Self-Care Strategies of Menopausal Women

ABSTRACT

The purpose of this study was to describe the self-care strategies related to natural menopause used by menopausal women. The Self Care Responses Questionnaire (SCR) was completed by a convenience sample of 99 middle class, mostly Caucasian, married, employed women. The women used many self-care responses, on average, 32 of the 39 possible. The frequently used strategies, “accept changes in my body,” “have faith,” “keep busy,” “educate myself,” and “accept as legitimate,” suggest that these women are successful in their self care related to menopause. Consistent with a women's health perspective, they seemed to view menopause as a developmental phase which they have integrated into their lives.     

Understanding and Reducing Stress and Psychological Distress in Older Women with Heart Disease

ABSTRACT

Stress and psychological distress were assessed in 457 older women who were subsequently randomized to a six-week heart disease management program (“Women take PRIDE”) or to a “usual care” control group. Baseline distress was significantly associated with age, symptoms, physical functioning, social support, optimism, and self-esteem (p < .05). Only 20% of women reported their physician had recommended reducing stress. At four months follow-up, intervention women compared to controls were significantly more likely to report reductions in stress levels (p = 0.02) and also showed improvement in emotional behavior (p = 0.09).     

The paradoxes of communication and collaboration in maternity care: A video-reflexivity study with professionals and parents

BackgroundResearch on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”.MethodsWe used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units.FindingsWe conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”.DiscussionAcknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents.ConclusionGood communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training.     

Mapping Queer Bioethics: Space,Place, and Locality

ABSTRACT

This article, which introduces the special issue of the Journal of Homosexuality on “Mapping Queer Bioethics,” begins by offering an overview of the analytical scope of the issue. Specifically, the first half of this essay raises critical questions central to the concept of a space-related queer bioethics, such as: How do we appreciate and understand the special needs of queer parties given the constraints of location, space, and geography? The second half of this article describes each feature article in the issue, as well as the subsequent special sections on the ethics of reading literal, health-related maps (“Cartographies”) and scrutinizing the history of this journal as concerns LGBT health (“Mapping the Journal of Homosexuality”).     

The Influence of the Built Environment and Other Factors on the Physical Activity of Older Women from Different Ethnic Communities

ABSTRACT

Inactivity has been identified as a major contributor to the burden of disease in older women. Study aims were: (a) to assess the personal, social, and environmental facilitators and impediments to physical activity in older women from ethnic communities; and (b) to determine the factors associated with physical activity participation. Older women (aged 60–84 years) were recruited from the local Italian (n = 20), Vietnamese (n = 26) and Anglo-Celtic (n = 26) communities. A survey questionnaire was administered in the participants' preferred language. The most common barriers were: “I am not in good health,” “I am self-conscious about my looks,” “I am too tired,” “I don't have time,” and “The weather is bad.” When comparing the ethnic groups, the Vietnamese women reported fewer barriers than the Italian women (2.6 vs. 5.9). While the Vietnamese women were much more likely to report being “self-conscious about my looks,” the Italian women more commonly reported poor health, being too tired, and not liking exercise as barriers. Overall, those living alone were more likely to be active and those who reported fear of injury, less active. Recognizing ethnospecific differences in the prevalence of barriers may be important when devising strategies to increase activity levels of older women.     

Women's experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence

IssueFear of childbirth (FOC) can be debilitating, impacting women's lives in pregnancy, the puerperium and beyond. Research investigated various interventions for FOC in the perinatal period, but there been no synthesis of the experiences of women who engaged with these interventions, which would inform clinical practice guidance and the development of future interventions.AimTo conduct a review and synthesis of qualitative studies of interventions for fear of childbirth in the perinatal period and women's experiences of them.MethodsA meta-synthesis was performed to examine all relevant qualitative studies describing women's experiences of interventions for FOC, in all languages. A comprehensive search of relevant databases from 1978 to 2019 was conducted. In total, following appraisal, seven qualitative studies were eligible for inclusion. The findings were integrated using thematic synthesis for the final stages in the thematic analysis.FindingsOne overarching theme “Ownership of Childbirth” and three analytical themes “Facing the fear”, “Feeling empowered”, “Managing the fear with a sense of security” were generated through the synthesis. There were no studies outside of Scandinavia located.DiscussionThis meta-synthesis provides a new way to describe the process of moving from fear to “Ownership of childbirth”. The first step in the process appears to be acknowledging and identifying the individual's fears. Women can be empowered to self-manage FOC but may be influenced by external factors such as the support of partners and staff.ConclusionThese findings provide evidence to inform the development of future interventions for FOC and highlight the need for further qualitative research globally.     

Openings: On the Journal of Homosexuality,Volume 1, Issue 1

ABSTRACT

This article serves as one of the supplementary pieces of this special issue on “Mapping Queer Bioethics,” in which we take a solipsistic turn to “map” the Journal of Homosexuality itself. Here, the author examines Volume 1, Issue 1 of the Journal of Homosexuality and asks whether the journal’s first contributors might reveal a historically problematic relationship whereby the categories of front-line LGBT health advocates in the 1970s might be incommensurate with the post-AIDS, queer politics that would follow in decades to come.     

Zero Feet Away: The Digital Geography of Gay Social Media

ABSTRACT

For this contribution to the “Cartographies” section of the special issue on “Mapping Queer Bioethics,” the author focuses on the terrains of digital media, geosocial networking, and sexually based social media in LGBT communities. Addressing the communal potentials and ethical complications of geosocial connections made possible by such sexually based social media, the author asks whether digital forms of cartography via applications such as Grindr and Scruff simplify, complicate, or merely expose historically longstanding notions of queer interconnectivity.     

Walt Whitman,Our Great Gay Poet?

ABSTRACT

This article surveys the critical debates around Walt Whitman's “Calamus” cluster, arguing that a “queer” reading of Whitman—one that does not see him as, for example, a closeted homosexual who censored his work for fear of being “outed”—is both historically accurate and politically efficacious. While previous efforts to reclaim Whitman as “our great gay poet” are understandable—particularly given critical readings of Whitman that denied the homoeroticism of his poems—today, a reading of Whitman as homosexual threatens to simplify our understanding of the history of homosexuality and to blunt the power of Whitman's poetry to continue to “queer” normative understandings of sex and gender identity categories and their relationship to politics.     

Dementia spousal caregivers and past transgressions: Measuring and understanding forgiveness experiences

ABSTRACT

The transition from “wife” to “caregiver” for a cognitively impaired husband can be an overwhelming experience. Communication patterns change and small conflicts can grow, at times bringing angry feelings and new burdens. Engagement with forgiveness processes may benefit wives by lowering resentment over past tensions, restoring trust, and enhancing the overall caregiving experience. This study examined the utility of the Enright Forgiveness Inventory (EFI) within a sample of caregiving wives. Our intent was to better understand this population’s experience with forgiveness when other contextual factors were likely to influence this process. Forgiveness scores on the EFI were positively related to the cognitive status of the care recipient, a particularly important finding for clinical intervention, and inversely related to marital distress and state anxiety.     

Women who experience feelings of aversion while breastfeeding: A meta-ethnographic review

ProblemLimited literature is available about women who wish to breastfeed but experience unexpected feelings of aversion in reaction to their infant suckling at the breast while breastfeeding.BackgroundBreastfeeding benefits mothers, infants and society yet breastfeeding rates continue to fall below recommendations in part due to inadequate tailored support after hospital discharge. Influences on breastfeeding are complex and include many physiological, psychosocial and cultural factors.AimTo better understand the experience of women who have feelings of aversion during breastfeeding by synthesising the existing literature.MethodsMEDLINE, CINAHL, PsycINFO, Maternity and Infant Care databases were searched for relevant literature published between 2000 to 2019. Using Covidence software, five qualitative research studies were identified. Studies were then analysed using meta-ethnographic qualitative synthesis.FindingsFeelings of aversion during breastfeeding were described as visceral and overwhelming; leading to feelings of shame and inadequacy. This synthesis identified five findings; a central conceptual category of “it’s such a strong feeling of get away from me” with four key metaphors translated from this central conceptual category: “I do it because I feel it is best for my baby”, “I can’t control those feelings”, “I should be able to breastfeed my son and enjoy it”, and “I’m glad I did it”. This phenomenon may negatively affect a women’s sense of self and impact on the mother-infant relationship.ConclusionSome women who want to breastfeed can experience feelings of aversion while breastfeeding. The feelings of ‘aversion’ while breastfeeding can inhibit women from achieving their personal breastfeeding goals.     

“Allow access to location?”: Digital feminist geographies

Abstract

This article looks at the impacts ongoing processes of digitization have on feminist politics of location. It argues that, rather than being borderless by nature, the digital has to be understood as producing different kinds of borders, demanding different kinds of politics of location. New potentialities arise with the challenge of creating a politics fitting to the current mode in which locations become slippery. Discussing the emergence of cyberfeminism in the early 1990s and a more recent example of digital feminism—the #SolitarityIsForWhiteWomen hashtag—this article thinks through the following questions: what does the “cyborg” as a posthuman (and postgender) category have to offer for those who have been (and are) excluded from the notion of the “human”? More specifically, how can we understand and conceptualize the “cyborg” beyond triumphalist narratives of being beyond difference?     

Love,Lust, and Loss in the Early Age of AIDS: The Discourse in the Body Politic From 1981 to 1987

ABSTRACT

This article explores the idea that the AIDS epidemic constituted a defining moment for the Canadian gay rights movement and illuminates the intricate power dynamics of the development of a community identity. Using grounded theory inductive and deductive content analysis, and interviews with activists from the Body Politic magazine, this article considers notions of health “from above” and “from below” by examining relations between the community and government and their confrontation with medicalization and the medical profession. I also examine how the magazine reported and negotiated issues related to the community’s self-policing and “self-managed oppression” through efforts to promote safer sex and risk reduction.     

Aging in e-place: reflections on online communities for the aged in India

ABSTRACT

In this short piece, I offer a reconfiguration of the term “aging in place” by analyzing media content of web-based senior-focused portals while demonstrating how these online consumer-driven spaces unwittingly re-create new social relations and imagined communities. Building on the sparse body of scholarship on extra-familial, kin-like networks, I reflect on the cultural possibility of internet spaces as surrogate “places” for later life non-kin sociality. In this exploration, I privilege the possibility of enriched selfhood of older Indians by moving away from the conventional gerontological trope of the (Indian) elderly as indivisible familial subjects, as a deliberate process of decolonizing the field of gerontology.     

Good Mothers Never Wane: Mothering at Menopause

ABSTRACT

Due to recent feminist scholarship, we know a considerable amount about women's mothering identities and activities, as well as the impact of mothering ideology on individual women. Nonetheless there are gaps in our knowledge about motherhood. For instance, we know mostly about experiences of mothers with young children, and an implicit assumption is that mothers are also fairly young themselves. Yet, what about mothers at midlife and beyond? What about menopausal mothers? This paper represents an initial attempt to explore motherhood experiences of middle-aged menopausal women. Findings presented in this article are based on 45 in-depth interviews with middle-class, heterosexual menopausal women in a midwestern state in 2001. Findings suggest that motherwork and the maintenance of “good” mothering ideology are still primary activities of women at menopause despite assumptions that menopausal women have completed mothering experiences and are now grandmothers (if caregivers at all). In analyzing menopausal mothers, I encourage broader explorations of women's experiences of both motherhood and menopause.     

The effect of “hands on” techniques on obstetric perineal laceration: A structured review of the literature

ObjectiveThe purpose of this structured review was to review current evidence of “hands on” and “hands off” techniques as it relates to rates of perineal laceration in order to provide direction for future research in this important area of midwifery practice.MethodA structured literature search using all identified keywords and index terms was undertaken in MEDLINE, EMBASE Joanna Briggs Institute, CINAHL, TRIP, and OVID nursing database.FindingsA total of 24 papers were identified from the initial searches as potentially relevant to the review questions. Of these a total of nine papers were considered relevant for this review. These nine included one systematic review with meta-analysis, four randomised controlled trials (RCTs), one quasi-experimental study and three cohort studies.Conclusion“Hands on” techniques have been traditionally used but not been well defined in the literature, therefore it is currently unclear as to whether or not “hands on” technique can reduce perineal laceration. More studies are required to test the effectiveness of a standardised “hands on” technique and also to determine what part other factors such as maternal position, visualisation and use of water might play in perineal laceration rates.     

Patriarchy,Power, and Female Masculinity

ABSTRACT

This article examines the place of “butch” within the women's movement. The political potentials of butch in both her refusal of patriarchal constructs of femininity and her transmutation of masculinity will be explored. It will be argued that the butch lesbian threatens male power by severing the naturalized connection between masculinity and male bodies, by causing masculinity to appear “queer,” and by usurping men's roles. However, for “butch” to truly have feminist potential, it also needs to be accompanied by a feminist awareness and a rejection of aspects of masculinity that are oppressive to women. Hence, “butch feminist” need not be an oxymoron, but a strategy for challenging male domination and power.