중년여성의 전환상태 모델

Transition Model of Middle-aged Women

  • 조인숙 (서울대학교 간호과학연구소) ;
  • 박영숙 (서울대학교 간호대학, 서울대학교 간호과학연구소)
  • 발행 : 2004.06.01

초록

Purpose: The purpose of this study was to develop and test a model to explain the transition state for Korean middle-aged women focusing on the transition concept. Method: A hypothetical model was constructed based on the transition model of Schumacher & Meleis(1994) and tested. Thehypothetical model consisted of 5 latent variables and 11 observed variables. Exogenous variables were demographic characteristics, obstetric characteristics, and health behavior. Endogenous variables were transition state and quality of life with 6 paths. The data from 221 middle-aged women selected by convenience was analyzed using covariance structure analysis. Result: The final model which was modified from the hypotheticalmodel improved to GFI=0.97, AGFI=0.94, NFI=0.94, and NNFI=0.95. The transition state was influenced directly by demographic characteristics, quality of life, and also indirectly by health behaviors. However, the influence of obstetric characteristics was not significant. The transition state was accountable for 68% of the variance by these factors. Conclusion: These results suggest that enhancing health behaviors of the women are necessary to increase quality of life and it consequently contributes toimproving the transition state. This model could be used to explain the health related vulnerability in these ages and to diagnosis individual women.

키워드

참고문헌

  1. Avis, N. E., Brambilla, D., McKinlay, S. M., & Vass, K. (1994). A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts women's health Study. Ann. Epidemiol. 4,214-220
  2. Back, S. S. (1998). An analysis of the relationship of menopausal symptoms of midlife women between urban area and rural area. Korean J Women Health Nurs, 4(3), 332-347
  3. Brzyski, R. G., Martha, A., Hyatt-Santos, J. M., & Ross, J. S. (2001). Quality of life in low-income menopausal women attending primary care clinics. Fertility & Sterility, 76(1), 44-50
  4. Burckhardt, C. S. (1985). The impact of arthritis on quality of life. Nurs Res, 34(1), 11
  5. Bush, H., Barth-Olofsson, A. S., Rosenhagen, S., & Collins, A. (2003). Menopausal transition and psychological development. Menopause, 10(2), 179-187
  6. Chang, H. K., & Cha, B. K. (2003). Influencing factors of climacteric women's depression. J Korean Acad Nurs, 33(7), 972-980
  7. Chick, N., & Meleis, A. I. (1986). Transition: A nursing concern. In P. L. Chinn(Ed.), Nursing research methodology: Issues and implementation, 237-257, Rockville, Md: Aspen
  8. Choi, N. Y., Choi, S. Y., & Cho, H. J. (1998). A study on the degree of knowledge of menopause and management of menopausal women. Korean J Women Health Nurs, 4(3), 402-415
  9. Datan, N. (1986). Corpses, lepers, and menstruating women: Tradition, transition, and the sociology of knowledge. Sex Roles, 14, 693-703 https://doi.org/10.1007/BF00287698
  10. Davis, M. S., & Youngkin, E. Q. (1998). Health and development through the life cycle. Women's Health A primary care clinical guide. 2nd ed. Apppeton & Lange. 30-44
  11. Dennerstein, L., Dudley, E. C., Hopper, J. L., Guthrie, J. R., & Burger, H. G. (2000). A prospective population-based study of menopausal symptoms. Obstet Gynecol. 96(3), 351-358 https://doi.org/10.1016/S0029-7844(00)00930-3
  12. Dennerstein, L., Smith, A. M. A., & Morse, C. (1993). Menopausal symptoms in Australian women. Med. J. Aust. 159, 232
  13. Dennerstein, L., Smith, A. M. A., & Morse, C. (1994). Psychological well-being, mid-life and the menopause. Maturitas, 20, 1-11 https://doi.org/10.1016/0378-5122(94)90095-7
  14. Erikson, E. H. (1982). The life cycle completed: A review. New York: Norton
  15. Erikson, E. H., Erikson, J. M., & Kivnick, H. Q. (1986). Vital involvement in old age. New York: Norton
  16. Gath, D., Osborn, M., & Bungay, G. (1987). Psychiatric disorder and gynaecological symptoms in middle aged women: A community survey. Br. Med. J, 294, 213-218 https://doi.org/10.1136/bmj.294.6566.213
  17. Gergen, M. M. (1990). Finished at 40: Women's development within the patriarchy. Psychology of Women Quarterly, 14, 471-494 https://doi.org/10.1111/j.1471-6402.1990.tb00225.x
  18. Greene, J. G., & Cooke, D. J. (1980). Life stress and symptoms at the climacterium. Br J Psychiatry, 136, 486-91 https://doi.org/10.1192/bjp.136.5.486
  19. Gutmann, D. L. (1987). Reclaimed Powers: Toward a new psychology of men and women in later life. New York: Basic Books
  20. Ham, E. M. (2003). Construction of a menopausal depression Model. Unpublished doctoral dissertation, Seoul National University, Seoul
  21. Hunter, M. S. (1993). Predictors of menopausal symptoms: psychosocial aspects. Baillieres Clin Endocrinol Metab, 7: 33-45
  22. Jacques, E. (1965). Death and the midlife crisis. International Journal of Psychoanalysis, 46, 502-514
  23. James, J. B., & Lewkowicz, C. J. (1997). Themes of power and affiliation across time. In M. E. Lachman & J. B. James(Eds.), Multiple paths of midlife development 109-143, Chicago: University of Chicago Press
  24. Kang, N. M. (1996). Theoretical structure model for stress in transition to fatherhood.Unpublished doctoral dissertation, Seoul National University, Seoul
  25. Karp, D. A. (1988). A decade of reminders: Changing age consciousness between fifty and sixty years old. The Gerontologist, 28, 727-738
  26. Kim, M. H. (1998). The relationship between menopausal symptoms and spiritual well-being. Korean J Women Health Nurs, 4(1), 38-51
  27. Lee, Y. H. (1993) The Relations between attributional style, life events, event attribution, hopelessness and depression. Unpublished doctoral dissertation, Seoul National University, Seoul
  28. Levinson, D. J., Darrow, C. M., Klein, E. B., Levinson, M. H., & McKee, B. (1978). The seasons of a man's life. New York: Ballantine Books
  29. Lim H. J. (2001). The relationship among urinary incontinence, menopausal symptom and life satisfaction in middle aged women. Korean J Women Health Nurs, 7(2), 157-168
  30. Lock, M. (1998). Menopause: lessons from anthropology. Psychosom Med, 60, 410-9
  31. Martin, M. C., Block, J. E., Sanchez, S. D., Arnaud, C. D., & Beyene, Y. (1993). Menopause without symptoms: the endocrinology of menopause among rural Mayan Indians. Am J Obstet Gynecol, 168(6 Pt 1),1839-43, discussion 1843-5
  32. Matthews, K. A. (1992). Myths and realities of the menopause. Psychosom Med, 54, 1-9
  33. Meleis, A. I., Sawyerm, L. M., Im, E. O., Messiasm, D. K. H., & Schumacherm, K. (2000). Experiencing transitions: An emerging middle-range theory. Adv Nurs Sci, 23(1), 12-28
  34. Mitchell, V., & Helson, R. (1990). Women's prime of life: Is it the fifties? Psychology of Women Quarterly, 14, 451-470
  35. Murphy, S. A. (1990). Human response to transition: A holistic nursing perspective. Holistic Nursing Practice, 4(3): 12-28
  36. Neugarten, B. L., & Kraines, R. J. (1965). 'Menopausal symptoms' in women of various ages. Psychosomatic Medicine, 27, 266-273
  37. Park, H. S., Lee, Y. M., & Cho, K. Y. (2002). A study on climacteric symptoms, knowledge of menopause, menopausal management in middle-aged women. Korean J Women Health Nurs. 8(4), 521-528
  38. Park, J. S., (2001). A study of symptom of health and fatigue-regulation behavior in middle-aged women. Korean J Women Health Nurs, 7(4), 447-460
  39. Park, M. S., & Yoo, S. J. (2001). The relationship of the perceived health status with somatic symptoms, family related stress, spousal support and sexual satisfaction in the middle aged women. Proceeding of Spring Conference of Korean Acad Nurs, 149
  40. Park, S. A., & Kim, M. A. (1999). The sexual life in climacteric women. Korean J Women Health Nurs, 5(2), 179-191
  41. Park, Y. S. (1991). Transition to motherhood of primipara in postpartum period. Unpublished doctoral dissertation, Seoul National University, Seoul
  42. Park, Y. S., & Cho, I. S. (2001). A survey of urban middle-aged women's transition. Korean J Women Health Nurs, 7(4), 486-498
  43. Pender, N. J., & Pender, A. R. (1987). Health promotion in nursing practice, 2nd ed. Appleton & Lange
  44. Polit, D. F., & LaRocco, S. A. (1980). Social and psychological correlates of menopausal symptoms. Psychosom Med, 42:335-45
  45. Ro, Y. J. (1988). An analytical study on the quality of life of the middle-aged in Seoul. Unpublished doctoral dissertation, Yonsei University, Seoul
  46. Schumacher, K. L., & Meleis, A. I. (1994). Transition: A central concept in nursing. IMAGE: J of Nurs Scholarship, 26(2), 119-127
  47. Song, A. L. (2001). An analysis of the relationship between climacteric symptoms and management of menopause in middle-aged women. J Korean Nurs Edu, 7(2), 308-322
  48. Speroff, L. (2000). The perimenopausal transition. Annuals of the New York Academy of Science. 900; 375-392
  49. Stewart, A. J., & Ostrove, J. M. (1998). Women's personality in middle age; Gender, history, and midcourse corrections. American Psychologist, 53(11), 1185-1194 https://doi.org/10.1037/0003-066X.53.11.1185
  50. Sung, M. H. (2002). Self-reported climacteric symptoms, self concept and depression in middle-aged women. J Korean Acad Adult Nurs, 14(1), 102-113
  51. Walker, S. N., Sechrist, K. R., & Pender, N. J. (1987). The health-promoting lifestyle profile: Development and psychometric characteristics. Nurs Res, 36(2), 76-81
  52. Wilbur, J., Miller, A., & Montgomery, A. (1995). The influence of demographic characteristics, menopausal status, and symptoms on women's attitudes toward menopause. Women Health, 23, 19-39 https://doi.org/10.1300/J013v23n03_02
  53. Yoo, E. K., & Kim, M. A. (1999). Middle aged women's related factors climacteric symptoms and coping pattern: The relationship with sanhujori. Korean J Women Health Nurs, 5(2), 200-211