건강한 폐경이행 구조모형 = Structural equation modeling on healthy menopausal transition

다국어 초록 (Multilingual Abstract)

Korean women's life expectancy is 84.6 years and the average age at menopause is 49 years. This means many of women will live more than 30 years after menopause. Menopausal transition is a passage from fairly stable state before menopause to fairly stable sate after menopause, also a period of temporal changes in health and quality of life.
Menopausal transition is a developmental normal experience that is linked to midlife, ageing, and role change. Nursing intervention is aimed at assisting middle-aged women to create conditions conductive to a healthful transition.
Therefore, It is important to investigate parameters affecting on healthy menopausal transition for developing effective nursing strategy.
This study was designed to construct and test the structural equation modeling on healthy menopausal transition in middle-aged women. A hypothetical model that involves factors influencing healthy menopausal transition in middle-aged women was constructed based on 'Transition theory' by Meleis et al. (2000) and previous research. It's suitability was tested by verifying the relationship among relevant variables. The hypothetical model assumed that the exogenous variables of self efficacy, self-differentiation, menopausal knowledge, menopausal attitude, menopausal symptom, and social network support influence on the endogenous variables of menopausal management and menopausal transition.
From August 20 to September 30, 2013, 276 women who were aged older than 45 and less than 60, whose menopausal symptom score was more than 5 by Korean version of menopause rating scale, were recruited in three cities and one county of Gyeongnam. Research data were collected via questionnaires and analysed by SPSS version 18.0 and AMOS version 20.0

The results are as follows:

1) After confirmatory factor analysis, some of observed variables were excluded due to relatively low factor loadings. The model fit indices for the hypothetical model were suitable for recommended level: GFI=.924, CFI=.920, RMSEA=0.046, normed x2 =1.585.

2) Menopausal transition was explained 70.7% by self efficacy, self-differentiation, menopausal attitude, menopausal symptom, and menopausal management and the most influential factor of menopausal transition was self-differentiation. Menopausal symptom was negatively influence on menopausal transition. Social network support had not direct influence on menopausal transition but indirect influence through menopausal management. Menopausal knowledge did not have direct and indirect influence on menopausal transition.

3) Menopausal management was explained 18.3% by self efficacy and social network support. Menopausal knowledge and menopausal attitude did not have direct influence on menopausal management.

These results suggest that nursing interventions for improving self-differentiation, self efficacy, menopausal management and decreasing menopausal symptom are critical for healthy menopausal transition in middle-aged women. Further development about a variety of community-based nursing intervention to facilitate healthy menopausal transition is suggested to be continued.

목차 (Table of Contents)

• 목 차 ⅰ
• List of Tables ⅲ
• List of Figures ⅲ
• List of Appendixes ⅲ
• Abstract ⅳ
• I. 서론 1
• 1. 연구의 필요성 1
• 2. 연구목적 4
• 3. 용어정의 4
• II. 문헌고찰 8
• 1. 이행 8
• 2. 건강한 폐경이행 12
• 3. 폐경관리 17
• 4. 폐경이행 조건 19
• III. 이론적 기틀 31
• 1. 본 연구의 개념틀 31
• 2. 가설적 모형 32
• 3. 연구가설 34
• Ⅳ. 연구방법 35
• 1. 연구설계 35
• 2. 연구대상 35
• 3. 연구도구 36
• 4. 자료수집 방법 39
• 5. 연구의 윤리적 측면 40
• 6. 자료분석 방법 40
• Ⅴ. 연구결과 42
• 1. 대상자의 특성 42
• 2. 연구변수에 대한 서술적 통계 45
• 3. 월경상태에 따른 연구변수의 서술적 통계 46
• 4. 연구변수간의 상관관계 47
• 5. 측정변수에 대한 확인적 요인 분석 49
• 6. 가설적 모형의 검정 52
• 7. 가설 검정 55
• Ⅵ. 논의 58
• 1. 건강한 폐경이행 모형의 적합도 58
• 2. 건강한 폐경이행에 대한 영향요인 59
• 3. 폐경관리에 대한 영향요인 64
• 4. 간호학적 의의 68
• Ⅶ. 결론 및 제언 71
• 1. 결론 71
• 2. 제언 72
• 참고문헌 73