Association between perceived life stress and subjective well-being among Chinese perimenopausal women: a moderated mediation analysis

Hardiness and Expectations for Future Life: The Roles of Perceived Stress, Music Listening for Negative Emotion Regulation, and Life Satisfaction

This study investigated the relationship between hardiness and Korean adults' expectations for future life, and verified the multiple mediating effects of perceived stress, music listening for negative emotion regulation, and life satisfaction on that relationship. The participants were 412 Korean adults aged 20-65 years. PROCESS Macro 3.5 Model 80 was used to examine the multiple mediating effects. Correlational analysis showed that hardiness was positively correlated with music listening for negative emotion regulation, life satisfaction, and expectations for future life, whereas it was negatively correlated with perceived stress. Perceived stress was negatively correlated with life satisfaction and expectations for future life, whereas music listening for negative emotion regulation was positively correlated with life satisfaction and expectations for future life. In the multiple mediation model, the relationships between hardiness and expectations for future life, the sequential mediating effect of perceived stress and life satisfaction, and the sequential mediating effect of music listening for negative emotion regulation and life satisfaction were significant. The direct effect of hardiness on expectations for future life was also significant, indicating that perceived stress, music listening for negative emotion regulation, and life satisfaction only partially mediated the relationship between hardiness and expectations for future life. It seems, thus, that perceived stress, music listening for negative emotion regulation, and life satisfaction play an important role in Korean adults' expectations for future life.

Climacteric symptoms, age, and sense of coherence are associated with sexual function scores in women after menopause

BACKGROUND

Postmenopausal sexual function presupposes the integration of hormonal, neural, and vascular interactions and is subject to optimal crosstalk among psychological, interpersonal, cultural, and environmental factors. Sense of coherence (SOC) reflects a person's ability to cope with stressors and may influence the occurrence of menopausal symptoms and sexual dysfunction.

AIM

To investigate the association of severity of climacteric symptoms, cardiometabolic risk factors, and SOC with sexual function in postmenopausal women.

METHODS

Overall 281 sexually active postmenopausal women without significant psychopathology or cardiovascular disease attending the Menopause Unit of Aretaieion Hospital were evaluated by the Female Sexual Function Index (FSFI), Greene Climacteric Scale, Beck Depression Scale, and Sense of Coherence Scale. Hormonal and biochemical parameters and cardiometabolic risk factors were evaluated. FSFI scores <26.5 were considered pathologic.

OUTCOMES

Total and subdomain scores of sexual response were determined.

RESULTS

Pathologic FSFI scores were found in 79.7% of the sample. Linear models of multivariable regression analysis showed that FSFI scores were associated with (1) Beck scores (b  = -0.200; 95% CI, -0.472 to -0.073, P = .001), vasomotor symptom severity (b = -0.324; 95% CI, -0.985 to 0.051; P < .001), and age and (2) SOC (b = 0.150, 95% CI, 0.036-0.331; P = .008), vasomotor symptom severity (b = -0.361; 95% CI, -0.743 to 0.245; P < .001), and age. Both models were adjusted for menopausal age, diabetes mellitus, hypertension, type of menopause, and menopausal hormone therapy intake. SOC was associated with Beck depression scores (β = -0.487, P < .001; Greene Climacteric Scale total scores, β = -0.199, P < .001). FSFI score <26.5 vs >26.5 was associated with SOC (odds ratio, 0.982; 95% CI, 0.563 to 1.947; P = .006) and moderate to severe vasomotor symptom severity (odds ratio, 2.476; 95% CI, 1.478 to 3.120; P = .009) independent of age, diabetes mellitus, hypertension, menopausal hormone therapy intake, type of menopause, or Beck depression classification.

CLINICAL IMPLICATIONS

The results indicate the importance of psychometric assessment of postmenopausal women when presenting with scores of low sexual function. The severity of vasomotor symptoms should also be addressed in any case.

STRENGTHS AND LIMITATIONS

This is the first study investigating the relationship between SOC and sexuality in menopause in a carefully selected homogenous population. Limitations included the cross-sectional design and the fact that sexual distress was not assessed.

CONCLUSIONS

Pathologic FSFI scores were highly prevalent in this sample of postmenopausal women. FSFI is associated positively with age and severity of vasomotor symptoms and negatively with SOC.

Care engagement with healthcare providers and symptom management self-efficacy in women living with HIV in China: secondary analysis of an intervention study

Background

Symptom management self-efficacy is a prerequisite for individuals to fully manage their symptoms. The literature reports associations between engagement with healthcare providers (HCPs), internalized stigma, and types of self-efficacy other than symptom management. However, the factors of symptom management self-efficacy are not well understood. This study aimed to investigate the relationship among engagement with HCPs, internalized stigma, and HIV symptom management self-efficacy in Chinese women living with HIV (WLWH).

Methods

This current analysis was part of the original randomized control trial, we used data collected from 41 women living with HIV (WLWH) assigned to an intervention arm or a control arm from Shanghai and Beijing, China, at baseline, Week 4 and Week 12. The CONSORT checklist was used. The study was registered in the Clinical Trial Registry (#NCT03049332) on 10/02/2017.

Results

The results demonstrate that HCPs should increase engagement with WLWH when providing care, thereby improving their symptom management self-efficacy. The results suggested that participants’ engagement with HCPs was significantly positively correlated with their HIV symptom management self-efficacy in the latter two time points. Internalized stigma was significantly negatively correlated with HIV symptom management self-efficacy only at the 4-week follow-up.

Conclusions

This study demonstrated the positive effect of engagement with HCPs on WLWHs’ symptom management self-efficacy as well as the negative effect of internalized stigma on symptom management self-efficacy. Future research can further test the relationship between the three key concepts, as well as explore interventions to decrease internalized stigma.