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Women’s conception of the menopausal transition – a qualitative study
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy, Göteborg, Sweden.
2007 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 3, 509-517 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To explore, with a qualitative approach, whether the conception of menopause varies between women seeking medical advice due to climacteric symptoms and, if so, to describe these different conceptions.

Background: For many women, the menopausal transition is a troublesome period of life, often associated with decreased well-being and a number of symptoms. Besides the hormonal changes, many other factors such as psychological, sociological and lifestyle factors affect how women perceive their menopause.

Method: Semi-structured interviews were held with 20 women after their first-time visits at outpatient clinics of gynaecology for discussion of climacteric symptoms. The interviews were audio-taped, transcribed and analysed using a phenomenographic approach.

Results: A wide variation of conceptions was revealed. Two main categories were identified including different physical changes with varying symptoms and both positive and negative psychological changes. The menopausal transition was also described as a natural process and as a developmental phase of life.

Conclusion and relevance to clinical practice: Women’s conceptions of the menopausal transition were individual and contained both physical and psychological symptoms but also expressed a more holistic view of the menopausal transition. The transition was described as a natural process affected by endocrine and life-style factors as well as by the psychosocial situation and by aging per se. It is important that health care providers are aware of women’s conceptions about the menopausal transition to be able to communicate optimally, support and empower middle-aged women in different health care situations and thereby optimise the result of care.

Place, publisher, year, edition, pages
Institutionen för klinisk och experimentell medicin , 2007. Vol. 16, no 3, 509-517 p.
Keyword [en]
Phenomenography, conceptions, menopausal transition, qualitative study, nurses, nursing.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-11699DOI: 10.1111/j.1365-2702.2005.01547.xOAI: oai:DiVA.org:liu-11699DiVA: diva2:18122
Note
The definitive version is available at www.blackwell-synergy.com: Lotta Lindh-Åstrand, Mikael Hoffmann, Mats Hammar and Karin I Kjellgren, Women’s conception of the menopausal transition – a qualitative study, 2007, Journal of Clinical Nursing, (16), 3, 509-517. http://dx.doi.org/10.1111/j.1365-2702.2005.01547.x. Copyright: Blackwell Publishing www.blackwell-synergy.comAvailable from: 2008-04-29 Created: 2008-04-29 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Women's knowledge, attitudes, and management of the menopausal transition
Open this publication in new window or tab >>Women's knowledge, attitudes, and management of the menopausal transition
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Hormone therapy (HT) has been considered as a safe treatment for menopausal symptoms. Use of HT increased dramatically in the 1980s and 1990s. Results from large randomized clinical trials (RCT) could, around the turn of the century, however not find evidence for long-term benefits with HT. These results attracted great attention from media and the scientific community leading to changed treatment guidelines and decreased use of HT.

Aim: The overall aim of this thesis was to explore Swedish women’s conceptions, knowledge, management, and attitudes regarding the menopausal transition and HT.

Material and methods: To explore and describe women’s conceptions of the menopausal transition women seeking medical advice due to climacteric symptoms were interviewed (n=20) and their statements were analyzed with a qualitative method (paper I). In 1999 (n=1760) and 2003 (n=1733) attitudes to (paper II) and knowledge of (paper III) the menopausal transition and HT among 53- and 54 year old women were investigated with a cross-sectional design using postal questionnaires. We also analyzed if attitudes differed before and after new scientific findings were published on risks and benefits of HT and if knowledge differed between educational levels. Since many women try to abandon use of HT a RCT was performed to study the effect of two different methods to discontinue HT, on recurrence of hot flushes, resumption of HT and on health related quality of life (HRQoL). Women (n=87) with vasomotor symptoms before initiating HT participated.

Results: We found that the majority of the middle aged women in our study viewed the menopausal transition as a natural process the nature of which is affected by both hormonal changes and by ageing. Each woman seems to experience a set of psychological and physical symptoms that are in some sense unique to her experience. Women’s answers to the questions about HT demonstrate that attitudes towards HT held by women going through menopause have changed rather dramatically between 1999 and 2003. These changes probably reflect the influence on the women of media reports based on research that identified risks associated with HT that had not been identified before 1998.

Women’s knowledge of the effects of HT seems to be unsatisfactory from a clinical perspective. No differences in hot flush frequency and resumption of HT were found between the women randomized to two different modes of discontinuation of HT. Almost 50 % of the women restarted HT within one year after discontinuation. Deteriorated wellbeing and severity of hot flushes were important predicting factors for resumption of HT.

Conclusion: It is important to be aware of the individual woman’s conceptions and attitudes about and knowledge of the menopausal transition and HT to be able to individualize the counselling situation. Women who initiate HT due to hot flushes may experience recurrence of vasomotor symptoms and deteriorated HRQoL after discontinuation. A great proportion of them may resume HT. At present knowledge of possible advantages for the taper-down method when discontinuing HT is still lacking.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 67 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1153
Keyword
Menopause, hormone therapy, knowledge, attitudes, conceptions, management/treatment, climacteric symptoms, hot flushes
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-21896 (URN)978-91-7393-531-9 (ISBN)
Public defence
2009-10-30, Aulan, Hälsans Hus, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2009-10-12 Created: 2009-10-06 Last updated: 2009-10-12Bibliographically approved

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Lindh-Åstrand, LottaHoffmann, MikaelHammar, Mats

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