Postmenopausal Symptoms Clinical Trial
Official title:
Investigation of the Relationship in Sleep With Low Back Pain in Postmenopausal Period
Introduction:The aim of this study was to investigate the incidence of low back pain in
postmenopausal period and the relationship between low back pain and emotional state,sleep
and quality of life i aimed at investigating low back pain during postmenopausal period of
women and its correlation with the emotional state,sleep quality and the quality of life of
woman.
Method:This cross-sectional study was conducted in 368 postmenopausal women aged between 40
and 65 years.All participants were recorded frequency and severity of low back
pain,depressive symptoms and anxiety,quality of life and sleep quality.Outcome measures are
described in more detail below.
Participants This cross-sectional study was conducted in 368 postmenopausal women aged
between 40 and 65 years. This study was carried out in family health centers in Istanbul.
Participants who have not had menstrual bleeding for the last 1 year and, with FSH levels
above 30 mlU / ml were included in this study. My exclusion criteria in the study were
illiterate women. All participants were given informed consent about the aim and methods of
the study.
Study design Data were collected via face-to-face interviews by the researcher.
Socio-demographic data ascertained included age, Body Mass Index (BMI), marital status,
tobacco and alcohol use, medication use, presence of chronic disease, age of menopause onset,
and educational level. All participants were recorded frequency and severity of low back
pain, depressive symptoms, anxiety, quality of life and sleep quality. Outcome measures are
described in more detail below. According to the power analysis results, when the number of
enough participants was reached, the study was stopped. Ethics committee approval for the
study was obtained from the Istanbul Science University Ethics Committee for Clinical
Researches (IBU17.02.2015/28-210).
Outcome measurements Pain To determine the frequency of current pain, all eligible
participants were evaluated and asked to report whether they had had pain. All participants
were evaluated for severity of pain using an 11-point numeric visual analog scale (VAS; 0= no
pain; 10=worst pain imaginable). Participants were asked to characterize their pain severity
along a horizontal, 10-cm line. Participants were questioned about the severity of low back
pain during rest, during activity and at night. Statistics were made by categorizing the
severity of low back pain during rest, activityand at night. Low back pain intensity were
classified that according to the cut-off point of the VAS. (0.1-3.8 mild pain, 3.9-5.7
moderate pain, 5.8-10 severe pain).
Emotional Status Hospital Anxiety and Depression Scale (HADS) was used to determine the level
of anxiety and depression of the participants. It contains 14 items, seven related to
depression and seven to anxiety. Each item is rated in a 4 point scale. A subscale score of
0-21 and to a total score of 0-42. Scores of 11 or more on either sub-scale is considered to
be a significant "case" of psychological morbidity, while scores of 8 to 10 represent
"borderline" and 0 to 7 "normal". It was originally developed in 1983 by Zigmond and Snaith
in order to evaluate the risk for anxiety and depression in patient and to measure the level
and severity of anxiety/ depression. The validity and reliability of Turkish version of the
HAD Scale was tested in 1997 by Aydemir.
Quality of Life Nottingham Health Profile (NHP) was used to determine quality of life of the
participants. NHP is a general health status scale (health-related quality of life), which
aims to measure a patient's perceived emotional, social and physical health status. This
scale consists of 38 items formed as yes-no questions that cover 6 subscales of the quality
of life. These six subscales are sleep (5 item), energy level (3 item), emotional status (9
item), social isolation (5 item), physical mobility (8 item) and pain (8 item). Each section
is scored from 0-100. 0 indicates the best health status, 100 indicates the worst health
status. In the study, the sub-scores of NHP and total NHP scores were evaluated. Total NHP
score was obtained from the sum of the sub-scores. The scale was developed by Hunt et
al.(1981). NHP is an easy-to-use scale and the validity and reliability of Turkish version
was by Küçükdeveci at al.(2000).
Sleep Quality Pittsburgh Sleep Quality Index (PSQI) was used to determine sleep quality of
the participants. PSQI was originally developed by Buysse et al.(1989). PSQI was adapted into
Turkish by Ağargün et al.(1996). PSQI is consisting of 24 items, 19 of which are
self-assessment questions and the rest 5 are answered by patient's spouse or roommate. The
scored 18 items covers 7 components, namely subjective sleep quality, sleep latency, sleep
duration, habitual sleep efficiency, sleep disorders, use of sleeping medication and daytime
dysfunction. Each component is evaluated on a 0-3 interval scale whereby 3 reflect the
negative extreme on the Likert Scale. The total score obtained from the seven components are
equivalent to the total scale score. The total score ranges between 0 and 21; higher scores
indicate worse sleep quality.
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