Thomas Annette Joan, Mitchell Ellen Sullivan, Woods Nancy Fugate
1College of Nursing, Seattle University, Seattle, Washington USA.
2Family and Child Nursing, University of Washington, Seattle, Washington USA.
Womens Midlife Health. 2018 Jun 15;4:8. doi: 10.1186/s40695-018-0039-9. eCollection 2018.
Midlife, the period of the lifespan between younger and older adulthood, has been described as a period of transition in women's lives. Investigators studying midlife have focused on women 40 to 65 years of age, who typically experience multiple social, psychological and biological challenges, among them the menopausal transition. Investigators have reported a diverse array of stressful events, for example, health concerns, family problems, work-related issues, deaths, frustrated goal attainment, and financial worries; however, none have identified which life events midlife women experience as the most salient. The purpose of this study was to understand the meaning behind the experiences that midlife women identify as the most challenging.
Participants were enrolled in The Seattle Midlife Women's Health Study, a longitudinal study spanning up to 23 years. Summative content analysis, incorporating manifest and latent analysis approaches, was used to identify life experiences that women described as the most challenging looking back over 15 years of being in the study. Eighty-one women responded to the question, "Since you have been in our study (since 1990 or 1991), what has been the most challenging part of life for you?"
Women identified the most challenging aspects of midlife as changing family relationships, re-balancing work/personal life, re-discovering self, securing enough resources, and coping with multiple co-occurring stressors. Within these themes the most frequently reported challenges were: multiple co-occurring stressors, divorce/breaking up with a partner, health problems of self, and death of parents. Few women mentioned menopause as the most challenging aspect of their lives.
Women found themselves searching for balance in the midst of multiple co-occurring stressors while coping with losses and transitions, for some in a context of limited resources. Menopause was infrequently mentioned. Future research to identify the challenges experienced by more diverse populations of women and further understanding of the dynamics among multiple co-occurring stressors is needed to provide individualized health care appropriately to midlife women.
中年是成年早期与成年晚期之间的生命阶段，被描述为女性生命中的一个过渡时期。研究中年阶段的调查人员将重点放在40至65岁的女性身上，她们通常会经历多种社会、心理和生理挑战，其中包括更年期过渡。调查人员报告了一系列不同的压力事件，例如健康问题、家庭问题、工作相关问题、死亡、目标达成受挫以及经济担忧；然而，没有人确定中年女性经历的哪些生活事件最为突出。本研究的目的是了解中年女性认为最具挑战性的经历背后的意义。
参与者被纳入西雅图中年女性健康研究，这是一项长达23年的纵向研究。采用结合显性和隐性分析方法的总结性内容分析，以确定女性在回顾参与该研究的15年中所描述的最具挑战性的生活经历。81名女性回答了“自您参与我们的研究（自1990年或1991年以来），您生活中最具挑战性的部分是什么？”这个问题。
女性将中年最具挑战性的方面确定为家庭关系的变化、工作/个人生活的重新平衡、重新发现自我、确保足够的资源以及应对多种同时出现的压力源。在这些主题中，最常报告的挑战是：多种同时出现的压力源、与伴侣离婚/分手、自身健康问题以及父母死亡。很少有女性提到更年期是她们生活中最具挑战性的方面。
女性发现自己在应对多种同时出现的压力源、损失和过渡的过程中寻求平衡，对一些人来说是在资源有限的情况下。更年期很少被提及。未来需要进行研究，以确定更多样化女性群体所经历的挑战，并进一步了解多种同时出现的压力源之间的动态关系，以便为中年女性提供适当的个性化医疗保健。
