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PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
DISSERTATION PROPOSAL
“A STUDY TO ASSESS THE KNOWLEDGE REGARDING COMMON
PSYCHOLOGICAL PROBLEMS AFTER MENOPAUSE, AMONG
PREMENOPAUSAL WOMEN RESIDING IN SELECTED RURAL
AREAS AT TUMKUR WITH A VIEW TO DEVELOP AN
INFORMATION BOOKLET”
SUBMITTED BY: - Mr. SAIJU M RAJAN
Ist YEAR M.Sc. NURSING,
PSYCHIATRIC NURSING
SRI RAMANAMAHARSHI COLLEGE
OF NURSING, TUMKUR
2012 - 2014.
1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE,
KARNATAKA
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1 NAME OF THE CANDIDATE
AND ADDRESS.
MR. SAIJU M RAJAN
SRI RAMANA MAHARSHI COLLEGE OF
NURSING
TUMKUR.
2 NAME OF THE INSTITUTE SRI RAMANA MAHARSHI COLLEGE OF
NURSING, TUMKUR
3 COURSE OF STUDY AND
SUBJECT
1st YEAR M.Sc NURSING
PSYCHIATRIC NURSING
4 DATE OF ADMISSION TO
COURSE
30.06.2012
5 TITLE OF THE TOPIC
“ASSESSMENT OF KNOWLEDGE
REGARDING COMMON PSYCHOLOGICAL
PROBLEMS AFTER MENOPAUSE, AMONG
PREMENOPAUSAL WOMEN RESIDING IN
SELECTED RURAL AREAS AT TUMKUR”
2
6. BRIEF RESUME OF INTENDED WORK
INTRODUCTION
“Pre menopausal women stand at a cross road, facing the possibility of living the remainder of their lives.”
Science is the search for truth. Psychiatry refers to a field of medicine focused
specifically on the mind, aiming to study, prevent, and treat mental disorders in humans.
Menopause literally means the "end of monthly cycles" (the end of monthly periods aka
menstruation), from the Greek word pausis (cessation) and the root men- (month).
Menopause is an event that typically (but not always) occurs in women in midlife, during
their late 40s or early 50s, and it signals the end of the fertile phase of a woman's life.
However rather than being defined by the state of the uterus and the absence of menstrual
flow, menopause is more accurately defined as the permanent cessation of the primary
functions of the ovaries the ripening and release of ova and the release of hormones that
cause both the creation of the uterine lining, and the subsequent shedding of the uterine
lining (a.k.a. the menses or the period).This transition from a potentially reproductive to a
non-reproductive state is the result of a reduction in female hormonal production by the
ovaries. The functional disorders often significantly speed up the menopausal process and
create more significant health problems, both physical and emotional, for the affected
woman.
Menopause is a major turning point in the life of a woman directly related to
her womanhood. Beginning of menopause marks the end of youth in a woman. It is the
stage after which a woman is incapable of bearing a child. Menopause is caused when the
production of estrogen hormone in the body is significantly decreased. Menopause is a
stage of life not a disease. The exact age of menopause differs from woman. In normal
women, menopause occurs somewhere between 45 to 50 years of age. In specific cases if
there are surgical operations in the body like removal of uterus, it may occur earlier.
Delay of menopause after 52 years is an indication of certain irregularities in the body.
The ideal age of menopause is 50, Menopause occurs in three major stages. The whole
process of menopause can take 15 years or longer, depending on your age and family
3
history. The first stage of menopause is known as perimenopause. The second stage of
menopause occurs when your period no longer arrives. This stage is simply called
menopause and usually occurs around age 50 or 51 and The final stage of menopause is
called postmenopause.1
Menopause causes many changes in a women’s life, both physically and
psychologically. Physical complaints in order of frequency are as follows: hot flashes,
night sweats or chills, disrupted sleep, vaginal dryness, loss of libido, loss of energy,
mood swings, increased irritability, loss of skin tone, and urinary leakage. Psychological
complaints include, loss of confidence, depressed mood, irritability, forgetfulness,
difficulty in concentrating, panic attacks and anxiety.2
The common Psychological problems that affects women’s after menopause are
Depression and/or anxiety Fatigue
Irritability
Memory loss , and problems with concentration
Mood distruralce
Sleep distruralces , poor quality sleep, light sleep, insomnia and sleepiness.3
Human life is a continuous process of changes and menopause is one of them. Accepting
this fact reduces major fraction of the problems since it induces a psychological strength
to combat the same. Thus a psychological adaptability may be sufficiently helpful for a
woman in facing menopause, one of the major turning points of her life.4
4
6.1. NEED FOR STUDY
“All our knowledge brings us nearer to our ignorance”
“Nothing on earth is more international than disease” said Paul Russell. Health
and disease have no barriers across the world. Diseases will last as long as humanity
itself. In the present scenario, more life threatening diseases are emerging in the universe
and will remain as a big threat to mankind. Interestingly, advancement in medical science
and research ensures a better quality in future life and helps the human beings to live up
to their expectations.
Health improves physiological and psychological condition of the
postmenopausal mothers and more significantly it reduces mortality. Moreover research
indicates that health awareness is not only clinically effective, but is cost-effective as
well. Health awareness program compares favorably with other medical interventions
performed commonly in population who are risk of diseases.5
A total of 130 million Indian women are expected to live beyond the menopause
into old age by 2015. The menopause is emerging as an issue owing to rapid
globalization, urbanization, awareness and increased longevity in rural middle-aged
Indian women, who are evolving as a homogeneous group. Improved economic
conditions and education may cause the attitude of rural working women to be more
positive towards the menopause. However, most remain oblivious of the short- and long-
term implications of the morbid conditions associated with middle and old age, simply
because of lack of awareness, and the unavailability or ever-increasing cost of the
medical and social support systems.6
A cross-sectional study was conducted by researcher in Chandigarh, India. With
an objective to assess the knowledge about menopause and postmenopausal bleeding in
women of rural and slum area of Chandigarh. For the current study researcher selected
528 women randomly who were aged above 40 years, The were collected and analyzed
The results of the study shows that, out of total 528 women interviewed, 302 (56.1) were 5
residing in rural area and rest were the residents of slums. 78.8%, rural and 60.2% from
slums have attained menopause. Majority (70.3%) of rural residents have heard about
menopause as compared to 30.9% in slums. The most common menopausal symptom
was vaginal irritation / discharge (42.7%). Less than half of females (38.7%) ever took
treatment for menopausal symptoms. Calcium supplements were taken by majority63%.
7.7% females complained of PMB out of which 13(44.8%) had it after intercourse. The
study highlights that there is lack of awareness regarding menopause and related aspects
especially PMB in both rural and slum population.7
A cross-sectional postal survey was conducted on the psychological status at the
menopausal transition. a sample of menopausal women recruited from the general
registry office in ferrara’s province were selected for the study. four thousands and
seventy-three women were sent a questionnaire designed on the basis of the Women
Health Questionnaire (WHQ). Result identifies three different clusters of psychiatric
symptoms, depressive symptoms, depressed mood with anxiety symptoms, and anxiety.
The cluster “depressive symptoms” was more evident in the postmenopausal period with
respect to the premenopausal one. The study concluded that the cluster “depressive
symptoms” is significantly different in the premenopausal group with respect to the
postmenopausal group, with greater levels of symptomatology in the postmenopausal
group.8
Postmenopausal women are less satisfied with their sleep and as many as
61% report insomnia symptoms.4 The National Sleep Foundation has reported that 20%
of menopausal and postmenopausal women sleep less than 6 hours per night during the
workweek, while only 12% of premenopausal women (with the exception of pregnant
women) sleep less than 6 hours.5 Snoring has also been found to be more common and
severe in postmenopausal women. The prevalence of clinically defined sleep apnea—
apnea/hypo apnea index >10 plus the presence of daytime symptoms including daytime
sleepiness, hypertension, or some other cardiovascular symptom—for premenopausal
women was 0.6% compared to 1.9% for postmenopausal women.9
6
A study was conducted on “Menopause, the metabolic syndrome, and mind-body
therapies” .The objective of the study was to assess that, traditional mind-body practices
such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing
insulin resistance syndrome-related risk factors for cardiovascular disease in older
populations, including postmenopausal women. Results show that these practices may
reduce insulin resistance and related physiological risk factors for cardiovascular disease;
improve mood, well-being, and sleep; decrease sympathetic activation; and enhance
cardiovagal function. However, additional rigorous studies are needed to confirm existing
findings and to examine long-term effects on cardiovascular health.10
A postmenopausal woman faces lot of problems, both physically and
psychologically. They have to cope with these changes and accept their new role in the
society and family. So there is a need of promoting and improving the coping strategies
and to reduce the psychological problems.
The need of health awareness has increased dramatically in recent years. Inpatient
and outpatient programs in the hospital and at community sites are being implemented all
over the country. Equally significant, research over the last 10 years has provided
empirical data suggesting that health awareness programs are a safe and effective method
of improving physical, physiological, and psychological wellbeing and greatly enhance
the quality of patients. 11
The researcher therefore has chosen this study, as an opportunity to educate
the patients regarding risk of psychological disorders so that they (clients) can incredibly
maintain the quality of health and safeguard themselves from the risk of psychological
diseases and able to manage it by early detection.
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6.2 REVIEW OF LITERATURE
A research literature review is a written summary of the state of evidence on
research problems. The major steps in preparing a written research review include
formulating a question, devising a search strategy, conducting a researches, retrieving
relevant sources, abstracting and encoding information, critiquing studies, analyzing the
aggregated information and preparing a written synthesis.
Review has been divided under the following headings
1. Studies related to incidence and prevalence of psychological problems in
Postmenopausal women.
2. Studies related psychological problems in postmenopausal women.
Menopause is normal physiological process that every women has to cross
that stage in her life time and she has to adopt to several physiological changes
that will occurs as a result of menopause, several studies shown that as women
crosses the menopausal stage she is prone to get several psychological problems,
that was supported by the following studies.
STUDIES RELATED TO INCIDENCE AND PREVALENCE OF
PSYCHOLOGICAL PROBLEMS IN POST MENOPAUSAL WOMEN.
8
A cross sectional study on postmenopausal women with an objective to assess
insomnia prevalence and related risk factors in postmenopausal women. For the study
researcher randomly selected study 204 natural postmenopausal women of rural area
and used Athens insomnia scale (AIS) was used to assess the level of insomnia, the
data were gather and analyzed and the results of the study revealed that there is an
positive correlation with menopause and the insomnia. Hence the researcher
concluded that the menopause induces insomnia in postmenopausal women hence the
medical intervention are recommended to rule it off.12
Another study conducted on employees of Norway with an objective to describe
the incidence and duration of d categories of mental health problems with at least two
weeks of compensated absence from work. For the present study researcher included the
90% of employees, a census data were collected by daily attendance register and a total
of 101,512 individuals with one or more were on long-term sick leaves (>2 weeks) due to
psychological problems. The results of the study revealed that, Employees absent for
psychological problems accounted for 16.8% of all incidences and 31.5% of all refunded
sick days. The average one-year incidence was 2.47%, and was significantly higher for
women (3.53%) than for men (1.66%). Hence the researcher concluded that, The
incidence increased with increasing age, and more so for women than for men and There
is an urgent need for more knowledge about the mental health.13
A Recent report of several study were published in an article according to that,
A total of 130 million Indian women are expected to live beyond the menopause into old
age by 2015. The menopause is emerging as an issue owing to rapid globalization,
urbanization, awareness and increased longevity in rural middle-aged Indian women, who
are evolving as a homogeneous group. Improved economic conditions and education may
cause the attitude of rural working women to be more positive towards the menopause.
However, most remain oblivious of the short- and long-term implications of the morbid
conditions associated with middle and old age, simply because of lack of awareness, and
the unavailability or ever-increasing cost of the medical and social support systems.14
9
A cross sectional comparative study on mothers with an objective aims to fill the
current knowledge gap about the prevalence and characteristics of psychological distress.
For the study the researcher selected 152 samples in one group and 33 samples in other A
6-item PD (psychological distress) scale was constructed with a summed score range of
0-12 and a cut-point of 7 indicating serious Psychological distress. Multiple statistical
tests were used to examine the characteristics of Psychological distress. The data were
collected and analyzed and the results of the study revealed that the rate of current
Psychological distress among American Indian women is approximately 2.5 times higher
than that of U.S. women in general.15
A study on women in India with an objective to find the association between
psychiatric morbidity and menopause. For the study the researcher randomly selected the
samples and the data were gathered by using the structured interview schedule, the data
were analysed and association was done with the help of chi-square. The results of the
study shown that, Women in menopause have been found to suffer higher psychological
morbidity as compared to pre menopausal and post menopausal women. The predominant
psycho pathology is from depressive spectrum. Various menopausal symptoms reported
in Indian settings include physical or mental exhaustion, irritability, depressed mood,
decreased sleep and decreased interest in sex.16
Studies related psychological problems of post menopausal women
10
A study on perimenopausal women at china with an objective to “report the
prevalence of symptoms in the Hong Kong Chinese perimenopausal women; to construct
reported symptoms into symptom groupings; and to clarify whether the symptom groups
are associated with menopausal status. For the study the researcher took perimenopausal
women aged 44-55 years, the data were collected from the samples using random
telephonic interview dialing of a random sample of the numbers listed in the residents'
telephone directory and a Standardized questionnaire, including a 22-item symptom
check list, was administered over the telephone. The principal component analysis
method followed by varimax rotation was used to examine the relations among the
symptoms. The Result of the study shows that psychological, non-specific somatic and
vasomotor symptoms were significantly associated with menopausal status, while
musculoskeletal and respiratory were of borderline statistical significance.17
Another study on “Health profile of middle-aged women: The Women's Health
in the Lund Area (WHILA) with an objective to evaluate the impacts of menopause status
and hormone intervention on women's health. For the study researcher randomly selected
4943 women, structured questionnaire was use to collect the data and data were analyzed.
The results reveal that, hot flushes and vaginal dryness were strongly related to
menopausal status. The prevalence of somatic symptoms worsened progressively from
the groups of PM(pre menopausal) to PMO(post menopausal without hormone
replacement therapy) to PMT(postmenopausal with hormone replacement therapy). The
most abundant complaints were headache and muscle-skeletal-joint problems. A total of
85% of women experienced psychological problems. Contrary to our expectation, a
poorer profile of psychological health was found in the PMT group when compared with
the PMO group. Hence the study concluded that high prevalence of symptoms in middle-
aged women could be attributed to age, hormonal influence as well as personality.18
A study on women with an objective to examine the relationship between
menopausal transition status and self-reported sleep difficulty. For the study researcher
selected women aged between 48 to 54 years. With the use of data on women
11
participating in the medical research council national survey of health and development
who have been followed up from birth in March 1946 (n = 962), relationships between
menopausal transition status and self-reported sleep difficulty were assessed. The results
of the study reveals that, Menopausal transition status was related to severe self-reported
sleep difficulty and sleep difficulty were increased approximately by 2- to 3.5-fold (95%
ci ranges from 1.08-3.27 to 1.99-6.04) for women in most menopausal transition statuses
compared with women who remained premenopausal. Hence the researcher concluded
that Women without prior health problems may experience severe self-reported sleeping
difficulty during the menopausal transition and require tailored care from health
professionals.19
A study on menopausal women with an objective to document the prevalence of
16 symptoms commonly associated with menopause, in women living in Kelantan. For
the study researcher selected 326 naturally menopaused healthy women in Kelantan a
semi-structured questionnaire in was administered to assess the prevalence of 16 common
symptoms, The data obtained were analysed and the results of the study reveals that,
Mean age at menopause was 49.4+/-3.4 (S.D.) years, The prevalence of atypical
symptoms was as follows: tiredness (79.1%), reduced level of concentration (77.5%),
whereas mood swings (51%), sleep problems (45.1%), loneliness (41.1%), anxiety
(39.8%) and crying spells (33.4%) were the main psychological symptoms. Hence the
study concluded that, There was a tendency for the women to admit to having more of the
psychological symptoms, the prevalence of some which increased with increasing
menopausal status.20
A study (health university of negiria) on women’s aged over 45 years with an
objective to identify the numerous health problems in women after 45 years of age. For
the study they took 50 university women workers who are aged above 45 years, A
questionnaire was designed and administered and the data were analyzed using simple
statistical techniques. The findings revealed the different types of health problems that
12
women experience after 45 and indicated that many women even at this age do not know
about health implications or coping strategies. Hence they concluded that the women’s
are more prone for health problems after 45 years of age so interventions are very much
needed in order to rule out the potential problems in women.21
A Cross-Sectional Study On Women’s At Brazil With An Objective to identify
The Prevalence Of Physical, Psychological, And Menopause-Related Symptoms And
Their Association With Minor Psychiatric Disorders In Premenopausal, Perimenopausal,
And Postmenopausal Women, For the study the researcher randomly selected 324 women
aged 36 to 62 years (86 premenopausal women, 156 perimenopausal women, and 82
postmenopausal women) and investigated Demographic characteristics, education, and
climacteric symptoms, The 20-item Self-Reporting Questionnaire was used to screen for
minor psychiatric disorders, with a score of 8 or higher indicating positive screening. The
data were gathered and analysed, results of the study revealed that, The variables most
frequently associated with positive findings during the screening for minor psychiatric
disorders were very low education level and memory loss and irritability. Classic
vasomotor complaints were weakly associated with non psychotic disease. In turn,
perimenopausal and postmenopausal women, were at greater risk of minor psychiatric
disorders. Hence the researcher concluded that, Low education level, memory loss,
irritability, and the menopausal transition represent risk factors for positive findings in a
screening for minor psychiatric disorders.22
Another study on elder population with an objective to examine “gender
differences in the associations between affection- and status-related stressors encountered
in the first half of life and physical and mental health problems later on”. Based on the
theory of Social Production Functions (SPF) two hypotheses have been formulated,
which were tested in a representative sample of 446 men and 514 women (aged 40-79).
Main outcome measures were number of chronic somatic diseases and level of
psychological distress. As expected, regression analyses showed no gender differences in
the associations between affection-related stressors and physical and mental health 13
problems later on. In contrast, but as also expected, status-related stressors encountered in
the first half of life were associated with later physical and mental health for men only. It
is concluded that the gender differences in the associations between earlier social
stressors and later health problems may be more complex than the common assumption
that men are only affected by status stress and women only by affection stress.23
A study on middle aged women in taiwanese with an objective to investigate the
role of menopausal transition and menopausal symptoms in relation to quality of life in a
cohort of middle-aged women. For the study researcher selected a total of 734
premenopausal women participated in the baseline study, and 579 women (78.9%)
completed a follow-up 2 years later. Quality of life was assessed by the medical
outcomes study short form-36. Participating women were asked for demographic data,
about vasomotor symptoms, and to complete the medical outcomes study short form-36
and the hospital anxiety and depression scale. In multivariate analysis, only vasomotor
symptoms had an adverse influence on role limitation of emotion after adjusting for age,
education, menopausal status, baseline cognitive score, and Hospital Anxiety and
Depression Scale score. Hence the researcher concluded that no significant effect of
menopausal transition on quality of life among Taiwanese women.24
A study on patients at south Africa and the result were published according
that report, Psychological co-morbidity is high in patients with obesity and is associated
with a variety of medical and dietary problems as well as demographic, social and
cognitive risk factors. Young overweight and obese women are at particular risk for
developing sustained depressive mood, which is an important gateway symptom for
major depressive disorder. Increased knowledge of behavioral risk factors has enabled
patients with obesity to be classified on a psychological basis and this needs to be
considered as part of a patient's clinical assessment and treatment strategy. Increased
awareness of abnormal eating behaviour, together with profiling of personality traits,
could improve treatment selection for obese women and improve the outcome of weight-
14
loss programmes. Individualized anti-obesity drug therapy/interventions may be required
depending on the patient's psychological characteristics25
STATEMENT OF THE PROBLEM
“A STUDY TO ASSESS THE KNOWLEDGE REGARDING COMMON
PSYCHOLOGICAL PROBLEMS AFTER MENOPAUSE, AMONG
PREMENOPAUSAL WOMEN RESIDING IN SELECTED RURAL AREAS AT
TUMKUR WITH A VIEW TO DEVELOP AN INFORMATION BOOKLET”
6.3 OBJECTIVES OF THE STUDY:
To assess the level of knowledge regarding the risk of common psychological
problems after menopause among pre menopausal women.
To determine the association between knowledge scores of samples with the
selected demographic variables.
To develop and distribute the information booklet on common psychological
problems after menopause.
6.4 RESEARCH HYPOTHESIS:
H1: There will be significant association between the knowledge score of Pre menopausal mothers with the selected demographic variables.
6.5 VARIABLES: Variables are an attribute of a person or objects that varies, that takes different values.
Research variable in this study the knowledge of Pre menopausal mothers regarding common psychological problems after menopause.
15
Extraneous variables in this study are age, educational qualification, religion, occupation, family income, source of health information.
6.6 OPERATIONAL DEFINITIONS :
Assessment: In this study assessment refers to an organized systemic process of collecting information about knowledge of premenopausal mothers regarding risk of common psychological problems after menopause.
Knowledge : In this study knowledge refers to the cognitive ability to interpret the information regarding the risk of common psychological problems after menopause.
Psychological problems : In these study psychological problems refers to the
problems occurring in the mind of postmenopausal women such as depression,
anxiety, irritation, insomnia, lack of concentration and is measured by Greene
climacteric scale.
Pre menopausal mothers: in the present study the premenopausal mothers refers to the women aged between 40 to 50 years of age and reached the menopause.
Information booklet : It is the information source prepared by the researcher on risk of common psychological problems after menopause and it will be distributed to the premenopausal mothers in order to create awareness among them.
6.7 ASSUMPTIONS:
The premenopausal mothers in selected rural areas may not have adequate knowledge regarding common psychological problems after menopause.
The premenopausal mothers will get an opportunity to gain knowledge regarding common psychological problems after menopause.
The premenopausal mothers utilize the information booklet in a positive way to safeguard themselves from potential complications.
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The response given by the samples to the questionnaire will represent their true measures of knowledge regarding common psychological problems after menopause among them.
The knowledge of premenopausal mothers may be influenced by demographic factors like education, age etc.
6.8 DELIMITATIONS OF THE STUDY:
- The study will be limited to only 100 premenopausal mothers.- The study is delimited to pre menopausal mothers who are residing in selected
rural areas of Tumkur.- The knowledge score will be measured by structured interview schedule
6.9 PILOT STUDY:
The pilot study will be conducted among 10 samples. The purpose of pilot study is to find out the feasibility of conducting study and design on plan of statistical analysis. This also will help to assess the practicability of carrying out the main study. The findings of the pilot study samples will not be included in main study.
7. MATERIALS AND METHODS:
7.1 SOURCE OF DATA: The data will be collected from premenopausal mothers residing in selected rural area at Tumkur.
7.2 METHODS OF DATA COLLECTION: The study will be initiated only after obtaining permission from concerned authorities. The data collection procedure will be carried out for a period of three months. At first a good rapport will be established with the samples and the purpose of the study will be explained to them, so as to get the co-operation from them. For procedure of data collection, a questionnaire interview schedule will be used for collection of data.PART I: questionnaire related to demographic data.
17
PART II: Consist of questionnaire assessing knowledge regarding risk of common psychological disorders after menopause.
7.2 (1) RESEARCH APPROACH: A descriptive research approach will be used.
7.2 (2) RESEARCH DESIGN: Non experimental descriptive survey research design is used for this study.
7.2 (3) RESEARCH SETTINGS: The study will be conducted in selected rural areas at Tumkur.
7.2 (4) POPULLATION: Population of the study will be premenopausal mothers.
TARGET POPULATION: Premenopausal mothers residing in selected rural areas.
ACCESSIBLE POPULATION: pre menopausal mothers of rural area who will be available during study.
7.2 (5) SAMPLE SIZE: The total study sample consists of 100 premenopausal mothers residing in selected rural areas at Tumkur.
7.2 (6) SAMPLE TECHNIQUES: Purposive sampling technique will be used for the current study.
7.2 (7) SAMPLING CRITERIA:
INCLUSIVE CRITERIA: Premenopausal mothers residing in selected rural area. Premenopausal mothers who are available during the study. Premenopausal mothers who are aged between 40years to 50 years.
18
EXCLUSIVE CRITERIA: Premenopausal mothers who suffering with illness. Those who are not willing to participate in the study. Premenopausal mothers who cannot understand either kannada nor English.
7.2 (8) DATA COLLECTION METHODS: Demographic Proforma. Structured interview schedule to assess knowledge.
7.2 (9) DATA ANALYSIS METHODS: The data collected will be organized tabulated and analyzed by using descriptive and inferential statistics. The data will be planned to present in the form of tables and figures.
DESCRIPTIVE STATISTICS: Mean, mean percentage, standard deviation and average will be used for assessing the level of knowledge.
INFERENTIAL STATISTICS: chi-square test will be used to find out the association between demographic variables with knowledge scores.
TIME AND DURATION OF THE STUDY: The time and duration of the study will be limited to three months or as per the guidelines of university.
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENT OR OTHER HUMAN OR ANIMAL? IF SO PLEASE, DESCRIBE BRIEFLY. Since the study is descriptive interventions are not required.
7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUTION? Yes, the pilot study and the main study will be conducted after the approval from the research committee. Permission will be obtained from the concerned head of the institution. The purpose and details of the study will be explained to the study subjects and an informed consent will be obtained from them. Assurance will be given to the
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study subjects regarding the confidentiality and anonymity of the data collected from them.
LIST OF REFERENCE:
1. Available from: URL:;www.naturalhealthcare.org
2. The Nurse Practitioner.The American Journal of Primary Health Care.2006;31(5):
44-49
3.Arakane M, Castillo C, Rosero MF, Peñafiel R, Pérez-López FR, Chedraui P.
Factors relating to insomnia during the menopausal transition as evaluated by the
Insomnia Severity Index.". Maturitas(2011). 69 (2): pp. 157–161.
4. Senguptha A. The Emergence Of Menopause In India.Climacteric.2003;6(2):92-5.
5. Cohen, B.E. Kanaya A.M. Macer. Feasibility and Acceptability of Restorative Yoga
for Treatment of Hot Flushes. Curr Med Res Opin. 2008 Sep;24(9):2711-7.
6. Sonia Puri. Vikas Bhatia. Chetna Mangat. Perceptions Of Menopause And
Postmenopausal Bleeding In Women Of Chandigarh India. The Internet Journal of
Family Practice. 2007 May 12;97(18):1837-47
7. Mario Amorea. Pietro Di Donatob. Alessandro Papalinic. Psychological status at the
menopausal transition: an Italian epidemiological study. 2004 aug 48(2):115-124
20
8. Neha H. Badheka, Mohamed T. Sameen, Russell Rozensky. Properly identifying and
managing sleep disturbances during menopause can improve women’s overall quality of
life. Sleep Review - September-October 2005
9. Kim E. Innes. Terry Kit Selfe. Ann Gill Taylor. Menopause, the metabolic syndrome,
and mind-body therapies. Menopause. 2008 Sep–Oct; 15(5): 1005–1013.
10)Sonia Puri. Vikas Bhatia. Chetna Mangat. Perceptions Of Menopause And
Postmenopausal Bleeding In Women Of Chandigarh India. The Internet Journal of
Family Practice. 2008 Volume 6 Number 2.
11) Mary R. Taylor, Cathryn Booth-LaForce, Eric Elven. Participant Perspectives on a
Yoga Intervention for Menopausal Symptoms. Int J Fertil Womens Med.
1998;43(2): 122.
12. Chedraui P. Miguel GS. Villacreses D. Dominguez A. Jaramillo W. Escobar
GS. Pérez-López FR. Genazzani AR. Simoncini T. Research Group for the Omega
Women's Health Project. Assessment of insomnia and related risk factors in
postmenopausal women screened for the metabolic syndrome. Maturitas. 2012; Nov 21.
13) PaE l Nystuen, KaE re B. Hagen and Jeph Herrin. Mental health problems as a cause
of long-term sick leave in the Norwegian workforce. Health Services Research Unit,
Department of Population Health Sciences, National Institute of Public Health, Oslo,
Norway. Scand J Public Health 2001; 29: 175±182.
14) Sonia Puri, Vikas Bhatia, Chetna Mangat. Perceptions Of Menopause And
Postmenopausal Bleeding In Women Of Chandigarh, India. The Internet Journal of
Family Practice. 2007 May 12;97(18):1837-47.
21
15) Parker T. Maviglia MA. Lewis PT. Phillip Gossage J. May PA. Psychological
distress among Plains Indian mothers with children referred to screening for Fetal
Alcohol Spectrum Disorders. Subst Abuse Treat Prev Policy. 2010 Sep 6;5:22.
16) Prakash IJ. Murthy VN. Psychiatric morbidity and menopause. Indian J
Psychiatry. 2001;23:242–6.
17) Mario Amorea. Pietro Di Donatob. Alessandro Papalinic. Psychological status at the
menopausal transition: an Italian epidemiological study. 2004;48(2):115-124
18) Neha H. Badheka, Mohamed T. Sameen, Russell Rozensky. Properly identifying and
managing sleep disturbances during menopause can improve women’s overall quality
of life. Sleep Review - September-October 2005
19) Tom SE. Kuh D. Guralnik JM. Mishra GD. Self-reported sleep difficulty during the
enopausal transition: results from a prospective cohort study Menopause. 2010 Nov-
Dec;17(6):1128-35.
20) Dhillon HK. Singh HJ. Shuib R. Hamid AM. Mohd Zaki Nik Mahmood N.
Prevalence of menopausal symptoms in women in Kelantan, Malaysia. Maturitas.
2006 Jun 20;54(3):213-21. Epub 2005 Dec 2.
21) Imogie AO. Sustenance of women's health after the age of 45 years at the University
of Benin, Benin City, Nigeria. Health Care Women Int. 2000 Dec;21(8):717-26.
22) Oppermann K. Fuchs SC. Donato G. Bastos CA. Spritzer PM Physical. psychological
and menopause-related symptoms and minor psychiatric disorders in a community-
based sample of Brazilian premenopausal. perimenopausal and postmenopausal
women. Menopause. 2012 Mar;19(3):355-60.
22
23) Steverink N. Veenstra R. Oldehinkel AJ. Gans RO. Rosmalen JG. Is social stress in
the first half of life detrimental to later physical and mental health in both men and
women?. Eur J Ageing. 2011 Mar;8(1):21-30. Epub 2011 Feb 11.
24) Cheng MH. Lee SJ. Wang SJ. Wang PH. Fuh JL. Does menopausal transition affect
the quality of life? A longitudinal study of middle-aged women in Kinmen.
Menopause. 2007 Sep-Oct;14(5):885-90.
25) Van der Merwe MT. Psychological correlates of obesity in women. Int J Obes
(Lond). 2007 Nov;31 Suppl 2:S14-8; discussion S31-2.
9 SIGNATURE OF THE CANDIDATE
10 REMARKS OF THE GUIDE
11 NAME AND DESIGNATION OF
11.1 GUIDE
11.2 SIGNATURE
PROF. NAGANANDINIHOD PSYCHIATRIC NURSING
11.3 CO-GUIDE(IF ANY)
11.4 SIGNATURE
23
11.5 HEAD OF THE DEPARTMENT
11.6 SIGNATURE
12 12.1 REMARKS OF PRINCIPAL
12.2 SIGNATURE
24