“A study to evaluate the impact of BCC (Behaviour Change

Communication) session in term of knowledge & Quality of life

regarding Menopause transition symptoms among women
residing in Selected Rural Community, At Uttarakhand”
Ph.D. NURSING PROBLEM STATEMENT

PANNA DHAI MAA SUBHARTI NURSING COLLEGE

SWAMI VIVEKANANDA SUBHARTI UNIVERSITY,
MEERUT
BY
MS. SHAILA PANCHAL
Ph.D SCHOLAR NURSING
DEPARTMENT OF COMMUNITY HEALTH NURSING
 PANNA DHAI MAA SUBHARTI NURSING COLLEGE,
SUBHARTI UNIVERSITY MEERUT, UTTAR PRADESH
REGISTRATION OF SUBJECT FOR DISSERTATION

NAME OF THE CANDIDATE AND MS. SHAILA PANCHAL

ADDRESS Ph.D NURSING
PANNA DHAI MAA SUBHARTI
NURSING COLLEGE,
SUBHARTI PURAM, MEERUT

NAME AND ADDRESS OF THE GUIDE-: DR. BHAWNA PANT

GUIDE SUBHARTI MEDICAL COLLEGE,
MEERUT.

CO-GUIDE-: DR. GEETA

PARWANDA
PANNA DHAI MAA SUBHARTI
NURSING COLLEGE, MEERUT.

PANNA DHAI MAA SUBHARTI

NAME OF THE INSTITUTION NURSING COLLEGE,
SUBHARTI PURAM, MEERUT

COURSE OF STUDY AND Ph.D NURSING

SUBJECT COMMUNITY HEALTH NURSING

DATE OF ADMISSION TO THE

COURSE

TITLE OF THE TOPIC

“A study to evaluate the impact of BCC (Behaviour Change
Communication) session in term of knowledge & Quality of life
regarding Menopause transition symptoms among women residing in
Selected Rural Community, At Uttarakhand”
 BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

“Changing women’s health-naturally”

Aging is a fact of life and it is a normal process of having brittle bones,

sagging skin and degenerating body functions. In aging women, they may
experience a popularly known condition called menopause. This is characterized by changes
that occur in a woman’s life before and her menstruation ends signalling her infertility years.

Menopause starts gradually and usually signalled by changes in menstruation. The

specific symptoms women experience may varies from woman to woman. In some women,
menstrual flow comes to a sudden halt. The monthly flow may increase, decrease, become
irregular and finally cease. Often interval between period is longer; a lapse of several months
between period is not uncommon.

Menopausal transition symptoms affect about 70% of women approaching

menopause. Typical menopause symptoms, such as hot flashes or night sweats, are caused by
changing hormonal levels in the female reproductive system. Almost all women notice early
symptoms while still having periods. This stage of gradually falling and fluctuating hormone
levels is called perimenopause, which often begins in the early40s.

The symptoms of menopause usually last for the whole menopause transition (until
the mid 50s), but some women may experience them for the rest of their lives. The most
common symptoms are: hot flashes, night sweats, irregular periods, loss of libido, and
vaginal, depression, anxiety, irritability, panic disorder, joint pain, burning tongue, digestive
problems ,muscle tension, tingling extremities and osteoporosis.

Women’s health primarily focuses on women’s psychosocial and physiological well

being, functional abilities, and experiences of symptoms and health problems. The major
health issues of the women are heart disease, cancer, HIV, aging, depression and midlife. In
order to address the women health problems all these factors to be noticed. The women’s
health has pivotal role in ensuring the family’s and community’s health. (Janette Lancaster,
2006)
 Approximately 10% of the women have no symptoms of menopausal other than
cessation of menstruation,70% to 80% are aware of other changes but have no problems and
approximately 10% experiences changed severe enough to interfere with activities of daily
living.

NEED FOR STUDY

Healthy women during their reproductive period will menstruates cyclically and
regularly with normal flow and duration of bleeding. As the age approach the women notices
changes in the menstrual cycle, such as changes in the frequency, duration and flow of
bleeding. These irregularities in the menstrual cycle signal the onset of menopause in the
midlife women. The onset of menopause denotes the gradual decline of fertile period in the
women. The onset natural menopause is signed by the changes in hormonal levels mainly
depletion in the oestrogen.

The prevalence of menopausal symptom varies in geographical region and ethnicity

of the population. Only limited studies are conducted among Asian women to analyse the
severity of premenopausal symptoms. According to The Study of women’s health Across
Nation (SWAN), studies report shows that Japanese and Chinese women manifested less
symptoms than Caucasian women.

According to various studies conducted in various parts of the world, among the
incidence of premenopausal symptoms, most commonly seen are hot flushes, menstrual
irregularity, fatigue, vaginal dryness, urinary incontinence, mood disturbances, depression
and anxiety. Among which most commonly occurring and hindering the daily life of women
are hot flushes (55.80%) and depression (37.30%).

In a study conducted in a selected urban community in India by Sudha Sharma has

found that with age advances the nature and prevalence of premenopausal Symptoms also
varies. The vasomotor symptoms (35%) and psychological disturbances (38%) increases with
increase in age. The occurrence in frequency and severity of symptoms varies among
individuals, population and different cultures of the world. The symptoms of menopause vary
with biological change, psychological factors, socio cultural factors and environmental
influences. According to various studies conducted to measure quality of life of Aged
Women from different socio cultural background reveals that perception of quality and
menopause status influences the quality of life.
REVIEW OF LITERATURE

Omaima M., et al. 2013, A descriptive study was conducted with descriptive
research design that included 200 married women randomly selected from Faculties of Ain
Shams University in Egypt. An interviewing questionnaire was used to collect data based on
literature review. Main finding 81% and 79% of premenopausal women had physical and
social health complaints, while 74% and 71% of them had sexual and psychological
complaints respectively.

Jennifer Whiteley., et al. (2012) A cross-sectional study that included 8,811women

40– 64 years from USA. Data from the 2005 United States National Health and Wellness
Survey were used. Finding reveals that women experiencing menopausal symptoms reported
significantly lower levels of HRQOL and significantly higher work impairment, and
healthcare utilization than women without menopausal symptoms, depression, anxiety, and
joint stiffness were symptoms with the strongest associations with health outcomes.

Jansirani Natarajan., et al. (2013), A literature review that included 15 studies

published between 2007 and 2013 conducted in 13 different countries. MRS (Modified
Menopausal Symptom), MENQOL (Menopausal quality of life), WHOQOL (World health
organization quality of life), and Self-reported menopausal symptom questionnaire has also
been used. Result of the study It is evident that there is great diversity in symptom
frequencies across the cultures and ways of coping adopted by these women. Based on these
values, the healthcare professionals can use different approaches to educate and treat women
with menopausal symptoms and concerns that are culturally relevant.

Nabarun Karmakar., et al. (2017) Descriptive cross-sectional study 100 peri and
postmenopausal women (40–60 years) in Dearah village of West Bengal, India during
February–March 2014. The Menopause-Specific Quality of Life Questionnaire MENQOL.
Result reveals that Occurrence of vasomotor symptoms was average with 60% of them
reporting hot flushes and 47% sweating. Most prevalent psychosocial symptoms reported
were feeling of anxiety and nervousness (94%) and overall depression (88%). Physical
symptoms were quite varying in occurrence with some symptoms such as feeling tired 49%
reported of avoiding intimacy with a partner and 26% complained of vaginal dryness.

Miranda Hajdini., et al. (2017), a study was conducted in Tirana and some rural
areas around in 2016. Sample included 1207 women aged 45-64 years old and for data
collection we used a self administered questionnaire. As all around the world, in Albania
women report various symptoms that can influence the quality of life, but with a lower
prevalence. The most frequently reported symptoms include forgetfulness (26.3%), hot
flushes (25.9%), frequent headaches (23.3%), aching joints (21.6%) and stomach bloating
(21.0%).

STATEMENT OF THE PROBLEM

“A study to evaluate the impact of BCC (Behaviour Change Communication) session in

term of knowledge & Quality of life regarding menopause transition symptoms among
women residing in selected Rural Community, At Uttarakhand”

OBJECTIVES

 To assess the Knowledge & Quality of life regarding menopause transition symptoms
among women residing in rural community at Dehradun before and after the
administration of BCC (Behaviour change communication) Session.
 To develop and validate the BCC (Behaviour change communication) Session
regarding menopause transition symptoms among women residing in rural community
at Dehradun.
 To determine the effectiveness of BCC (Behaviour change communication) Session
regarding menopause transition symptoms among women residing in rural community
at Dehradun.
 To find out the relationship between level of knowledge and Quality of life regarding
menopause transition symptoms among women residing in rural community at
Dehradun.

OPERATIONAL DEFINITION

1. Evaluate: - It refers to determining the effectiveness of BCC Session and it is

measured in terms of significant knowledge gain in the post test knowledge score.

2. BCC Session :- In this study BCC Session refers to the intervention which is used
to provide including Yoga, Meditation, Pranayam and knowledge about Menopause
transition symptoms.

3. Knowledge:- It refers to the appropriate response by the Women on knowledge

regarding Menopausal transition symptoms and its management before and after
intervention as measured by structured knowledge questionnaire.
 4. Quality of Life:- It refers to transition into menopause is related to different
physical and mental changes that may affect women’s health. That the physical,
psychological, social, and sexual changes in menopause have an adverse effect on
women’s quality of life. 

5. Menopause transition symptoms:- The physical and psychological changes in

women such as hot flushes, menstrual irregularity, weight gain, palpitation, urinary
incontinence, vaginal dryness, fatigue, anxiety, mood swings, depression and panic
disorders experienced by the women in the period just before the menopause.

6. Women:- The women refers to females aged between 40-50 years.

7. Rural Community:- A rural community or a countryside is a geographic

community that is located outside towns and cities.

RESEARCH HYPOTHESIS

The hypothesis mentioned below will be tested at 0.05 level of significance

 H1:-There will be significant relationship between the knowledge & quality of life of
rural women regarding menopausal transition symptoms.
 H2:- There will be significant relationship between the post test knowledge & quality
of life scores with the selected rural community, at Dehradun..

ASSUMPTIONS

The study will be based on the following assumptions:

 Women may have inadequate knowledge regarding menopausal transition symptoms.
 Women may gain knowledge about menopausal transition symptoms from BCC
(Behaviour change communication) session which will prepare to educate them.

DELIMITATIONS

 The subjects are limited to those women aged between 35-45 years.
 The sample size was limited to only 400 women from rural community so that
findings cannot be generalized.
PILOT STUDY

It is planned to be conducted in the selected rural community at Dehradun and the

sample size will be 1/4th of the main study.

VARIABLES UNDER STUDY

 Independent variable: - The independent variable is the variable that stands alone
and not dependent on any other. It is the cause of action.
In this study the BCC (Behaviour Change Communication) session regarding
menopausal transition women is the independent variable.
 
 Dependent variable: - Dependent variable is the effect of the action of independent
variable and cannot exist by itself.
Knowledge and quality of life are the dependent variable under in this study.

MATERIALS AND METHODS

Source of data-
1. Primary source of data-
The knowledge regarding menopausal transition symptoms among women of rural area
with the help of structured knowledge questionnaire.

Research Approach
In the view of accomplishing the objectives and developing a BCC (Behavioural
changes communication) session for improving the knowledge & quality of life regarding
menopausal transition symptoms among women of rural area an evaluative research
approach is considered to be the most appropriate.

Research Design

To assess the validity of the BCC (Behavioural changes communication) session and
to evaluate the knowledge & quality of life of menopausal transition symptoms, a quasi
experimental research design (Experimental quantitative research design) was adopted
for the study.

Setting of The Study

The study will be conducted in selected rural community area, at Dehradun.

Population

The population included in the study are 35-50 women of rural community area at Dehradun.

Sampling Techniques

Random sampling technique will be use for collect the sample, which will fulfill the
inclusion criteria.

Sample Size

Sample size included in the study will be 400 Rural women.

CRITERIA FOR SAMPLE SELECTION

Inclusion Criteria

Aged women in the selected urban and rural community

1. Who can read, write and speaks Hindi.

2. Women those who are available in the selected rural community area during study.

Exclusion Criteria

1. Women those who are not willing to participate in the study.

Tools and methods of data collection

It includes a structured questionnaire of menopausal transition to evaluate the knowledge &

Quality of life of women in selected rural community area at Dehradun.

 Tool-1:- Demographic variables of the samples.

It includes Age, religion, education, occupation, marital status, family income, type of
family, source of information, dietary pattern.

 Tool-2:-

Structured questionnaire of menopausal transition.

Link For Structured Questionnaire

 1. (https://assets.jeanhailes.org.au/Health-professionals/
Menopause_symptom_scale_Greene_Climacteric.pdf)

2. (https://www.researchgate.net/figure/Menopausal-specific-quality-of-life-
questionnaire_tbl1_235393008)

PLAN FOR DATA ANALYSIS

Collected data will be organized, tabulated and analyzed by descriptive statistics

(Mean, SD, %) and inferential statistics (t-test, p-value, f-test, co-efficient
correlations and chi square test) for assessing the effectiveness of BCC session on
the knowledge & quality of life regarding menopausal transition symptoms
among rural community women.

ETHICAL CLEARENCE

1. Ethical clearance can be obtained from the community, Dehradun.

2. Information will be collected from the samples after obtaining the informed
consent.

REFERENCES:

1. Goolsby, “Postmenopausal hormones and incontinence”, Journal of American

Medical Association, 97(1), 116-120.

2. Ginsberg J et al, “The management of Menopause”, The Millenium Review, 2000,

59-68.

3. Nachtigall L E, Nachtigall m J, “Menopausal changes and Quality of life and

Hormone therapy”, Clinical obstetrics and gynecology, 2004, 47(2), Page no. 485-
488.

4. Utian W, Bogys P, “Menopause and midlife”, Menopause, 6, Page no. 122-128.

5. B Jayabharathi, “Perception of physical and psychological symptoms of

Perimenopause, 2011 september 7(8), Page no. 15-17.
6. Omaima M., et al. “Menopausal Transition and Its Effect on Women’s Health”.
American Journal of Science 9.1 (2013): 369-379.
7. Miranda Hajdini Vanesa Osmani. “Prevalence of symptoms and attitudes towards
menopause in midlife female population in Albania”. International Journal of
Ecosystems and Ecology Science (IJEES) 7.3 (2017): 613-618.
8. Jansirani Natarajan., et al. “Review Literature on Distress during the Menopausal
Transition and Their Impact on the Quality Of Life of Women: What is The
Evidence”? IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2.4 (2013):
01-10.
9. Aida Al Dughaither., et al. “Menopausal symptoms and quality of life among Saudi
women visiting primary care clinics in Riyadh, Saudi Arabia”. International Journal
of Women’s Health 7 (2015): 645-653.

10. Nabarun Karmakar., et al. “Quality of life among menopausal women: A community-
based study in a rural area of West Bengal”. Journal of Mid-Life Health 8.1 (2017):
21-27.

WEBSITES:-
 www,Menopause.org
 www.healthorchid.com
 www.pubmedcentral.nih.gov
 www.boimed central.com
 www.hglo.com
 www.menopause-metamorphosis.com
 www.health.indiatimes.com