Effect of laughter therapy on level of stress: A study among nursing students

http://doi.org/10.33698/NRF0074-  Lakhwinder Kaur, Indarjit Walia

Abstract : In a study of senescence of females, menopause is an important landmark, which is accompanied by various other changes. The female morphology also undergo a considerable change in this period. The present study was undertaken among 500 rural and 500 urban Jat Sikh women from the age group of 36 to 81 + years during 2001 to 2002 to ascertain relationship of age at menopause and morphological parameters and psychosocial stresses. Five yearly age groups have been formed and in each group a minimum of 50 women have been studied. Standardized tools were used to collect the data. Findings revealed that rural Jat Sikh women experience slightly early menopause then urban Jat Sikh women. It has also been found that in both settings of urban and rural, early menopausal women are shorter and lighter in weight, where as the late menopausal women are taller and heavier. It has been observed that early menopausal women have more stress score during their lifetime whereas the late menopausal women have lesser stress score during their lifetime in both rural and urban settings.

Key words :

Menopause, psychosocial stress

Correspondence at : Jasbir Kaur,

Principal,

College of Nsg. DMC, Ludhiana

Introduction

Climacteric is an important period in the life of women, during which ovulation and menstruation are arrested, which is referred as menopause that occurs around the age of 50 years. During the climacteric period, there is a gradual but progressive loss of ovarian functions accompanied by a variety of endocrine, somatic and psychological changes. Women show lot of variations in the age of menopause. Some women experience it as early as 35 years of age and in some normal menstruation continues up to the age of 56 years.1,2 The aging process is also enhanced during this phase. The physique of an individual as assessed from his somatotype may undergo change with advancing age. It has been reported that shrinkage takes place in various linear dimensions with advancing age. Moreover age at menopause may vary with stature or weight. Singal and Sidhu (1982) reported that heavier and taller females experienced menopause at a later age compared to the lighter and shorter women.3 Similar findings have also been reported by Luoto(1994)4.

Objective

To find the age at menopause and its association with morphological parameters and psychosocial stresses during the period of climacteric.

Methodology

The present study has been conducted on a cross-sectional sample comprising of 500 rural and 500 urban Jat Sikh women, ranging in age from 36 to 81 + years. The data have been collected from January 2001 to March 2002 from various villages and cities of Punjab. The data collected have been arranged in 10 age groups, each of five years duration starting from 35.5 to 40.49 years till 81+ years and in each group a minimum of 50 women have been studied. The data on 500 urban Jat Sikh women have been collected from Chandigarh, Phagwara, Ludhiana, Jalandhar and Patiala and on 500 rural Jat Sikh women have been collected from various villages. All women were questioned about the continuation and cessation of menstrual cycles. Standard techniques as given by Tanner et al.,(1969) were used to check height and weight.5 The psychosocial stress score for both rural and urban Jat Sikh women for the last one year and whole life has been obtained by applying presumptive stressful life events (PSLE) scale developed by Singh et al. (1983).6 Analysis has been undertaken by descriptive and inferential statistics.

Findings

In the present sample the median age at menopause has been calculated by applying probit analysis and found to be 47.54 years in urban and 46.67 years in rural Jat Sikh women. The differences in menopausal age of the two groups have not been found to be significant in statistical terms. Mean age of menopause has been found to be 46.91years in urban and 46.74 years in rural Jat Sikh women. From the median as well as mean age at menopause in urban and rural Jat Sikh women, it has been revealed that rural women experience slightly early menopause. The mean age at menopause in urban and rural Jat Sikh women fell in the age group 45-50 years. The fifth decade has been taken as a possible period of climacteric. (Table-1)

Table-1 : Mean, Median Age of Urban and Rural Jat Sikh Women                                   N=1000

 

Group Median age S. E. of Median age Mean age (Yrs)
Urban
n=500 47.54 3.05 46.91
Rural
n=500 46.67 4.48 46.74

As from the total sample only 241 women had attained menopause, so they were fur ther studied in relation to morphological parameters and stress score of whole life. For this purpose the data have been divided in to three groups.

  1. Early menopausal group – The women experiencing the onset of menopause before 45 years of
  2. Middle group – The women experiencing the onset of menopause between 45-49 years
  • Late menopausal group – The women experiencing the onset of menopause after 50 years and As from the total sample only 241 women had attained menopause, so they were fur ther studied in relation to morphological parameters and stress score of whole life. It has been seen in both setting of urban and rural that early menopausal women are shorter and lighter in weight, where as the late menopausal women are taller and heavier (Table no. 2) and the middle group have their height and weight in between these groups. Urban Jat Sikh women are heavier and taller than their rural counter parts in all the three groups.

Table 2 : Age at menopause in relation to Weight, Height and Stress.         N=241

Area Age at menopause (yrs) No of Women Weight (Kg) Height (cm) Stress score of Whole life
 

Urban

 <45(early menopausal) 24 65.79 156.28 464.42
45-49 (middle group) 80 67.97 156.39 410.04
>50 (late menopausal) 16 69.56 159.94 442.25
 

Rural

 <45(early menopausal) 11 58.45 153.78 593.27
45-49 (middle group) 98 62.07 154.11 494.52
>50 (late menopausal) 12 64.83 154.59 443.67

It has been observed that early menopausal women have more stress score during their life time whereas the late menopausal women have lesser stress score during their life time in both rural and urban women (Table no. 2). The urban Jat Sikh women have more weight, height and less stress score than their rural counter parts in all the three groups experienced slightly late menopause. The stress score has been higher in rural women in all the three groups with highest score in the early menopausal group. It clearly reveals the influence of stress on the health status of an individual. Therefore the healthier women have experienced later onset of menopause and have lesser stress score during their lifetime. The women who have experienced early menopause have more stress score of whole life than the women who experienced the menopause in the later age in both the groups.

Discussion

Women show lot of variation in the age of menopause. Some women experience it as early as 35 years of age and some women experience it as late as 56 years.1,2

Many investigators have repor ted different ages of menopause in different population of India. Rakshit (1962) reported the onset of menopause at 45.8 years in Brahmins of Maharashtra where as in the Brahmin of West Bengal, the mean age at menopause has been reported to be 47.1 years1. For Assamese females the mean age at menopause has been 48.44 years.7 Ghosh and Kumari (1973) reported menopause  at 44.6 years and 46.53 years in Sindhu and Khatris of Delhi.8 The onset of menopause has been reported by Kar and Mahato (1975) to be 43.63 years among Singhpho of Arunachal Pradesh.2 Mean menopause age of Punjabi females has been reported to be 44.68 years (Singh and Ahuja, 1980).9 Singal and Sidhu (1982) repor ted median age at menopause 48.62 years in Jat Sikh females and 47.33 years in Bania females with significant difference of 1.29 years3.

In many studies carried out on different population residing in different countries have also reported different ages for onset of menopause. McKinlay et al. (1972) found the menopausal age to be 47.49 years in British women.11 Treolar (1974) reported age at menopause as 49.5 years in Minnesota.12 Goodman et al. (1977) found the menopause age to be 49.88 years in different groups of Hawai.13 In South Africa menopausal age is 51.44 years in white and 50.7 years for Bantu females (Frere 1971).14 Jan and Zukowski (1988) studied a sample of 7337 women from Poland and found the age at menopause to be 49.54 years.15 Luoto et al.(1994) showed the median age for menopause to be 51 years for women in Finland. They also reported that median menopausal age for smokers and nulliparus women was 50 years and for non- smokers and women whose first full term pregnancy occurred before age of 25 years was 52 years.4 Berg (1999) conducted study on women who were born in Philippines and lived in America and reported menopausal age as 48.9 years.16 North et al. (2000) reported 46.94 years as mean age of menopause in American Indian women.17

Thomas et al.(2001) presented summery table including mean value of the age at menopause of 26 countries and found the 44.6 years in India (Punjab) as compared to mean age of menopause at 51.3 years in USA. It has also been reported that there has been significant positive relationship between age at menopause and age at first childbirth. Women with a more number of children might have started their reproductive life earlier.18 Berg, (1999) stated that neither the age at menarche nor the number of pregnancies and children born were significantly related to age at menopause.16

Several other factors significantly influence age at menopause such as genetic parameters19 (Damon, et al., 1989), Socio economic conditions4 (Luoto et al., 1994), Nutritional status and life style20,21 (Beall 1983 and Parazzini et al., 1992), Seasonality22 (Boldsen 1990) physical activity23,24 (Malina 1983; Baker 1985) and altitude level25,20,26 (Flint 1976; Beall 1983, Kapoor and Kapoor 1986), Menarche and Parity11,16,18 (Mckinlay et al., 1972, Berg 1999, Thomas 2001).

The later onset of menopause in urban Jat Sikh women may be attributed to better socio-economic conditions as compared to rural women. Parazzini et al. (1992) and Luoto et al. (1994) also reported that women from higher socio-economic status experience menopause at a later age.21,4 Sethi et al. (1996) also reported later onset of menopause in working Khatri females as compared to non- working females because the working women were in a better financial position and have better standards of living.10

Singal and Sidhu (1982) also reported that taller and heavier females experience menopause at a later age as compared to lighter and shor ter females who have experienced menopause at an early age in both Jat Sikh and Bania females in Punjab.3 In the present study, rural Jat Sikh women have experienced menopause at an early age than urban women. Sethi et al. (1996) also reported that late menopausal women are taller and heavier in Khatri working women in comparison with early and middle menopausal women. However no consistent trend has been observed in non-working Khatri women.10

Conclusion

Mean age at menopause of urban Jat Sikh women was 46.91 years, whereas it was 46.74 among rural Jat Sikh women. Tall and heavy women attained menopause at a later age, whereas shor t and lighter women attained at an early age. Stress score of whole life was found to be more among women who attained early menopause in both urban and rural settings.

References

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