A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE ON MIDLIFE CRISIS AMONG WOMEN WITH MIDLIFE CRISIS

Background: In the transition to old age, midlife plays a signi?cant preparatory role. During this period, a person may go through a stage called the stage of Midlife crisis. In a life review process, a woman with midlife crisis may search for her identity. Some women may be disturbed due to the missed educational or occupational opportunities and, some may have regrets about the decisions made in the past. Poor knowledge and understanding regarding midlife crisis may lower the psychological resilience of women. Knowledge regarding the midlife crisis will help a woman to take measures to be more resilient, and this understanding is essential for the proper management of the midlife crisis. Objectives: 1) To assess the knowledge on midlife crisis among women with midlife crisis in selected community areas in Malappuram district, Kerala.2) To ?nd the association between the knowledge score on midlife crisis with selected socio demographic variables among women with midlife crisis in selected community areas in Malappuram district, Kerala. Methods: A descriptive study was conducted among 60 female middle-aged women with midlife crisis to assess their knowledge on midlife crisis in different community areas in Malappuram district, Kerala. The data was collected during the month of January 2022. A structured knowledge questionnaire was developed to assess the knowledge on Midlife crisis. The data analysis was done using descriptive and inferential statistics. The results of the study showed that 13.33% of the Results: sample had low knowledge on midlife crisis and only 1.67% were having adequate knowledge on midlife crisis. The results also showed that 85% of the sample had moderate knowledge on midlife crisis. There was no signi?cant association between the knowledge score on midlife crisis with the selected socio demographic variables among the sample. The Conclusions: knowledge regarding midlife crisis is essential for the early identi?cation and management of the crisis. Women's understanding of the crisis they are experiencing in middle age is critical in the management of midlife crisis-related physical and mental health issues. This will help a woman to prevent mental health- related issues in the future and is an essential component in the promotion of mental health. Overall, good mental health will positively in?uence the quality of life of women.

Marital Quality in Middle Aged Women: A Qualitative study

Background: Marital quality is an essential feature of family life that affects one’s wellbeing; higher marital quality is linked to less vulnerability to depression, self-rated health, less physical ailments and subjective well-being and happiness. Cross sectional studies have found low marital satisfaction and happiness in middle aged adults compared to the younger or older adults, whereas cohort studies have revealed that marital quality tends to decrease after the initial of marriage years and into the middle adulthood and then either steadies or continue to decrease after midlife. This study explored marital quality in women and the dimensions that contribute to greater marital quality in midlife stage of marriage. Methodology: The sample consisted of 15 middle aged married women. A semi-structured interview schedule was used to explore their marital quality and the dimensions related to marital quality. The interviews were analysed using content analysis method. Results: The results showed that aspects such as handling problems and disagreements, communication, having an egalitarian approach, making compromises or adjustments, support of extended family were related to better marital quality. Conclusion: The study highlights that marital enrichment programs that focus on communication between partners, problem solving strategies and effective handling of disagreements can increase the marital quality and strengthen the marital relationship.

Sexual satisfaction and associated individual factors among midlife and older people in Ile-Ife, Southwest Nigeria: implications for sexual and reproductive health

Background: Studies in Nigeria have rarely documented the prevalence and associated factors of sexual satisfaction among the midlife and older persons as a special group of underserved population in the country. This study investigates the prevalence and individual associated factors of sexual satisfaction among the midlife and older people in Ile-Ife, Southwest Nigeria.Methods: A sample size of 404 was analysed in the study. The outcome variable was sexual satisfaction. The explanatory variables are sets of individual and relational characteristics. Data were analysed using Stata 14. Bivariable and multivariable binary logistic regression models were estimated.Results: Findings reveal 42.0% level of sexual satisfaction. Higher educational attainment (AOR=0.864, p<0.01; 95% CI: 0.841-0.886), longer length of marriage (AOR=0.931, p<0.01; 95% CI: 0.912-0.950), remarriage (AOR=0.536, p<0.01; 95% CI: 0.387-0.742), economic inactivity (AOR=0.456, p<0.01; 95% CI: 0.322-0.646) reduces the odds of sexual satisfaction while absence of serious health challenges (AOR=2.742, p<0.01; 95% CI: 1.594-4.716) and spousal high wealth level (AOR=1.038, p<0.01; 95% CI: 1.017-1.059) increase the odds of sexual satisfaction.Conclusions: Individual characteristics of midlife and older men and women are significantly associated with their sexual satisfaction. These characteristics should be targeted in a special programme focusing on midlife and older persons in Nigeria.

Mid-life fertility: Challenges & policy planning

This review highlights the challenges, priority areas of research and planning, strategies for regulation of services and the need to develop guidelines and laws for fertility treatments during mid-life. The success rate of all treatments is poor in advanced age women because of declining ovarian reserve and natural fertility. There is often a need of third-party involvement which has its own ethical, legal and medical issues. Welfare of children born to older women and early death of parents are important concerns. Most of the new techniques such as the pre-implantation genetic diagnosis, oocyte augmentation, use of stem cells or artificial gametes, ovarian tissue preservation and ovarian transplantation are directed to improve, preserve or replace the declining ovarian reserve. These techniques are costly and have limited availability, safety and efficacy data. Continued research and policies are required to keep pace with these techniques. The other important issues include the patients' personal autonomy and right of self-determination, welfare of offspring, public vs. private funding for research and development of new technologies vs. indiscriminate use of unproven technology. It is important that mid-life fertility is recognized as a distinct area of human reproduction requiring special considerations.

Advance in Exercise for Brain Health in Every Age and Associated Mechanism (review) / 中国康复理论与实践

Exercise can promote brain health in all the ages, directly or indirectly. In early childhood and adolescence, exercise can increase cardiorespiratory fitness to optimize the neuronal environment to benefit cerebral maturation and cognitive de-velopment. In mid-life, exercise may maintain cognitive function by increasing cerebral gray volume and cardiovascular fitness, and preventing a lot of neurobiological events which result in cognitive decline later in life. Finally, regular exer-cise in late life is very important for integrity of brain white matter, cardiorespiratory fitness, and prevention of future de-cline.

Associations between Vasomotor Symptoms and Depression, Stress and Quality of Life in Midlife Women / 정신신체의학

OBJECTIVES: The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. METHODS: We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. RESULTS: 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory≥16), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. CONCLUSIONS: Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.

Knowledge and perception of HIV prevention through condom use among midlife and older adults in Calabar, Nigeria / Conocimientos y percepción de la prevención del VIH a través del uso del condón entre adultos de mediana y avanzada edad en Calabar, Nigeria

OBJECTIVES: Older people are at increasing risk of HIV/AIDS and other sexually transmitted diseases. The use of condoms which can protect both partners from sexually transmitted infections (STIs) including HIV during vaginal and anal sex is mostly neglected by them. In fact, postmenopausal women may not see the need for condom use when they are no longer at risk for pregnancy. Even though HIV/AIDS in older patients carry a high mortality, it is many times neglected by even healthcare providers because of the belief that older persons are no longer sexually active. This study aimed to determine the perception and knowledge ofcondom use as a strategy for HIV/AIDS prevention among midlife and older adults in Calabar, Nigeria. METHOD: A cross-sectional study was carried out to identify the perception and knowledge of HIV transmission and condom use among adults over 50 years of age, in the University of Calabar Teaching Hospital, Calabar, Nigeria. A structured questionnaire was used to get the demographic data, sources of information about the disease, knowledge about the use of condom and its efficacy in preventing the disease. RESULTS: A total of 488 participants were interviewed, comprising 263 males (53.9%) and 225 females (46.1%). Most of them (83.8%) were married and the rest (16.2%) were single. The majority of the respondents (368, 75.7%) got their information about HIV/AIDS transmission and prevention from the television. Other sources of information for respondents on HIV/AIDS were awareness campaigns (43.5%), newspapers (38.6%), friends (37.3%) and neighbours (27.1%). Three hundred and four (62.3%) of the respondents said that they had used condoms and believed that condoms could effectively prevent transmission of STIs including HIV compared to the one hundred and eighty-four (31.7%) who opined otherwise. Abstinence was the major mode of prevention of the disease among respondents while unprotected sexual intercourse was identified by the majority of the respondents (87.5%) as a high risk factor. CONCLUSION: There should be more public education on HIV/AIDS to midlife and older adults.

OBJETIVOS: Las personas de edad más avanzada enfrentan un riesgo creciente de VIH/SIDA y otras enfermedades de transmisión sexual. El uso de condones que pueden proteger a las parejas de las infecciones de transmisión sexual (ITS) - incluyendo el VIH - durante el sexo vaginal y anal, es descuidado la mayor parte de las veces. De hecho, las mujeres post-menopáusicas pueden no ver la necesidad del uso del condón cuando no corren ya más riesgo de salir embarazadas. Aunque el VIH/SIDA en los pacientes más viejos conlleva una mortalidad alta, a menudo es descuidado por los proveedores de salud debido a la creencia de que las personas de mayor edad no están ya sexualmente activas. Este estudio se propuso determinar la percepción y los conocimientos del uso del condón como una estrategia para la prevención de VIH/SIDA entre los adultos de mediana y avanzada edad en Calabar. METODOLOGIA: Se llevó a cabo un estudio transversal con el fin de identificar la percepción y los conocimientos de transmisión de VIHy el uso del condón entre los adultos mayores de 50 años de edad, en la Universidad del Hospital Docente de Calabar, en Cross River State. Se aplicó un cuestionario estructurado para obtener los datos demográficos, las fuentes de información sobre la enfermedad, así como el conocimiento sobre el uso del condón y su eficacia para prevenir la enfermedad. RESULTADOS: Un total de 488 participantes fueron entrevistados, de los cuales 263 eran varones (53.9%) y 225 hembras (46.1%). La mayoría de ellos (83.8%) estaban casados y el resto (16.2%) eran solteros. La mayoría de los encuestados (368, 75.7%) recibió la información queposeían sobre la transmisión y prevención del VIH/SIDA, a través de la televisión. Otras fuentes de información para los encuestados sobre el VIH/SIDA fueron las campanas de concientización (43.5%), los periódicos (38.6%), los amigos (37.3%) y los vecinos (27.1%). Trescientos cuatro (62.3%) encuestados dijeron que habían usado condones y creían que los condones podían prevenir de forma efectiva la transmisión de ITS, incluyendo el VIH, en comparación con los ciento ochenta y cuatro (31.7%) que opinaban diferente. La abstinencia fue el modo mayor de prevención de la enfermedad entre los encuestados, mientras que las relaciones sexuales sin protección fueron identificadas como un factor de riesgo alto por la mayoría de los entrevistados (87.5%) CONCLUSIÓN: Debe aumentarse la educación pública sobre el VIH/SIDA para las personas de mediana y avanzada edad.

The Relation of Trait anger and Anger Expression to Cardiovascular Responses and Depression in Middle-aged Korean Women / 간호학회지

PURPOSE: This study was designed to examine the relation of trait anger and anger expression to blood pressure, cholesterol, and depression in middle-aged Korean women. METHODS: This descriptive correlational design was conducted using a convenient sample taken from the health center of K University Hospital located in Kyungki province, Korea. The subjects were 252 women aged 40 to 64 years. Spielberger's state trait anger expression inventory - Korean version and Beck's depression inventory were used for measuring trait anger, state anger, anger expression and depression. Data was analyzed by descriptive statistics, t-test, Pearson correlation, two-way ANOVA, and cluster analysis using a pc-SAS program. RESULTS: The anger expression types by cluster analysis were Anger out/in type, Low anger expression type, and Anger control type. The level of cholesterol and depression were significantly higher in women with high anger in and high trait anger. In addition, the level of depression was significantly higher in women with a high anger temperament. CONCLUSIONS: Trait anger and anger in might be related to cholesterol and depression in women. However, this study does not reveal the relation between blood pressure and trait anger and anger expression.

Depressive symptoms are related with hemostatic factors in middle-aged women: A report from the Study of Women Health Across the Nation (SWAN)

OBJECTIVE: Depression may be a risk factor for coronary heart disease (CHD) morbidity and mortality, but the mechanism(s) for the association are not established. The present study examined the relationship between one possible mechanism, hemostatic factors, and depressive symptoms in middle-aged women. METHOD: We measured levels of fibrinogen, Factor VIIc, plasminogen activator inhibitor antigen-1 (PAI-1), and tissue plasminogen activator antigen (TPA-ag) in 3,016 women aged 42-52 years enrolled in the Study of Women's Health Across the Nation (SWAN). Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D), with scores > 16 suggestive of depression. RESULTS: Depressed women had high levels of all four hemostatic factors ( all p <0 .01). After controlling for age, smoking, ethnicity, prevalent cardiovascular disease, osteoarthritis, and dia-betes, and use of medications (including psychotropics), depressed women still had elevated levels of fibrinogen (mean, 95% confidence intervals 299, 304 ­ 295 mg/dl vs. 291, 294 ­ 288mg/dl, p= 0.003) and Factor VIIc (124, 127 ­ 121 ng/dl vs. 119, 121 ­ 117 ng/dl, p= 0.01) levels, compared to nondepressed women. CONCLUSIONS: These findings suggest that hemostatic factors may be a key me-chanism accounting for the relationship between depression and CHD. [Castilla RC, Bromberger JT, Zhang Y, Perel JM, Matthews KA. Depressive symptoms are related with hemostatic factors in middle-aged women: A report from the Study of Women Health Across the Nation (SWAN). MedUNAB 2004; 7:57-64

Effects of Dan-jun Breathing Exercise Program Experienced by Women in Midlife / 기본간호학회지

PURPOSE: This study focused on affirming of the effects of Dan-jun breathing exercise experienced by women in midlife. METHOD: The data were collected via direct interview from 20 participants, who participated in a Dan-Jun exercise program during three months. Collected data were analyzed by content analysis. RESULT: 1. As for the health problems of women in midlife before the Dan-jun exercise program, 93 items were extracted in the content analysis. These items were categorized into 59 attributes and 15 higher attributes. 1) Of the 59 attributes of health problems, shoulder pain (30%) was the most dominant. 2) The 15 higher attributes consisted for the physical domain of, weakness, pain, joint stiffness, sexual problem, sleep disorder, gastro-intestinal disorder, menstrual irregularity, circulatory disorder, respiratory disorder, constipation, urinary incontinence, and for the psychological domain, anger, emptiness, depression, and anxiety. 2. As for the effects experienced by women in midlife after the Dan-jun exercise program, 169 items were extracted in the content analysis. These items were categorized into 85 attributes and 14 higher attributes. 1) Of 85 attributes, lightening of physical condition (55%) was the most dominant. 2) The higher attributes consisted in physical domain of, recovery of vigor, pain relief, menstrual regularity and improvements in flexibility, sexual problem, sleep disorder, gastro- intestinal disorder, circulatory disorder, constipation, respiratory disorder and urinary incontinence, and for the psychological domain, relaxation, cultured mind and self-confidence. CONCLUSIONS: Dan-jun breathing exercise program for three months showed positive effects on physical and psychological health in women in midlife. In this context, it can be also considered as a significant nursing intervention for maintenance and promotion of the health of these women.

The Effect of the Dan-Jun Breathing Exercise Program on pulmonary function and psychological Health of Women in Midlife / 간호학회지

PURPOSE: This study was to examine the effects of the Dan-Jun Breathing Exercise Program on pulmonary function and psychological health promotion of women in midlife. METHOD: Experimental group(20) was matched to control group(20) according to age, education, religion and marital status. The Dan-Jun Breathing Exercise Program was carried out for 80 minutes a day, 3 times a week for 12 weeks. FVC and FEV1.0/FVC(%) were measured by using the Health Management System developed by the Korean Physical Science Institution. The scores of depression, anxiety and hostility were measured by the Korean Manual of Symptoms-Checklist -90 revision. RESULT: 1) FVC of the experimental group was higher than that of the control group, FEV1.0/FVC(%) was not higher than that of the control group. 2) The scores for depression, anxiety and hostility in the experimental group were lower than those of the control group. 3) FVC of 6 weeks and 12 weeks experiment in the experimental group was higher than that of pre-experimental group. CONCLUSION: The Dan-Jun Breathing Exercise Program promotes the Pulmonary function and psychological health of women in midlife.

The Effect of the DanJeon Breathing Exercise Program Applied to Health Promotion in Women in Midlife / 성인간호학회지

The purpose of this study was to develop a DanJeon Breathing Exercise Program for health promotion and to examine the effects of a DanJeon Breathing Exercise Program on the physical and emotional health promotion of women in midlife. The design utilized for this study was quasi-experimental with a nonequivalent control group pretest-posttest design. This study was done between February 1 and July 4, 2000 and the subjects of the study were 40 women in midlife living in Seoul. There were 20 members in experimental group who participated in the DanJeon Breathing Exercise Program and 20 members in the control group who were chosen as matched to members of the experimental group according to age, education and religion. The DanJeon Breathing Exercise Program was carried out for 80 minutes a day, 3 times a week for 12 weeks. The percent of body fat, back strength, flexibility (trunk flexion), balance and vital capacity were measured using the Health Management System developed by the Korea Physical Science Institution. Blood tests were done at D infirmary for total cholesterol, and the atherogenic index was calculated using an established formula. The scores of anxiety and depression were measured by a questionnaire with 10 questions on anxiety and 13 questions on depression. It was developed from the Korean Manual of Symptoms-Checklist-90 revision. The collected data were processed using the SPSS PC program and analyzed using X2-test and t-test. The result of this study are as follows: 1. The percent of body fat for the experimental group who participated in the DanJeon Breathing Exercise Program was lower than that of the control group. 2. The degree of back strength, flexibility (trunk flexion) and balance of the experimental group that participated in the DanJeon Breathing Exercise Program was higher than that of the control group. 3. The vital capacity of the experimental group that participated in the DanJeon Breathing Exercise Program was higher than that of the control group. 4. The total cholesterol level and atherogenic index of the experimental group that participated in the DanJeon Breathing Exercise Program were lower than those of the control group. 5. The scores for anxiety and depression in the experimental group that participated in the DanJeon Breathing Exercise Program were lower than those of the control group. In conclusion, DanJeon Breathing Exercise Program promotes the physical and emotional health of women in midlife. The DanJeon Breathing Exercise Program can be utilized as a nursing intervention for the promotion of health in women in midlife.

An Effect of Health Promotion Program in Mid-life Women / 간호학회지

The purpose of the study was to test the effect of the health promotion program in middle women. The research design was a quasi experimental, nonequivalent control-group pretest-posttest design. The data were collected from February 24 to April 14, 1988. The subjects were midlife women, age 40 to 50 years who reside in Chonju city. The experimental group consisted of 41 subjects and the control group 40 subjects. The instruments used for the study were the Self Efficacy Scale and the Health Promotion Behavior Scale developed by Park(1995). The data was analyzed by SPSS/PC. The study result were as follows: Through the 7 week education program for health promotion, self efficacy and health behavior were effectively changed in middle-aged.