Middle-aged women experience psychological and emotional changes situational crises related to aging, and many life events and changes in family system, and re-adaptation of roles. Menopause is a phenomenon in which menstruation is interrupted by a decreasing estrogen hormone in women of this period. It causes many changes in physical, mental, and social aspects, and requires proper management because can lead to negative consequences such as depression, anger, and aging anxiety.
Recently, it has been reported that the REBT is effective for mental health. Among them, it is known that the program utilizing the literature is effective for psychological and emotional treatment by analyzing and interpreting the literature through natural approaching to subjects and generating empathy. The purpose of this study was to investigate the effects of REBT program utilizing literature on the self-esteem, ego-resilience, perceived stress, body image, depression, state anger, anger expression, and aging anxiety for the mental health of menopausal women.
This study is a quantitative study, and it is a Quasi-Experimental study of non-equivalent control group pretest-posttest design. The REBT program utilizing literature for mental health of menopausal women was conducted after passing the ethical review by K University IRB. Before real program, 4 menopausal women were selected for pilot study and 4sessions program was practiced, and the results were verified. Based on the result, the program is composed of the following areas: introduction, work, integration, and new direction setting. It consists of recognizing of irrational emotion, converting to rational belief, purifying of negative feeling and emotion, and establishing of new direction. Reading, writing, presenting, discussing, sharing experiences, and lecturing were used to stimulating empathy of the participants.

The REBT program utilizing literature for mental health of menopausal women was conducted in the public cultural center in C city, Chungnam, semiweekly, 90～120minutes per session, 10sessions during 5weeks, from February to April 2018. Subjects were 48 menopausal women aged 45 to 60 years old. 24 subjects in the experimental group and 24 subjects in the control group were sampled intentionally. The major variables were self-esteem, ego-resilience, perceived stress, body image, depression, state anger, anger expression, and aging anxiety. The experimental group was measured before and after the intervention, and the control group was measured before and after offer the material about information and management of menopause.

The collected data were analyzed by frequency, percentage, mean, standard deviation, χ2-test, independent t-test and paired t-test, Fisher''s exact test, Mann-Whitney U test and Wilcoxon signed rank test, and covariance analysis (ANCOVA) using SPSS 21.0 program.

The result were as follows :

1. Hypothesis one, "The experimental group participating in the REBT program utilizing literature would have higher self-esteem scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(t=-3.39 p<.001).
2. Hypothesis two, "The experimental group participating in the REBT program utilizing literature would have higher ego-resilience scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(t=-2.50, p=.016).
3. Hypothesis three, "The experimental group participating in the REBT program utilizing literature would have lower perceived stress scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(t=2.03, p=.048).
4. Hypothesis four, "The experimental group participating in the REBT program utilizing literature would have lower body image scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(t=2.75, p=.009).
5. Hypothesis five, "The experimental group participating in the REBT program utilizing literature would have lower depression scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(z=4.06, p<.000).
6. Hypothesis six, "The experimental group participating in the REBT program utilizing literature would have lower state anger scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(z=3.77, p<.000).

7. Hypothesis seven, "The experimental group participating in the REBT program utilizing literature would have lower anger expression scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(t=3.14, p=.003).
8. Hypothesis eight, "The experimental group participating in the REBT program utilizing literature would have lower aging anxiety scores than the control group not participating in the program." was supported by statistically significant differences between the two groups(z=2.35, p=.019).

Based on the above results, it was confirmed that the REBT program utilizing literature for mental health of menopausal women improved the self-esteem and ego-resilience of women, and was effective in reducing perceived stress, negative body image, depression, state anger, anger expression and aging anxiety.