@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(2):111-117
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(2):111-117
Associated Factors with the Use of Health Services among Postmenopausal Women in Mashhad Based on the Theory of Planned Behavior: The Role of Health Literacy
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Abdolmalaki B. (1)Peyman N. (*2 )
Esmaeili H. (3)
Tajfard M. (1)
(*2 ) “Social Determinants of Health Research Center” and “Health Education & Promotion Department, Public Health Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
(1) Health Education & Promotion Department, Public Health Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
(1) Health Education & Promotion Department, Public Health Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
(3) Epidemiology & Biostatistics Department, Public Health Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
Correspondence
Address: Public Health Faculty, Mashhad University of Medical Sciences, Daneshgah Street, Mashhad, Khorasan Razavi, IranPhone: +98 (51) 31892201
Fax: +98 (51) 38713638
peymann@mums.ac.ir
Article History
Received: December 7, 2018Accepted: March 12, 2019
ePublished: June 20, 2019
ABSTRACT
Aims
It can be expected that postmenopausal women are living longer than ever with the advances in medical science. Therefore, the health of women in the years after menopause is very important. 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 the theory of planned behavior and the role of health literacy.
Materials & Methods This cross-sectional descriptive-analytical study was carried out on 245 postmenopausal women aged 45-56 years old in Mashhad in 2018. The subjects were selected by random cluster sampling method. The research tools were a demographic questionnaire, health literacy of adult and native-based questionnaire based on the planned behavior theory, which was completed through the interview. Data were analyzed by SPSS 24 software, using Kruskal–Wallis test, linear regression method, Pearson correlation coefficient and one-way analysis of variance.
Findings Among the demographic features, the variables of income and level of education were effective in the health literacy of the postmenopausal women (p=0.001). The health literacy of the target group was inadequate so that the mean of this variable was 54.06±20.69 which is equivalent to the boundary level. The most effective structure that had the most predictive capability was the perceived behavioral control structure with the regression coefficient of 0.6 for the behavior structure and 0.11 for the behavioral intention structure.
Conclusion 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.
Materials & Methods This cross-sectional descriptive-analytical study was carried out on 245 postmenopausal women aged 45-56 years old in Mashhad in 2018. The subjects were selected by random cluster sampling method. The research tools were a demographic questionnaire, health literacy of adult and native-based questionnaire based on the planned behavior theory, which was completed through the interview. Data were analyzed by SPSS 24 software, using Kruskal–Wallis test, linear regression method, Pearson correlation coefficient and one-way analysis of variance.
Findings Among the demographic features, the variables of income and level of education were effective in the health literacy of the postmenopausal women (p=0.001). The health literacy of the target group was inadequate so that the mean of this variable was 54.06±20.69 which is equivalent to the boundary level. The most effective structure that had the most predictive capability was the perceived behavioral control structure with the regression coefficient of 0.6 for the behavior structure and 0.11 for the behavioral intention structure.
Conclusion 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.
CITATION LINKS
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[21] Sahraei M, Panahi R, Kazemi SS, Goli Rostami Z, Rezaei H, Jorvand R. The study of health literacy of adults in Karaj. J Health Literacy. 2017;1(4):230-8. [Persian]
[22]Damman OC, van der Beek AJ, Timmermans DR. Workers' knowledge and beliefs about cardiometabolic health risk. J Occup Environ Med. 2014;56(1):92-100.
[23]Reisi M, Mostafavi F, Javadzadeh H, Mahaki B, Tavassoli E, Sharifirad G. Communicative and critical health literacy and self-care behaviors in patients with type 2 diabetes. Iran J Diabetes Metab. 2016;14(3):199-208. [Persian]
[24]Ghanbari S, Majlessi F, Ghaffari M, Mahmoodi Majdabadi M. Evaluation of health literacy of pregnant women in urban health centers of Shahid Beheshti Medical University. Daneshvar Med. 2012;19(97):1-12. [Persian]
[25]Seyam S. A survey on women’s knowledge about menopause in Rasht. J Urmia Nurs Midwifery Fac. 2009;7(4):233-9. [Persian]
[26]Izadirad H, Zareban I. The relationship of health literacy with health status, preventive behaviors and health services utilization in Baluchistan, Iran. J Educ Community Health. 2015;2(3):43-50. [Persian]
[27]Saatchi M, Panahi MH, Ashraf Mozafari A, Sahebkar M, Azarpakan A, Baigi V, et al. Health literacy and its associated factors: a population-based study, Hormuz Island. Iran J Epidemiol. 2017;13(2):136-44. [Persian]
[28]Borji M, Tarjoman A, Otaghi M, Salimi E, Naseri A. Health literacy level and its related factors among the elderlies in Ilam in 2015. Iran J Nurs. 2017;30(108):33-43. [Persian]
[29]Mollakhalili H, Papi A, Zare-Farashbandi F, Sharifirad G, Hasanzadeh A. A survey on health literacy of inpatient's educational hospitals of Isfahan University of Medical Sciences in 2012. J Educ Health Promot. 2014;3:66.
[30]Nekoei-Moghadam M, Parva S, Amiresmaili MR, Baneshi MR. Health literacy and utilization of health services in Kerman urban area 2011. Toloo-e-Behdasht. 2013;11(14):123-34. [Persian]
[31]Salehi-Pourmehr H, Niroomand S, Shakouri SK, Asgarlou Z, Farshbaf-Khalili A. Association between antenatal and postpartum depression and anxiety with weight retention 1 year after childbirth: a longitudinal study. Community Ment Health J. 2018;54(8):1284-94.
[32]Keshavarz Z, Simbar M, Ramezankhani A, Alavi Majd H. Assessing the relationship between health promoting behaviors and the Integrated Model of Planned Behavior and Self-Efficacy of female workers at reproductive age. Mod Care J. 2014;11(4):293-303. [Persian]
[33]Khoshravesh S, Moeini B, Rezapur-Shahkolai F, Taheri-Kharameh Z, Bandehelahi K. Health literacy of employees of Hamadan University of Medical Sciences and related demographic factors. J Educ Community Health. 2018;5(1):19-26. [Persian
[34]Peyman N, Behzad F, Taghipour A, Esmaeili H. Assessment of the effect of a health literacy educational program for health personnel on promoting self-efficacy among patients with chronic diseases. J Health Syst Res. 2016;12(3):350-7. [Persian]
[35]Javadzadeh M, Sharifirad G, Reisi M, Nasr Esfahani M, Mahaki B, Mostafavi F. Applying the theory of planned behavior to predicting nurse’s intention and behavior in using health literacy strategies in patient education. Iran J Nurs. 2015;28(97):23-33. [Persian]
[36]Millstein SG. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: a prospective analysis. Health Psychol. 1996;15(5):398-402.
[37]Ko NY, Feng MC, Chiu DY, Wu MH, Feng JY, Pan SM. Applying theory of planned behavior to predict nurses' intention and volunteering to care for SARS patients in southern Taiwan. Kaohsiung J Med Sci. 2004;20(8):389-98.
[38]Hosseini M, Shojaeizadeh D, Chaleshgar M, Pishva H. A study of educational intervention on knowledge, attitude, practice about iron deficiency anemia in female adolescent students. J Gorgan Univ Med Sci. 2006; 8(3):37-42. [Persian]
[39] Peyman N, Hidarnia A, Ghofranipour F, Kazemnezhad A, Oakley D, Khodaee G, et al. Self-efficacy: does it predict the effectiveness of contraceptive use in Iranian women? East Mediterr Health J. 2009;15(5):1254-62.
[40]Tolma EL, Reininger BM, Evans A, Ureda J. Examining the theory of planned behavior and the construct of self-efficacy to predict mammography intention. Health Educ Behav. 2006;33(2):233-51.
[2]Forouzanmehr S, Zendehdel T, Mirmohammadali M, Faghihzadeh S. Valerian effect on anxiety in postmenopausal women. Iran J Obstet Gynecol Infertil. 2017;20(6):31-9. [Persian]
[3]Golyan Tehrani S, Mirmohammadali M, Mahmoudi M, Khaledian Z. Study of quality of life and its patterns in different stages of menopause for women in Tehran. J Hayat. 2002;8(3):33-41. [Persian]
[4]Blumel JE, Castelo-Branco C, Binfa L, Gramegna G, Tacla X, Aracena B, et al. Quality of life after the menopause: a population study. Maturitas. 2000;34(1):17-23.
[5]Abdolmalaki B, Peyman N, Esmaeili H. Evaluation of health literacy rate of postmenopausal women covered by Mashhad health centers in 2018. J Health Literacy. 2018;3(3):182-90. [Persian]
[6]Golmakani A, Shariati Sarcheshmeh M, Marouzi P, Rezaie Sani T. Body mass index and its relation to menopausal women’s quality of life. J Holist Nurs Midwifery. 2016;26(1):48-55. [Persian]
[7]Babazadeh Zavieh SS, Vasaghi Gharamalaki B, Nikjooy A, Sarrafzadeh J. Effect of age, menopause, diabetes, drinking fluids, and regular exercise on urinary incontinence in obese women based on anthropometric indices. Sci J Rehabil Med. 2018;7(3):226-35. [Persian]
[8]Farshadbakht F, Tadayon M, Abedi P. The effect of walking with pedometer on sleep subjective quality in postmenopausal women. Iran J Obstet Gynecol Infertil. 2015;18(161):10-9. [Persian]
[9]Sepehrian F. Effect of, yoga based lifestyle intervention on sleeping problem in perimenopausal women. J Urmia Nurs Midwifery Fac. 2012;10(1):41-8. [Persian]
[10]Rotem M, Kushnir T, Levine R, Ehrenfeld M. A psycho‐educational program for improving women's attitudes and coping with menopause symptoms. J Obstet Gynecol Neonatal Nurs. 2005;34(2):233-40.
[11]Mohammadi Zeidi I, Pakpour A, Mohammadi Zeidi B. The impact of educational interventions based on individual empowerment model on knowledge, attitude, self-efficacy, self-esteem and quality of life of postmenopausal women. Iran J Nurs. 2013;26(81):21-31. [Persian]
[12]World Health Organization. What is the evidence on effectiveness of empowerment to improve health [Internet]. Geneva: World Health Organization; 2006
[13]Suka M, Taniuchi A, Igarashi S, Yanagisawa H, Ishizuka B. Menopause-specific health literacy in Japanese women. Maturitas. 2016;91:51-9.
[14]Jorm AF. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. 2012;67(3):231-43.
[15]Hatefnia E, Niknami S, Mahmoudi M, Lamyian M. The effects of theory of planned behavior based education on the promotion of mammography performance in employed women. Birjand Univ Med Sci. 2010;17(1):50-8. [Persian]
[16]Allahverdipoor H. Passing through traditional health education towards theory-oriented health education. J Health Promot Educ. 2004;1(3):75-9. [Persian]
[17]Jalali M, Shamsi M, Roozbahani N, Kabir K. The effect of health education based on theory of planned behavior on behavioral promotion of urinary infection prevention in pregnant women. J Jahrom Univ Med Sci. 2014;12(3):49-57. [Persian]
[18]Tehrani Banihashemi SA, Amirkhani MA, Haghdoost AA, Alavian SM, Asgharifard H, Baradaran H, et al. Health literacy and the influencing factors: a study in five provinces of Iran. Strides Dev Med Educ. 2007;4(1):1-9. [Persian]
[19]Tavousi M, Haeri Mehrizi AA, Rafieifar S, Soleimanian A, Sarbandi F, Ardestani M, et al . Health literacy in Iran: findings from a national study. Payesh. 2016;15(1):95-102. [Persian]
[20]Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33-42.
[21] Sahraei M, Panahi R, Kazemi SS, Goli Rostami Z, Rezaei H, Jorvand R. The study of health literacy of adults in Karaj. J Health Literacy. 2017;1(4):230-8. [Persian]
[22]Damman OC, van der Beek AJ, Timmermans DR. Workers' knowledge and beliefs about cardiometabolic health risk. J Occup Environ Med. 2014;56(1):92-100.
[23]Reisi M, Mostafavi F, Javadzadeh H, Mahaki B, Tavassoli E, Sharifirad G. Communicative and critical health literacy and self-care behaviors in patients with type 2 diabetes. Iran J Diabetes Metab. 2016;14(3):199-208. [Persian]
[24]Ghanbari S, Majlessi F, Ghaffari M, Mahmoodi Majdabadi M. Evaluation of health literacy of pregnant women in urban health centers of Shahid Beheshti Medical University. Daneshvar Med. 2012;19(97):1-12. [Persian]
[25]Seyam S. A survey on women’s knowledge about menopause in Rasht. J Urmia Nurs Midwifery Fac. 2009;7(4):233-9. [Persian]
[26]Izadirad H, Zareban I. The relationship of health literacy with health status, preventive behaviors and health services utilization in Baluchistan, Iran. J Educ Community Health. 2015;2(3):43-50. [Persian]
[27]Saatchi M, Panahi MH, Ashraf Mozafari A, Sahebkar M, Azarpakan A, Baigi V, et al. Health literacy and its associated factors: a population-based study, Hormuz Island. Iran J Epidemiol. 2017;13(2):136-44. [Persian]
[28]Borji M, Tarjoman A, Otaghi M, Salimi E, Naseri A. Health literacy level and its related factors among the elderlies in Ilam in 2015. Iran J Nurs. 2017;30(108):33-43. [Persian]
[29]Mollakhalili H, Papi A, Zare-Farashbandi F, Sharifirad G, Hasanzadeh A. A survey on health literacy of inpatient's educational hospitals of Isfahan University of Medical Sciences in 2012. J Educ Health Promot. 2014;3:66.
[30]Nekoei-Moghadam M, Parva S, Amiresmaili MR, Baneshi MR. Health literacy and utilization of health services in Kerman urban area 2011. Toloo-e-Behdasht. 2013;11(14):123-34. [Persian]
[31]Salehi-Pourmehr H, Niroomand S, Shakouri SK, Asgarlou Z, Farshbaf-Khalili A. Association between antenatal and postpartum depression and anxiety with weight retention 1 year after childbirth: a longitudinal study. Community Ment Health J. 2018;54(8):1284-94.
[32]Keshavarz Z, Simbar M, Ramezankhani A, Alavi Majd H. Assessing the relationship between health promoting behaviors and the Integrated Model of Planned Behavior and Self-Efficacy of female workers at reproductive age. Mod Care J. 2014;11(4):293-303. [Persian]
[33]Khoshravesh S, Moeini B, Rezapur-Shahkolai F, Taheri-Kharameh Z, Bandehelahi K. Health literacy of employees of Hamadan University of Medical Sciences and related demographic factors. J Educ Community Health. 2018;5(1):19-26. [Persian
[34]Peyman N, Behzad F, Taghipour A, Esmaeili H. Assessment of the effect of a health literacy educational program for health personnel on promoting self-efficacy among patients with chronic diseases. J Health Syst Res. 2016;12(3):350-7. [Persian]
[35]Javadzadeh M, Sharifirad G, Reisi M, Nasr Esfahani M, Mahaki B, Mostafavi F. Applying the theory of planned behavior to predicting nurse’s intention and behavior in using health literacy strategies in patient education. Iran J Nurs. 2015;28(97):23-33. [Persian]
[36]Millstein SG. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: a prospective analysis. Health Psychol. 1996;15(5):398-402.
[37]Ko NY, Feng MC, Chiu DY, Wu MH, Feng JY, Pan SM. Applying theory of planned behavior to predict nurses' intention and volunteering to care for SARS patients in southern Taiwan. Kaohsiung J Med Sci. 2004;20(8):389-98.
[38]Hosseini M, Shojaeizadeh D, Chaleshgar M, Pishva H. A study of educational intervention on knowledge, attitude, practice about iron deficiency anemia in female adolescent students. J Gorgan Univ Med Sci. 2006; 8(3):37-42. [Persian]
[39] Peyman N, Hidarnia A, Ghofranipour F, Kazemnezhad A, Oakley D, Khodaee G, et al. Self-efficacy: does it predict the effectiveness of contraceptive use in Iranian women? East Mediterr Health J. 2009;15(5):1254-62.
[40]Tolma EL, Reininger BM, Evans A, Ureda J. Examining the theory of planned behavior and the construct of self-efficacy to predict mammography intention. Health Educ Behav. 2006;33(2):233-51.