รูปแบบการให้บริการทางคลินิกสำหรับสตรีไทยวัยหมดระดู : การวิจัยเชิงปฏิบัติการแบบมีส่วนร่วม

Abstract

The model of the menopause clinic for Thai women: praticipatory action research The purpose of this study was to develop the model of the menopause clinic at Royal Irrigation hospital. The strategy was developed by using a participatory action research, which enabled women and health workers collaborated together to design and evaluate the situation to create a new plan of the clinic. The process was described as a spiral consisting of planning, acting, observing, reflecting, analyzing and replanting. The data was collected by in-depth interview, observation and was recorded on audio-tapes and kept diaries. Analysis of the data was based on the techniques of coding, developing categories and the final analysis was completed in 19 months. The model of menopause clinic was then developed and the results were as follow: Thai women in this study perceived menopause as a natural biological event. They were glad for they could no longer have menstruation but they were not sure what would happen to their general health status after menopause. The most frequently experienced symptoms of women attended clinic were joint pain, backaches headaches dizziness, irritability, mood changes, depression and urinary problems including urgency of micturition, dysuria, stress incontinence. Hot flushes and sweating were common complaints of women in perimenopausal period. The methods for the management of menopausal women obtained from PAR process were: Located the policy and the strategy of the clinic. The clinic staff included a gynecologist, nurses and physiotherapist. The age limit for women attended the clinic was 35-65 years of age. Arranged the places and the time of service properly. There would be signs for both new and regular patients. The information of patients including personnel history past illness and symptoms experienced by women in the previous month was recorded. Then the patients were taken to complete a laboratory and physical examination. Women were scheduled to attend the health promotion activity of the clinic including health education lectures, aerobic exercise and other recreational activities. They were also encouraged to share their problems and to take increased responsibility for other women. Follow up visit were not scheduled routinely but arranged on an individual basis. For those who were fine, their next appointment will be scheduled in the next 6 months. The aims of the study confirm that the essential part for the management of menopausal Thai Woman in health promotion approaches. These include: health screening, attitudinal changes, lifestyle modification, stress reduction and personal counseling.