INFLUENCE OF HEALTH LOCUS OF CONTROL ON MENSTRUAL ATTITUDE AMONGST THREE GENERATIONS OF WOMEN IN LAGOS METROPOLIS

ABSTRACT

The study examined influence of health locus of control on menstrual attitude amongst three generations of women in Lagos Metropolis, a study of ikeja local government.

The study employed the survey design and the purposive sampling technique to select 450 three generation women in Lagos State. A well-constructed questionnaire, which was adjudged valid and reliable, was used for collection of data from the respondents. The data obtained through the administration of the questionnaires was analyzed using the Pearson correlation analysis.

The results of the correlation analysis showed that there is positive and significant relationship between health locus of control and three generations of women (r=0.772; p<0.05). Furthermore, a positive and significant relationship exists between menstrual attitude and three generations of women (r=.896; p<0.05). Also, a positive and significant relationship between Health locus of control and menstrual attitude (r=0.772; p<0.05).

The study concluded that health locus of control has influence on menstrual attitude amongst three generations of women in Lagos Metropolis.

The study suggested that; Further studies need to be conducted in order to determine the widespread attitudes and beliefs of the experience of menstruation in Nigeria women, as well as what factors, other than those included in this study, may contribute to these attitudes and beliefs; There is a need for the development of a context-specific instrument measuring the attitudes and beliefs that women have towards their menstruation.; Education about menstruation is also of particular concern, as the majority of the sample in this study indicated feeling unprepared at the onset of menstruation; The stereotype of secrecy and taboo surrounding menstruation needs to be abolished in order to prepare young girls properly for menarche and in turn ensure that their attitudes and beliefs of menstruation are more positive.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND TO THE STUDY

Menstruation is a biological phenomenon laden with cultural implications. Individuals do not experience the body in a socio-cultural vacuum. In turn, women’s interpretations of the physiological and hormonal changes associated with menstruation cannot be understood outside of the social and historical context in which they live, which is influenced by the meaning ascribed to these menstrual changes by westernised medical discourses (Ussher, 2006). Throughout history, menstruation has been assigned roles that ranged from defining a woman’s status and social role to being seen as a curse that all women had to endure (Anjum, Zehra, Haider, Rani, Siddique & Munir, 2010). It is this positioning of the female reproductive body as inadequate and needing to be controlled, and of menstruation as a site of madness and debilitation, which provide the framework for women to interpret changes associated with menstruation as pathological symptoms (Ussher, 2006). For centuries, both medicine and religion have methodically devalued the roles assigned to females and excluded women from power in society through patriarchal beliefs about the female reproductive body (Cahill, 2001). This is still evident in many cultures and religions today (Tiwari, Oza & Tiwari, 2006; Umeora & Egwuatu, 2008).

All over the world women are encouraged by culture and religion to avoid certain activities such as cooking, working, praying and having sexual intercourse while menstruating, as they are considered to be in a state of uncleanliness (Buckley & Gottlieb, 1988). In many societies menstruation also encompasses an element of secrecy, where, although menarche may be celebrated as a developmental milestone, menstruation is regarded as something about which women should always be discreet (Marván & Molina-Abolnik, 2012). These restrictions during, and the secrecy surrounding menstruation, may in turn, impact negatively on womanhood by essentially assaulting the women psychologically, degrading their self-image and self-esteem, creating a feeling of shame and undermining the physiological significance of menstruation (Umeora & Egwuatu, 2008).

As early as the 1980‟s, menstrual taboos have been seen as evidence of a primitive irrationality of the understood universal dominance of men over women in society (Buckley & Gottlieb, 1988). A view endorsed by western medicine and science is that being male is considered „normal‟ and therefore the male body is ideal. This results in most women internalising the idea that something is fundamentally wrong with their bodies (Northrup, 2010). The term medicalisation refers to, subordinating certain practices, experiences and behaviours to the authority of medicine‟ (Cindoglu & Sayan-Cengiz, 2010, pp. 226). Women‟s natural life processes (particularly those concerning reproduction) are more likely to be medicalized than men‟s life processes, due to the western understanding of the male body being the „normal‟ body, therefore highlighting gender as an important factor in understanding medicalization (Conrad, 1992). The result has been that women‟s bodies, specifically biological processes such as menstruation, have been pathologised and construed as diseased (Chadwick, 2006).

The medicalization of the female reproductive body, therefore, is loaded with implications of control over those bodies and experiences (Cindoglu & Sayan-Cengiz, 2010). It is also argued that the medicalization of the female reproductive body is closely connected to patriarchy, because defining natural biological processes, such as menstruation and pregnancy, as abnormal and pathological reflects the perception that women are, by nature, victims of their own reproductive systems (Cindoglu & Sayan-Cengiz, 2010). The power of social control comes from having the authority to define certain behaviours, practices and experiences (Conrad, 1992), and as men have that authority in western society, the medicalization of menstruation can be seen as a direct form of social control of women. There are very few things in western society that have been more effective in keeping women in their place than the degradation of the menstrual cycle (Northrup, 2010).

The dominant medical view of the female body has also led to stereotypical expectations regarding menstruating women that continue to be prevalent in western societies today (Marván, Cortés-Iniestra & González, 2005). For example, there is a belief that menstruation affects the performance of women, in that the menstruating woman is said to have difficulty concentrating, displays poor judgement, lacks physical coordination, exhibits decreased efficiency, and performs less well at school or at work (Chrisler & Caplan, 2002). There is very little scientific evidence to support this belief; however subscribing to this belief may cause many women to detach themselves from their responsibilities. If this belief is widespread, it could also lead to a restriction of women’s opportunities in the workplace and as contributors to society in general, and this could be another important source of discrimination against women and a form of social control (Chrisler & Caplan, 2002).

Perceptions about menstruation, both negative and positive, are constructed primarily by young women's introduction to menstruation and are perpetuated by the influences of their culture, religion, peers, family members, and the media (Rembeck, Möller & Gunnarsson, 2006; Roberts, 2004). These perceptions, in turn, create attitudes towards menstruation that may negatively affect a woman’s body image, views on disease causation, diet, willingness to take medication, the use of contraceptives and the ability to plan a family (Anjum et al., 2010).

Women’s attitudes towards, and their behaviours associated with menstruation, are the result of a complex interaction of cultural beliefs, socialization factors and actual experiences (Morrison, Larkspur, Calibuso & Brown, 2010; Rembeck et al., 2006; Wong & Khoo, 2011). Attitudes towards menstruation can be affected by a woman’s age at menarche, her cycle length, and the intensity and duration of her menstrual flows (Morrison et al., 2010).

Research has been conducted on the attitudes and beliefs surrounding menstruation in a number of countries such as India, Pakistan, Mexico and Nigeria (Anjum et al., 2010; Marván et al., 2005; Marván & Molina-Abolnik, 2012; Patil et al., 2011; Shanbhag et al., 2012; Tiwari et al., 2006; Umeora & Egwuatu, 2008). du Toit (1988) conducted a study exploring the attitudes and experiences of menstruation of Indian South African women; and Cronje and Kritzinger (1991) conducted a study documenting the attitude towards menstruation in Afrikaans speaking university students. The use of such dated sources does present a problem, as the results may not be indicative of the current attitudes and beliefs of South African women. However, a paucity of information was found for the South African context and therefore the sources are included

Health locus of control (HLOC) refers to LOC specifically related to health behaviors (Wallston & Wallston, 1982). That is, HLOC describes the belief that one’s health is dependent upon internal versus external factors. As measured by the Multidimensional Health Locus of Control (MHLC) scales (Wallston, Wallston, & DeVellis, 1978), HLOC consists of three major dimensions. Internal health locus of control (IHLC) refers to an individual’s belief that her or his health is dependent upon her or his own behavior; chance locus of control (CHLC) refers to the belief that chance factors determine health outcomes; and powerful others locus of control (PHLC) refers to an individual’s belief that her or his health is dependent upon the behaviors of powerful others such as medical doctors. The PHLC dimension is further divided on one version, Form C, of the MHLC to indicate whether LOC beliefs are directed specifically toward medical professionals or toward others in general. Thus, on Form C of the MHLC, four dimensions of HLOC are represented: internal (IHLC), chance (CHLC), doctor (DHLC), and other (OHLC). The bulk of research using the MHLC, however, has focused more on Form A of the MHLC, which combines OHLC and DHLC into one dimension of PHLC. Studies have demonstrated that, in comparing the MHLC subscales, IHLC is related to better physical and mental well-being (Pucheu, Consoli, D’Auzac, Français, & Issad, 2004) and more proactive health behaviors (Bonetti et al., 2001), CHLC is related to poorer physical and mental well-being (Bonetti et al., 2001) and less proactive health behaviors (O’Carroll, Smith, Grubb, Fox, & Masterson, 2001), and PHLC is related to stronger adherence to medical recommendations but higher likelihood of chronic pain or disability (Wallston & Wallston, 1982).

A generation is a group of people born around the same time and raised around the same place People in this “birth cohort” exhibit similar characteristics, preferences, and values over their lifetimes. There are big differences between the generations and it's important to know the years when each generation begins and ends and currently, five generations make up our society. Each of those five generations has an active role they play in the society. Here are the birth years for each generation:

• Gen Z, or Centennials: Born 1996 and later
• Millennial or Gen Y: Born 1977 to 1995
• Generation X: Born 1965 to 1976
• Baby Boomers: Born 1946 to 1964
• Traditionalists or Silent Generation: Born 1945 and before

Three generations would be used for the purpose of this research that is, Generation x, y and z.

1.2 STATEMENT OF PROBLEM

All over the world women are encouraged by culture and religion to avoid certain activities such as cooking, working, praying and having sexual intercourse while menstruating, as they are considered to be in a state of uncleanliness. In many societies menstruation also encompasses an element of secrecy, where, although menarche may be celebrated as a developmental milestone, menstruation is regarded as something about which women should always be discreet. These restrictions during, and the secrecy surrounding menstruation, may in turn, impact negatively on womanhood by essentially assaulting the women psychologically, degrading their self-image and self-esteem, creating a feeling of shame and undermining the physiological significance of menstruation. Also, women may want to attribute the cause of her attitude change and belief to either external or internal factor. Several factors have observed and reported for the cause of women’s negative or positive attitude towards menstruation. Since menstruation is a great part of women’s health, it is on this premise that this study seeks to investigate the extent to which health locus of control influence menstrual attitude amongst three generations of women in Lagos Metropolis.

1.3 RESEARCH QUESTIONS

1. Will there be an impact of health locus of control amongst three generations of women in lagos metropolis
2. Will there be a difference in the menstrual attitude of three generation of women.
3. Will there be a difference in the health locus of control of three generations of women.
4. Will health locus of control predict menstrual attitude in women .

1.4 OBJECTIVES OF THE STUDY

1. To investigate the impact of health locus of control amongst three generation of women in Lagos metropolis.
2. To examine the difference in menstrual attitude amongst three generations of women.
3. To examine pattern of  the health locus of control of three generation of women
4. To investigate health locus of control as a predictor of menstrual attitude in women

1.5 RESEARCH HYPOTHESES

1. There will be an impact  of health locus of control amongst three generations of women in Lagos metropolis 
2. There will be a significant difference in the menstrual attitude of three generations of women
3. Health locus of control will significantly predict menstrual attitude amongst women.

1.6 SIGNIFICANCE OF THE STUDY

This study will be of significance in the following ways:

1. It will help health practitioner in planning or learning what to do.
2. It will add to the existing knowledge on menstrual attitude, particularly in Nigeria.
3. This study will be highly useful in assisting reproductive health in planning and improving behaviour towards women of reproductive age.

1.7 SCOPE OF THE STUDY

This study focuses on health locus of control and menstrual attitude amongst three generations of women.

The study will be carried out in Lagos metropolis, Nigeria

1.8 LIMITATIONS OF THE STUDY

Like any other empirical undertaking the present study is constrained by the following:

1. Money might be a limitation because I will need a huge amount of money to carry out this project.
2. Time might also be a limitation because there will be limited time to carry out  the project and also time for my personal needs

People see menstruation has a very sensitive and a private part of their lives so  they might not want to talk about it.