Self-efficacy and self-esteem are associated with health-promoting lifestyle in Iranian post-menopausal women: a cross-sectional study

Abstract Introduction The number of postmenopausal women is expected to grow dramatically in the coming decades in Iran. Adopting a health-promoting lifestyle (HPL) is essential for improving health and quality of life of this population. This study pursues two objectives: (1) to assess the HPL levels among Iranian postmenopausal women and (2) to investigate the socio-demographic and psychological variables including self-efficacy and self-esteem associated with HPL. Methods In this cross-sectional study with correlational design, 400 married postmenopausal women in Shiraz (southwestern Iran) were selected via stratified random sampling. The data collection tools were the Health-Promoting Lifestyle Profile-II (HPLP-II), General Self-Efficacy Scale (GSE), the Rosenberg Self-Esteem Scale, and a sociodemographic information questionnaire. Pearson’s correlation coefficient test, independent samples t-tests, and stepwise multiple linear regression were used for analyzing the data in SPSS v. 22. Results The average age of natural menopause among participants was 49.33 ± 3.43 years, and they had relatively good HPLP (136.52 ± 21.46). The results highlighted that among all the HPLP subscales, the highest mean score was observed for health responsibility (33.62 ± 6.98), whereas the lowest scores were observed for stress management (12.26 ± 3.13) and physical activity (17.64 ± 6.52). Both self-efficacy (r = 0.445, p < 0.01) and self-esteem (r = 0.425, p < 0.01) demonstrated significant, moderate positive correlations with the total HPL score. Also, there was a significant association between the total HPLP score and two demographic variables: women’s education (r = 0.17, p < 0.01) and husband’s educational level (r = 0.113, p < 0.05). In addition, the HPLP total score had a significant negative relationship with the number of children (r=-0.114, p < 0.05). The stepwise multiple linear regression analysis revealed that the variables independently associated with the HPL of participants were self-efficacy (β = 0.32, p < 0.001), self-esteem (β = 0.27, p < 0.001), and occupation (β = 0.144, p < 0.001). Conclusion It is suggested that health care professionals implement comprehensive planning to enhance the HPL of postmenopausal women. Interventions aimed at improving HPL in this population should prioritize strategies to enhance self-efficacy and self-esteem. Particular attention should be paid to women with lower education, unemployment, and a higher number of children.