Assisted living and the aging trajectory

Assisted living (AL) is a caregiving option between independent living and nursing home placement. This study explores women residents' experience of AL in four Midwestern facilities, using interview and field research methods. We found that most residents wanted to stay in AL rather than move to a nursing home; they looked backward nostalgically toward home, and complied with staff rules and directives in order to remain in place. In contrast to nursing homes, AL allows residents to experience continuities with self and home: a private room, some of their own belongings, and access to relationships and activities associated with self and home. Given the expanded lifespan and growing popularity of AL, it is becoming a new stage in the trajectory of women's aging.     

Puts the magic back into life: Fathers’ experience of planned home birth

BackgroundIn Ireland, planned home birth is seen as an alternative but safe choice of maternity care. Women's experience of home birth is reported as positive but little is known about fathers’ thoughts and feelings about planned home birth.AimThe aim of the study was to explore fathers’ experience of planned home birth.MethodHermeneutic phenomenology was selected to explore the experiences of eight fathers whose partners had a recent planned home birth. Data were analysed using Interpretative Phenomenological Analysis (IPA).ResultsThemes identified were ‘negotiating the decision’, ‘ownership of the birth’ and ‘changed way of being’. Fathers overcame their initial reservations about home birth before the decision to plan a home birth was agreed. They were actively involved with their partner in labour which gave themselves a sense of ownership of the experience and a valued post-birth intimacy. Their belief in natural birth was reaffirmed and the experience gave them a new perspective on life.ConclusionWhen men have a positive experience of childbirth they benefit personally and emotionally. This experience can strengthen their relationship with their partner and the family. Midwives are ideally placed to involve fathers actively in birth either in a home or hospital setting.     

Several Common Bonds: Addressing the Needs of Gay and Bisexual Men in LGBT-Specific Recovery Housing

ABSTRACT

Recovery housing is a promising way to augment the substance use continuum of care, but we know little about the experiences of members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community who live in them or about residences specifically for them. Within the LGBTQ community, gay, bisexual, and other men who have sex with men (MSM) often experience co-occurring syndemic conditions (e.g., trauma, depression, HIV) that present unique recovery challenges. Using qualitative data gathered from residents living in a recovery residence specifically for gay and bisexual men and from community key informants, we examine the experiences of men living in the home and factors that facilitate operating it. Findings highlight the need for residences that can address syndemic burden among gay and bisexual men in recovery and identify programmatic and community-level factors critical to operating residences for this population.     

Relationships Among Older Women Living in a Nursing Home

SUMMARY

Literature suggests that women's skills in establishing close ties with other women help sustain them in old age by giving them a sense of control over their lives. This paper questions how such a notion may apply to women in a nursing home setting and contrasts women's experiences with those of men. It is a reanalysis of data from a previously reported study of institutionalized elders' social networks, this time with a specific focus on women residents' relationships with one another. Here, I consider the role of negative interaction in personal relationships, the meaning of intimacy and reciprocity in the nursing home context, and issues of age and gender. The final section, implications for practice and future research, includes a discussion of the opportunities for and constraints on relationship formation.     

Assisted Living,Elderly Women and Sense of Self: Communicating the Impact of Reduction of Long-Standing Activities

ABSTRACT

Through the use of in-depth interviews this study examines elderly women's communication about transitioning to assisted living and personal sense of self. A combination of communication and aging theory and socio historical factors aid in understanding the communication elderly women use to describe themselves within the context of life events prior to and after becoming an assisted living resident. Findings reveal that decrease in long-standing feminine sphere (traditionally female household) tasks due to the transition to assisted living is the major factor leading to the inability to communicate the sense of self. Inability to adjust and accept the downsizing of feminine sphere activities leads to several mental, physical and social implications.     

Uncovered and disrespected. A qualitative study of Jordanian women’s experience of privacy in birth

BackgroundPrivacy is related to a person’s sense of self and the need to be respected and it is a key factor that contributes to women’s satisfaction with their birth experiences.AimTo examine the meaning of privacy for Jordanian women during labour and birth.MethodA qualitative interpretive design was used. Data were collected through face-to-face semi-structured interviews with 27 Jordanian women. Of these women, 20 were living in Jordan while seven were living in Australia (with birthing experience in both Jordan and Australia). Thematic analysis was used to analyse the data.ResultsThe phrase ‘there is no privacy’ captured women’s experience of birth in Jordanian public hospitals and in some private hospital settings. Women in public hospitals in Jordan had to share a room during their labour with no screening. This experience meant that they were, “lying there for everyone to see”, “not even covered by a sheet” and with doctors and others coming in and out of their room. This experience contrasted with birth experienced in Australia.ConclusionsThis study explicates the meaning of privacy to Jordanian women and demonstrates the impact of the lack of privacy during labour and birth. Seeking a birth in a private hospital in Jordan was one of the strategies that women used to gain privacy, although this was not always achieved. Some strategies were identified to facilitate privacy, such as being covered by a sheet; however, even simple practices are difficult to change in a patriarchal, medically dominated maternity system.     

Experience,perceptions and attitudes of parents who planned home birth in Spain: A qualitative study

BackgroundA woman’s home birth and postpartum experience can have a major impact on her baby’s, partner’s and family’s well being. It is a life-altering event that can help improve or worsen women’s self-esteem and self-confidence.AimThe aim of this study was to describe and understand the experiences, perceptions and attitudes of parents who planned a home birth in Spain.MethodsA qualitative study was conducted based on Gadamer’s hermeneutic phenomenology. Two main methods were used for data collection; narratives and individual in-depth interviews with 14 mothers and 8 fathers who had planned a home birth in the last year. Inductive analysis was used to find themes based on the data obtained.FindingsSix main themes emerged from the data analysis: (1) in search of a natural and personalised birth, (2) breaking with social pressures, (3) experience of home birth for the mother, (4) role of the father in home birth, (5) how does the father experience home birth?, (6) home birth is not available to all mothers and fathers.ConclusionFor the mothers and fathers in this study the home birth experience fulfilled their previous expectations of an intimate and natural moment, making it a highly satisfying experience for both. However, parents expressed experiencing negative feelings such as fear and worry about complications and labor pain. According to our research society in general and public health professionals in particular issue numerous criticisms and value judgments towards mothers and fathers who opt for a home birth in our country. In addition, the study shows the economic and cultural inequalities in access to home birth in Spain.     

Childbirth experience in women participating in a continuity of midwifery care project

BackgroundContinuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies. Previous studies have shown certain factors are associated with a positive birth experience, including continuity of midwifery care.AimThe aim was to investigate women's childbirth experiences in relation to background data, birth outcome and continuity with a known midwife, in a rural area of Sweden.MethodsAn experimental cohort study. Participating women were offered continuity of midwifery care in pregnancy and birth, during selected time periods. Data were collected in mid-pregnancy and two months after birth. The Childbirth Experience Questionnaire was used to determine women's birth experiences.ResultA total of 226 women responded to the follow-up questionnaire. Not living with a partner, fear of giving birth, and a birth preference other than vaginal were associated with a less positive birth experience. Having had a vaginal birth with no epidural, no augmentation and no birth complication all yield a better birth experience. Women who had had a known midwife were more likely to have had a positive birth experience overall, predominantly in the domain Professional support.ConclusionsThe results of this study showed that women who received care from a known midwife in labour were more likely to have a positive birth experience. The results also pointed out the benefits of a less medicalized birth as important for a good birth experience, and that some women may need extra support to avoid a less positive birth experience.     

Attitudes of Nursing Home Licensed Practical Nurses Toward Sexually Active,Older Residents

The participants were 87 Licensed Practical Nurses (LPNs) working in a nursing home for the elderly. Vignettes were used to elicit the LPNs' attitudes toward sexually active older nursing home residents. Each LPN was randomly assigned one of four versions of a vignette which either contained or excluded information about sexual activity in a 68-year-old male or female nursing home resident. Contrary to assumptions about widespread taboos for aged sexuality, the LPNs showed a statistically si-cant bias favoring the sexually active resident, regardless of whether the resident was a woman or man. Implications of these findings are discussed.     

“Ghosts From the Past”: The Re-Emergence of Internalized Religious Stigma Following Diagnosis of HIV Among Northern Irish Gay Men

ABSTRACT

This article explores how previous exposure to religious homonegativity features in the sense-making process following HIV diagnosis in a homogenous sample of six gay men living in Northern Ireland. Interpretive phenomenological analysis was used to identify two key overarching themes: Negotiating authenticity in unsafe space, which relates to the experience of negotiating same-sex attraction within religious environments, and Re-emergence of religious shame in diagnosis, which relates to the way in which the men made sense of diagnosis from the position of having been exposed to religious homonegativity earlier in their lives. Findings demonstrate how the men negotiated their sexual orientation within religious contexts and how a reconstruction of God was necessary to preserve an authentic sense of self. Despite reaching reconciliation, HIV was initially appraised within a retributive religious framework that served to temporarily reinforce previously learned shame-based models of understanding this aspect of the self.     

Care Arrangement Choices for Older Widows: Decision Participants' Perspectives

SUMMARY

This research examines how a wide range of care arrangement decisions for frail older women are made. Interviews were conducted with 11 older women (ten of whom are widows), nine of their family members, and six professional service providers. Maintaining the older woman's independence was identified as a major theme. While all decision participants identified it as an explicit or implicit decision-making goal, their meanings of independence were different. The older women's meanings were flexible, changing in response to changes in their physical condition and need for assistance. Adult children tended to identify their mothers as independent when they did not actually need assistance, or when they received help from other sources (e.g., home health care). Professional service providers were inclined to define independence narrowly, as avoiding nursing home placement. Minor themes associated with independence include responsibility, reciprocity, and the family's importance in maintaining independence. These themes help to clarify the complex dynamics that take place during care arrangement decisions and explain how care arrangement choices are made.     

Targeting Intermediaries to Recruit Older Women for Qualitative,Longitudinal Research

ABSTRACT

Crafting a comprehensive recruitment plan for qualitative, longitudinal research requires consideration of many issues, particularly when a culturally diverse sample of older women is to be recruited for interviews conducted in their homes. The development of a detailed recruitment plan for a phenomenological investigation of older widows' experience of home care is described. The plan's two inter-related foci (targeted intermediaries and sequential phases) are presented. Strategies used to recruit participants through each targeted intermediary are explained, and the implementation of the sequential phases of the recruitment process is described. Successes and difficulties are considered in relation to the literature on recruiting older adults for research.     

Women’s experiences of antenatal transfer for threatened premature labour in NSW: A qualitative study

BackgroundEach year thousands of pregnant women experiencing threatened premature labour are transferred considerable distances across Australia to access higher level facilities but only a small proportion of these women go on to actually give birth to a premature baby. Women from regional areas are required to move away from their home, children and support networks because of a perceived risk of birthing in a centre without neonatal intensive care facilities.AimThis study examines the experience of women undergoing antenatal transfer for threatened premature labour in New South Wales and the Australian Capital Territory who do not give birth during their transfer admission.MethodsThirteen semi-structured in-depth interviews were held with women across five tertiary referral sites across New South Wales and the Australian Capital Territory, and analysed until saturation for themes.FindingsSeven urban and six rural women were interviewed. Women and their families were all negatively affected by antenatal transfer. Factors that helped enable a positive experience were; enhanced sense of safety in the tertiary unit, and individual qualities of staff. Factors that contributed to negative experiences were; inadequate and conflicting information, and no involvement or choice in the clinical decision-making process to move to another facility.ConclusionsAntenatal transfer is an extremely stressful experience for women and their families. The provision of high quality written and verbal information, and the inclusion of women's perception of risk in the clinical decision making process will improve the experience for women and their families in NSW and the ACT.     

Australian women's experiences of living with gestational diabetes

PurposeThe purpose of this study was to describe Australian women's reflections on the experience of having a pregnancy affected by GDM.MethodsParticipants were women aged ≥18 years, diagnosed with GDM ≤3 years previously and registered with the National Diabetes Services Scheme. Data was collected from a cross-sectional written postal survey which included the opportunity for women to document their experiences of living with GDM. Thematic framework analysis was undertaken to determine underlying themes.ResultsOf 4098 invited eligible women, 1372 consented to participate. Of these, 393 provided feedback on their experiences of living with GDM. Eight key themes emerged from the data (1) shock, fear and anxiety (8.9%), (2) uncertainty and scepticism (9.4%), (3) an opportunity to improve one's health (9.6%), (4) adapting to life with GDM (11.6%), (5) the need for support (17.2%), (6) better awareness (3.5%), (7) abandoned (14.9%), (8) staying healthy and preventing diabetes (13.7%). Women taking insulin were more likely to experience shock, fear or anxiety (p = 0.001) and there was a trend towards women who spoke another language also being more likely to report this experience (p = 0.061). Those diagnosed with GDM in a previous pregnancy (p = 0.034) and younger women (p = 0.054) were less likely to view the diagnosis as an opportunity to improve their health.ConclusionsThis study provides an insight into the experience of the pregnant woman diagnosed with GDM. It emphasises the importance of health professional support and provides insight into the challenges and opportunities for future diabetes risk reduction.     

Health-Related Interactions and the Self in Marriage

ABSTRACT

This study investigated the association between self processes and married partners' (N = 59 couples) perspectives of their health-related social interactions. Findings revealed that wives' self processes were associated with their social behavior from the perspective of each partner. The wives' self processes differentially predicted wives' and husbands' perspectives of their interactions, however. These findings demonstrate that wives' future expectations for the health of their husband, as well as for their role in maintaining his future health, motivate their current social behavior to promote the positive health lifestyle behaviors of their husband.     

‘Home is Never Fully Achieved … Even When We Are In it’: Migration,Belonging and Social Exclusion within Punjabi Transnational Mobility

ABSTRACT

Drawing upon transnational research in the UK and India, primarily over 150 semi-structured interviews in Newcastle, UK and Doaba, Punjab, as well as the ‘mobilities turn’ within contemporary social science, this paper examines the pursuit of ‘home’ within a diasporic British Indian Punjabi community. It is argued that this transnational pursuit of home is significantly shaped by the dynamic social context of South Asia, in particular processes of social inclusion and exclusion therein. Thus, returning Punjabi migrant attempts to distinguish themselves from the resident population through conspicuous consumption, and simultaneous attempts from Punjabi residents to exclude Non-Resident Indians from ‘real’ Indian status, lead to a continual reprocessing of home across different sites of mobility, as well as demonstrating the ‘never fully achieved’ nature of home.     

Impact of Caregiver-Receiver Relationship Quality on Burden and Satisfaction

ABSTRACT

The purpose of this study was to investigate, through an interview process, both the burden and satisfaction of the caregiving relationship between female primary caregivers and female care-receivers living in the same home. The ten cases were families involved in a caregiver/care-receiver shared-residence situation of at least one year's duration. The primary method of data collection was semi-structured interviews.

The results of the qualitative approach called for a reversal of perspective. The intent was to examine how burden and satisfaction impacted the caregiver-receiver relationship quality. However, it was the quality of the relationship between the caregiver and care-receiver which distinguished low burden and high satisfaction.