Page 316 - Encyclopedia of Nursing Research

MENOPAUSE n 283

Tao, & Mitchell, 2007; Woods & Mitchell, focused on women with breast cancer or
2010; Woods et al., 2008). The chronology of other contraindications to estrogen use. This
symptoms has been tracked using health work is exemplified by Carpenter’s clinical M
diaries and repeated measures of symptoms trial demonstrating the efficacy of on paced
over the course of the menopausal transition respiration for reduction of hot flash bother
for as long as 20 years (Woods et al., 2007). and interference (Carpenter, Neal, Kimmick,
In addition, the staging system has been & Sotrniolo, 2007) as well as Cohen’s research
useful in discerning when changes in lipid on acupuncture for hot flashes (Cohen,
levels and metabolic markers related to Roussouw, & Carey, 2003).
healthy aging (Lee et al., 2009). Healthy aging is increasingly under-
Factors associated with symptom sever- stood in relation to a life span view of health.
ity span biological, behavioral, social, and cul- This perspective is beginning to permeate
tural. Biological hypotheses accounting for the understanding of menopause and its
hot flashes have addressed glucose metabo- effects on future health. Although most bio-
lism (Dormire & Bongiovanni, 2008; Dormire medical researchers have emphasized the
& Howharn, 2007), serotonin (Carpenter et al., consequences of menopause and hormone
2009), and gene polymorphisms influencing changes on osteoporosis, cardiovascular dis-
estrogen synthesis, metabolism, and recep- ease, diabetes, and more recently metabolic
tors (Woods et al., 2006). syndrome, nurse researchers have empha-
Menopause among special populations sized health promotion and prevention strat-
of women has attracted the interest of nurse egies that may also alleviate symptoms, such
scientists, as exemplified by Carpenter’s work as use of health education and cognitive-
focusing on women with breast cancer who behavioral therapy interventions.
experience induced menopause. This body of Although contributions to symptom
work has contributed not only to understand- management from nurse investigators are
ing utility of hot flash monitors to assess skin beginning to influence the field of menopause
temperature but also use of increasingly care, trials examining nonpharmacological
more sophisticated approaches to under- agents compared with standard care proto-
standing symptoms (Carpenter, Monaham, & cols are needed. Given the pressing need for
Azzouzz, 2004). Carpenter (2001) developed evidence to guide primary care interven-
the Hot Flash Daily Symptom Interference tions, new models of therapeutics should be
Scale to further understand the degree to tested in these settings. Tailoring therapies to
which hot flashes interfered with multiple women from diverse ethnic backgrounds will
dimensions of life, including work, social, require collaboration between investigators
leisure, sleep, mood, concentration, relation- trained to conduct clinical trials and those
ships, sexuality, and enjoyment as well as schooled in culturally appropriate strategies
asking women to describe the extent to which for the delivery of care. In addition, health
they were bothered by their symptoms. education about menopause delivered in pri-
Following publication of the results of mary care and community settings should be
the Women’s Health Initiative Trial, women examined for effects on women’s uncertainty
exhibited increased interest in nonhormonal about what to expect during the menopausal
therapies for symptoms related to meno- transition and postmenopause.
pause. Given the recommendation to women Although nursing research on symp-
who experienced breast cancer to avoid using tom clusters is commonplace in the oncology
hormone therapy, the field of nonpharmaco- specialty, identification of symptom clusters
logical approaches to managing menopause is just beginning in studies of menopause
symptoms has also been enriched by contri- (Cray Woods, & Mitchell, 2010). Growing
butions of nurse investigators whose work evidence that women experience clusters of