Analysis of Factors Affecting the Need for Health Education Programs in Middle-aged Women

Article information

Korean J Health Promot. 2015;15(2):63-74

Publication date (electronic) : 2015 December 19

doi : https://doi.org/10.15384/kjhp.2015.15.2.63

¹Educational Administration Major, Kangnam University the Graduation School of Educate, Yongin, Korea

²Department of Education, Kang Nam University of Teacher's College, Yongin, Korea

Corresponding author：Chang Oh Bae, PhD Department of Education, Kang Nam University of Teacher's College, 40 Gangnam-ro, Giheung-gu, Yongin 446-702, Korea Tel: +82-31-280-3919, Fax: +82-31-280-3919 E-mail: chango@kangnam.ac.kr

Received 2014 August 24; Accepted 2015 March 23.

Abstract

Background

This study aimed to analyze the factors affecting health education program needs as defined by the World Health Organization (WHO) for promoting health in middle-aged women.

Methods

Study subjects included 203 middle-aged women ranging in ages between 40 and 59 years, living in S-city. Data were collected from September 10 to 24, 2011. Descriptive statistics, independent t-test, and one-way ANOVA were used to analyze general characteristics and the need for health education programs related to the general characteristics. Hierarchical multiple regression was used to access the factors influencing the need for health education programs. All data were analyzed by SPSS/WIN 17.0 program.

Results

The average score of the health promotion behaviors was 3.46 (±0.74). The average score of the need for health education programs (including physical, psychological, and social health education programs) was 3.88 (±0.13); and this was affected by age (psychological health education programs β=-0.21), self-actualization (physical, psychological, social health education programs β=0.28, β=0.30, β=0.30), health responsibility (social health education programs β=0.21), interpersonal support (physical health education programs β=0.18), and stress management (social health education programs β=0.18).

Conclusions

Based on the study results, health education for middle-aged women should be impacted less by monthly income and educational background, and should have more specialized, accessible contents considering not only programs that middle-aged women prefer but also the factors influencing the needs of health education.

Keywords: Middle-aged women; Health promoting behavior; Health education program; Lifelong-education

Figure 1.

Research model.

Table 1.

General characteristics

Table 2.

Level of health promoting behaviors

Table 3.

Need of health education programs (n=203)

Table 4.

Need of health education program related to general characteristics (n=203)

Table 5.

Factors affecting for need of health education program^a (n=203)

References

1. Kim MK. A study of relationship between health promoting behavior indices and quality of life indices [dissertation] Seoul: Yonsei University; 2001.

2. Kim MJ. A study on factors affecting the quality of north Korean female defectors' subjective life [dissertation] Pyongtaek: Pyongtaek University; 2008.

3. Bergner M. Quality of life, health status and clinical research. Med Care 1989;27(3):148–56.

4. World Health Organization. Frequently asked questions. WHO 2014. [Assessed August 8, 2014]. http://www.who.int/suggestions/faq/en/.

5. Kim YT, Ahn SS, Chung JJ, Choi SW. Korean women's health conditions and policy agenda-10 Seoul: KWDI; 2008. [Assessed August 8, 2013]. http://www.kwdi.re.kr/reportList.kw?currtPg=3&sgrp=S01&siteCmsCd=CM0001&topCmsCd=CM0002&cmsCd=CM0004&pnum=1&cnum=0&sbjCdSel=&rptCdSel=&src=INCHARGE_NM&srcTemp=%EA%B9%80%EC%98%81%ED%83%9D.

6. Korea Statistical Information Service Seoul: KOSIS; 2010. [Assessed August 8, 2014]. http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE&parentId=A#SubCont.

7. Hong YR, Hyun YS, Jung HR. The International Comparative Study of Social Outcomes of Learning Seoul: KEDI; 2008. [Assessed August 8, 2013]. https://www.kedi.re.kr/khome/main/research/selectPubForm.do.

8. Kim MC. Mid life crisis and it's related variables [dissertation] Seoul: Ewha Womans University; 1988.

9. Lee SJ. A Study on the Women's Adult & Continuing Education in Korea [dissertation] Seoul: Dan Kook University; 2007.

10. Lim SK. An sem analysis on participation out comes and effect factors of female adult learners [dissertation] Busan: Dong-A University; 2007.

11. Chung YC, Han KS. Psychoneuroimmunology: stress, depression, schizophrenia and the immune system. J Korean Neuro-psychiatr Assoc 1992;31(5):825–36.

12. Kim SJ. A study of relationship between health promoting lifestyle, depression, quality of life among middle aged women [dissertation] Suwon: Ajou University; 2007.

13. Kim JH. Physical, psychological and social education needs of the Korean elderly. J Korean Acad Soc Nurs Edu 2005;11(2):260–9.

14. Erdfelder E, Faul F, Buchner A. GPOWER: a general power analysis program. Behavior Research Methods, Instruments, & Computers 1996;28(1):1–11.

15. Suh YO. Health promoting lifestyle, hardiness and gender role characteristics in middle-aged women. J Korean Acad Womens Health Nurs 1996;2(1):119–34.

16. Kang YS. A research on lifelong education programs for women implemented by some institutes in Seoul [dissertation] Seoul: Korea National Open University; 2004.

17. Kim GO. Comparative analysis of program in women lifelong education institutions [dissertation] Suwon: Ajou University; 2005.

18. Kim YS. A comparison and analysis of the educational goals and programs in lifelong education institutions attached to women's universities [dissertation] Seoul: Ewha Womans University; 2002.

19. Kim CG. The needs analysis of middle aged women in aging society [dissertation] Seoul: Korea University; 2002.

20. Park HA, Park YS, Oh HS, Kim HJ. Development of health information program for the middle aged women. Korean J Women Health Nurs 2002;8(2):165–76.

21. Shin YH. A Study of Female Farmers' Needs on Lifelong Education Programs [dissertation] Inchon: INHA University; 2008.

22. Ajou University Educational Training Institute Group. Health Training of Health Curriculum for Health Teacher. 2011. 86–98.

23. Chun HK. A study on the health education needs assessment of middle aged women [dissertation] Seoul: Ewha Womans University; 1997.

24. Kim YD. An application of delphi and analytic hierarchy process method to elderly physical training policy [dissertation] Seoul: Korea University; 2007.

25. Fehring RJ. Methods to validate nursing diagnoses. Heart and Lung 1987;16(6):625–9.

26. Chung V, Wong E, Griffiths S. Content validity of the integrative medicine attitude questionnaire: Perspectives of a Hong Kong Chinese expert panel. J Alternative Complementary Med 2007;13(5):563–70.

27. Lee GS. Relationship between cognitive-perceptual factors and health promoting lifestyle of middle aged women [dissertation] Seongnam: Gachon University; 2006.

28. Park BY. Factors influencing the health promotion behaviors among middle-aged women [dissertation] Seoul: Ewha Womans University; 2008.

29. Maslow A. Motivation and personality 3rd ed.th ed. Paju: Book21; 2009. p. 10–530.

30. Acton GJ, Malathum P. Basic need status and health promoting self-care behavior in adults. West J Nurs Res 2000;22(7):796–811.

31. Park JS, Lee YE. Effects of integrated menopause management program for middle aged woman. Korean J Women Health Nurs 2011;17(1):10–20.

32. Hudson T. Managing perimenopausal symptom: an integrative medicine approach. Female Patient 2001;26(8):33–40.

33. Han SH. A study on the menopausal symptoms, menopausal management and quality of life in middle aged women [dissertation] Seoul: Ewha Womans University; 2004.

34. Lee DS. Effects of a marital growth program on middle-aged couples. J Korean Family Ther 2008;16(1):81–111.

Article information Continued

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1.

Research model.

Table 1.

General characteristics

(n=203)
Characteristics	Categories	Values^a
Age, y	40's (40-49)	132 (65.0)
Age, y	50's (50-59)	71 (35.0)
Marital status	Yes	187 (92.1)
(does living with a spouse)	No	16 (7.9)
Educational level, y	≤High school	103 (50.7)
	≤College	92 (45.3)
	≥Graduate school	8 (3.9)
Monthly income, mo	Less than 1.5 million won	17 (8.4)
	1.51-3 million won	87 (42.9)
	3.01-5 million won	79 (38.9)
	More 5.01 million won	20 (9.9)
Job	Yes	86 (42.4)
Job	No	117 (57.6)
Menstruous status	Menopausal transition^b ^c	31 (15.3)
	Natural menopause^c	31 (15.3)
	Artificial menopause^d ^e	16 (7.9)
	Menstruation^e	125 (61.5)
Female hormone therapy	Yes	15 (7.4)
Female hormone therapy	No	188 (92.6)

Values are presented as N (%).

Defined as irregular menstruation and period of up to one year after the last menstrual.

Defined as more than 12 months of amenorrhea status.

Defined as menopause due to surgical obstetrics and gynecology.

Defined as regular menstruation.

Table 2.

Level of health promoting behaviors

Categories	Number of question	Values^a
Self-actualization	11	3.88 (±0.62)
Health responsibility	10	3.10 (±0.77)
Exercise & nutrition	12	3.15 (±0.75)
Interpersonal support	7	3.83 (±0.59)
Stress management	7	3.36 (±0.65)
Total	47	3.46 (±0.74)

Values are presented as mean±SD unless otherwise indicated.

Table 3.

Need of health education programs (n=203)

Category				Values^a		Total
Physical health care programs	Disease management	Menopausal care and successful aging	4.34 (±0.74)	4.26 (±0.51)	3.95 (±0.39)	3.88 (±0.13)
		Prevention ․ management of cancer	4.53 (±0.69)
		Prevention of osteoporosis and exercise therapy	4.32 (±0.69)
		Prevention of urinary incontinence and exercise therapy	4.20 (±0.71)
		Prevention ․ management of adult disease	4.36 (±0.72)
		Menopausal management of oriental medicine	3.86 (±0.84)
	Sport for all	Physical fitness program	4.11 (±0.83)	3.86 (±0.03)
		Dance	3.58 (±0.91)
		Sport	3.88 (±0.87)
	Alternative therapy	Type of western medicine	3.70 (±0.80)	3.73 (±0.08)
		Type of oriental medicine	3.80 (±0.85)
		Type of oriental-western medicine	3.70 (±0.82)
Psychological health care programs	Disease management Counseling	Prevention of depression․suicide	4.37 (±0.83)	4.38 (±0.01)	3.92 (±0.58)
		Prevention of dementia	4.38 (±0.85)
		Group counseling	3.60 (±0.93)	3.58 (±0.03)
		Art therapy (mandala)	3.56 (±0.88)
	Stress management	Singing	3.99 (±0.79)	3.80 (±0.46)
		Laughter therapy	4.07 (±0.78)
		Aromatherapy	3.58 (±0.91)
		Mindfulness-based stress reduction (MBSR)	3.56 (±0.91)
Social health care programs	Interpersonal relations	Marital relationship enhancement program	4.03 (±0.93)	3.91 (±0.37)	3.78 (±0.25)
		Role playing	3.61 (±0.87)
		Communication for conflict management	4.08 (±0.78)
	Protection of the environment	Making related to eco-friendly household items	3.55 (±0.91)	3.58 (±0.05)
		Eco-activism (NGO activities)	3.62 (±0.86)
	Citizenship	Women-related legal and welfare policy	3.92 (±0.82)	3.85 (±0.15)
		Gender Equality volunteer activity	3.73 (±0.85)
			3.91 (±0.94)

Abbreviation: NGO, non-governmental organization.

Values are presented as mean±SD.

Table 4.

Need of health education program related to general characteristics (n=203)

General characteristics	Physical						Psychological						Social
	Disease management		Sport for all		Alternative therapy		Disease management		Counseling		Stress management		Interpersonal relation		Protection of the environment		Citizenship
	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)	Mean (SD)	t/F (P^a)
Age, y		1.78 (0.077)		1.94 (0.053)		-0.02 (0.982)		2.87 (0.005^b)		2.08 (0.039^c)		1.48 (0.141)		1.80 (0.073)		2.25 (0.026)		2.33 (0.021^c)
40-49	4.32 (0.53)		3.93 (0.72)		3.74 (0.72)		4.50 (0.73)		3.67 (0.82)		3.85 (0.68)		3.99 (0.68)		3.65 (0.76)		3.94 (0.76)
50-59	4.18 (0.51)		3.73 (0.64)		3.74 (0.62)		4.17 (0.87)		3.42 (0.79)		3.71 (0.67)		3.76 (0.76)		3.48 (0.71)		3.69 (0.66)
Marital status		2.25		0.54		0.55		2.30		1.23		1.78		1.76		1.36		3.53
(does living with a spouse)		(0.026^c)		(0.589)		(0.583)		(0.023^c)		(0.221)		(0.076)		(0.080)		(0.175)		(0.001^b)
Yes	4.29 (0.50)		3.87 (0.69)		3.74 (0.65)		4.45 (0.69)		3.60 (0.80)		3.83 (0.64)		3.95 (0.69)		3.60 (0.74)		3.91 (0.69)
No	3.99 (0.69)		3.77 (0.84)		3.60 (1.02)		3.63 (1.42)		3.34 (0.98)		3.52 (0.97)		3.50 (1.00)		3.44 (0.81)		3.25 (0.96)
Educational level, y		7.57 (0.001^b)		5.43 (0.005^b)		3.11 (0.047^c)		10.56 (p ＜ 0.0001)		2.90 (0.057)		4.87 (0.009^b)		3.88 (0.022^c)		3.46 (0.033^c)		3.77 (0.025^c)
≤ High school	4.25 (0.50)		3.71 (0.67)		3.63 (0.67)		4.39 (0.67)		3.46 (0.83)		3.68 (0.71)		3.78 (0.72)		3.49 (0.73)		3.73 (0.73)
≤ College	4.35 (0.51)		4.03 (0.69)		3.87 (0.71)		4.48 (0.75)		3.73 (0.78)		3.96 (0.62)		4.07 (0-67)		3.71 (0.76)		4.01 (0.69)
≥Graduate school	3.63 (0.46)		3.50 (0.85)		3.58 (0.53)		3.19 (1.67)		3.44 (0.82)		3.63 (0.52)		3.71 (1.00)		3.50 (0.80)		3.75 (1.05)
Monthly income, mo		1.46 (0.226)		2.36 (0.073)		3.39 (0.019^c)		3.78 (0.011^c)		3.08 (0.028^c)		4.34 (0.005^b)		2.52 (0.059)		1.73 (0.162)		1.40 (0.243)
Less than 1.5 million won	4.06 (0.83)		3.51 (0.97)		3.31 (1.15)		3.88 (1.05)		3.32 (0.97)		3.46 (0.97)		3.55 (1.00)		3.38 (0.99)		3.59 (1.15)
1.51-3 million won	4.28 (0.47)		3.87 (0.61)		3.74 (0.65)		4.53 (0.63)		3.51 (0.89)		3.79 (0.63)		3.94 (0.62)		3.56 (0.68)		3.81 (0.73)
3.01-5 million won	4.27 (0.49)		3.87 (0.67)		3.76 (0.58)		4.30 (0.84)		3.60 (0.69)		3.79 (0.63)		3.88 (0.75)		3.64 (0.73)		3.92 (0.64)
More 5.01 million won	4.42 (0.55)		4.12 (0.85)		4.02 (0.59)		4.46 (0.87)		4.05 (0.67)		4.23 (0.57)		4.25 (0.65)		3.68 (0.89)		4.03 (0.67)
Job		-0.22 (0.823)		-0.97 (0.332)		-1.09 (0.277)		0.08 (0.936)		0.89 (0.376)		0.90 (0.368)		-1.47 (0.142)		-0.11 (0.916)		-0.78 (0.436)
Yes	4.26 (0.54)		3.81 (0.69)		3.67 (0.75)		4.39 (0.90)		3.50 (0.80)		3.71 (0.69)		3.82 (0.81)		3.62 (0.76)		3.81 (0.76)
No	4.28 (0.51)		3.90 (0.71)		3.78 (0.64)		4.38 (0.72)		3.65 (0.83)		3.87 (0.65)		3.98 (0.65)		3.57 (0.74)		3.89 (0.72)
Menstruous status		6.08 (0.001^b)		5.27 (0.002^b)		0.24 (0.869)		3.63 (0.014^c)		0.11 (0.957)		0.33 (0.807)		0.22 (0.884)		1.60 (0.190)		6.36 (p< 0.0001)
Menopausal transition	3.93 (0.65)		3.46 (0.85)		3.71 (0.94)		4.03 (1.08)		3.57 (0.84)		3.79 (0.72)		3.82 (0.85)		3.36 (0.80)		3.52 (0.97)
Natural menopause	4.26 (0.50)		3.82 (0.61)		3.77 (0.67)		4.26 (0.55)		3.52 (0.85)		3.73 (0.75)		3.84 (0.67)		3.63 (0.79)		3.69 (0.68)
Artificial menopause	4.26 (0.53)		3.73 (0.57)		3.85 (0.38)		4.28 (1.00)		3.63 (0.56)		3.70 (0.41)		3.94 (0.53)		3.44 (0.51)		3.54 (0.69)
Menstruation	4.36 (0.46)		3.99 (0.66)		3.71 (0.65)		4.52 (0.71)		3.60 (0.82)		3.84 (0.68)		3.95 (0.73)		3.66 (0.75)		4.02 (0.64)
Female hormone therapy		-0.96 (0.339)		-0.10 (0.920)		0.12 (0.908)		-1.41 (0.159)		0.24 (0.807)		-0.51 (0.608)		0.13 (0.898)		0.29 (0.776)		-1.47 (0.144)
Yes	3.93 (0.65)		3.46 (0.85)		3.73 (0.94)		3.97 (1.22)		3.63 (0.74)		3.72 (0.87)		3.87 (0.86)		3.70 (0.92)		3.47 (1.10)
No	4.26 (0.50)		3.82 (0.61)		3.77 (0.67)		4.28 (0.75)		3.58 (0.82)		3.81 (0.66)		3.92 (0.71)		3.58 (0.74)		3.89 (0.70)

Abbreviation: SD, standard deviation.

Calculated by independent t-test or one-way ANOVA.

P ＜ 0.01.

P ＜ 0.05.

Table 5.

Factors affecting for need of health education program^a (n=203)

Physical	Physical						Psychological						Social
	Model I			Model II			Model I			Model II			Model I			Model II
	β	t	P	β	t	P	β	t	P	β	t	P	β	t	P	β	t	P
General characteristics
Age (ref.=40's^b), y	-0.08	-0.82	0.413	-0.11	-1.22	0.224	-0.17	-1.85	0.066	-0.21	-2.29	0.023^c	-0.11	-1.23	0.222	-0.14	-1.62	0.107
Marital status (ref.=don't live with spouse)	0.06	0.89	0.374	0.00	0.03	0.976	0.15	2.12	0.035^c	0.11	1.62	0.106	0.16	2.31	0.022^c	0.11	1.71	0.089
Education level, y	0.01	0.06	0.952	-0.02	-0.32	0.749	0.03	0.47	0.973	0.01	0.07	0.947	0.13	1.75	0.081	0.09	1.45	0.147
Monthly income degree, mo	0.12	1.60	0.111	-0.05	-0.72	0.472	0.14	1.78	0.076	-0.01	-0.09	0.925	0.06	0.74	0.459	-0.10	-1.35	0.179
Job	-0.05	-0.74	0.460	-0.11	-1.63	0.105	-0.07	-1.02	0.309	-0.11	-1.58	0.115	-0.05	-0.67	0.507	-0.09	-1.42	0.160
Menstruous status (ref=regular menstruation^d)
Menopausal transition	-0.21	-2.60	0.010^c	-0.12	-1.74	0.083	0.01	0.13	0.899	0.08	1.09	0.275	-0.12	-1.50	0.135	-0.04	-0.50	0.618
Natural menopause	0.01	0.00	1.000	0.06	0.69	0.491	0.08	0.82	0.413	0.13	1.45	0.147	0.01	0.09	0.922	0.05	0.58	0.565
Artificial menopause	-0.01	-0.10	0.920	0.04	0.60	0.579	0.04	0.51	0.610	0.08	1.15	0.250	-0.04	-0.44	0.658	0.01	0.18	0.857
Female hormone therapy	0.05	0.61	0.543	0.03	0.48	0.632	-0.01	-0.13	0.897	-0.02	-0.29	0.770	0.01	0.18	0.860	-0.01	-0.07	0.947
Health promoting behaviors
Self-actualization				0.28	3.54	<0.001				0.30	3.61	<0.001				0.30	3.79	< 0.001
Health responsibility				0.11	1.34	0.182				0.16	1.84	0.068				0.21	2.52	0.013^c
Exercise & nutrition				-0.05	-0.50	0.618				-0.13	-1.39	0.170				-0.16	-1.76	0.080
Interpersonal support				0.18	2.31	0.022^c				0.07	0.87	0.384				0.02	0.22	0.830
Stress management				0.14	1.69	0.093				0.09	1.06	0.289				0.18	2.09	0.037^c
R²	0.087			0.293			0.087			0.222			0.104			0.268
AdjR²	0.044			0.240			0.045			0.164			0.062			0.214
F(P)	2.03 (0.044^c)			5.57(P＜0.001)			2.05 (0.043^c)			3.83 (P ＜ 0.001)			2.49 (0.014^c)			4.92 (P＜0.001)

Assessed by hierarchical multiple regression analysis.

Reference group for comparison was the 40's group

P ＜ 0.05.

Reference group for comparison was the group with regular menstruation.