@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2020;7(1):29-36

Background
Although menopause and changes in ovarian function is a physiological process, it is accompanied by symptoms and problems that affect the quality of life of postmenopausal women. ... [1].
Previous Studies
... [2-5]. Self-efficacy is one of the important factors affecting quality of life [6]. ... [7, 8]. Health literacy is another factor determining behavior and affecting quality of life. Health literacy is a wide range of skills and competencies that people acquire to seek, understand, evaluate and use health information and concepts to make informed choices, reduce risks, and improve quality of life. A report in 2004 stated that people with poor health literacy have worse health status, follow health guidelines less than others, and use fewer disease prevention services [9]. ... [10]. Several problems and costs of mental illness are preventable in individuals by providing health literacy training [11]. … [12, 13].
Aim(s)
This study aimed at predicting the quality of life of postmenopausal women based on health literacy and self-efficacy.
Research type
This community-based research used a cross-sectional and descriptive-analytic method.
Research society, place and time
This study was performed on 400 postmenopausal women referred to the comprehensive health services centers of Mashhad in 2018.
Sampling method and number
Sample size was estimated 314 individuals based on a relevant article review [14] with 95% confidence interval, accuracy of 0.6, mean of 14.42, and SD of 5.43 for self-efficacy using the formula to assess the mean of a variable and finally for more accuracy, 400 cases were studied. Sampling was done by random cluster method.
Used devices&materials
Health literacy, self-efficacy and quality of life questionnaires were completed by interview. The instrument used in the study was a four-part questionnaire, the first part assessed demographic characteristics of the participants, the second part was the Test of Functional Health Literacy in Adults (TOFHLA) [15, 16], the third part was the Sherer Self-efficacy Questionnaire, and the fourth part related to the Menopausal Quality of Life Questionnaire. Questionnaires were completed by interview through 60 min. The data collection lasted 5 months. After completing the questionnaires, the data were analyzed by SPSS 22 software and Kolmogorov-Smirnov tests (to assess the normal distribution of data), Kruskal-Wallis, Mann-Whitney, Spearman correlation and linear regression test.
Findings by Text
The mean age of menopausal women was 53.83 ± 3.87 years. Most of the samples had primary education, were housewives, and had sufficient income. The quality of life of postmenopausal women was significantly correlated with education, occupation and income (Table 1).Most participants consumed less than 3 servings of dairy daily, consumed less than 2 servings of fruit per day, and consumed less than 3 servings of vegetable daily, and often did not regularly consume vitamin D. The mean scores of quality of life in postmenopausal women were statistically significant in terms of type of delivery, dairy consumption, fruit and vitamin D supplementation (Table 2).The highest correlation was found between health literacy and self-efficacy. Also, health literacy and self-efficacy variables were significantly correlated with quality of life; by increasing health literacy and self-efficacy, quality of life improved, as well. The negative sign indicates that as quality of life scores decreases, the quality of life improves (Table 3).Health literacy and self-efficacy were predictors of quality of life in postmenopausal women and predicted 18% of quality of life variance (Table 4).Among demographic and contextual variables, age of marriage, type of delivery and vitamin D, dairy and fruit intake were predictors of quality of life in postmenopausal women as they predicted 31% of the variance of quality of life in postmenopausal women (R2 = 0.31; R = 0.55). Education, occupation, and income were not recognized as predictors of quality of life (Table 5).
Main comparison to the similar studies
Some studies have confirmed the association between health literacy and quality of life in non-menopausal populations as by increasing health literacy quality of life increases, as well. The results of a study (2018) on pregnant women [19], a study in 2014 on the diabetic elderly population [20] and a study (2015) on Chinese rural women [21] are consistent with the results of the present study. ... [22-26]. There was a significant relationship between self-efficacy and quality of life in postmenopausal women. The results of some studies on non-menopausal population are in line with the present results; for example, a study on the elderly in 2017, a study in 2014 on the middle-aged and rural population, a study in 2019 on people with schizophrenia, a study in 2019 on cancer patients, and a study in 2018 on diabetic patients [31] . ... [32]. A significant relationship between health literacy and self-efficacy was confirmed in our study, which is consistent with the results of some studies; such as a study (2009) on colorectal cancer patients and a study (2018) on parents of newborns [34]. ... [35-45].
Suggestions
None
Limitations
One of the limitations of this study was its cross-sectional design and conducting studies over a longer period can make it possible to investigate the causal relationships between variables.
Conclusions
Quality of life of women decreases in menopause period. Health literacy and self-efficacy are two factors that affect the quality of life of postmenopausal women.
Acknowledgments
The researchers are grateful to the Vice chancellor for research of Mashhad University of Medical Sciences in support of this research (research ID: 960776), as well as all participants in this research.
Conflict of interest
None
Ethical Permissions
Regarding ethical considerations, the necessary permission was obtained from the Ethics Committee of Mashhad University of Medical Sciences (Ethics Code: IR.MUMS.REC.1397.011), the mothers participating in the study were explained about the research objectives and its importance. The written consent was obtained from the subjects and they were assured of the confidentiality of information.
Funding Sources
None

TABLES and CHARTS

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