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Research Article
Development of a Well-Dying Awareness Scale for Middle-Aged adults in Korea: a mixed-methods study
Yu Jin Jung, Eun Joung Choi
Received October 15, 2024  Accepted February 2, 2025  Published online March 28, 2025  
DOI: https://doi.org/10.4040/jkan.24121    [Epub ahead of print]
AbstractAbstract PDFePub
Purpose
This study aimed to develop a valid and reliable tool to measure awareness of well-dying among middle-aged adults.
Methods
A mixed-methods approach was adopted, consisting of a qualitative phase to identify the characteristics of well-dying and a quantitative phase to validate the instrument with middle-aged participants. Initially, 76 items were generated through a literature review and in-depth interviews, and these were reduced to 35 items through expert validation. A pilot survey was conducted with 112 individuals aged 40–65, selected via quota sampling from 17 administrative regions in South Korea. Based on the pilot survey results, the instrument was refined to 32 items for the main survey. The main survey included 314 participants recruited through quota sampling in Busan and Ulsan Metropolitan Cities and Gyeongsang Region. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing were performed to validate the instrument.
Results
The final scale comprised 23 items across six factors. EFA demonstrated an explanatory power of 69.1%, with factor loadings ranging from 0.53 to 0.88. CFA confirmed the instrument’s validity, and reliability was established with a Cronbach’s α of .93.
Conclusion
This instrument is a validated and reliable tool for measuring middle-aged individuals’ awareness of well-dying. It can serve as an effective resource for evaluating and assessing well-dying awareness in the middle-aged population.
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Research Paper
Lived Experience of Middle-Aged Patients with Complex Regional Pain Syndrome
Seo, Young-suk , Lee, Sunhee
J Korean Acad Nurs 2022;52(6):598-607.   Published online December 31, 2022
DOI: https://doi.org/10.4040/jkan.22086
AbstractAbstract PDF
Purpose
This qualitative study aimed to explore the lived and true meaning of experiences of middle-aged patients with complex regional pain syndrome.
Methods
The participants were 10 men and women aged 40 to 60 years who received outpatient treatment at a university hospital, could communicate, and agreed to participate in the study. Data were collected through individual interviews using open and semi-structured questions from September 2019 to July 2021 and were analyzed using the content analysis method suggested by Hsieh and Shannon (2005).
Results
As a result of this study, 42 summarized semantic units related to life experience, 15 subthemes, and seven themes were derived. The seven themes were “pressed by severe pain,” “frustrated because I cannot be part of the community,” “distressed because people do not recognize my disease,” “sad about conflicts with family,” “unmotivated because of desperate life,” “appreciating for support,” and “putting oneself together and living daily life.” Conclusion: The vivid experiences of the participants derived in this study are the basic data for developing treatment guidelines. In the future, we propose a study on life and family care experiences according to the developmental characteristics of the life cycle of patients with complex regional pain syndrome and develop and apply programs to support patients and their families.

Citations

Citations to this article as recorded by  
  • Experiences of diagnosis and treatment for upper limb Complex Regional Pain Syndrome: a qualitative analysis
    Grace S Griffiths, Bronwyn L Thompson, Deborah L Snell, Jennifer A Dunn
    Pain Medicine.2023; 24(12): 1355.     CrossRef
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Original Articles
Actor and Partner Effects of Health Status, Marital Satisfaction and Self Efficacy on Retirement Preparation of Middle Aged Couples: Actor-Partner Interdependence Model Analysis
Eun Hee Jung, Sung Hee Shin
J Korean Acad Nurs 2018;48(2):154-166.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.154
AbstractAbstract PDF
Abstract Purpose

This study aimed to identify the actor and partner effects of health status, marital satisfaction, and self efficacy on retirement preparation in middle aged couples using the Actor-Partner Interdependence Model.

Methods

Participants were 121 middle aged couples living in Seoul, Gyeonggi-do and Daegu City, Korea. All measures were self-administered. The collected data were analyzed using SPSS 20.0 and AMOS 20.0.

Results

1) Wife's self efficacy and marital satisfaction showed direct actor and partner effects on retirement preparation in middle aged couples. Wife's health status showed an indirect actor effect through wife's self efficacy and marital satisfaction on wife's retirement preparation, and showed an indirect partner effect through husband's self efficacy on husband's retirement preparation. 2) Husband's self efficacy and marital satisfaction showed only direct actor effect on retirement preparation. Health status among the husbands showed an indirect actor effect on husband's retirement preparation through their self efficacy and marital satisfaction, and an indirect partner effect through wife's marital satisfaction on wife's retirement preparation. 3) The actor effect size of health status on self efficacy and marital satisfaction was larger among husband's than wife's. Additionally, the partner effect size of health status on self efficacy and marital satisfaction was different between the two groups; however, the actor and partner effect size of self efficacy and marital satisfaction on retirement preparation was the same for husband and wife.

Conclusion

The results of this study indicate that nursing intervention strategies for improving self efficacy and marital satisfaction are strongly needed to enhance retirement preparation of middle aged couples in Korean community.

Citations

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  • Dyadic Research of Patients and Their Family Caregivers in the Context of Chronic Illness: Current Status and Challenges
    Youn-Jung Son
    Korean Journal of Adult Nursing.2021; 33(5): 415.     CrossRef
  • The Effects of Climacteric Symptom Cognition, Self-efficacy on Aging Anxiety in Middle-Aged Couples: Actor and Partner Interdependence Mediation Model
    Yeon-Suk Kim, Myung-Haeng Hur
    Korean Journal of Adult Nursing.2021; 33(3): 247.     CrossRef
  • Actor and Partner Effects of Couple's Daily Stress and Dyadic Coping on Marital Satisfaction
    Su Kyung Won, Kyoung Ok Seol
    Journal of Korean Academy of Nursing.2020; 50(6): 813.     CrossRef
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Determinants of Health Promoting Behavior of Middle Aged Women in Korea
Sook Ja Lee, Eun Sook Park, Young Joo Park
Journal of Nurses Academic Society 1996;26(2):320-336.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.320
AbstractAbstract PDF

Health promoting behaviors of an individual are affected by various variables. Recently, there has been a growing concern over important health problems of the middle aged women. Physiological changes in the middle aged women and their responsibility for family care can result in physical and psychological burden experienced by middle aged women. This study was designed to test Pender's model and thus purpose a model that explains health promoting behaviors among middle-aged women in Korea. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 863 women living in Seoul, between 20th, April and 15th, July 1995. Data were analyzed using descriptive statistics and correlation analysis. The Linear Structural Relationship (LISREL) modeling process was used to find the best fit model which assumes causal relationships among variables. The results are as follows; 1. The overall fit of the hypothetical model to the data was good expect chi -square value (GFI=.96, AGFI=.91, RMR=.04). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data expect chi-square value (GFI=. 95, AFGI=.92, RMR=.04). 3. Some of modifying factors, especially age, occupation, educational levels and body mass index (BMI) are revealed significant effects on health promoting behaviors. 4. Some of cognitive -perceptual factors, especially internal health locus of control, self-efficacy and perceptive health status are revealed significant effects on health promoting behaviors. 5. All predictive variables of health promoting behaviors, especially age, occupation, educational levels, body mass index(BMI), internal health locus of control, self-efficacy and perceptive health status are explained 20.0% of the total variance in the model.

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The Age at Menopause and Related Factors in Korean Women
Young Joo Park, Hesook Suzie Kim, Hyun Choel Kang
Journal of Korean Academy of Nursing 2002;32(7):1024-1031.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.7.1024
AbstractAbstract PDF

This cross-sectional design was to identify the age at menopause of Korean women using a national sample, and to examine relationships between age at menopause and the anthropometric, sociodemographic, biological and life style behavioral factors. Two thousand eight hundred seven naturally postmenopausal women aged between 41-65 years were recruited by self-selection from 7 metropolitans and 6 provinces in Korea from Dec. 20, 1998 to April 30, 1999. The age at menopause of Korean women was 49.2 years (mean) and 50.0 years (median). The range of age at menopause was 33.0 to 61.0 years. The significant influencing factors on age at menopause were body mass index, mother's and sister's age at menopause, alcohol use, physical activity, coffee preference, and residential area. The menopausal age of Korean women has slightly increased compared to a previous study.

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    Siyuan Lin, Laura Argys, Susan Averett
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    Ryun S Ahn, Jee H Choi, Bum C Choi, Jung H Kim, Sung H Lee, Simon S Sung
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Influencing Factors on Symptoms of Stress of Middle Aged Women
Kuem Sun Han, Pyoung Sook Lee, Yong Mi Lee
Journal of Korean Academy of Nursing 2000;30(6):1427-1436.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1427
AbstractAbstract PDF

The purpose of this study was to identify the influencing factor on Symptoms of Stress of Middle Aged Women. The subjects of this study were 35 middle aged women who lives in Seattle, Washington in U.S, and 74 middle aged women who lives in Seoul. Data collection was performed at the University of Washington and Seoul from Oct. 1998 to May. 1999. Data collected through 4 types of questionnaires : SOS, Ways of Coping, Mood Status, Perceived Stress. The results of this study are as follows: 1. The stress symptoms showed positive correlation with emotion-oriented coping, mood status, and perceives stress. 2. Stepwised multiple regression analysis revealed that most powerful predictor of Stress Symptoms was mood status. A combination of perceived stress, mood status and ways of coping account for 64% of the variance in Symptoms of stress in Middle aged women. From the results of the study, the following recommendations are presented as follow: 1. It is necessary to replicate this study with a larger sample. 2. It is necessary to develop a stress management program focused on ways of coping, mood status, perceived stress for middle aged women.

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    Jihyun Oh, Sunghee Kim
    BMC Nursing.2023;[Epub]     CrossRef
  • Effects of Forest Therapy on Health Promotion among Middle-Aged Women: Focusing on Physiological Indicators
    Bum-Jin Park, Chang-Seob Shin, Won-Sop Shin, Chung-Yeub Chung, Si-Hyung Lee, Dong-Jun Kim, Youn-Hee Kim, Chang-Eun Park
    International Journal of Environmental Research and Public Health.2020; 17(12): 4348.     CrossRef
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    Hae-Mi Kim
    Journal of Digital Convergence.2015; 13(12): 453.     CrossRef
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    Eon Sook Lee, Ho Cheol Shin, Jun Hyung Lee, Yun Jun Yang, Jung Jin Cho, Gwiyeoroo Ahn, Yeong Sook Yoon, Eunju Sung
    Korean Journal of Family Medicine.2015; 36(6): 286.     CrossRef
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Health Problem of the Middle-Aged Women
Mi Hae Sung
Journal of Korean Academy of Nursing 1999;29(2):258-270.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.2.258
AbstractAbstract PDF

This study was carried out to offer the basic data for more qualitative lives of the middle-aged women through their health maintenance and control. So, the researcher reviewed and analyzed the health problems of the middle-aged women, the differences of main symptoms in each subject, positive rates in screening tests, the difference of screening tests with age and the correlation of obesity and blood pressure with screening tests. All subjects were 218 women(40-59 years) who had a check-up at a comprehensive health check-up center in K University Hospital in Seoul from July 1, 1998 to August 31, 1998. Questionnaires were developed to get subjects, general characteristics, main symptoms, medical examination and diagnosed disease by the researcher referring through the questionnaires of comprehensive health check-up center and the medical recorders where used as a tool of study. The researcher analyzed the data with SPSS PC+; the distribution of the subjects, general characteristics and main symptoms with percentage; the difference between main symptoms and screening tests with X2-test, ANOVA. The results are as follows. 1) Among the age distribution, most were 40-45 years old and unemployed. 2) The most common complaints were indigestion in digestive system, cough in respiratory system, heart beat in cardiovascular system, general sweat in endocrine system, edema in urinary system, easy bruise in hematologic system, backache in musculoskeletal system, headache in psychoneurologic system, lochia in gynecology, itch in dermatology system, eye ball pain in visual system and tinnitus in auditory system. 3) In main symptoms according to age, the 40-45 age group had a higher rate of complaints in digestive system and gynecology than other age group ; the 46-49 age group in endocrine system. 4) The main symptoms according to diagnosis had no difference statistically. 5) The screening tests which showed high rates of abnormality were mammography(the highest), abdominal ultrasonography, upper gastrointestinal series/gastrofiberscopy, PFT. In all age group the highest rate of abnormality was seen n mammography. 6) In screening tests according to age, the 46-49 age group showed higher positive rates of pap smear, blood sugar test, urine test than any other age group; the 50-55 age group showerd higher positive rates of obesity, BP, chest X-ray, abdominal ultrasonography, ESR, SGOT, CRP and urine micro. 7) In correlation of obesity with screening test, the obesity group showed higher positive rates of blood pressure, chest X-ray, abdominal ultrasonography, HCT and CRP than the normal weight group. 8) In correlation of blood pressure with screening test, the hypertension group showed higher positive rate of obesity, chest X-ray, abdominal ultrasonography, pap smear and blood sugar than the normal blood pressure group. In conclusion, the middle-aged women have various physical symptoms and affected by age. The obesity and BP have an important effect on the health of the middle aged women. Therefore, this study is considered significant as data for qualitative lives of the middle-aged women playing an important part of family health care by catching of their health problem complaints for prevention of disease and promotion of health.

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Process of Change, Decisional Balance, Self-efficacy and Depression across the Stages of Change for Exercise among Middle Aged Women in Korea
Yun Mi Lee, Nam Hee Park, Young Hee Kim
Journal of Korean Academy of Nursing 2006;36(4):587-595.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.4.587
AbstractAbstract PDF
Purpose

The purpose of this study was to differentiate the change in exercise behavior into different stages and to investigate differences in the process of change, self efficacy, decisional balances and depression according to the stages of exercise behavior change among middle aged women in Korea by using the transtheoretical Model.

Methods

A convenience sample of 434 middle aged women (40-64 years) completed measures of all transtheoretical model constructs involved in exercise behaviors (stages and processes of exercise behaviors change, self efficacy and decisional balance) and depression. The data were analyzed by using the SPSS 10.0 program including descriptive statistics, and one-way ANOVA.

Results

The subjects were distributed in each stage of change in exercise behaviors: pre-contemplation (n=106; 24.4%), contemplation (n=126; 29%), preparation (n=88; 20.3%), action (n=51; 11.8%), and maintenance (n=63; 14.5%). The processes of change, pros(advantages of behaviors), self-efficacy and depression were significantly differentiated across the stages of exercise behavior change. Cons(disadvantage of behaviors) was not significantly differentiated across the stages of exercise behavior change.

Conclusions

Results of this study suggested that discriminating of processes of change, self-efficacy, decisional balance, and depression could provide positive information to people about the stages of change in exercise behavior. Therefore, in designing interventions, the stage of a client's exercise behaviors change needs to be assessed prior to application of intervention programs in order to increase and maintain exercise behavior in middle aged women.

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Process of Change, Decisional Balance and Self Efficacy Corresponding to Stages of Change in Exercise Behaviors in Middle Aged Women
Yun Mi Lee
Journal of Korean Academy of Nursing 2004;34(2):362-371.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.2.362
AbstractAbstract PDF
Purpose

The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior change based on a Transtheoretical Model in middle aged women.

Method

The subjects consisted of 317 women by convenience sampling residing in city B. The collected data were analyzed using one-way ANOVA, Scheffe test, and Discriminant analysis by SPSS/WIN program.

Result

The subjects were distributed in each stage of change of exercise behaviors: 53 subjects (16.7%) in the precontemplation stage, 86 subjects (27.1%) in the contemplation stage, 88 subjects (27.8%) in the preparation stage, 51 subjects (16.1%) in the action stage and 39 subjects(12.3%) in the maintenance stage. Analysis of variance showed that consciousness raising (F=24.96, p=.00), environmental reevaluation (F=7.13, p=.00), self reevaluation (F=19.47, p=.00), dramatic relief (F=15.22, p=.00), social liberation (F=4.26, p=.00), counter conditioning (F=26.44, p=.00), a helping relationship (F=13.17, p=.00), reinforcement management (F=21.25, p=.00), self liberation (F=27.70, p=.00), stimulus control (F=13.49, p=.00), pros (F=14.40, p=.00) and self-efficacy (F=39.91, p=.00) were significantly associated with the stages of change of exercise behaviors. Through discriminant analysis, it was found that 'stimulus control' was the most influential variable in discriminating the five stages of change.

Conclusion

This study can provide the basis of a staged matching exercise program using TTM for more effective and useful intervention.

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    Young-Ran Lee, Sun-Nam Park, Sook-Ja Yu, Jung-Soon Moon
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    Young Mi Kim, Ihn Sook Jeong
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    Myoung-Ae Choe, Yang Sook Hah, Keum Soon Kim, Myungsun Yi, Jung-An Choi
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A Study on Regular Cervical Cancer Screening Behavior among Middle-aged Women
In Sook Cho, Young Sook Park
Journal of Korean Academy of Nursing 2004;34(1):141-149.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.1.141
AbstractAbstract PDF
Purpose

To identify the status of regular cervical cancer screening practices among middle-aged women, the associations between regular practice and research factors, and the predictive model and factors effecting such behavior was studied.

Method

Two hundred women, aged 40 to 60, were selected by convenience in one urban area of Seoul. They were asked about their regular attendance for screening, knowledge of cancer and screening, health belief, health self-determination index and certain personal factors.

Result

Approximately 54.5% of the women had periodic screening tests every 6 months to 2 years. Their knowledge of cervical cancer and health belief were at the medium level of each scale, but their health self-determination scores (HSDI) were low. Some influencing factors, and their cancer odds ratio were identified through univariate regression analysis. These variables were included in a predictive model, and this model proved to have enough fit and classification power (83.5%). In this model, the financial state, self-belief and self-determination scores were found to be significant.

Conclusion

Middle-age women's intrinsic motivation for healthy behavior was found to be low in those who felt to be in a poor financial state, had higher perceived barriers, lower perceived benefits and a lower prevalence of undergoing regular screening test.

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Influencing Factors on Quality of Life of Middle-aged Women Living in Rural Area
Kyung Rim Shin, Jin Hyang Yang
Journal of Korean Academy of Nursing 2003;33(7):999-1007.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.999
AbstractAbstract PDF
Purpose

This study was to investigate the factors influencing quality of life of middle-aged women in rural area, to provide the basic data for health promoting intervention in order to improve quality of life.

Method

The subjects were 469 middle-aged women by 40-64 from 7 rural areas in Gyeonggi-do, Jeolla-do and Gyeongsang-do. Data collection was conducted by using 6 questionnaires.

Result

There were significant differences in the quality of life by age, educational level, marital status, religion, family pattern, and economic level. There were positive relationships between quality of life and health perception, social support, and negative relationships between quality of life and depression and stress. Stepwise Multiple Regression Analysis for quality of life revealed that the most powerful predictor was depression. Depression, health perception, social support, stress and economic level explained 51.5% of the variance.

Conclusion

Depression, health perception, social support, stress and economic level were related with quality of life of middle-aged women in rural area. Therefore, it is necessary to develop the nursing intervention these psycho-social aspects to increase the quality of life.

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    Jung Sook Choi, EunHee Lee, AeYoung So, Kyung-Sook Lee
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    Ok Kyung Ham
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    Young Rye Park, Hwee Wee, Soo Jin Kim
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    So Young Min
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Effectiveness of Aromatherapy Massage on Abdominal Obesity among Middle Aged Women
Seon Hee Han, Bok Soon Yang, Hee Ja Kim
Journal of Korean Academy of Nursing 2003;33(6):839-846.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.6.839
AbstractAbstract PDF
Purpose

Objectives of the study is to examine the effectiveness of aromatherapy massage among middle aged women with abdominal obesity.

Method

AB/BA crossover design of random blind assignment was applied. Aromatherapy and placebo massage were given to Group(A), Group(B), each groups applied each massages for 2weeks alternatively. Weight, abdominal circumference and appetite were compared for results check among the subjects.

Result

The apparent effectiveness of Aromatherapy Massage in reducing weight, abdominal circumference and appetite was noted.

Conclusion

On the basis of results, they strongly support the facts of reduction of abdominal obesity by applying aromatherapy massage for middle aged women.

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    Yasser O. Mosaad, Hayam Ateyya, Mohammed A. Hussein, Ahmed M. Moro, Ebtsam A. Abdel-Wahab, Amr A. El-Ella, Zahraa N. Nassar
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Life Experience following Suicide Attempt among Middle-aged Men
Eun-Young Chin, Hyun Kyung Kim
J Korean Acad Nurs 2016;46(2):215-225.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.215
AbstractAbstract PDF
Purpose

This study was performed to identify the meaning of life experience following suicide attempt among middle-aged men.

Methods

A qualitative research design was adopted using van Manen's hermeneutic phenomenological approach. The participants were six middle-aged men who had attempted suicide at least one time. Data were collected in 2013 through in-depth interviews. Individual interviews were recorded; and literary, art works and phenomenological literature were searched to identify the meaning of the experience.

Results

The five essential themes of the life experience of middle-aged men who attempted suicide were 'Bitter reality confronted again', 'Anger buried deep inside', 'Broken family, inescapable fetters', 'Blocked relationships, closed world' and 'A step towards a new life'.

Conclusion

The meaning of lived experience found in this study provides deep insight into the experience following suicide attempt in middle-aged men and crucial information to give directions to appropriate support and nursing interventions.

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    Min-Soo Kang, Hye-Young Jang
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    Suyoun Ahn, Yeojin Yi
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    Youngsuk Cho, Dong Moon Yeum
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    Jeong Lim Cho, Eun Nam Lee, Eun Young Park
    Journal of Korean Academic Society of Nursing Education.2017; 23(3): 341.     CrossRef
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The Effect of K-MBSR Program on Stress, Stress Coping Style, Depression, Anger and Sleep of Middle Aged Women
Jeong Min Park, In-Ryoung Choi
J Korean Acad Nurs 2016;46(2):194-206.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.194
AbstractAbstract PDF
Purpose

The purpose of this study was to examine a Korean Mindfulness Based Stress Reduction (K-MBSR) program for middle aged women and to verify the program's effectiveness on stress, stress coping style, depression, anger and sleep.

Methods

Fifty-two women aged from 40 to 59 (26 in the experimental group and 26 in the control group) from G city participated in the study. Data were collected from February 13 to April 3, 2013. The experimental group received 8 sessions, scheduled once a week, with each session lasting two and a half hours. Outcome variables included stress, stress coping style, depression, anger, sleep and a physiological measure (EEG).

Results

There were significant decreases for stress (t=-2.14, p=.037), depression (t=-2.64, p=.011), state trait anger (t=-3.79, p<.001) in the experimental group compared to the control group.

Conclusion

The findings in this study indicate that the K-MBSR program is an effective program to decrease stress, depression, and state trait anger in middle aged women.

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Structural Equation Modeling on Healthy Menopausal Transition
Eunyoung Hong, Young Sil Kang
J Korean Acad Nurs 2015;45(1):64-75.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.64
AbstractAbstract
Purpose

This study was designed to construct and test structural equation modeling on healthy menopausal transition in middle-aged women in order to identify variables affecting healthy menopausal transition.

Methods

Participants, 276 women, 45 to 60 years of age, with menopausal symptom score higher than 5 on the Korean version of Menopause Rating Scale, were recruited in three cities and one county of Gyeongnam Province. Research data were collected via questionnaires and analysed using SPSS version 18.0 and AMOS version 20.0.

Results

After confirmatory factor analysis, one of the observed variables was excluded due to relatively low factor loading. The model fit indices for the hypothetical model were suitable for the recommended level: GFI=.93, CFI=.92, RMSEA=.05. Self-efficacy, self-differentiation, and menopausal symptoms explained 67.7% of variance in menopausal transition, and self-differentiation was the most influential factor for menopausal transition. Self efficacy and menopausal symptoms explained 9.6% of variance in menopausal management, although "menopausal symptoms" was not significant.

Conclusion

These results suggest that nursing interventions to improve self-differentiation, self efficacy, menopausal management and decrease menopausal symptoms are critical for healthy menopausal transition in middle-aged women. Continued development of a variety of community-based nursing interventions to facilitate healthy menopausal transition is suggested.

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    Hyeja Gu, Eunyoung Hong
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    Jiwon Lee, Jong-Eun Lee
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Relationship between Expectations Regarding Aging and Physical Activity among Middle Aged Adults in Urban Areas: Based on the Pender's Health Promotion Model
Sung-Hye Cho, MoonKi Choi, JuHee Lee, Hyewon Cho
J Korean Acad Nurs 2015;45(1):14-24.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.14
AbstractAbstract PDF
Purpose

The purpose of this study was to measure the level of expectations regarding aging (ERA) and identify relationship between ERA and physical activity of middle aged adults.

Methods

Participants were middle aged adults who resided in the community in three cities in Korea. Data were collected using questionnaires that contained items on individual characteristic, International Physical Activity Questionnaires (IPAQ), and behavior-specific cognitive factors including ERA-12. Hierarchical multiple regression was conducted to examine whether ERA would predict physical activity by controlling other factors.

Results

The mean age of the participants was 51.1±6.9 years. The mean score for ERA (possible range=0 to 100) was 40.04±14.31. More than half of the participants (62.6%) were not engaged in health promoting physical activity. Gender, employment status and exercise confidence were associated with level of physical activity (F=7.14, p<.001, R2=.36). After controlling for individual factors and behavior-specific cognitive factors, ERA was independently related to physical activity (F=7.19, p<.001, R2=.38).

Conclusion

The results demonstrate that individuals' belief about aging has effects on physical activity in Korean middle aged adults. Thus, nursing interventions which focused on ERA could help enhance physical activity in middle aged adults.

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Effects of Perceived Health Status, Self-esteem and Family Function on Expectations Regarding Aging among Middle-aged Women
Yoo Rim Kweon, Hae Ok Jeon
J Korean Acad Nurs 2013;43(2):176-184.   Published online April 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.2.176
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate expectations regarding aging by middle-aged women in the community, and identify factors contributing to their expectations about aging.

Methods

Participants in the survey for this study were 303 middle-aged women from community health centers and religious facilities in Seoul, Gyeonggi Province, and Chungcheongbuk Province. Data were collected from March 2 to April 17, 2012 using self-report structured questionnaires. The instruments were the Health Perceptions, Rosenberg Self-esteem Scale (RSES), Family APGAR, Expectations Regarding Aging (ERA-12). The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and hierarchical multiple regression with IBM SPSS/WIN 20.0 program.

Results

Perceived health status (β=0.16, p=.009) and self-esteem (β=0.20, p=.001) of middle-aged women were identified as significant predictors of expectations regarding aging, after adjusting for age, education, occupation, monthly income and menstrual status.

Conclusion

These results suggest that nurses should make an effort to improve expectations about aging among middle-aged women. Ultimately, community health programs for middle aged women need to be developed to achieve successful aging.

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    Hyun-E Yeom, Kyoung Ok Ju
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Patterns of Anger Expression among Middle-aged Korean Women: Q methodology
Yong Mi Lee, Geun Myun Kim
J Korean Acad Nurs 2012;42(7):1001-1008.   Published online December 12, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.7.1001
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the characteristics of anger expression in middle-aged Korean women by categorizing their patterns of expression while considering the complexity and multidimensionality of anger, and by investigating the characteristics relative to the patterns.

Methods

The research design was a descriptive design using Q methodology, which is a method of measuring subjectivity. A convenience sample of 42 participants aged 40–60 years and living in the community in Korea was recruited. The PC-QUANL software program (a factor analysis program for the Q technique) was used to analyze the Q-sort data.

Results

Four factors were extracted that described different expressions of anger among middle-aged Korean women; these factors explained 50.1% of the total variance. The frames of reference of the four factors were a) direct diversion, b) silent masking with remaining anger, c) self digestion, and d) controlling anger with objectification.

Conclusion

In this study has identified patterns and characteristics of anger expression among middle-aged Korean women were identified, which will aid the development of effective anger-management programs for controlling anger in this population. In future studies, it would be helpful to investigate how the patterns of anger expression established herein are associated with specific health problems such as cardiovascular disorder and cancer.

Citations

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    Mao-Meng Tiao, Yu-Che Chang, Liang-Shiou Ou, Chi-Fa Hung, Madalitso Khwepeya
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Effects of Self-Foot Reflexology on Stress, Fatigue and Blood Circulation in Premenopausal Middle-Aged Women
Soo Hyun Jang, Kye Ha Kim
J Korean Acad Nurs 2009;39(5):662-672.   Published online October 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.5.662
AbstractAbstract PDF
Purpose

This study was to examine the effects of self-foot reflexology on stress, fatigue and blood circulation in premenopausal middle-aged women.

Methods

A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants were 59 premenopausal, middle-aged women in their 40s and 60s living in G city: 30 in the experiment group and 29 in the control group. Data were collected from May to August 2008. Self-foot reflexology was performed three times a week for 6 weeks for 40 min at each session.

Results

The results showed that self-foot reflexology was effective in reducing perceived stress and fatigue and helped blood circulation in premenopausal middle-aged women.

Conclusion

Self-foot reflexology may be an effective nursing intervention in reducing perceived stress and fatigue and in improving blood circulation.

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A Study on Exercise Behavior, Exercise Environment and Social Support of Middle-Aged Women
Myoung-Ae Choe, Yang Sook Hah, Keum Soon Kim, Myungsun Yi, Jung-An Choi
Journal of Korean Academy of Nursing 2008;38(1):101-110.   Published online February 28, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.1.101
AbstractAbstract PDF
Purpose

The purpose of this study was to identify exercise environments and social support associated with exercise behaviors in middle-aged women

Methods

Subjects were 207 women aged between 41 and 59 yr in an urban community. The research instruments utilized in this study were exercise stages, exercise environments, exercise partners and social support scale. Subjects were given a self-report questionnaire. Data was analyzed using the SPSS Win program.

Results

The subjects were in the stages of precontemplation (3.4%), contemplation (25.1%), preparation (40.6%), action (5.8%), and maintenance (25.1%). Subjects who engaged in regular exercise were 30.9%. The mean score of the exercise environment was 6.34. The mean score of social support was 21.28, and 65.7% of subjects had exercise partners. The score of the exercise environment was significantly associated with the exercise stage (p=.01). The number of exercise partners of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support was significantly associated with the exercise stage (p=.00).

Conclusion

Exercise environments and social support need to be considered in planning exercise programs to improve exercise behavior among middle-aged women.

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Effect of Self-Foot Reflexology massage on Depression, Stress Responses and Immune Functions of Middle Aged Women
Yun Mi Lee
Journal of Korean Academy of Nursing 2006;36(1):179-188.   Published online February 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.1.179
AbstractAbstract PDF
Purpose

This study was aimed to identify the effects of a self-foot reflexology massage on depression, stress responses and functions of the immune system of middle-aged women.

Method

This study was a one group pretest-posttest experimental design and the data was collected from August 1st, 2004 to May 31st, 2005. The subjects consisted of 46 middle-aged women (40 - 64 years) who were recruited from the Community Health Center in Busan city. Subjects were not treated for 4 weeks, subsequently they were trained in self foot reflexology massage for 2 weeks, and then they did their own daily for 6weeks (2 days at the research center, 5 days at home).The outcome variables were measured 4 times, at baseline, pre training, after training, and after the intervention. The collected data was analyzed using repeated measure ANOVA by the SPSS/WIN program.

Result

There was a statistically significant difference in depression, perceived stress, systolic blood pressure, natural-killer cells and Ig G. However, there was not a statistically significant difference in dyastolic blood pressure, pulse or serum cortisol.

Conclusion

These results suggest that a self-foot reflexology massage could be utilized as an effective nursing intervention to reduce depression and stress responses, and to strengthen immune systems in middle-aged women.

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    J Sirumalar
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    Ja Ok Kim, In Sook Kim
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    Young-Mee Lee
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Development of a Dan Jeon Breathing Model for Health Promotion in Middle-aged Women
Kyung Won Kim
Journal of Korean Academy of Nursing 2005;35(3):565-574.   Published online June 30, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.3.565
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a Dan Jeon Breathing Model and to identify effects of the developed Dan Jeon Breathing Model for maintenance and promotion of health and improvement of health problems in middle-aged women.

Method

This study was constructed with two procedures. The first procedure was to develop appropriate movements for middle-aged women, performing a focus group discussion and developing a Dan Jeon Breathing Model in qualitative research. The collected data from focus group discussions was categorized for fitting movements. The second procedure was to verify and conclude a Hypothetic Dan Jeon Breathing Model through a quasi-experimental nonequivalent control group pre-post test design.

Result

The developed Dan Jeon Breathing Model was composed of 28 preparation movements to accept Ki comfortably, 10 breathing movements to accumulate Ki for activation of metabolic function in organs and 14 finishing movements to transmit activated Ki to organs. It took 40 minutes to do them. In the Second procedure, the score of physical health (t=4.205, p=.000), psycho-social health(t=3.292, p=.002) and physical strength of the experimental group(t=5.905, p=.000) was higher than that of the control group.

Conclusion

The Dan Jeon Breathing Model developed in this study is the correct health promotion model for middle-aged women, their demand, developmental traits and health problems.

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    Young A Song, Hye Sook Shin
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    Hee-Young Kang, Yang-Sook Yoo
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