Bakgrund Perimenopaus är en period som kvinnan genomgår innan hon når menopaus, även kallat klimakteriet. Perimenopausen kan innebära många besvärliga symtom, psykiska såväl som fysiska, vilket påverkar kvinnans livskvalité. Många kvinnor har otillräcklig kunskap gällande perimenopaus och dess symtom, men även vart man söker vård, stöd och råd samt upplever kvinnorna att ämnet sällan diskuteras. Syfte Syftet var att beskriva kvinnors upplevelser och erfarenheter av vården vid perimenopaussymtom. Metod Metod av studien var en icke-systematisk litteraturöversikt med ett resultat baserat på 13 vetenskapliga originalartiklar. Av dessa var nio av kvalitativ design, tre av kvantitativ design samt en tvärsnittsstudie. Artiklarna inhämtades i databaserna CINAHL och PubMed. Artiklarna har kvalitetsgranskats enligt Sophiahemmet Högskolas bedömningsunderlag och analyserats med användning av en integrerad dataanalys. Resultat Litteraturöversiktens resulterade i form av två huvudkategorier med tillhörande underkategorier, som formades utifrån resultatets huvudfynd. Utifrån huvudkategorierna Erfarenhet av vården och Upplevelse av behandling beskrivs kvinnors upplevelser och erfarenheter av vården vid perimenopaussymtom. Slutsats Kvinnorna upplevde även variation i kunskapen hos vårdpersonal och kände att de inte fått tillräcklig information från vården, vilket fick många kvinnor att känna sig dåligt förberedda inför denna period. Det var av stor betydelse förutsatt att kvinnorna med perimenopaussymtom blev bemötta med förståelse för de besvär som kan upplevas. Ett bra bemötande samt en god relation till sin vårdgivare ledde till minskade symtom och besvär hos kvinnorna. / Background Perimenopause is the period before a woman reach menopause. This period can cause several distressing symptoms, both psychological and physical, which affects women’s quality of life. A large number of women lack knowledge about perimenopause and its symptoms, but also where to seek care, advice and support. Additionally, women also felt that this topic is infrequently discussed. Aim The aim was to describe women’s experiences of health care during perimenopausal symptoms. Method The method used in this study was a literature review with a result based on 13 original scientific articles. We used 9 qualitative design, three quantitative study’s and one cross sectional study. The articles were obtained from the databases CINAHL and PubMed. The articles have been reviewed in accordance with Sophiahemmet University’s assessment basis. Further, the data analysis was accomplished with an integrated analysis model. Results The result of this literature review was formed into two main categories with associated subcategories, which were formed after the main findings in the result. Women’s experiences of healthcare regarding perimenopausal symptoms are described under the main categories Experience of health care and Experience of treatment. Conclusions It was of great significance that women with perimenopausal symptoms were treated with an understanding of the distressing problems they might experience. Providing the patience with a good treatment in addition to the patient having a good relationship with its healthcare provider led to a decrease in symptoms and discomfort for the women. Additionally, women also felt that health professionals' knowledge varied and that they had not received enough information from the health service about menopause and its symptoms, causing many to feel unprepared for this period.

Thesis (MSc. (Physiology)--Faculty of Health Sciences) - University of Pretoria, 2008. / Includes bibliographical references.

Introdução: A insônia está entre os mais frequentes transtornos que afetam a população na contemporaneidade, devido a mudanças hormonais e psicossociais importantes é muito prevalente na perimenopausa. Há uma relação ainda pouco estudada entre eficiência do sono e prática meditativa. Os tratamentos utilizados para insônia normalmente são de alto custo e paliativos. Objetivo: Avaliar o efeito da meditação na insônia (causada por sintomas característicos da perimenopausa) e qualidade de vida nesta fase da vida. Método: Ensaio clínico controlado para avaliar os efeitos da meditação em mulheres com insônia no período da perimenopausa e o impacto na qualidade de vida em 8 semanas de intervenção. O estudo foi realizado de abril a julho de 2013 com 33 mulheres na perimenopausa de idade entre 40 a 55 anos em 3 unidades de órgão público no município de São Paulo, SP. As participantes foram divididas aleatoriamente em dois grupos, um que praticou somente Higiene do Sono-HS (n=15) e outro que praticou Meditação + Higiene do Sono-M+HS (n=18). Foram realizados encontros semanais com as participantes de ambos os grupos para pratica de meditação em grupo e/ou critérios de higiene do sono. O grupo M+HS também realizou prática diária de meditação. Para avaliar a significância estatística das diferenças de médias antes e depois das intervenções em cada grupo foi utilizado o teste de Wilcoxon. Resultados: Houve melhora da insônia em ambos os grupos, no entanto comparando as diferenças de escore do Índice de Gravidade de Insônia entre os grupos estudados, o grupo M+HS teve um efeito superior em ambas as medições em relação ao grupos HS. No grupo M+HS, houve redução estatisticamente significativa nas categorias do Índice Menopausal de Kupperman: Palpitação, Parestesia e a Pontuação Total já no grupo HS não houve redução significativa em nenhum parâmetro do Índice de Kupperman. Houve melhora significativa da pontuação geral de qualidade de vida aferida pelo WHOQOL breve no grupo M +HS, e no grupo HS houve melhora no domínio relações sociais. Conclusão: Os resultados sugerem que a meditação pode ser ferramenta útil no tratamento da insônia primária durante o período da perimenopausa. A qualidade de vida durante este período também é favorecida de maneira global pela prática diária de meditação. / Introduction: Insomnia is one of the most common disorders that affect the population in contemporaneity, because of important hormonal and psychosocial changes is very prevalent in perimenopause. There is a still understudied relationship between sleep efficiency and meditative practice. The treatments for insomnia are usually expensive and palliative. Objective: Evaluate the effects of meditation in insomnia (caused by typical symptoms of perimenopause) and quality of life in this phase of life. Method: controlled clinical trial to evaluate the effects of meditation in women with insomnia during perimenopause and impact on quality of life in 8-week intervention. The study was conducted from April to July 2013 with 33 perimenopausal women aged between 40-55 years in 3 units of public organization in São Paulo, SP, Brazil. The participants were randomly assigned to two groups, one who performed only Sleep Hygiene-HS (n = 15) and another who performed Meditation + Sleep Hygiene - SH + M (n = 18). Weekly meetings were held with the participants of both groups to practice meditation in a group and / or criteria for the sleep hygiene. The M + SH group also performed daily meditation practice. To assess the statistical significance of differences in means before and after the interventions in each group, the Wilcoxon test was applied. Results: Improvement of sleep quality in both groups, however comparing the differences in the scores of the Insomnia Severity Index between groups, group M + SH had a greater effect on both measures compared to the SH group. In M + SH group showed a statistically significant reduction in the categories of the Kupperman Menopausal Index: palpitations, paresthesia and Total Score, already in the SH group there was no significant reduction in any parameter of the Kupperman Index. A Significant improvement in overall quality of life (measured by WHOQOL-brief) score in group M + HS, and HS group had improvement in social relationships domain. Conclusion: The results suggest that meditation can be useful tool in the treatment of primary insomnia during the perimenopause. The quality of life during this period is also favored globally by daily meditation practice.

Introdução: A insônia está entre os mais frequentes transtornos que afetam a população na contemporaneidade, devido a mudanças hormonais e psicossociais importantes é muito prevalente na perimenopausa. Há uma relação ainda pouco estudada entre eficiência do sono e prática meditativa. Os tratamentos utilizados para insônia normalmente são de alto custo e paliativos. Objetivo: Avaliar o efeito da meditação na insônia (causada por sintomas característicos da perimenopausa) e qualidade de vida nesta fase da vida. Método: Ensaio clínico controlado para avaliar os efeitos da meditação em mulheres com insônia no período da perimenopausa e o impacto na qualidade de vida em 8 semanas de intervenção. O estudo foi realizado de abril a julho de 2013 com 33 mulheres na perimenopausa de idade entre 40 a 55 anos em 3 unidades de órgão público no município de São Paulo, SP. As participantes foram divididas aleatoriamente em dois grupos, um que praticou somente Higiene do Sono-HS (n=15) e outro que praticou Meditação + Higiene do Sono-M+HS (n=18). Foram realizados encontros semanais com as participantes de ambos os grupos para pratica de meditação em grupo e/ou critérios de higiene do sono. O grupo M+HS também realizou prática diária de meditação. Para avaliar a significância estatística das diferenças de médias antes e depois das intervenções em cada grupo foi utilizado o teste de Wilcoxon. Resultados: Houve melhora da insônia em ambos os grupos, no entanto comparando as diferenças de escore do Índice de Gravidade de Insônia entre os grupos estudados, o grupo M+HS teve um efeito superior em ambas as medições em relação ao grupos HS. No grupo M+HS, houve redução estatisticamente significativa nas categorias do Índice Menopausal de Kupperman: Palpitação, Parestesia e a Pontuação Total já no grupo HS não houve redução significativa em nenhum parâmetro do Índice de Kupperman. Houve melhora significativa da pontuação geral de qualidade de vida aferida pelo WHOQOL breve no grupo M +HS, e no grupo HS houve melhora no domínio relações sociais. Conclusão: Os resultados sugerem que a meditação pode ser ferramenta útil no tratamento da insônia primária durante o período da perimenopausa. A qualidade de vida durante este período também é favorecida de maneira global pela prática diária de meditação. / Introduction: Insomnia is one of the most common disorders that affect the population in contemporaneity, because of important hormonal and psychosocial changes is very prevalent in perimenopause. There is a still understudied relationship between sleep efficiency and meditative practice. The treatments for insomnia are usually expensive and palliative. Objective: Evaluate the effects of meditation in insomnia (caused by typical symptoms of perimenopause) and quality of life in this phase of life. Method: controlled clinical trial to evaluate the effects of meditation in women with insomnia during perimenopause and impact on quality of life in 8-week intervention. The study was conducted from April to July 2013 with 33 perimenopausal women aged between 40-55 years in 3 units of public organization in São Paulo, SP, Brazil. The participants were randomly assigned to two groups, one who performed only Sleep Hygiene-HS (n = 15) and another who performed Meditation + Sleep Hygiene - SH + M (n = 18). Weekly meetings were held with the participants of both groups to practice meditation in a group and / or criteria for the sleep hygiene. The M + SH group also performed daily meditation practice. To assess the statistical significance of differences in means before and after the interventions in each group, the Wilcoxon test was applied. Results: Improvement of sleep quality in both groups, however comparing the differences in the scores of the Insomnia Severity Index between groups, group M + SH had a greater effect on both measures compared to the SH group. In M + SH group showed a statistically significant reduction in the categories of the Kupperman Menopausal Index: palpitations, paresthesia and Total Score, already in the SH group there was no significant reduction in any parameter of the Kupperman Index. A Significant improvement in overall quality of life (measured by WHOQOL-brief) score in group M + HS, and HS group had improvement in social relationships domain. Conclusion: The results suggest that meditation can be useful tool in the treatment of primary insomnia during the perimenopause. The quality of life during this period is also favored globally by daily meditation practice.

Three studies were designed to investigate the effects of exercise-based lifestyle interventions including diet change and exercise training on cardiovascular and autonomic responses to various physical and mental challenges in untrained premenopausal women. In Study 1, the effects of different tasks designed to activate the sympathetic nervous system on autonomic control of cardiovascular functioning such as the Stroop colour-word task (Stroop) and lower body negative pressure (LBNP) in 20 untrained premenopausal women (22.6??0.7 years) were determined. In Study 2, a longitudinal exercise intervention strategy was used with 18 untrained premenopausal women (22.5??0.7 years) in order to investigate the effect of 15 weeks of high intensity intermittent exercise (HIIE) training on cardiac autonomic responses to mental challenge (Stroop) and LBNP. In Study 3, the effects of HIIE training combined with a Mediterranean-style eating plan and fish oil supplement (Fish oil, Exercise, Mediterranean diet; FEM) on cardiovascular function during mental challenge (Stroop) and physical tasks (handgrip and reactive hyperaemia) were examined in 32 overweight untrained premenopausal women (22.0??0.6 years). In these studies, forearm blood flow (FBF) was assessed using Hokanson Plethysmography with the venous occlusion technique. The surface electrocardiogram and continuous beat-to-beat arterial blood pressure were also monitored. Peak oxygen uptake was assessed using open-circuit spirometry (True Max 2400, ParvoMedics). In addition, body composition was measured using DEXA (dual energy X-ray absorptiometry; DPX-IQ, Lunar Radiation). Results from Study 1 indicate that FBF response to mental challenge in young females was smaller compared to previously obtained data from age-matched males. Furthermore, this FBF response to mental challenge was negatively correlated to insulin resistance estimated by the homeostasis model assessment (HOMA-IR) (r = - .52, p < .05). In addition, when cardiopulmonary baroreceptors were unloaded by a mild level of LBNP (-20 mmHg) during Stoop, FBF response to mental challenge (vasodilation) was abolished suggesting a large dependency of vasodilation response during mental challenge on cardiopulmonary baroreflex. After 15 weeks of supervised HIIE training, aerobic fitness improved (p < .05) whereas percent of body fat was significantly decreased (p < .05). In addition, recovery BP following Stroop was significantly reduced. Insulin resistance (HOMA-IR) was marginally decreased (p = .056). Women who had higher insulin resistance (HOMA-IR) lost less fat than women with lower HOMA-IR (r = .60, p = .088). In addition, change in FBF during Stroop after training was directly related to pretest insulin resistance levels (r = .68, p < .05). Therefore, HIIE training had a normalising effect on FBF response to mental challenge. PEP/LVET ratio at rest and during LBNP was also significantly increased in women with higher HOMA-IR suggesting a reduction in cardiac contractility via a decrease in sympathetic stimulation (r = .62, p = .076, r = .62, p = .75 respectively). In Study 3 results indicated that 12 weeks of the FEM trial significantly reduced percent of body fat (p < .001), fasting insulin (p < .05), interleukin-6 (p < .05) and cortisol (p < .05), and significantly improved aerobic fitness ( ; p < .001). With respect to cardiovascular and cardiac autonomic measures, rate pressure product (RPP) was significantly reduced at rest (p < .05) and during recovery after Stoop (p < .05), suggesting decreased myocardial oxygen consumption. In addition, baseline heart rate determined in the sitting position was significantly reduced (p < .05), while both baseline high frequency power (HF) determined in supine (p < .01) and cardiac baroreflex sensitivity (BRS) determined in the sitting position (p < .05) were increased after the FEM trial. In addition, BRS determined during mental challenge also marginally increased (p = .051). In summary, lifestyle intervention including HIIE training, Mediterranean-style eating plan, and a fish oil supplement significantly enhanced parasympathetic influence of the heart and improved fitness, blood profiles, and body composition.

Thesis (Ph. D.)--University of Missouri-Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 80-89). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 80-89). Also available on the Internet.

The purpose of this longitudinal repeated measures experimental study was to determine the effects of bone health testing using dual energy X-ray absorptiometry (DXA) on outcomes of intentions toward and actual engagement in bone health behaviors (calcium intake, vitamin D intake, physical activity) among perimenopausal women. The Perimenopausal Bone Health Behaviors Model was developed based on the Theory of Planned Behavior and guided this study to determine how perimenopausal women respond to DXA and bone health information compared to bone health information only.One hundred fifty community-based perimenopausal women (ages 35-55) were randomly assigned to an intervention group (n=75 DXA and bone health information) or to a comparison group (n=75 bone health information). Baseline demographic data were collected. The Prevention Intentions Questionnaire and Behaviors Questionnaire were administered at baseline, at two weeks, and at two months after both groups received assigned interventions.Results showed 32% (n = 24) of intervention group women had low bone density. The intervention of DXA and bone health information showed near-significance (p = .068) over the intervention of bone health information alone in affecting women's intentions, and showed near-significance in affecting calcium intake (p = .052). Lower bone density test scores were related to higher intentions (r(74) = -.23, p = .046) at two weeks after DXA and bone health information, and were related to improved vitamin D intake (r(73) = -.25, p = .03) at two months after DXA and bone health information. At study end, Attitudes contributed 27.0% of the variance in Intentions among women who received DXA and bone health information; Attitudes, Subjective Norms, and Perceived Behavioral Control contributed 62.0% of the variance in Intentions among women who received bone health information only.Nursing interventions focusing on perimenopausal women should include providing bone health information to all perimenopausal women. Interventions targeting attitudes toward bone health behaviors may motivate some perimenopausal women to participate in behaviors that contribute to decreased risk of osteoporosis. Early detection and intervention in perimenopausal bone loss may reduce osteoporosis morbidity and may impact women's quality of life, reduce financial consequences to individuals, families, communities, and the nation.

Three studies were designed to investigate the effects of exercise-based lifestyle interventions including diet change and exercise training on cardiovascular and autonomic responses to various physical and mental challenges in untrained premenopausal women. In Study 1, the effects of different tasks designed to activate the sympathetic nervous system on autonomic control of cardiovascular functioning such as the Stroop colour-word task (Stroop) and lower body negative pressure (LBNP) in 20 untrained premenopausal women (22.6??0.7 years) were determined. In Study 2, a longitudinal exercise intervention strategy was used with 18 untrained premenopausal women (22.5??0.7 years) in order to investigate the effect of 15 weeks of high intensity intermittent exercise (HIIE) training on cardiac autonomic responses to mental challenge (Stroop) and LBNP. In Study 3, the effects of HIIE training combined with a Mediterranean-style eating plan and fish oil supplement (Fish oil, Exercise, Mediterranean diet; FEM) on cardiovascular function during mental challenge (Stroop) and physical tasks (handgrip and reactive hyperaemia) were examined in 32 overweight untrained premenopausal women (22.0??0.6 years). In these studies, forearm blood flow (FBF) was assessed using Hokanson Plethysmography with the venous occlusion technique. The surface electrocardiogram and continuous beat-to-beat arterial blood pressure were also monitored. Peak oxygen uptake was assessed using open-circuit spirometry (True Max 2400, ParvoMedics). In addition, body composition was measured using DEXA (dual energy X-ray absorptiometry; DPX-IQ, Lunar Radiation). Results from Study 1 indicate that FBF response to mental challenge in young females was smaller compared to previously obtained data from age-matched males. Furthermore, this FBF response to mental challenge was negatively correlated to insulin resistance estimated by the homeostasis model assessment (HOMA-IR) (r = - .52, p < .05). In addition, when cardiopulmonary baroreceptors were unloaded by a mild level of LBNP (-20 mmHg) during Stoop, FBF response to mental challenge (vasodilation) was abolished suggesting a large dependency of vasodilation response during mental challenge on cardiopulmonary baroreflex. After 15 weeks of supervised HIIE training, aerobic fitness improved (p < .05) whereas percent of body fat was significantly decreased (p < .05). In addition, recovery BP following Stroop was significantly reduced. Insulin resistance (HOMA-IR) was marginally decreased (p = .056). Women who had higher insulin resistance (HOMA-IR) lost less fat than women with lower HOMA-IR (r = .60, p = .088). In addition, change in FBF during Stroop after training was directly related to pretest insulin resistance levels (r = .68, p < .05). Therefore, HIIE training had a normalising effect on FBF response to mental challenge. PEP/LVET ratio at rest and during LBNP was also significantly increased in women with higher HOMA-IR suggesting a reduction in cardiac contractility via a decrease in sympathetic stimulation (r = .62, p = .076, r = .62, p = .75 respectively). In Study 3 results indicated that 12 weeks of the FEM trial significantly reduced percent of body fat (p < .001), fasting insulin (p < .05), interleukin-6 (p < .05) and cortisol (p < .05), and significantly improved aerobic fitness ( ; p < .001). With respect to cardiovascular and cardiac autonomic measures, rate pressure product (RPP) was significantly reduced at rest (p < .05) and during recovery after Stoop (p < .05), suggesting decreased myocardial oxygen consumption. In addition, baseline heart rate determined in the sitting position was significantly reduced (p < .05), while both baseline high frequency power (HF) determined in supine (p < .01) and cardiac baroreflex sensitivity (BRS) determined in the sitting position (p < .05) were increased after the FEM trial. In addition, BRS determined during mental challenge also marginally increased (p = .051). In summary, lifestyle intervention including HIIE training, Mediterranean-style eating plan, and a fish oil supplement significantly enhanced parasympathetic influence of the heart and improved fitness, blood profiles, and body composition.

Thesis (M.S.)--University of Texas at El Paso, 2008. / Title from title screen. Vita. CD-ROM. Includes bibliographical references. Also available online.