中年糖尿病婦女在更年期之轉變期，除經歷身心重大的改變之外，且面對疾病帶來的壓力和血糖控制不易的困境。本研究目的為探討糖尿病婦女人口學屬性、疾病特性、不同更年分期狀態、更年期症狀、更年期態度與憂鬱之關係。本研究採橫斷性相關性調查法，以立意性取樣，在南部某醫學中心及區域醫院之門診進行收案，研究對象為四十四歲至五十八歲之第2型糖尿病婦女。以結構式問卷「基本資料」、「更年期症狀量表」、「更年期態度量表」、及「憂鬱量表」進行資料收集，共收案120位婦女。研究結果發現：一、糖尿病婦女的平均停經年齡為49.9歲。二、糖尿病婦女常見更年期症狀依序為感覺疲累或缺少活力、肌肉關節痛、難以入睡。罹患合併症之糖尿病婦女，其更年期症狀較沒有合併症者為嚴重。三、83.3% 更年期婦女視更年期為自然現象。教育程度低及血糖控制不良之糖尿病婦女對更年期態度較為負向。四、34.2% 的糖尿病中年婦女有憂鬱情形。有糖尿病合併症之婦女其憂鬱顯著高於無糖尿病合併症者。五、處於停經中期之糖尿病婦女，比停經前期之婦女其更年期症狀較嚴重、對更年期態度較為負向；但不同停經狀態之婦女在憂鬱情緒上並無差異。六、中年期糖尿病婦女之憂鬱與更年期症狀有顯著正相關，憂鬱與更年期態度有顯著負相關。七、更年期症狀與糖尿病合併症數目是預測糖尿病婦女憂鬱之重要變項，可解釋憂鬱22.5%的總變異量。本研究結果可提供國內對中年糖尿病婦女更年期現況之瞭解，作為健康專業人員推動糖尿病婦女在更年期過渡期照護之重要參考。

Women with diabetes experience profound physical and psychological changes during their climacteric transitional period. Also, they must deal with healthy stress and difficulity in blood sugar controlling . The purpose of this study was to explore the relationship among demographic data, disease characteristic, climacteric stages, climacteric symptoms, perimenopause attitude, and depression among women with type 2 diabetes mellitus. A cross-sectional design and self-administered questionnaires were applied to this study. The women aged between 44 and 58 years were recruited by purposive sampling at two hospitals in Southern Taiwan. A total of 120 women participated in this study. The following four instruments were used: demographic sheet, the Greene Climacteric Symptom Scale, the Perimenopause Attitude Scale, and the Center of Epidemiological Study Depression Scale. The study has concluded following findings: (1) The mean age of menopause women with diabetes were at 49.9 years. (2) The three leading frequent climacteric symptoms among women with diabetes were: feeling tired or lacking energy, experiencing muscle and joint pains, and falling asleep difficultly. Moreover, women with diabetic complications have more climacteric symptoms. (3) 83.3% of the women considered menopause as a natural phenomenon; however, those who with lower education and poor metabolic control have more negative attitude toward to menopause. (4) 34.2 % of women with diabetes had depression; however, for those women who were diagnosed with diabetic complication disease had even worse depression. (5) Women with diabetes in perimenopsual stage had more climacteric symptoms and negative perimenopause attitude than those who in premenopausal stage. However, there were no differences in the level of depression symptoms among these three climacteric stages. (6) The association between depression and climacteric symptoms was positive; the association between depression and perimenopause attitude was negative. (7) Climacteric symptoms and diabetic complications significantly predicted depression for diabetic women during the climacteric period. Moreover, the two variables could explain 22.5% of the variances of depression among women with diabetes.
This study provides a profound reference to health professionals to take care of the type 2 diabetes women during their climacteric transitional period.

一、中文部份
方茂守、楊美賞、蔡英美(2006) ‧都市原住民婦女更年期之症狀‧台灣醫學，10，166-174。
王馨世(1999) ‧女性生殖生理與內分泌學‧台北：合記圖書出版社。
行政院衛生署（2006. 3. 8）‧台灣中年人口主要死亡原因‧衛生統計資訊網‧取自: http://www.doh.gov.tw/statistic/data/死因摘要/93年/93.htm。
行政院衛生署（2005.5.27）‧台灣地區主要疾病就診率‧衛生統計資訊網‧ http://www.doh.gov.tw/statistic/data/全民健保主要疾病就診率統計/2003/中華民國台灣地區2003全民健保主要疾病就診率統計.xls。
行政院衛生署(2003)‧糖尿病防治手冊‧台中：行政院國民健康局。
白香菊(2003)‧更年期婦女對更年期知識、不確定感及親子關係之研究‧未發表碩士論文，台中：中山醫學大學。
白香菊、李選、曾月霞(2004)‧更年期婦女自覺不確定感相關因素之研究‧護理雜誌，51(5)，45-52。
江佳錡、陳健志、林光洋(2004) ‧女性更年期‧基層醫學，19（1），2-7。
李佩珊、李降桃、黃久美、李奇龍（2006）‧更年期婦女之更年期態度、
更年期症狀與憂鬱情緒之相關研究‧實證護理，2（2），156-165。
李逸、王秀紅（2000）‧中年婦女之停經經驗與自我照顧行為‧護理研究，8（1），71-84。
李逸、王秀紅（2001）‧更年期婦女自我照顧行為類型與相關因素‧公共衛生，28（2），151-160。
李淑桂、郭碧照（2002）‧中年婦女與護理人員之更年期態度與健康行為之相關探討‧中山醫學雜誌，13，101-120。
李選、盧瑛琪、顏文娟、林淑琴 (2004) ‧中年於其人生轉折過程所呈現之健康問題與因應‧護理雜誌，51(1)，14-19。
吳佳璇、林信男 (2002) ‧更年期、女性荷爾蒙補充與憂鬱症‧當代醫學，29（4），303-306。
呂淑妤、林宗義（2000）‧南部社區老人憂鬱症狀盛行率及其相關因素研究‧中華衛誌，19（1），50-60。
邱皓政(2002) ‧量化研究與統計分析‧台北：五南。
林宇旋、張幸真、陳姿伶(2005.12.5)‧台灣地區婦女更年期身心症狀盛行率及健康相關知識行為─民國91年國民健康促進知識態度與行為調查結果‧台灣大學‧取自: http://www.ccms.ntu. Edu.tw/ ~psc/C2004paper/ 7-3.pdf#research。
林惠珍（2003）‧宜蘭地區第2型糖尿病患者憂鬱程度及其相關因素之探討‧未發表碩士論文，花蓮：慈濟大學護理學研究所。
林瓊華 (2002)‧社區更年期婦女生品質及其相關因素之探討‧未發表碩士論文，台北：國立台北護理院。
張玨（2003a）‧更年期婦女健康是公共政策的議題‧台灣衛誌，22（4），245-250。
張玨(2003b)‧婦女經期健康與政策‧護理雜誌，50（5），22-28。
張玨、周松勇、陳芬苓、張菊惠 (1995)‧一般經期與更年期自訴症狀的研究‧中華衛誌，14(2)，191-200。
張玨、張菊惠(1998)‧婦女健康與「醫療化」：以停經期/更年期為例‧婦女與兩性學刊，9，145-185。
張玨、張菊惠(2000)‧停經階段與心理衛生‧中華心理衛生學刊，12(4)，1-27。
張玨、陳芬苓（1993）‧女性更年期研究的回顧與展望‧婦女與兩性學刊，4，263-294。
張玨、陳芬苓、胡幼慧(1993)‧中老年婦女更年期態度的研究‧中華衛誌，12(1)， 26-39。
陳正誠（2002）‧非胰島素依賴型糖尿病門診病患憂鬱程度與血糖控制情形之相關研究‧未發表之博士論文，台北：國立台灣師範大學。
陳建仁、游山林、白其卉、蘇大成、曾慶孝、簡國龍等(2004.9.15)‧台灣地區高血糖、高血脂、高血壓盛行率調查期末報告‧國民健康局中老年保健網‧取自: http://163.29.76.18/study-2.htm.。
陳朝宗(1996)‧更年期與紫河車‧北市中醫會刊，2(4)，68-72。
陳靜敏、何美華、簡逸毅 (2000)‧婦女接受賀爾蒙補療法的遵從行為與其更年期
黃俊仁、楊明仁(2004)‧糖尿病照護之社會心理探討‧安泰醫護雜誌，10（3），111-116。
曹麗英（1998）‧台灣婦女更年期經驗之探討—處於健康多變化的時期‧護理研究，6（6），448-460。
曹麗英、周碧琴、洪麗玲、張淑紅、高月梅、蕭冰如等(2002)‧更年期婦女自覺不確定感及健康行為之探討‧長庚護理，13(3) ，228-239。
曹麗英、蘇美禎(2002)‧婦女重要的人生過渡期：更年期面面觀，於王秀紅、曾綺華編，婦女健康理論與實務，台北：禾楓。
曹麗英、蘇美楨、安奇(2004)‧中年期之健康照護：多重衝擊的人生過渡‧護理研究，51（1），9-19。
曹麗英、蘇美楨、邱小鳳(2002)‧中醫及西醫求診婦女更年期症狀困擾情形之探討‧長庚醫技學刊，1，91-102。
梁繼權、呂碧鴻、李明濱、湯麗玉(1998)‧成年人慢性疾病壓力與憂鬱相關之探討‧中華家庭醫學雜誌，8，124-133。
蔡秀玲、黃國晉（1999）‧更年期婦女體脂肪與心血管疾病危險因子評估‧華醫學報，11，11-21。
蔡純美(2004)‧第二型糖尿病婦女性功能及其影響因素之探討‧未發表碩士論文，高雄：樹德科技大學。
盧成皆(1997)‧線性複迴歸所需樣本數之討論‧護理研究，5（4），377-383。
盧欣怡（2003）‧更年婦女的生活事件壓力、更年期態度、更年期症狀、自我概念與憂鬱之關係‧未發表碩士論文，台南：國立成功大學。
盧茲豔、林貴雪(2001) ‧更年期的論述分析‧護理雜誌，48（1），77-82。
盧茲豔、嚴毋過(2000)‧台北地區中年婦女與醫護人員對更年期態度之比較‧慈濟醫學，12(4)，267-275。
嚴毋過(1998)‧台北市社區中年婦女與醫護專業人員對更年期態度與不適之比較研究‧已發表碩士論文，台北：國立陽明大學。
蘇美禎、黃璉華、曹麗英、周松男(2003)‧更年期婦女健康需求‧台灣醫學，7(5)，708-716。

二、英文部份
American Diabetes Association (2005). Standards of medical care in diabetes. Diabetes Care, 28(Suppl. 1), S4-S36.
Amore, M., Donato, P. D., Papalini, A., Berti, A., Palareti, A., & Ferrari, G, et. al. (2004). Psychological status at the menopausal transition: an Italian epidemiological study. Maturitas, 48, 115-124.
Anderson, R. J., Clouse, R. E., Freedland, K. E, & Lustman, P. J. (2001). The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care, 24, 1069-1078.
Arroyo, C., Hu, F. B., Kawachi, I., Colditz, G. A., Speizer, F. E., & Manson, J. M. (2004). Depression symptoms and risk of type 2 diabetes in women. Diabetes Care, 27, 129-133.
Avis, N. E, & McKinlay, S. M. (1991). A longitudinal analysis of the association between women’s attitude toward menopause: Results from the Massachusetts Women’s Health Study. Maturitas, 13(1), 65-79.
Avis, N. E., Kaufert, P. A., Lock, M, McKinlay, S. M., & Vass, K. (1994). A longitudinal study of hormone levels and depression among women transitioning through menopause. Annuals of Epidemiology, 4(3), 214-220.
Barentsen, R., van de Weijer P. H. M. , De Gend S., & Foekema, H. (2001). Climacteric symptoms in a representative Dutch population sample as measured with the Greene Climacteric Scale. Maturitas, 38, 123-128.
Bastian, L. A., Smith, C. M., & Nanda, K. (2003). Is this woman perimenopausal? JAMA, 289(7), 895-902.
Berkman, L. S., Berkman, C. S., Kasl, S., Freeman, D. H., Leo, L., Ostfeld, A. M., et al. (1986). Depression symptoms in relation to physical health and functioning in the elderly. American Journal of Epidemiology, 124, 372-399.
Bloch. A. (2002). Self-awareness during the menopause. Maturitas, 41, 61-68.
Bosworth, H. B., Bastian, L. A., Kuchibhatla, M. N., Steffens, D. C., Mcbride, C. M., Skinner, C. S., et.al. (2001). Depression symptoms, menopausal status, and climacteric systems in women at midwife. Psychosomatic Medicine, 63, 605-608.
Bromberger, J. T., Meyer, P. M., Kravitz, H. M., Sommer, B., Cordal, A., Powell, L., et al. (2001). Psychological distress and natural menopause: A multiethnic community study. American Journal of Public Health, 91(9), 1435-1442.
Bromberger, J. T., Karlow, S. , Avis, N., Kravitz, H. M., & Cordal, A. (2004). Racial/ethnic in prevalence of depressive symptoms among middle-aged women: The study of women’s health across the nation (SWAN). American Journal of Public Health, 94(8), 1378-1385.
Brown, W. J., Mishra, G. D., & Dobson, A. (2002). Changes in physical symptoms during menopause transition. International Journal of Behavioral Medicine, 9(1), 53-67.
Chen, C. P., & Cheng, T. A. (1985). Depression in Taiwan: Epidemiological survey utilizing CED-S. Seishin Shinkeigaku Zasshi-Psychiatria Neurologia et Japonica. 87(5), 335-338.
Chen, L. H., Tsao, Y. T., Yen, K. Y., Chen, Y. F., Chou, M. H., & Lin, M. F. (2003). A pilot study comparing the clinical effects of Jia-Wey Shiau-Yau San, a traditional Chinese herbal prescription, and acontinuous combined hormone replacement therapy in 76 postmenopausal women with climacteric symptoms. Maturitas, 44, 55-62.
Cheng, M. H., Wang, S. J., Wang, P. H., & Fuh, J. L. (2005). Attitudes toward menopause among middle-aged women: A community survey in an island of Taiwan. Maturitas, 52, 348-355.
Chim, H., Tan, B. H. I., Ang, C. C., Chew, E. M. D., Chong, Y. S., & Saw, S. M. (2002). The prevalence of menopause symptoms in a community in Singapore. Maturitas 41, 275-282.
Choi, H., Lee, D., Lee, K., Kim, H., & Ham, E. (2004). A structural model of menopausal depression in Korean women. Archives of Psychiatric Nursing, 18(6), 235-242.
De Groot, M. D., Anderson, R. Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). Association of depression and diabetes complications : A meta-analysis. Psychosomatic Medicine, 63, 619-630.
Dennerstein, L. (1996). Well-being, symptoms and the menopausal transition. Maturitas, 23(2), 147-157.
Dennerstein, L., Dudley, E. C., Hopper, J. L., Guthrie, J. R., & Burger, H. G. (2000). A perspective population-based study of menopausal symptom. Obstetrics & Gynecology, 96(3), 351-358.
Fisher, L., Skaff, M. M., Chesla, C. A., Kanter, R. A. & Mullan, J. T.( 2001). Contributors to depression in Latino and European-American patients with Type 2 diabetes. Diabetes Care, 24(10), 1751-1757.
Gary, T. L., Crum, R. M., Cooper-Pactrick, L., Ford, D. & Brancati, F. L. (2000). Depressive symptoms and metabolic control in African-American with Type 2 Diabetes. Diabetes Care, 23(1), 23-29.
Gavard, J. A., Lustman, P. J., & Clouse, R. E. (1993). Prevalence of depression in adults with diabetes: an epidemiological evaluation. Diabetes Care, 16, 1167-1178.
Grandinetti, A., Kaholokula, J. K., Crabbe, K. M., Kenui, C., Chen, R., & Chang, H. K. (2000). Relationship between depressive symptoms and diabetes among native Hawaiians. Psychoneuroendocrinology, 25, 239-246.
Greendale, G. A., Lee N. P. , & Arriola, E. R. (1999). The menopause. The Lancet, 353, 571-580.
Greene, J. G. (1976). A factor analytic study of climacteric symptoms. Journal of Psychosomatic research, 20, 425-430.
Greene, J. G. (1991). Guide to use the Greene Climacteric Scale. University of Glasgow: Glasgow.
Greene, J. G. (1998). Constructing a standard climacteric scale. Maturitas, 29, 25-31.
Greene, J. G., & Cooke, D. J. (1980). Life stress and symptoms of climacterium. British Journal of Psychiatry, 136, 486-491.
Griffith, J. A. & Lustman, P. J. (1997). Depression in women with diabetes. Diabetes Spectrum, 10, 216-223.
Haffner, S. M., Valdez, R. A., Morales, P. A., Hazuda, H. P., & Stern, M. P. (1993). Decreased sex hormone-binding globulin predicts noninsulin-dependent diabetes in women but not in men. Journal of Clinical Enodocrinology, 77(1), 56-60.
Haines, C. J., Rong, L., Chuang, T. K. H., & Leung, D. H. Y. (1995). The perception of menopause and the climacteric among women in Hong Kong and Southern China. Preventive Medicine, 24, 245-248.
Hardy, R., & Kuh, D. (2002). Change in psychological and vasomotor symptom reporting during the menopause. Social Science & Medicine, 55, 1975-1988.
Hay, A. G., Bancroft, J., & Johnston, E. C. (1994). Affective symptoms in women attending a menopause clinic. British Journal of Psychology, 164(4), 513-516.
Herpertz, S., Kramer-Paust, R., Paust, R., Schleppinghoff, B. S., Best, F., et al. (2002). Association between psychosocial stress and psychosocial support in diabetic patient. International Congress Series, 1241, 51-58.
Ho, S. C., Chan, S. G., Yip, Y. B., Chan, S. Y., & Sham, A. (2003). Factors associated with menopausal symptoms reporting in Chinese midlife women. Maturitas, 44, 149-156.
Hsu, H. C., & Lin, M. H. (2005). Exploring quality of sleep and its related factors among menopausal women. Journal of Nursing Research, 13(2), 153-164.
Jokinen, K., Rautava, P., Makinen, J., Ojanlayva, A., Sundell, J., Helenius, H. (2003). Experience of climateric symptoms among 42-46 and 52-56-year-old women. Maturitas, 46, 199-205.
Kaufert , P., Boggs, P., Ettinger, B., Woods, N. F., & Utian, W. H. (1998). Women and menopause: belief, attitudes, and behavior: The North American Menopause Society 1997 Menopause Survey. Menopause, 5(4), 513-516.
Kessler, R. C. (2003). Epidemoilogy of women and depression. Journal of Affective Disorder, 74, 5-13.
King, H., & Rewers, M., (1993). Gobal estimates for prevalence of diabetes and impaired glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care, 16, 157-177.
Kuh, D., Hardy, R., Rodgers, B., & Wadsworth, M. E. J. (2002). Lifetime risk factors for women’s psychological distress in midlife. Social Science & Medicine, 55, 1957-1973.
Lam, P. M., Leung, T. N., Haines, C., & Chung, T. K. H. (2003). Climacteric symptoms and knowledge about hormone replacement among Hong Kong Chinese women aged 40-60 years. Maturitas, 45, 99-107.
Lange, L. J. & Piette, J. D. (2005). Perceived health status and perceived diabetes control: psychological indicators and accuracy. Journal of Psychosomatic research, 58, 129-137.
Li, S., Carlson, E., Snyder, D. & Holm, K. (1995). Perspective on menopause. Clinical Nurse Specialist, 9(3), 145-148.
Loh, F. H., Khin, L. W., Saw, S. M., lee, J. J. M., & Gu, K. (2005). The age of menopause transition in a multiracial population: a national wide Singapore study, Maturitas, 50, 169-180.
Lopez- Lopez, R., Huerta, R., & Malacara, J. M. (1999). Age at menopause in women with type 2 diabetes mellitus. Menopause, 6(2), 174-178.
Ludman, E. J., Katon, W., Russo, J., Korff, M. V., Simon, G., Ciechanowski, P., et al., (2004). Depression and diabetes symptom burden. General Hospital Psychiatry, 26, 430-436.
Lustman, P. J., Groot, M., Anderson, R. J., Carney, R. M. , Freedland, K. E., & Clouse, R. E. (2000). Depression and glycemic control: A meta-analytic review of the literature. Diabetes Care, 23(7), 934-942.
Malacara, J. M., Huerta, R., Rivera, B, Esparza, S., & Fajardo, M. E. (1997). Menopause in normal and uncomplicated NIDDM women: physical and emotional symptoms and hormone profile. Maturitas, 28, 35-45.
Mariella, A., Mitche E. S., ＆ Woods, N. F. ( 2002). Depression in mudlife women: what have we learned from longitudinal studies. International Congress Series, 1229, 39-43.
Meleis, A. I., Sawyer, L. M., Im, E., Messias, D. K. H., & Schumacher, K. (2000). Experiencing transitions: An emerging middle-range theory. Advanced Nursing Science, 23(1), 12-28.
Milewicz, A., & Demissie, M. (2002). Matabolic and endocrine changes in climacteric women. International Congress Series, 1229, 3-7.
Munro, B. H. (2005). Statistical methods for healyj care research (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
Pan, H., Wu, M., Hsu, C., Yao, B., & Huang, K. (2002). The perception of menopause among women in Taiwan. Maturitas, 41, 269-274.
Poirier-Solomon, L. (2001). Menopause: transition with balance. Diabetes Forecast, 54(3), 37-40.
Pouwer, F., & Snoek, F. J. (2001). Association between symptoms of depression and glycaemic control may be unstable across gender. Diabetic Medicine, 18, 595-598.
Rakovac, I., Gfrerer, R. J, Habacger, W., Seereiner, S. P., Beck, P., Risse, A., et.al, (2004). Screening of depressiomn in patients with diabetes mellitus. Diabetologia, 47, 1469-1470.
Richardson, T. A. & Robinson, R. D.（2000). Menopause and depression: a review of psychologic function and sex steroid neurobiology during the menopause. Primary Care Update Obstet/Gynecol, 7(6), 215-223.
Rosskx, I. (2004). Screening of depression with diabetes mellitus. Diabetologia, 47, 1469-1470.
Sagsoz, N., Oguzturk, O., Bayram, M., & Kamaci, M. (2001). Anxietiy and depression before and after menopause. Archives of gynecology and Obstetrics, 264(4), 199-202.
Schumacher, K. L., & Meleis, A. I. (1994). Transitions: A central concept in nursing. Image. Journal of Nursing Scholarship, 26(2), 119-126.
Speroff, L. ( 2000). Management of the perimenopausal transition. Contemporary OB/GYN, 14-34.
Steward, D. E., & Boydell, K. M.(1993). Psychologic distress during the menopause: associations across the reproductive cycle. International Journal of Psychiatry Medicine, 23(2), 157-162.
Stover, J. C., Skelly, A. N., Holditch-Davis, D. , & Dunn,P. F. (2001). Perceptions of health and the relationship to symptoms in African American women with type 2 diabetes. Applied Nursing research, 14(2), 72-80.
Tam, L. W., Stucky, V., Hanson, R. E., & Parry, B. L. (1999). Prevalence of depression in menopause: a pilot study. Archives of Women’s Mental Health, 2, 175-181
Tellez-Zenteno, J. F., & Cardiel,M. H. (2002). Risk factors associated with depression in patients with Type 2 diabetes mellitus. Archives of Medical Research, 33, 53-60.
Theisen, S. C., Mansfield, P. K., Seery, B. L., & Voda, A. (1995). Predictors of midwife women’s attitude toward menopause. Health Values, 19, 22-31.
Thunell, L. Stadberg, E., Milsom, I., & Mattsson, L. A. (2004). A longitudinal study
population study of climacteric symptoms and their treatment in a random sample
of Swedish women. Climacteric, 7, 357-365.
Turner-Henson, A., & Holada, B. (1995). Daily life experience for the chronically ill:
A life-span perspective. Family & Community Health , 17(4), 1-11.
Utian, W. H. (2004). Menopause related definition. International Congress Series, 1266, 133-138.
Voda, A. M.（1994）. Risks and benefits associated with hormonal and surgical therapies for healthy midlife women. West Journal of Nursing Research, 16, 507-523.
Whittemore, R., Melkus, G. D., & Grey, M. (2004). Self-report of depression mood and depression in women with type 2 diabetes. Issues in Mental Health Nursing, 25, 243-260.
WHO (1996). Research on the menopause. Progress in Human Reproduction Research, 40, 1-8.
Wilbur, J., Miller, A. , & Montogometry, A.（1995). The influence of demographic characteristics, menopausal status, and symptoms on women’s attitude toward menopause. Women & Health, 23(3), 19-39.
Woods, N. F., & Mitchell, E. S. (1997). Pathways to depressed mood for midwife women: observation from the Seattle midwife women’s health study. Research in Nursing & health, 20, 119-129.
Woods, N. F., Mariella, A., & Mitchell, E. S. (2002). Patterns of depressed mood across the menopausal transition: approaches to studying patterns in longitudinal data. Acta Obstetricia et Gynecologica Scandinavica, 81, 623-632.
Wu, S., Chou, P., & Tsai, S. (2001). The impact of years since menopause on the development of impaired glucose tolerance. Journal of Clinical Epidemiology, 54, 117-120.
Xu, L., Ren, J., Cheng, M., Tang, K., Dong, M., & Hou, X. et al. (2004). Depression symptoms and risk factors in Chinese persons with Type 2 diabetes. Archives of Medical Research, 35, 301-307.