| Popis: |
This thesis examines the multi-disciplinary literature on menopause, develops and evaluates an intervention to prepare mid-aged women for the menopause transition. The literature review suggests that the intervention should aim to increase knowledge of menopause, counter overly negative attitudes, and promote health-enhancing behaviours, framed in a biopsychosocial perspective. Forty-five-year-old women registered at five general practices were targeted for the research. One hundred and seventy-eight women were sent baseline questionnaires assessing knowledge and beliefs about the menopause, and a number of healthrelated beliefs and behaviours. Sixty per cent (N=106) of the women responded. Overall, health-related behaviours were not inter-correlated, nor were health beliefs strong predictors of health behaviours. A number of relationships were found which have implications for health services for mid-aged women. The women appeared to have a low level of awareness of empirically derived information about menopause. Beliefs about menopause were complex and multi-faceted, and not necessarily congruent. Intention to use hormone replacement therapy was related to a disease model of menopause, depressed mood and a poorer sense of personal control over the experience of menopause. An as-sociation between smoking and earlier menopausal changes was found. A complex relationship between lack of exercise, greater body mass index, low self-esteem and perceived barriers to regular exercise was also evident. Fifty women subsequently participated in a health education intervention in the form of two small group sessions. Fiftyone women acted as control. The post-intervention assessment was carried out three months later, and the follow-up assessment a year later. A third group of women (N=44) was contacted for the first time at follow-up, to control for the effects of completing questionnaires by the first control group. Knowledge improved and fewer negative beliefs were expressed after the intervention. The proportion of smokers in the intervention group decreased, as did the proportion of women intending to use hormone replacement therapy, though these changes did not reach statistical significance due to the sample size. These changes were maintained at the 1-year follow-up. These outcome measures were unchanged for the control group. The results are discussed with reference to previous findings for mid-aged samples. The implications for further research are drawn. A range of suggestions for further development of health promotion services for mid-aged women are made. |
