationship between the
knowledge & quality of life of rural women regarding
menopausal transition & it’s symptoms.
H02-: There will be no significant effect of Nurse led Program
on knowledge and quality of life regarding menopausal
transition & it’s symptoms among perimenopausal women.
16. ASSUMPTIONS
The study will be based on the following assumptions:
Women may have inadequate knowledge regarding
menopausal transition & it’s symptoms.
Women may gain knowledge & lifestyle changes about
menopausal transition & it’s symptoms from Nurse Led
Program which will prepare to educate them.
17. DELIMITATIONS
The subjects are limited to those women aged
between 45-55 years.
The sample size was limited to only 400 women
from rural community so that findings can be
generalized.
19. RESEARCHGAP
Hormone therapy and alternative treatment options provide
evidence to inform updates on existing policy
recommendations and coverage.
To promote health and wellness during the menopausal
transition and post-menopause, healthcare providers.
Knowledge gaps among healthcare providers concerning
menopause.
Menopause-specific education, providers can easily
misunderstand or dismiss menopause symptoms related to
irregular menstrual cycles or heavy bleeding, mood, vaginal
symptoms, and disordered sleep.
20. RESEARCH SCOPE
Menopausal transition related research
scope improve the knowledge of Health
care providers, and do the research with
psychomotor domain, vasomotor domain.
22. Research Approach
In the view of accomplishing the objectives
and developing a nurse led awareness program
for improving the knowledge & quality of life
regarding menopausal transition & it’s
symptoms among women of rural area an
evaluative research approach is considered to
be the most appropriate.
23. Systematic Presentation of Research Design
Quasi experimental research
design (Non- Randomized
control group design)
Experimental
Group
Control
Group
Pre- test
Pre-test
Treatment
Post-test
Post-test
Mix Methodology Research
Design
QUANTITATIVE QUAILITATIVE
Data Analysis
By the
Structured
Questionnaire
INTERPITATIO
N
DATA ANALYSIS
Inferential Statistical
Analysis
DATA
ANALYSIS
24. Systematic Presentation of the
study
Research Approach
(Quantitative)
Evaluative Research
Approach
Research Design
Quantitative
Quasi experimental
Research (Non-
Randomized control
group design)
Research Setting
Rural Area at Dehradun
Sampling Technique
Purposive sampling
technique (Non-
Probability Sampling) Population
45-55 women of rural
community
Sample size
400 Women of rural
community
Tools
Tool-1 Demographic variables of the samples
Tool-2 Knowledge Related Questionnaire
Tool-3 Quality of Life Related Checklist
Data Analysis
Descriptive & inferential
statistical Analysis
Qualitative Research
Design
25. VARIABLE UNDER STUDY
Attribute variable-: The demographic variables included in the study are: age group,
education, occupation, marital status, types of family, income, personal history,
source of information about menopause, living with children, dietary pattern, and
family history of medical illness. etc.
Independent variable: -In this study the Nurse Led Program regarding Menopausal
transition & it’s symptoms is the independent variable.
Dependent variable: In this study Knowledge and Quality of Life levels are the
dependent variable under in this study.
26. SAMPLING CRITERIA
INCLUSION CRITERIA:-
Women aged 45-55 years present during the time of the study.
Women who are willing to participate in the study.
Women who could understand and speak in Hindi language.
27. EXCLUSION CRITERIA
Women already treated with Hysterectomy.
Women already had Chronic Gynaecological Illness .
Women with induced menopause, receiving any kind of hormone therapy,
presence of medical conditions such as diabetes, hypertension, cardiac
disease, and thyroid disorders.
Locked houses or the women who did not give the consent were not
included in the study.
Women who are on the treatment of mental illness.
Women who are physical disabled.
28. Sample Size
Sample size included in the study will 400 Rural women. According to
(Cochran’s formula) in the study will be 384 Women.
S= z2x p* (1-P)/ M2
S = sample size for infinite population
Z = z score (95%= 1.96)
P= population proportion (assumed 50%= 0.5)
M= margin of error (5% =0.05)
S= (1.96)2 x 0.5 (1-0.5)/ (0.05)2
S= 3.8416x 0.25/0.0025
S=384.16
29. Pilot Study
After taking the formal approval for conducting the pilot study,
it was initiated to take sample in rural community at Laxmipur,
Horrawala and Bharotiwala, Jamankhata villages at
Dehradun. The pilot study can conduct to assess the
effectiveness of criterion measures, to find out the feasibility of
undertaking the study and decide on the plan of statistical
analysis. It is planned to be conducted in the selected rural
community at Dehradun and the sample size will be 1/4th of the
main study. 100 women from each rural community area
will select respectively. Findings of the study revealed that the
criterion measures i.e. knowledge and Quality of life can assess
to be effective group. It was feasible to conduct the pilot study.
30. INTERVENTION FOR THE STUDY
In this study Nurse Led Program refers to the intervention
(Health Education, Yoga, Deep Breathing Exercise & One
Structured Hobby Club (Ludo play, Dancing, Self Made
Video, Discussion about Dietary Habit & Daily Life
Activities, Knitting Sweaters, Aerobics))which is used to
provide knowledge about Menopause transition symptoms &
which will improve the knowledge and quality of life of
women.
31. DataCollection Method
Section A-: consisted of items seeking information about demographic
characteristics
Section B-: It consist self-structured questionnaire section. These sections
containing set of questions seeking knowledge of the subjects on menopausal
transitions. Each item carries one mark for the correct response.
Section C-: It consist Structured question checklist. These sections
containing set of questions to express competency skill of Quality of life of
the subjects on menopausal transitions and it’s symptoms. Each item carries
one mark for the correct response.
35. Day 1 to 49 Days
(7 Weeks)
(Pre-Test)
Days 51 to 160 Days
(16 Weeks)
Nurse Led Program
Nurse Led Program refers to the intervention ((Health Education, Yoga,
Deep Breathing Exercise & One Structured Hobby Club (Ludo play,
Dancing, Self-Made Video, Discussion about Dietary Habit & Daily
Life Activities, Knitting Sweaters, Aerobics))which is used to provide
knowledge and assess the daily life activity about Menopause transition
& it’s symptoms & which will improve the knowledge and quality of
life of women.
Day 192 to 238 Days
(7 Weeks)
(Post-Test)
Diagramatic Data
Collection Presentation
36. PLAN FOR DATA ANALYSIS
Tool 1-: Collect data and will analyse by descriptive statistics the tabulation
on frequency distribution & Percentage.
Tool 2-: Collect data for Knowledge and will prepare descriptive statistics
and inferential statistics (Mean, Median, Standard deviation & T test, Chi
square)
Tool 3-: Collect data for Quality of life and will prepare descriptive
statistics and inferential statistics (Mean, Median, Standard deviation & T
test, Chi square)
37. ETHICAL CLEARENCE
1.Ethical clearance can be obtained from the
community, Dehradun.
2.Information will be collected from the samples after
obtaining the informed consent.
39. REFERENCES
1. Goolsby, “Postmenopausal hormones and incontinence”, Journal of American
Medical Association, 97(1), 116-120.
2. Ginsberg J et al, “The management of Menopause”, The Millenium Review, 2000, 59-
68.
3. Nachtigall L E, Nachtigall m J, “Menopausal changes and Quality of life and
Hormone therapy”, Clinical obstetrics and gynecology, 2004, 47(2), Page no. 485-
488.
4. Utian W, Bogys P, “Menopause and midlife”, Menopause, 6, Page no. 122-128.
5. B Jayabharathi, “Perception of physical and psychological symptoms of
Perimenopause, 2011 september 7(8), Page no. 15-17.
40. 6. Omaima M., et al. “Menopausal Transition and Its Effect on Women’s Health”. American Journal
of Science 9.1 (2013): 369-379.
7. Miranda Hajdini Vanesa Osmani. “Prevalence of symptoms and attitudes towards menopause in
midlife female population in Albania”. International Journal of Ecosystems and Ecology Science
(IJEES) 7.3 (2017): 613-618.
8. Jansirani Natarajan., et al. “Review Literature on Distress during the Menopausal Transition and
Their Impact on the Quality Of Life of Women: What is The Evidence”? IOSR Journal of Nursing
and Health Science (IOSR-JNHS) 2.4 (2013): 01-10.
9. Aida Al Dughaither., et al. “Menopausal symptoms and quality of life among Saudi women
visiting primary care clinics in Riyadh, Saudi Arabia”. International Journal of Women’s Health 7
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10. Nabarun Karmakar., et al. “Quality of life among menopausal women: A community-based study
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