Comparative Study of 35-50 Years Old Women ’ s Attitude About Menopause Before and After Reading a Pamphlet

In various studies, adverse effects of women’s inadequate information about menopausal has been approved. This research studying the effect of reading a pamphlet about menopause on attitude of 35-50 years old women. This intervention study was contained 100 women on clinic of obstetrics and gynecology, in Besat, 501, and Khanevade hospitals. Sampling was non-randomized and sequential. Assessment questionnaire of attitudes about menopause were given to each participants asked to complete with accuracy before and after reading the pamphlet. Data obtained from questionnaire analyzed with SPSS ver. 15. The mean age of studied population was 40.51±5.96. Improvement of the participant’s attitude was statistically significant after reading pamphlets (Pvalue=0.029). According to this study results, it seems the use of pamphlets has an important effect on women’s education in the prevention of menopause complications.


INTRODUCTION
In the past, medical science had mainly focused its attention on disease control, but with progression of science, disease prevention became particularly more important.In this regard, one of the society concerns is the women's knowledge who had not good awareness about menopause and its symptoms.Menopause is a natural and important phase of women's life and its main symptoms are ending of fertility and menstruation.Passing a year after the last menstruation means menopause is happened.Being familiar with physical, mental and emotional changes of this life phase can help women to know what awaits them and they can be more ready to adapt themselves to these changes and enjoy this stage of their life enough.The onset of menopause in women is different, but generally it will happen between the ages of 48-52 years or after it.Menopause symptoms include hot flush, sleep disturbances, changes in the urogenital system, bone and muscle changes, emotional changes and changes in libido [1][2][3] Adequate nutrition, physical exercise, hormone therapy and regular visits by a gynecologist can help women to prevent complications of menopause 4,5 Today, a third of women's life is on postmenopausal period and physical changes during this alteration should not be an impediment to the enjoyment of life.Many studies have investigated menopause, prevention and treatment of its complications [6][7][8][9][10][11][12] Currently there is not enough information about the women's awareness of the menopause and methods for preventive measures of this phenomenon complications.But it is notable, the prepostmenopausal complication will be reduced, if women's awareness be sufficient.
Unfortunately, there is not enough data about women's knowledge about menopause are not available in Iran.Understanding the attitudes of Iranian women can help in use of different systems to help them about this natural phenomenon.One way to increase women's knowledge about menopause is participation on counseling sessions and using educational pamphlets.According to the lack of such researches in Iran, or unavailability of their results, and due to complications of menopause in the absence of prevention methods, this study was conducted with aim of determination and comparison of 35 to 50 years old women's attitudes of menopause, before and after reading the pamphlet.

METHODS
This intervention study applied as before and after and contained 100 women on clinic of obstetrics and gynecology, in Besat, 501, and Khanevade hospitals.Sampling was nonrandomized and sequential.Thus, all qualified individuals were chosen in order until the required sample size was complete.First, the project was explained to them and participated in this study by their consent.The prepared questionnaire was given to participants in two steps, before and after reading the pamphlet, and asked to complete with accuracy.The questionnaire consisted of 26 multiple-choice and explaining questions to investigate attitude of participants about menopause.
Answers of each participants was scored before and after reading the pamphlet and obtained data were analyzed by chi-square and t-test by SPSS ver.15.
The result of statistical comparison of data for attitudes of participants about menopause before and after reading of the pamphlet can be seen on table.1 which was statistically significant (P-value<0.05)

DISCUSSION
In this study the effect of pamphlet on the attitude level of 35-50 years old women about menopause were studied.Our results illustrated that reading a pamphlet would have significant effect on this people about this phase of their life.All participant were on good group at the end of experiment.Based on these findings, it seems that the providing booklets and pamphlets caused a significant increase in the level of attitude in women about menopause.The effectiveness of this approach is listed different in various countries [13][14][15][16][17] In the present study, it was shown that the attitude of participants about complications of menopause, such as cardiovascular disease, changes in libido, hot flush, and osteoporosis have been improved.Also, using this pamphlet could increase awareness of strategies to prevent menopause symptoms such as the role of diet, medicine consumption, need for regular and periodic checkups of breasts, conduct periodic and regular testing for cervical cancer, role of hormone therapy in menopause complications, prevention of cardiovascular disease, impact of hormone therapy and increasing risk of breast cancer, need to visiting the nutritionist at this phase of life, and effect of plant estrogen hormone therapy in those who are contraindicated.These results suggest that providing educational materials in the form of pamphlets, leaflets, meetings and through mass media on how to deal with medical and health issues has a significant impact.Today, in many countries of the world it is more progressive to provide more useful information about how to deal with diseases, followup of diseases and also improve the quality of life.On the other hand, in this study participant's attitude toward referring to special centers and health centers and referring to gynecologist for postmenopausal care was good before reading the pamphlet.It seems that the importance of going to health centers for specialized care for women during this period is clear.Also in this study, 50.5% of those surveyed have a high school diploma and 83.5% were housekeeper that shows a probable need of this groups for more education.

CONCLUSION
According to the findings of this study and considering the fact that the use of educational pamphlets have little use for menopause, need this kind of education is necessary.Possibly, attempt to this needs approval and support of the Ministry of Health and Medical Education to provide booklets, pamphlets, counseling at health centers in each region, the use of mass media like radio and television health programs and also keep track of attendance at training sessions and consultations in every region.It is recommended that presentations and counseling sessions be free to increase participants.It is also recommended that similar studies in other provinces of the country and in a larger population should be conducted and the participant's satisfaction of the type of educational aids should be considered.