J Korean Acad Nurs.  2015 Feb;45(1):64-75. 10.4040/jkan.2015.45.1.64.

Structural Equation Modeling on Healthy Menopausal Transition

• Hong E
• Kang YS

• KMID: 2363063
• DOI: http://doi.org/10.4040/jkan.2015.45.1.64

Abstract

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.

Keyword

Menopause; Quality of life; Self efficacy; Nursing care; Middle aged

MeSH Terms

Factor Analysis, Statistical
Female
Humans
Menopause/*physiology
Middle Aged
*Models, Theoretical
Postmenopause
Quality of Life
Republic of Korea
*Self Efficacy
Surveys and Questionnaires
Translating

Figure

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  Figure 1 Conceptual framework of this study.

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  Figure 2 Hypothetical model.

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  Figure 3 Path diagram for the hypothetical model.

Reference

1. Statistics Korea. 2012 life tables for Korea [Internet]. Daejeon: Author;2013. cited 2013 December 20. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/2/7/index.board.

2. Kim SG, Kim YG, Cho AJ, Kim HR, Im SE. Report No.: Research Paper 2009-33. The 2009 national survey on fertility, family health and welfare in Korea. Seoul: The Korea Institute for Health and Social Affairs;2009.

3. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the stages of reproductive aging workshop+10: Addressing the unfinished agenda of staging reproductive aging. Fertil Steril. 2012; 97(4):843–851. DOI: 10.1016/j.fertnstert.2012.01.128.

4. Breheny M, Stephens C. Healthy living and keeping busy: A discourse analysis of mid-aged women's attributions for menopausal experience. J Lang Soc Psychol. 2003; 22(2):169–189. DOI: 10.1177/0261927X03252282.

5. Kim MJ, Kim JH. How long do menopausal hot flushes really last? J Korean Soc Menopause. 2009; 15(2):73–78.

6. Yoon JH, Han JH. A study on the psychological phenomenon experienced by menopausal middle-aged women. Korean J Couns. 2013; 14(4):2195–2212.

7. Meleis AI, Sawyer LM, Im EO, Hilfinger Messias DK, Schumacher K. Experiencing transitions: An emerging middle-range theory. ANS Adv Nurs Sci. 2000; 23(1):12–28.

8. Schumacher KL, Meleis AI. Transitions: A central concept in nursing. Image J Nurs Sch. 1994; 26(2):119–127.

9. Yeo JH. Correlational study on management of menopause, marital satisfaction, and quality of life in middle-aged women. J Korean Acad Nurs. 2004; 34(2):261–269.

10. Lee KH, Chang CJ. Korean urban woman's experience of menopause: New life. Korean J Matern Child Health Nurs. 1992; 2(1):70–86.

11. Im EO, Meleis AI. A situation-specific theory of Korean immigrant women's menopausal transition. Image J Nurs Sch. 1999; 31(4):333–338.

12. Hong E, Kang YS, Ha Y. Factors affecting on health promoting behaviors among teachers with middle-aged women experiencing menopause. Korean J Occup Health Nurs. 2013; 22(1):66–74.

13. Park CH, Oh EJ, Park JS. The relationships between menopausal symptoms, menopausal knowledge, menopausal attitude and menopausal management of middle aged women. J Korean Soc Matern Child Health. 2012; 16(1):89–99.

14. Song AR. Development of and educational program for the management of menopause and it's effect. J Korean Acad Nurs. 1998; 28(2):280–290.

15. Lee KH. Relationships between role adaptations and identity formation of married mid-life women [dissertation]. Daegu: Keimyung University;1998.

16. Byeon WJ, Kim CK. Effects of socio-demographic variables, self-differentiation and internal systems on ego-identity of middle-aged women. J Korean Home Econ Assoc. 2006; 44(12):155–165.

17. Kim KS, Kim JR. The effects of ego-identity and crisis on quality of life in midlife married women. J Korean Home Econ Assoc. 2001; 39(4):105–120.

18. Song HO, Park AC, Choi SY. A structure model analysis between a family environment, perceived social support, self-efficacy and ego-identity of adolescents. Korean J Youth Stud. 2010; 17(2):109–129.

19. Jung YJ, Hong SR. Mediating effects of school life satisfactions and relationship satisfactions on the relations between self-efficacy and subjective quality of life in university students. J Adolesc Welf. 2012; 14(3):239–257.

20. Royal College of Nursing. Menopause: Lifestyle and therapeutic approaches: RCN guidance for nurses, midwives and health visitors [Internet]. London, UK: Author;2010. cited 2013 March 2. Available from: http://www.rcn.org.uk/development/publications.

21. Ro YJ. An analytical study on the quality of life of the middle-aged in Seoul [dissertation]. Seoul: Yonsei University;1988.

22. Lee YM, Schwarzer R, Jerusalem M. Korean adaptation of the general self-efficacy scale [Internet]. 1994. cited 2013 June 2. Available from: http://userpage.fu-berlin.de/~health/korean.htm.

23. Bowen M. Theory in the practice of psychotherapy. In : Guerin PJ, editor. Family therapy: Theory and practice. New York, NY: Gardner Press;1976. p. 42–90.

24. Je SB. The relationship between differentiation of self and dysfunctional behavior [dissertation]. Busan: Pusan National University;1989.

25. Heinemann LA, Potthoff P, Schneider HP. International versions of the menopause rating scale (MRS). Health Qual Life Outcomes. 2003; 1:28. DOI: 10.1186/1477-7525-1-28.

26. Heinemann LA, DoMinh T, Strelow F, Gerbsch S, Schnitker J, Schneider HP. The menopause rating scale (MRS) as outcome measure for hormone treatment? A validation study. Health Qual Life Outcomes. 2004; 2:67. DOI: 10.1186/1477-7525-2-67.

27. Kim GS. Analysis structural equation modeling. Seoul: Hannarae Publishing Co.;2010.

28. Lee SS. A study on the relationship between married adult's level of self differentiation and their life satisfaction. J Fam Relat. 2000; 5(1):23–43.

29. Kim JT, Sim HS. The main characteristics of Bowen's psychodynamic family therapy in the context of self-differentiation. Korean J Fam Ther. 1993; 1(1):31–45.

30. Kim YH, Ha EH, Shin SJ. A study on the menopausal symptoms and quality of life in middle aged women. J Korean Acad Nurs. 2003; 33(5):601–608.