Development of an Aging Anxiety Scale for Middle-Aged Women

Haejin Lee; Mi-Ae You

doi:10.4040/jkan.2019.49.1.14

Journal List > J Korean Acad Nurs > v.49(1) > 1117323

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee and You: Development of an Aging Anxiety Scale for Middle-Aged Women

Original Article

J Korean Acad Nurs 2019;49(1):14-25.

Published online: 15 January 2019

DOI: https://doi.org/10.4040/jkan.2019.49.1.14

Development of an Aging Anxiety Scale for Middle-Aged Women

Haejin Lee¹, Mi-Ae You^2,

¹Department of Nursing, Gyeongbuk College of Health, Gimcheon

²College of Nursing · Research Institute of Nursing Science, Ajou University, Suwon, Korea

Address reprint requests to : You, Mi-Ae College of Nursing · Research Institute of Nursing Science, Ajou University, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-7016 Fax: +82-31-219-7020 E-mail: dew218@ajou.ac.kr

Received 28 August 2018 Revised 18 December 2018 Accepted 18 December 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This was a methodological study that aimed to develop a measurement scale for aging anxiety among middle-aged women.

Methods

In this study, construct factors were extracted, and a conceptual framework was established through an extensive literature review and in-depth interviews with middle-aged women. Under the conceptual framework, 44 preliminary items were constructed, and a preliminary scale of 25 items was completed after two rounds of expert validation and item review. For this study, data were collected from 201 women aged 40∼59 years, and the construct validity and reliability of the preliminary scale were verified.

Results

To verify the construct validity, exploratory factor analysis was conducted. Four factors containing 19 items were extracted. Concurrent validity of the developed scale was verified with Pearson's correlation analysis. The final scale comprised 4 factors (“Social valueless”, “Physical weakness”, “Concern about changes in appearance”, and “Expectations of old age”) and 19 items. The Cronbach's α value was .91.

Conclusion

The scale for measuring aging anxiety in middle-aged women developed in this study validly reflected the peculiarities of aging anxiety in middle-aged women, who experience many physical, emotional, and social changes. The scale can be said to reflect the cultural background, as it reflected real experiences gained through in-depth interviews with middle-aged women.

Keywords: Aging, Anxiety, Validation Studies, Women

References

1. Kim SA. A study on influential variables on climacteric women’s meaning of life [dissertation]. Cheonan: Baekseok University;2010. p. 1–141.

2. Kim JH, Kim W. Effects of anxiety about aging on life satisfaction: A comparison of the young, the middle aged, and the elderly. Korean Journal of Gerontological Social Welfare. 2015; 68:187–216.

3. Chung OB. Theories of life-span development. 3rd ed. Seoul: Hakjisa;2015. p. 445–500.

4. Sowers MFR. The menopause transition and the aging process: A population perspective. Aging Clinical and Experimental Research. 2000; 12(2):85–92.

5. Kim JS, Shin KR. A study on depression, stress, and social support in adult women. Journal of Korean Academy of Nursing. 2004; 34(2):352–361. https://doi.org/10.4040/jkan.2004.34.2.352.

6. Baek IJ. Research on job identity formation procedure of middle age women [master’s thesis]. Seoul: Korea University;2015. p. 1–68.

7. Seo HS, Han YH. Effects of health-related indexes on life satisfaction for the elderly people. Korean Journal of Research in Gerontology. 2006; 15:159–170.

8. Kim EH. A study on anxiety about aging of middle aged and elderly women. The Journal of Korean Academic Society of Nursing Education. 2007; 13(2):192–202.

9. Shin KI. Aging anxiety of adult women: Moderating effect of self-efficacy. The Korean Journal of Woman Psychology. 2015; 20(3):329–346.

10. Watkins RE, Coates R, Ferroni P. Measurement of aging anxiety in an elderly Australian population. The International Journal of Aging and Human Development. 1998; 46(4):319–332. https://doi.org/10.2190/0LU1-0UWE-2TLW-QVAP.

11. Kim W. A comparative study on anxiety about aging of older adults in Korea and the United States. Korean Journal of Gerontological Social Welfare. 2010; 47:71–94.

12. Kim SM, Kim SY. A study on aging anxiety and self-efficacy of middle aged adults. Journal of Korean Psychiatric Mental Health Nursing. 2008; 17(3):281–291.

13. Jung YO, Oh HS. The effects of social support, self-efficacy and perceived health status on aging anxiety of the middle-aged women. Journal of Korean Public Health Nursing. 2016; 30(1):30–41.

14. Lee D, Kim J, Nam SI. The effect of social support on aging anxiety: Double mediation effect of depression and coping on elderly. Korean Journal of Gerontological Social Welfare. 2017; 72(2):323–348.

15. Suh SR, Choi HJ. Aging anxiety and related factors of middle-aged adults. Korean Journal of Adult Nursing. 2013; 25(4):464–472. https://doi.org/10.7475/kjan.2013.25.4.464.

16. Hong KH, Ha JY. Aging anxiety, factors of successful aging and preparation for aging in early and late middle age. Journal of Korean Public Health Nursing. 2015; 29(1):29–39. https://doi.org/10.5932/jkphn.2015.29.1.29.

17. Kim SN, Choi SO, Shin KI, Lee JH. Validation of the anxiety about aging scale. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2008; 17(3):292–301.

18. Barrett AE, Robbins C. The multiple sources of women’s aging anxiety and their relationship with psychological distress. Journal of Aging and Health. 2008; 20(1):32–65. https://doi.org/10.1177/0898264307309932.

19. Lasher KP, Faulkender PJ. Measurement of aging anxiety: Development of the anxiety about aging scale. The International Journal of Aging & Human Development. 1993; 37(4):247–259. https://doi.org/10.2190/1U69-9AU2-V6LH-9Y1L.

20. Lynn MR. Determination and quantification of content validity. Nursing Research. 1986; 35(6):382–386. https://doi.org/10.1097/00006199-198611000-00017.

21. DeVellis RF. Scale Development: Theory and applications. 3rd ed. Thousand Oaks (CA): Sage Publications;2012. p. 42–60. 80-110.

22. Kang H. A guide on the use of factor analysis in the assessment of construct validity. Journal of Korean Academy of Nursing. 2013; 43(5):587–594. https://doi.org/10.4040/jkan.2013.43.5.587.

23. Lynch SM. Measurement and prediction of aging anxiety. Research on Aging. 2000; 22(5):533–558. https://doi.org/10.1177/0164027500225004.

24. De Vaus D. Surveys in Social Research. 5th ed. Abingdon: Rutledge;2002. p. 186–191.

25. Worthington RL, Whittaker TA. Scale development research: A content analysis and recommendations for best practices. The Counseling Psychologist. 2006; 34(6):806–838. https://doi.org/10.1177/0011000006288127.

26. Han SS, Lee SC. Nursing and Health Statistical Analysis. Seoul: Hannarae;2012. p. 263–280.

27. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis: A global perspective. 7th ed. Upper Saddle River (NJ): Pearson Prentice Hall;2010. p. 109–136.

28. Martens A, Goldenberg JL, Greenberg J. A terror management perspective on ageism. Journal of Social Issues. 2005; 61(2):223–239. https://doi.org/10.1111/j.1540-4560.2005.00403.x.

29. Lee EJ. Effects of health perception, aging anxiety and perception of successful aging on health promotion behavior of late middle-aged women [master’s thesis]. Gimhae: Inje University;2016. p. 1–88.

30. Kim SY, Lee JI. A study on aging anxiety, depression, and self-esteem of middle-aged people. Journal of Korean Academy of Fundamentals of Nursing. 2007; 14(1):103–109.

31. Choi SO, Kim SN, Shin KI, Lee JH. Anxiety about aging of a resident community of adult. Journal of the Korea Gerontological Society. 2008; 28(1):19–32.

32. Benton JP, Christopher AN, Walter MI. Death anxiety as a function of aging anxiety. Death Studies. 2007; 31(4):337–350. https://doi.org/10.1080/07481180601187100.

33. Kim HS, Choi EJ, Yang JN. A study of knowledge about aging and aging anxiety. Mental Health & Social Work. 2009; 32:135–165.

Table 1.

Demographic Characteristics of Participants (N=201)

Characteristics	Categories	n (%) or M±SD
Age (yr)	40~49	133 (66.2)
	50~59	68 (33.8)
		47.32±5.19
	Range	40~59
Occupation	Yes	161 (80.1)
	No	40 (19.9)
Marriage type	Married	181 (90.0)
	Single	16 (8.0)
	Divorce	3 (1.5)
	Widow	1 (0.5)
Religion	Yes	136 (67.7)
	No	65 (32.3)
Educational level	<High school	3 (1.5)
	High school	49 (24.4)
	≥College	149 (74.1)
Monthly income	≤200	8 (4.0)
(10,000 won)	201~250	11 (5.5)
	251~300	11 (5.5)
	301~350	24 (11.9)
	≥351	147 (73.1)
Family type	Nuclear family	157 (78.1)
	Couple only	14 (7.0)
	Extended family	24 (11.9)
	Alone	6 (3.0)
Extended family	Yes	117 (58.2)
experience	No	84 (41.8)
Perceived current	Very healthy	31 (15.4)
health status	Healthy	98 (48.8)
	Average	60 (29.9)
	Unhealthy	12 (5.9)
Menopausal symptoms	Yes	61 (30.3)
	No	140 (69.7)

M=Mean; SD=Standard Deviation.

Table 2.

Item-CVI, Mean, Internal Consistency of the Aging Anxiety Scale for Middle-Aged Women

Item	CVI	M±SD	Corrected item to total correlation	Cronbach’s α if the item was deleted
1. I feel my body is not the same as before.	.83	3.79±0.86	.36	.91
2. I feel that there are more and more physical limitations in my activities.	.83	3.49±0.90	.45	.91
3. I am afraid menopause will cause me a health problem.	1.00	3.25±1.03	.53	.91
4. I don’t like seeing myself changing when I look in the mirror.	1.00	3.02±1.01	.58	.91
5. I am afraid my appeal as a woman is fading away.	1.00	2.92±0.97	.54	.91
6. I am afraid my life will be boring as I get older.	1.00	2.54±0.99	.71	.90
7. I am afraid the people around me will not need me.	1.00	2.52±0.84	.73	.90
8. I am afraid I will be left alone.	1.00	2.68±0.97	.73	.90
9. I feel a little uneasy about the rest of my time.	.83	2.99±1.02	.60	.91
10. I do not know what to do with the rest of my life.	.83	2.52±0.89	.68	.91
11. I am afraid I will look old and ugly.	1.00	2.83±1.01	.70	.90
12. I do not want to think about how I am getting old.	1.00	3.05±0.95	.36	.91
13. I am afraid there are fewer things I can decide or do myself.	.83	2.90±0.92	.67	.91
14. I feel I can not learn new things more quickly than before.	1.00	3.46±0.86	.38	.91
15. I am afraid I will have to face financial difficulty in my old age.	.83	3.25±1.02	.56	.91
16. I think as you grow older, you need something to trust and count on.	.83	3.81±0.85	.42	.91
17. There are always people around to help me.	1.00	2.47±0.83	.28	.91
18. I think I need to learn something for my extend spare time.	.83	3.97±0.79	.11	.91
19. I am afraid people will ignore me when I get older.	1.00	2.62±0.92	.67	.91
20. I am afraid I will be able to portray the elderly as alienated.	1.00	2.66±1.00	.74	.90
21. Life seems to be satisfactory even when I’m older.	1.00	2.75±0.78	.60	.91
22. I know a lot about the aging process.	.83	2.83±0.81	.23	.91
23. I’m confident I’ll do my job well when I get older.	1.00	2.68±0.86	.27	.91
24. I think I will feel more relaxed as I get older.	.83	2.76±0.86	.54	.91
25. I think I will be wiser than I am now.	.83	2.81±0.94	.41	.91
Cronbach’s α 25 item total=.91; Cronbach’s α 21 item total=.92
Range of skewness of items=-1.23~0.57; Kurtosis of items=-0.95~2.67

CVI=Content Validity Index; M=Mean; SD=Standard Deviation.

Table 3.

Factor Loadin ngs and E Eigen Value

Factor	No.	Item	F1	F2	F3	F4	Communality
Social valueless	9	I feel a little uneasy about the rest of my time.	.75	-.01	.20	.09	.65
	15	I am afraid I will have to face financial difficulty in my old age.	.69	.19	.02	.16	.54
	20	I am afraid I will be able to portray the elderly as alienated.	.69	.01	.38	.29	.70
	19	I am afraid people will ignore me when I get older.	.67	.10	.34	.17	.61
	8	I am afraid I will be left alone.	.66	.18	.28	.25	.61
	13	I am afraid there are fewer things I can decide or do myself.	.66	.29	.07	.29	.60
	10	I do not know what to do with the rest of my life.	.64	-.03	.26	.35	.60
	16	I think as you grow older, you need something to trust and	.62	.23	-.07	-.03	.44
		count on.
Physical weakness	1	I feel my body is not the same as before.	.10	.87	.05	.03	.76
	2	I feel that there are more and more physical limitations in my	.15	.85	.08	.14	.78
		activities.
	14	I feel I can not learn new things more quickly than before.	.15	.79	.09	.08	.66
	3	I am afraid menopause will cause me a health problem.	.46	.42	.19	.10	.43
Concern about changes in appearance	12	I do not want to think about how I am getting old.	.02	-.02	.80	.17	.67
	4	I don’t like seeing myself changing when I look in the mirror.	.22	.24	.75	.17	.70
	5	I am afraid my appeal as a woman is fading away.	.40	.09	.70	-.05	.67
	11	I am afraid I will look old and ugly.	.50	.18	.44	.29	.56
Expectations of old age	24*	I think I will feel more relaxed as I get older.	.23	.11	.10	.82	.75
	25*	I think I will be wiser than I am now.	.10	.05	.08	.80	.65
	21*	Life seems to be satisfactory even when I’m older.	.31	.13	.19	.69	.63
Eigen value			4.52	2.62	2.46	2.37
Explained variance (%)			23.8	13.8	12.9	12.5
Cummulative variance (%)			23.8	37.6	50.5	63.0
KMO (Kaiser-Meyer-Olkin)=.89, χ²=1804.61 (p<.001)
Communality (≥.40)

^* 24, 25, 21 are reverse items.

Table 4.

Finding of Multi-trait/Multi-item Matrix Analysis

Factor	No.	Item	Correlation between each item and total scores of sub-factor
Factor	No.	Item	F1	F2	F3	F4	2Standard Error
Social valueless	9	I feel a little uneasy about the rest of my time.	.68	.26	.44	.31	.08
	15	I am afraid I will have to face financial difficulty in my old age.	.60	.39	.36	.35	.09
	20	I am afraid I will be able to portray the elderly as alienated.	.73	.30	.62	.47	.07
	19	I am afraid people will ignore me when I get older.	.68	.33	.56	.40	.09
	8	I am afraid I will be left alone.	.69	.42	.55	.43	.07
	13	I am afraid there are fewer things I can decide or do myself.	.68	.44	.41	.46	.07
	10	I do not know what to do with the rest of my life.	.67	.26	.50	.48	.08
	16	I think as you grow older, you need something to trust and count on.	.46	.33	.26	.20	.12
Physical weakness	1	I feel my body is not the same as before.	.26	.68	.22	.17	.08
	2	I feel that there are more and more physical limitations in my activities.	.35	.70	.28	.26	.07
	14	I feel I can not learn new things more quickly than before.	.31	.63	.26	.19	.10
	3	I am afraid menopause will cause me a health problem.	.49	.41	.41	.31	.12
Concern about changes in appearance	12	I do not want to think about how I am getting old.	.20	.20	.52	.20	.14
	4	I don’t like seeing myself changing when I look in the mirror.	.47	.35	.68	.35	.08
	5	I am afraid my appeal as a woman is fading away.	.52	.30	.59	.23	.09
	11	I am afraid I will look old and ugly.	.64	.39	.51	.44	.12
Expectations of old age	24*	I think I will feel more relaxed as I get older.	.46	.28	.35	.70	.10
	25*	I think I will be wiser than I am now.	.34	.17	.23	.55	.12
	21*	Life seems to be satisfactory even when I’m older.	.52	.31	.42	.55	.11

^* 24, 25, 21 are reverse items.

Table 5.

Correlation between the Mean, Standard Deviation, Factor and Reliability of the Aging Anxiety Scale for Middle-Aged Women

Factor	M±SD	1 r (p)	2 r (p)	3 r (p)	4 r (p)	Cronbach’s α
Factor 1. Social valueless (8 items)	23.42±5.62	1				.88
Factor 2. Physical weakness (4 items)	13.99±2.85	.46 (<.001)	1			.79
Factor 3. Concern about changes in appearance (4 items)	11.81±3.02	.63 (<.001)	.38 (<.001)	1		.77
Factor 4. Expectations of old age (3 items)	8.31±2.12	.53 (<.001)	.30 (<.001)	.42 (<.001)	1	.76
Total	57.54±13.63					.91

M=Mean; SD=Standard Deviation.

TOOLS

Similar articles