The Correlation between Menopausal Women's Attitude Towards Menopause and Depression in Northeast Iran

The Correlation between Menopausal Women's Attitude Towards Menopause and Depression in Northeast Iran | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Correlation between Menopausal Women's Attitude Towards Menopause and Depression in Northeast Iran Razieh Pirouzeh, Marzieh Mahmudimanesh, Zeynab Ghorbani, Ahmad Sadeghi, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4028891/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Menopause is a crucial and inherent biological event in women's lives. Menopausal women are more prone to depression than individuals who are not experiencing menopause. This study aims to establish the correlation between women's attitudes toward menopause and depression in Esfarayen, Northeast Iran. Methods: This descriptive-analytical study included 335 menopausal women referring to health centers and health houses in Esfarayen using multistage sampling. Data collection tools included a demographic information questionnaire, the Knowledge and Attitude Toward Menopause Questionnaire by Noroozi et al., and the Beck Depression Inventory-II (BDI-II). The data were analyzed using descriptive and analytical statistics with SPSS version 26. Results: The participants' mean age was 55.81 ± 5.30 years, and 59.7% lived in urban areas. The mean score of attitudes towards menopause in menopausal women was 30.04 ± 4.28, and the mean depression score was 10.03 ± 8.6. There was a significant difference in attitude toward menopause among different levels of education, income satisfaction, residential status, marital status, and living arrangements. According to the results of multiple linear regression analysis, residential status (β = -1.451, p = 0.007), income satisfaction (β = 0.803, p = 0.027), and living arrangements (β = 1.627, p = 0.026) were predictors of attitude toward menopause. There was a significant inverse relationship between participants’ attitudes toward menopause and depression. Conclusion: This study provides deeper insight into the relationship between attitude toward menopause and depression in menopausal women, which can guide healthcare providers toward offering a valid educational package or protocol to improve the health and quality of life during the menopausal period. menopausal symptoms attitude depression attitudes towards menopause women Figures Figure 1 Background The menopause is a normal occurrence that marks the end of the menstrual cycle and a decline in ovarian function. It is typically identified retrospectively; the only reliable way to determine if a woman has reached this stage is the cessation of the menstrual cycle (amenorrhea) for 12 consecutive months [1]. Women undergo social, psychological, and physical changes during menopause [2], leading to several mental and physical symptoms. Urogenital symptoms, such as dyspareunia, vaginal dryness, and vaginal atrophy, and vasomotor symptoms, such as hot flashes, joint pain, and night sweats, are examples of physical symptoms. Anxieties, stress, and mood swings like hopelessness and despair are common in menstruating women, and they can all contribute to the onset of depression symptoms [2-5]. Sociocultural variables, lifestyle choices, and attitudes towards menopause can cause these symptoms to last longer, be more intense, or have different impacts on different populations [2, 6, 7]. On the other hand, menopausal transition is accompanied by challenges regarding social and gender roles, changes in family relationships and structures, and professional positions; these stress-inducing factors make women in this period more vulnerable to depression [8]. Depression, a lifelong condition, may be associated with other severe conditions [2]. Depression affects more than 300 million people globally, with women being 70% more impacted than males. Furthermore, depressive symptoms in women can be more severe and have a higher risk of recurrence [8]. A study by Mulhall et al. demonstrated that menopausal status is associated with the risk of depressive and anxiety symptoms. Depressive symptoms are more likely to occur before menopause, while anxiety symptoms are more likely to increase after menopause. During the menopausal stage, even women without a prior history of anxiety or depression are more susceptible to developing symptoms of anxiety and depression compared to the pre-menopausal stage [9]. For a successful menopausal transition, women's attitudes toward the changes of this period determine their experiences [2]. Therefore, women's awareness of the phenomenon of menopause plays an essential role in their mental, psychological, and physical health [10]. Women who know about menopause are more likely to embrace the changes during this phase. With heightened awareness and a positive attitude, they are more inclined to seek specialized healthcare [4]. Research has emphasized the crucial impact of attitude in enhancing quality of life; however, perceptions, beliefs, and attitudes can differ among different countries [11]. Due to increased life expectancy, more women are expected to spend one-third or more of their lives in menopause [11]. The average age of menopause in Iran is 48.26 years, with a range of 46.85 to 49.67 years. By 2036, about 17 million of Iran's population is estimated to be women aged 40 to 60; therefore, many women will experience this transition [12]. The menopausal period is a crucial stage in women’s lives; however, there is a lack of sufficient studies on its relationship with depression, as well as the impact of attitudes towards menopause on the quality of life during this period [11]. This study aimed to answer the following questions, so that the results can be used for interventions to improve the quality of life and proper planning and management for a healthy menopausal experience. 1. What is the status of attitudes towards menopause and depressive symptoms in menopausal women? 2. How do women's attitudes towards menopause and susceptibility to depression in menopausal women vary by demographic variables? 3. Is there a significant relationship between attitudes towards menopause and depression in menopausal women? Methods Design and Participants This observational study was conducted using a descriptive-analytical method in a cross-sectional manner on 335 menopausal women attending health centers and health houses in Esfarayen County. The sample size was determined using G Power software with a power of 80%, a margin of error of 5% (α = 0.05), and an effect size of 0.152. Inclusion criteria for the study were age between 45 to 65 years, at least one year since the last menstruation due to natural menopause, and willingness to participate in the survey. The exclusion criteria included receiving estrogen hormone therapy in the past three months, metrorrhagia in the past year, the occurrence of significant stressful events in the past two months, engaging in heavy physical activities, using menopause symptom-reducing medications, and unwillingness to continue responding to questions. Questionnaire The data were collected using a questionnaire administered through face-to-face interviews. The questionnaire included demographic information, Noroozi et al.’s Knowledge and Attitude Toward Menopause Questionnaire[13], and the Beck Depression Inventory-II (BDI-II) [14]. Demographic information was based on previous studies and included education level, housing status, income satisfaction, occupation, residential status, number of living children, number of pregnancies, level of physical activity, medical history, smoking status, marital status, and living arrangements. The Knowledge and Attitude Toward Menopause Questionnaire comprised ten questions evaluating attitudes towards menopause. The questionnaire was scored using a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The scoring method is reversed for questions 1, 3, 5, 6, and 8. The total score ranges from 10 to 50, with interpretations as follows: less than 15 indicates a negative attitude towards menopause, between 16 and 33 indicates a neutral attitude, and above 34 indicates a positive attitude towards menopause. Nooroozi et al. (2011) confirmed this scale's face and content validity. The scale's validity was determined with a Cronbach's alpha coefficient of 0.71 [13]. The Beck Depression Inventory-II (BDI-II) is one of the most widely used self-report measures for screening depression in individuals aged 13 and above. The second version of this questionnaire consists of 21 questions assessing an individual's feelings over the past two weeks across various dimensions, including cognitive, motivational, emotional, physiological, and other factors. Each question has four options, scored from 0 to 3, with higher scores indicating greater severity of depression. The maximum score on this questionnaire is 63, with scores of 14-19 indicating mild depression, 20-28 indicating moderate depression, and 29-63 indicating severe depression. Taheri Tanjani et al. (2015) tested this study's validity and reliability with Cronbach's alpha coefficients of 0.93 and 0.64, respectively [14]. Statistical Analysis The data collected from the questionnaires were analyzed using SPSS version 26 software. The analysis included descriptive statistics (frequency, mean, and standard deviation) and analytical statistics (comparison of means, correlation, and regression). Results In this study, 335 menopausal women aged 45 to 65 years (200 urban and 135 rural residents) were examined. The mean age of these individuals was 55.81 ± 5.30 years. Most participating women were housewives (301 individuals, 89.9%) and had an educational level of less than a diploma (151 individuals, 45.1%). Most were married (246 individuals, 78.8%) and lived with their spouses and children (285 individuals, 85.1%). Details of the demographic characteristics of the study participants are presented in Table 1. Table 1 participants' demographic variables The study found that menopausal women had a mean score of 30.04 ± 4.28 (ranging from 25 to 47), with 170 participants (50.7%) having a positive attitude towards menopause. In addition, the mean depression score was 10.03 ± 8.6 (ranging from 0 to 47), with 241 individuals (71.9%) having no depression and 14 (4.2%) experiencing severe depression (Figure 1). Fig. 1 Status of Depression and Attitudes Toward Menopause The independent t-test and analysis of variance (ANOVA) revealed significant differences in mean attitudes toward menopause across demographic variables, including education (F = 2.73, P = 0.029), income satisfaction (F = 3.46, P = 0.032), residential status (t = 3.28, P = 0.001), marital status (F = 4.52, P = 0.004), and living arrangements (F = 7.29, P = 0.001). Women with higher educational levels than a bachelor's degree, satisfied with their income level, living in cities, and married and living with their spouse and children had a more favorable attitude toward menopause (Table 2). Table 2 Assessing attitude scores toward menopause by demographic variables and their relationship Furthermore, based on the independent t-test and ANOVA, the comparison of mean depression scores across demographic variables revealed significant differences. There were significant differences in depression scores across satisfaction with income (F = 9.130, P < 0.001) and living arrangements (F = 4.333, P = 0.014) (Table 3). Table 3 Assessing depression scores by demographic variables and their relationship To examine the correlation between attitudes towards menopause and demographic variables, a multiple linear regression model was constructed using the variables that were determined to be significant in the preliminary tests. The findings of this model indicated that there was a significant relationship between attitudes toward menopause and the variables of residential status (β = -1.451, p = 0.007), satisfaction with income (β = 0.803, p = 0.027), and living arrangements (β = 1.627, p = 0.026) (Table 4). Table 4 Multiple linear regression analysis of predictors of attitude toward menopause Furthermore, to examine the potential association between demographic factors and depression, a multiple linear regression model was developed, incorporating the variables that were considered significant in the initial analyses. The results of this model revealed a statistically significant association between depression and living arrangements (β = -3.129, p = 0.015) and income satisfaction (β = -3.057, p < 0.001) variables (Table 5). Table 5 Results of multiple linear regression analysis of predictors of depression The Pearson correlation test revealed a significant inverse relationship between depression and attitude toward menopause in the participating menopausal women (r = -0.354, p-value < 0.001). Discussion Menopause impacts different facets of women's lives due to the biological, psychological, and social changes it brings about [5, 11]. Women view menopause as a natural stage of life and have varying perspectives on it. It is essential to explore attitudes toward menopause, as having a positive outlook on this stage may enhance awareness and experience of menopausal symptoms in the future [15]. This study aimed to investigate the correlation between depression and attitude toward menopause. In this research, nearly half of the individuals under study (50.7%) had a positive attitude toward menopause. The results are consistent with other studies conducted in Iran, including Faraji et al. [10], Taherpour et al. [7], and Noroozi et al. [13]. Furthermore, studies conducted in other regions of the world yielded similar results to our research. For example, Shams-Eldin's study in Cairo, Egypt, found that more than 90% of women had positive attitudes toward menopause [6]. Additionally, in Donati et al.'s study, most Italian women had a positive attitude toward menopause [16]. Similarly, Inayat et al.'s study in Pakistan showed that more than half of the participating women had a positive attitude toward menopause and considered it a natural stage of aging [17]. The positive attitudes of the participants toward the menopausal period in the present study can be regarded as a pivotal point for designing interventions to improve the quality of life for women transitioning to menopause. However, the results of other studies have shown discrepancies with our research both within the country and in other parts of the world. For example, a survey conducted by Alirezaei et al. in Iran showed that more than half of the women surveyed had a negative attitude toward menopause [4]. Similarly, studies by Gözüyeşil et al. [18] and Erbil [2] in Turkey indicated that the majority of women participating in the studies had a negative attitude toward menopause. Religious beliefs, individual life experiences, traditions, and cultural structures may cause different attitudes toward menopause in different societies. Additionally, other reasons that may contribute to these differences in results include variations in sample size and data collection tools. The study discovered a notable disparity in the perception of menopause across various educational levels. Women with advanced academic qualifications displayed a more positive attitude toward menopause than those with bachelor's degrees. According to a study conducted by Alshogran et al. in Jordan, education level emerged as the sole significant predictor for menopausal awareness. It was recognized that higher education could impact women's self-care practices, as educated women tend to use healthcare resources more and have better access to reliable information on menopause [15]. Furthermore, our research found that individuals who are content with their income and live in urban areas tend to have a more favorable attitude toward menopause, possibly due to higher levels of education. These results align with the studies conducted by Shoushtari et al. [19] and Baradaran Binazir et al. [20]. On the other hand, we found a correlation between a positive attitude toward the menopausal period and marital status and family arrangements, as married women living with their spouses and children had a more positive attitude toward menopause. A woman's menopausal symptoms and overall experience can be improved if her family is knowledgeable about the physical and mental changes that occur during this time and is willing to offer the support that is needed [12]. Hence, healthcare providers should offer educational packages to give families trustworthy and crucial information about menopausal symptoms and necessary care, given that people's access to reliable scientific information is limited for various reasons, including a lack of general (non-specialized) scientific resources [7, 11, 21-23]. Furthermore, this topic is essential because friends and family often serve as women's primary sources of information on menopause [15, 22, 23]. Our results, which show that 71.9% of participants had no depression and 4.2% had severe depression, are comparable to those of Yassary et al., who found that 65.3% of menopausal women had no depression and 4.2% had severe depression [24]. On the other hand, Safaei et al. discovered that severe depression affected 83% of participants in their study [25]. Furthermore, Shojaeian et al. found that 14.3% of people suffered from severe depression [26]. To prevent depression from worsening during menopause, women who experienced depression before menopause must be continuously watched [2]. In the present study, depression was significantly associated with education level, income satisfaction, and living arrangements. Increased knowledge about menopause can contribute to better adaptation to the changes and undesirable psychological symptoms [6, 7, 22]. Through proper awareness of the menopausal period, many challenges of this phase can be facilitated, and individuals' attitudes toward this stage of life can be improved [2]. The present study found no significant relationship between physical activity and depression in menopausal women. However, Abdi et al. showed that physical activities could somewhat reduce the adverse effects of menopause and improve mental health [27]. This difference may be due to variations in the level of physical activity between the study groups, as some of the participants in the present study consisted of rural women who potentially engaged in significant daily physical activity. The final results of the current study demonstrated a statistically significant relationship between depression and attitude toward menopause, indicating that depression influences attitude. Consistent with these results, Séjourné et al. [28], van de Griff et al. [29], Abdelrahman et al. [30], and Jane Suk Ra and Yun Hee Cho [31] have shown that dissatisfaction with body image increases during menopause. Women with positive attitudes toward menopause have a better body image, higher self-acceptance, and lower levels of depression. Additionally, the study by Erbil demonstrated that women with optimistic attitudes toward menopause have a more positive body image and lower levels of depression [2]. Considering the findings of these studies, it would have been beneficial to include body image satisfaction among the participants in this study. Erbil [2] and Ghazanfarpour et al. [11] found a significant relationship between the severity of menopausal symptoms and attitude toward menopause. Women with a more negative attitude toward menopause experienced more severe symptoms. Furthermore, they found a positive and bidirectional relationship between depression and negative attitudes in menopausal women. Although the exact cause of depression during menopause is not precisely determined, it is believed to be associated with hormonal changes such as a decrease in estrogen levels. Strengths and Limitations This study provided an opportunity to expand knowledge about attitudes toward menopause, depression during this period, and their relationship in menopausal women. The findings can inform the design and implementation of interventions to adapt women to the menopausal period better. The limited sample size and the participants' restricted demographic characteristics may reduce the results' generalizability. Participants' lower levels of education and difficulties in responding to questionnaires due to the incomprehensibility of global questionnaires were noted. Further investigation and refinement of data collection methods, including qualitative methods, meta-analysis, and prospective cohort studies, are recommended to conduct a more in-depth examination and needs assessment regarding the challenges of the menopausal period. Conclusion A significant association was reported between attitudes toward menopause and depression. Women with a more positive attitude toward menopause exhibit lower levels of depression. To foster a healthy and positive attitude toward menopause, women need accurate information and practical education from healthcare professionals and caregivers throughout their lives. In this regard, the role of family support, especially from spouses and children, should not be overlooked Declarations Ethics approval and consent to participate This work was approved under the ethical code IR.ESFARAYENUMS.REC.1401.024 by the Student Research and Technology Committee of Esfarayen University of Medical Sciences. Before sampling, participants' written consent and an official introduction letter from this university were received. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not‑for‑profit sectors. Authors' contributions RP, ZG, and AS have contributed to the design, performed the interviews, and written the Introduction section; MM, HRS, and NP have supervised the program and written the Methods, Results, Discussion & Conclusion sections. All of the authors have approved the final manuscript as well. Acknowledgments We extend our utmost gratitude and appreciation to the participants who generously contributed their valuable time to our study. References Yisma E, Eshetu N, Ly S, Dessalegn B. Prevalence and severity of menopause symptoms among perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia. BMC women's health. 2017;17:1-8. https://doi.org/10.1186/s12905-017-0484-x. Erbil N. 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Tables Table 1 participants' demographic variables Variable Level Frequency Percentage frequency Educational status Illiterate 129 38.5 Under diploma 151 45.1 Diploma 34 10.1 Associate 9 2.7 Bachelor’s and higher 12 3.6 Housing status Owner 308 91.9 Rental 27 8.1 Income satisfaction Not satisfied 134 40.0 Somewhat satisfied 166 49.6 Fully satisfied 35 10.4 Occupation Laborer 6 1.8 State employee 9 2.7 Housewife 301 89.9 Retired 14 4.2 Self-employed 5 1.5 Residential status Urban 200 59.7 Rural 135 40.3 Number of living children 0 10 3.0 1 14 4.2 2 51 15.2 3 72 21.5 >3 188 56.1 Gravida 0 9 2.7 1 5 1.5 2 36 10.7 3 54 16.1 >3 231 69 Physical activity Less than 30 minutes for three days a week 219 65.4 More than 30 minutes for three days a week 116 34.6 Medical history Yes 219 65.4 No 116 34.6 Smoking Yes 25 7.5 No 310 92.5 Marital status Single 2 0.6 Married 264 78.8 Widowed 63 18.8 Divorced 6 1.8 Living arrangements Alone 48 14 with spouse and children 285 85.1 With other relatives 3 0.9 Table 2 Assessing attitude scores toward menopause by demographic variables and their relationship Variable Level Number Mean ± standard deviation Test statistics P-value Educational status Illiterate 129 33.22 ± 4.07 2.73 0.029 Under diploma 151 34.66 ± 4.2 Diploma 34 34.88 ± 4.89 Associate 9 35.33 ± 4.44 Bachelor’s and higher 12 33 ± 4.26 Housing status Owner 308 34.08 ± 4.34 -0.11 0.907 Rental 27 34.18 ± 3.51 Income satisfaction Not satisfied 134 33.55 ± 4.01 3.46 0.032 Somewhat satisfied 166 34.19 ± 4.23 Fully satisfied 35 35.65 ± 5.13 Occupation Laborer 6 30.83 ± 1.83 1.57 0.181 State employee 9 33 ±5.85 Housewife 301 34.1 ± 4.17 Retired 14 35.78 ± 4.99 Self-employed 5 34.2 ± 6.57 Residential status Urban 200 34.71 ± 4.41 3.28 0.001 Rural 135 33.17 ± 3.92 Number of living children 0 10 31.1 ± 4.35 1.73 0.141 1 14 35.21 ± 3.96 2 51 33.68 ± 4.63 3 72 34.47 ± 3.84 >3 188 34.13 ± 4.32 Gravida 0 9 31.33 ± 4.66 1.36 0.247 1 5 32.6 ± 3.5 2 36 33.72 ± 5.17 3 54 34.59 ± 3.54 >3 231 34.17 ± 4.27 Physical activity Less than 30 minutes for three days a week 219 34.01 ± 4.34 -0.46 0.644 More than 30 minutes for three days a week 116 34.24 ± 4.16 Medical history Yes 219 33.91 ± 4.17 -1.05 0.293 No 116 34.43 ± 4.48 Smoking Yes 25 32.8 ± 3.16 -1.57 0.117 No 310 34.19 ± 4.34 Marital status Single 2 29.5 ± 0.7 4.52 0.004 Married 264 34.51 ± 4.35 Widowed 63 32.58 ± 3.67 Divorced 6 32.83 ± 3.37 Living arrangements Alone 47 31.93 ± 3.58 7.29 0.001 With spouse and children 285 34.45 ± 4.3 With other relatives 3 33.33 ± 1.52 Table 3 Assessing depression scores by demographic variables and their relationship Variable Level Number Mean ± standard deviation Test statistics P-value Educational status Illiterate 129 11.03 ± 8.39 2.541 0.04 Under diploma 151 8.80 ± 8.04 Diploma 34 11.67 ± 9.95 Associate 9 5.77 ± 5.56 Bachelor’s and higher 12 13.25 ± 12.51 Housing status Owner 308 9.65 ± 8.16 -1.994 0.056 Rental 27 14.33 ± 11.94 Income satisfaction Not satisfied 134 12.11 ±9.64 9.130 <0.001 Somewhat satisfied 166 9.22 ± 7.59 Fully satisfied 35 5.88 ± 6.72 Occupation Laborer 6 14.33 ± 14.10 0.515 0.725 State employee 9 8.66 ± 8.68 Housewife 301 10.05 ± 8.36 Retired 14 8.71 ± 10.80 Self-employed 5 9.60 ± 10.62 Residential status Urban 200 9.71 ± 8.26 -0.820 0.413 Rural 135 10.51 ± 9.08 Number of living children 0 10 10.90 ± 8.51 0.576 0.680 1 14 10.71 ± 9.47 2 51 11.25 ± 9.58 3 72 8.97 ± 6.95 >3 188 10.01 ± 8.86 Gravida 0 9 13.22 ± 7.45 1.327 0.260 1 5 10.60 ± 9.93 2 36 8.77 ± 8.77 3 54 11.98 ± 9.38 >3 231 9.63 ± 8.36 Physical activity Less than 30 minutes for three days a week 219 1035 ± 8.20 0.945 0.345 More than 30 minutes for three days a week 116 9.42 ± 9.20 Medical history Yes 219 9.88 ± 8.25 -0.429 0.688 No 116 10.31 ± 9.24 Smoking Yes 25 12.44 ± 10.72 1.457 0.146 No 310 9.83 ± 8.39 Marital status Single 2 14.50 ± 13.43 2.310 0.076 Married 264 9.40 ± 8.13 Widowed 63 12.20 ± 9.95 Divorced 6 13.33 ± 9.81 Living arrangements Alone 47 13.34 ± 10.79 4.333 0.014 With spouse and children 285 9.45 ± 8.06 With other relatives 3 12.66 ± 11.59 Table 4 Multiple linear regression analysis of predictors of attitude toward menopause Variable Regression Coefficient SE t P-value Educational status 0.055 0.249 0.222 0.824 Residential status -1.451 0.466 -3.11 0.002 Income satisfaction 0.803 0.361 2.216 0.027 Marital status -0.497 0.561 -0.886 0.377 living arrangements 1.627 0.726 2.239 0.026 Table 5 Results of multiple linear regression analysis of predictors of depression Variable Regression coefficient SE T P-value Educational status 0.563 1.666 2.514 0.259 Income satisfaction -3.057 0.705 -3.878 p <0.001 Household living arrangement -3.129 1.249 -2.367 0.015 Additional Declarations No competing interests reported. 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It is typically identified retrospectively; the only reliable way to determine if a woman has reached this stage is the cessation of the menstrual cycle (amenorrhea) for 12 consecutive months\u0026nbsp;[1]. Women undergo social, psychological, and physical changes during menopause\u0026nbsp;[2], leading to several mental and physical symptoms. Urogenital symptoms, such as dyspareunia, vaginal dryness, and vaginal atrophy, and vasomotor symptoms, such as hot flashes, joint pain, and night sweats, are examples of physical symptoms.\u0026nbsp;Anxieties, stress, and mood swings like hopelessness and despair are common in menstruating women, and they can all contribute to the onset of depression symptoms\u0026nbsp;[2-5].\u0026nbsp;Sociocultural variables, lifestyle choices, and attitudes towards menopause can cause these symptoms to last longer, be more intense, or have different impacts on different populations\u0026nbsp;[2, 6, 7].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOn the other hand, menopausal transition is accompanied by challenges regarding social and gender roles, changes in family relationships and structures, and professional positions; these stress-inducing factors make women in this period more vulnerable to depression\u0026nbsp;[8]. Depression, a lifelong condition, may be associated with other severe conditions\u0026nbsp;[2].\u0026nbsp;Depression affects more than 300 million people globally, with women being 70% more impacted than males.\u0026nbsp;Furthermore, depressive symptoms in women can be more severe and have a higher risk of recurrence\u0026nbsp;[8]. A study by Mulhall et al. demonstrated that menopausal status is associated with the risk of depressive and anxiety symptoms. Depressive symptoms are more likely to occur before menopause, while anxiety symptoms are more likely to increase after menopause. During the menopausal stage, even women without a prior history of anxiety or depression are more susceptible to developing symptoms of anxiety and depression compared to the pre-menopausal stage\u0026nbsp;[9].\u003c/p\u003e\n\u003cp\u003eFor a successful menopausal transition, women\u0026apos;s attitudes toward the changes of this period determine their experiences\u0026nbsp;[2]. Therefore, women\u0026apos;s awareness of the phenomenon of menopause plays an essential role in their mental, psychological, and physical health\u0026nbsp;[10]. Women who know about menopause are more likely to embrace the changes during this phase. With heightened awareness and a positive attitude, they are more inclined to seek specialized healthcare\u0026nbsp;[4]. Research has emphasized the crucial impact of attitude in enhancing quality of life; however, perceptions, beliefs, and attitudes can differ among different countries\u0026nbsp;[11].\u003c/p\u003e\n\u003cp\u003eDue to increased life expectancy, more women are expected to spend one-third or more of their lives in menopause\u0026nbsp;[11]. The average age of menopause in Iran is 48.26 years, with a range of 46.85 to 49.67 years. By 2036, about 17 million of Iran\u0026apos;s population is estimated to be women aged 40 to 60; therefore, many women will experience this transition\u0026nbsp;[12]. The menopausal period is a crucial stage in women\u0026rsquo;s lives; however, there is a lack of sufficient studies on its relationship with depression, as well as the impact of attitudes towards menopause on the quality of life during this period\u0026nbsp;[11]. This study aimed to answer the following questions, so that the results can be used for interventions to improve the quality of life and proper planning and management for a healthy menopausal experience.\u003c/p\u003e\n\u003cp\u003e1. What is the status of attitudes towards menopause and depressive symptoms in menopausal women?\u003c/p\u003e\n\u003cp\u003e2. How do women\u0026apos;s attitudes towards menopause and susceptibility to depression in menopausal women vary by demographic variables?\u003c/p\u003e\n\u003cp\u003e3. Is there a significant relationship between attitudes towards menopause and depression in menopausal women?\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eDesign and Participants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis observational study was conducted using a descriptive-analytical method in a cross-sectional manner on 335 menopausal women attending health centers and health houses in Esfarayen County. The sample size was determined using G Power software with a power of 80%, a margin of error of 5% (\u0026alpha; = 0.05), and an effect size of 0.152. Inclusion criteria for the study were age between 45 to 65 years, at least one year since the last menstruation due to natural menopause, and willingness to participate in the survey. The exclusion criteria included receiving estrogen hormone therapy in the past three months, metrorrhagia in the past year, the occurrence of significant stressful events in the past two months, engaging in heavy physical activities, using menopause symptom-reducing medications, and unwillingness to continue responding to questions.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eQuestionnaire\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe data were collected using a questionnaire administered through face-to-face interviews. The questionnaire included demographic information, Noroozi et al.\u0026rsquo;s Knowledge and Attitude Toward Menopause Questionnaire[13], and the Beck Depression Inventory-II (BDI-II)\u0026nbsp;[14]. Demographic information was based on previous studies and included education level, housing status, income satisfaction, occupation, residential status, number of living children, number of pregnancies, level of physical activity, medical history, smoking status, marital status, and living arrangements.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Knowledge and Attitude Toward Menopause Questionnaire comprised ten questions evaluating attitudes towards menopause. The questionnaire was scored using a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The scoring method is reversed for questions 1, 3, 5, 6, and 8. The total score ranges from 10 to 50, with interpretations as follows: less than 15 indicates a negative attitude towards menopause, between 16 and 33 indicates a neutral attitude, and above 34 indicates a positive attitude towards menopause. Nooroozi et al. (2011) confirmed this scale\u0026apos;s face and content validity. The scale\u0026apos;s validity was determined with a Cronbach\u0026apos;s alpha coefficient of 0.71\u0026nbsp;[13].\u003c/p\u003e\n\u003cp\u003eThe Beck Depression Inventory-II (BDI-II) is one of the most widely used self-report measures for screening depression in individuals aged 13 and above. The second version of this questionnaire consists of 21 questions assessing an individual\u0026apos;s feelings over the past two weeks across various dimensions, including cognitive, motivational, emotional, physiological, and other factors. Each question has four options, scored from 0 to 3, with higher scores indicating greater severity of depression. The maximum score on this questionnaire is 63, with scores of 14-19 indicating mild depression, 20-28 indicating moderate depression, and 29-63 indicating severe depression. Taheri Tanjani et al. (2015) tested this study\u0026apos;s validity and reliability with Cronbach\u0026apos;s alpha coefficients of 0.93 and 0.64, respectively\u0026nbsp;[14].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe data collected from the questionnaires were analyzed using SPSS version 26 software. The analysis included descriptive statistics (frequency, mean, and standard deviation) and analytical statistics (comparison of means, correlation, and regression).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, 335 menopausal women aged 45 to 65 years (200 urban and 135 rural residents) were examined. The mean age of these individuals was 55.81 \u0026plusmn; 5.30 years. Most participating women were housewives (301 individuals, 89.9%) and had an educational level of less than a diploma (151 individuals, 45.1%). Most were married (246 individuals, 78.8%) and lived with their spouses and children (285 individuals, 85.1%). Details of the demographic characteristics of the study participants are presented in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eparticipants\u0026apos; demographic variables\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study found that menopausal women had a mean score of 30.04 \u0026plusmn; 4.28 (ranging from 25 to 47), with 170 participants (50.7%) having a positive attitude towards menopause. In addition, the mean depression score was 10.03 \u0026plusmn; 8.6 (ranging from 0 to 47), with 241 individuals (71.9%) having no depression and 14 (4.2%) experiencing severe depression (Figure 1).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eFig. 1\u0026nbsp;\u003c/strong\u003eStatus of Depression and Attitudes Toward Menopause\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe independent t-test and analysis of variance (ANOVA) revealed significant differences in mean attitudes toward menopause across demographic variables, including education (F = 2.73, P = 0.029), income\u0026nbsp;satisfaction\u0026nbsp;(F = 3.46, P = 0.032), residential status (t = 3.28, P = 0.001), marital status (F = 4.52, P = 0.004), and living arrangements (F = 7.29, P = 0.001). Women with higher educational levels than a bachelor\u0026apos;s degree, satisfied with their income level, living in cities, and married and living with their spouse and children had a more favorable attitude toward menopause (Table 2).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eAssessing attitude scores toward menopause by demographic variables and their relationship\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Furthermore, based on the independent t-test and ANOVA, the comparison of mean depression scores across demographic variables revealed significant differences. There were significant differences in depression scores across satisfaction with income (F = 9.130, P \u0026lt; 0.001) and living arrangements (F = 4.333, P = 0.014) (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eAssessing depression scores by demographic variables and their relationship\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;To examine the correlation between attitudes towards menopause and demographic variables, a multiple linear regression model was constructed using the variables that were determined to be significant in the preliminary tests. The findings of this model indicated that there was a significant relationship between attitudes toward menopause and the variables of residential status (\u0026beta; = -1.451, p = 0.007), satisfaction with income (\u0026beta; = 0.803, p = 0.027), and living arrangements (\u0026beta; = 1.627, p = 0.026) (Table 4).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003eMultiple linear regression analysis of predictors of attitude toward menopause\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Furthermore, to examine the potential association between demographic factors and depression, a multiple linear regression model was developed, incorporating the variables that were considered significant in the initial analyses. The results of this model revealed a statistically significant association between depression and living arrangements (\u0026beta; = -3.129, p = 0.015) and income satisfaction (\u0026beta; = -3.057, p \u0026lt; 0.001) variables (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e Results of multiple linear regression analysis of predictors of depression\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The Pearson correlation test revealed a significant inverse relationship between depression and attitude toward menopause in the participating menopausal women (r = -0.354, p-value \u0026lt; 0.001).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eMenopause impacts different facets of women\u0026apos;s lives due to the biological, psychological, and social changes it brings about\u0026nbsp;[5, 11]. Women view menopause as a natural stage of life and have varying perspectives on it. It is essential to explore attitudes toward menopause, as having a positive outlook on this stage may enhance awareness and experience of menopausal symptoms in the future\u0026nbsp;[15]. This study aimed to investigate the correlation between depression and attitude toward menopause.\u003c/p\u003e\n\u003cp\u003eIn this research, nearly half of the individuals under study (50.7%) had a positive attitude toward menopause. The results are consistent with other studies conducted in Iran, including Faraji et al.\u0026nbsp;[10], Taherpour et al.\u0026nbsp;[7], and Noroozi et al.\u0026nbsp;[13]. Furthermore, studies conducted in other regions of the world yielded similar results to our research. For example, Shams-Eldin\u0026apos;s study in Cairo, Egypt, found that more than 90% of women had positive attitudes toward menopause\u0026nbsp;[6]. Additionally, in Donati et al.\u0026apos;s study, most Italian women had a positive attitude toward menopause\u0026nbsp;[16]. Similarly, Inayat et al.\u0026apos;s study in Pakistan showed that more than half of the participating women had a positive attitude toward menopause and considered it a natural stage of aging\u0026nbsp;[17]. The positive attitudes of the participants toward the menopausal period in the present study can be regarded as a pivotal point for designing interventions to improve the quality of life for women transitioning to menopause.\u003c/p\u003e\n\u003cp\u003eHowever, the results of other studies have shown discrepancies with our research both within the country and in other parts of the world. For example, a survey conducted by Alirezaei et al. in Iran showed that more than half of the women surveyed had a negative attitude toward menopause\u0026nbsp;[4]. Similarly, studies by G\u0026ouml;z\u0026uuml;yeşil et al.\u0026nbsp;[18]\u0026nbsp;and Erbil\u0026nbsp;[2]\u0026nbsp;in Turkey indicated that the majority of women participating in the studies had a negative attitude toward menopause. Religious beliefs, individual life experiences, traditions, and cultural structures may cause different attitudes toward menopause in different societies. Additionally, other reasons that may contribute to these differences in results include variations in sample size and data collection tools.\u003c/p\u003e\n\u003cp\u003eThe study discovered a notable disparity in the perception of menopause across various educational levels. Women with advanced academic qualifications displayed a more positive attitude toward menopause than those with bachelor\u0026apos;s degrees. According to a study conducted by Alshogran et al. in Jordan, education level emerged as the sole significant predictor for menopausal awareness. It was recognized that higher education could impact women\u0026apos;s self-care practices, as educated women tend to use healthcare resources more and have better access to reliable information on menopause\u0026nbsp;[15]. Furthermore, our research found that individuals who are content with their income and live in urban areas tend to have a more favorable attitude toward menopause, possibly due to higher levels of education. These results align with the studies conducted by Shoushtari et al.\u0026nbsp;[19]\u0026nbsp;and Baradaran Binazir et al.\u0026nbsp;[20].\u003c/p\u003e\n\u003cp\u003eOn the other hand, we found a correlation between a positive attitude toward the menopausal period and marital status and family arrangements, as married women living with their spouses and children had a more positive attitude toward menopause. A woman\u0026apos;s menopausal symptoms and overall experience can be improved if her family is knowledgeable about the physical and mental changes that occur during this time and is willing to offer the support that is needed\u0026nbsp;[12]. Hence, healthcare providers should offer educational packages to give families trustworthy and crucial information about menopausal symptoms and necessary care, given that people\u0026apos;s access to reliable scientific information is limited for various reasons, including a lack of general (non-specialized) scientific resources\u0026nbsp;[7, 11, 21-23]. Furthermore, this topic is essential because friends and family often serve as women\u0026apos;s primary sources of information on menopause\u0026nbsp;[15, 22, 23].\u003c/p\u003e\n\u003cp\u003eOur results, which show that 71.9% of participants had no depression and 4.2% had severe depression, are comparable to those of Yassary et al., who found that 65.3% of menopausal women had no depression and 4.2% had severe depression\u0026nbsp;[24]. On the other hand, Safaei et al. discovered that severe depression affected 83% of participants in their study\u0026nbsp;[25]. Furthermore, Shojaeian et al. found that 14.3% of people suffered from severe depression\u0026nbsp;[26]. To prevent depression from worsening during menopause, women who experienced depression before menopause must be continuously watched\u0026nbsp;[2].\u003c/p\u003e\n\u003cp\u003eIn the present study, depression was significantly associated with education level, income satisfaction, and living arrangements. Increased knowledge about menopause can contribute to better adaptation to the changes and undesirable psychological symptoms\u0026nbsp;[6, 7, 22]. Through proper awareness of the menopausal period, many challenges of this phase can be facilitated, and individuals\u0026apos; attitudes toward this stage of life can be improved\u0026nbsp;[2].\u003c/p\u003e\n\u003cp\u003eThe present study found no significant relationship between physical activity and depression in menopausal women. However, Abdi et al. showed that physical activities could somewhat reduce the adverse effects of menopause and improve mental health\u0026nbsp;[27]. This difference may be due to variations in the level of physical activity between the study groups, as some of the participants in the present study consisted of rural women who potentially engaged in significant daily physical activity.\u003c/p\u003e\n\u003cp\u003eThe final results of the current study demonstrated a statistically significant relationship between depression and attitude toward menopause, indicating that depression influences attitude. Consistent with these results, S\u0026eacute;journ\u0026eacute; et al.\u0026nbsp;[28], van de Griff et al.\u0026nbsp;[29], Abdelrahman et al.\u0026nbsp;[30], and Jane Suk Ra and Yun Hee Cho\u0026nbsp;[31]\u0026nbsp;have shown that dissatisfaction with body image increases during menopause. Women with positive attitudes toward menopause have a better body image, higher self-acceptance, and lower levels of depression. Additionally, the study by Erbil demonstrated that women with optimistic attitudes toward menopause have a more positive body image and lower levels of depression\u0026nbsp;[2]. Considering the findings of these studies, it would have been beneficial to include body image satisfaction among the participants in this study.\u003c/p\u003e\n\u003cp\u003eErbil [2] and Ghazanfarpour et al. [11] found a significant relationship between the severity of menopausal symptoms and attitude toward menopause. Women with a more negative attitude toward menopause experienced more severe symptoms. Furthermore, they found a positive and bidirectional relationship between depression and negative attitudes in menopausal women. Although the exact cause of depression during menopause is not precisely determined, it is believed to be associated with hormonal changes such as a decrease in estrogen levels.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and Limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study provided an opportunity to expand knowledge about attitudes toward menopause, depression during this period, and their relationship in menopausal women. The findings can inform the design and implementation of interventions to adapt women to the menopausal period better.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe limited sample size and the participants\u0026apos; restricted demographic characteristics may reduce the results\u0026apos; generalizability. Participants\u0026apos; lower levels of education and difficulties in responding to questionnaires due to the incomprehensibility of global questionnaires were noted. Further investigation and refinement of data collection methods, including qualitative methods, meta-analysis, and prospective cohort studies, are recommended to conduct a more in-depth examination and needs assessment regarding the challenges of the menopausal period.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eA significant association was reported between attitudes toward menopause and depression. Women with a more positive attitude toward menopause exhibit lower levels of depression. To foster a healthy and positive attitude toward menopause, women need accurate information and practical education from healthcare professionals and caregivers throughout their lives. In this regard, the role of family support, especially from spouses and children, should not be overlooked\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was approved under the\u0026nbsp;ethical code IR.ESFARAYENUMS.REC.1401.024 by the Student Research and Technology Committee of Esfarayen University of Medical Sciences. Before sampling, participants\u0026apos; written consent and an official introduction letter from this university were received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not‑for‑profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRP, ZG, and AS have contributed to the design, performed the interviews, and written the Introduction section; MM, HRS, and NP have supervised the program and written the Methods, Results, Discussion \u0026amp; Conclusion sections. All of the authors have approved the final manuscript as well.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe extend our utmost gratitude and appreciation to the participants who generously contributed their valuable time to our study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eYisma E, Eshetu N, Ly S, Dessalegn B. Prevalence and severity of menopause symptoms among perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia. BMC women\u0026apos;s health. 2017;17:1-8. https://doi.org/10.1186/s12905-017-0484-x.\u003c/li\u003e\n\u003cli\u003eErbil N. Attitudes towards menopause and depression, body image of women during menopause. Alexandria Journal of Medicine. 2018;54(3):241-6. https://doi.org/10.1016/j.ajme.2017.05.012.\u003c/li\u003e\n\u003cli\u003eMoghani SS, Simbar M, Fakari FR, Ghasemi V, Dolatian M, Golmakani N, et al. 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Journal of Holistic Nursing And Midwifery. 2014;24(1):48-55.\u003c/li\u003e\n\u003cli\u003eGhazanfarpour M, Kaviani M, Abdolahian S, Bonakchi H, Najmabadi Khadijeh M, Naghavi M, et al. The relationship between women\u0026rsquo;s attitude towards menopause and menopausal symptoms among postmenopausal women. Gynecological Endocrinology. 2015;31(11):860-5. https://doi.org/10.3109/09513590.2015.1056138.\u003c/li\u003e\n\u003cli\u003eRefaei M, Mardanpour S, Masoumi SZ, Parsa P. Women\u0026apos;s experiences in the transition to menopause: a qualitative research. BMC Women\u0026apos;s Health. 2022;22(1):53. https://doi.org/10.1186/s12905-022-01633-0.\u003c/li\u003e\n\u003cli\u003eNoroozi E, Dolatabadi NK, Eslami AA, Hassanzadeh A, Davari S. Knowledge and attitude toward menopause phenomenon among women aged 40-45 years. 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Depiction of Health. 2021;12(4):368-77. 10.34172/doh.2021.35.\u003c/li\u003e\n\u003cli\u003eSatpathy M. A study on the knowledge and awareness about menopause among middle aged women from Western Odisha. International Journal of Science and Research (IJSR). 2016;5(7):1759-61.\u003c/li\u003e\n\u003cli\u003eMore S, Sujatha P. Knowledge, attitude and experiences of menopause in the postmenopausal women at a tertiary care center: a cross sectional study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018;7(11):4758-62. http://dx.doi.org/10.18203/2320-1770.ijrcog20184543.\u003c/li\u003e\n\u003cli\u003eEzeome IV, Ezugworie JO, Nwankwo TO. Attitude of postmenopausal women toward the menopause and hormone treatment in enugu, Southeast Nigeria. 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The Iranian Journal of Obstetrics, Gynecology and Infertility. 2007;9(2):85-92. https://doi.org/10.22038/ijogi.2006.5980.\u003c/li\u003e\n\u003cli\u003eAbdi H, Khodaparast S, Bakhshalipour V, Ghoredan L, Ezadi RA. The effect of aerobic exercise on the mental health of non-athlete postmenopausal women. Medical Journal of Mashhad University of Medical Sciences. 2021;65(1):399-406.\u003c/li\u003e\n\u003cli\u003eS\u0026eacute;journ\u0026eacute; N, Got F, Solans C, Raynal P. Body image, satisfaction with sexual life, self-esteem, and anxiodepressive symptoms: A comparative study between premenopausal, perimenopausal, and postmenopausal women. Journal of women \u0026amp; aging. 2019;31(1):18-29. https://doi.org/10.1080/08952841.2018.1510247.\u003c/li\u003e\n\u003cli\u003evan de Grift TC, Cohen-Kettenis PT, de Vries AL, Kreukels BP. Body image and self-esteem in disorders of sex development: A European multicenter study. Health Psychology. 2018;37(4):334. https://psycnet.apa.org/doi/10.1037/hea0000600.\u003c/li\u003e\n\u003cli\u003eAbdelrahman RY, Abushaikha LA, al-Motlaq MA. Predictors of psychological well-being and stress among Jordanian menopausal women. Quality of life Research. 2014;23:167-73. https://doi.org/10.1007/s11136-013-0464-z.\u003c/li\u003e\n\u003cli\u003eRa JS, Cho YH. Depression moderates the relationship between body image and health-related quality of life in adolescent girls. Journal of Child and Family Studies. 2017;26:1799-807. https://doi.org/10.007/s10826-017-0720-x.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eparticipants\u0026apos; demographic variables\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage frequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e38.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eUnder diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e45.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eDiploma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e10.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eAssociate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s and higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousing status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eOwner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e91.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eRental\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome satisfaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eNot satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eSomewhat satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e49.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eFully satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eLaborer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eState employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eHousewife\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e89.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidential\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003estatus\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e59.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e40.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of living children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e56.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGravida\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 30 minutes for three days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e65.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eMore than 30 minutes for three days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e34.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e65.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e34.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e92.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e78.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.20754716981132%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving arrangements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.50943396226415%\" valign=\"top\"\u003e\n \u003cp\u003eAlone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.471698113207546%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.81132075471698%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003ewith spouse and children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e85.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.03194103194103%\" valign=\"top\"\u003e\n \u003cp\u003eWith other relatives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.147420147420146%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.82063882063882%\" valign=\"top\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eAssessing attitude scores toward menopause by demographic variables and their relationship\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; standard deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest statistics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e33.22\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eUnder diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.66\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eDiploma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.88\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eAssociate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e35.33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s and higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousing status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eOwner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e34.08\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.907\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eRental\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.18\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome satisfaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eNot satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e33.55\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e3.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eSomewhat satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.19\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eFully satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e35.65\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e5.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eLaborer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e30.83\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eState employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;5.85\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eHousewife\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.1\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e35.78\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.2\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e6.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidential status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e34.71\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e3.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e33.17\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of living children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e31.1\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e1.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.141\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e35.21\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e33.68\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.47\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.13\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGravida\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e31.33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e1.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e32.6\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e33.72\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e5.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.59\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.17\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 30 minutes for three days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e34.01\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.644\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eMore than 30 minutes for three days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.24\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e33.91\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.43\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e32.8\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.19\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e29.5\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e4.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.51\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e32.58\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e32.83\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.39871382636656%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving arrangements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.54662379421222%\" valign=\"top\"\u003e\n \u003cp\u003eAlone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.771704180064308%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.774919614147908%\" valign=\"top\"\u003e\n \u003cp\u003e31.93\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e3.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.897106109324758%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e7.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.610932475884244%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eWith spouse and children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e34.45\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eWith other relatives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63157894736842%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.36842105263158%\" valign=\"top\"\u003e\n \u003cp\u003e33.33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e1.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eAssessing depression scores by demographic variables and their relationship\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; standard deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest statistics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e11.03\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e2.541\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eUnder diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e8.80\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eDiploma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e11.67\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eAssociate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e5.77\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s and higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e13.25\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e12.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousing status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eOwner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e9.65\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-1.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eRental\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e14.33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e11.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome satisfaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eNot satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e12.11\u003cspan dir=\"RTL\"\u003e\u0026plusmn;9.64\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e9.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eSomewhat satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.22\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e7.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eFully satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e5.88\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e6.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eLaborer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e14.33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e14.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.515\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.725\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eState employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e8.66\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eHousewife\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e10.05\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e8.71\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e10.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.60\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e10.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidential status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e9.71\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.413\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e10.51\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of living children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e10.90\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.576\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.680\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e10.71\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e11.25\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e8.97\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e6.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e10.01\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGravida\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e13.22\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e7.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e1.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e0.260\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e10.60\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e8.77\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e11.98\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.63\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 30 minutes for three days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e1035\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.345\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eMore than 30 minutes for three days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.42\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e9.88\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-0.429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e10.31\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e12.44\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e10.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.83\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e14.50\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e13.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e2.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.40\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e12.20\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e13.33\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e9.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.859504132231404%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving arrangements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.429752066115704%\" valign=\"top\"\u003e\n \u003cp\u003eAlone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.561983471074381%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.330578512396695%\" valign=\"top\"\u003e\n \u003cp\u003e13.34\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e10.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.239669421487603%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e4.333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.578512396694215%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eWith spouse and children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e9.45\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e8.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.3611859838275%\" valign=\"top\"\u003e\n \u003cp\u003eWith other relatives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.485175202156334%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.15363881401617%\" valign=\"top\"\u003e\n \u003cp\u003e12.66\u003cspan dir=\"RTL\"\u003e\u0026plusmn;\u003c/span\u003e11.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003eMultiple linear regression analysis of predictors of attitude toward menopause\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.014842300556587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.539888682745826%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression Coefficient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.014842300556587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.539888682745826%\" valign=\"top\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" valign=\"top\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.014842300556587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidential status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.539888682745826%\" valign=\"top\"\u003e\n \u003cp\u003e-1.451\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" valign=\"top\"\u003e\n \u003cp\u003e-3.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.014842300556587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome satisfaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.539888682745826%\" valign=\"top\"\u003e\n \u003cp\u003e0.803\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" valign=\"top\"\u003e\n \u003cp\u003e2.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.014842300556587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.539888682745826%\" valign=\"top\"\u003e\n \u003cp\u003e-0.497\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" valign=\"top\"\u003e\n \u003cp\u003e-0.886\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.377\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.014842300556587%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eliving arrangements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.539888682745826%\" valign=\"top\"\u003e\n \u003cp\u003e1.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" valign=\"top\"\u003e\n \u003cp\u003e2.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.100185528756958%\" valign=\"top\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e Results of multiple linear regression analysis of predictors of depression\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.640159045725646%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.39960238568588%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression coefficient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.717693836978132%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.640159045725646%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.39960238568588%\" valign=\"top\"\u003e\n \u003cp\u003e0.563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e1.666\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e2.514\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.717693836978132%\" valign=\"top\"\u003e\n \u003cp\u003e0.259\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.640159045725646%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome satisfaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.39960238568588%\" valign=\"top\"\u003e\n \u003cp\u003e-3.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e0.705\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e-3.878\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.717693836978132%\" valign=\"top\"\u003e\n \u003cp\u003ep \u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.640159045725646%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold living arrangement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.39960238568588%\" valign=\"top\"\u003e\n \u003cp\u003e-3.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e1.249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.121272365805169%\" valign=\"top\"\u003e\n \u003cp\u003e-2.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.717693836978132%\" valign=\"top\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"menopausal symptoms, attitude, depression, attitudes towards menopause, women","lastPublishedDoi":"10.21203/rs.3.rs-4028891/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4028891/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Menopause is a crucial and inherent biological event in women's lives. Menopausal women are more prone to depression than individuals who are not experiencing menopause. This study aims to establish the correlation between women's attitudes toward menopause and depression in Esfarayen, Northeast Iran.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This descriptive-analytical study included 335 menopausal women referring to health centers and health houses in Esfarayen using multistage sampling. Data collection tools included a demographic information questionnaire, the Knowledge and Attitude Toward Menopause Questionnaire by Noroozi et al., and the Beck Depression Inventory-II (BDI-II). The data were analyzed using descriptive and analytical statistics with SPSS version 26.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The participants' mean age was 55.81 ± 5.30 years, and 59.7% lived in urban areas. The mean score of attitudes towards menopause in menopausal women was 30.04 ± 4.28, and the mean depression score was 10.03 ± 8.6. There was a significant difference in attitude toward menopause among different levels of education, income satisfaction, residential status, marital status, and living arrangements. According to the results of multiple linear regression analysis, residential status (β = -1.451, p = 0.007), income satisfaction (β = 0.803, p = 0.027), and living arrangements (β = 1.627, p = 0.026) were predictors of attitude toward menopause. There was a significant inverse relationship between participants’ attitudes toward menopause and depression.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e This study provides deeper insight into the relationship between attitude toward menopause and depression in menopausal women, which can guide healthcare providers toward offering a valid educational package or protocol to improve the health and quality of life during the menopausal period.\u003c/p\u003e","manuscriptTitle":"The Correlation between Menopausal Women's Attitude Towards Menopause and Depression in Northeast Iran","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-12 17:31:42","doi":"10.21203/rs.3.rs-4028891/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4232cb60-1aaa-4003-a199-c34779486281","owner":[],"postedDate":"March 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-09T06:48:03+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-12 17:31:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4028891","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4028891","identity":"rs-4028891","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}