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.

Autocuidado en mujeres de mediana edad con obesidad / Self-care in middle-aged women with obesity

RESUMEN Introducción: El énfasis del autocuidado recae en la responsabilidad de la persona sobre su propia salud y enfermedad. Los cuidados brindados a si mismo desde el punto de vista físico, psicológico y social resultan pertinentes ante la prevalencia creciente de enfermedades crónicas no transmisibles como la obesidad, que va más allá de una cuestión estética y ocasiona graves consecuencias para la salud. Objetivo: Caracterizar la dimensión física, psicológica y social del autocuidado en mujeres de mediana edad con obesidad que se atienden en el Instituto Nacional de Endocrinología. Métodos: Se realizó un estudio exploratorio-descriptivo con una metodología cualitativa, haciendo uso del método de estudio de casos múltiples y la integración de diferentes técnicas. Se realizó un análisis de contenido que permitió identificar regularidades y rupturas entre los casos de estudio. Fueron considerados y aplicados los aspectos éticos. Resultados: Se encontró que el conocimiento de la enfermedad, la ausencia de hábitos nocivos y el buen control de la salud, fueron los aspectos del autocuidado físico más promovidos. Se mostró un pobre desarrollo del autocuidado psicológico mediante un afrontamiento pasivo de la enfermedad, emociones negativas e insatisfacción con la imagen corporal que afectaba la esfera autovalorativa, junto a una escasa proyección futura. El autocuidado social se vio favorecido por la red de apoyo familiar y las actividades en el tiempo libre. Conclusiones: Las dimensiones física y social del autocuidado son las más atendidas por las mujeres, en cambio, la psicológica es la de mayor vulnerabilidad(AU)

ABSTRACT Introduction: The emphasis of self-care lies in the responsibility of each person on their own health and diseases. The self-care given from the physical, psychological and social perspectives are relevant in view of the increasing prevalence of chronic non-communicable diseases such as obesity, which goes beyond an aesthetic issue and causes serious health consequences. Objective: To characterize the physical, psychological and social dimensions of self-care in middle-aged women with obesity, that are treated in the National Institute of Endocrinology. Methods: It was carried out a descriptive exploratory study with a qualitative methodology by using the method of multiple case studies and the integration of different techniques. It was conducted an analysis of content that made possible to identify regularities and ruptures between the cases of study. The ethical aspects were considered and applied. Results: It was found that the knowledge of this disease, the absence of harmful habits and the good control of health were the most promoted physical aspects of self-care. It was shown a poor development of psychological self-care through a passive coping with the disease, negative emotions and dissatisfaction with the body image that affected the self-evaluative area, along together to a short future projection. The social self-care was favoured by a family support network and activities in the spare time. Conclusions: The physical and social dimensions of self-care are the most cared by women; on the other hand, the psychological dimension is of greater vulnerability(AU)

Development & cross-validation of anthropometric predictive models to estimate the appendicular skeletal muscle mass in middle-aged women in Sri Lanka

Background & objectives: Attempts have been made to estimate appendicular skeletal muscle mass (ASMM) using anthropometric indices and most of these are country specific. This study was designed to develop and cross-validate simple predictive models to estimate the ASMM based on anthropometry in a group of healthy middle-aged women in Sri Lanka. Methods: The study was conducted on a randomly selected group of community-dwelling women aged 30-60 years. ASMM (kg) quantified with dual-energy X-ray absorptiometry (DXA) (ASMMDXA) was used as the reference standard. Anthropometric measurements such as body weight (kg), height (m), limb circumferences (cm) and skinfold thickness (mm) which showed significant correlations with ASMMDXA, were used to develop the models. The models were developed using a group of 165 women (aged 30-60 yr) and were cross-validated using a separate sample of women (n=167) (mean age: 48.9±8.56 yr), selected randomly. Results: Nine anthropometry-based models were developed using weight, height, skinfold thicknesses, circumferences, body mass index, menopausal status (MS) and age as independent variables. Four models which were based on height, weight, triceps skinfold thickness (TSFT), age and MS met all the validation criteria with high correlations (ranged 0.89-0.92) and high predictive values explaining high variance (80-84%) with low standard error of estimate (1.10-1.24 kg). Interpretation & conclusions: The four models (ASMM 1-ASMM 4) developed based on height, weight, TSFT, age and MS showed a high accuracy in estimating the ASMM in middle-aged women.

Efeitos do treinamento muscular do assoalho pélvico associado à musculação na perda urinária e nos aspectos psicológicos em mulheres idosas: ensaio clínico randomizado / Effects of pelvic floor muscle training associated with resistance training on urinary loss and psychological aspects in older women: a randomized clinical trial

Objetivo: Comparar os efeitos do treinamento muscular do assoalho pélvico (TMAP), associado ou não à musculação, na perda urinária, estado de humor e autoeficácia do tratamento em mulheres idosas com incontinência urinária (IU). Métodos: Ensaio clínico randomizado, cego, realizado com mulheres idosas (≥60 anos), residentes na Grande Florianópolis/SC. Os critérios de inclusão foram: autorrelato positivo de IU de esforço e mista; força muscular do assoalho pélvico (Oxford ≥2); e função cognitiva preservada. Foram selecionadas 31 idosas para distribuição randomizada cega entre Grupo Experimental (GE) (n = 14) e Grupo Controle (GC) (n = 17), 26 idosas concluíram o tratamento (GE = 12 e GC = 14). Foram coletados dados socioeconômicos e de fatores de risco, além de medidas antropométricas (IMC e circunferência da cintura) e satisfação com o tratamento. Os desfechos principais foram: International Consultation on Incontinence Questionnaire ­ Short Form (ICIQ-SF); Escala de Humor de Brunel (BRUMS); Escala de Autoeficácia para Prática de Exercícios do Assoalho Pélvico (EAPEAP). Todas as idosas realizaram o TMAP e, no GE, foi acrescentada a musculação, durante 12 semanas em ambos os grupos. Resultados: A idade média foi de 64,8 (± 4,7) anos no GE e 66,5 (± 5,6) anos. Os principais fatores de risco ginecológicos, obstétricos, histórico familiar e perfil antropométrico foram semelhantes nos dois grupos. A comorbidade prevalente em ambos os grupos foi a hipertensão arterial (GE = 50,0% e GC = 64,3%). A perda urinária apresentou diferença significativa na comparação intragrupos e entre grupos na pré-intervenção, sem variação significativa no estado de humor e na autoeficácia com o tratamento. Conclusão: O TMAP, associado ou não com musculação no tratamento da IU, foi efetivo para redução da perda urinária, mas não teve melhora significativa no estado de humor e na autoeficácia com o tratamento.

Objective: To compare the effects of pelvic floor muscle training (TMAP), associated or not to bodybuilding, on urinary loss, mood and self-efficacy of treatment in elderly women with urinary incontinence (UI). Methods: Randomized, blinded clinical trial of elderly women (≥60 years old) living in Florianópolis/SC. The inclusion criteria were: self-report of stress and mixed UI; muscle strength of the pelvic floor (Oxford ≥2); and preserved cognitive function. Thirty-one elderly women were selected for randomized blinded distribution between the Experimental Group (SG) (n = 14) and the Control Group (CG) (n = 17) 26 elderly women completed treatment (SG = 12 and GC = 14). Socioeconomic data and risk factors were collected, as well as anthropometric measures (BMI and waist circumference) and treatment satisfaction. The main outcomes were: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF); Brunel Humor Scale (BRUMS); Self-efficacy Scale for Exercise of the Pelvic Floor (EAPEAP). All the elderly women underwent TMAP and, in GE, bodybuilding was added for 12 weeks in both groups. Results: The mean age was 64.8 (± 4.7) years in GE and 66.5 (± 5.6) years. The main gynecological, obstetric, family history and anthropometric risk factors were similar in both groups. The prevalent comorbidities were arterial hypertension (GE = 50.0% and GC = 64.3%). Urinary loss showed a significant difference in the intragroup and pre-intervention groups, with no significant variation in mood and self-efficacy with the treatment. Conclusion: TMAP, associated or not with bodybuilding in the treatment of UI, was effective in reducing urinary loss, but there was no significant improvement in mood and self-efficacy with treatment.

Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women / 대한지역사회영양학회지

OBJECTIVES: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. METHODS: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value < 0.05 was considered to be statistically significant. RESULTS: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p < 0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p < 0.001). CONCLUSIONS: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women / 대한지역사회영양학회지

OBJECTIVES: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. METHODS: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value < 0.05 was considered to be statistically significant. RESULTS: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p < 0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p < 0.001). CONCLUSIONS: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

Effects of Health Qigong Baduanjin on diabetes related indexes in middle-aged obese women / 中国应用生理学杂志

OBJECTIVE@#To investigate the effect of Health Qigong Baduanjin on the related indexes of obese middle aged women with diabetes and to provide new ideas for the intervention treatment of diabetes.@*METHODS@#A total of 40 middle-aged female obese diabetic patients were randomly divided into the control group and the exercise group(=20), the age was(57.2±5.4) years old. Fitness training group performed eight new Baduanjin exercises for 24 weeks of intervention, the control group did not exercise, body weight, waist circumference, body mass index (BMI), waist hip ratio (WHR), fasting blood glucose (FPG), glycosylated hemoglobin (HbAlc), triglyceride(TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) levels and serum retinol binding protein 4(RBP4) index were observed in the two groups.@*RESULTS@#After exercise, the waist, WHR, FPG, TG, HbAlc, HDL and RBP4 levels of the the patients in the experimental group were decreased significantly compared with those of before exercise and those of the patients in the experimental control group before and after exercise (<0.05).@*CONCLUSIONS@#Health Qigong Baduanjin can reduce the blood sugar of obese female patients with diabetes, and has some improvement effect on the body part of obesity and blood lipid indicators.

The Influence of Health Status and Type of Health Management on Depression in Middle-Aged Women / 한국간호교육학회지

PURPOSE: This study aimed to investigate the influence of health status and types of health management on depression in middle-aged women. METHODS: A convenience sample of 188 participants was recruited from health centers in S city. Using a structured questionnaire, data was collected and analyzed by t-test, ANOVA, Pearson's correlation, and linear regression using SPSS/WIN 23 program. RESULTS: Results of the regression analysis showed that perceived current health status (β=−0.55, p < .001), no caregiver (β=0.47, p < .001), chronic diseases lasting more than three months (β=0.36, p < .001), perceived health status compared to peer group (β=0.32, p < .001), walking for health (β=−0.20, p=.002), caregiver except family (β=0.18, p=.001), and gastrointestinal disease (β=0.10, p=.022) influenced depression in middle-aged women. Overall, approximately 69.7% of total variance explained this model (adjusted R2=0.678, F=57.21, p < .001). CONCLUSION: This study suggests that it is more important to understand the level of perceived health status in middle-aged women. Furthermore, it is necessary to develop programs that include various health management methods and strengthen the health care with the help of families and neighbors in order to manage depression in middle-aged women.

Status and influencing factors of folic acid intake by childbearing-aged women in Shaanxi Province / 西安交通大学学报(医学版)

Objective To understand the status of perinatal folic acid intake by childbearing-aged women in Shaanxi Province and analyze the influencing factors so as to provide data support for current policy adjustment.Methods We sampled in 10 cities of Shaanxi and Yangling Demonstration area,and chose women who had been pregnant in the past 3 years or were pregnant at the time of the survey to answer questionnaires.The unconditional logistic regression model was used to analyze the influencing factors.Results At the whole provincial level,the intake rate of folic acid was 84.1％.The intake rate of folic acid varied significantly among different regions,being 88.9％ in southern Shaanxi,85.7％ in Guanzhong area,and 88.9％ in northern Shaanxi (x2=24.011,P＜0.001).It also significantly differed between urban and rural areas (89.5％ vs.80.6％,x2=19.974,P ＜ 0.001).The intake rate of folic acid was different significantly among different age groups,too,being lower in the old-age group than in the young-age group (x2 =13.637,P=0.003).The rate of free access to folic acid and duration of folic acid intake also significantly differed among urban and rural areas,different regions and different age groups (P ＜ 0.05).By using logistic regression model we found that the childbearing-aged women's knowlage of folic acid was the most important influencing factors besides urban/rural area,region,age and education level.Among these factors the odds ratio of awareness intake of folic acid during perinatal period was 14.13 (95％ CI:6.16-32.44),the odds ratio of knowing that folic acid can prevent neural-tube defects was 2.71 (95％ CI:1.43-5.14) and odds ratio of knowing the policy of free distribution of folic acid supplements was 2.88 (95％ CI:1.52-5.47).Conclusion The rate of folic acid intake among childbearing-aged women in Shaanxi Province is relatively high,but the duration of folic acid intake is still short.The understanding about folic acid is an important factor which affects the use of folic acid.Improving the cognitive level of folic acid among childbearing-aged women is the most useful way to enhance the effective prevention of neural tube defects.

Effect of Obesity on Blood Pressure and Arterial Stiffness in Middle-Aged Korean Women

OBJECTIVES: Our study aims to provide basic scientific data on the importance of obesity management in middle-aged Korean women by analyzing its effects on blood pressure and arterial stiffness. In addition, we examined the correlations of these two parameters. METHODS: The study participants were 40 middle-aged female volunteers, who were classified into obesity group (n = 20) and normal weight group (n = 20). Statistical analysis was performed using independent t-test and the Pearson correlation coefficient was used to correlate blood pressure and arterial stiffness. RESULTS: This study evaluated the systolic blood pressure, diastolic blood pressure, and pulse wave velocity (PWV). These results were higher in the obesity group than the normal weight group. Furthermore, blood pressure and arterial stiffness (PWV, augmentation pressure) were static correlated. CONCLUSION: Obesity is closely related to blood pressure and arterial stiffness. Therefore, indices for blood pressure and arterial stiffness may play a vital role in predicting and preventing obesity and its sequelae.

Publicaciones de artículos originales de autores cubanos sobre algunas afecciones endocrinas en la mujer de edad mediana / Publication of original papers on some endocrine illnesses in middle-aged women by Cuban authors

Introducción: en la posmenopausia se incrementa la morbilidad por afecciones endocrinas, cuya frecuencia varía en las diferentes regiones del mundo y que desconocemos en nuestro medio. Objetivo: identificar la frecuencia que en artículos originales autores cubanos hacen referencia sobre afecciones endocrinas frecuentes en la edad mediana de la mujer cubana, y reportar los artículos útiles. Métodos: estudio infométrico referido a las publicaciones de autores cubanos recuperados de las bases de datos (Lilacs, Medicc Review, Esbco, PubMed, Cochrane Library, Scielo Cuba y Cumed), repositorios de tesis, eventos médicos nacionales, relacionados con la osteoporosis posmenopausia, la diabetes mellitus tipo 2, el nódulo del tiroides, el hipo e hipertiroidismo y la tiroiditis autoinmune. Se incluyeron los artículos originales reportados entre 1995-2012, accesibles, con referencia a mujeres con edades 40-59 años, y en los que se especificara la metodología utilizada para establecer los diagnósticos de referencia. Resultados: se identificaron 7 703 trabajos que incluían al menos uno de los descriptores definidos. El 2,4 por ciento de los reportes de autores cubanos fueron útiles, y en todos se identificó una alta frecuencia de las afecciones referidas. La dificultad en el acceso virtual e impreso fue la principal causa de no utilidad de los artículos. Conclusiones: se evidencia la poca frecuencia o visibilidad de la morbilidad por afecciones endocrinas en la mujer de edad mediana(AU)

Introduction: in the postmenopausal period, morbidity from endocrine illnesses increases and their frequency varies in different parts of the world, but knowledge about this topic is limited in our country. Objective: to determine the frequency of reference to common endocrine illnesses affecting Cuban middle-aged women in original papers by Cuban authors and to report on useful articles. Methods: informative study of the publication of Cuban papers retrieved in Lilacs, Medicc Review, Esbco, PubMed, Cochrane Library, Scielo Cuba and Cumed databases, thesis repositories and national medical events, which cover postmenopausal osteoporosis, type 2 diabetes mellitus, thyroid modes, hypo and hyperthyroidism and autoimmune thyroiditis. It included accessible original papers from the 1995 to 2012 period, making reference to 40-59 years-old women and specifying the used methodology to make diagnoses. Results: there were found 7 703 papers that comprised at least one of the defined subject headings. In the group, 2.4 percent of reports by Cuban authors were useful and all identified high frequency of the above-mentioned illnesses. The extent of difficulties in having access, either digital or printed, to these articles was the main cause of classifying them as useless. Conclusions: low frequency of visibility of morbidity from endocrine illnesses in the Cuban middle-aged women was demonstrated(AU)

Health Status Assessment Tool Development based on Dietary Patterns in Middle-Aged Women / 대한지역사회영양학회지

OBJECTIVES: This study was performed to develop an assessment tool for middle aged women's health status based on dietary patterns, which will have practical applications in the working field of health and hygiene, aiming at improving the middle aged women's quality of life through their health improvement. METHODS: As a first step, a literature review was conducted and the original data of '2008~2009 Korea Health and Nutrition Examination Survey' were reanalyzed. This analysis identified 65 preliminary questions that may be relevant to the study. After verifying the content validity by experts, the 65 questions were reduced into 51 questions. In order to secure higher validity of the candidate items, verification of their clinical validity was conducted among women aged between 45 and 60 years. Finally, an assessment tool was developed by applying weight and scoring. RESULTS: Selected 51 questions were used to verify clinical validity and the results showed that 20 questions were relevant, nine questions ('regular meal time', 'regular amount of meal', 'intake frequency of dairy products', 'intake frequency of fruits', 'intake frequency of meat products', 'intake frequency of high cholesterol foods', 'intake frequency of salty foods', 'appetite', 'eat breakfast everyday') were related to dietary life. Eleven other questions ('self-rated health status', 'deep sleep', 'smoking', 'frequency of drinking', 'stress levels', 'health-related fitness levels', 'pounding of the heart', 'strange feelings on the skin', 'interfere with daily life', 'menopause will bring you a chance to see the life in a different perspective', and 'body mass index') were selected as valid questions. For the response scale for each question, 5 point Likert scale was used to make total 100 point score. CONCLUSIONS: This study is the first attempt to develop a health status assessment tool for middle aged women based on their dietary patterns. We conclude that this tool is expected to be a useful and practical tool in the field.

Status of Maternal Nutrition in South and North Korea / 대한지역사회영양학회지

OBJECTIVES: This study compared the nutritional status of child-bearing age women between the Democratic People's Republic of Korea (North Korea) and the Republic of Korea (South Korea). METHODS: The data presented in the DPRK Final Report of the National Nutrition Survey 2012 was utilized for the nutritional status and food intake of North Korean women. To produce the South Korean women's data comparable to those of North Korean women, the data from the 2012 National Health and Nutrition Survey were analyzed and the data presented in the 2010 Report of the Korean Agency for Technology and Standards were utilized. RESULTS: The prevalence of maternal anemia (blood hemoglobin < 12.0 g/dL) was over 30% in all the age groups of North Korean women and 8.9%, 14.2%, 16.4% in 20-29, 30-39, 40-49 year old South Korean women, respectively. The prevalence of maternal protein-energy malnutrition (Mid-Upper Arm Circumference < 22.5 cm) was 25.2%, 21.4%, 21.8% in 20-29, 30-39, 40-49 year old North Korean women, respectively and less than 10% in all the age groups of South Korean women. Result of dietary diversity comparison showed that North Korean women consumed less food than South Korean women at all food groups: grains, fruits, vegetables, meat, and dairy. Percentage of North Korean women having consumed protein rich foods-meat and fish, eggs or dairy products-were much lower than those of South Korean women. CONCLUSIONS: The striking disparity of nutritional status between South and North Korean women indicates that nutrition support for North Korean women is essential in the process of preparation for a unified nation.

Analysis of Factors Affecting the Need for Health Education Programs in Middle-aged Women

BACKGROUND: This study aimed to analyze the factors affecting health education program needs as defined by the World Health Organization (WHO) for promoting health in middle-aged women. METHODS: Study subjects included 203 middle-aged women ranging in ages between 40 and 59 years, living in S-city. Data were collected from September 10 to 24, 2011. Descriptive statistics, independent t-test, and one-way ANOVA were used to analyze general characteristics and the need for health education programs related to the general characteristics. Hierarchical multiple regression was used to access the factors influencing the need for health education programs. All data were analyzed by SPSS/WIN 17.0 program. RESULTS: The average score of the health promotion behaviors was 3.46 (+/-0.74). The average score of the need for health education programs (including physical, psychological, and social health education programs) was 3.88 (+/-0.13); and this was affected by age (psychological health education programs beta=-0.21), self-actualization (physical, psychological, social health education programs beta=0.28, beta=0.30, beta=0.30), health responsibility (social health education programs beta=0.21), interpersonal support (physical health education programs beta=0.18), and stress management (social health education programs beta=0.18). CONCLUSIONS: Based on the study results, health education for middle-aged women should be impacted less by monthly income and educational background, and should have more specialized, accessible contents considering not only programs that middle-aged women prefer but also the factors influencing the needs of health education.

A Qualitative Study On Ageing Related Anxiety Among Middle Aged Women In Malaysia

Ageing anxiety is commoner among women compared to men. However, little is known on the possible contributing factors towards the development of ageing related anxiety among Malaysian women. This study aimed to explore ageing anxiety among the middle-aged women in Malaysia in facing the ageing process. Series of 6 focus group discussions (FGD) were conducted involving a total of 36 women aged between 35 and 59 years old. Each FGD consisted of 5 to 7 respondents and was conducted for an average of 1 to 2 hours. The respondents were selected using the maximum variation sampling method focussing on five age categories, between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Representative from several residential areas in the area of Putrajaya Federal Territory and Seri Kembangan, Selangor were involved in the selection of respondents. The interviews revealed that, majority of the respondents were seriously thinking of the possible negative experiences associated with ageing and being old, but very few experiencing ageing anxiety. Three main themes that were identified to contribute to the ageing anxiety were issues related to caregiving at old age and fear of loneliness, the welfare and care of their children when they are old and eventually die and also physical changes that occurred with ageing process. These themes were not specifically associated with any particular age groups, marital or income status. However, the development of the ageing anxiety was found to be related to their personal experiences and observations from the surrounding community. The findings show that women in Malaysia are still emphasizing on the importance of traditional caregiving system, where elderly parents are looked after by the children or extended family members rather than living in formal institutions. Despite the important role of formal institutions in the care of elderly people in the future, it is still negatively perceived. With the shrinking of the size of nuclear family and massive involvement of women in employment sector, more elderly will be expected to reside in formal institutions in the near future. Relevant authorities should be made aware on the importance to maintain the quality of care in the formal institution for elderly, in order to tackle the negative perceptions.

lllness Perceptions of Breast Cancer in Japanese Middle-and Early Old-Aged Women: Psychometric Properties of the Brief lllness Perception Questionnaire for Use in Diagnosing Breast Cancer in Japan.

Objectives: The present study was aimed at constructing the Japanese version of the Brief Illness Perception Questionnaire for breast cancer (Brief IPQ-JBC), for use with Japanese middle- and early old-aged women who had not previously undergone mammography. We also examined the psychometric properties of the translated instrument. Methods: Patients were 824 middle- and early old-aged women living in all parts of Japan, who completed surveys on the Internet in January 2014. Of these, 282 had not previously undergone mammography and were included in this study, completing the Internet survey again, six months later, in July 2014.The participants were evaluated on the basis of a battery of questionnaires comprising demographic details, the tentative version of the Brief IPQ-JBC, the Japanese version of the Illness Perception Questionnaire (J-IPQ), Self-Directedness subscale from the Japanese version of the Temperament and Character Inventory-125 items, perceived breast cancer risk, and anticipated worry about breast cancer. Results: The Brief IPQ-JBC was found to have good long-term test-retest reliability, as well as concurrent validity with the J-IPQ. The scale also showed good construct validity, based on the results of a path model using structural equation modeling, thus supporting the theoretical perspective of the common-sense model of self-regulation. Conclusion: We have validated the Brief-JBC in a sample of Japanese middle- and earlyold-aged women and believe our results will be useful for subsequent research.

Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women

PURPOSE: This study was done to examine how laughter therapy impacts serotonin levels, QOL and depression in middle-aged women and to perform a path analysis for verification of the effects. METHODS: A quasi-experimental study employing a nonequivalent control group and pre-post design was conducted. Participants were 64 middle-aged women (control=14 and experimental=50 in 3 groups according to level of depression). The intervention was conducted five times a week for a period of 2 weeks and the data analysis was conducted using repeated measures ANOVA, ANCOVA and LISREL. RESULTS: Results showed that pre serotonin and QOL in women with severe depression were the lowest. Serotonin in the experimental groups increased after the 10th intervention (p=.006) and the rise was the highest in the group with severe depression (p=.001). Depression in all groups decreased after the 5th intervention (p=.022) and the biggest decline was observed in group with severe depression (p=.007). QOL of the moderate and severe groups increased after the 10th intervention (p=.049), and the increase rate was highest in group with severe depression (p<.006). Path analysis revealed that laughter therapy did not directly affect depression, but its effect was indirectly meditated through serotonin variation (p<.001). CONCLUSION: Results indicate that serotonin activation through laughter therapy can help middle-aged women by lessening depression and providing important grounds for depression control.

Expectations of Middle aged Women for a life of Happiness to the Spouse

PURPOSE: This study was to define and analyze the expectations of middle-aged woman to their spouse. METHODS: A sample of 39 middle-aged women was recruited from the workplace, religious organization and acquaintances. The survey was conducted with participants using self-reported questionnaire. The data were analyzed using Q methodology. RESULTS: There were four different types of expectations of middle-aged women. First type was "Collaborative and self-development type," meaning that women developed self and were collaborated with their family or spouses. The second type was "Maintain their own life" meaning that women recognized and maintained their expertise without interference from their spouses. The third one was "Respect for the inner value" meaning that women gave continued respect and understanding their inner value. The last one was "Realistic acceptance" meaning that women kept the current situation without implementing new self-development type. CONCLUSION: There is a subjective structure within the types of expectations of middle-aged women for a life of happiness to the spouse.

Effect of winter swimming on blood lipid,Cr and UA of middle women / 重庆医学

Objective To explore the mechanism of winter swimming exercise related fitness with six blood indexes:low den-sity lipoprotein (LDL),high density lipoprotein (HDL),triglyceride (TG),cholesterol (TC),serum creatinine (Cr)and blood uric acid (UA).Methods Totally 48 women winter swimmers who were 45 -59 years old were choosen as the test group.During the winter,the water temperature was 3-9 ℃,winter swimming before and 4 months after their six blood items of the test group were respectively tested.In the control group,we detected twice LDL,HDL,TG,TC,Cr,and UA in winter in 26 women who are 50-55 years old as control group.Results The blood LDL,TG,TC Cr and UA of the test group after 4 months of winter swimming were significantly lower than winter swimming(P 0.05).Conclusion The middle-aged women insist on winter swimming can reduce blood fat,regulate blood vessel elasticity,improve cardiovascular function,improve blood circulation,enhance the ability of anti-disease,improving renal function.Winter swimming plays an important role in enhancing physique.