The climacteric period involves physical, hormonal, and emotional changes that can impact a woman's quality of life. This mixed-methods study aims to explore the perceptions and experiences of women during menopause and the influence of cultural ethnicity on their quality of life in Primary Care centers in Tarragona. The research includes a quantitative phase to assess healthcare professionals' knowledge via electronic surveys and a qualitative phase using individual interviews with women from diverse backgrounds. The goal is to identify specific needs to adapt community nursing interventions and improve health promotion and equity during the climacteric stage.

This study employs a mixed-methods approach to provide a comprehensive understanding of the climacteric process in the health area of Tarragona. The research is divided into two distinct but complementary phases:

1. Quantitative Phase (Cross-sectional Descriptive Study):

   The objective is to evaluate the level of knowledge and the attitudes of healthcare professionals (nurses and physicians) regarding menopause management.

   Data Collection: An ad hoc questionnaire will be distributed electronically through the corporate email systems of the Primary Care centers (ICS).

   Variables: Sociodemographic data, professional profile, and specific knowledge scores on menopause, Mediterranean diet, and physical activity recommendations.

   Analysis: Descriptive and inferential statistics will be performed using IBM SPSS Statistics.

2. Qualitative Phase (Phenomenological Approach):

The objective is to explore the lived experiences, perceptions, and cultural influences of women in the climacteric stage.

Data Collection: Semi-structured individual interviews will be conducted with women from diverse sociocultural and ethnic backgrounds to ensure maximum variation.

Sampling: Purposeful sampling will be used until data saturation is reached.

Analysis: All interviews will be transcribed verbatim and analyzed using thematic analysis with the support of Atlas.ti software.

Ethics and Integration:

The study follows the Declaration of Helsinki and has been approved by the Ethics Committee (IDIAP Jordi Gol). Data from both phases will be integrated to identify specific gaps in clinical practice and the real-world needs of women, aiming to design better community nursing interventions.

Inclusion Criteria:

For professionals:

• Healthcare professional aged 18 years or older.
• Currently working in the Primary Care setting.
• Provide care or work with women in the climateric stage.
• Agreement to participate and completion of the anonymous survey after providing informed consent.

For Women (Qualitative Phase):

• Women aged 40 to 65 years.
• Currently in the climacteric stage (perimenopause or postmenopause).
• Belonging to diverse sociocultural or ethnic backgrounds.
• Ability to communicate and provide informed consent for the individual interview.

Exclusion Criteria:

For porfessionals:

*Refusal to participate in the study or incomplete electronic survey.

For Women (Qualitative Phase):

• Inability to understand the study's language (Spanish or Catalan).
• Cognitive impairment that prevents the participant from providing informed consent or participating in the interview/survey.
• Refusal to participate in the study.

The study population consists of two main groups located in the Tarragona healthcare area:

Healthcare Professionals: Nurses and physicians working in Primary Care centers (Institut Català de la Salut) who provide care to women during the climacteric stage.

Women in the Climacteric Stage: Women aged 40 to 65 years from diverse sociocultural and ethnic backgrounds who are users of the Primary Care centers in the same geographical area.

The sample will be drawn from urban and rural health centers to ensure a representative professional perspective and a diverse range of lived experiences from the women interviewed.

"Individual participant data will not be shared to protect the confidentiality and anonymity of the participants, in accordance with the informed consent and Spanish data protection laws (LOPDGDD 3/2018)."