Perception and coping with aging among middle-aged women: a qualitative study

Abstract

Middle-aged women face distinct physiological, psychological, and social challenges during the transition from adulthood to later life. However, their perceptions of aging and the strategies they employ to cope with this process remain insufficiently understood. This qualitative study aimed to explore how middle-aged women perceive and respond to aging, with the goal of informing the development of future assessment instruments and targeted health interventions. Semi-structured interviews were conducted with 15 middle-aged women aged 46–57 years in Changsha, Hunan Province, from April to June 2025. Participants represented diverse educational backgrounds, residential areas, and menopausal statuses. Thematic analysis was employed for data analysis, and the study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The perceptions and coping strategies of middle-aged women regarding aging were categorized into five themes, summarized as “1H4W”: (1) H- “How am I aging”: A three-dimensional experience of aging; (2) W1- “What does aging bring me”: The dual impact of aging; (3) W2- “Why am I aging”: Multidimensional attribution of aging; (4) W3- “What can I do”: Dual trajectories of coping strategies and their perceived efficacy; (5) W4- “What prevents me from acting”: Barriers to aging coping actions. Middle-aged women experience complex and multifaceted perceptions of aging, encompassing physical, psychological, and social dimensions. Their perceptions reflect both threat and growth, and their attribution patterns influence their choices of coping behaviors. However, translating these perceptions into action faces significant barriers. These preliminary findings point toward the potential value of developing a validated tool to assess aging perceptions in middle-aged women, which may enhance self-awareness, promote proactive health behaviors, and support healthy aging.