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Abstract

Midlife is filled with challenges and unique stressors for women, which necessitate a greater understanding of the factors that influence their life satisfaction. This study examined the relationship of family strains/changes and weight to life satisfaction, as mediated by family coping, physical activity, sleep and health stress. The findings indicated that women in midlife, who experienced more stressful life changes and had higher body mass index scores, slept fewer hours and had greater health stress, which resulted in lower life satisfaction. These results have implications for family health professionals and programmes that deal with family and health problems, including sleep, weight and stress.

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... For Mexican midlife women, an important indicator for life satisfaction is the perception they have about their family support (Martínez et al., 2012). In a study conducted in the USA, it was found that postmenopausal women who have the most stressful life changes, who have highest body mass index, who sleep fewer hours, and who have the greatest health stress, are those who report lowest life satisfaction (Darling et al., 2012). In another study conducted in Poland, it was found that some menopause-related symptoms (hot flushes, irritability, reduced concentration and coordination, sleep disturbances, and increased sweating) negatively influence life satisfaction (Nowakowska et al., 2015). ...
... Moreover, it has also been found that some of the factors that may contribute to life satisfaction also influence menopause-related symptoms (Kling et al., 2019;Sakson-Obada & Wycisk, 2015). Among midlife women, stressful life changes are one of the factors that affect life satisfaction (Darling et al., 2012), which in turn, as we found, affects psychological menopause-related symptoms. There is evidence that life satisfaction is unrelated to menopausal status or hormone levels (Dennerstein et al., 2000), and does not necessarily improve or worsen with age, but rather there are women who adapt better or worse to new circumstances such as perimenopause (Martínez et al., 2012). ...
Article
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We studied the influence of meaninglessness and life satisfaction on menopause-related symptoms in 342 middle-aged Mexican women. They completed the Greene Climacteric Scale, the Dimensional Scale of the Meaning of Life, and the Satisfaction with Life Scale. Psychological symptoms were predicted by meaninglessness and life satisfaction; somatic symptoms only by meaninglessness; and the sexual symptom by meaninglessness and by the menopausal status. These findings may be useful in designing strategies to help women find meaning and satisfaction in their lives and thereby enable them to experience menopause under optimum conditions.
... Women face multiple challenges and personal life stressors in midlife, including changing family roles, loss of significant others, changes and increasing demands at work, health concerns, and worries about retiring and getting old. 93 Perimenopausal women have higher levels of psychological distress compared with premenopausal women 94 ; employment, depressed mood, and poor perceived health are among the most significant factors causing stress in midlife women. 95 Life stressors and experiencing stress could contribute to sleep disturbances. ...
... 95 Life stressors and experiencing stress could contribute to sleep disturbances. 93,96,97 Indeed, perceived stress and poor perceived health have been associated with sleep disturbances in midlife women. 16,90 Further, Hall and colleagues 66 found that midlife women with more chronic stress exposure over a 9-year period had greater PSGassessed WASO and were more likely to have insomnia at follow-up than participants with moderate stress exposure. ...
Article
The menopausal transition is associated with an increase in insomnia symptoms, especially difficulty staying asleep, which negatively impacts quality of life. Vasomotor symptoms are a key component of sleep disruption. Findings from polysomnographic studies are less consistent in showing disrupted sleep in menopausal transition independent of aging; further prospective studies are needed. Hormone therapy alleviates subjective sleep disturbances, particularly if vasomotor symptoms are present. However, because of contraindications, other options should be considered. Further work is needed to develop preventive and treatment strategies for alleviating sleep disturbances to ensure better health, quality of life, and productivity in midlife women.
... However, life satisfaction did not predict physical health. Thus, based on the aforementioned studies, health is considered an important predictor of life satisfaction (Darling et al, 2011). ...
... Despite the fact that research has begun to explore social exclusion factors and life satisfaction, some findings are inconsistent and many of these studies are limited in scope (often only focusing on single dimensions), sample size or population pool (Angelini et al, 2011;Bayram et al, 2012;Chang and Yen 2011;Darling et al, 2011). Thus, our understanding about the relationship between social exclusion factors and life satisfaction, particularly among older adults, remains incomplete. ...
Article
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This study aims to examine the relative impact of social exclusion factors on older adults' life satisfaction. This study conducted a cross-sectional analysis of psychosocial measures from the 2012 wave of the Health and Retirement Study (N=4,139). Results found that social exclusion factors indeed affect life satisfaction. Health had the strongest effect on life satisfaction. Good social relationships also positively affect life satisfaction. These findings call for considering multidimensionality of social exclusion in the future research. Researchers and practitioners could pay greater attention to social exclusion, ways to measure it, and its impact on life satisfaction through this study.
... On the one hand, findings of age-related declines in stress and mood are not unanimous (e.g., Gold et al. 2000;Bromberger et al. 2003). There is evidence that age and BMI are positively related to heightened menopause symptoms, disrupted sleep patterns, as well as changes in lifestyle factors during the transition to menopause (e.g., physical activity), which in turn can have an effect on women's mood (Gold et al. 2000;Darling et al. 2012). There is some epidemiological data to support a strong association between BMI and common mental disorders (McCrea et al. 2012) while the SWAN study revealed that BMI was associated with significantly greater odds of a major depressive episode during annual follow-ups across the menopause transition (Bromberger et al. 2011). ...
... Such an approach may safeguard not only against some of the physical symptoms of menopause but also offer resilience vis-à-vis the many psychosocial factors (e.g., hassles, life stress, work satisfaction) which may impact mid-life women's well-being (Dennerstein et al. 2002;Gordon et al. 2016). Indeed the various hormonal and social transformations that accompany the transition to menopause can become sources of distress (Darling et al. 2012). Nonetheless, the results of our study showed that over half of participants followed a high and steadily increasing profile for vigor, consistent with the suggestion that overall well-being may actually improve into the later stages of the transition to menopausal (Dennerstein et al. 2002). ...
Article
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The menopause transition is characterized by significant hormonal changes that may predispose women to psychosocial maladjustment. Prospective studies to date have focused primarily on negative mood states and show equivocal findings. The primary goal of this study was to identify patterns of change with respect to positive and negative mood states (vigor, depression, tension, and stress) over a 5-year period in a cohort of women undergoing the transition to menopause. A secondary aim was to determine whether the identified trajectories were associated with menopause status as well as baseline health-related and psychological characteristics. This longitudinal study observed 102 healthy Canadian women who were premenopausal at baseline (age 47–55 years). Analyses consisted of latent class growth modeling. Mood states were predominantly normal and stable, raising doubts regarding the notion that psychosocial distress is a common and natural occurrence during the transition to menopause. Neither time spent in perimenopause nor BMI had a significant influence on levels of mood indicators. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the 5-year period. Targeting improvements in self-perceptions may promote a healthier psychological adjustment during this natural transitional period in a women’s lifespan.
... Within this thesis we examine three common forms of eudaimonic wellbeing: life satisfaction, self-esteem and subjective vitality. Menopausal symptoms can have deleterious effects on body image and wellbeing (Deeks & McGabe, 2001;Pearce, Thøgersen-Ntoumani, & Duda, under review-a) but menopausal women who exercise regularly have greater levels of wellbeing, specifically life satisfaction and self-esteem (Darling, Coccia, & Senatore, 2012;Elavsky & McAuley, 2005, 2007a, 2007b. Therefore, in our model in chapter 5, satisfaction with life and levels of self-esteem represented the wellbeing outcomes in our structural equation model. ...
... Life satisfaction and self-esteem are two more common forms of eudaimonic wellbeing examined in relation to menopause, exercise and body image. Overall, research has discussed the associations between menopausal symptoms and exercise (Daley, et al., 2009;, menopausal symptoms, health and life satisfaction (Dennerstein, Dudley, Guthrie, & Barrett-Connor, 2000;Dennerstein, Dudley, & Guthrie, 2003;Dennerstein, Lehert, Guthrie, & Burger, 2007), exercise and body image (Campbell & Hausenblas, 2009;Hausenblas, Brewer & Raalte, 2004;Hausenblas & Fallon, 2006), and body image and wellbeing (Cash, 2004;Fox, 1997 (Darling, Coccia, & Senatore, 2012;Elavsky & McAuley, 2005, 2007a, 2007b. Therefore satisfaction with life and levels of self-esteem represented the wellbeing outcomes in our model. ...
Thesis
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Aim: To undertake exploratory work examining the relationship between menopausal symptoms, body image, exercise and wellbeing. Method: A mixed methods approach was used, including a systematic scoping review, the development of a synchronous text-based online interviewing tool; a qualitative Interpretative Phenomenological Analysis study, and mixed methods study. Results: The review showed that women’s experiences of the menopause and body image can be both positive and negative simultaneously, which has implications for the way these concepts are quantitatively measured. A synchronous online interviewing tool is an additional method to be added to the researchers’ tool kit, especially if the topic is sensitive and an extra level of anonymity is needed. The IPA study focused on experiences of body image concerns and identified a range of ways menopausal women cope with such changes. Through Structural Equation Modelling and interviews, we identified that menopausal symptoms may act as a barrier to exercise participation by decreasing a woman’s subjective vitality, and reducing perceptions of attractiveness, life satisfaction and self-esteem. Conclusion: Health psychology of the menopausal transition is in its infancy. It is not only important to consider methods to reduce symptoms, but also the impact symptoms have on health behaviour, body image and wellbeing.
... The Menopause-Specific Quality of Life Questionnaire developed by Hilditch et al., has 29 sub-items and a 7-point scale ranging from 0 to 6. Each sub-item comprises four domains: vasomotor (items 1-3), psychosocial (items 4-10), physical (items [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26], and sexual (items [27][28][29], and each sub-item includes a symptom that may arise during menopause. Respondents indicate whether or not a specific issue has affected them in the previous month. ...
Article
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The study aimed to determine whether self-efficacy acts as a moderator between the severity of menopausal symptoms and life satisfaction. The research tools were: The Generalized Self-Efficacy Scale (GSES), The Satisfaction with Life Scale (SWLS) The Menopause – Specific Quality of Life (MENQOL), and a standardized questionnaire comprising questions on the participants’ characteristics. 516 women using health care services who had menopausal symptoms took part in the study. Self-efficacy (GSES) (r = −0.176; p < 0.001) and life satisfaction (SWLS) (r = −0.106; p = 0.016) were negatively correlated with the severity of menopausal symptoms (MENQOL). The self-efficacy correlated positively with satisfaction with life (r = 0.278; p < 0.001). A low level of self-efficacy was associated with a significant and negative relationship between the severity of menopausal symptoms and satisfaction with life (p = 0.005), while at a high and moderate level of self-efficacy, the severity of menopausal symptoms was not associated with life satisfaction (p > 0.05). Self-efficacy moderates the relationship between the severity of menopausal symptoms and life satisfaction in menopausal women. The moderating function of self-efficacy is that, at its low level, an increase in the severity of menopausal symptoms reduces life satisfaction, while at medium and high levels, an increase in the severity of menopausal symptoms does not reduce life satisfaction.
... In midlife women, higher BMI may be associated with an increased prevalence of depressive symptoms and major depression diagnosis [95]. Further, midlife women with higher BMI are more likely to have lower life satisfaction and higher physical and psychological health stress such as body aches, difficulty relaxing, headaches, or feeling stressed and nervous [96]. ...
Article
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Purpose of Review To summarize the evidence and clinical implications of weight and body composition changes during midlife in women and provide an overview of weight gain prevention and management in this population. Recent Findings Aging-related changes such as decreased energy expenditure and physical activity are important culprits for weight gain in midlife women. The hormonal changes of menopause also influence body adiposity distribution and increase central adiposity. These body changes can have health consequences including the development of cardiometabolic diseases, osteoarthritis, cancer, worsening in cognition, mental health, and menopause symptoms. Summary Midlife women experience changes related to aging, menopause, and lifestyle which favor weight gain. Clinical practice should focus on early counseling and anticipatory guidance on the importance of dietary changes and physical activity to attenuate this phenomenon. Future research should focus on the longitudinal relationship between weight trends in midlife and health consequences and mortality.
... The extent to which interventions are acceptable to women may depend on whether the approach to delivery addresses potential challenges they might face with respect to intervention participation. Women have reported multiple and complex role demands and stressors [21] and barriers to PA (eg, lack of time, motivation, and family support; caregiving responsibilities; climate; and safety concerns [22,23]) that can impair their ability to access and engage in behavior change interventions [24]. Practical ways of promoting PA that are effective, efficient, and sustainable should be used to address such barriers. ...
Article
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Background: Insufficient physical activity (PA) and excess weight increase illness risk for women. Face-to-face interventions can increase PA levels; however, they are often inaccessible. With growing interest in digital interventions, a Self-Determination Theory (SDT)–driven intervention was developed and delivered via email to promote PA in women who were insufficiently active and overweight or obese. Objective: This substudy explores users’ perspectives about the acceptability and usability of the intervention, which was coupled with a wearable activity monitor and PA recommendations. Methods: A 3-arm, parallel group, randomized controlled trial (unblinded) was conducted in Ontario, Canada. Recruitment occurred from September 2018 to March 2019 via advertising through social media, web-based boards, and posters in publicly accessible areas. In total, 47 women with a BMI of ≥25 kg/m2 who were not meeting the Canadian PA guidelines were randomly assigned to 1 of 3 arms (arm 1: n=15, 32%; arm 2: n=16, 34%; arm 3: n=16, 34%). This substudy focused on the 15 participants allocated to the main intervention arm. Participants received an automated intervention consisting of (1) 6 weekly emails, (2) a Polar Electro Inc A300 activity monitor (with access to the Polar Flow website and companion smartphone app), and (3) a copy of the Canadian PA guidelines for adults. Emails were developed using SDT and designed to enhance autonomous motivation by fostering the psychological needs of competence, autonomy, and relatedness. Well-established motivational and behavior change techniques were embedded in the emails to promote needs satisfaction. After the intervention (ie, 7 weeks after randomization), participants were invited to complete a web-based acceptability and usability survey containing open-ended and closed-ended questions; responses were analyzed using descriptive and content analyses, respectively. Results: The analyses included data from 93% (14/15) of the women (age: mean 33.4, SD 7.5; range 24-44 years; BMI: mean 31.3, SD 5.8 kg/m2; range 25-40.5 kg/m2) who received the main intervention and completed the postintervention survey. Open-ended responses indicated that participants were generally satisfied with the intervention and appreciated that emails prompted self-reflection, kept them on track and accountable, provided informational support, and were nonpressuring. Furthermore, they suggested that the monitor was “enjoyable” and “helpful”; quantitative data corroborated this, as 71% (10/14) said that the monitor was “very valuable/absolutely valuable,” 71% (10/14) would “very probably/definitely” still use one, and 86% (12/14) wore it for ≥5 days per week for ≥8 hours per day and checked it “occasionally/frequently/very frequently.” Potential threats to acceptability included “long” and “text-heavy” emails; lack of personal contact; and cumbersome, unaesthetic monitors. Conclusions: Results suggest that this SDT-driven, email-delivered intervention may be an acceptable low-contact approach to promote PA in women who are overweight or obese and insufficiently active; however, improvements are warranted and studies ascertaining its effectiveness are needed.
... Exercise and physical activity are associated with increased mood, increased attention capacity, and cognitive capacity. Many studies have found that physical activities such as horseback riding, walking, cycling, fishing, and conservation activities in nature lead to significant improvements in self-esteem and coping with mood disorders (Asztalos et al., 2012;Darling, Coccia, & Senatore, 2012;Steptoe & Butler, 1996). ...
Conference Paper
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For Indonesia, the sport has become a public need and therefore policies are made to regulate and provide services so that people can carry out sports activities optimally. Sport makes people get physical and psychological health, social and economic benefits that lead to a better quality of life. Research conducted on 20,010 respondents aged 10-60 years in 34 provinces in Indonesia showed that the active participation rate in sports was 32.83% and 53.63% of physical fitness was in the "very poor" category. Those who are active in sports have been shown to have better health, resilience, and social capital than those who do not exercise. There are 56% or around 110.45 million people who spend their money on sports needs reaching IDR43.8 trillion/year. Research also proves that physical activity contributes significantly to the quality of life which is reflected in psychological, health, environmental, and social aspects.
... Compared with men, women are more likely to use smartphones and health apps daily [28], and 83% of adults aged 55 to 64 years owned a smartphone in 2021 [29]. Moreover, women may particularly favor mobile-based interventions that use flexible delivery modes as a motivator to overcome the risk of not allocating sufficient time to be physically active [30][31][32]. Unlike in-person training programs, mobile PA interventions may encourage women to overcome physical barriers (ie, lack of time because of multiple responsibilities [33][34][35][36]) and feelings of stigma, social discomfort, and self-consciousness linked with participation in group-based PA programs and gym attendance [35,37], for example, a fear of being judged for decreasing abilities [37]. ...
Article
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Background: Midlife women with menopausal symptoms are less likely to meet the recommended level of physical activity (PA). Promoting PA among women in midlife could reduce their risk of cardiovascular diseases and perhaps improve menopausal symptoms. Mobile PA interventions in the form of smartphone apps and wearable activity trackers can potentially encourage users to increase PA levels and address time and resource barriers to PA. However, evidence on the acceptability and effectiveness of these interventions among midlife women is unclear. Objective: This systematic review evaluated the effectiveness, acceptability, and active behavior change techniques (BCTs) of mobile PA technologies among midlife menopausal women. Methods: A mixed methods systematic review of qualitative and quantitative studies was conducted. MEDLINE (Ovid), Embase, Scopus, CINAHL, Web of Science, SPORTDiscus, CENTRAL, PsycINFO, and the ProQuest Sports Medicine and Education Index were systematically searched. Studies were selected and screened according to predetermined eligibility criteria. In total, 2 reviewers independently assessed the risk of bias using the Mixed Methods Appraisal Tool and completed BCT mapping of the included interventions using the BCT Taxonomy v1. Results: A total of 12 studies were included in this review. Overall risk of bias was "Moderate to high" in 58% (7/12) of the included studies and "low" in 42% (5/12) of the studies. Of the 12 studies, 7 (58%) assessed changes in PA levels. The pooled effect size of 2 randomized controlled trials resulted in a small to moderate increase in moderate to vigorous PA of approximately 61.36 weekly minutes among midlife women, at least in the short term (95% CI 17.70-105.01; P=.006). Although a meta-analysis was not feasible because of heterogeneity, positive improvements were also found in a range of menopause-related outcomes such as weight reduction, anxiety management, sleep quality, and menopause-related quality of life. Midlife women perceived mobile PA interventions to be acceptable and potentially helpful in increasing PA and daily steps. The average number of BCTs per mobile PA intervention was 8.8 (range 4-13) according to the BCT Taxonomy v1. "Self-monitoring of behaviour," "Biofeedback," and "Goal setting (behaviour)" were the most frequently described BCTs across the included interventions. Conclusions: This review demonstrated that mobile PA interventions in the form of smartphone apps and wearable trackers are potentially effective for small to moderate increases in moderate to vigorous PA among midlife women with menopausal symptoms. Although menopause is a natural condition affecting half the population worldwide, there is a substantial lack of evidence to support the acceptability and effectiveness of mobile PA interventions on menopause-related outcomes, which needs further investigation. Trial registration: PROSPERO CRD42021273062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273062.
... For women who have experienced intimate partner violence, resilience and life satisfaction might be negatively influenced. According to Darling, Coccia, and Senatore (2012), selfassessment of feelings and attitudes about life and whether or not they have met the standards they have set for themselves will determine their satisfaction. Factors that can affect Latinas who survive intimate partner violence can influence the priorities they give to the components that influence their life satisfaction. ...
Article
We implemented a small series (N = 3) single-case research design to assess the effectiveness of a nine-session positive psychology treatment program for Latina survivors of intimate partner violence. Analysis of participants’ scores on life satisfaction and depression scales using the percentage of non-overlapping data point’s procedure yielded treatment effects indicating that a positive psychology treatment program may be effective for improving life satisfaction for Latina survivors of intimate partner violence. Implications for counselors and researchers are provided.
... La satisfacción con la vida es dinámica de acuerdo al ciclo vital, y cambia conforme a las condiciones del entorno social (Vera, et al., 2016). En mujeres maduras, ésta se ve influida negativamente por el estrés, problemas de salud, angustia, mala calidad del sueño y problemas en la economía familiar (Darling, Coccia, y Senatore, 2012). En un estudio realizado con mujeres mexicanas, se encontró que la autoestima, la percepción del apoyo familiar, el autoconcepto y la ocupación predicen la satisfacción con la vida en mujeres post y perimenopáusicas (Martínez-Garduño, 2012). ...
Article
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El climaterio (transición entre la vida reproductiva y no reproductiva de una mujer) se ha asociado con una variedad de síntomas tanto somáticos como psicológicos, aunque éstos difieren en su severidad. El objetivo de este estudio fue analizar la influencia de la satisfacción con la vida y la escolaridad sobre los síntomas asociados al climaterio en mujeres perimenopáusicas, tomando en cuenta su estatus laboral (trabajo fuera del hogar o amas de casa). Participaron 314 mujeres entre 45 y 53 años de edad, quienes contestaron la Escala de Climaterio de Greene y la Escala de Satisfacción con la Vida. Los resultados mostraron que las mujeres que no eran profesionistas reportaron síntomas psicológicos más severos que las profesionistas, pero solo entre aquéllas que trabajaban fuera del hogar.La satisfacción con la vida fue un predictor significativo de ocho de los nueve síntomas psicológicos estudiados. En conclusión, este estudio arroja evidencia empírica de la influencia de estas variables psicosociales en el reporte de la sintomatología del climaterio, y los resultados pueden ser útiles para diseñar programas de intervención dirigidos a mujeres maduras.
... Determining the life satisfaction of dentists is important because they are essential for public health; therefore, efforts to increase their life satisfaction should be made. 18,19 Unemployment has a negative effect on life satisfaction, and this effect is more pronounced among males than females. 20 In our study, most general practitioner dentists (82.3%) indicated unemployment as the main future professional problem. ...
Article
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Objectives The present study aimed to determine the levels of happiness among dentists and to investigate their associations with emotional well-being and satisfaction with life. Methods Dentists in Turkey were surveyed with 25 questions on age, gender, place of work, and years of experience, and a five-item life satisfaction scale. Results A total of 486 dentists completed the survey. Dentists' workplaces and professional titles were associated with their life satisfaction scores. Most dentists (n = 373; 76.25%) reported feeling pressured in their work environment, and the institution where they worked was significantly associated with the degree of pressure (p < 0.001). Institution (p < 0.001), job title (p < 0.001), and work experience (p < 0.019) were significant factors in whether they would recommend their profession to others. Dentists' institutions and titles were significantly associated with life satisfaction (p < 0.001). Conclusions Our findings suggest that dentists in Turkey have a low life satisfaction with respect to that of other professionals and dentists from other countries. In addition, the factors associated with life satisfaction vary.
... A midlife crisis refers to physical, social, and emotional confusion and conflict that may be experienced as a middle-aged adult faces a developmental transition [10,11]. Moreover, a midlife crisis may be triggered by multiple life stressors or events, such as job demands, financial responsibilities for family, parental death, or children leaving home upon entering adulthood [12,13]. These factors can generate a family crisis [10], increase the difficulty of preparing for a successful postretirement life, and eventually hinder the transition into older adulthood [10,14]. ...
Article
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Middle-aged men bridge younger and older generations and are burdened with social roles and responsibilities that increase their risk of poor health. The aim of this study was to investigate whether family stress had a mediating effect on the relationship between self-efficacy and midlife crisis in a sample of 198 middle-aged South Korean men. Mediation analysis was performed according to the Baron and Kenny method and using the Sobel test. This study confirmed that midlife crisis decreased with increased self-efficacy and increased with family stress level. Family stress was also a significant partial mediator of the relationship between self-efficacy and midlife crisis. As family stress influences all members of the family, interventions are required that engage all family members to alleviate stress. Strategies to boost self-efficacy should be utilized, and family support constitutes the best means of coping.
... The findings of previous research indicate financial stress can be one of the determinants of life satisfaction for farmers. Stress, including financial stress, is known to affect one's life satisfaction (Darling et al., 2012;Marum et al., 2014;Veldorale-Griffin et al., 2013). Thus, it is inferred that farmers' level of financial stress is negatively related to their life satisfaction. ...
Article
Farmers as individual financial decision-makers can be better identified as those under the greater responsibility of managing multi-faceted stressful situations in both family and farm management. With using 1044 random sampling survey method, this study investigates how financial stress, financial risk tolerance, locus of control, and financial self-efficacy are associated with the life satisfaction of farmers. By investigating the farmer's financial stress and finance-related psychological factors on their life satisfaction, this study has a purpose to inform financial services professionals, such as financial planners and advisors, of how to better serve a population in the farmland industries. Our findings showed that: (a)_ financial stress decreases the life satisfaction, but farmers show lower maringal effect than the non-farmers; (b) locus of control increases the life satisfaction, but the farmers show smaller marginal effect than non-farmers, and (c) demographic factors show different maringal effects among non-famrers and farmers (i.e., age, education, gender). Overall, identification of themselves as a farmer eased the negative relationship between financial stress and life satisfaction but reduced the positive relationship between locus of control and life satisfaction.
... There is evidence that multiple health behavior change (MHBC) interventions tailored for women are effective in changing behavior [12,13]. Furthermore, given the multiple and complex role demands and stressors reported by women in this age group [14], flexible health promotion interventions have the potential to yield greater success. Over the past decade, Web-based or internet interventions also show promising results in promoting physical activity and healthy eating [15]. ...
Article
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Background: Noncommunicable diseases pose a significant threat to women's health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise. Objective: This study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women's Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women. Methods: Women aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time. Results: Participants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time. Conclusions: The results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.
... Women in midlife frequently experience stress 1,2 . Midlife stress may relate to concerns regarding personal health and aging, psychosocial factors, work-related pressures, and worry about elderly parents and teenaged children 2 . ...
Article
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Purpose: Midlife women frequently experience stress and menopausal symptoms. Mindfulness is thought to mitigate stress by avoiding emotional reactivity and ruminative thinking. We sought to assess the association of mindfulness and stress on menopausal symptoms among midlife women. Materials and methods: In this cross-sectional study, women aged 40–65 years completed questionnaires, including the Menopause Rating Scale (MRS), the Perceived Stress Scale-4 (PSS-4), and the Mindfulness Attention Awareness Scale (MAAS). Linear regression was used to assess the impact of mindfulness and stress on menopausal symptoms with use of univariate and multivariable analyses, adjusting for patient characteristics. Results: In this cohort of 1744 midlife women, higher mindfulness (MAAS) and lower stress (PSS-4) scores correlated independently with lower menopausal symptom (MRS) scores. On multivariable analysis, a significant interaction effect was observed between the MAAS and PSS-4 on the MRS, such that with higher PSS-4 scores, the magnitude of association between the MAAS and lower MRS scores was larger. Conclusion: Among midlife women, higher mindfulness and lower stress correlated with lower menopausal symptom scores independently. Among women experiencing more stress, the magnitude of association between mindfulness and lower menopausal symptom scores was greater, largely driven by psychological subdomain scores. Mindfulness may mitigate menopausal symptoms among midlife women.
... However, some symptoms may be better explained by combining physiological information with the social changes that coincide with this time of life. For example, a woman's children are likely to be adolescents with their own challenges, husbands may be undergoing transition in social status such as retirement or struggling with health issues, and parents may be in need of substantial levels of care [7,8]. ...
Article
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Background Stress has been implicated as a factor in the presence and severity of symptoms during the menopausal transition. Our primary aim was to test the hypothesis that stress-sensitive biological measures and self-reported stress would be positively associated with a greater likelihood and intensity of hot flashes. Our secondary aim was to examine measures of stress in relation to the most often reported symptoms in Campeche, Mexico. We also hypothesized ethnic differences (Maya versus non-Maya) in relation to measures of stress and symptom reports. Methods Participants aged 40–60 (n = 305) were drawn from multiple sites across the city of San Francisco de Campeche to achieve a generally representative sample. Measures included C-reactive protein (CRP), an indicator of inflammation; Epstein-Barr virus antibodies (EBV-Ab), an indicator of immune function; the Perceived Stress Scale (PSS); a symptom checklist; anthropometric measures; and a questionnaire that elicited symptoms, ethnicity (based on language, birthplace, and last names of the woman, her parents, and her grandparents) and ten dimensions of socioeconomic status (SES). The relationships between symptoms and stress-sensitive biological and self-reported measures were examined in bivariate analyses, and with logistic and linear regressions. Results The twelve most common symptoms reported, in descending order of frequency, were tiredness, muscle and joint pain, nervous tension, problems concentrating, feeling depressed, difficulty sleeping, headaches, feeling of ants crawling on the skin, loss of interest in sex, urinary stress incontinence, hot flashes, and night sweats. PSS scores were significantly associated with the likelihood of seven symptoms (yes/no), and with the intensity of ten symptoms after controlling for ethnicity, SES, education, cohabitation status, parity, smoking, body mass index, and menopausal status. The stress-sensitive biological measures of immune function (EBV-Ab and CRP) were not significantly associated with midlife symptoms. The PSS was associated with more symptoms among the Maya (e.g., feeling nervous/tense and having difficulty concentrating) than non-Maya. Conclusion PSS scores were associated with the intensity, but not the likelihood, of hot flashes. Other symptoms were also associated with self-reported stress but not with physiological measures. Maya/non-Maya differences may indicate that either symptoms or stress were experienced and/or reported in culture-specific ways.
... PS is higher among women than men, and more prevalent in individuals with lower income and educational level [10][11][12][13]38,39]. Middle-aged and old women experience stressful life changes and insomnia, have increased body weight and more significant health worries, low life satisfaction and greater loneliness [10][11][12]16,40]. PE is associated with a higher prevalence of chronic conditions, multi-morbidity and worse health outcomes [41]. ...
Article
Objective: To clarify the effect of programmed exercise (PE), performed for at least six weeks, on perceived stress (PS) in middle aged and old women. Methods: A structured search was carried out in PubMed, Embase, Cochrane Library, Scielo, Web of Science and Scopus, from database inception through January 10, 2018, without language restriction. The US, UK, and Australian clinical trials databases were also searched. The search included a combination of the terms "programmed exercise", "perceived stress", "menopausal women" and "randomized controlled trial" (RCTs). PE was classified according to duration as "mid-term exercise intervention" (MTEI; mean duration 6 months), and "long-term exercise intervention" (LTEI; mean duration 12 months). Mean ± standard deviations of changes in PS scores, as assessed with different questionnaires, were calculated as standardized mean differences (SMDs) and used as effect size for meta-analysis. SMDs of PS after intervention were pooled using a random-effects model. Study quality and bias risk were assessed with the Cochrane tool. Results: Five RCTs that studied midlife and older women (mean age 47.0 ± 1.7 years minimum to 71.8 ± 5.6 maximum) were included in the meta-analysis. There was no significant effect of PE on PS score (SMD: -0.16; 95% CI: -0.43 to 0.11). In subgroup analyses, there was no significant effect of PE on PS with mid-term interventions (SMD: - 0.17; 95% CI: -0.59 to 0.25) nor with long-term interventions (SMD: -0.02; 95% CI: -0.42 to 0.38) as compared with controls. Conclusion: PE of low to moderate intensity does not improve PS in midlife and older women.
... There is evidence that multiple health behaviour change (MHBC) interventions tailored for women are effective in changing behaviour [13][14][15][16]. Further, given the multiple and complex role demands and stressors reported by women in this age group [17], flexible health promotion interventions have the potential to yield greater success. Over the past decade 'web-based' or 'internet' interventions also show promising results in promoting physical activity and healthy eating [18]. ...
Preprint
BACKGROUND Noncommunicable diseases pose a significant threat to women’s health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise. OBJECTIVE This study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women’s Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women. METHODS Women aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time. RESULTS Participants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time. CONCLUSIONS The results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.
... Generally, "other orientated" carer roles are more common for women (Fullagar & O'Brien, 2014). In addition, middle-aged women often suffer from perimenopausal or menopausal symptoms such as hormone changes, reduced energy, body fat re-distribution, weight gain and sleep disturbances (Darling, Coccia, & Senatore, 2012). ...
Article
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The aim of this paper is to analyse why the largest percentage of spa, wellness and health tourism customers tend to be middle aged (around 45 on average) and predominantly female. Both academic and popular psychological research indicate that life satisfaction reaches a nadir during the middle years of life during which many adults experience a so-called mid-life crisis. However, it is often the case that people become happier again as they age – the “U-bend” of life theory. The first part of this paper explores a number of studies which support these theories, followed by an analysis of primary research which consisted of 60 e-interviews with professional people aged 40 and over. The final part of the paper considers the implications for the spa, wellness and health tourism industries and makes recommendations for how these sectors can provide the ideal services for their core market of middle-aged and female guests.
... Furthermore, both number of stressors and perception of stress are associated with depression [12,13]. Research supports gender differences both in terms of stressor perception and stressor-associated depression, with women typically being found more susceptible to depression than men [14][15][16]. ...
Article
Purpose: Middle-age may be a challenging time for people with physical disabilities as life demands, secondary symptoms such as fatigue, and risk for depression increase, yet little is known about types, levels, and impact of life stressors in individuals aging with disability. Our aims were to describe aging- and disability-associated life stressors, explore gender differences, and evaluate effects of resilience on adjustment to these stressors. Materials and methods: Longitudinal data analysis of self-report surveys completed by 541 middle-aged community-dwelling participants with long-term physical disability from baseline to 5-year follow-up. Results: 97% of participants endorsed one or more stressful life events (M = 8.2, SD = 4.9), all of whom endorsed at least one life stressor with a negative impact. Reporting more life stressors and having lower resilience were significantly associated with developing more depressive symptoms. Interaction analyses indicated that women developed more depressive symptoms as negative impact increased than men. Conclusions: Findings suggest that middle-aged individuals with physical disability experience a range of life stressors, many with negative impact. Women are at higher risk of depressive symptoms than men. Resilience may buffer against negative impact of life stressors on development of depressive symptoms. Targeted intervention to increase resilience, especially in women, may decrease risk of depression in persons aging with disability. • Implications for Rehabilitation • Middle-age adults living with physical disability experience a number of aging- and disability-associated stressors that can have a negative impact and contribute to depression. • Women aging with disability who experience more negative impact from life stressors may be more vulnerable to developing depression. • Providing interventions that enhance resilience when faced with life stressors could prevent development of depression.
... The husband is the leader of the house, and the wife has to obey him. All these situations in Jordan are supported by law and social structure (Al-Badayneh, 2012), affected women's psychological status and increased their stress, and consequently, lowered their life satisfaction (Darling, Coccia, & Senatore, 2012). ...
Article
Dissatisfied pregnant women who are at higher risk of negative outcomes perinatally have not been identified in Jordan. The purposes of the researchers were to identify and compare socio-demographic characteristics of satisfied pregnant women with dissatisfied pregnant women. A non-experimental, descriptive, comparative design was employed. Jordanian pregnant women (n = 203) were consecutively selected. We found that younger, better educated pregnant women, with high economic status and small number of children were more satisfied with their life. Practitioners can identify dissatisfied women and develop an educational and interventional package that focuses on improving satisfaction with life for pregnant mothers.
... For example, Hess et al. (2012) found that mental health and emotional well-being tend to be lower during late periods of peri-menopause (i.e. during the transition) and the initial phases of post-menopause compared to pre-menopause. In addition, significant shifts and transformations across personal, family, and social contexts during the menopause transition can become a significant source of distress (Darling et al., 2012). Data from the Study of Women's Health Across the Nation (SWAN) revealed that compared to pre-menopausal women, women in peri-menopause reported higher levels of psychological distress (Bromberger et al., 2001). ...
Article
The transition to menopause is a critical period of significant biopsychosocial change. The purpose of this study was to examine the influence of the transition to menopause and volume of physical activity on levels of perceived stress over five years in 102 healthy middle-aged women. Questionnaire and accelerometer data were analyzed using linear mixed models. Adjusting for age and body mass index, there were no significant effects of menopause status or time on perceived stress. Independent of menopause status, minutes per week of vigorous activity was associated with lower perceived stress in years 1 and 2 of the study.
... However, at any time point, individuals might face numerous adversities and challenges, which can lead to stress, strain, or pressure (Lazarus & Folkman, 1984). Given the established link between high stress and low life satisfaction among mid-and late-life adults in the research literature (Darling, Coccia, & Senatore, 2012;Krause, 2005), we assumed that individuals who reported high levels of ongoing stress, strain, or pressure in their lives would report low levels of life satisfaction. ...
Conference Paper
Background and Purpose: The divorce rate among individuals who are 50 years old or older (late-life divorce) doubled between 1990 and 2010, and roughly 1 in 4 divorces in 2010 involved persons aged 50 and older. Yet, this population has received little empirical attention. This investigation seeks to identify the correlates of post-divorce life satisfaction of women and men who divorce at age 50 or older. Drawing on Schlossberg’s Transition Theory, four sets of risk and protective factors are modeled for their influence on the success of the divorce transition: (a) situation (e.g., previous experience), (b) self (e.g., health) (c) support (e.g., new relationship), and (d) coping responses and strategies (e.g., cognitive appraisal). The task of identifying “malleable mediators” that account for variation in an outcome of interest is the first step in an intervention research model. Method: Source of Data: The data were collected from nationally representative sample of the U.S. population via an online survey in December 2003 as part of AARP’s study, The Divorce Experience: A Study of Divorce at Midlife and Beyond (Montenegro, 2004). A stratified random sample of 1,148 respondents who reported a divorce between the ages of 40 and 69 completed the survey. Sample: The sample was restricted to those respondents who reported a divorce at age 50 or older, which included 131 women and 150 men. Measures: Single items were used to assess the constructs in the empirical model, including life satisfaction. Analysis: The life satisfaction of sample respondents was regressed on a set of time covariates and sets of situation, self, support, and strategy variables for women and men. Analyses were averaged over five imputations to account for missing data, and robust standard errors were used to correct for slight heteroskedasticity. Results: Overall, the regression model accounted for 28.0% of the variance in the life satisfaction of women and 40.0% of the variance in the life satisfaction of men. Being in a new relationship with a marital or domestic partner had a positive influence on the life satisfaction of both women (β = .26) and men (β = .37); current stress, strain or pressure had a negative influence for women and men (β = -.31 and β = -24, respectively). Compared to women without children, having at least one child 18 years old or older at the time of divorce was positively associated with the life satisfaction of women (β = .24). Conclusions and Implications: The availability of companionship and social support from a spouse or partner may help account for the higher level of life satisfaction of those respondents who had remarried or who were in domestic partnerships. Not surprising, the life satisfaction of divorced men and women is compromised in the face continued stress, strain or pressure—a “malleable mediator” for intervention planning. Future analysis is needed to determine the profile of women and men reporting high levels of current stress. The cross-sectional nature of the data warrants caution in the interpretation of findings.
... For example, Hess et al. (2012) found that mental health and emotional well-being tend to be lower during late periods of peri-menopause (i.e. during the transition) and the initial phases of post-menopause compared to pre-menopause. In addition, significant shifts and transformations across personal, family, and social contexts during the menopause transition can become a significant source of distress (Darling et al., 2012). Data from the Study of Women's Health Across the Nation (SWAN) revealed that compared to pre-menopausal women, women in peri-menopause reported higher levels of psychological distress (Bromberger et al., 2001). ...
... However, at any time point, individuals might face numerous adversities and challenges, which can lead to stress, strain, or pressure (Lazarus & Folkman, 1984). Given the established link between high stress and low life satisfaction among mid-and late-life adults in the research literature (Darling, Coccia, & Senatore, 2012;Krause, 2005), we assumed that individuals who reported high levels of ongoing stress, strain, or pressure in their lives would report low levels of life satisfaction. ...
Article
Late-life divorce—divorce at 50 years and older—is an increasingly common event in the United States. Despite this trend, the conditions and outcomes for those involved in late-life divorce remain understudied. Drawing on Schlossberg’s transition theory, we assess four sets of risk and protective factors (i.e., situation, self, support, and coping strategies) that could influence the postdivorce life satisfaction of adults who experience late-life divorces. Using the data set of a nationally representative study, we obtained an analytical sample of 164 men and 145 women who reported a divorce at 50 years or older (N = 309). Results from ordinary least squares regression analysis indicate few statistically significant effects from the sets of risk and protective factors entered in the second and third steps of the analysis. Implications, limitations, and directions for future research are discussed.
... Divorce for older Hispanic adults in Miami-Dade is related to personal choice, selffulfillment, and self-betterment (Darling, Coccia, & Senatore, 2012). It is also related to developing and maintaining healthy relationships. ...
Article
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The objective of this research is to test the granting of stock options as part of CEO compensation to earnings quality. Agency theory posits a conflict between the CEO’s own self- interest and that of the owners who seek to maximize the long-term value of their investment. To avoid this conflict, compensation should align and bond these parties. The authors acquired the data from CompuStat and ExecuComp databases spanning the years of 2000 through 2009. The Dechow and Dichev (2002) model provides the earnings quality model for this study using the change in working capital with the error terms serving as the residuals. The hypothesis uses earnings quality as a proxy for management choices and as the predictive power of accruals. The first hypothesis indicated granting of CEO stock options has a positive association to earnings quality.
... Collectively, these studies suggest a biochemical mechanism through which stress could exert an influence on skin condition. Given the high stress load on adult women in today's modern world [21] and the presence of a specific system involved in stress response in the sebaceous gland [27,28,70,71], it is possible that persistent or lateonset acne could be influenced by stress [5,17,46,76]. ...
Article
In recent years, the prevalence of adult female acne has increased, but the reason for this increase remains unclear. Acne is one of the most common skin disorders. It can be triggered or worsened by endogenous and exogenous factors, including genetic predisposition, hormone concentrations, diet, smoke and stress; although the interaction with this last factor is not well understood. Modern life presents many stresses including urban noises, socioeconomic pressures and light stimuli. Women are especially affected by stress during daily routine. The recent insertion in the labor market is added to the duties of the mother and wife. Women also have a higher risk of developing psychiatric disorders such as depression and anxiety. Sleep restriction is added to these factors, with several negative consequences on health, including on hormonal secretion and the immune system. This is further complicated by the natural variation in sleep architecture across the menstrual cycle. Recent studies have brought new data about the mechanisms and possible factors involved. This review aims to establish a connection between stress, sleep deprivation and adult female acne.
... Being overweight and obesity have become an increasing problem of modern society 1) . Previous research has shown high levels of Body-Mass-Index (BMI) to be a risk factor for impaired well-being [2][3][4] and health [5][6][7][8] . Additionally, being overweight and obesity are associated with considerable costs in the workplace 9,10) , direct medical costs and indirect costs following disability retirement 11,12) or occupational injuries 13) . ...
Article
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Social stressors at work (such as conflict or animosities) imply disrespect or a lack of appreciation and thus a threat to self. Stress induced by this offence to self might result, over time, in a change in body weight. The current study investigated the impact of changing working conditions - specifically social stressors, demands, and control at work - on women's change in weighted Body-Mass-Index over the course of a year. Fifty-seven women in their first year of occupational life participated at baseline and thirty-eight at follow-up. Working conditions were assessed by self-reports and observer-ratings. Body-Mass-Index at baseline and change in Body-Mass-Index one year later were regressed on self-reported social stressors as well as observed work stressors, observed job control, and their interaction. Seen individually, social stressors at work predicted Body-Mass-Index. Moreover, increase in social stressors and decrease of job control during the first year of occupational life predicted increase in Body-Mass-Index. Work redesign that reduces social stressors at work and increases job control could help to prevent obesity epidemic.
... Poor sleep quality, impaired sleep [16,17], and chronic psychological stress have also been linked with inflammation [18][19][20]. On the other hand, stressful life changes, health stress, a high body mass index and poor quality of sleep have been related to lower life satisfaction among women [21]. However, better knowledge is needed of the link between inflammatory factors and life satisfaction [22]. ...
Article
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Mental health is interconnected with somatic health and can manifest itself in biological processes. Life dissatisfaction is an indicator of subjective well-being, but information on its biological correlates is scarce. The aim of this study was to investigate the biological correlates along with other health-related factors of long-term life dissatisfaction in a population-based sample. As part of the Kuopio Depression Study, health questionnaires were sent to a randomly selected population-based sample in 1998, 1999, and 2001. In 2005, among a clinically studied sub-sample (n = 305), the 7-year long-term life dissatisfaction burden was assessed by summing life satisfaction scores from previous health questionnaires. Several sociodemographic, health, health behavior, and biological factors were investigated in respect to their associations to categorized (low and high) and continuous (linear regression) life satisfaction burden score (higher values indicating dissatisfaction). In the final linear regression model long-term life dissatisfaction burden was significantly associated with poor social support (B = 0.138; p < 0.001), marital status (i.e. living alone) (B = 0.049; p = 0.019), current smoking (B = 0.087; p < 0.001), poor sleep (B = 0.052; p = 0.001), use of statins (B = -0.052; p = 0.002) and lower serum adiponectin level (B = -0.001; p = 0.039) whereas association of metabolic syndrome was marginally nonsignificant (B = 0.029; p = 0.055). Long-term life dissatisfaction is associated with adverse health, health behavioral, and social factors, as well as with a decreased anti-inflammatory buffer capacity, all indicating close relationships between subjective well-being and somatic morbidity.
Preprint
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Background: Insufficient physical activity and excess weight increase illness risk for women. Email-delivered interventions may be a solution for offering accessible, cost-effective, brief support to women to increase their engagement in physical activity. This study explored participants’ perspectives of the acceptability and usability of a theory-driven, email-delivered intervention coupled with a wearable activity monitor designed to promote physical activity in women who were insufficiently active and overweight/obese. Methods: In this three-arm parallel group randomized controlled trial (unblinded), participants allocated to the main intervention arm received a fully automated intervention consisting of: (a) six weekly emails, (b) a Polar A300 activity monitor (with access to the Polar website and companion smartphone application), and (c) a copy of the Canadian physical activity guidelines for adults (18-64 years). Email content, informed by self-determination theory, was designed to enhance autonomous motivation for physical activity through fostering perceptions of competence, autonomy, and relatedness by sharing motivational and behaviour change techniques to promote needs satisfaction. Post-intervention, participants completed an acceptability survey containing open- and closed-ended questions online. Descriptive and content analyses were performed for responses to closed- and open-ended questions, respectively. Results: Data from 14 women (age range=18-63 years, mean body mass index=31.3±5.8 kg/m2) who received the main intervention and completed the post-intervention survey were analyzed. Qualitative data indicated most were satisfied with the intervention and appreciated that emails prompted self-reflection, kept them on track and accountable, provided informational support, and were non-pressuring. Further, it suggested the monitor was “enjoyable” and “helpful;” quantitative data corroborated this as 71.4% said the monitor was “very valuable/absolutely valuable,” 71.7% would “very probably/definitely” still use one, and 85.7% wore it ≥5 days/week for ≥8 hours/day and checked it “occasionally/frequently/very frequently.” However, potential threats to acceptability were noted, including “long” and “text-heavy” emails, lack of personal contact, and cumbersome, non-aesthetic monitors. Conclusions: Results suggest this self-determination theory-driven email-delivered intervention may be an acceptable low-contact approach to help promote physical activity in women who are overweight or obese and insufficiently active, although improvements are warranted and studies ascertaining its effectiveness are needed. Nonetheless, results may inform the development or refinement of similar interventions in other contexts. Trial Registration: This trial was registered at ClinicalTrials.gov (ID: NCT03601663, Date: July 26, 2018; http://clinicaltrials.gov/ct2/show/NCT03601663).
Article
Psychological distress, which has become widespread globally amid the COVID-19 pandemic, poses detrimental consequences on the lives of employees and the functioning of organizations. The present study seeks to explore the nexus between psychological distress, perceptions of health, and employee life satisfaction. A survey was conducted on 246 employees working in Indian organizations, and the data were analyzed using hierarchical regression analysis. The findings show that an employee's life satisfaction is greatly reduced by psychological distress. It was further observed that perceptions of health moderate the link between psychological distress and employee life satisfaction. Organizations should therefore implement psychological interventions and conduct training programs in order to cope with adverse impacts of perceived poor health and psychological distress in employees. Organizational researchers, HR managers, and organizational psychologists can also use psychological testing and conduct established interventions, which can help employees handle psychological distress and cultivate enhanced life satisfaction during unprecedented circumstances.
Article
Objective: Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women. Design: With data from the Study of Women's Health Across the Nation (SWAN; N = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group. Results: Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]). Conclusions: These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.
Article
Prior research has established a positive association between social support and psychological resilience. In this study, we seek to examine whether and to what extent aspects of individuals’ social network – specifically size (how many relatives and friends one has) and strength (how often did one communicate with close network members and at the time of important decisions) – are related to greater psychological resilience. We use data pertaining to 1,609 respondents from the Panel on Ageing and Transitions in Health Survey (PATHS), 2016–2017, a national study of 1,654 older midlife adults, aged 50–59, in Singapore. We estimate the relationship between social networks and psychological resilience, using inverse probability weighted regression adjustment to account for the possibility of a selection bias whereby individuals with larger or stronger social networks may be more resilient at the outset. We find that strong social networks are associated with greater psychological resilience among older midlife adults, regardless of the size of the network. Having a large social network is associated with greater resilience only if it is also a strong network. Maintaining stronger, even if small, social networks may enable individuals at the cusp of older ages to be better prepared to deal with stressful life events and challenges associated with older midlife.
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Objective: Middle-aged women experience a lot of events of physical changes and various mental conflicts. The purpose of this study is to determine variables related to happiness, and to make and verify the model for happiness of middle-aged women. Methods: We constructed conceptual model for happiness of middle-aged women in Korea, based on Maslow's hierarchy of needs. This model consisted of three exogenous variables (health status, financial distress, and social support) and three endogenous variables (selfesteem, positive thinking, and happiness). For middle-aged women in Korea, we returned 442 questionnaires of 460 participants. Results: Model fit of the modified model was satisfied; χ2=102.108, GFI=0.959, CMIN/DF=2.917, RMSEA=0.068, AGFI=0.922, CFI=0.977, SRMR=0.0368. Happiness was explained by 82% through health status, financial distress, social support, self-esteem, and positive thinking. As Maslow's hierarchy of needs, happiness of middle-aged women is related to basic needs (health status, financial distress, and social support), psychological needs (self-esteem and positive thinking) and self-fulfillment needs (happiness). Conclusion: Our study shows that it is required intervention for meeting basic factor such as health status, financial distress and social support in order to increase happiness of middle-aged women.
Chapter
Climacteric is related to an increase in sleep disturbances, especially insomnia symptoms, which are linked with poorer quality of life, adverse physical and mental health, reduced productivity, and increased healthcare costs. Vasomotor symptoms are a key component of sleep disruption in climacteric, although other symptoms, like depressive symptoms, or challenges in life often contribute to sleep disorders. Findings from polysomnographic studies are less consistent in showing disrupted sleep in climacteric. Menopausal hormone therapy alleviates subjective sleep disturbances, particularly if vasomotor symptoms are present. However, due to contraindications and adverse effects, other options should also be considered; especially results from cognitive behavioral therapy are positive. Given that climacteric symptoms may persist for several years, consideration, prevention, and treatment of climacteric sleep disturbances are essential in order to ensure better health, quality of life, and work productivity in midlife women.
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Introduction: Perceived stress (PS) is strongly associated with sleep disturbances (SD) [e.g. 1 Darling CA, Coccia C, Senatore N. Women in midlife: stress, health and life satisfaction. Stress and health. 2012;28(1):31–40.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. Despite the growing body of evidence linking these two variables, research examining the non-recursive relationship is lacking. The effect of coping [e.g. 2 Abe Y, Mishima K, Kaneita Y, et al. Stress coping behaviors and sleep hygiene practices in a sample of Japanese adults with insomnia. Sleep and Biological Rhythms. 2011;9(1):35–45. doi:10.1111/j.1479-8425.2010.00483.x[Crossref], [Web of Science ®] , [Google Scholar]] and quality of life (QoL) [e.g. 3 Bolge SC, Doan JF, Kannan H, et al. Association of insomnia with quality of life, work productivity, and activity impairment. Quality of life Research. 2009;18(4):415.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]] in sleep patterns is also well established. The main objective of this research was to analyze the bidirectional relation between PS and SD with a model that includes coping and QoL as predictors of both variables. Materials and methods: This cross-sectional study comprised 987 Portuguese adults (M = 40.90, SD = 17.17) with SD (M = 2.10, SD = 0.55) that completed questionnaires about sleep patterns (BaSIQS [4 Allen Gomes A, Ruivo Marques D, Meia-Via AM, et al. Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS): Reliability, initial validity and normative scores in higher education students. Chronobiology international. 2015;32(3):428–440. doi:10.3109/07420528.2014.986681[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]]), perceived stress (Perceived Stress Scale [5 Trigo M, Canudo N, Branco F, et al. Estudo das propriedades psicométricas da Perceived Stress Scale (PSS) na população portuguesa. Psychologica. 2010;53:353–378. doi:10.14195/1647-8606_53_17[Crossref] , [Google Scholar]], coping strategies (BriefCOPE [6 Ribeiro JL, Rodrigues AP. Questões acerca do coping: A propósito do estudo de adaptação do Brief Cope. Psicologia, Saúde & Doenças. 2004;5(1):3–15. [Google Scholar]]) and QoL (WHOQOL-BREF [7 Vaz Serra A, Canavarro MC, Simões M, et al. Estudos psicométricos do instrumento de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal. Psiquiatria clínica. 2006;27(1):41–49. [Google Scholar]]). The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and the protocol was approved by IUEM Scientific Council. All participants signed informed consent. Results: Canonical Correlation Analysis’ results showed that the first correlation (0.562), dominated by PS, suggested a direct association with SD. The second correlation (0.146), dominated by SD, suggested a reverse association with PS. The results of a Structural Equation Modeling with PS and SD as dependent variables showed excellent model fit (X2/df =0.916, p = .469, GFI =0.992, RMSEA =0.000 [0.000 - 0.042]). Self-Blame, Positive Reframing, Denial, Self-Distraction, Social Relationships and Environment were significant predictors of PS. Denial and Environment significantly predicted SD. Discussion and conclusions: SD depends on PS, but no evidence of a direct effect of SD on PS was observed. Despite the bidirectional relationship not having been confirmed, this study supports the importance of PS in the management of SD. Also, we conclude that coping strategies are important factors in explaining PS rather than SD and that social relationships and environment are the two domains of quality of life that are predictors of PS. Environment is also a predictor of SD.
Poster
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Perceived stress (PS) is strongly associated with sleep disturbances (SD) [e.g. 1]. Despite the growing body of evidence linking these two variables, research examining the non-recursive relationship is lacking. The effect of coping [e.g. 2] and quality of life (QoL) [e.g. 3] in sleep patterns is also well established. The main objective of this research was to analyze the bidirectional relation between PS and SD with a model that includes coping and QoL as predictors of both variables. This cross-sectional study comprised 987 Portuguese adults (M = 40.90, SD = 17.17) with SD (M = 2.10, SD = 0.55) that completed questionnaires about sleep patterns (BaSIQS [4]), perceived stress (Perceived Stress Scale [5], coping strategies (BriefCOPE [6]) and QoL (WHOQOL-BREF [7]). The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and the protocol was approved by IUEM Scientific Council. All participants signed informed consent. Canonical Correlation Analysis’ results showed that the first correlation (0.562), dominated by PS, suggested a direct association with SD. The second correlation (0.146), dominated by SD, suggested a reverse association with PS. The results of a Structural Equation Modeling with PS and SD as dependent variables showed excellent model fit (X2/df = 0.916, p = .469, GFI = 0.992, RMSEA = 0.000 [0.000 - 0.042]). Self-Blame, Positive Reframing, Denial, Self-Distraction, Social Relationships and Environment were significant predictors of PS. Denial and Environment significantly predicted SD. SD depends on PS, but no evidence of a direct effect of SD on PS was observed. Despite the bidirectional relationship not having been confirmed, this study supports the importance of PS in the management of SD. Also, we conclude that coping strategies are important factors in explaining PS rather than SD and that social relationships and environment are the two domains of quality of life that are predictors of PS. Environment is also a predictor of SD. References: [1] Darling CA, Coccia C, Senatore N. Women in midlife: stress, health and life satisfaction. Stress and health. 2012 Feb 1;28(1):31-40. [2] Abe Y, Mishima K, Kaneita Y, Li L, Ohida T, Nishikawa T, Uchiyama M. Stress coping behaviors and sleep hygiene practices in a sample of Japanese adults with insomnia. Sleep and Biological Rhythms. 2011 Jan 1;9(1):35-45. [3] Bolge SC, Doan JF, Kannan H, Baran RW. Association of insomnia with quality of life, work productivity, and activity impairment. Quality of life Research. 2009 May 1;18(4):415. [4] Allen Gomes A, Ruivo Marques D, Meia-Via AM, Meia-Via M, Tavares J, Fernandes da Silva C, et al. Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS): Reliability, initial validity and normative scores in higher education students. Chronobiology international. 2015 Mar 16;32(3):428-40. [5] Trigo M, Canudo N, Branco F, Silva D. Estudo das propriedades psicométricas da Perceived Stress Scale (PSS) na população portuguesa. Psychologica. 2010 Dec 1:353-78. [6] Ribeiro JL, Rodrigues AP. Questões acerca do coping: A propósito do estudo de adaptação do Brief Cope. Psicologia, Saúde & Doenças. 2004 Jul;5(1):3-15. [7] Vaz Serra A, Canavarro MC, Simões M, Pereira M, Gameiro S, Quartilho MJ, et al. Estudos psicométricos do instrumento de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal. In Psiquiatria clínica 2006 (Vol. 27, No. 1, pp. 41-49).
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The first comprehensive text on stress and crisis management specifically tailored to courses focusing on the family Organized by stress model, this book helps readers understand the relationships among models, research, crisis prevention, and crisis management with individuals and families. Providing a balance of theory, research, hands-on applications, and intervention strategies, this innovative text presents a comprehensive overview of the field. Intended Audience Individual and Family Stress and Crises is ideal as a core text for upper division undergraduate and graduate students in courses such as Family Crisis, Family Stress & Coping, and Dysfunctions in Marriage & Family.
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Preface Acknowledgements 1. What Is New? 2. The Contextual Model: Understanding Family Stress in Science and Practice 3. Definitions: A Guide to Family Stress Theory 4. Coping, Adapting, Being Resilient...or Is It Managing? 5. Boundary Ambiguity: A Risk Factor in Family Stress Management 6. The Link Between Ambiguity and Ambivalence in Family Stress Management 7. Denial: Barrier if Buffer in Family Stress Management 8. Family Values and Belief Systems: Influences on Family Stress Management 9. The Family's External Context 10. Family Crisis: Overcoming Trauma and Victimization 11. Where Have We Been and Where Are We Going? Postscript References Index About the Author
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This study examines the relationships among the major variables of the Double ABCX model of family stress and adaptation. The theoretical model is translated into an empirically testable model using data on Army families' adaptation to the crisis of relocation overseas, and the data is analyzed by structural equation models with latent (unobserved) variables. The results support the notion of pile-up of demands, in that previous family life events significantly influence the postcrisis strain. Family system resources and social support are both found to facilitate adaptation, but in different ways: family system resources affect adaptation directly, whereas social support appears to have a buffering role in that it reduces the postcrisis strain. This study demonstrates the applicability of structural equation modeling approach (LISREL VI program) for theory building.
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The sense of coherence (SOC) is a construct that refers to the extent to which one sees one's world as comprehensible, manageable, and meaningful. This article applies the SOC construct to the study of family adaptation. A family SOC scale was developed to measure the perceived coherence of family life. The study tested the hypothesis that the strength of the SOC, central to successful coping with family stressors, is associated with adaptation, here defined in terms of perceived satisfaction with intrafamily and family-community fit. A sample of 60 married Israeli males who were disabled by injury or illness completed SOC and adaptation scales, along with their wives. The data provide strong support for the hypothesis and show a considerable degree of consensus among spouses. The discussion considers the dual meaning of the term "the family SOC," the nature of the links between coherence and adaptation, and the variable conceptions of adaptation.
Article
This study investigated the linear and curvilinear relationships between coping strategies and health outcomes among a sample of 159 divorced individuals. Participants completed questionnaires which included measures of coping strategies, physical health, and psychological health. Results indicated that linear relationships existed between three of the five coping strategies-reframing, acquiring social support, and passive appraisal-and health. Curvilinear relationships were shown between four of the five coping strategies-acquiring social support, seeking spiritual support, mobilizing formal support, and passive appraisal-and health. Different patterns of results were shown for men andwomen.
Article
Subjective well-being, or what is popularly often called “happiness,” has been of intense interest throughout human history. We review research showing that it is not a single factor, but that subjective well-being is composed of a number of separable although somewhat related variables. For example, positive feelings, negative feelings, and life satisfaction are clearly separable. In understanding the various types of subjective well-being, it is important to remember that appraisals move from immediate situations to a later recall of feelings, and then to global evaluations of life. At each stage, from momentary feelings to large global life eval-uations, somewhat different processes are involved in what is called “happiness.” In order to understand how to measure subjective well-being, one must understand the time course and components of the phenomenon in question, and be clear about what is most important to assess. On-line feelings are very different from global evaluations of life, although both have been studied under the rubric of subjective well-being. Although debate has focused on which type of subjective well-being should be called “true happiness,” the goal of scientists is to understand each type, their relations with each other, and their causes. The future of the field depends on understanding the differences between various types of well-being, and the different and similar causes of each.
Article
Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women. One hundred and sixteen women aged 45-55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health. Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping. Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause.
Article
This paper reviews the knowledge accumulated from published population studies of health and ill-health experiences during the menopausal transition. Well-being: mid-aged women are more likely to report positive moods than negative moods. Well-being is not associated with menopausal status but is associated with current health status, psychosocial and lifestyle variables. Symptoms: Symptoms vary greatly across cultures, with North American and European samples reporting higher rates of symptoms than Asian women. The most symptomatic women in the North American samples and Australian studies are those whose menstrual cycles have changed. Vasomotor symptoms increase through the menopausal transition. Other variables such as socio-demographic, health status, stress, premenstrual complaints, attitudes to ageing and menopause, and health behaviors are associated with the occurrence of symptoms. Psychological complaints: There is no increase in the incidence of major depression with the menopause. Negative moods are not associated with the natural menopausal transition. Factors associated with negative moods include surgical menopause, prior depression, health status, menstrual problems, social and family stressors and negative attitudes to menopause. Sexuality: Several studies suggest a decline in sexual functioning associated with menopausal status rather than ageing. Social factors and health status factors are also associated with sexual outcomes. Future research should bring together biomedical and sociological aspects. Positive aspects of health should be assessed as well as troubling symptoms. Longitudinal studies are needed with measures of hormonal change. Promoting positive attitudes to ageing and menopause, health lifestyles and stress reduction can be used as community interventions and as part of individual care.
Article
Numerous physical and psychological symptoms have been attributed to the hormonal changes of menopause. Symptoms have also been attributed to loss of fertility, redefining of roles, empty nest syndrome, loss of femininity, and changes of status. Cross-cultural studies allow researchers to examine the contribution of physiological, psychological, and sociocultural influences to the experience of menopausal symptoms. Such research is complicated by differences between cultures in the definition of menopause, reproductive histories, symptom expression, and beliefs as to what constitutes status. A review of five important cross-cultural studies indicates that there are enormous differences in the experience of menopause among women in the same culture and among cultures. Menopausal symptoms seem to be caused by a combination of physical changes, cultural influences, and individual perceptions and expectations.
Article
Research on women's multiple roles frequently adopts one of two perspectives: role strain, which argues that assuming multiple roles is detrimental to mental well-being, or role enhancement, which argues that engaging in multiple roles enhances mental well-being. We argue that the relationship between role occupancy and well-being is manifested through multiple dimensions of role experiences. We investigate the association between depressive symptomatology and various dimensions of the roles of wife, mother, paid worker, and informal caregiver to aging parents. Data are from the 1992 wave of the Health and Retirement Study. Depressive symptomatology, measured by a subset of the CES-D scale, is the dependent variable. To assess the robustness of findings relative to different functional forms of the dependent variable, we estimate multiple regression, log-linear regression, and multinomial logit models. Independent variables include demographic characteristics, measures of role occupancy, role demands, and role satisfaction. Although the number of roles women assume affects their reports of depressive symptoms, once the demand and satisfaction associated with these roles is controlled, number has no effect; that is, the effect of the number of roles is indirect. Our results highlight the importance of women's perceptions of the quality of their roles in relation to their overall well-being. Future investigations of women's multiple roles should examine how roles may provide rewards, impose constraints, or generate conflict, as well as the extent to which the willingness to assume multiple roles and the reported levels of role satisfaction and mental well-being may be jointly endogenous.
Article
To assess the impact of menopause and some sociodemographic variables on quality of life (QoL). Four hundred and eighty-one women aged 40-59 years attending the Southern Metropolitan Health Service in Santiago de Chile were studied using the Specific Quality of Life Questionnaire for Menopause from Toronto University. Univariate analysis showed that menopausal women have worse QoL scores than women conserving cycles in the four areas of the questionnaire: They show a 10.6-fold higher risk for suffering vasomotor disorders affecting QoL, a 3.5-fold higher risk for psychosocial impairment, a 5.7-fold higher risk for physical disorders, and a 3.2-fold higher risk for sexual disorders (P < 0.0001). Regarding the influence of social markers (age, marital status, school years, work, number of children and sexual activity), housewives were found to have higher, worse, scores than working women in all test components (vasomotor, 3.11+/-1.90 versus 2.57+/-1.71, P < 0.003; psychosocial, 3.44+/-1.59 versus 2.92+/-1.45, P < 0.0007; physical, 3.45+/-1.36 versus 2.96+/-1.20, P < 0.0001; sexual, 3.63+/-2.23 versus 2.49+/-1.95, P < 0.0001). However, logistic regression demonstrated that the only variable found to cause a significant impairment in QoL was menopause. Menopause causes a decrease in quality of life, which is independent from age and other sociodemographic variables.
Article
Research on the causes of psychological distress in women in midlife has focused on current adversity and hormonal changes associated with menopause and paid less attention to possible risk factors across the life course. We examined the factors in childhood, adolescence and earlier adult life that show persisting effects on psychological symptoms reported annually over a 6 year period (47-52 years) using prospective data on a cohort of 1500 British women who have been followed since their birth in 1946. Even after taking into account the powerful effect of recent life stress, this study found that women with a high level of psychological distress had different life course trajectories than those with less distress. They were more likely to have scored highly on the neuroticism scale or exhibited antisocial behaviour when they were teenagers, and to have had prior experience of mental and physical health problems in adult life. Those whose parents had divorced reported more distress in midlife, particularly if they too had experienced marital breakdown. These factors accounted for the associations between some of the adult sources of risk, particularly those to do with interpersonal difficulties or poor adult socioeconomic circumstances, and psychological distress in midlife. There was no evidence that concurrent menopausal status had any effect on the level of psychological symptoms except for those women on hormone replacement therapy who had a small and independent additional risk. More attention to a long term temporal perspective is warranted in research on the causes of psychological distress in women at midlife.
Article
Relatively little is known about the association between menopause and health-related quality of life (HRQL) across ethnic groups. To examine the association between HRQL and early perimenopause and ethnicity, adjusting for health, lifestyle, psychosocial, and sociodemographic factors. Questionnaires were administered to pre- and early perimenopausal women. We studied a cohort of 3302 black, Chinese, Hispanic, Japanese, and white women aged 42 to 52 years from the multisite Study of Women's Health Across the Nation (SWAN). We measured HRQL, menstrual regularity, and a variety of covariates. HRQL was assessed with 5 subscales from the Short Form-36; impaired functioning was defined as being in the 25% most impaired on a subscale. In unadjusted, but not adjusted, analyses, significantly more early perimenopausal women, as compared with premenopausal women, were classified as having impaired functioning on each of the 5 subscales. For 4 of the subscales, the effect of menopausal status was explained by menopause-related symptoms. There were significant ethnic group differences across all 5 subscales in unadjusted analyses. Ethnicity was no longer significant for the Vitality or Role-Emotional subscales when adjusted for health variables or for the Role-Physical subscale when analyses were adjusted for socioeconomic status, health, lifestyle, or social circumstances. Ethnicity remained significant for the Bodily Pain and Social Functioning subscales, even in adjusted analyses. Early perimenopause is not associated with impaired functioning when adjusted for symptoms. Significant ethnic differences in HRQL exist. Some, but not all, differences can be explained by differences in health, lifestyle, and social circumstances.
Article
There has been controversy about the relationship between menopause and depression. This study utilizes a unique prospective population-based data set of middle-aged, Australian-born women to identify determinants of depressed mood. The Melbourne Women's Midlife Health Project sample consisted of 438 women aged 45 to 55 at baseline; they were followed annually for 11 years. Of this group, 314 (72%) completed the Center for Epidemiologic Studies Depression Scale (CES-D) scale in year 11 to measure depressed mood. Variables measured at baseline and annually included negative mood (measured with Affectometer) and psychosocial, hormonal, health, and lifestyle factors. Women who had the highest CES-D scores were those who by year 11 were still in the menopause transition stage (had not reached final menstrual period) or had experienced surgical menopause. CES-D correlated with negative mood measured concurrently (r = 0.63) and baseline negative mood (r = 0.37). There was a significant reduction in negative mood for all menopause status groups, but those who experienced surgical menopause showed less reduction than other women. Ever-use or number of years of use of hormone therapy made no difference to CES-D outcome. CES-D was associated with baseline negative attitudes toward aging, mood, and premenstrual complaint experience and annual mood, poor self-rated health, number of bothersome symptoms, and daily hassles. Women most likely to have higher depressed mood in the age group 57 to 67 are those who have undergone surgical menopause or have menstruated within the last 12 months. Prior negative mood, history of premenstrual complaints, negative attitudes toward aging or menopause, poor health, and daily hassles predict depressed mood.
Article
The United States has the most expensive health care system in the world, with per capita health expenditures far above those of any other nation. For many years, U.S. health care expenditures have been growing above the overall rate of inflation in the economy. A few experts have argued that high and rising costs are not such a serious problem. Most observers disagree with this view, pointing to the negative impact of employee health care costs on employers, the government budgetary problems caused by rising health care expenditures, and an association between high health care costs and reduced access for individuals needing health services. Several explanations have been offered for high and rising health care costs. These include the perspectives that high and rising costs are created by forces external to the health system, by the weakness of a competitive free market within the health system, by the rapid diffusion of new technologies, by excessive costs of administering the health system, by the absence of strong cost-containment measures, and by undue market power of health care providers. This article, the first in a 4-part series, discusses 3 perspectives on health care: 1) Are high and rising health care costs a serious problem? 2) Are rising costs explained by factors outside the health care system? 3) Does the absence of a free market in health care explain why costs are high and rising? The remaining 3 articles in this series address other perspectives on health care costs.
Article
The directly attributable effect of menopausal transition on women's quality of life (QoL) remains unclear. This study investigates the relationship between perceived change in QoL and menopausal transition status, socio-economic circumstances, lifestyle factors, and life stress. Prospective data were collected from a cohort of 1525 British women followed up since their birth in 1946 and annually from 47 to 54 years. Following factor analysis, the 10 survey items for perceived change were combined into three QoL domains: physical health (physical health, energy level, and body weight), psychosomatic status (nervous and emotional state, self-confidence, work life, ability to make decisions, and ability to concentrate), and personal life (family life and time for self, hobbies, and interests).
Article
The present study examined the relationships among physical activity (PA), symptom reporting, self-esteem, and satisfaction with life (SWL) in 133 women (M age=51.12, S.D.=4.10) of varying menopausal status. Multivariate analyses of co-variance (MANCOVA) revealed that independent of menopausal status, women who were more physically active reported significantly less severe vaso-somatic and general somatic symptoms, and higher levels of physical self-worth (PSW). Subsequent hierarchical regression analyses indicated that expended MET-h/week, reported symptoms (frequency and severity, respectively), and PSW accounted for significant variance in SWL (R2 model=0.32, for symptom frequency, and 0.33, for symptom severity). Physical activity was significantly related to SWL through the mediation of PSW. However, both reported symptom frequency and severity retained significant association with SWL after controlling for PSW, although the original associations were significantly reduced. Finally, both symptoms and MET-h/week were independent contributors to the variance in PSW (R2 model=0.33 and 0.34). The results suggest that being physically active may reduce perceived severity of menopausal symptoms and enhance psychological well-being, and that the relationship between physical activity and QOL in mid-life women may be mediated by factors such as physical self-perceptions and menopausal symptoms.
Article
Sleep deprivation has been hypothesized to contribute toward obesity by decreasing leptin, increasing ghrelin, and compromising insulin sensitivity. This study examines cross-sectional and longitudinal data from a large United States sample to determine whether sleep duration is associated with obesity and weight gain. Longitudinal analyses of the 1982-1984, 1987, and 1992 NHANES I Followup Studies and cross-sectional analysis of the 1982-1984 study. Probability sample of the civilian noninstitutionalized population of the United States. Sample sizes of 9,588 for the cross-sectional analyses, 8,073 for the 1987, and 6,981 for the 1992 longitudinal analyses. Measured weight in 1982-1984 and self-reported weights in 1987 and 1992. Subjects between the ages of 32 and 49 years with self-reported sleep durations at baseline less than 7 hours had higher average body mass indexes and were more likely to be obese than subjects with sleep durations of 7 hours. Sleep durations over 7 hours were not consistently associated with either an increased or decreased likelihood of obesity in the cross-sectional and longitudinal results. Each additional hour of sleep at baseline was negatively associated with change in body mass index over the follow-up period, but this association was small and statistically insignificant. These findings support the hypothesis that sleep duration is associated with obesity in a large longitudinally monitored United States sample. These observations support earlier experimental sleep studies and provide a basis for future studies on weight control interventions that increase the quantity and quality of sleep.