This study aimed to assess the effect of the health belief model-based training on the self-compassion and self-efficacy of premenopausal women. In this study, the age of women was 40–50 years. Also, the study of Simangunsong et al. (2017) included premenopausal women aged 40–45 years, so there is a good overlap between the two studies regarding age. In another study, the premenopausal age of women was 20–50 years, which shows that in some countries, the premenopausal age can be lower than the age range defined by WHO. Of course, it should be noted that the mean age of perimenopause and menopause varies across countries. Cultures and regions are influenced by various factors such as genetics, lifestyle (nutrition, physical activity, smoking, etc.), body mass index, employment status, socio-economic status, and place of life [18, 24].
The present study showed the positive impact of self-compassion on the life of premenopausal women. The results of this study are compliant with the results of Catherine Jones's study that calculated the total score of self-compassion as 3.50 (0.74) [25]. However, in the present study, the total score of self-compassion in the intervention group after training was 112.78 (3.79), which indicates the positive effect of training based on the health belief model. In this study, it was found that increasing self-compassion could improve hot flashes, night sweats, and anxiety in menopausal women. This study did not determine the effect of self-compassion level on vasomotor symptoms. However, considering the effect of increased self-compassion on the quality of life of premenopausal women, the present study confirms the study of Catherine Jones [25]. In the present study, self-compassion improves the quality of life, which is in line with the study by Arab in 2018. This study showed that the self-compassion score after the educational intervention was 31.46 (7.72) [26], while the total self-compassion score in the present study after the training was (3.51) 113.68, suggesting the positive effect of the educational method on increased self-compassion. Therefore, the health belief model can raise self-compassion among premenopausal and menopausal women in other cities. This includes offering educational and counseling sessions about the premenopausal and menopausal phenomena and strategies related to the model's dimensions (perceived sensitivity, severity, benefits, barriers, and action guidelines).
The present study showed the positive impact of self-efficacy on the life of premenopausal women, which is compliant with the study of Mariola Janiszewska; their study showed the level of self-efficacy increased after the intervention, and the effect of treatment was more significant in women who had higher self-efficacy. Also, the total score of self-efficacy was 57.42 (7.75)[27], while in the present study, the total score of self-compassion in the intervention group after training was 74.31 (4.08), which indicates the positive effect of training based on the health belief model.
According to this study, the health belief model plays a major role in disease prevention. According to the model, a person's decision and motivation in adopting a health behavior is divided into three categories: personal perception, modifying behaviors, and probability of performing that behavior or action. The present study showed that, among dimensions of the health belief model, perceived benefits had the greatest impact on the use of self-compassion and self-efficacy in the lives of premenopausal women. Also, the self-efficacy and self-compassion of premenopausal women have increased using the health belief model training.
Abedi (2007) reported that the most effective dimension in applying the health belief model for education is perceived obstacles, with a score of 64.7 (8.8) [28]. The score of the perceived obstacles dimension after the intervention in the present study was 13.43 (1.16), which contradicts the two studies. In the present study, the score of total health belief after intervention was 117.60 (3.96). Similarly, Simangunsong et al. (2017) calculated the score of total health belief after intervention as 76.89, indicating that the two studies are aligned in this sense.
It can be concluded that health beliefs can positively affect educational interventions. Karimzadeh et al. (2020) discovered that, out of all the health belief model aspects, felt sensitivity following the intervention has the highest mean score—4.01 (1.27). Even though this is more than in the previously mentioned study, the perceived sensitivity following the intervention in the current trial was 18.60 (1.11), suggesting that the perceived benefits had a stronger influence. When women can manage perimenopause well according to their desire and understanding instead of their judgment, they will be able to achieve a high quality of life.
While answering questions, individuals can have certain mental conditions that have minimal impact on their ability to answer questions. These disorders are beyond the control of the researcher. The researcher conducted randomization to mitigate the influence of unpredictable factors on participants' responses to the questions.