Effectiveness of an integrative health-care model for climacteric-stage women

Abstract

Objectives To evaluate an integrative health-care model (IHCM) with an empowerment approach for self-care in terms of improving health-related quality of life (HR-QoL) and lifestyle.

Methods We conducted a field trial with one intervention (IHCM) and one comparison group receiving usual care (UC), with ex ante and ex post measurements. The IHCM was provided for 3 months to each woman in the first group, with follow-up of both groups at 3 and 6 months. The differences in differences estimator was used to assess the effect of intervention, adjusting for clinically important covariates in the framework of a generalized linear regression model.

Results A total of 380 women (IHCM 190 and UC 190) participated in the study. The differences in differences estimator between IHCM and UC for aerobic physical activity was 81 and 87 min/week at 3 and 6 months, respectively; for consumption of dairy products, fruit and vegetables the estimator was 4.8, 6.6 and 9.4 servings per week respectively at 3 months, and 3.9, 6.3 and 9.7 servings at 6 months. The effect of IHCM on HR-QoL at 3 months was greater for the domains of vasomotor, somatic symptoms and sleep problems (11.7, 10.0 and 13.2 points, respectively); at 6 months the differences of major positive change were observed in the domains of memory/concentration, vasomotor symptoms and sleep problems (12.2, 10.4 and 10.8 points, respectively).

Conclusion The results support the importance of patient-centered health care during the climacteric stage, within integrative care programs with an empowerment approach.

Key words::

• INTEGRATIVE HEALTH-CARE MODEL
• CLIMACTERIC STAGE
• HEALTH-RELATED QUALITY OF LIFE
• SELF-CARE
• LIFESTYLE

ACKNOWLEDGEMENTS

The authors would like to thank Dr Roberto Olivares-Santos, chief of the Education Department of the IMSS Family Medicine Clinic, Number 10. We are also grateful to Dr Victoria Pineda Aquino, chief of the Education Department, and Dr Eduardo Iturburu Valdovinos, Medical Director of IMSS Family Medicine Clinic, Number 20, as well as the chiefs of clinical services at both family medicine clinics. Coordination of the nurses’ work by Leticia Rodriguez-Aguilar was invaluable to the successful completion of our study.

Conflict of interest The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper. The views and opinions expressed in this article are those of the authors and do not reflect the official policy or position of the institutions for which the authors work.

Source of funding The study is sponsored by the IMSS, grant number FIS/IMSS/PROT/G09/740.