Abstract
Objectives: This study aimed to determine the effect of group counseling on the identity crisis of middle-aged women referred to outskirt health centers of Urmia, Iran in 2018.
 Methods: This randomized, pre-test and post-test control study was conducted on 90 middle-aged women registered in Iranian Registry of Clinical Trials (IRCT). A researcher visited selected health centers of Urmia randomly divided into three groups according to their social, economic and cultural status (26 health centers at high level, 19 health centers at average level, and 20 health centers at low level). The subjects were those who referred to the family health unit for receiving health care. The demographic characteristics questionnaire (such as age, marital status, number of children, educational level, body mass index, employment status and economic situation, which was designed by the researcher), and middle aged Identity Crisis Questionnaire (ICQ) including aimlessness, futility, hopelessness, lack of self-confidence, worthlessness, dissatisfaction with life, anxiety, sadness, aggression and anger subscales. The intervention (counseling group) was conducted for six weeks held weekly and each session for 60-90 minutes. Independent t-test, Chi-square test and Fisher's exact test were performed and analyzed through SPSS software. A P value less than of 0.05 was considered significant.
 Results: Mean age of women in the intervention group (50. 93 ± 5.38 years) and in the control group (50.55 ± 6.23 years) was 50 years. Also, in the intervention and control groups, the mean number of children was 2.43 ± 1.47 and 2.44 ± 1.49, respectively. In this study, the two groups were homogeneous regarding BMI, education level, husband's education level, economic status, marital status, occupation and dwelling situation (P> 0.05). Mean score of identity crisis and its ten dimensions before and after the intervention in the two groups were significantly different (P<0.001). There was no significant difference in any of the dimensions of identity crisis in the control group (P>0.05).
 Conclusion: According to the results, the use of group counseling intervention has been able to improve the identity crisis of middle-aged women in the most dimensions of identity crisis including aimlessness, futility, hopelessness, lack of self-confidence, worthless, dissatisfaction with life and anxiety.
Highlights
Middle-age is defined as a phase of psychological transformation in the range of life or transitional period that encompasses biological, psychological, and social changes [1]
This study aimed to determine the effect of group counseling on the identity crisis of middle-aged women referred to outskirt health centers of Urmia, Iran in 2018
Sampling was done randomly based on the population covered by each center and the list provided by one of the contributors to the health centers that were eligible to participate in the study, so that the list of names in each center was poured into a bowl and, the paper A and B was assigned to the intervention and control groups, respectively
Summary
Middle-age is defined as a phase of psychological transformation in the range of life or transitional period that encompasses biological, psychological, and social changes [1]. One of the transitional stages in the human life cycle resulting in changes in different aspects is the middle-age transition. These changes in the person's life affect on overall function and may cause problems in daily activities [2,3]. The middle-aged crisis is an emotional state of doubt and anxiety in which a person is unhappy because he realizes that half of life has passed. This situation usually involves reflections of the way a person has lived so far, and is often accompanied by an emotion that life has not been sufficiently achieved and has not significant results [4]
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