A Study to Assess Effectiveness of Structured Teaching Programme on Knowledge on Knowledge of Menopausal Symptoms and Its Management Among Middle Aged Women in Selected Rural Areas in Valsad, Gujarat, India

Nature does not allow a child to bring a baby into the world and similarly avoids a baby having a mother who is beyond middle age. Menopause is the physiological cessation of menses associated with declining ovarian function. An evaluative approach with pre-experimental one group pretest posttest research design was adopted for this study. A total of 100 middle aged women were selected by convenient sampling method Data were collected by using structured interview schedule. Impacted knowledge to middle aged women by using structured teaching program. The overall mean percentage of knowledge in the pre-test was 36.5% with standard deviation of 5.5 In the post test the overall mean percentage of knowledge was 75% with standard deviation 43 with a positive difference of 15.7 and 12. There is significant association between pretest knowledge score of middle-aged women and selected demographic variables is accepted for education and occupation. Analysis data shows that posttest knowledge score is significantly higher than the pretest knowledge score at p<0.05 level of significance Le, mean difference is 15.7 There is significant improvement in knowledge of middle-aged women regarding menopausal symptoms and its management There is significant association between pretest knowledge score of middle-aged women and selected demographic variables is accepted for education and occupation. Thus, investigator concluded that structured teaching program is good method of conveying information to middle aged women and it is very effective in order to gain knowledge


INTRODUCTION "Middle age can be emotionally the mutinous transition period characterized by inner struggle before one becomes resolved to having left the Pepsi generation forever." -Gelein and Heiple
One period of the life in which women loose youngness and enter in degenerative period in which they lose god gift that is reproductively which is called menopause period.Menopause is the permanent physiologic cessation of menses associated with declining ovarian function; during this time reproductive function diminishes and ends.It is also natural event that normally occurs between the ages of 45 and 55.
The symptoms of menopause are caused by change s in estrogen and progesterone levels.As the ovaries becomes less functional they produce less of these hormones and body responds accordingly.

NEED FOR THE STUDY
Menopause is not a disease.It is a normal life process which must take place at proper time.Many women don't know about it because of education, culture norms and they will take it wrongly as a disease or illness because menopausal symptoms like hot flashes, migraine, insomnia, night sweat, irregular period, loss of libido, and vaginal changes, depression, anxiety & Many more.According to the 2011 census of India, there were about 96 million women aged 45 year and above and this number is expected to increase to 401 million in 2026.In a cross-sectional survey of 3,369 postmenopausal women aged 50-79 years at Bengaluru, panic attacks were most prevalent among women in the menopausal transition.These attacks were associated with negative life events and functional impairment.menopause does not discriminate Nations around the world should continue to educate women about menopause and the benefits of promotive health care, Knowledge, Attitudes, and behaviors regarding Menopausal Issues among Women from a Rural area.

OBJECTIVES OF THE STUDY
➢ To assess the existing knowledge on menopausal symptoms and its management among middle aged women.➢ To find the effectiveness of structured teaching programme on menopausal symptoms and its management among middle aged women.➢ To find out an association between the pretest knowledge scores of women and selected demographic variables among middle aged women.

RESEARCH HYPOTHESIS H1
There will be a significant difference between mean pretest and posttest knowledge scores on menopausal symptoms and its management among women.

H2
There will be a significant association between pretest knowledge scores on menopausal symptoms and its management with selected demographic variables.ASSUMPTION 1.The middle-aged women may have some knowledge regarding menopausal symptoms and its remedial measures knowledge of middle-aged women is measurable.2. STP could be an effective teaching tool which may enhance knowledge regarding menopausal symptoms and its remedial measures.3. Women's level of knowledge is influenced by demographic variables.

METHADOLOGY RESEARCH APPROACH: -
The research approach adopted for this study was evaluative approach

Type of family
• Joint

• Nuclear
The table values revealed that the mean obtained for overall knowledge in the pretest was 14.6 and in posttest were 30.The gain in mean for overall knowledge was 15.4 with 't' value at d f 99 = 1.66 which was highly significant at p < 0.05.The findings reveal that the overall mean posttest knowledge scores of the subjects are significantly higher than the overall mean pre-test knowledge scores at 0.05 level of significance.Hence the hypothesis H1 is accepted.is evident that the obtained chi-square values for education and occupation were more than the table values and found that there is significant association between them.Hence hypothesis H2 there is significant association between pretest practice score of middle-aged women and selected demographic variables is accepted for education and occupation.

LIMITATION
➢ The sample size is limited to 100 middle aged women in selected rural areas; Valsad Hence generalization is possible only to the selected settings.➢ Duration of data collection is limited to 4 weeks.➢ Due to time constraint and the sample availability a convenience sampling technique was used in the present study ➢ Randomization was not done.So, the sample may not be the true representation of the population RECOMMENDATION ➢ A similar study can be conducted by including practical aspect.➢ A similar study can be carried out to evaluate the efficiency of various teaching strategies like selfinstructional module, pamphlets, leaflets and computer-assisted instruction on knowledge regarding menopausal problems and its remedial measures.➢ Based on study findings, intervention should be given to all women through mass media, role-play, drama, and puppet show, etc. to enhance the knowledge level.➢ A similar study can be undertaken with control group design.

CONCLUSION
This research revealed that there is a significant difference in knowledge of middle aged women regarding menopausal problems and its remedial measures after Structured Teaching Programme the study statistically proved that there is an association between pretest knowledge and selected socio-demographic variables of the middle aged women.

1 .
The research design provides an overall blueprint to cut out the study.research design used in this study was the quantitative, pre-experimental design i.e. "Pre-test, posttest with one group" VARIABLES: -• Independent variable: Structured teaching programme on knowledge regarding menopausal symptoms and its management among middle age in rural area.• Dependent variable: Knowledge of rural women under middle age regarding menopausal symptoms and its management.• Socio-Demographic variable: Socio-Demographic Variable are Age, education, occupation, type of family, previous source of information.SETTING: Rural Area of Valsad.POPULATION: -Target Population: Middle aged women in rural area of valsad.Accessible population: Middle aged women who are in selected rural area of Valsad.SAMPLE AND SAMPLING TECHNIQUE:-Samples: -Middle aged women (who fulfill the selection criteria) of selected rural area of Valsad.Sample Size: -100 middle aged women of selected rural area of Valsad.Sampling Technique: -"Non-Probability Convenient" sampling technique CRITERIA FOR SAMPLE SELECTION: -INCLUSION CRITERIA 1. Who had menopausal period.2. Women are willing to participate in the study.3. Women are present at the time of data collection.4. Women can understand and speak Gujarati, Hindi.EXCLUSION CRIRETIA Women who are suffering from any other major illness.2. Women who are not willing to participate in the study.3.Women who are not present at the time of data collection.DATA COLLECTION METHOD: -A structured Questioner Data collection instrument Data collection instrument used were ✓ Demographic data ✓ Structured Questioner (pretest and posttest) to assess the knowledge of middle aged women regarding menopause, symptoms and its management DESCRIPTION OF TOOL: Section A-It contains socio demographic profile which consists of age, type of family, education, occupation, previous source of information.Section B -A structured interview schedule on menopause, symptoms and its management.It consists of 40 items divided into areas like anatomy and physiology of the reproductive system, menopause and its symptoms and its management.All the items were multiple-choice questions, which had 4 alternative responses.A score of [1] for correct answer and a score of [0] for incorrect answer was answer was awarded.Thus, there were 40 maximum obtainable scores.Knowledge • 76% -100% = Adequate • 51% -75% = Moderately adequate • 50% below = Inadequate TESTING THE INSTRUMENT:-Validation of the Tool:-• Structured teaching programme was assessed by obtaining opinion from obstetrical gynecological health experts as per the suggestions of the experts.The investigator had made necessary modifications in the tool.• Reliability: -In order to establish reliability of the tool, structured questionnaires and observational rating scale was established through split half method.Reliability of the structured teaching program was established through split half method of knowledge and practice of instruments.Correlation co-efficient was 0.89.It shows high degree of reliability of the tool to conduct study.