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Empowerment and Coping Strategies in Menopause Women: A Review

Latest Content Archive Authors About. Log in via Institution. Abstract Objective To understand current gestational weight gain GWG counselling practices of healthcare providers, and the relationships between practices, knowledge and attitudes. Introduction Supporting all women to achieve healthy gestational weight gain GWG is of clinical importance because GWG lower or higher than recommended is linked to a range of poor maternal, fetal and childhood outcomes.

Methods Study design This study was conducted using a concurrent mixed methods design, consisting of an online survey and semistructured qualitative interviews. Supplementary file 1 [SP1. Recruitment and data collection Healthcare providers including general practitioners, obstetricians, midwives, nurse practitioners and registered nurses in primary care settings from across Canada were recruited through professional associations and networks who agreed to distribute survey information to their members.

Women's Health During and After Pregnancy: A Theory-Based Study of Adaptation to Change

Outcomes Survey participants provided information about their professional characteristics, and were asked to respond to questions regarding their practices, knowledge and attitudes related to GWG, nutrition and physical activity. Qualitative methods Materials A semistructured interview guide was developed by the study team based on the study objectives and included questions and prompts regarding healthcare provider practices in relation to GWG, as well as the reasons behind these practices.

Recruitment and data collection Potential participants were identified through collaborating members of the study team. Data analysis Qualitative content analysis was used to describe and inductively interpret the data. Data integration The categories emerging inductively from the interviews were compared with the results from the quantitative survey to determine if findings from each method confirmed the other, as well as to expand the strength of each type of data to better explain the phenomenon.

Results Participant characteristics Overall, healthcare providers responded to the survey. View inline View popup. Table 1 Characteristics of participating Canadian healthcare providers. Table 4 Overarching categories and key concepts emerging from qualitative content analysis of interviews with healthcare providers. Predictors of counselling practices Healthcare providers, regardless of discipline, reported similar responses for having appropriate general knowledge of GWG, physical activity and nutrition, as well as knowledge of related practice guidelines table 3 ; only the difference between midwives and registered nurses responses was significant.

Predictors of providing weight gain advice and discussing risks The composite score for providing weight gain advice and discussing risks of inappropriate GWG was most strongly related to the priority level that healthcare providers placed on GWG table 5 , followed by their detailed knowledge of GWG, physical activity and nutrition guidelines.

Predictors of discussing physical activity and food requirements The priority level that healthcare providers place on GWG, their detailed knowledge of GWG, nutrition, and physical activity guidelines, and their general knowledge of this area were all significantly related to their discussing physical activity and food requirements with women during a prenatal visit table 6. Table 6 Predictors of Canadian healthcare providers discussing physical activity and food requirements with women as part of a prenatal visit.

Discussion GWG counselling by healthcare providers falls below the recommendations from the IOM and other national health agencies. Strengths and limitations A major strength of this study is the use of mixed research methods. Acknowledgments We would like to thank all of the participants in both components of the study for their time and insight. Outcomes of maternal weight gain. Evid Rep Technol Assess ; Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women.

Obstet Gynecol ; The impact of maternal obesity on the incidence of adverse pregnancy outcomes in high-risk term pregnancies.


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Am J Perinatol ; Weight gain in women of normal weight before pregnancy: Obstet Gynecol ; 99 5 Pt 1: Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG ; Modifiable early-life risk factors for childhood adiposity and overweight: Am J Clin Nutr ; Maternal weight gain in excess of pregnancy guidelines is related to daughters being overweight 40 years later.

Empowerment and Coping Strategies in Menopause Women: A Review

Am J Obstet Gynecol ; Obesity ; Pregnancy as a window to future health: Semin Perinatol ; The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol ; 1: Melzer K , Schutz Y. Pre-pregnancy and pregnancy predictors of obesity. Int J Obes ; 34 Suppl 2: BMC Pregnancy Childbirth ; Healthy weight gain during pregnancy. Government of Canada , Rasmussen KM , Yaktine A , eds. Weight gain during pregnancy: National Academies Press , Implementing guidelines on weight gain and pregnancy.

Institute of Medicine and National Research Council , Canadian consensus on female nutrition: J Obstet Gynaecol Can ; National Health and Medical Research Council; American College of Obstetricians and Gynecologists. Nutrition during pregnancy Swedish National Food Agency. Food for you who are pregnant. Swedish National Food Agency , Little congruence between health care provider and patient perceptions of counselling on gestational weight gain. Provider advice about weight loss and physical activity in the postpartum period. J Womens Health ; Perspectives about and approaches to weight gain in pregnancy: Patient-provider communication about gestational weight gain among nulliparous women: Addressing obesity in pregnancy: Preventing excessive weight gain in pregnancy: The Canadian maternity experiences survey: Counseling about gestational weight gain and healthy lifestyle during pregnancy: Int J Womens Health ; 5: Zhang W , Creswell J.

Med Care ; Best practices for mixed methods research in the health sciences. Research electronic data capture REDCap --a metadata-driven methodology and workflow process for providing translational research informatics support. A randomised controlled trial in the north of England examining the effects of skin-to-skin care on breast feeding. Midwifery , 21 , 71— Newborn temperature during skin-to-skin breastfeeding in couples having breastfeeding difficulties. Birth , 32 2 , — Separation distress call in the human neonate in the absence of maternal body contact.

Acta Paediatrica , 84 , — An evidence-based practice model. Journal of Perianesthesia Nursing , 25 5 , — Giving birth back to mothers and babies. An early contact with the baby—benefit for the mother. Medicinski Pregled , 61 11—12 , — A concept analysis of reflective practice: Determining its value to nurses. British Journal of Nursing , 16 22 , — Influence of skin-to-skin contact and rooming-in on early mother-infant interaction: A randomized controlled trial.

Clinical Nursing Research , 22 3. Barriers to skin-to-skin care during the postpartum stay. Building a culture of best practice. Nurse Leader , 3 6 , 26— Temperature variation in newborn babies: Importance of physical contact with the mother. Randomized controlled trial of early skin-to-skin contact: Effects on the mother and the newborn. Organizational readiness for evidence-based pratice. The Journal of Nursing Administration , 39 2 , 91— International Journal of Nursing Education Scholarship , 6 1 , 1— Skin-to-skin contact is analgesic in healthy newborns.

Pediatics , , e Bridging the implementation gap between knowledge and action for health. Bulletin of the World Health Organization , 82 10 , — Implementing skin-to-skin contact at birth using the Iowa model: Applying evidence to practice. New Directions for Teaching and Learning , , 31— Improving prevention in primary care: Evaluating the sustainability of outreach facilitation. Canadian Family Physician , 54 , — Journal of Holistic Nursing , 23 3 , — Early skin-to-skin after cesarean to improve breastfeeding.

The effect of Kangaroo Care on behavioral responses to pain of an intramuscular injection in neonates. Journal for Specialists in Pediatric Nursing , 13 4 , — Interventions that change clinician behavior: Reflection and reflective practice in health professions education: Advances in Health Sciences Education , 14 , — Influence of an education program of pregnant women on delivery. Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. Early skin-to-skin contact for mothers and their healthy newborn infants. Meta-analysis of physiological effects of skin-to-skin contact for newborns and mothers.

Pediatrics International , 52 , — How to change practice: Understand, identify and overcome barriers to change.


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Towards universal Kangaroo Mother Care: State of the art and recommendations Kangaroo Mother Care: Application in a high-tech environment. Closing the gap between nursing research and practice In Cullum N. A systematic review of trials of interventions to improve professional practice. Canadian Medical Association Journal , 10 , — Uninterrupted skin-to-skin contact immediately after birth. The effectiveness of clinical guideline implementation strategies—A synthesis of systematic review findings.

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Journal of Evaluation in Clinical Practice , 14 , — An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing , 13 , — Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing , 69 5 , — Innovative strategies for 21st century perinatal nursing education. Sex differences in newborn interaction with mother or father during skin-to-skin contact after caesarean section. Acta Paediatrica , , — Kangaroo care at birth for full term infants: Newborn behaviour to locate the breast when skin-to-skin: A possible method for enabling early self-regulation.

Acta Paediatrica , , 79— Support Center Support Center. Please review our privacy policy. Increases the rate of exclusive breastfeeding at discharge Gabriel et al. Facilitates the development of the attachment bond Dageville et al. Calms newborns and reduces crying Bystrova et al. Improves the mutual recognition mother—newborn Dabrowski, ; Dageville et al. Increases the activation of different sensory systems Dageville et al.

Reduces risk of maternal depression Nyqvist et al. Improves the control of pain in mothers distraction caused by the close presence of the newborn Dabrowski, Fasten the expulsion of the placenta Gabriel et al. Middle-aged women are vulnerable to physiologic, psychosocial, and economic factors.


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On the other hand, several of the chronic diseases, such as hypertension, arthritis, heart disease, and diabetes, occur in the middle-aged women Therefore, women must be empowered to take decisions concerning their health. Empowerment is a person's right, along with which comes the responsibility of seeking education and support, utilizing available health care resources, and practicing active self-care of oneself Most interventions for menopause women have focused on: Research has revealed that postmenopausal women living in rural areas of Iran have more negative attitudes towards menopause than their urban counterparts.

Cross-cultural studies have also confirmed the impacts of social and cultural factors on menopause symptoms 4. In other words, consistency between a person's psychological and physical changes and social conditions, personal values, and the belief in health systems can reduce the severity of menopause symptoms By accepting menopause, women become more physically and mentally prepared to confront changes of this period and will seek ways to lessen the severity of its disturbing symptoms. Various training methods may be selected under different circumstances and according to the goals, motivations, individual characteristics, and available facilities, time, equipment A survey in Iran showed that menopausal women preferred to receive training through various techniques including lectures, support group, and individual training Health education intervention strategy is one of the alternative strategies 7 for improving women's attitudes and coping with menopause symptoms 8 , identified as one of the subcategories of health promotion programs There was significant relationship between severity of menopausal symptoms and decreasing level of QOL, too Understanding the physical, psychosocial, and lifestyle changes that arise following menopause is a way to acclimate to this physiological event 3.

The symptoms of menopause vary across cultures. This should be understood by health providers, who should strive for cultural competence, especially when dealing with multiethnic patient populations Comparison between the experiences of western and eastern women showed that eastern women regarded menopause as a natural process of life, i.

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Moreover, women who resist accepting menopause experience more menopause symptoms 8. The model designed by Foxy Yang to measure women's attitudes toward menopause revealed that women with a positive attitude toward menopause encountered significantly fewer problems than those with a negative attitude Influencing health education policy to promote health and adopt a menopause lifestyle requires alternative strategies, including health training programs with community-based interventions Learning and awareness can be achieved by using a variety of methods, such as self-reliance, social impact, group reinforcement, and increased participation in structured activities Self-managed learning 28 and support group have been introduced as effective, affordable, and practical learning methods in this regard In this method, fewer classes are held, since the learners are motivated to learn due to their own inner needs 29 , Therefore, the learner controls her learning process without class participation Educational packages are generally used as a practical self-managed learning technique.

It provides the subjects with educational material in the form of manuals, booklets, or packets, based on their educational needs. The materials are prepared in accordance with the preset objectives and delivered at specific intervals Another efficient method called support group assists groups in objective-based decision-making by creating positive and constructive relationships between them.

It also modifies the attitudes and beliefs of the participants, expands their knowledge, and promotes their critical thinking and verbal skills 32 , A support group is an efficient tool in QOL research due to mutual exchange of experiences, promotion of critical thinking and verbal skills Complementary and alternative medicines CAM may have the potential to provide relief from menopausal symptoms and promote long-term wellbeing in menopausal women. The efficacy of black cohosh and phytoestrogens in reducing hot flushes has been assessed in clinical trials. In the one conducted by Gollschewski et al.

In a study involving 82 American women, CAM was used to reduce menopausal symptoms and as a preventative measure for long-term health. Herbal preparations, vitamin supplements, healthy living and mental healing were mentioned as possible alternatives for managing symptoms 35 , Since women are the basis of family care, the empowerment of postmenopausal women will guarantee their health during over one third of their life.

It will also help them benefit from their final years of reproductive life 2 , Accordingly, along with the empowerment-based education, other empowerment models and adaptation techniques are recommended during menopause 10 , Due to no awareness of health care providers about empowerment techniques, the empowerment of postmenopausal women will guarantee their health during over one third of their life.

Limitation of access to journals and articles due to international problems. We would like to express our appreciation to everyone involved in this project.

We are also grateful for the helpful comments of anonymous referees. Designed the study, performed the literature review and preparation of the manuscript, Fatemeh Abdi: Management of the study, writing the paper, designing the search strategy and literature review. Participated in the design of the search strategy and literature review. All of the authors had the same contribution in various process performed in this project.

National Center for Biotechnology Information , U. Iran Red Crescent Med J. Published online Mar