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Go Back       Himalayan Journal of Nursing and Midwifery | Volume:1 Issue:1 | Feb. 18, 2022
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Knowledge Regarding Menopausal Osteoporosis and Its Prevention among Perimenopausal Women in Selected Government Hospitals Shimla (H.P)


Renuka Devi*1 and Dr. Amita Puri2

1M.Sc. Nursing, Obstetrics and Gynaecological Nursing, Sister Nivedita Government Nursing College.IGMC, Shimla, Himachal Pradesh, India

2Associate Professor, Obstetrics and Gynaecological Nursing, Sister Nivedita Government Nursing College.IGMC, Shimla, Himachal Pradesh, India

Article History

Received: 06.01.2022

Accepted: 15.02.2022

Published: 18.02.2022


Abstract: Background: Menopausal osteoporosis for perimenopausal women should provide is an important for prevention of menopausal osteoporosis.it is very important to identify risk factors in women and to address them aggressively early in life, because they can impart adverse effect on daily routine life. Material & Methods: A pre-experimental research study was done from September 2021 among 60 perimenopausal women in selected government hospitals of Shimla. The convenient sampling technique was used for hospitals and total enumeration technique was used for perimenopausal women. Tool was validated by ten experts and reliability was checked by split half method. Pre-test was done to check the level of knowledge among perimenopausal women using self-structured questionnaire followed by administration of planned teaching programme. Post-test was administered after intervention with same questionnaire used in pre-test. Results: The pre-test knowledge score of perimenopausal women was average (44.83%). The post-test knowledge score of perimenopausal women was 59.17%. The significant difference (14.33%) was present in pre and post-test knowledge of perimenopausal women after giving planned teaching programme. Conclusion: Study concluded that the planned teaching programme was effective on increasing the knowledge of perimenopausal women regarding menopausal osteoporosis in selected government hospitals Shimla (H.P.).


Keywords: Menopausal osteoporosis, perimenopausal women, knowledge.

Copyright @ 2022: This is an open-access article distributed under the terms of the Creative Commons Attribution license which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use (Noncommercial, or CC-BY-NC) provided the original author and source are credited.

INTRODUCTION

Health is a fundamental human right. It is central to the concept of quality of life. Health and its maintenance is a major social investment and is World-wide social goal. Health is multidimensional. This health may be assessed by such indicators as death rate, infant mortality rate and expectation of life. Ideally, each piece of information should be individually useful and when combined should permit a more complete health profile of individuals and communities. (Indian journal of community medicine 2007)


Menopause derived from the Latin word ‘meno’ means month and ‘pausia’ means halt and it marks the end of the woman’s fertility period. Postmenopausal syndrome is one which ranges from hot flushes and irritability to osteoporosis and heart disease and is experienced by all women in varying degrees. (Liya Bavadan, India's National Magazine, 2004)


"osteon" which means bone and "poros" which means pore. In osteoporosis the bone mineral density is reduced, bone micro architecture is deteriorating, and the amount and variety of proteins in bone is altered. (Amer Shakil, Nora E Gimpel 2011)

Osteoporosis is a disease in which bones become fragile and weak, leading to increased risk of fractures. This condition is more common in old age. Osteoporosis has no signs and symptoms until a fracture occurs- so that it is called a silent disease. (Susan A Krum, Nightingale Nursing Times, vol.9, oct.2013)


OBJECTIVES OF THE STUDY

  • To assess the pre-existing knowledge regarding menopausal osteoporosis and its prevention among perimenopausal women in selected government hospitals Shimla (H.P.).

  • To prepare and administer the planned teaching program regarding menopausal osteoporosis and its prevention among perimenopausal women in selected government hospitals Shimla (H.P.).

  • To evaluate the effectiveness of planned teaching program regarding menopausal osteoporosis and its prevention among perimenopausal women in selected government hospitals Shimla (H.P.).

  • To find out the association between pre-test knowledge score and post-test knowledge score with selected demographic variables.


MATERIALS AND METHODS

Research Approach-Quantitative

Research Design-Pre-experimental design using one group pre-test and post-test

Research Setting-Selected hospitals of Shimla.

Study Duration: Between September to October 2021

Study Population: Perimenopausal women of selected government hospitals of Shimla (H.P)

Sample Size: 60 perimenopausal women

Sampling Technique: Randomly Sampling Technique

Sampling criteria: The sample will have selected by the following predetermined criteria.


Inclusion Criteria

  • Clients who will be taking treatment from selected hospitals Shimla.

  • Clients who will be willing to participate.

  • Clients who will understand Hindi/Pahari.


Exclusion Criteria

  • Clients who will not be present at the time of data collection.

  • Clients who are not willing.

  • Clients at the below of 40 years.

Development of tool: Knowledge related questionnaires (30)


Description of Tool

Tool will be prepared on the objectives of the study. A planned teaching questionnaire will be selected to effectiveness of planned teaching program on menopausal osteoporosis and its prevention among perimenoposaual women. Tool consists of the following sections-


Section-A: A socio-demographic characteristic of the perimenopausal women (age, education, occupation, marital status, religion and source of information regarding menopausal osteoporosis).


Section-B: There were thirty structured knowledge questionnaires having four options. The perimenopausal women has choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 30 and minimum score was zero. Scoring was done on the basis of marks as (0-11) = Poor, (12-23) = Average, (24-30) = Good


Validity of tool: By the experts in this field


Permission: Obtained from the concerned head of the hospitals.


Ethical considerations: Ethical approval was taken from research ethical committee of Sister Nivedita Govt.Nursing College, IGMC, Shimla.


Data collection: By myself under the guidance of supervisors and perimenopausal women was given time to complete that questionnaires and collected at the end of the prescribed time


Data analysis: With appropriate statistical test in terms of frequency, percentage, mean, standard deviation and Chi-Square test. P value of less than 0.05was considered to be statistically significant.


DATA ANALYSIS AND RESULTS

The collected data was tabulated and analyzed using descriptive and inferential statistics under following headings:


Section A: Finding related to sociodemographic variables in terms of frequency and percentage.


Section B: Finding related to pre-test knowledge scores of perimenoposaual women in prevention of menopausal osteoporosis.


Section C: Findings related to post-test knowledge scores of perimenoposaual women in prevention of menopausal osteoporosis.


Section D: Findings related to effectiveness of planned teaching programme regarding menopausal osteoporosis and its prevention among perimenoposaual women.


Section E: Finding related to association between knowledge of perimenopausal women in prevention of menopausal osteoporosis with their selected demographic variables.


Section A

Table 1: Frequency and Percentage Distribution according to Their Socio-Demographic Variables (N=60)

Part-A: Demographic Variables

Socio demographic variables

Category

Frequency (f)

Percentage (%)

Age in years

40 -44years

23

38.3

45-50years

21

35.0

51-55years

16

26.7

Above 55years

-

0.0

Education

Uneducated/Illiterate

5

8.3

Primary education

5

8.3

Secondary education

49

81.7

Higher education

1

1.7

Occupation

Home Maker

55

90.0

Private employed

-

0.0

Government-employed

5

8.3

Any other

-

0.0

Dietary Habits

Vegetarian

55

90

Non vegetarian

5

8.3

Eggetarian

-

0.0

Family Income

Below 5000

7

11.7

5001– 10,000

28

46.7

10,001 –15,000

9

15.0

Above 20,000

16

26.7

Religion

Hindu

60

100.0

Muslim

-

0.0

Christian

-

0.0

Sikh

-

0.0

Any Other

-

0.0

Residential area

Rural

41

68.3

Urban

17

28.3

Types of family

Nuclear family

-

0.0

Joint family

3

5.0

Extended family

-

0.0

No. of children

No child

-

0.0

1 child

3

5.0

2 children

23

38.3

Above 2 children

34

56.7

Marital status

Married

54

90.0

Unmarried

-

0.0

Divorce

4

8.0

Widow

2

3.3

Family history related to arthritis/fractures

Yes

17

28.3

No

41

68.3

Source of health information regarding osteoporosis

Television/ Radio

12

20.0

Relatives/Friends

5

8.3

Internet

2

3.3

Any Other

41

68.3


Part –B: Obstetric History (N=60)

Socio demographic variables

Category

Frequency (f)

Percentage (%)

Age at menarche in years

10-11 years

16

26.7

12-13 years

11

18.3

14-15 years

24

40.0

16-17 years

9

15.0

Menstrual cycle

Regular

55

91.7

Irregular

5

8.3

Duration of menstruation

1 or less day

-

0.0

2-3 days

33

55.0

4-5days

19

31.7

More than 5days

8

13.3

Nature of bleeding

Less bleeding

10

16.7

Moderate bleeding

15

25.0

Normal bleeding

33

55.0

Excessive bleeding

2

3.3

Menopause

Yes

13

21.7

No

46

76.7

Type of menopause

Surgical menopause

2

3.3

Natural menopause

7

11.7

No

51

85.0

If yes specify

Cyst

2

3.3

Prolapsed uterus

1

1.7

Any other

57

95.0

Calcium supplementation

Yes

16

26.7


No

44

73.1


The table.1 shows that in the experimental group out of 60 participant’s majority 38.3% were from the age group were 40-44 years, 35.0% were in 45-50years, 26.7% were in 51-55 years and 0.0% study subjects were in the age group above than 55 years. As per qualification, majority 81.7% of subjects were secondary education, 8.3% has done no uneducated/illiterate and primary education,1.7% subject were higher education. As per the occupation 90.0% subject were home maker,8.3% subject were government employed, 0.0% subject were private job and any other work. Out of 60 study subject 90% subject were vegetarian,8.3% were non vegetarian and 0.0% were eggetarain. As per monthly income, 46.7% study subjects were having income 5001-10,000, 26.7% have above than 20,000 monthly incomes, 15.0%% subjects were 10.000-15,000 monthly income, and only 11.7% study samples have below than 5000 monthly incomes. As per religion majority of samples 100% were Hindu followed by none subjects were Muslim, Sikh, Christian and any other. As per residential area, majority 68.3% of subjects belongs to Rural area, and only 28.3% belongs to rural area. As per type of family 5.0% subject were live in joint family, 0.0% subject were live in nuclear family and extended family. As per no of children 0.0% subject were no child,5.0% subject were 1 child,38.3% subject 2 children and 56.7% subject were above than 2 children. As per marital status 90.0% subject were married, 0.0% subject were unmarried,8.0% subject were divorce and 3.3% subject were widow. As per family history related to arthritis/fracture 68.3 % subject were no family history related to arthritis and fracture and 28.3% subject have family history related to arthritis and fracture. As per source of information, 20.0% study subjects had information from the television/radio, 8.3% had knowledge from the relatives /friends, while 3.3% subjects had knowledge from the internet and 68.3% subjects had knowledge from any other sources.


The age of majority of menarche were (40%) 14 and 15years, followed by 26.7% were10-11years,18.3% were 12-13 years and 15.0% were 16-17 years. Menstrual cycle regular were 91.7% while irregular were 8.3%. Duration of menstruation were (55.0%) 2-3 days, 31.7% were 4-5days, 13.3%were more than 5days and 0.0% were 1 or less day. Nature of bleeding were (55.0%) normal bleeding, 25.0% were moderate bleeding, 16.7% were less bleeding and 3.3% were excessive bleeding. Most of subject no menopause were 76.7% and menopause were 21.7%. Type of natural menopause were 11.7% and surgical menopause were 3.3%. Surgical menopause due to cyst were 3.3% and prolapsed uterus were 1.7%. Most of not taking calcium were 77.3% and calcium taking were 26.7%.


Section B

Table No 2: Table Showing Frequency And Percentage Distribution Of Pre-Test Knowledge Score of Perimenopausal Women On Prevention Of Menopausal Osteoporosis Perimenopausal Women.

PRE-TEST KNOWLEDGE SCORE

Levels

Frequency

Percentage

Inadequate knowledge.(0-10)

16

26.7

Moderate knowledge.(11-20)

40

66.7

Adequate knowledge.(21-30)

4

6.7


Table No 2. Depicts that 26.7% women has inadequate knowledge in prevention of menopausal osteoporosis, 66.7% have moderate knowledge score and 6.7% have adequate knowledge in prevention of menopausal osteoporosis.


Figure Image is Available in PDF Format

Figure No 1: Shows Pre-Test Knowledge Score of Perimenopausal Women Regarding Menopausal Osteoporosis.


Section C

Table No 3: Table Showing Frequency and Percentage Distribution of Post-Test Knowledge Score of Perimenopausal Women on Prevention of Menopausal Osteoporosis in Perimenopausal Women.

POST-TEST KNOWLEDGE SCORE

Levels

Frequency

Percentage

Inadequate knowledge.(0-10)

1

1.7

Moderate knowledge.(11-20)

43

71.7

Adequate knowledge.(21-30)

16

26.7

Table No. 4. 4 Depicts that 1.7% women has inadequate knowledge related to prevention of menopausal osteoporosis,71.7% have moderate knowledge score and 26.7% have adequate knowledge related to prevention of menopausal osteoporosis.

Figure Image is Available in PDF Format


Figure 2: Showing Percentage Wise Distribution of Post-Test Knowledge Score of Perimenopausal Women Regarding Menopausal Osteoporosis.

Section D

Table No 4: Findings Related to Effectiveness of Planned Teaching Programme Regarding Menopausal Osteoporosis and Its Prevention among Perimenoposaual Women. (N=60)

Paired t test

Mean±S.D.

Mean%

Range

Mean Diff.

Paired t test

p value

Table Value at 0.05

Pre-test Knowledge

13.45±3.916

44.80

7-22

4.300

16.292 *Sig

<0.001

2.00

Post-test Knowledge

17.75±3.99

59.20

10-27

* Significance Level at P ≥0.05


Table No. 4. Depicts that the pre-test range was 7-22, mean 13.45 and standard deviation was 3.916, mean percentage was 44.80% and in the post-test range was 10-27, mean 17.75and standard deviation was 3.99, mean percentage was 59.20% and mean difference was 4.300. Above table shows that the mean post-test knowledge score (17.75) was higher than the mean pre-test knowledge score (13.45). The paired‘t’ test shows comparison within the group. The value of‘t’ test was 16.292 which was significant at 0.05 level of significance. Hence Hypothesis H1was accepted and it can be inferred that there is significant difference between pre-test and post-test knowledge.


Figure Image is Available in PDF Format


Figure No 3: Bar Graph Showing Difference between Pre-Test and Post-Test Knowledge Score of Perimenopausal Women Regarding Menopausal Osteoporosis.

Section E

Finding related to association between knowledge of perimenopausal women in prevention of menopausal osteoporosis with their selected demographic variables.


The association between the level of score and socio demographic variable. Based on the objectives used to Chi-square test used to associate the level of knowledge and selected demographic variables. The Chi-square value shows that there is significance association between the score level and demographic variable (Family history related to arthritis/fracture).


The calculated chi-square values were 8.577 which was more than the table value at the 0.05 level of significance with degree of freedom(2df). Hence it can be calculated that knowledge of perimenopausal women was significantly associated with family history related arthritis/fracture.


There is no significance association between the level of scores and other demographic variables such as age in years, education, occupation, marital status, family income, religion, residential area, type of family, marital status, source of health information regarding osteoporosis, age at menarche in years, menstrual cycle, duration of menstruation, nature of bleeding, menopause, type of menopause and calcium supplementation. The calculated chi-square values were less than the table value at the 0.05 level of significance.


CONCLUSION

Study reveals that most of the perimenopausal women have inadequate knowledge regarding menopausal osteoporosis and its prevention among perimenopausal women. The study concluded that the knowledge of perimenopausal women regarding menopausal osteoporosis can be increased by ongoing teaching programme to perimenopausal women.


Recommendations

A quasi-experimental design to find out the effectiveness of the planned teaching programme in a more reliable manner. A study similar to the present study can be replicated in different settings. A descriptive study can be undertaken to assess knowledge using large sample and wider setting like covering various districts in a state, which can be helpful to collect important statistics and then give useful recommendations.


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