Lupine Publishers | Journal of Health Research and Reviews
Abstract
Increased life expectancy at birth decreases the quality of life that women experience during menopause. Decreased quality of life reduces the chance of living healthy. Therefore, nurses who communicate with women mostly have important duties. This review highlights the problems experienced during the menopausal period, the impact of the problems on the quality of life and the responsibilities of nurses.
Keywords: Menopause; Quality of life; Nursing
Introduction
The word menopause is derived from the Greek word Mens (month) and pause and is a period of transition from the reproductive age of women to the period in which the reproductive ability of the ovary functions is lost. According to the World Health Organization [WHO] definition of menopause, it is the permanent termination of menstruation as a result of loss of ovarian activity [1,2]. The average age of menopause in the world varies between 50- 52. Menopause is not a process that suddenly develops. It occurs at the end of an ongoing process over the years [3]. In the menopausal period, a number of complaints related to estrogen deficiency due to loss of function of the ovarial follicles can be seen [1,4,5]. The most common problems experienced by women in menopausal period due to estrogen deficiency are night sweats, hot flashes, sleep problems, anxiety, depression, restlessness, decreased sexual interest, vaginal atrophy, stress incontinas and painful sexual intercourse [6-8]. Menopausal period-specific changes can be overcome without any problems when adapted to these changes. However, sometimes physiological and psychological changes caused by hormonal changes can cause problems and affect the quality of life of women, increase depression and decrease the general health level of the society [1,9-13]. The concept of quality of life is defined as the integrity of subjective perception, emotion and cognition processes that are based on self-evaluation of individual’s life, and includes the expressions of pleasure and satisfaction taken from the individual’s own life related to individual well-being and various aspects of life. To summarize briefly, quality of life is the satisfaction that individuals take from home and community life, from physical and mental well-being and from health [14]. The scope of quality of life is very wide and includes physical, physiological and social health concepts from one’s social life [14,15]. Today, parameters such as reducing complaints caused by physical and physiological reasons or prolonging life expectancy are inadequate in the evaluation of health perception. How the individual perceives his/her own situation in the changing health perception is also included in these parameters. This emphasizes the importance of the concept of quality of life in health. When evaluating the quality of life related to health, all dimensions affecting the quality of life should be considered and a holistic approach should be adopted. For example, parameters such as income level, social opportunities, political environment, environmental conditions and personal beliefs, which are among the main factors that determine health problems, should not be considered separately from the quality of life [15].
With the prolongation of the life expectancy, there was also a prolongation of the women’s menopausal period. In this prolonged period, menopausal complaints experienced by women and health problems increased by menopause adversely affect quality of life [16]. Symptoms in menopause are not the only criterion for quality of life and health perception. However, these menopausal symptoms in women may adversely affect the quality of life and physical and mental health of women [17]. In addition, the knowledge of menopause by women in the pre-menopausal period and the knowledge about the symptoms and changes to be experienced sometimes result in no change in the quality of life between premenopausal and menopausal periods [5]. Factors affecting the quality of life and menopausal complaints during menopausal period include many factors such as age, marital status, education level, presence of chronic disease, menopausal period, regular gynecological control and number of births [7-18]. Determining the factors affecting the quality of life of women in menopausal period and using the results to improve women’s health, preserving and improving the quality of life in menopause are among the important roles and responsibilities of health professionals [14].
Nursing Approach in Menopausal Complaints
Nurses are health professionals who play an active role in prevention of diseases in the community, undertaking good care at the time of illness and improving health. As it can be understood from the definition, the duty of the nurse was extended from providing health service to individuals and family in the society to preventive health services with holistic health understanding [19]. Nurses should evaluate the factors holistically in order to improve the quality of life by enabling women to adapt to life. Therefore, nurses play a major role in this process when approaching women in menopause and nurses need to have sufficient knowledge of menopause [14]. In the menopausal period, which is an important and difficult period for women, women may experience some mental changes such as mood changes along with physical changes. This may adversely affect the physical and psychosocial health of women. In addition, these problems may affect not only the woman but also the family and society. In the menopausal period, medical treatment alone is not sufficient and women may need the knowledge and experience of nurses and counseling. An important task for the nurse at this point is that the nurse should be a good educator [19]. For this reason, nurses should have knowledge in every area and be equipped with special information about menopause [20]. In the menopausal period, women and their families should be informed about this special period and at the same time, they should be educated and supported about the menopausal period. In the trainings given, physical and psychological problems specific to the menopause period should be explained, obscurity of the process should be eliminated and thus, anxiety of the woman should be decreased. As a result, the coping mechanisms of the woman are activated. In this process, nurses should facilitate women’s adaptation to menopausal period, support women, and guide women in their problems and help them cope [14]. The objectives of the health care that the nurse will offer to the women in menopause are:
a) Collecting data about the experiences and expectations, social and cultural support systems of women during this period,
b) Determining the quality of life of women and planning health care according to these data,
c) Providing training and consultancy to women and their families in meeting basic requirements,
d) Ensuring that women play an active role both in decisionmaking and in the implementation of behaviors in the protection and promotion of health [4].
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