الفهرس 
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Abstract
Summary
Vitamin D deficiency may be more common in peri-menopausal women than previously that impair quality of life. The occurrence of vitamin-D-deficiency state also varies across the lifespan, this is particularly apparent for women. In premenopausal women, vitamin D deficiency may lead to osteoporosis and an increased risk of breast and colon cancer. In postmenopausal women, a further increase occurs in the expression of these malignancies and in bone loss. In addition, muscle weakness, postural instability, falls, osteoporotic fractures, cognitive impairment, depression and, ultimately, the frailty syndrome become expressions of the deficiency state.
Perimenopause means ”around menopause” and refers to the time during which the body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition. Women start perimenopause at different ages. That may notice signs of progression toward menopause, such as menstrual irregularity, sometime in 40s. But some women notice changes as early as their mid-30s. The level of estrogen in the body rises and falls unevenly during perimenopause. The menstrual cycles may lengthen or shorten, and may begin having menstrual cycles in which ovaries don’t release an egg (ovulate)
The present study aimed to assess perimenopausal women’s perception regarding vitamin D deficiency through assessing perimenopausal women’s knowledge regarding vitamin D deficiency and assessing perimenopausal women’s attitude regarding vitamin D deficiency. A descriptive study was carried out at the gynecological outpatient clinic at Maternity Hospital Ain Shams University. A Purposive sample with criteria women age between 35-55 years regardless their education level with different marital status and number of gravida and para, (311) perimenopausal women were involved in this study.
A pilot study was carried out on 10% of total sample size (31) women under the study; for testing clarity, arrangement of the items, applicability of the data collection tools and time consuming for each tool.
The data had been collected by using tool 1 structured interviewing questionnaire which it was consisted of four parts. Part one was designed to assess perimenopausal women’s general characteristic and the second part was designed to assess their knowledge regarding vitamin D deficiency with the scoring system responses ranged from (1-2): (2) correct answer and (1) incorrect answer/ don’t know, while the total knowledge scored was ranged between (0-18) and other tool Lirket attitude scale to assess perimenopausal women’s attitude regarding vitamin D deficiency with scoring system each statement took 3 responses in which score (1) denote disagree, score (2) denote uncertain and score (3) denote agree and the total attitude score range from 12 to 36 which divided into negative attitude<65% from total score and positive attitude > or = 65%from total score.
The main results of this study revealed that:
• Women age range from <40 - >50 years with mean age (43.17+5.82), 71.7% of them from urban areas, 34.1% of them Secondary educated and 65.9 % were not working and 76.5% of them married women.
• 48.5% of the studied sample delivered normal, and 44.1% of them had pregnancy from 1-3 times, and 59.8% of them had no abortion. It were revealed that 34.2% of them had pregnancy complication as preeclampsia, gestational diabetes, (42.1%, 21.05%) respectively. Otherwise 24.6% of them had delivery complication as PIH, bleeding during delivery, premature birth, (28.4%, 26.9%, 25.4%) respectively. Also 22.9% of them had postpartum complication as postpartum hemorrhage, postpartum depression, (32.2%, 30.6%) respectively.
• 79.4% of the studied sample exposed to sunlight daily, while 76.2% of them never using sunscreen / sun protection and 62.7% of them not had foods rich in vitamin D. 48.2% of studied sample reported that they did exercise regularly, 69.3%of them did low – moderate exercise and 44.6% of them did exercise from 60 to 120mins per week.
• Total knowledge score of studied samples (80.4%) had satisfactory total knowledge score regarding vitamin D deficiency while (19.6%) of them had unsatisfactory total knowledge score about vitamin D deficiency.
• The overall score of studied samples regarding vitamin D deficiency revealed that (91%) of the studied sample had a positive total attitude score and (9.0%) of them had negative total attitude score regarding vitamin D deficiency.
• There was statistically significant relation between the studied sample’s total knowledge score and their general characteristics regarding their residence, educational level and occupation.
• There was statistically significant relation between the studied sample’s total knowledge score of vitamin D and their life style history regarding doing exercise regularly, taking vitamin D supplements and exposure to sun light at (p< 0.05).
• There was highly statistically significant relation between attitudes of studied sample regarding vitamin D deficiency with their educational level. Meanwhile, there was statistically significant relation between total attitude score of studied sample regarding vitamin D deficiency and their occupation.
• There was highly statistically significant relation between total attitude score of studied sample regarding vitamin D deficiency with their life style history regarding duration of exposure to the sun light, eating foods rich in vitamin D on a daily basis and eat oily fish that rich in vitamin D on a daily basis at (P < 0.01).Meanwhile, there was statistically significant relation between total attitudes score of studied sample regarding vitamin D deficiency with their life style history regarding doing exercise regularly at (p < 0.05).
• There were a positive correlation between the studied sample’s total knowledge score regarding vitamin D deficiency and their level of total attitude score.
Conclusions:
• The perimenopausal women’s perception in term of their knowledge & attitude related to vitamin D deficiency; the study findings emphasized that the majority of the studied samples had satisfactory total knowledge score regarding vitamin D deficiency while less than one fifth of them had unsatisfactory level, as well as the majority of the studied samples had a positive total attitude score toward vitamin D deficiency, In addition to there was a positive correlation between total knowledge score and level of total attitude score regarding vitamin D deficiency of the study sample.
Recommendations:
• Establish perimenopausal educational program to increase women health awareness about screening for vitamin D deficiency.
• Application of preventive strategy through evidence based practices information to prevent vitamin D deficiency through face book group or what’s App.
Further study:
• Effect of self-care guideline on perimenopausal women’s screening regarding vitamin D deficiency.
• Barriers & factors associated with lifestyle preventive measures regarding vitamin D deficiency.