Thomas Annette Joan, Mitchell Ellen Sullivan, Pike Kenneth C, Woods Nancy Fugate
College of Nursing, Seattle University, Seattle, WA, USA.
Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA.
Womens Midlife Health. 2023 Sep 5;9(1):6. doi: 10.1186/s40695-023-00089-y.
Midlife is a time of increased responsibilities for women who have multiple roles including taking care of children, caring for elderly parents, managing households, and working outside the home. With little time for themselves, women additionally experience stressful life events (SLEs). The purpose of this study was to describe the longitudinal patterns of SLEs of women during midlife and to identify predictors of the SLE longitudinal patterns using baseline data of socio-economic factors and demographic characteristics.
Women who were part of the Seattle Midlife Women's Health Study (SMWHS), a longitudinal study spanning more than 23 years, who had SLEs measured at baseline and at years 2, 7, and 10 were included in these analyses (N = 380 women at baseline). The Life Event Scale (LES), a 70-item scale based on a yes/no response and a Likert-based scoring system with 0 (no effect) to 4 (large effect), was used to determine the total and impact scores of midlife women. The LES was adapted to midlife women from the Norbeck Scale for younger, pregnant women. Analytic strategies consisted of a group-based trajectory model (GBTM) to examine subgroups of women with similar exposure to SLEs using socio-economic factors (gross family income, education, race/ethnicity, employment), demographic variables (age, marital status, being a parent), and menopausal transition stage to differentiate trajectories over time.
Approximately 86% of women had medium high exposure to undesirable SLEs with a slight decrease (65.5%), or a sharp decrease (20.1%), over 10 years. The majority (approximately 64%) had moderate, sustained impact ratings, while approximately 35% had impact ratings that decreased over time. Most women (approximately 88%) reported desirable life events, which were sustained over the ten years, and which may help to balance or offset the high ratings of undesirable stressful life events. The rated impact of these desirable events decreased slightly over time for 65% of the sample. Socio-economic factors, demographic variables, and menopausal transition stages were not significant predictors of any of the four GBTMs.
Midlife women experience SLEs throughout the menopausal transition. Most of these midlife women had had a large amount of sustained stress over 10 years although all trajectories decreased to some extent over time. Since the menopausal transition stages were not significant predictors of the ratings of SLEs, a more complex set of factors, including social as well as biological, may explain the ratings of the women over the course of this ten-year observational study.
中年时期，女性肩负着更多责任，她们扮演着多种角色，包括照顾孩子、照料年迈的父母、管理家庭以及外出工作。由于几乎没有属于自己的时间，女性还会经历压力性生活事件（SLEs）。本研究的目的是描述中年女性SLEs的纵向模式，并利用社会经济因素和人口统计学特征的基线数据确定SLEs纵向模式的预测因素。
参与西雅图中年女性健康研究（SMWHS）的女性被纳入这些分析，该纵向研究跨越23年以上，在基线、第2年、第7年和第10年测量了她们的SLEs（基线时N = 380名女性）。生活事件量表（LES）是一个基于是/否回答的70项量表，以及一个基于李克特量表的评分系统，从0（无影响）到4（影响大），用于确定中年女性的总分和影响得分。LES是从Norbeck量表改编而来，用于更年轻的孕妇。分析策略包括基于群体的轨迹模型（GBTM），以使用社会经济因素（家庭总收入、教育程度、种族/民族、就业情况）、人口统计学变量（年龄、婚姻状况、是否为父母）以及绝经过渡阶段来检查暴露于SLEs情况相似的女性亚组，以区分不同时间的轨迹。
大约86%的女性在10年内对不良SLEs有中度高暴露，其中有轻微下降（65.5%）或急剧下降（20.1%）。大多数（约64%）有中度、持续的影响评分，而约35%的影响评分随时间下降。大多数女性（约88%）报告了良好的生活事件，这些事件在十年中持续存在，可能有助于平衡或抵消不良压力性生活事件的高评分。对于65%的样本，这些良好事件的评分随时间略有下降。社会经济因素、人口统计学变量和绝经过渡阶段不是四个GBTM中任何一个的显著预测因素。
中年女性在整个绝经过渡期间都会经历SLEs。尽管所有轨迹随着时间的推移都有一定程度的下降，但大多数中年女性在10年中都承受了大量持续的压力。由于绝经过渡阶段不是SLEs评分的显著预测因素，在这项为期十年的观察性研究过程中，一组更复杂的因素，包括社会因素和生物学因素，可能解释了女性的评分情况。
