الفهرس 
MenopauseOnly 14 pages are availabe for public view
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Abstract
Menopause, a normal part of women’s lives, and it is associated with considerable biological, physiological, and social changes. It may be associated with symptoms such as hot flashes, night sweats, insomnia, vaginal dryness, sexual dysfunction, constipation, and emotional and behavioral changes (El Hajj et al., 2020). While, menopause is a natural and physical condition affecting all women, this phenomenon is of high importance in Palestine, where the life expectancy at birth for females in is around 74.6 according to the Palestinian Central Bureau of Statistics (PCBS, 2017). The women populations who are above 40 years conform about 20% of the female population, counting for around 190 thousand women, according to the PCBS (2017).
The health care of women during this stage requires special attention to the identification of their health needs in order to provide competent care. However, the achievements made in terms of longevity stand diminished owing to the lack of specialized health care that addresses the health needs of the aged. These facts illustrate the need to assess the menopausal symptoms of midlife women accurately and to develop successful culturally focused preventive and control strategies for menopausal problems to have an easy and smooth midlife transition and to improve their quality of life (Lalo, Kamberi & Peto. 2017).
Aim of the study
The Present study was aimed to evaluate the effect of self-care module on coping with menopausal symptoms in west Bank-Palestine.
This aim was achieved through:
1- Assess Palestinian menopausal women coping with menopausal symptom before implementation of self-care module.
2- Measure the severity of menopausal symptoms among the menopausal women in west Bank-Palestine before implementation of self-care module.
3- Design and implement self-care module for menopausal women.
4- Evaluate the effect of self-care module on severity of menopausal symptoms among the menopausal women in west Bank-Palestine.
5- Evaluate the effect of self-care module on coping of women with menopausal symptom in west Bank-Palestine. After implementation of self-care module
Research hypothesis
• Self-care module will improve coping with menopause symptoms among the menopausal women in Nablus city.
A quasi-experimental design (per-post- test) used to achieve aim of the study. The current study was conducted at twenty governmental secondary schools at Nablus city in west Bank-Palestine. 75 menopausal women working at governmental secondary schools were selected though using of a purposive sampling technique. While, multi-stage random sampling design was used to choose the study schools.
Tools of data collection; First tool: Self-Structured interviewing questionnaire sheet, it divided into; socio - general characteristics, menopause history, and studied women’s knowledge regarding menopausal symptoms and coping with these symptoms. Second tool: The Menopause Symptoms’ Severity Inventory-38, it used to assess the intensity (how strong/intense) of each symptom of the studied women before and after implementation of self-care module under two subscales which contain Physical& Psychological symptoms. Third tool: The “coping with menopause symptoms” questionnaire, it used to assess the studied women coping with menopausal symptoms before and after implementation of self-care module. Fourth tool: Self-care assessment tools strategies and assessment it used to assess menopausal women self-care practices before and after implementation of self-care module.
Results
Concerning their knowledge about menopause symptoms, the most symptoms mentioned by studied women before intervention were 49.3%, 41.33% and 32.0% for weight gain, mood changes and hot flashes respectively, but their percentages have been drastically increased to 77.33%, 52.0% and 76.0% respectively after intervention. Also, a highly significant statistical difference between knowledge about menopausal symptoms mentioned before and after intervention.
More than half (57.33%) of the studied women had previous knowledge about coping strategies of menopausal symptom before intervention. The most known strategies were 42.67% and 36% for healthy nutrition and physical exercise respectively. That there was improvement of studied women’s knowledge regarding coping strategies for menopausal symptoms, as there was highly statistically significant difference between before and after intervention.
There was improvement regarding to severity of menopausal psychological symptoms before and after intervention; as 17.3%, 13.3%, 0% and 0% of studied women highly lose interest in most things before intervention, after one month, two months and three months respectively. Generally, the result showed progressive decrease in the menopausal psychological symptom severity for the studied women by the time.
Improvement in practicing self-care activities with time for all items. The improvement was progressive regarding the questions dealt with health care activities, such as visit doctor in need and having sick leave in need. For the other items, the frequency of practicing the self-care activities slightly declined after two months of intervention, then improved again after three months of intervention. The statistical analysis showed highly significant differences between the different self-care practices before and after intervention.
Average menopausal symptoms severity score for the studied women decreased gradually by time. It slightly decreased from 52.240 to 51.333 before intervention and one-month after intervention, respectively. Thereafter, the average score sharply decreased to reach 31.373 three months after interventions. A statistically significant reducing the severity of menopausal symptom.
The average coping strategies score for the studied women increased gradually by time and improved. It increased from 31.427 to 40.48 before intervention and three months after intervention, respectively. Also, it was obvious that there was no significant difference between the score before and one month after intervention. On the other hand, there were highly statistically significant differences between the women scores after two and three months of intervention.
The average menopause total self-care practice score for the studied women slightly increased from 23.613 to 26.107 before intervention and one-month after intervention, respectively. Thereafter, there was a considerable decline in the score average to reach 17.827 two months after intervention. Less the expectance because of spread of (COVID 19) pandemic virus that reflected on women self-care practice Then, the average score sharply increased to reach 28.973 three months after interventions. There is the positive correlation between self-care practice and menopause symptoms severity that when improve or increase self-care practices for women the symptom severity decrease.
Conclusion
Implementation of self-care module for menopausal women was effective on reducing severity of menopausal symptoms among them and significantly improve coping with menopausal symptoms at Nablus city in west bank -Palestine.
Recommendation
Application of self-care module for menopausal women in different health setting in west bank -Palestine to reduce severity of menopausal symptom and improve the coping with these symptoms.