Introduction
Women are the central pillar of social development and the main axis of family health. Success, survival, and promotion of society depend on women’s health [1]. Middle age is a pivotal period in the whole period of life, and this period leads to various physical, psychological, social, and family changes that strongly affect women’s health [3]. A healthy lifestyle is significant for maintaining health, improving quality of life, reducing disabilities caused by chronic diseases, and reducing mortality [7]. On the other hand, psychological well-being is an essential factor in the freshness and vitality and increase of individual and social performance of women [13]. It also plays an influential role in preventing the occurrence of Psychopathy [14]. therefore, this study was conducted to determine the Health Promotion lifestyle and psychological well-being in women attending the health centers of Arak City in 2019.
Materials and Methods
In this descriptive cross-sectional study, among women who attended health centers in Arak City, 221 women who met the inclusion criteria were included in the study by continuous sampling. Inclusion criteria included age 30-60 years, no divorce and death of dears in the last six months, and no drug addiction. Demographic information form, Health Promoting Lifestyle Profile-II (HPLP-II), and psychological well-being were completed to collect data. HPLP II measures 52 healthy lifestyle behaviors on six scales, including responsibility for health, nutrition, physical activity, spiritual growth, stress management, and interpersonal relationships. The overall score of this tool is in the range of 52 to 208 [27]. The Ryff Psychological Well-being Questionnaire (18 items) has 6 subscales of self-acceptance, positive relations with others, autonomy, purpose in life, personal growth, and environmental Mastery. The overall psychological well-being score is obtained from the sum of the subscales’ scores. The total score range is 18 to 108 (25)0 Data were described using descriptive statistics of frequency, frequency percentage, mean, standard deviation, and data analysis by analysis of variance, independent t-test, and regression using SPSS software v. 19.
Results
The mean health-promoting lifestyle in the study units was 135.96, the mean physical activity components were 16.31, and the mean nutrition was 26.41, respectively, the lowest and highest scores (Table 1).


Age, chronic diseases, employment, number of children, and alcohol consumption had a significant negative relationship with the health-promoting lifestyle, and education of a woman and her husband had a meaningful positive relationship with the health-promoting lifestyle (P<0.05) (Table 2).


The results of multiple regression between health-promoting lifestyle and demographic variables showed that after adjusting and maintaining the level of other variables, educational status (P=0.009) and job status (P=0.012) still depend on lifestyle. Overall demographic variables predict as much as 13% of health-promoting lifestyles.
The mean psychological well-being in the study units was 72.29, the mean components of purpose in life were 10.76, and the mean personal growth was 13.19, respectively, the lowest and highest scores (Table 3).


Age, number of children, and chronic physical and psychological diseases had a significant negative relationship with psychological well-being and economic status. The education of a woman and her husband had a meaningful positive relationship with psychological well-being (P<0.05). After adjusting and maintaining the level of other variables, psychological diseases remained an important factor in predicting psychological well-being (P=0.04). Overall, demographic variables predict as much as 10% of psychological well-being.
Discussion
The results showed that women’s lifestyle and psychological well-being are far from reaching the desired state. Women have the lowest score in the components of physical activity, stress management, and purposefulness in life, which is a threat to their physical and psychological health during the transition from middle age. Inactivity in research samples can be explained by the fact that women do not perceive the physical activity as part of a healthy lifestyle [29]. This can be due to insufficient motivation, lack of correct belief, lack of equipment and facilities, and sufficient time [2]. Therefore, it is necessary to investigate the causes of women’s sedentary lifestyle, plan educational interventions, and adopt methods to improve physical activity. low scores in stress management and purpose in life indicate that Despite the employment of psychology experts in recent years in health centers and providing free counseling for clients. Still, serious planning for effective counseling and holding a training class seems necessary. Also, keeping extensive training courses for primary health care providers to screen clients accurately can help promote women’s health.
Several demographic variables were related to lifestyle and psychological well-being. Paying attention to these variables can open a comprehensive view for women’s health authorities to take action by using appropriate methods and educational, clinical, and research interventions for promoting physical and psychological women’s health

Ethical Considerations
Compliance with ethical guidelines
The ethics committee has approved this study of research Deputy of Iran University of Medical Sciences (Code: IR.IUMS.REC.1398.609).

Funding
This article is an excerpt from the first author's master's thesis in the Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences.

Authors' contributions
All authors contributed equally in preparing all parts of the research.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors thank all those involved in this study, including all women participants, Arak Health Center, and the Vice Chancellor for Research, Iran University of Medical Sciences, for their financial support.


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