"But at a certain point, the lights literally went out": A qualitative study exploring midlife women's experiences of health, wellbeing, and functioning in relation to paid work.

BACKGROUND: In the Netherlands, the fact that midlife women constitute a considerable segment of the working population is relatively new. Generally paid work contributes to midlife women's wellbeing, but they also report health challenges, such as work-related fatigue and the menopause. OBJECTIVE: The objective of this study is to understand how midlife women themselves perceive their health, wellbeing, and functioning in relation to paid work. METHODS: In this exploratory qualitative study, 28 women participated in five ethnically homogeneous focus group discussions (FGDs). De FGDs were recorded, transcribed verbatim, and thematically analyzed using MAXQDA. RESULTS: We identified exhaustion as central to our analysis. During midlife, exhaustion seems to occur once a certain limit has been reached, both physically and mentally, with women feeling to have reached the end of their rope. Besides obvious physiological challenges, we identified two major themes in which we discuss challenges both in paid work and private life: (1) work environment and working conditions, and (2) burdens in private life. Participants took various measures to manage and try to reduce exhaustion, including finding a new job or negotiating different job tasks, and reducing work hours. CONCLUSION: This study indicates that the extent to which women experience exhaustion is associated with challenges in both paid work and private life. The underlying processes do not seem to reflect individual problems, but reflect a complex set of factors at the structural level. Nevertheless, women take several individual measures to reduce their exhaustion, including reducing their participation in paid work.

Workplace Health Promotion Among Ethnically Diverse Women in Midlife With a Low Socioeconomic Position.

Workplace health promotion (WHP) may be an appropriate way to support women with a low socioeconomic position (SEP) during midlife. Little is known about reaching and engaging women in WHP, particularly not at the intersection of midlife, low SEP, and ethnicity. We initiated the ProudWoman project, in which we implemented a WHP intervention aimed at supporting midlife women as a pilot in an academic hospital. We qualitatively evaluated the implementation using the RE-AIM framework. The pilot comprised multiple steps: tailoring the intervention to the needs of ethnically diverse group of midlife women with a low SEP, developing an implementation protocol, implementing the tailored intervention, and evaluating the implementation process. The main findings of our study are: (1) due to a wide range of recruitment activities that were actively deployed, we were able to reach an ethnically diverse group of midlife women with a low SEP; (2) regarding adoption, awareness of the relevance of this topic as an occupational health challenge was not self-evident at the organizational level; (3) according to our participants, various facilitators and barriers should be taken into account in the implementation of the work-life program; and (4) our focus group discussion revealed as maintenance is relevant to these levels in different ways, awareness of midlife and menopause as an occupational health challenge should be raised at four professional levels. We conclude that elements, such as an active and personal recruitment approach, are important in the implementation of WHP for ethnically diverse midlife women with an SEP.

"I Get That Spirit in Me"-Mentally Empowering Workplace Health Promotion for Female Workers in Low-Paid Jobs during Menopause and Midlife.

During menopause and midlife, female workers, particularly those in low-paid jobs, experience more occupational health problems than other groups of workers. Workplace interventions are often lacking, however. In the Netherlands, a workplace health promotion intervention-the work-life program (WLP)-has been developed to support female workers. Here, we tailored the WLP to the needs of female workers in low-paid jobs working at Amsterdam University Medical Center. In an exploratory mixed-methods study with a convergent design, among 56 participants, we used questionnaires before and after the intervention and semi-structured, in-depth interviews to address the following research question: What is the impact of the WLP on the women's health and work functioning? Our quantitative data showed that menopausal symptoms improved significantly after the WLP. Our qualitative data, derived from 12 participants, showed that the WLP initiated a process of mental empowerment that initiated positive changes in four domains: behavior, physical health, mental wellbeing, and in the workplace. Taken with caution, our findings suggest that the WLP mentally empowers female workers to make choices that enhance their health and wellbeing, both at work and in their private lives, as summarized in the quote of one participant: "I get that spirit in me!".