Submitted by,
Ms. Nameela Anirudhan
1st year M.Sc Nursing,
OBG Nursing,
2009-2011,
Oriental College of Nursing,
Bangalore – 44.
1 / NAME OF THE CANDIDATE AND ADDRESS / Ms. Nameela AnirudhanI st year M.Sc. Nursing
Oriental college of Nursing
43/52,2nd main,industial town,west of chord road,rajajinagar,
Banaglore – 44
2 / NAME OF THE INSTITUTION / Oriental college of nursing
COURSE OF THE STUDY AND SUBJECT / I st year M.Sc. Nursing
OBG Nursing
4. / DATE OF ADMISSION OF COURSE / 22-10-2009
5. / TITLE OF THE STUDY / “A Study to evaluate the effectiveness of structured teaching programme on complimentary therapies among menopausal women in a selected rural community, bangalore.”
6 / BRIEF RESUME OF THE INTENDED WORK
6.1 INTRODUCTION
6.2 NEED FOR THE STUDY
6.3 STATEMENT OF THE PROBLEM
6.4 OBJECTIVES OF THE STUDY
6.5 OPERATIONAL DEFINITIONS
6.6 SAMPLING CRITERIA
6.7 ASSUMPTIONS
6.8 REVIEW OF RELATED LITERATURE / Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
7 / MATERIALS AND METHODS
7.1 Source of data-Data will be collected from the menopausal women in selected community, Bangalore.
7.2 Method of data collection: Structured questionnaire.
7.3 Does the study require and investigation or interventions to be conducted on
the on the patients or other human being or animals - NO
7.4 Has ethical clearance been obtained from your institutions?
YES, ethical committee's report is here with enclosed.
RAGIVGANDHIUNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION.
1. / NAME OF THE CANIDATE AND ADDRESS / Ms. Nameela AnirudhanI st year M.Sc. Nursing,
Orientalcollege of Nursing,
43/52,2nd main,industial town,west of chord road,rajajinagar,Banaglore – 44.
2. / NAME OF THE INSTITUTION / Oriental College of Nursing
3. / COURSE OF THE STUDY AND SUBJECT / I st year M.Sc. Nursing.
[OBG Nursing]
4. / DATE OF ADMISSION / 22-10-2009
5. / TITLE OF THE STUDY / “A study to evaluate the effectiveness of structured teaching programme on complimentary therapies among menopausal women in a selected rural community at Bangalore.”
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
6. BRIEF RESUME OF THE INTENDED WORK
6.1 Introduction
Women are the vital set up and heart of the family. When women have been tired, family function would be altered. Women are facing lot more problems through their life. One of most common problem they are facing is menopause and hormonal changes during their middle adulthood. The menopausal problems of women always make them so tired. So they need treatment and health education regarding menopausal care and prevention of problems.
When a woman's hormone balance begins to shift, she may have menstrual cycles with no ovulation called anovulatory cycles. She may begin to have menopausal symptomsMenopause is that stage in women’s life when both physiological and emotional changes in their bodies are precipitated by hormonal deficiencies as a result of age. During pre menopause, estrogen levels drop because the ovaries ability to produce enough estrogen has weakened. Pre menopause usually occurs five years before menopause - a period in women’s life when the ovaries no long produce estrogen and therefore completely without further egg production.
Because pre menopause is a very important period in women’s life; informed knowledge of what to expect will go a long way to prepare a woman for what is to come during menopause proper, especially because each woman's transition from pre menopause to menopause may differ drastically due to the difference in the amount of the male hormone androgens that may be produced, which accounts for the devastating secondary male characteristics often exhibited by menopausal women.
Pre menopause symptoms vary from person to person: some women will experience hot flashes, mood swings, dry vaginal canal, loss of sex drive, irritability, gums bleeding, tinnitus or even heat attack or stroke, while others will experience just a few of those as pre menopause symptom1.
Pre menopause is the physiological termination of normal menstrual cycles. Pre menopause is generally caused more early than the normal age which is associated with the cessation of the menstrual cycles. Pre menopause occurs when the ovaries virtually stops producing the estrogen which generally leads the fertility aspect of the women to shut down
Pre menopause generally occurs before a woman reaches the age of 40 years. Pre menopause can be estimated to have occurred only in 1% of the woman folk. Proper diagnosis of pre menopause symptoms can be availed out with proper diagnosis of estrogen supplements. Thus pre menopause is virtually a period when the woman's body crosses the age markers which is normal to be noticed in the aged woman but it appears in this respect before 10-15 years of the actual age2
Complimentary therapyis one of the natural therapies for reducing the menopausal symptoms. Complimentary therapyis any healing practice "that does not fall within the realm of conventional medicine", or "that which has not been shown consistently to be effective." It is often opposed to evidence based medicine and encompasses therapies with a historical or cultural, rather than a scientific, basis. Commonly cited examples include naturopathy, herbalism, traditional Chinese medicine, Unani, Ayurveda, meditation, yoga, hypnosis, homeopathy, acupuncture, and nutritional-based therapies, in addition to a range of other practices. It is frequently grouped with complimentary medicine, which generally refers to the same interventions when used in conjunction with mainstream techniques, under the umbrella term complimentary and alternative medicine, or CAM.
Increasing number of women should turn to complimentary therapy, such as dietary supplements like isoflavones, black cohosh, dong qui, ginsend, eveing primrose oil, wild yam and vitamin E, yoga aroma therapy, herbal medicine for the management of menopausal symptoms. Because, these products are natural, safe and no side effectrs4.
Yoga can benefit both the body and mind, bringing energy and balance.This is
particularly helpful to women who are currently in menopause or in transition because
their hormonal level and body chemistry may be flactuating rapidly.Yoga balances the
endocrine system which controls our bodys production of hormones.It calms the nervous
system, reducing stress and the aggrevation of hot flashes.Yoga is a weight bearing
exercise, strenthening our bones and preventing osteoporosis.Yoga also massages the
reproductive organs, relieves pelvic congestion and boosts the immune system,reduces
fatigue and smoothes out mood swings. The deep breathing that goes hand in hand with
asana(yoga poses) oxygenates the blood, cleaning the organs and nourishing the nervous
system. Yoga creates strength and flexibility in our bodies,soothes,balances and
rejuvenates all parts of us,bringing us towholeness allowing us to shine.
Aromatherapy is the use of plant essential oils for healing purposes. Menopause
symptoms are caused by alterations in the endocrine system’s production of hormones.
Aromatherapy acts by stimulating the activity of specific brain cells that naturally
influence a woman’s endocrine system. Aromatherapy directed changes in the endocrine
system then lead to relief of menopausal symptoms.
6.2 Need for the study
The percentage of women affected by Pre menopause symptoms vary widely. According to the AmericanCollege of Obstetricians and Gynecologists, at least 85 percent of menstruating women have at least one Pre menopause symptom as part of their monthly cycle. Most of these women have symptoms that are fairly mild and do not need treatment. Some women (about three to eight percent of menstruating women) have a more severe form of PMS, called Premenstrual Dysphoric Disorder (PMDD). See the question, "What is Premenstrual Dysphoric Disorder (PMDD)?" below for more information5.
One of the foremost menopause symptoms seems to be weight gain and a change in the overall shape of your body. Though you may not be so happy about this, it is important to keep in mind that this weight gain is normal and to be expected. About 90% of menopausal women gain some weight between the ages of 35 and 55 in India. But you may not necessarily have to blame yourself for this newly acquired weight - research now shows that weight gain during menopause is caused by shifts in your hormones, not greedy eating6.
A cross-sectional survey was conducted on themenopausal experience of Chinese women living in Sydney and to explore the prevalence of symptoms. An objective was to investigate the menopausal experience of Chinese women living in Sydney and to explore the prevalence of symptoms and the relationship between the frequency of symptoms and various socio-demographic factors. A cross-sectional survey was conducted among 310 Chinese women aged between 45 and 65 years. Result of the study was Chinese women in Sydney more commonly reported psychological symptoms such as poor memory and physical symptoms such as dry skin, aching in muscles and joints and decreased physical strength. Changes in sexual desire and vaginal dryness were significantly different in perimenopausual women7
A Qualitative study examined women's approaches to evaluating complimentary and alternative therapies for menopausal symptoms among twenty-two women with a mean age of 52 years (range 42 to 58 years) in Calgary, Alta by semistructured interviews The objective of the study was to examine how women gather, evaluate, and use information on complementary therapies for managing menopausal symptoms. This study concluded that there is a need for reliable information about menopause and the risks and benefits of Complimentary therapies for menopausal symptoms in a format accessible to the range of women who will experience or are experiencing this transition. As a trusted source, family physicians have a role in disseminating this information8
A study conducted on Prevalence of and satisfaction with complimentary therapies menopause clinic. Objective of the study was to assess the usage of both conventional and complimentary therapies by peri- and postmenopausal women for the treatment of menopausal symptoms. A prospective questionnaire was completed by 200 consecutive patients attending a tertiary referral London-based specialist menopause clinic between September and December 1999. Conclusions of the study were high rates of usage and satisfaction were found with both conventional and complimentary treatments for the relief of menopausal symptoms in our unit.
A qualitative study examined the effect of yoga on cognitive function in climacteric syndrome. Objective was to asses the efficacy of an integrated approach of yoga therapy on cognitive abilities in climacteric syndrome. One hundred and eight perimenopausal women between 40 and 55 years were randomly allotted into yoga and control goups.The yoga group practiced a module comprising breathing and sun salution.
The control group practiced a set of simple physical exercise under supervision(1hr/day for 8 weeks).Assessment were made by Wilcoxan test,six letter cancellation test(SLCT) and Punit Govil intelligence scale(PGIMS) before and after test. Conclusion of the study was eight week of an integrated approach of yoga therapy helps in the reduction of hot flashes, night sweats and sleep disturbances among perimenopausal women in yoga group.
A study investigated the effects of aromatherapy massage on menopausal symptoms in Korean climacteric women.The purpose of this study was to asses the effectiveness of
aromatherapy massage for menopausal symptoms.
Kupperman's menopausal index was used to compare an experimental group of 25 climacteric women with a wait-listed control group of 27 climacteric women. Aromatherapy was applied topically to subjects in the experimental group in the form of massage on the abdomen, back and arms using lavender, rose geranium, rose and jasmine in almond and primrose oils once a week for 8 weeks (eight times in total). The experimental group reported a significantly lower total menopausal index than wait-listed controls. There were also significant intergroup differences in subcategories such as vasomotor, melancholia, arthralgia and myalgia. These findings suggest that aromatherapy massage may be an effective treatment of menopausal symptoms such as hot flushes, depression and pain in climacteric women.
This statistical analysis and study are showed most of the women are suffering more premenopausal problem that altered their quality of life. The most common problem they facing during the premenopausal period are Unexplained weight gain, Headaches, Mood swings, Hot Flashes,Night Sweats,Depression, Irritability, Inability to handle stress and Fibrocystic breasts.
The study shows complimentary therapy helps the women for reducing the menopausal symptoms. But women are unaware about complementary therapy. And also very less study conducted on awareness of complimentary therapy for reducing menopausal symptoms, motivated the researcher to do this study.
6.3 Statement of the problem
“A study to evaluate the effectiveness of structured teaching programme on complimentary therapies among menopausal women in a selected rural community at Bangalore.”
6.4 Objectives of the study
- To assess the pre-post knowledge regarding complimentary therapies among menopausal women
- To evaluate the effectiveness of structured teaching programme on complimentary therapies among menopausal women.
- To determine the association between the knowledge regarding complimentary
therapies and selected demographic variables.
6.5 Operational definitions
1.Effectiveness: Refers to the extent to which the structured teaching programmes achieved the desired effect in improving the knowledge of menopausal women as assessed by post test which is elicited through structured interview.
2.Structured Teaching Programme: Refers to systematically planned group instructions by lecture cum discussion method designed to provide information regarding complementary therapy.
3.complimentary therapy: refers to therapy like yoga, aroma therapy and supplementary food products for reducing menopausal symptoms among menopausal women.
4.Menopausal women: women who attained menopause within 1-5years.
6.7 Sampling Criteria
Inclusion Criteria
1. Women who are willing to participate.
2. Women who can understand and speak english or kannada.
3.women who are present at the time of data collection.
Exclusion criteria
1.Women who are terminally ill.
2.Women who had undergone hystrectomy.
6.8 Hypothesis
H1: There will be a significant difference in knowledge on complimentary therapies among menopausal women before and after STP..
6.9Assumption
Menopausal women may have inadequate knowledge regarding complimentary therapies in reducing menopausal symptoms.
6.10 Review of literature
Review of related literature is an integral component of any study or research project. It enhances the depth of the knowledge and inspires a clear insight into the crux of the problem. Literature review throws light on the studies and their findings reported about the problem under study.
The review of literature is a broad, comprehensive, in depth, systemic and critical review of scholarly publications, unpublished scholarly print materials, audio visual materials and personal communications. Reviewing and evaluating the literature is central to the research process.
The literature for present study is organized under the following headings.
- Review Of Literature Related To Yoga
- Review of literature related to Aromatherapy
- Review of literature related to diet supplimenteries.
- Review Of Literature Related To Yoga
A pilot study conducted on a Hatha yoga treatment for menopausal symptoms. The objective of the study was to assess the feasibility and efficacy of a yoga treatment for menopausal symptoms. Both physiologic and self-reported measures of hot flashes were included. A prospective within-group pilot study was conducted. Participants were 12 peri- and post-menopausal women experiencing at least 4 menopausal hot flashes per day, at least 4 days per week. Assessments were administered before and after completion of a 10-week yoga program. Conclusion of the study was the yoga treatment and study procedures were feasible for midlife women. Improvement in symptom perceptions and well being warrant further study of yoga for menopausal symptoms, with a larger number of women and including a control group10.
A pilot trial conducted on Feasibility and acceptability of restorative yoga for treatment of hot flushes. Objective of the study was to determine the feasibility and acceptability of a restorative yoga intervention for the treatment of hot flushes in postmenopausal women. A pilot trial in 14 postmenopausal women experiencing ≥4 moderate to severe hot flushes per day or ≥30 moderate to severe hot flushes per week. The intervention consisted of eight restorative yoga poses taught in a 3-h introductory session and 8 weekly 90-min sessions. Feasibility was measured by recruitment rates, subject retention and adherence. Acceptability was assessed by subject interview and questionnaires. Efficacy measures included change in frequency and severity of hot flushes as recorded on a 7-day diary.Results of the study was the majority of the subjects were satisfied with the study and 75% continued to practice yoga 3 months after the study. Mean number of hot flushes per week decreased by 30.8% (95% CI 15.6-45.9%) and mean hot flush score decreased 34.2% (95% CI 16.0-52.5%) from baseline to week 8. No adverse events were observed11.
A randomized control study investigated on treating the climacteric symptoms in Indian women with an integrated approach to yoga therapy. Objective of the study was to study the effect of yoga on the climacteric symptoms, perceived stress, and personality in perimenopausal women. One hundred twenty participants (ages 40-55 y) were randomly divided into two study arms, ie, yoga and control. The yoga group practiced an integrated approach to yoga therapy comprising surya namaskara (sun salutation) with 12 postures, pranayama(breathing practices), and avartan dhyan (cyclic meditation), whereas the control group practiced a set of simple physical exercises under supervision of trained teachers for 8 weeks (1 h daily, 5 days per week). The assessments were made by Greene Climacteric Scale, Perceived Stress Scale, and Eysenck's Personality Inventory before and after the intervention. Conclusions of the study was eight weeks of an integrated approach to yoga therapy decreases climacteric symptoms, perceived stress, and neuroticism in perimenopausal women better than physical exercise12.
A study conducted on Yoga for menopausal symptoms Objective of the study was the aim of this study was to assess the effectiveness of yoga as a treatment option for menopausal symptoms. The methodological quality of all studies was assessed using a modified Jadad score. Conclusion of the study was evidence is insufficient to suggest that yoga is an effective intervention for menopause. Further research is required to investigate whether there are specific benefits of yoga for treating menopausal symptoms13.