ATTITUDE TO MENOPAUSE AS A DETERMINANT OF EXPERIENCES OF MENOPAUSAL SYMPTOMS AMONG WOMEN IN EMEKUKU COMMUNITY IN OWERRI NORTH LOCAL GOVERNMENT AREA

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ABSTRACT

 Menopause is one area that has been shrouded in myths and taboos and the way a woman perceives menopause depends largely on the social belief and expectation about menopause in the society. Depending on these cultural and social factors, menopause can be viewed as either negative or positive. But the fact remains that menopause is a universal female midlife transition that remains poorly understood. The purpose of this study is to investigate attitude to menopause as a determinant of experiences of menopausal symptoms among women in Emekuku. Six (6) objectives were set for the study.  The design for the study was a correlational design.  The sample size was 522 menopausal women aged 45 to 60 years in Emekuku.  Proportional stratified sampling method was used to draw a representative sample size from the ten villages in Emekuku. Data were collected using validated structured questionnaire.  Data wee analyzed using simple descriptive statistics, Chi-square and Partial eta square.  Results revealed that majority (53.8%) of the respondents have positive attitude, majority of the respondents did not frequently experience menopausal symptoms, there is a significant relationship between positive attitude to menopause and the symptoms experienced by the women.  There is a significant relationship between neutral attitude to menopause and the symptoms experienced, there is a significant relationship between negative attitude and the symptoms experienced among the women, there was significant difference in the relationship between attitude to menopause and the symptoms experienced based on age at menopause, there is no significant association between educational level of the women and the symptoms experienced.  Recommendations made include; health care providers should create programs that will involve women and educate them on how to improve their attitudes toward menopause.

TABLE OF CONTENTS

Title page
Table of Content
List of Tables
Abstract

CHAPTER ONE: INTRODUCTION
Background of the Study
Statement of Problem
Purpose of the Study
Research Questions
Hypotheses
Significance of the Study
Scope of the Study
Operational Definition of Terms

CHAPTER TWO: LITERATURE REVIEW
Conceptual Review
Concept of Menopause
Factors Influencing Menopause
Factors Affecting Menopausal Symptoms Experience
Differences in Meaning of menopause
Perception of Menopause
Attitude
Attitude towards Menopause
Factors that can influence attitude to menopause
Relationship Between Attitude and Symptoms Experienced
Theoretical Review
The theory of Planned Behavior
Empirical Review
Summary of Literature and Critical Analysis of Empirical Studies Reviewed

CHAPTER THREE: RESEARCH METHOD
Research Design
Area of Study
Population
Sample
Sampling Procedure
Instrument for Data Collection
Validity of Instruments
Reliability of the Instrument
Ethical Consideration
Procedure for Data Collection
Data Analysis

CHAPTER FOUR: PRESENTATION OF RESULT
Summary of Major Findings

CHAPTER FIVE: DISCUSSION OF FINDINGS
Research Objective one
Implication of the Study for Nursing
Limitations of the Study
Suggestion for Further Studies
Summary
Conclusion
Recommendations
References

Appendix

CHAPTER ONE
INTRODUCTION
Background to the Study
Aging is a process of slow cell death triggered by automatic cellular change or environmental influences. As more cells die, the body’s adjustment capability to meet all the physiological demands decreases and this affects the well-being of people (Wardlow, 2002). Aging process affects the reproductive system of both men and women though at different rates and periods in life. The most striking age-related change in the female reproductive system occurs at menopause (Martin, Timmons & Touitsh, 2006). The term menopause or climacteric is a normal physiological process which occurs in majority of women. With advancing age, a permanent cessation of menstruation (menopause) resulting from loss of ovarian follicular activity occurs.
Menopause according to North American Menopausal Society (2010) is defined as a natural event whereby a woman has missed her menstrual period for consecutive 12months (not explained by other medical factors). It occurs around the age of 51 years. There are, however, variations across different countries with a general mean age range of 50 years throughout the world, (Ikeme, Okeke & Chinweuba, 2010). Menopause usually signifies the end of a physiological process. As a twelve month period of amenorrhea confirms that menopause has set in, it is therefore a retrospective diagnosis.
Menopause is a gradual biological process in which the ovaries reduce the Production of female sex hormones. In other words, menopause is concerned with the end of possible sexual production, evidenced by the cessation of menstruation period and prevention of pregnancy. Buchbeum (2002), had observed that the aim of menopause occurrence is to preserve the life of women from late pregnancies and to enable them contribute effectively to development of their family and the nation as a whole. Menopause is therefore an estrogenic deficiency period associated with a wide variety of physiological and psychological symptoms. For majority of women, the menopause did indeed make a change or transition in their lives. It is a unique experience with varying symptoms. According to Love (2003), most women undergoing menopause transition, experience a combination of thirty-four commonly reported symptoms. The most common among these symptoms are hot flashes, night sweat, and irregular periods, loss of libido and vaginal dryness. Others include mood swings, early awakening and memory lapses, and fluctuations in sexual desire or response and difficulty sleeping. These symptoms may not be widely experienced by every woman or confirmed to a minority of women. While menopause symptoms may cease for some women, others continue experiencing them well into old age.
Formerly, it was assumed that menopause and the associated symptoms were universally experienced by all women regardless of their culture, racial, belief or ethnic group. These believes have been challenged given the multifaceted issues of culture that researchers attempt to disentangle. (Block, 2006). Although available literature provides clear support for relationship between perceptions,  behavior, attitudes and experiences.Menopause is said to be a very individual experience, influenced by a myriad of personal factors including general health, reproductive history and genetic background. (Block, 2001). Cultural and social factors, though less completely understood, also have an important impact (Block, 2001). Every woman has her own menopause. Some experience problems while some do not. Menopause is thus one area that has been shrouded in myths and taboos and the way a woman perceives menopause depends largely on the social belief and expectation about menopause in their society (Mohammed, 2007, Bowles, 2006). Depending on these cultural and social factors, menopause can be viewed as either negative or positive ( Huffman &Myers, 2009).But the fact remains that menopause is a universal female midlife transition that remains poorly understood.
             In some countries and cultures like Asia, for example women gain greater respect and have greater authority in the household as these women age (Kwam, 2005). Consequently, for such women, menopause represents a positive transition. There is therefore, a positive attitude towards menopause. While in some other cultures, women believe that they are retaining ‘bad blood” as a result of lack of menstruation. This they believe will lead to illness as menstrual flow was meant to drain away impurities. (Adekunle, 2002). For these women, menopause has a negative connotation. In Mayan culture in Mexico, there was no word for “hot flashes and Mayan women indicated that they did not experience hot flashes (Beyner & Martini, 2000). For Hmong tribal women living in Australia, there was no word for menopause. When asked emotional symptoms, the women reported none and found the concept of emotional difficulties caused by menopause amusing (Rice, Pog, Tsis & Lawan, 2005).

Another major factor that affects how menopausal symptoms are experienced is attitude. Oxford Learners Dictionary defines attitude as the way one thinks and feels about something, the way one behaves towards something which may be good or bad. Attitude is a mental and neural state of readiness organized through experience exerting a dynamic influence upon individual response to all objects and situations with which it is related (Alliport, 2002). According to Suzanne and Brenda (2001), attitude is a feeling based on a person’s impression on an event or object. Similarly, Morgan (2005) stated that attitude is a way of feeling, thinking and behaving toward an object or an event or idea. It is a learned predisposition on the part of an individual to respond positively or negatively to some object or situation. This response of an individual to the situation depends on how much he/she likes or dislikes the event or situation. It is this response to an event that hurts most, not the event itself. An event that energizes one may depress or lead to illness in another. This is likely because attitude influences action and conducts which in turn influences life pattern.....

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