Abstract
This cross-sectional study aims to identify distinct subgroups of proactive health management among perimenopausal women in China, examine differences in symptom burden and psychological distress across these categories, and examine whether symptom burden statistically mediates the relationship between different subgroups of proactive health management and psychological distress. From February to August 2025, data were consecutively collected via convenience sampling from 502 perimenopausal women attending gynecology and perimenopause specialty clinics at four tertiary hospitals in Chengdu and Deyang, Sichuan Province. The data included sociodemographic information, the Kessler Psychological Distress Scale, Menopause Rating Scale, and Proactive Health Management Scale. Data analysis was performed using Spss 27.0 and Mplus 8.3 software. Latent profile analysis identified latent categories of proactive health management among perimenopausal women. The BCH command tested differences in symptom burden and psychological distress across categories. Category mediation analysis(Latent class membership was included as a categorical predictor) examined the mediating effect of symptom burden between different proactive health management categories and psychological distress,. Finally, latent profile analysis identified three distinct categories of proactive health management among perimenopausal women, Model fit indices (AIC, BIC, entropy, and LMR test) supported a three-class solution as the optimal model: Comprehensive Weakness Type (40.0%, N = 201), Support Compensatory Type (23.9%, N = 120), and Comprehensive Strength Type (36.1%, N = 181). Statistically significant differences in symptom burden and psychological distress were observed between the Comprehensive Weakness Type and both the Support Compensatory and Comprehensive Strength Types. In the relationship between different proactive health management categories and psychological distress, symptom burden was observed to exert a statistically significant mediating effect (β=-0.165, SE = 0.027, 95% CI=-0.222, -0.115; β=-0.199, SE = 0.031, 95% CI=-0.263, -0.143). Proactive health management levels exhibit heterogeneity among perimenopausal women, with the findings are consistent with a potential mediating role of symptom burden in the relationship between proactive health management and psychological distress. Healthcare providers should focus on individuals with poor proactive health management while also addressing physiological symptoms, as they represent a high-risk group for psychological distress. Measures such as health education and online remote management can be evaluated in future research.
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The authors thank all women who volunteered to participate in the study.
Funding
The research leading to these results received funding from Science and Technology Bureau of Deyang City(No.2024SZY033), Deyang Nursing Association(No.DH2501), Sichuan Research Center of Applied Psychology(No.CSXL-24305).
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Liu, X., Zhong, X., Li, Y. et al. Proactive health management and psychological distress among perimenopausal women: A cross-sectional latent profile and mediation analysis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-50676-y
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DOI: https://doi.org/10.1038/s41598-026-50676-y
