Min Se Hee, Yang Qing, Docherty Sharron L, Lee Chiyoung
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Duke University School of Nursing, Durham, NC, USA.
West J Nurs Res. 2025 Jul;47(7):630-640. doi: 10.1177/01939459251333669. Epub 2025 Apr 12.
Midlife women in perimenopause and postmenopause experience a complex array of symptoms. However, there is conflicting evidence on how their symptom experiences differ by menopausal stage. Current studies have not examined the interconnected relationship among menopausal symptoms and understood how this relationship may differ based on the menopausal stage.
This is a secondary data analysis using cross-sectional data (visit 5) from the Study of Women's Health Across the Nation. Network analysis was used to visualize the network structure and to identify key symptoms. Then, a network comparison test was conducted to compare the symptom network properties. Propensity score matching was used to match participants in terms of their covariates.
In midlife women in perimenopause, frequent mood change was the key symptom with the highest strength (1.59), closeness (1.27), and expected influence (1.62). In midlife women in postmenopause, anxiety was the key symptom with the highest closeness (0.95) and expected influence (1.48). The symptom networks were not significantly different between the 2 groups in terms of global strength (global strength = 0.01, = .974), network structure (network structure = 0.10, = .461), and specific centrality measure (centrality = -0.10, = .083). While the symptom networks were not invariant, the key symptoms were different between the 2 groups.
Our study findings indicate a potential need for different symptom management approaches for midlife women in perimenopause and postmenopause. With this new knowledge, clinicians should offer targeted key symptom assessment and management.
围绝经期和绝经后期的中年女性会经历一系列复杂的症状。然而，关于她们的症状体验如何因绝经阶段而异，存在相互矛盾的证据。目前的研究尚未考察绝经症状之间的相互联系，也未了解这种关系如何因绝经阶段而有所不同。
这是一项对来自全国女性健康研究的横断面数据（第5次访视）进行的二次数据分析。采用网络分析来可视化网络结构并识别关键症状。然后，进行网络比较测试以比较症状网络属性。倾向得分匹配用于根据协变量对参与者进行匹配。
在围绝经期的中年女性中，频繁情绪变化是强度最高（1.59）、紧密性最高（1.27）和预期影响力最高（1.62）的关键症状。在绝经后期的中年女性中，焦虑是紧密性最高（0.95）和预期影响力最高（1.48）的关键症状。两组之间的症状网络在全局强度（全局强度 = 0.01，P = 0.974）、网络结构（网络结构 = 0.10，P = 0.461）和特定中心性度量（中心性 = -0.10，P = 0.083）方面无显著差异。虽然症状网络并非一成不变，但两组的关键症状不同。
我们的研究结果表明，围绝经期和绝经后期的中年女性可能需要不同的症状管理方法。有了这些新知识，临床医生应提供有针对性的关键症状评估和管理。
