Document Type : Original Article


1 Saber Counseling Center, Mashhad, Iran

2 MSc, Gonabad University of Medical Sciences, Gonabad, Iran


BACKGROUND: Positive psychology introduce mental health as a positive psychological functioning 
and represent it as well‑being psychology. From this point of view, psychological health is more 
supposed to be known as having positive characteristics such as self‑esteem, positive social 
relationships, and satisfaction. This study was conducted to compare the effect of education in two 
methods of person‑centered and supportive group based on the PRECEDE‑PROCEED model on 
women’s psychological well‑being during menopause.
MATERIALS AND METHODS: The present study was a clinical trial. One hundred and ten 
menopausal women have been placed in two groups (tests and control). The training program 
was designed according to the PRECEDE‑PROCEED model. The educational intervention was 
implemented for two groups (person‑centered and the supportive group) and the control group did 
not receive any training. Data analysis was used by descriptive statistics and in the case of normal 
distribution of alternative tests such as Kruskal–Wallis test, Man–Whitney test, Wilcoxon, spearman 
correlation, Spearman correlation was used.
RESULTS: Results of variance analysis showed that awareness, attitude, self‑efficacy, enabling 
factors, reinforcement, support, behavioral environment, six psychological well‑being factors were 
significantly different from the individual group and control group. Furthermore, the overall score of 
the psychological well‑being was significantly higher than the control group.
CONCLUSIONS: As a result of the design and deployment of health care monitoring system, 
building and reform of community beliefs toward women’s status in decision making and their role 
in menopause, the design and development of support group meetings in women’s health care 
system and enhancing women’s access to specialist and heterogeneous health services tailored to 
the needs of the menopause.


  1. Taebi M, Abdolahian S, Ozgoli G, Ebadi A, Kariman N. Strategies 
    to improve menopausal quality of life: A systematic review. J Educ 
    Health Promot 2018;7:93.
    2. Jabbari A, Yarmohamadian MH, Hadian M. Iran’s struggling 
    health system: An increase in natural childbirth: A case study. 
    Int J Prev Med 2018;9:47.
    3. Hoga L, Rodolpho J, Gonçalves B, Quirino B. Women’s experience 
    of menopause: A systematic review of qualitative evidence. JBI 
    Database System Rev Implement Rep 2015;13:250‑337.
    4. Minkin MJ. Menopause: Hormones, lifestyle, and optimizing 
    aging. Obstet Gynecol Clin North Am 2019;46:501‑14.
    5. Avis NE, Crawford SL, Green R. Vasomotor symptoms across 
    the menopause transition: Differences among women. Obstet 
    Gynecol Clin North Am 2018;45:629‑40.
    6. Kagan R, Kellogg‑Spadt S, Parish SJ. Practical treatment 
    considerations in the management of genitourinary syndrome 
    of menopause. Drugs Aging 2019;36:897‑908.
    7. Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, 
    Becker CM. The management of menopause in women with a 
    history of endometriosis: A systematic review. Hum Reprod 
    Update 2017;23:481‑500.
    8. Gracia CR, Freeman EW. Onset of the menopause transition: The 
    earliest signs and symptoms. Obstet Gynecol Clin North Am 
    9. Morgan KN, Derby CA, Gleason CE. Cognitive changes with 
    reproductive aging, perimenopause, and menopause. Obstet 
    Gynecol Clin North Am 2018;45:751‑63.
    10. Monteleone P, Mascagni G, Giannini A, Genazzani AR, 
    Simoncini T. Symptoms of menopause – global prevalence, 
    physiology and implications. Nat Rev Endocrinol 2018;14:199.
    11. Yisma E, Eshetu N, Ly S, Dessalegn B. Prevalence and 
    severity of menopause symptoms among perimenopausal and 
    postmenopausal women aged 30‑49 years in Gulele sub‑city of 
    Addis Ababa, Ethiopia. BMC Womens Health 2017;17:1‑8.
    12. Marlatt KL, Beyl RA, Redman LM. A qualitative assessment 
    of health behaviors and experiences during menopause: 
    A cross‑sectional, observational study. Maturitas 2018;116:36‑42.
    13. Saulle R, Sinopoli A, De Paula Baer A, Mannocci A, Marino M, 
    De Belvis AG, et al. The PRECEDE‑PROCEED model as a 
    tool in public health screening: A systematic review. Clin Ter 
    14. Calano BJ, Cacal MJ, Cal CB, Calletor KP, Guce FI, Bongar MV,
    et al. Effectiveness of a community‑based health programme on 
    the blood pressure control, adherence and knowledge of adults 
    with hypertension: A PRECEDE‑PROCEED model approach. 
    J Clin Nurs 2019;28:1879‑88.
    15. Parvin N, KazemianA, AlaviA, Safdari F, Hasanpour DehkordiA, 
    Hosseinzadeh S, et al. The effect of supportive group therapy on 
    menopause mental health. J Gorgan Univ Med Sci 2007;9. 14‑18.
    16. RyffC. Happiness is everything, or is it? Explorations on the meaning 
    of psychological well‑being. J Pers Soc Psychol 1989;57:1069‑81.
  2. 17. Bayani AA, Mohammad Koochekya A, Bayani A. Reliability and 
    validity of Ryff’s psychological well‑being scales. Iran J Psychiatry 
    Clin Psychol 2008;14:146‑51.
    18. Yar Yari F, Moradi AR, Yahya Zadeh S. The relationship between 
    emotional intelligence and locus of control with psychological 
    well‑being among students at Mazandaran University. Psychol 
    Stud 2007;3:8,31‑39.
    19. Golyan Tehrani S, Mir Mohammad Ali M, Mahmoudi M, 
    Khaledian Z. Study of quality of life and its patterns in different 
    stages of menopause for women in Tehran. Hayat 2002;8:33‑41.
    20. Hunter M, O’Dea I. An evaluation of a health education 
    intervention for mid‑aged women: Five year follow‑up of effects 
    upon knowledge, impact of menopause and health. Patient Educ 
    Couns 1999;38:249‑55.
    21. Ryff CD. Psychological well‑being in adult life. Curr Dir Psychol 
    Sci 1995;4:99‑104.
    22. Moshki M, Ghofranipour F, Azadfallah P, Hajizadeh E. 
    Implementation of participatory‑educational program based 
    on Precede model for self‑esteem and psychological well‑being 
    enhancement of university students. Hormozgan Med J 
    23. BensonR, Taub DE. Using the PRECEDE model for causal analysis 
    of bulimic tendencies among elite women swimmers. J Health 
    Educ 1993;24:360‑8.
    24. 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 2012;11:986‑94.
    25. Iliodromiti S, WangW, LumsdenMA, HunterMS, BellR, MishraG,
    et al. Variation in menopausal vasomotor symptoms outcomes in 
    clinical trials: A systematic review. BJOG 2020;127:320‑33.
    26. Yousefi A, Gordanshekan M. The effect of teaching problem 
    solving on self‑efficacy and perceived self‑efficacy in adolescents. 
    J Res Behav Sci 2013;10:421‑30.
    27. Krok D, Gerymski R. Self‑efficacy as a mediator of the relationship 
    between meaning in life and subjective well‑being in cardiac 
    patients. Curr Issues Pers Psychol 2019;7:242‑51.
    28. Scott CM. Health Promotion Planning: “An Educational and 
    Ecological Approach”: Company, 1999; 621 pp. Can J Public 
    Health 2001;92:384.
    29. Chen CH, Tseng YF, Chou FH, Wang SY. Effects of support group 
    intervention in postnatally distressed women: A controlled study 
    in Taiwan. J Psychosom Res 2000;49:395‑9.
    30. Abdelrahman RY, Abushaikha LA, al‑Motlaq MA. Predictors of 
    psychological well‑being and stress among Jordanian menopausal 
    women. Qual Life Res 2014;23:167‑73.
    31. Veenhoven R. Healthy happiness: Effects of happiness on 
    physical health and the consequences for preventive health care. 
    J Happiness Stud 2008;9:449‑69.
    32. Joshanloo M, Rasouli R, Nosratabadi M. Examining the factor 
    structure of Keyes’ comprehensive scale of well‑being. J Iran 
    Psychol 2016;3:104‑9.