الفهرس 
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Abstract
Today, with increasing life expectancy and lifespan, women spend one-third of their lifetime after menopause. Menopause is defined as” the permanent cessation of menses resulting from reduced ovarian follicular activity”. The natural menopause is recognized to have occurred after 12 consecutive months of amenorrhea. The age of natural menopause ranges between 45-55 years and some women exceed up to 60 years.
As the aging process unfolds, ovarian senescence leads to decline of serum estrogen levels which elicit various somatic, psychological, vasomotor as well as sexual symptoms. These symptoms occur whether menopause ensues either naturally, surgically or failure of the pituitary gland to function. Menopausal symptoms experience varied widely from mild to severe, and while many women pass through menopause with manageable symptoms, others experience more severe symptoms that may be disabling .Self-care practices having an important place in the management of menopausal symptoms
The World Health Organization (WHO) defines self- care as activities, individuals, families, communities undertake with intention of enhancing health, preventing disease, limiting illness and restoring health.
Aim of the study
The aim was to identify self-care practices among working women regarding physical menopausal symptoms.
Settings:
The study was conducted at all faculties affiliated to University of Alexandria except nursing and medical faculties because the study subjects in this settings attended workshop about self- care practices for menopausal symptoms.
Subjects:
A convenience sample of (300) menopausal working women at the previously mentioned settings.
Two tools were developed and used by the researcher to collect the necessary data.
Tool (I): Individual biosocial demographic characteristics of working menopausal women Questionnaire.
It included Three main parts: Part one:- Biosocial demographic characteristics: such as age, education, occupation, marital status, residence….etc. Part two:-Reproductive history such as: gravidity, parity, number of abortions and number of living children. Part three:-Menopause rating scale (MRS): It is originally developed in Germany by The Berlin Center for Epidemiology and Health Research in 1990s.It was used to measure the severity of menopausal symptoms It was modified by the researcher where the psychological symptoms will be excluded to suit the aim of the study. Then the modified tool will include 8 statement.
Tool (II) self-care practices Questionnaire:
It was developed by the researcher to asses self-care practices among study subjects based on Pender health promotion model (1982). It included three parts. Part one: It included self-care practices that were used by menopausal women to release their menopausal symptoms. It consists of 46 statements that are divided into 8 menopausal symptoms. Part two: Behavior specific cognition: It included: Barriers of performing and or following the self-care practice. Part three: Behavior specific affect measured by self- efficacy: Modified version of Self efficacy scale adapted from Ralf Schwarzer’s (1991) to measure women’s self-efficacy.
- Tools were tested for content validity by a jury of five experts in the related field, and also checked for their reliability using Cronbach’s Alpha test (0.924).A pilot study was carried out on (30) menopausal women who were excluded from the selected subjects to ascertain relevance, clarity and the applicability of the tools. Data was collected over a period of 3 months starting from the beginning of September 2016 till the end of November 2016. Data was collected through questionnaire sheet given to the women. The number of questionnaire per day was 12 in each faculty. Two days per week. Statistical analysis of results were done after data were collected it was revised, coded and fed to statistical software IBM SPSS version 20.
The mean finding of the present study were:
Socio-demographic and clinical data interview schedule:
• The mean age of the study subjects was mean age was (50.48 ± 2.242) years.
• It was found that more than one half (58.7%) of study subjects had university education.
• The vast majority of study subjects (99.0%) had office work.
• More than four fifths (82.0%) of the study subjects were urban dwellers.
• Three fifths (60.0%) of the study subjects had enough monthly income. And 56.3% of husbands of the study subjects were employees.
Reproductive History:
• It was observed that 61.2% of the study subjects were pregnant for three times or more, and almost three fifths (59.1%) of the study subjects had three or more deliveries.
• When abortion was considered, it was found that 91.5% of study subjects had no abortion. And more than one half (56.9%) had three or more living children.
Severity of menopausal symptoms according to modified version of menopause rating scale (MRS):
• It was found that almost equal percent of the study subjects (40.0% & 40.0% & 39.6%) respectively didn’t experience any palpitation, sexual problems or/and urinary problems.
• Furthermore, 48.0% & 41.7% & 39.7% of the study subjects reported that they had moderate hot flashes, insomnia, and /or loss of concentration respectively.
• 38.30% of the study subjects had experienced severe hot flashes and night sweeting, and 31.30% had severe muscle and joint pain.
Total score of self-care practices to alleviate menopausal symptoms:
• It was obvious that about one half (49.0%)of the study subjects obtained good total score of self-care practices, while 44.7% obtained fair total score and a minority (6.3%) of the study subjects obtained poor total score.
Total score of behavior specific affect from the women point of view measured by modified version of self-efficacy scale
• It was found that about two thirds of study subjects (65.4%) had high total score of self-efficacy and more than one third of them (34.3%) had average total score of self-efficacy.
Relationship between total score of the study subjects self-care practices and their severity of the symptom:
• It was found that there was a highly statistical significant correlation between total score of the study subjects self-care practices and their severity of the symptoms where p=<0.001*.
Relationship between total score of Self-care practices and total score of self-efficacy
• There was a highly statistical significant correlation between the total score of self-efficacy from the women point of view and total score of self-care practices to alleviate their symptoms where p=<0.001.
Based on the study finding, the following was recommended:
1. Combined effort by educational programs and health care providers will help in increasing women awareness about menopause, its symptoms, long term consequences and treatment options.
2. .Empowerment by increasing menopausal women decision aids abilities to those who need them to improve the perception about this stage as well as their practices of self-care.