The Influence of Premenopausal and Menopausal Women's Demographic Characteristics on Anxiety and Quality of Life

Introduction: The premenopausal and menopausal periods are natural processes that occur in women. Both of these periods bring about changes in physical, psychological, and social aspects. The symptoms and changes experienced in the body can make women feel fearful, anxious, and lead to changes in their quality of life. The research aims to determine the influence of premenopausal and menopausal women's demographic characteristics on anxiety and quality of life. Methods: This study employed a descriptive design with an analytical observational approach and a cross-sectional design. The study population consisted of community health Center Jagir cadres aged ≥ 35 years, selected through purposive sampling, with a sample size of 70 respondents. The analysis use the ordinal regression statistical test. Results: Demographic characteristics revealed that the majority were aged 46-55 years (46%), had a high level of education (83%), and were married (81%). The majority experienced mild anxiety (40%) and had good quality of life (67%). The demographic characteristics of women (age, education, and marital status) significantly influenced anxiety and quality of life with a p-value <0.05. The Pseudo R Square values for anxiety were age 0.011, education 0.105, marital status 0.004, and for quality of life were age 0.007, education 0.028, marital status 0.004. Conclusion: Demographic characteristics, including age, education, and marital status, have an impact on anxiety and quality of life with a P Value < 0.05. Providing menopausal syndrome education and husband support is needed in dealing with the pre-menopause period to reduce anxiety and improve quality of life.


Introduction:
The premenopausal and menopausal periods are natural processes that occur in women.Both of these periods bring about changes in physical, psychological, and social aspects.The symptoms and changes experienced in the body can make women feel fearful, anxious, and lead to changes in their quality of life.The research aims to determine the influence of premenopausal and menopausal women's demographic characteristics on anxiety and quality of life.Methods: This study employed a descriptive design with an analytical observational approach and a cross-sectional design.The study population consisted of community health Center Jagir cadres aged ≥ 35 years, selected through purposive sampling, with a sample size of 70 respondents.The analysis use the ordinal regression statistical test.Results: Demographic characteristics revealed that the majority were aged 46-55 years (46%), had a high level of education (83%), and were married (81%).The majority experienced mild anxiety (40%) and had good quality of life (67%).The demographic characteristics of women (age, education, and marital status) significantly influenced anxiety and quality of life with a p-value <0.05.The Pseudo R Square values for anxiety were age 0.011, education 0.105, marital status 0.004, and for quality of life were age 0.007, education 0.028, marital status 0.004.Conclusion: Demographic characteristics, including age, education, and marital status, have an impact on anxiety and quality of life with a P Value < 0.05.Providing menopausal syndrome education and husband support is needed in dealing with the pre-menopause period to reduce anxiety and improve quality of life.

INTRODUCTION
Every woman will go through the premenopausal and menopausal periods.
Both of these cycles occur as individuals age.
Each period is experienced differently by women.Pre-menopause and menopause depict varying symptoms and conditions experienced and felt as a result of changes in physical, psychosocial aspects, and the occurrence of anxiety [1].This process is a natural occurrence in women, and different characteristic factors influence it.Hormonal changes in the body lead to physical and psychological alterations.One of the psychological changes that occur is anxiety.
The concerns experienced by each woman are highly variable and distinct [2].Complaints and disturbances that occur affect over 40% of women and can sometimes disrupt daily activities; in severe cases, they can lead to a decrease in the quality of life [3].
The premenopausal stage through senescence in Indonesia typically occurs between the ages of 40 to 65, with over 75% experiencing complaints related to physical and psychological issues, such as anxiety, which, if left unaddressed, can lead to a change in the quality of life [4].Menopause syndrome is associated with anxiety levels, with 48% falling into the mild anxiety category, 19% experiencing moderate anxiety, and 6% classified as severe anxiety [5].Physical and psychological symptoms are experienced by over 70% of women approaching menopause and can result in a decline in the quality of life [6].A preliminary survey conducted on women aged ≥ 45 years, both pre-and post-menopausal, revealed that women who had not yet experienced menopause were concerned about the symptoms that would occur, while some women considered them normal because they observed that friends who had already gone through menopause did not experience many symptoms.Women who had already experienced menopause reported experiencing different levels of worry compared to before and during menopause.
The climacteric period occurs at age ≥ 45 years, marking the end of the productive/fertile phase and the transition to a non-productive or infertile phase.Various signs and symptoms that occur are sometimes unnoticed by women, or conversely, women may sense significant changes in their bodies, both physically and psychologically [2].The majority of women who experience a decline in estrogen hormone levels in their bodies will also experience a decline in physical and mental conditions [6].Emotional disturbances, unpreparedness, uncertainty, and the emergence of symptoms in the body, such as hot flashes, irritability, changes in vitality, alter self-perception.Characteristics such as age and education can influence how women face the menopausal period [7].
Factors like age and occupation are among the causes of different responses during the premenopausal and menopausal periods [8].
Menopausal women experience physical changes (hot flushes, vaginal discomfort, changes in sexuality) and mood swings (irritability, easily offended) in their bodies, leading to changes in behavior, such as experiencing anxiety, sensitivity, and lowered self-esteem [9].In premenopausal women, experiencing mild anxiety when facing menopause is entirely normal, but if it reaches a severe intensity, it requires intervention.If anxiety and perceived complaints are not addressed correctly, it can lead to a decline in the quality of life [10].Based on the above discussion, the researcher aims to understand the influence of demographic characteristics of premenopausal and menopausal women on anxiety and quality of life.

Setting
This study utilizes a descriptive design with an analytical observational approach and a cross-sectional design.The population for this study consists of community health center (Puskesmas Jagir) cadres aged ≥ 35 years.A sample size of 70 respondents meeting the inclusion criteria was selected.

Measures
The assessment of anxiety variables was carried out using the Hamilton Rating Scale for Anxiety (HARS) questionnaire, while the assessment of quality of life variables is conducted using the World Health Organization Quality of Life Instrument (WHOQOL) questionnaire.Both the HARS and WHOQOL questionnaires underwent validity and reliability testing before being administered to the respondents.

Data Analysis
The independent variables were demographic characteristics, while the dependent variables encompass anxiety and quality of life.The assessment of demographic characteristic variables includes age, education, and marital status.The analysis use the ordinal regression statistical test.

Ethical Aspect
The research was conducted in February  Individuals with higher education levels tend to have more knowledge and experience, and self-esteem can be formed through experiences.The self-esteem of menopausal women can influence their well-being, including physical, psychological, social, and environmental well-being, which in turn affects their quality of life [17].

According to the data presented in
The majority of respondents are married, accounting for 81% of respondents.
The ordinal regression analysis shows that marital status significantly influences anxiety with a p-value of 0.000 and an impact percentage of 0.4%, and it also has an impact on quality of life with a percentage of 0.4%.wives in undergoing the period before, during and after menopause so that women can undergo without happiness so that they have 2023, following the necessary permissions obtained from the relevant authorities.Ethical approval for the research was obtained from the Research Ethics Commission of the Faculty of Medicine, Widya Mandala Catholic University of Surabaya, with protocol number 003/WM12/KEPK/DSN/T/2023.The research was carried out after providing explanations to the respondents about the research objectives and obtaining their informed consent.This study ensures the protection of respondent data, which can only be accessed by the research team.
characteristic variables were interrelated and mutually influenced each other.The research results indicated that individuals aged 50-54 years had a good and very good quality of life compared to those aged 45-49 and 55-59 years.Higher education was associated with a better quality of life and was more prevalent than basic education.Education level was one of the factors that affected subjective quality of life, and quality of life increased with higher levels of individual education [23].Knowledge and social support were factors that influenced the level of anxiety in menopausal women.Women with good knowledge and information about menopause tended to know how to reduce anxiety.The changes associated with menopause could make women anxious due to physical changes and facing situations they had never experienced before.Successful adjustment within the family, mutual support, and having a husband who could engage in discussions to solve problems resulted in lower levels of anxiety in women [24].The research results on the characteristics of respondents in menopausal women (age, education, occupation, marital status) regarding quality of life indicated that respondents with higher education had a good quality of life in three domains (psychological, physical, environmental), and married individuals had a good quality of life in one domain (social) [23].LIMITATION The limitations of this research include a limited number of independent variables.It is hoped that future studies can expand the number of independent variables, encompassing various internal and external factors that may influence a woman's characteristics in facing the pre and menopausal periods.CONCLUSION There are a total of 70 respondents, consisting of 35 premenopausal and 35 menopausal respondents.Overall, demographic characteristics (age, education, and marital status) significantly influence anxiety and quality of life in premenopausal and menopausal women, with a significant pvalue <0.05.Education has the most significant influence, with a Pseudo R Square value of 0.105 (10.5%) on anxiety and a Pseudo R Square value of 0.028 (2.that affect women's characteristics.Health facilities are expected to provide education on women's preparation before menopause and husband support to

Table 1
Distribution of Respondents' Demographic Characteristics.

Table 2
Distribution of Anxiety Categories Frequencies.

Table 3
Distribution of Quality of Life Category Frequencies.

Table 4
The result of the ordinal regression statistical test