Effectiveness of Soybean Vs Chickpea on Menopausal Symptoms Among Women in Selected Rural Areas, Puducherry, India Iniyaval R1, Lavanya S2, Renuka K3

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ORIGINAL ARTICLE Effectiveness of Soybean vs Chickpea on Menopausal Symptoms among Women in Selected Rural Areas, Puducherry, India Iniyaval R1, Lavanya S2, Renuka K3

Abstract Introduction: An average Indian woman spends almost one-third of her life span in the postmenopausal phase enduring the consequences of hormonal decline. About 89.3% menopausal women experience at least one or more menopausal symptom(s). Soybeans and chickpeas naturally contains the phytoestrogens that are used to mitigate the menopausal problems. Hence, to ensure a quality life to these women, attention needs to be focused on menopausal problems to alleviate these problems through appropriate interventions. Natural estrogens can be very helpful during menopause to mitigate the problems. Objective: To evaluate and compare the effectiveness of soybean vs chickpeas on menopausal symptoms among women. Materials and methods: True experimental research design was adopted for the study. A total of 150 menopausal women were selected by the purposive sampling technique with randomization (50 samples in each group). Group I received soybean, group II received chickpea, and group III was the control group. Pretest and posttest were done by using the Greene Climacteric Menopausal Assessment Scale. About 50 g of boiled soybean and chickpea were given to group I and group II for 21 days, respectively. Results: The findings implicate that the menopausal women were in the age group of 49–52 years. The pretest mean standard deviation for the level of menopausal symptoms of the soybean group was 67.0 ± 4.745 and posttest was 33.4 ± 6.021. The pretest mean standard deviation for the level of menopausal symptoms of the chickpea group was 66.8 ± 4.929 and posttest was 43.2 ± 7.301. Soybean and chickpea were effective in reduction of menopausal symptoms in both group I and group II. Results show that the t value for group I was 32.4 and group II was 22.60, which was significant at p < 0.001 level. Conclusion: The study concludes that soybean was effective in reduction of menopausal symptoms among women than chickpea. Keywords: Chick pea, Menopausal symptoms, Soybean. Pondicherry Journal of Nursing (2019): 10.5005/jp-journals-10084-12127

Introduction 1,2Department of Obstetrics and Gynecology Nursing, Kasturba Gandhi According to the Indian Menopause society, the number of Nursing College, Sri Balaji Vidyapeeth, Puducherry, India menopausal women is approximately 43 million and it may reach 3 1,2 Department of Medical Surgical Nursing, Kasturba Gandhi Nursing 103 million by 2026. Menopausal women are the most vulnerable College, Sri Balaji Vidyapeeth,, Puducherry, India group affected due to physiological changes especially with an Corresponding Author: Lavanya S, Department of Obstetrics and estrogen-deficient state and is susceptible to various vasomotor, Gynecology Nursing, Kasturba Gandhi Nursing College, Sri Balaji psychosocial, physical, and sexual symptoms,3–5 which can Vidyapeeth, Puducherry, India, Phone: +91 9994747440, e-mail: significantly affects the quality of life and decline their perceptions [email protected] 6 of well-being (Fig. 1). How to cite this article: Iniyaval R, Lavanya S, Renuka K. Effectiveness of Soybean vs Chickpea on Menopausal Symptoms among Women in Selected Rural Areas, Puducherry, India. Pon J Nurs 2019;12(4):82–86. Source of support: Nil Conflict of interest: None

Administration of estrogen can aid in managing the menopausal symptoms.7 Various studies have proven that phytoestrogen is the natural estrogen that is found in soybean and chickpea.8–10 Instead of pharmacological management, reduction of menopausal symptoms can be achieved by the supplementation of soybean and chickpea.10–12 The main responsibility goes to nurses for providing comprehensive health care to them and they must bring newer strategies to promote the women support in India to develop health and well-being.12–15 This study examines the currently available evidence supporting the use of soybean and chickpea for alleviating Fig. 1: Percentage of menopausal women in India the menopausal symptoms.

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Effectiveness of Soybean vs Chickpea on Menopausal Symptoms among Women in Selected Rural Areas, Puducherry, India

Objectives Pretest and posttest was conducted using the tool that consists of two sections. Section I—demographic variables, Section II— • To assess the menopausal symptoms among women Modified Greene Climacteric Assessment Scale for menopausal • To evaluate the effectiveness of soybean vs chickpea on symptoms. Data were collected using the interview schedule from menopausal symptoms among women all the samples. The components of the Modified Greene Climacteric • To compare the effectiveness of soybean vs chickpea on Assessment Scale include the physiological and psychological menopausal symptoms among women. symptoms of menopause. The menopause symptoms were • To find out the association between menopausal symptoms assessed with the tool and were graded into mild, moderate, and among the women with the selected demographic variables severe symptoms. The SPSS 16 Epidata version 2.2.2.186 was used for the data analysis. Data analysis and interpretation was done by descriptive statistics: frequency, percentage, mean, standard Hypotheses deviation, and inferential statistics: paired t test, independent t test, and Chi-square test (Flowchart 1). • H1—Menopausal symptoms differs among women before and after soybean vs chickpea supplementation. Results • H2—Effectiveness of soybean vs chickpea supplementation differs among women with menopausal symptoms. Major Findings • H3—Menopausal symptoms differ among women with the • Description of demographic variables among menopausal selected demographic variables. women: majority of women in group I (26; 52%), group II (29; 58%), and group III (24; 48%) were between 49 years and 52 years of age. Materials and Methods • Assessment of level of menopausal symptoms among women: The quantitative research approach was adopted with true Figures 2 to 4 shows the percentage wise distribution of pretest experimental research design. The setting of the study was selected and posttest of menopausal symptoms among women. rural areas in Puducherry. Population was women with menopausal • Group I: In the pretest, 43 (86%) participants had severe symptoms. Sampling size was 150 samples (50 samples in each group) menopause symptoms and 7 (14%) had moderate and was calculated by using the power analysis method. The samples menopausal symptoms. In the posttest, average of 27 women were selected based on the inclusion criteria. The sampling technique (54%) had moderate rates of menopausal symptoms and 23 used was the purposive sampling technique with the randomization (46%) had mild rates of menopausal symptoms. lottery method. Women who are picking up the lot A are group I and • Group II: In pretesting, the majority of women (38; 76%) had were administered with 50 g of boiled soybeans, women getting lot B extreme menopause symptoms and 12 (24%) had moderate are group II and were administered with 50 g of boiled chickpeas, and menopause symptoms. During the posttest, 40 participants women who are picking lot C are group III and were in daily routine. (80%) had moderate rates of menopausal symptoms and 10 The duration of intervention is 3 weeks (21 days). (20%) had mild rates of menopausal symptoms.

Flowchart 1: Research methodology

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Fig. 2: Percentage distribution of pretest and posttest of the level of the menopausal symptoms among women in group I (soybean) Fig. 3: Percentage distribution of pretest and posttest of the level of the menopausal symptoms among women in group II (chickpea)

Fig. 5: Comparison of the pretest and posttest of the level of the menopausal symptoms among women in groups I, II, and III

Table 1: Comparison of the group I vs. group II vs. group III in the posttest Fig. 4: Percentage distribution of pretest and posttest of the level of the level of menopausal symptoms among women (n 150) menopausal symptoms among women in group III (control) = Posttest level t value • Group III: In the pretest, 38 (76%) females had extreme rates of of menopausal Standard independent menopausal symptoms and 12 (24%) had moderate levels of symptoms Groups Mean deviation t test p value menopausal symptoms and in the posttest, 33 (66%) females 1 Group I 33.48 6.021 −7.322 0.001* had serious levels of menopausal symptoms and 17 (34%) Group II 43.28 7.301 had moderate levels of menopausal symptoms. 2 Group II 43.28 7.301 −17.51 0.001* • Soybean and chickpea therefore have been successful in Group III 65.96 5.529 reducing menopausal symptoms. 3 Group III 65.96 5.529 28.09 0.001* • Evaluation of soybean, chickpea, and control effectiveness among women’s menopausal symptoms: Figure 5 presents Group I 33.48 6.021 a distinction between the pre- and posttest of menopausal *p < 0.001 highly significant symptoms in groups I, II, and III people. • Statistics show that the t value for group I was 32.4 and group and p value 0.001 indicates statistically highly significant II was 22.60, which was significant at p = 0.001 and for group between group I and group II. III t was 2.124, which was marginally significant at p = 0.039, • The mean score of menopausal symptoms was 43.28 ± respectively. There is a major difference between soybean 7.301 in group II and 65.96 ± 5.529 in group III. In post test, and chickpea supplementation in pre- and posttest values the independent ‘t’ test value −17.51 and p value 0.001 for group I and group II, respectively. Both soybean and indicates statistically highly significant between group II and chickpea supplementation has therefore been successful in group III. reducing menopausal symptoms among women in group I • The mean score level of menopausal symptom was and group II. 65.96 ± 5.529 in group III and 33.48 ± 6.021 in group I. In post • Comparison of the effectiveness of soybean, chickpea, and test, the independent ‘t’ test value 28.09 and p value 0.001 control groups on menopausal symptoms among women: indicates statistically highly significant between group III • Table 1 indicates that in group I the mean score for and group I. menopausal symptoms was 33.48 ± 6.021 and in group II was • Association of the level of menopausal symptoms among 43.28 ± 7.301. In post test, the independent ‘t’ test value −7.322 women with selected demographic variables:

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• Using Chi-square test, there is no substantial correlation with selected demographic variables. Therefore, the stated between demographic variables and the level of menopausal hypothesis (H3) was rejected. symptoms among women in group I, group II, and group • The present objective was opposed by Mrs Manubaikm (2007), III. Therefore, menopausal symptoms did not vary among in which there is no association found between menopausal women with selected demographic variables. symptoms and their selected demographic variables such as age, religion, education, occupation, family type, income, marital Discussion status, and dietary pattern. The present study reveals the effectiveness of soybean vs chickpea Conclusion on menopausal symptoms among women in selected rural areas of Puducherry. The results suggest that the menopausal women were in the 49–52 The first objective of the study was to assess the level of year age range. The pretest mean standard deviation for level of menopausal symptoms among women. menopausal symptoms of group I was 67.0 ± 4.745 and posttest was 33.4 ± 6.021. The pretest mean standard deviation for the • The pretest and the posttest values in groups I, II, and III show level of menopausal symptoms of group II was 66.8 ± 4.929 and in that the level of menopausal symptoms differs among women posttest was 43.2 ± 7.301. Soybean and chickpea were effective in before and after soybean, chickpea, and control groups. Hence, reduction of menopausal symptoms in both group I and group II. the stated hypothesis (H1) was accepted. Results show that the t value for group I was 32.4 and group II was • An experimental study was conducted by Ms Rukmani (2010); in 22.60, which was significant at p < 0.001 level. The study concludes her study majority of menopausal women (60%) had moderate that soybean was more successful than chickpea in reducing symptoms, 40% of women had severe symptoms during pretest, menopausal symptoms among women. Therefore, soybean and whereas in posttest after the supplementation of soybeans all chickpea have been effective in reducing the effects of menopause. menopausal women (100%) had moderate symptoms and no Soybean, by comparison, has been more effective in alleviating one had severe symptoms. women’s menopause symptoms than chickpea. The second objective of the study was to evaluate the effectiveness of soybean, chickpea, and control on menopausal Scientific Implication and symptoms among women. Recommendation • There is significant difference between pretest and posttest • A similar study may be replicated on a large sample, thereby values of soybean and chickpea supplementation in group I and findings can be generalized for a large population. group II, respectively. Therefore, both soybean and chickpea • Soybean and chickpea should be administered by the health supplementation was effective in reduction of menopausal centers for the well-being of the menopausal women. symptoms among women in group I and group II. Through • Have to improve postmenopausal women’s quality of life by the mean score, soybean was more effective than chickpea in creating awareness about postmenopausal symptoms and their reduction in the level of menopausal symptoms among women. treatment by taking steps for lifestyle modifications. 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