الفهرس 
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Abstract
Osteoporosis is a global health problem, and its prevalence is rapidly increasing worldwide. The International Osteoporosis Foundation (IOF) estimates that 200 million women suffer from osteoporosis around the world, affecting more than75 million people in Europe, Japan, Australia and North America. In Egypt, 53.9% of postmenopausal women have osteopenia while 28.4% have osteoporosis Elsabagh et al., (2015). Moreover, this disease and fractures secondary to it are an essential reason of mortality and morbidity. About 1.6 million hip fractures occur every year worldwide; the incidence is set to increase to 6.3 million by 2050 (IOF, 2014).
Increasing knowledge, correcting health beliefs and promoting behaviors towards preventing and treating osteoporosis are effective measures for building and maintaining strong bone throughout ones’ life-span. Therefore, exercise practice becomes a crucial intervention, by increasing the confidence of the woman to independently perform her tasks. In addition to a reduction in bone loss, the regular practice of exercise by women with osteoporosis has, as positive effects, overall health, socialization, self-esteem, mood and body awareness improvement; and reduction of depression, anxiety and fear of falls (Chan et al., 2018).
The present study aimed to evaluate the efficacy of Health promotion model on improving physical activity among post-menopausal women with osteoporosis through:
Assess the women knowledge and health beliefs about osteoporosis.
Evaluate the effect of health promotion model on physical activity among postmenopausal women with osteoporosis.
The study was conducted at Women’s health center in Nasser institute hospital, 3days per week form 9 am to 1 pm. A simple random sample ”tossing technique” was used to recruit one hundred post- menopausal women with osteoporosis, those women divided into two equal groups randomly, 50 post- menopausal women were selected as intervention group who received physical activity and another 50 post-women were selected as a control group who received only routine care. The period of implementation was seven months started from the beginning of August 2017 to the end of February 2018.
Four tools of data collection were used through; Interview questionnaire sheet & The Osteoporosis Knowledge Test & Osteoporosis Health Belief Scale & Global physical activity questionnaire (GPAQ).
The main results of the present study were as follows:
The mean age of post- menopausal women in the study group was (55.90±13.98) compared to (58.52±14.63) of menopausal women in the control group.
As regard occupational status 50% of menopausal women in the study group were worker versus 48.0% of menopausal women in the control group.
The majority (92.0% and 88.0%) of post-menopausal women in the study group had complete correct knowledge regarding osteoporosis after intervention and at follow up respectively with highly statistical improvement on total level of knowledge (p<0.001).
The mean total score of the health beliefs regarding osteoporosis was high in the study group post intervention and at follow up (95.90±6.86 and 96.20±7.32 respectively) with a statistical significant difference (p <0.05) of all subscale of health belief of osteoporosis except susceptibility post intervention. While, at follow-up there was a statistical significant difference of all subscale of health belief of osteoporosis except susceptibility and seriousness.
Regarding total physical activity, (58%) of post-menopausal women was highly active and (42%) was moderately active among the study group post intervention and at follow up with highly statistical significant improvement (p<0.001).
There was a highly statistical significant relation (p<0.001) between level of knowledge and level of health belief of osteoporosis after intervention with moderate positive correlation (r = 0.591).
There was a statistically significant relation (p<0.05) between level of knowledge and level of physical activity with moderate positive correlation (r = 0.644).
There was a statistically significant relation (p<0.05) between level of health beliefs of osteoporosis and total physical activity with moderate positive correlation (r = 0.661).
Based on the findings of the present study, it is concluded that:
The findings of the current study supported the hypothesis of this study which stated that application of nursing intervention based on health promotion model had positive effect on improving physical activity among post-menopausal women with osteoporosis. In addition, post-menopausal women’s knowledge and health beliefs regarding osteoporosis were significantly improved after intervention and at follow-up.
In the light of the previous results of the present study, the following recommendations are suggested:
Implementation of awareness sessions for post-menopausal women to improve their knowledge and health beliefs regarding osteoporosis.
Application of physical activity program for post-menopausal women with osteoporosis to prevent osteoporosis complication.
Further research is needed to evaluate effect of physical activity on cardiovascular problems that face women in post -menopausal period.