RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE,

BANGALORE, KARNATAKA.

ANNEXURE-II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION.

1. / NAME OF THE CANDIDATE AND ADDRESS / MS. NIDIYA MOHAN
1ST YEAR M.SC.NURSING,
ST. ANN’S COLLEGE OF NURSING,
MULKI,
MANGALORE-574154.
2. / NAME OF THE INSTITUTION / ST. ANN’S COLLEGE OF NURSING,
MULKI,
MANGALORE-574154.
3. / COURSE OF STUDY AND
SUBJECT / M.SC. NURSING
OBSTETRICS AND GYNAECOLOGICAL NURSING
4. / DATE OF ADMISSION TO THE COURSE / 10-05-2010
5. / TITLE OF THE TOPIC / EFFECT OF PSYCHOEDUCATION PROGRAMME ON MENOPAUSAL PROBLEMS AMONG WOMEN IN A SELECTED COMMUNITY OF MANGLORE.
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8 / BRIEF RESUME OF THE INTENDED STUDY:
6.1 Need for the study
Women are one of the most important members of the family and society. Community health is dependent on provision of the needs of this group. In most cases she is also a provider of the family with the epitome and embodiment of morality. Menopause is one of the most critical stages of life among women. Menopause, also known as "the change” or “change of life,” is a normal part of a woman’s life. It is a point in time—the last menstrual cycle, the last period. The menopausal transition occurs at a time in a woman’s reproductive life when the production of estrogen and progesterone, two hormones made by the ovaries, may vary dramatically and unpredictably1.
Dorothy M Barbo states that “menopause is an event in life, not a disease”. It is a single event in women’s life, her last menstrual period. .Menopause is the absence of menses for consecutive months. Around 25.1 percentage of Indian population belongs to menopausal age. Whether it is during or after menopause, a woman likely to experience health problems – physical and psychological- caused by hormonal changes2. Menopause which brings a change in menstrual cycle is accompanied by a host of possible symptoms including physical and psychological symptoms, in which the psychological disturbances of women including feeling of depression, sleeplessness, tiredness ,loss of concentration and memory deficit seems to be more crucial and in need of any supportive measures. So there is a need for developing and giving a psycho education programme which will help the women to understand more the available remedies for their problems related to menopause
A cross-sectional study was conducted on perceptions regarding menopause, prevalence of menopausal symptoms and association of family environmental factors with menopausal symptoms among 100 postmenopausal and 100 perimenopausal rural women in south India. It was reported that 57% of postmenopausal women perceived menopause as convenient. The study findings revealed that 69% of them complained of diminishing abilities after menopause, 23% felt that sexual life ends with the onset of menopause, 16% reported that their husbands had become disinterested in them after menopause and 11% were apprehensive about the loss of femininity. A higher proportion of menopausal women reported hot flushes, night sweats, urge incontinence and other somatic symptoms. The study concluded that there was significant associations between multiple somatic symptoms, vasomotor symptoms, urge incontinence, loss of sexual desire and menopause3.
A descriptive co-relational survey was conducted on assessment of the knowledge and problems faced remedial measures adopted by menopausal women was conducted among 100 menopausal women in selected urban areas of south Delhi. The study was found that although 51% of the menopausal women were literates, 54% they had inadequate knowledge regarding menopause and they were facing different type of problem due to menopause. The study concludes that appropriate and timely education of the menopausal women would definitely help these women to cope with this transition in their life in a better way4.
A study was conducted to assess the effect of soy phytoestrogens and exercise on lipid profiles and menopause symptoms among 37 menopausal women in Iran.37 menopausal women randomly assigned to soymilk (n=15), exercise and soymilk (n=12) and control group (n=10) which were provided daily for 3 months. The study findings revealed that exercise and soy supplementation decreased of hot flushes by 83%, nervousness by 30% and vaginal symptoms by 50% and sexual symptoms by 45%. The study concluded that the consumption of soymilk and exercise for three months helps for the reduction of menopausal symptoms.5
The investigator during her clinical posting and interaction with women observed that they lack knowledge regarding menopausal problems and its remedial measures. Therefore, investigator felt the need to evaluate the effectiveness of a psycho education programme on menopausal problems and their remedies.
6.2 Review of literature
Review of literature enables the researcher to develop an insight into the study and plan the methodology. Further, it provides the basis for future investigation, justifies the need for replication, throws light on the feasibility of the study and indicates constraints of data collection.
An experimental study was conducted to examine the effect of an exercise programme on relieving menopausal symptoms and improving the quality of life among 48 menopausal women in Spain .The 12 month programme consisted of cardiovascular, stretching, muscle stretching and relaxation exercises in which half of them participated and the other half did not. At the start of study, 50% of the women in the exercise group and 58% of non exercisers had severe menopausal symptoms. The study findings revealed that the percentage of women with severe menopausal symptoms dropped to 37 %. The study concluded that regular exercise improves mental and physical health of menopausal women6.
A study on psychosocial factors in Japanese patients suffering from menopausal disorders was conducted among 97women in Japan. The result showed that half of them were found to have experienced various interpersonal problem as well as health – related problems. The study concludes that problems related to families and the patients health account for a large part of the psychosocial factors affecting the development of menopausal disorders in Japan Incorporating these finding into counseling and education will make outpatient clinics services more acceptable to such patients.
A cross sectional study on mental and physical problems women undergo during menopause was conducted among 100 women at Mangalore. The result showed that 62% experienced hot flush, 46% headache, 70% joint pain, 54% back pain 58% insomnia, 68 % mood disturbance and 54% anger. This study concludes that a women need to be educated to accept in a positive way that menopause is a part of women hood7.
A community based study was undertaken to evaluate menopausal symptoms among 500 urban women belonging to the middle socio- economic strata from Mumbai. The result showed that women frequently complained of muscle pains (37.4%), fatigue (35.6%), hot flushes (19.9%) ,sweating(18.6%) and mood disturbance (27.6%) This study concludes that efforts should be made to educate and inform women about the menopausal transition8.
6.3 Problem statement
Effect Of Psycho Education Programme On Menopausal Problems Among Women In A Selected Community Of Mangalore.
6.4 Objectives
The objectives of the study are,
-  to determine the level of knowledge of women regarding the menopausal problems using structured knowledge questionnaire in experimental (Group 1) and control group(Group 2)
-  to assess the level of severity of menopausal symptoms among women regarding the menopausal problems using modified NAMS (The North American Menopause Society) menopause health questionnaire in Group 1 and Group 2.
-  to evaluate the psycho education programme on menopausal problems in term of gain in knowledge scores using structured knowledge questionnaire in Group 1.
-  to evaluate the psycho education programme on menopausal problems in terms of reduction in severity of symptoms using modified NAMS menopause health questionnaire in Group 1.
-  to compare the effect of psycho education programme in terms of gain in knowledge scores between Group 1 and Group 2.
-  to compare the effect of psycho education programme in terms of reduction in symptom scores between Group 1 and Group 2.
6.5 Operational definitions
Effect:-
In the study it refers to the extent to which the psycho education on menopausal problems has achieved the intended results in terms of gain in knowledge score and reduction in symptom scores.
Psycho educational programme:-
In this study it refers to the systematically planned and developed programme by the investigator comprising of a teaching programme on menopause- meaning, signs and symptoms with physiology and management, lasting for 15 minutes delivered through lecture assisted with video clips. The teaching will be followed by a training session in which the investigator demonstrates selected exercises and relaxation techniques in specific to management of menopausal problems.
Menopausal problems: - In this study it refers to the physiological problems- hot flushes, breast tenderness, vaginal dryness, tiredness, joint pain and, urinary incontinence, Psychological problems- increased stress, forgetfulness, mood change, sleeplessness, lack of concentration, irritability, depression, and vasomotor problems includes night sweats which are associated with permanent cessation of menstruation.
women:-
In this study it refers to the religious sisters in the age group of 40-55 years residing in selected convents of Mangalore.
Selected community:-
In this study it refers to selected convents of Mangalore where religious sisters are living together.
6.6 Assumption
* Menopausal women may have some knowledge regarding menopausal problems and their management.
* Education programme is an accepted teaching strategy.
6.7 Hypotheses
All the hypothesis will be tested at 0.05 level of significance.
H1:- There will be significant difference between mean pre and post test knowledge scores in experimental group.
H2:- There will be significant difference between mean pre and post test symptom scores in experimental group.
H3:- There will be significant difference between mean post test knowledge scores of experimental and control group.
H4:- There will be significant difference between mean post test symptoms scores of experimental and control group.
6.8 Delimitation
The study is delimited to ,
Women who are between the age group of 40-55 years.
Women who are residing in a selected community.
Materials and methods
7.1 Sources of data:-
Data will be collected from 30 women who are in the age group of 40-55 years.
7.1.1 Research design:-
Quasi experimental time series non equivalent control group design will be used for the study.
Group / Pretest / Treatment / Posttest
Experimental / √ / × / √
Control / √ / - / √
7.1.2 Setting
The study will be undertaken among the members of selected convents in Mangalore each having 15-20 inmates each which are located within 30kms from the institution.
7.1.3 Population
The population in this study comprises of all the women who are in the age group of 40-55 years of Mangalore.
7.2 Methods of data collection
7.2.1 Sampling procedure
The sampling technique used in this study will be Purposive sampling then randomly assigned to experimental (n=15) and control (n=15) group.
7.2.2 Sampling size:-
The study will be conducted among 30women who are in the age group of 40-55 years.
Experimental group -15 women who will be receiving the psycho education programme
Control group -15 women who will not receive the psycho education programme.
7.2.3 Inclusion criteria:-
·  Women who are between the age group of 40-55 years of the selected community.
·  Women who are willing to participate in the study.
·  Women who experience menopausal symptoms.
7.2.4 Exclusion criteria
·  Women who are suffering from medical illness.
·  Women who have attended similar teaching classes.
7.2.5 Instrument used
Instrument intended to be used in this study is
TOOL1-Structured questionnaire on knowledge regarding menopausal problems and their management. It consist of
Part 1 .Baseline characteristics
Part 2.Structured knowledge questionnaire.
TOOL 2-Symptom checklist on menopausal problems using modified NAMS menopause health questionnaire.
7.2.6 Method of data collection
- Prior permission from concerned authorities would be sought.
-The investigator will introduce herself to the participants and objectives of the study will be explained to the participants.
-Pre testing will be done by administrating the structured knowledge questionnaire and symptom check list followed by the psycho education on the same day.
-Post test will be conducted using the symptom check list 3 times (10 days interval) and the knowledge questionnaire after 30 days of psycho education programme.
7.2.7 Data analysis plan
In this study data will be analysed in terms of descriptive statistics (frequency, mean, percentage, median and standard deviation) and inferential statistics (unpaired‘t’ test). The data will be presented in the form of table and diagrams.
7.3 Does the study require any investigation or intervention to be conducted on
Patients or other humans or animals? If so describe briefly.
Yes, psycho education (administering knowledge questionnaire and NAMS menopause health questionnaire followed by a training session) on menopausal problem will be provided to the menopausal women.
.7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, ethical clearance has been obtained from the concerned institution.
LIST OF REFERANCES
1.  Dr. Bimalkanta Nayak.The mental and physical problems women undergo during menopause and suggests ways to overcome such problems: Health action,2008:Pp 18- 21.
2.  Barbo DM, The Physiology of Menopause. Med clin North Am.1987;71(1):11-19
3.  Aaron R, Muliyil J, Abraham S. Medico-Social dimensions of menopause. Menopause MedlinePlusHealth Information .Aust N Z J Obstetric Gynaecol .2009; 49(1):106-9. Available from: Pubmed. http/ www. ncbi. nlm.gov/pubmed.
4.  Sharma N. Assessment of the knowledge, attidue,problems and remedial measures adopted by menopausal women:JNRSOI vol 1:2008 Pp25-29.
5.  Hanachi P, Golko S. Assessment of Soy Phytoestrogens and Exercise on lipid profiles and menopause symptoms in menopausal women.. J Biol Sci. 2008; 8(4):789-93.
6.  Warner J. Exercise eases menopause symptoms.2006Mar (Cited).www.webmed.com.
7.  Kryoshi T, Kazua M, Shiro N study of psychosocial factors in Japanese patients suffering from menopausal disorder.J. Obstet.Gynaecol. Res. 2004;vol.30, ( 4) 309 – 15.
8.  Rashmi S, Shubhangi K, Lalita S.Menopasual symptoms in Urban Indian women.OBG and GYNAE today. Pp667 -70.
9 / Signature of the candidate
10 / Remark of the guide
11 / Name and designation of
11.1 Guide
11.2 Signature
11.3 Co-Guide
11.4 Signature /
SR.LOREDANA KORAH
PROFESSOR
ST.ANNS COLLEGE OF NURSING
MULKI,MANGALORE
MRS.MARIE. E .PINTO
PROFESSOR
ST.ANNS COLLEGE OF NURSING
MULKI,MANGALORE
11.5 Head of the department
11.6 Signature
12 / 12.1 Remark of the chairman and principal
12.2 Signature

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