Towards the development of a gender-sensitive measure of women's mental health.

AIMS AND OBJECTIVES: To develop a gender-sensitive measure of women's mental health and to evaluate the measure's psychometric properties. BACKGROUND: Mental health problems are a leading global burden of disease, and gender differences in the prevalence of these problems are well documented. Improving mental health is as important as resolving mental health problems. Although many mental health scales have been developed, few measure women's positive mental health from a gender perspective. DESIGN: Instrument development and psychometric evaluation were used. METHODS: First, a new mental health scale (Women's Mental Health Scale) grounded in women's subjective experiences was formulated from the narratives of four female focus groups (n = 23). The new scale was evaluated using principal component analysis and internal consistency reliability in a sample of female participants (n = 106). Next, the Women's Mental Health Scale, the Chinese version of Beck Depression Inventory-II and Social Adjustment Scale Self-Report were used in a survey of female undergraduate students (n = 163) for examining the concurrent criterion-related validity. Finally, gender differences were examined by assessing the discriminated validity of the Women's Mental Health Scale in a sample of male and female undergraduate students (n = 357). All participants were recruited from communities and universities in middle and south Taiwan. RESULTS: A 50-item Women's Mental Health Scale with four concepts of self, interpersonal, family and social domains was developed. It revealed that the Women's Mental Health Scale had acceptable psychometric properties. There was a significant negative correlation between scores of the Women's Mental Health Scale and the Chinese version of Beck Depression Inventory-II and a significant positive correlation between scores of the Women's Mental Health Scale and Social Adjustment Scale Self-Report. There were significant gender differences in the family domain and social domain. Women reported greater mental health in the family domain and social domain than men. CONCLUSIONS: The Women's Mental Health Scale is a promising gender-sensitive tool to measure women's mental health. RELEVANCE TO CLINICAL PRACTICE: The Women's Mental Health Scale appears to be a gender-sensitive measure to assess the positive mental health potentials among women population.

Self-concept and menopause among mid-life women: a survey in southern Taiwan.

UNLABELLED: The purpose of this study was to understand the self-concept of community women in southern Taiwan during mid-life and its relationship with menopause symptoms. Women between 45 and 55 years of age were selected by simple cluster random sampling process from a name list obtained from the Household Registrar Office in one city of southern Taiwan. A total of 266 women were enrolled. The Chinese version of the Tennessee Self-Concept Scale and Greene Climacteric Symptom Scale were used for assessment. RESULTS: (1) (a) 92.5% of women's total self-concept scores were within normal range; (b) the scores of the physical self-concept, psychological self-concept, and academic attainment self-concept in women with higher educational levels were significantly higher than those in women with lower educational levels; (c) among six subscales, only the score of the psychological self-concept of those women with a history of using hormone replacement therapy (HRT) was significantly lower than that in women who had never taken any. (2) Women with chronic disease history and with a history of using HRT (no. 54) showed significantly more menopause symptoms (physiological and psychological). (3) (a) Stepwise regression analysis showed that the physical self-concept, family self-concept and academic attainment self-concept were the best predictors for menopause symptoms (both psychological and physiological) for pre-menopausal women; (b) for peri- and post-menopausal women, only physical self-concept could significantly predict psychological and physiological symptoms. Our findings suggest that self-concept is an important factor for mid-life women to adjust to their menopause.

The outcome expectancy model for areca-quid chewing behavior.

Outcome expectancies as regards areca-quid chewing played an important role in areca-quid addiction. In this study, areca-quid user expectancies will be explored. A total of 179 adolescents selected from high school completed the areca-quid chewing expectancy questionnaire and related chewing-behavior scale. Three factors (physical/emotional reward, negative consequences and social benefit) relating to areca-quid chewing behavior were explored by factor analysis and the two-dimensional model of chewing expectancy (positive-negative effect of chewing and physical-social reaction to chewing) was found using non-metric multi-dimensional scaling. The structure of the areca-quid chewing expectancy was determined for an adolescent group and the social factors involved in areca-quid chewing clearly warrant further investigation.

The Lived Experience of Midlife Women With Major Depression.

BACKGROUND: Midlife, a significant developmental phase for women, is a period of biological, psychological, and social role changes. However, not all women transition smoothly into middle age, with those who experience depression typically bearing significantly greater physical and psychological discomforts in midlife. Despite the expanding body of research on women and depression, little is understood about how depressed women handle the midlife transition. PURPOSE: The aim of this study was to gain a deeper understanding about the lived experience of middle-aged women with major depression. METHODS: This study used a phenomenological design. Four women between 43 and 55 years old with a diagnosis of major depression were interviewed. There were seven transcripts in total. A 62-year-old depressed woman was also interviewed to verify the results. RESULTS: After data analysis, "a harder life" emerged as the core of these women's experiences. Two themes with two respective subthemes were identified. The theme "struggling to redefine the self" was associated with the subthemes "taking pills in the dump" and "the inane life." The theme "swinging to develop new social interactions" was associated with the subthemes "being alienated from former social contacts" and "starting new social interactions." Results indicate that the participants encountered greater challenges in adapting to middle age than their nondepressed peers. CONCLUSIONS: Much adaptation and help are needed for depressed women to experience a smooth transition into midlife. In caring for these women, their interpersonal relationships with others should be the main target. Meanwhile, nurses must understand what challenges depressed women typically encounter in midlife based on the developmental perspective and then assess how pharmaceutical treatments impact the view of self of women.

Exploring the Relationship Between Illness Perceptions and Negative Emotions in Relatives of People With Schizophrenia Within the Context of an Affiliate Stigma Model.

BACKGROUND: Stigma affects patients with schizophrenia and may influence perceptions of the illness, which may affect how family members interact with and care for these patients. PURPOSE: The aims of this study were to (a) explore the relationship between perceptions of schizophrenia and the negative emotions of family members within the context of an affiliate stigma model, and (b) validate the proposed affiliate stigma model. METHODS: A cross-sectional design was used. Eligibility for participation was limited to the relatives of patients with schizophrenia. The participants were recruited from two regional psychiatric hospitals in central Taiwan. The study was approved by an Institutional Review Board, and all potential participants signed informed consent before enrollment. Sixty-two participants completed the set of self-administered questionnaires, including (a) a demographic questionnaire, (b) Affiliate Stigma Scale, and (c) the Illness Perception Questionnaire for Schizophrenia-Relatives version. Canonical correlations and structural equation modeling in STATISTICA 6.0 were used to validate the model of illness perceptions and negative emotions. RESULTS: (a) There were three domains of perception regarding schizophrenia for the relatives of patients: disease chronicity, disease in control, and disease treatability. The correlation between these dimensions and negative emotion was r = .42. (b) The adjusted goodness of fit for the proposed affiliate stigma model was .79. CONCLUSIONS: The results of this study suggest that the affiliate stigma model is an appropriate resource for developing practical disease management strategies for the relatives of patients with schizophrenia.

Areca quid chewing by Taiwanese adolescents: application of the Attitudes Social Influence Self-efficacy (ASE) model.

AIMS: To investigate the factors associated with areca quid-chewing behaviour using the Attitudes-Social influence-Self-efficacy (ASE) model as a theoretical framework. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: A total of 400 students from a junior high school participated in the study in 2001 in Chia-Yi city (Taiwan). MEASUREMENTS: Expectancy scales (for the attitude component of the ASE), a self-efficacy scale (for the self-efficacy component of the ASE) and a social norm scale (for the social influence component of the ASE) were utilized. These measures displayed good reliability and validity. FINDINGS: Forty-seven students (11.75%) reported that they had tried chewing areca quid previously, eight of them practicing chewing it every day. Positive and negative expectancy (r = 0.43, r=- 0.20), self- efficacy (r = - 0.65), and subject social norm (r = 0.53) were significantly correlated with participants' intentions to chew areca quid. In a regression model, self-efficacy (beta = - 0.46, P < 0.001), social norm (beta = 0.22, P < 0.001), positive expectancy (beta = 0.18, P < 0.001) and negative expectancy (beta = - 0.08, P = 0.040) all made independent contributions to predicting intentions to chew and explained 46.8% of the variance in areca quid-chewing behaviour. CONCLUSIONS: Areca quid chewing appeared to be linked to positive expectancy and social norms pertaining to areca quid chewing associated with adolescents. However, high negative expectancy and high self-efficacy encouraged contrary behaviour. The application of the ASE model as the scenario could improve our understanding of the intention of the areca quid chewing among these adolescents.