Women's experience of menopause: a systematic review of qualitative evidence.
Women's experience of menopause: a systematic review of qualitative evidence.
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DOI：
10.11124/jbisrir-2015-1948
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发表时间：
2015-09-16
期刊：
影响因子：
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通讯作者：
Quirino, Bruna
中科院分区：
文献类型：
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作者：
Hoga, Luiza;Rodolpho, Juliana;Quirino, Bruna
背景：有证据表明，全世界估计有10亿妇女经历过更年期。更年期的经历受到社会文化环境中普遍存在的信仰和价值观、妇女的背景以及妇女在这一生命阶段应对变化的方式的影响。独立的情况下，经历更年期的妇女需要有自己的护理需求和相应的支持，根据他们的个人和背景的角度确定。虽然这是至关重要的，以提供适当的支持，妇女经历更年期，迄今尚未进行系统的审查，重点是更年期经历的妇女worldwide.结论：本审查的目的是确定最好的证据有关妇女如何经历更年期世界各地。本综述考虑了包括年龄在40至65岁之间的绝经期妇女的研究，这些妇女从生育年龄过渡到绝经期及以后。该综述仅包括参与者经历过自然更年期的研究。已诱导绝经或过早绝经的妇女被排除在本综述之外。干预类型/感兴趣的现象：本综述考虑了在不同社会和文化背景下调查女性自然绝经经历的研究。研究类型：本综述考虑了采用定性方法进行的描述性和解释性研究。定性研究，重点是程序评估被排除在本次审查。定性数据，包括但不限于，研究设计，如现象学，扎根理论，民族志，行动研究和女权主义研究被认为是纳入本审查。结局类型：本次审查认为，包括以下结果的措施研究：直接和间接的经验，更年期的各个方面，具体生活的妇女，并根据自己的观点。以英文、法文、葡萄牙文和西班牙文出版的研究报告被考虑纳入本审查，对出版年份没有任何限制。作出这一决定是为了允许纳入自这类研究开始以来与全世界妇女更年期生活经历有关的所有研究。检索的数据库包括CINAHL、Medline和Pubmed、PsycInfo、Lilacs、Scielo、Scopus、Dissertation Abstracts International和圣保罗大学论文和论文。方法质量：每项主要研究都由两名独立评审员评估方法质量。使用乔安娜布里格斯研究所的定性评价和评论工具数据提取表来评价所有论文的方法学质量。资料收集：定性数据是使用乔安娜布里格斯研究所开发的标准化数据提取工具从评论中包含的论文中提取的。资料综合：结果：从纳入的24篇研究中，共提取出108项研究结果。这些调查结果分为17个类别，然后分为6个综合调查结果。这六项综合调查结果是：（一）更年期是妇女生活中的一个自然事件，与中年和衰老过程中的心理社会事件密切相关;（二）更年期的身体和情绪变化对妇女产生强烈影响;（三）妇女认为更年期是一个有得有失的时期; ㈣提高更年期的复原力，并采取应对战略，以增强身心健康; ㈤健康问题、家庭和婚姻关系、社会文化背景和妇女性生活的意义决定了更年期的性经历是否愉快;和（vi）妇女应该做好准备，并根据她们的观点支持她们的需求。结论：系统评价表明，更年期是一个阶段的生活经历了不同的方式。更年期经历的特点是个人的挑战和个人在家庭和社会中的角色变化。潮热和盗汗是受更年期变化影响的妇女报告的最强烈的症状。每个妇女对更年期变化的积极或消极态度受到其个人、家庭和社会文化背景的影响。卫生保健提供者很少注意妇女对更年期的看法。考虑到更年期是女性感到脆弱的时候，应该根据个人需求，偏好和期望提供个性化和量身定制的医疗保健。应通过查明和考虑所涉的复杂问题，以创造性和动态的方式确定应对更年期影响的战略。这些措施对于确保有效支持更年期妇女至关重要。
BACKGROUND: Evidence shows than an estimated one billion women have experienced menopause worldwide. The experience of menopause is influenced by beliefs and values prevalent in the sociocultural setting, the background of the women, and the ways in which the women approach changes in this phase of life. Independently of the circumstances involved, women experiencing menopause need to have their care needs and corresponding support identified based on their personal and contextual perspectives. Although it is essential to provide appropriate support to women experiencing menopause, no systematic reviews have so far been conducted that focus on menopause experienced by women worldwide.OBJECTIVES: The objective of this review is to identify the best available evidence related to how women experience menopause worldwide.INCLUSION CRITERIA:TYPES OF PARTICIPANTS: This review considered studies that included menopausal women aged between 40 and 65 years, who have lived the transition from reproductive years through menopause and beyond. This review included only studies whose participants have lived the experience of natural menopause. Women who have had induced menopause, or with premature menopause were excluded from this review. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: This review considered studies that investigate women's experiences of natural menopause under the scope of different social and cultural settings. TYPES OF STUDIES: This review considered studies that have a descriptive and interpretive approach, conducted using qualitative methodology. Qualitative studies that focus on program evaluation were excluded from this review. Qualitative data including, but not limited to, study designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion in this review. TYPES OF OUTCOMES: This review considered studies that include the following outcome measures: all aspects related both directly and indirectly to the experience of menopause, as concretely lived by women and according to their own point of view.SEARCH STRATEGY: The search strategy aimed to find both published and unpublished studies. Studies published in English, French, Portuguese and Spanish were considered for inclusion in this review, without any restriction in terms of year of publication. This decision was made to permit the inclusion of all of research related to women's lived experiences of menopause worldwide since the inception of this type of research. The databases searched included CINAHL, Medline and Pubmed, PsycINFO, Lilacs, Scielo, Scopus, Dissertation Abstracts International and the University of Sao Paulo Dissertations and Thesis.METHODOLOGICAL QUALITY: Each primary study was assessed by two independent reviewers for methodological quality. The Joanna Briggs Institute Qualitative Appraisal and Review Instrument Data Extraction Form for Interpretive and Critical Research was used to appraise the methodological quality of all papers.DATA COLLECTION: Qualitative data was extracted from papers included in the review using standardized data extraction tools developed by the Joanna Briggs Institute.DATA SYNTHESIS: Qualitative research findings were synthesized using The Joanna Briggs Institute Qualitative Appraisal and Review Instrument.RESULTS: From the 24 included studies, 108 findings were extracted. These findings were aggregated into 17 categories, and then into six synthesized findings. The six synthesized findings are: (i) Menopause is a natural event in a womans life that is closely associated with psychosocial events of midlife and the aging process; (ii) The physical and emotional changes of menopause strongly affect the women; (iii) The women perceive menopause as a time characterized by gains and losses; (iv) Resilience is improved at the time of menopause and coping strategies are adopted to enhance physical and emotional wellbeing; (v) Health issues, family and marital relations, sociocultural background and meaning attributed to the womens sex life determine if the sexual experiences during menopause are pleasant or not; and (vi) The women should be prepared and have their needs supported according to their perspectives.CONCLUSIONS: The systematic review shows that menopause is a stage of life experienced in different ways. The experience of menopause is characterized by personal challenges and changes in personal roles within the family and society. Hot flushes and night sweats are the strongest symptoms of those reported by women affected by the changes experienced during menopause. The positive or negative ways in which each woman approaches the changes during menopause are influenced by their personal, family and sociocultural background. Health care providers pay little attention to womens perceptions regarding menopause. Considering menopause is a time when women feel vulnerable, personal and tailored healthcare according to individual needs, preferences and expectations should be provided. Coping strategies regarding the effects of menopause should be determined in creative and dynamic ways through the identification and consideration of the complex issues involved. These measures are essential to ensuring effective support for menopausal women.