This study showed that education could improve the postmenopausal quality of life (7) and lifestyle and promote women's health (8). Some studies in Iran and other parts of the world indicate the negative impact of menopause on quality of life (9,10,11).
One of the main factors to improve quality of life is the improvement of lifestyle (7). Increasing knowledge about menopause can correct quality of life, reduce complications and increase self-efficacy (12). Quality of life is a perception state of physical, mental, social, and environmental health. Various variables such as personal characteristics such as age, gender, personality, education, and organizational factors such as stress experienced in the workplace, the nature of work and tasks, and social factors such as relationships between family members and co-workers have affected the quality of life.
The people with higher self-care and health care have a more positive perception of their health and experience a better quality of life (13). In various qualitative studies, as the study of the peyman and khandehroo (12), different interpretations such as satisfaction and dissatisfaction (12) identity transformation, disability, and helplessness (14) feel of aging (9) were perception. The women will have different attitudes towards menopause depending on their interpretations and consequently may have various quality of life.
In Nazarpour's study, individual and social factors aggravated menopausal complications thus were affected the quality of life (16). In addition, these imposing an economic burden on the family and society affect the menopausal quality of life (15). health literacy is another factor that affects the menopausal quality of life
.World Health Organization named health literacy one of the sufficient determinants of health (7). Health literacy has been offered a global issue in the 21st century(2). it is necessary to choose an educational approach to promote health literacy and quality of life by considering the abilities and skills (5).
Health education aims to raise the level of health literacy of people, to help them make the right decisions about their health and
the community in which they live (3). In addition, Bandura introduces a view of human behavior in which the beliefs that people have about themselves are vital to controlling their behavior (17).
People with higher self-efficacy believe that they can do any difficult task (5). In the study of Forough Jafari et .al a direct and significant relationship was seen between the variables of the meaning of life and self-efficacy and body areas satisfaction and health assessment with quality of life (18).
In the study of Mostafavi in Isfahan, the level of health literacy in the elderly was very inadequate. The people with lower age, less education, less income, and more doctor visits had low health literacy(19). In Khaledian's study, there was no statistically significant relationship between education (p = 0.48, occupation) (p = 0.12) and the number of family members (p = 0.43) and quality of life (20),however this relationship was confirmed in the present study.
In Abdi's research, there was a statistically significant relationship between quality of life and job (p = 0.04) and quality of life and income (p = 0.009). The present study was certified too. The quality of life and health literacy gained a direct and significant relationship and an inverse and significant between the quality of life and self-efficacy.
The positive and significant effect of educational intervention in improving the quality of life and increasing health literacy and self-efficacy was certified in the khandehroo research (21). It acknowledges in this study. This increase was more significant in 3 months after the intervention.
The limitations of this study were the presence of covid 19 and limited communication and education of participants, the fear of covid 19 if they participated in training classes. This limitation had somewhat modified. This study did with individual funding.
Using the results of such studies in the community cause women's health promotion, make them healthier and more productive for the rest of their lives, take more effective steps towards sustainable development. In addition to providing the necessary knowledge about menopausal symptoms and complications, how to deal with and adapt to them to maintain health and improve the menopausal quality of life. to Create support groups, induce a positive attitude, and promote healthier behaviors should strive in postmenopausal women.
It can also help managers of health services in controlling and reducing the complications of menopause and reducing the resulting burden on the health care system. Authorities can consider the results of this study in their policies in disease and health services management.