Cardiovascular disease, osteoporosis, and dementia are three disease processes that have been directly linked to estrogen deficiency. Cardiovascular disease (CVD) is the number one cause of death for all postmenopausal women, including those with end-stage renal disease (ESRD). Osteoporosis and dementia are disease processes that profoundly affect the quality of life for postmenopausal women. Currently, 34% of women in the general population receive hormone replacement therapy (HRT), while only 10% of women with ESRD receive this therapy. Therefore, the purpose of this descriptive study was to examine the facilitators and barriers of nephrology health care providers to initiation of HRT among their postmenopausal patients. Pender's Health Promotion Model was utilized for the theoretical framework. The research questions that guided the study were as follows: What are the barriers to nephrology health care providers initiating HRT on postmenopausal women with ESRD? And what are the facilitators to nephrology health care providers initiating HRT on postmenopausal women with ESRD? The target population was nephrology health care providers at outpatient hemodialysis facilities. Tramel's Questionnaire was utilized to collect data. The convenience sample (N = 2 6) consisted of subjects who completed and returned the questionnaire for a 17% return. Descriptive statistics, including frequency distribution, percentage, and ranking, were utilized to analyze the data. Nephrology health care providers were 80.77% (n — 21) male and practiced nephrology for an average 12.8 years. The average number of postmenopausal women under their care was 138, and 42.31% (n = 11) reported prescribing HRT for these women. The number one ranked health facilitator to prescribing HRT was surgically-induced menopause. The need for more research in the area of HRT for women with renal failure was the number one ranked external facilitator. The number one ranked barrier to HRT initiation was a concern of physician liability. One implication for nursing is the need for continued research in the area of menopause for women with ESRD. Recommendations for further research included replication of this study with expanded geographical area and continued use of the research tool to establish reliability and validity.


Master of Science in Nursing (MSN)


Graduate Nursing

Degree Date


Publication Number


First Advisor

Dr. Mary Patricia Curtis

Second Advisor

Lorraine Hamm

Third Advisor

Denise Arnold

Document Type


Included in

Nursing Commons