The Joys and Challenges of Midlife Women

Friday, April 24, 2015
Annette Joan Thomas, RN, BSN, MS , Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, WA
Purpose/Aims: To examine how midlife women experience joyful events and challenges, to determine how, if at all, midlife women use joyful events to increase their resilience for their challenges, and to investigate how women experience the menopausal transition (MT). 

Background: Women in midlife who have a lot of responsibilities and severe menopausal transition symptoms may also have higher levels of stress.  Disease states often occur after having chronic, high levels of stress, often with sustained high cortisol levels and self-reports of perceived stress.  It is not only important to learn what kind of experiences midlife women have that increase their stress levels and what they do to moderate the stress response, but also to explore the joyful experiences they have.  Learning about their joyful experiences may provide an insight into how these joyful experiences balance their lives.  Everyone has stress in her life, but being able to be joyful may be the difference between high, chronic stress that leads to disease and low stress that can be managed effectively.

Theoretical Framework: Both internal and external stressors contribute to allostatic load.  Allostatic load refers to the burden of chronic stress and altered personal behaviors that result from the effects of overuse (McEwen, 1998).  Women in midlife are at risk of allostatic load, since their stress levels tend to be very high, especially if these women have limited support and negative coping mechanisms.  

Methods: The study design utilized qualitative research with grounded theory.  The population involved a purposeful sample comprised of three women who answered flyers posted in local coffee shops. The data analyzed consisted of field notes and audio recordings of the individual interviews and drawings that the women made.  These three data types gave rise to method triangulation providing a consistent and coherent understanding of the topic.   

Results: In reviewing transcripts and drawings, the following themes emerged divided into two categories, joyful themes and challenging themes.  The joyful themes were “Taking Care of Yourself,” “Seeking Companionship,” and “What’s Next?”  The challenging themes were “Dealing with Aging,” “Sacrifices,” and “Curve Balls.” 

Conclusions/Implications: In reference to McEwen’s allostatic load theory, the positive coping mechanisms that prevent allostatic load fall under the joyful themes of “Taking Care of Yourself” and “Seeking Companionship.”  The stress part of the theory gives rise to the challenging themes of “Sacrifices” and “Curve Balls.”  “Dealing with Aging” involves the MT and midlife changes.  The joys that midlife women have may help buffer the stress associated with the challenges and prevent allostatic overload.  In this way, primary care providers and researchers will be informed of what resources these women need, how to address their lack of joy, and what interventions to prescribe in order to decrease allostatic load that may result from challenges leading to future disease states.