Graduate School of Nursing
Menopause; Estrogen Replacement Therapy; Decision Making; Patients; Women's Health
Objective:To describe women’s experiences when making decisions about the use of hormonal or nonprescription remedies during or after the menopausal transition. The specific aims were to identify the influences on women’s decisions, identify their counseling needs, and describe how women evaluated the care and counseling provided.
Design:A qualitative descriptive approach was used. Semi-structured, tape recorded interviews were conducted with seven women who were currently making a decision about menopausal management and at two subsequent points after the initial interview. Transcripts were analyzed using content analysis with grounded theory techniques. Findings were validated with study participants at the end of the study to assure trustworthiness.
Results:Women’s priorities were feeling well and returning to their former level of functioning. Their decision-making was a non-linear process that consisted of several stages in which women became aware and made sense of symptoms, sought information about management options, assured safety, weighed benefits and risks, tried various prescription and non-prescription remedies, judged the efficacy of their choice, and re-evaluated their decision. If symptoms were severe or quality of life was low women reconciled the risks of hormone therapy before trying this option. Women were unsure about the meaning of research findings about the safety of hormone therapy and felt anxiety about using hormone therapy. Decision-making was influenced by women’s needs, perception of risks and benefits, and beliefs about menopause and its management.
Conclusions:Decision support can be provided through individual counseling, group support programs, internet sites, and articles in consumer literature, and should be tailored to each woman based on her individual preferences.
Presented October 14, 2006, at North American Menopause Society Annual Scientific Sessions meeting, Nashville, TN.