Risk of coronary heart disease, dietary fat modification, stages of change, and self-efficacy in surgical and natural postmenopausal women

The purpose of this nonexperimental two-by-two design study was to determine whether a difference exists in postmenopausal women between those who have undergone surgical menopause and those who have experienced natural menopause and between those who are taking hormone replacement therapy (HRT) and those who are not taking HRT on the variables of risk of coronary heart disease (CHD), dietary fat modification, stages of change, and self-efficacy. The framework for the study was Bandura's self-efficacy theory and Prochaska and DiClemente's transtheoretical model of change.

Seventy-seven subjects were recruited from an internal medicine physician's practice at one large metropolitan multispecialty outpatient clinic. Instruments were the Demographic Data Form, Anderson et al.'s Risk of Coronary Heart Disease Table, Kristal et al.'s Food Habits Questionnaire, Curry et al.'s Stage of Change to Dietary Fat Reduction, and Sallis et al.'s Self-Efficacy for Health-Related Diet Behaviors. The independent variables--type of menopause and hormone status--had two levels. The four dependent variables were: CHD risk, dietary fat modification, stages of change, and self-efficacy.

Two-way ANOVAs were used to determine differences between the two independent variables on the dependent variables. Findings indicated that those women who experienced natural menopause and were not on HRT were at greater risk for CHD than those women who underwent surgical menopause, the majority of whom were on HRT. The majority of women who experienced surgical menopause were on HRT. In addition, those women with natural menopause had a greater risk of developing CHD over time than their counterparts. These significant findings indicated that women who experience natural menopause should receive education on the risks and benefits of HRT. Hopefully, this education will enhance their ability to wisely choose hormone replacement therapy.