Document Type : Original Article


1 Department of Community Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: Women during menopause stages experience many symptoms, for which they
lack enough knowledge to manage them. This study aimed to compare the effect of self‑directed and
support group health education on the quality of life (QOL (and self‑care of postmenopausal women.
MATERIALS AND METHODS: This field trial study was carried out with three groups. One hundred
and eight menopause women were selected through convenient sampling method based on the
inclusion criteria from three comprehensive health centers. Health centers were randomly assigned to
support (n = 36), self‑directed (n = 36), and control groups (n = 36). In the self‑directed group, education
was provided through educational package, and the control group received routine care from the
health center. The support group received education through four group sessions by trained healthy
volunteers. Data were collected by menopause‑specific QOL and self‑care standard questionnaire.
RESULTS: Immediately after the intervention, the mean scores of QOL in the self‑directed
group, support group, and control group were 41.82  ±  7.61, 40.31  ±  4.80, and 48.17  ±  8.45,
respectively (P  <  0.05). In addition, the mean scores of self‑care were significantly different
between the self‑directed (40.67 ± 7.36) and support (36.50 ± 3.36) groups compared to the control
group (47.83 ± 8.47) (P < 0.05). After 1 month from intervention, QOL scores in the self‑directed
group (40.67 ± 7.36), support group (36.50 ± 3.36), and control group (47.83 ± 8.47) were significantly
different (P < 0.05). In addition, the mean scores of self‑care were 64 ± 6.79 and 65 ± 8.32 in the
self‑directed and support groups, respectively, compared to the control group (49.09 ± 9.43). Post hoc
test (least significant difference) revealed higher effectiveness of the support group (P < 0.001).
CONCLUSIONS: Results indicated QOL and self‑care in menopause women in self‑directed and
support groups improved. However, the support group provided higher effectiveness. Therefore,
we recommended paying more attention to the capabilities of healthy volunteers for the promotion
of QOL in menopause women.


1. Chaplin S. NICE guideline: Diagnosis and management of the
menopause. Prescriber 2016;27:27‑32.
2. Formoso G, Perrone E, Maltoni S, Balduzzi S, Wilkinson J,
Basevi V, et al. Short‑term and long‑term effects of tibolone
in postmenopausal women. Cochrane Database Syst Rev
3. Daley A, MacArthur C, Mutrie N, Stokes‑Lampard H. Exercise
for vasomotor menopausal symptoms. Cochrane Database of
Systematic Reviews 2014. Art. No.: CD006108.
4. Liu K, He L, Tang X, Wang J, Li N, Wu Y, et al. Relationship
between menopause and health‑related quality of life in
middle‑aged Chinese women: A cross‑sectional study. BMC
Womens Health 2014;14:7.
5. Shobeiri F, Jenabi E, Hazavehei SM, Roshanaei G. Quality of life
in postmenopausal women in Iran: A population‑based study.
J Menopausal Med 2016;22:31‑8.
6. Noroozi E, Dolatabadi NK, Eslami AA, Hassanzadeh A, Davari S.
Knowledge and attitude toward menopause phenomenon among
women aged 40‑45 years. J Educ Health Promot 2013;2:25.
7. Mirghafourvand M, Jafari M. Effects of self‑directed learning
on the early symptoms of menopause. Caspian J Int Med
8. Lipman EL, Kenny M, Jack S, Cameron R, Secord M, Byrne C.
Understanding how education/support groups help lone mothers.
BMC Public Health 2010;10:4.
9. Karbaschi K, Zareiyan A, Dadgari F, Saidati S. The effect of
self‑care program based on Orem’s theory on quality of life of
cancer patients undergoing chemotherapy in military personnel.
Military Caring Sci 2015;2:69‑78.
10. Yazdkhasti M, Keshavarz M, Merghati Khoei E, Hosseini AF.
The effect of structured educational program by support
group on menopause women’s quality of life. Iran J Med Educ
11. Ebrahimi M, Moghadamnia M, Farmanbar R, Zayeni SH, Leili EK.
Status of self‑care ability of patients with rheumatoid arthritis.
JHNM 2015;25:9‑18.
12. Dąbrowska J, Dąbrowska‑Galas M, Rutkowska M,
Michalski BA. Twelve‑week exercise training and the quality of
life in menopausal women – Clinical trial. Prz Menopauzalny
13. Jayabharathi B, Judie A. Complementary health approach to
quality of life in menopausal women: A community‑based
interventional study. Clin Interv Aging 2014;9:1913‑21.
14. Farokhi F, Narenji F, Salehi B, Mehrabi F, Rafiei M. Effect of
skill life training in quality of life in menopausal women. Sci J
Hamadan Nurs Midwifery Fac 2015;23:54‑64.
15. Firouznia R. Development and design of self‑care educational
guide for improving symptoms of hot flashes during menopause
with an emphasis on physical activity and diet in women aged
45‑60. Knowledge Health 2014;2:45‑60.
16. Motaghi M, Mojarrad LM, Nadjafi M, Omidi M. The effect of
education based on the health promotion model on awareness
about menopause among healthcare volunteers in Kashan. Int
Arch Health Sci 2017;4:31.
17. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms
and their management. Endocrinol Metab Clin North Am
18. Jafarzadeh M. Comparing Effectiveness of Individual and
Group Education on Satisfaction and Sexual Performance of
Menopause Woman. Ahvaz: Jandi Shapoor University; 2014.
19. Abedi P, Jafarzadeh M, Abbaspoor Z, Bastami P,
Haghighizadeh MH, Hassani M. Education for sexual satisfaction
promotion in postmenopausal women: Individual or group
education? Iran. J Obstet Gynecol Infertil 2017;20:16‑23.
20. Fisher EB, Coufal MM, Parada H, Robinette JB, Tang PY,
Urlaub DM, et al. Peer support in health care and prevention:
Cultural, organizational, and dissemination issues. Annu Rev
Public Health 2014;35:363‑83.
21. Parsa P, Tabesh RA, Soltani F, Karami M. Effect of group
counseling on quality of life among postmenopausal women in
Hamadan, Iran. J Menopausal Med 2017;23:49‑55.