@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2019;6(2):111-117

Background
It can be expected that postmenopausal women are living longer than ever with the advances in medical science.
Previous Studies
... [2]. Glian Tehrani et al. showed that 38.8% of postmenopausal women of Tehran suffer from severe flashing and 43% of them suffer from severe anxiety [3]. ... [4]. … [5]. Health care activities have recently focused on education and counseling. Another method of controlling menopausal complications, especially vasomotor symptoms, is moderate-intensity aerobic exercise [6]. This method was also approved in Iran by Babazadeh et al. [7]. [8]. ... [9]. Alternative strategies for promoting health and better coping with menopausal symptoms and complications of health education interventions include enhancing health literacy and a sense of self-efficacy [10]. ... [11, 12]. … [13]. …[14]. One of the used theories in health education and health promotion is the theory of planned behavior (TPB), which has been used successfully in many studies, including healthy behaviors training, family planning, cervical cancer and physical activity [15]. ... [16, 17].
Aim(s)
The purpose of the present study was to determine the associated factors with the use of health services among postmenopausal women in Mashhad based on TPB.
Research type
This research was a cross-sectional descriptive-analytical study.
Research society, place and time
This research was carried out on postmenopausal women aged 45-65 years old in Mashhad in 2018.
Sampling method and number
Inclusion criteria included no hormone medication, no hysterectomy, no menstruation for at least 12 months, and willingness to participate in the study. Exclusion criteria were also considered as non-answering of more than 10% of the questionnaire questions [13]. Sample size was determined 380 subjects using the formula for estimation of a quantitative variable, p = 0.65 and d = 0.05, and due to the 10% probability of falling considered 425 subjects. Sampling was done by random cluster sampling, so that each health center was considered as one cluster. Three comprehensive health care centers were selected from each headquarters and finally a randomized center was randomly selected from each center. Samples were collected according to inclusion criteria, so that most parts of Mashhad were considered for sampling.
Used devices&materials
The research tools were health literacy of adult [18] and native-based questionnaire based on the TPB [13] were completed for the purpose of the study through the interview. Data were analyzed by SPSS 24 software using Kolmogorov-Smirnov, Kruskal-Wallis tests, linear regression, Pearson correlation and one-way ANOVA.
Findings by Text
Of the 425 participants, the majority were 55-60 years old. The majority of subjects were married and had below diploma education. In terms of income, only 37 people had an income of above 3 million Tomans. 198 participated women had sexual activity, out of which only 154 were satisfied and the rest reported dissatisfaction (Table 1).48.9% of women reported flashing, 45.4% sweating, 44.5% sleep problems and 43.8% irritability as menopausal symptoms and they had experienced these symptoms themselves. Based on the questions of the native-based questionnaire, 53.4% of the women chose the herbal medicine therapy and 43.1% chose the hormone therapy as their treatment. Among demographic characteristics, income and education level were influenced by health literacy (Table 2). The most effective construct that had the most predictive power in the proposed model was the perceived behavioral control construct with a regression coefficient of 0.6 for the behavior construct and 0.11 for the behavioral intention construct (Table 3).Health literacy was positively and significantly correlated with attitude (p <0.001 r = 0.21), social norm (p <0.001 r = 0.29) and the behavior (p <0.004 r = 0.14). The health literacy of the target group with the mean of 54.06 ±20.69 was inadequate, which is equivalent to the borderline level. Moreover, 203 subjects (47.8%) had inadequate health literacy, 73 subjects (17.2%) had borderline health literacy and only 149 (35.0%) had adequate health literacy (Table 4).
Main comparison to the similar studies
According to the results of this study, postmenopausal women in Mashhad had insufficient level of health literacy and about half of the subjects were classified as inadequate. The results are in agreement with the studies of Tavousi et al. [19], Baker et al. [20], and Sahraei et al. [21]. ... [22-24]. … [25]. ... [26-31]. The results of other studies showed that there is a relationship between marital status and health literacy, which is not consistent with the results of the present study, which can be attributed to differences in target group and conditions of studies [21, 32, 33]. [34]. Since individuals' intentions and behaviors can be influenced by different factors, in this study, perceived behavioral control was the strongest construct in the model. This finding was in line with research by Javadzadeh et al. [35]. In Millstein research, this construct also had the greatest predictive power [36]. In Ko et al. research, perceived behavioral control was the strongest construct in nurses' intention and behavior in caring for patients [37]. In a study conducted by Hosseini et al. using TPB, perceived behavioral control construct was a strong predictor of mothers' intentions toward iron supplementation for their children [38]. … [15, 39, 40].
Suggestions
It is recommended that future studies be conducted to promote health literacy in other groups with social and cultural characteristics of Iran.
Limitations
Like other studies, our study also had limitations, including self-report information.
Conclusions
The health literacy of the postmenopausal women is in the undesirable level and the perceived behavioral control construct is the most effective factor in the intent and behavior of the postmenopausal women.
Acknowledgments
We are thankful to the all the research samples and also Vice Chancellor for Research of the School of Health of Mashhad university.
Conflict of interest
None declared.
Ethical Permissions
This study was registered at the Iranian registry for clinical trials (approval code: IRCT20160710028863N27).
Funding Sources
This article is part of a Master's Degree thesis in Health Education and Health Promotion.

TABLES and CHARTS

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