The Effect of Positive Emotional Regulation towards Happiness Level in Menopausal Women

Background: Menopausal women experience various physical changes leading to psychological problems, such as anxiety, and may cause negative emotions. Regulating positive emotions in menopausal women may increase the happiness level in this population.
Objective: This study aims to analyze the effect of positive emotional regulation towards the happiness level in menopausal women
Methods: This analytic observational study utilized cross sectional design. The population was all female elders living in community under the supervision of Kenjeran Public Health Center, and the sampel was menopausal women. The independent variable was positive emotional regulation, while the dependent variable was the  happiness level. Valid and reliable questionnaires were used in data collection. Linear regression test was used in data analysis.
Results: All respondents (100%) had good positive emotions, and most respondents (59.5%) had a high level of happiness. Linear regression test showed that positive emotional regulation affected the happiness level significantly in menopausal women (p<0.05).
Conclusions:  Positive emotions affect the happiness level ini menopausal women.


INTRODUCTION
During menopause, women will experience several impacts, including what often occurs in our society, namely anxiety, fear, irritability, insecurity, decreased memory, difficulty in concentrating, nervousness, feeling useless, stress, and even depression (Rostiana and Kurniati, 2009). Atamimi in (Oktaviani, 2012) found the causal factors for women to become anxious during perimenopause period, one of which is the occurrence of severe emotional shocks that have an impact on health conditions and mental well-being. People who experience negative emotions tend to pay more attention to emotions that have negative values, such as anxiety (Syaiful and Bahar, 2016). Seligman (2005) explains that if you have a lot of negative emotions, it is possible to have fewer positive emotions than the average, even though positive emotions affect a person's happiness. It can be concluded that negative emotions will reduce one's happiness.

women.
Conclusions: Positive emotions affect the happiness level ini menopausal menopausal women (p<0.05).
that positive emotional regulation affected the happiness level significantly in respondents (59.5%) had a high level of happiness. Linear regression test showed The data obtained, almost all over the world, about 70-80% of European women, 60% in America, 57% in Malaysia, 18% in China and 10% in Japan and Indonesia experience pre-menopausal syndrome (Fitriana, 2014). An increase in women's life expectancy to 73.77 years in 2025 is predicted to have an impact on the majority of women who will experience menopausal symptoms for more than 30 years. Women who have gone through menopause will undergo and spend about one third of their life with an estrogen deficiency that can cause various health problems (Bener and Falah, 2014) A decrease in estrogen levels in menopausal women affects brain neuro-transmitters, causing anxious feelings resulted in depression or stress (Mulyani, 2013). Neglected anxiety will cause psychomatic disorders, such as constant worrying, irritability, insecurity, mild depression to major depression, sleep disturbances, decreased appetite, susceptibility to illness, and some even don't want to meet other people, in which all of these will affect the quality of life and the social activities of menopausal women (Lestari, 2010). Usually, people who tend to pay more attention to negative emotions, such as sadness, anger, anxiety, offense, hatred, disgust, prejudice, fear, suspicion and so on, will experience negative emotions. These negative emotions will have a negative impact on those who experience them as well as for others.
Premenopausal women who have a positive attitude encourage them to prepare themselves for menopause (Ariyani, 2014). Diener and Ryan (2009) (Seligman,2005) This study aims to analyze the effect of positive emotional regulation towards the happiness level in menopausal women

Study Design
The research design used was a cross-sectional study.

Settings
The research was conducted in 2020 at Kenjeran Public Health Center.

Research Subject
The population was all menopausal women living in community under the supervision of Kenjeran Public Health Center (N=68). Purposive sampling was applied, so that sample size of 37 was obtained. The samples' criteria were menopause, present in study site by appointment, and signing the consent form

Instruments
The instrument for measuring positive emotional regulation was adopted from the theory of Fieldman (2008) which has been modified by Syarifah and Kusumaputri (2015). It has 24 items using a Likert scale format with a high level of reliability (Chronbach Alpha = 0.856). The Oxford Happiness Questionnaire (OHQ) was used for measuring the happiness level. It has 29 itemsusing a Likert scale format with a high level of reliability (the Alpha OHQ rehabilitation coefficient ranges from 0.84 to 0.92.

Data Collection
Data collection was carried out by distributing questionnaires to respondents directly. In the data collection process, researchers still pay attention to health protocols. Researchers continue to use masks, maintain distance, and use latex gloves in data collection.

Data analysis
Analysis of the data used in this study using the independen t-test. Statistical significance was accepted if p<0.05.

Ethical Consideration
Ethical clearance was issued by Faculty of Medicine, Widya Mandala Surabaya Catholic University, by certificate number: 081/WM12/KEPK/DOSEN/T/2020     (Ponterotto, Mendelowitz and Collabolletta, 2008). According to the WHOQOL Group (Prastiwi, 2013) quality of life is an individual's perception of his position in life and its relationship to a person's goals, expectations, standards and concerns. The level of quality of life of a person varies depending on physical, psychological, social and environmental factors (Rohmah, et al, 2012). By focusing on the positive dimensions of a situation or situation at hand will help individuals to deal with situations that threaten or cause stress, so that individuals are able to react positively in all events that occur. People who have emotional intelligence will be able to monitor their own feelings and the feelings of others, and use information to direct thoughts and actions (Saam and Wahyuni, 2014) Researchers assume that if the respondent's positive emotions are good, then psychologically the respondent can overcome worries and anxiety about menopause, and will have a high quality of life.

Results
Cohen & Lazarus (Marettih, 2012) states that the quality of life is a level that describes the excellence of an individual that can be assessed from their life. The excellence of the individual can usually be assessed from his life goals, personal control, interpersonal relationships, personal development, intellectual, material conditions, as well as expectations that are of individual concern (Rohmah, Purwaningsih and Bariyah, 2012) Positive quality of life criteria are determined that a person has a positive psychological view, emotional well-being, good physical and mental health, the physical ability to do the things he wants to do, good relationships with friends and family, participates in social activities and recreation, living in a safe environment with good facilities, having enough money and being independent (Yeni, 2013).
According to Diener (in Berg 2008), an assessment of life satisfaction as a cognitive global assessment of a person's life is likely to be influenced by affection (emotional experience). Positive emotions will increase one's life satisfaction, and this life satisfaction will increase the quality of life. This opinion are supported by study of (Yeni, 2013) which found that there is a strong and positive relationship between positive emotions and life satisfaction, and by study of Syaiful and Bahar (2016)

CONFLICT OF INTEREST
There is no conflict of interest in this research.

ACKNOWLEDGEMENT
This study was funded and supported for publication by Faculty of Nursing, Widya Mandala Surabaya Catholic University.